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Sample records for psg assessed sleep

  1. Validation of the Sonomat Against PSG and Quantitative Measurement of Partial Upper Airway Obstruction in Children With Sleep-Disordered Breathing.

    Science.gov (United States)

    Norman, Mark B; Pithers, Sonia M; Teng, Arthur Y; Waters, Karen A; Sullivan, Colin E

    2017-03-01

    To validate the Sonomat against polysomnography (PSG) metrics in children and to objectively measure snoring and stertor to produce a quantitative indicator of partial upper airway obstruction that accurately reflects the pathology of pediatric sleep-disordered breathing (SDB). Simultaneous PSG and Sonomat recordings were performed in 76 children (46 male, age 5.8 ± 2.8, BMI = 18.5 ± 3.8 kg/m2). Sleep time, individual respiratory events and the apnea/hypopnea index (AHI) were compared. Obstructed breathing sounds were measured from the unobtrusive non-contact experimental device. There was no significant difference in total sleep time (TST), respiratory events or AHI values, the latter over-estimated by 0.3 events hr-1 by the Sonomat. Poor signal quality was minimal and gender, BMI, and body position did not adversely influence event detection. Obstructive and central events were classified correctly. The number of runs and duration of snoring (13 399 events, 20% TST) and stertor (5748 events, 24% TST) were an order of magnitude greater than respiratory events (1367 events, 1% TST). Many children defined as normal by PSG had just as many or more runs of snoring and stertor as those with mild, moderate and severe obstructive sleep apnea (OSA). The Sonomat accurately diagnoses SDB in children using current metrics. In addition, it permits quantification of partial airway obstruction that can be used to better describe pediatric SDB. Its non-contact design makes it ideal for use in children.

  2. Automatic sleep staging using ear-EEG

    OpenAIRE

    Mikkelsen, Kaare B.; Villadsen, David Bov?; Otto, Marit; Kidmose, Preben

    2017-01-01

    Background Sleep and sleep quality assessment by means of sleep stage analysis is important for both scientific and clinical applications. Unfortunately, the presently preferred method, polysomnography (PSG), requires considerable expert assistance and significantly affects the sleep of the person under observation. A reliable, accurate and mobile alternative to the PSG would make sleep information much more readily available in a wide range of medical circumstances. New method Using an alrea...

  3. Alterations in Polysomnographic (PSG profile in drug-naïve Parkinson′s disease

    Directory of Open Access Journals (Sweden)

    Sanju P Joy

    2014-01-01

    Full Text Available Objective: We studied the changes in Polysomnographic (PSG profile in drug-naïve patients of Parkinson′s disease (PD who underwent evaluation with sleep overnight PSG. Materials and Methods: This prospective study included 30 with newly diagnosed levodopa-naïve patients with PD, fulfilling the UK-PD society brain bank clinical diagnostic criteria (M:F = 25:5; age: 57.2 ± 10.7 years. The disease severity scales and sleep related questionnaires were administered, and then patients were subjected to overnight PSG. Results: The mean duration of illness was 9.7 ± 9.5 months. The mean Hoehn and Yahr stage was 1.8 ± 0.4. The mean Unified Parkinson′s Disease Rating Scale (UPDRS motor score improved from 27.7 ± 9.2 to 17.5 ± 8.9 with sustained usage of levodopa. Nocturnal sleep as assessed by Pittsburgh Sleep Quality Index (PSQI was impaired in 10 (33.3% patients (mean PSQI score: 5.1 ± 3.1. Excessive day time somnolence was recorded in three patients with Epworth Sleepiness Scale (ESS score ≥ 10 (mean ESS score: 4.0 ± 3.4. PSG analysis revealed that poor sleep efficiency of <85% was present in 86.7% of patients (mean: 68.3 ± 21.3%. The latencies to sleep onset (mean: 49.8 ± 67.0 minutes and stage 2 sleep (36.5 ± 13.1% were prolonged while slow wave sleep was shortened. Respiration during sleep was significantly impaired in which 43.3% had impaired apnoea hyperpnoea index (AHI ≥5, mean AHI: 8.3 ± 12.1. Apnoeic episodes were predominantly obstructive (obstructive sleep apnea, OSA index = 2.2 ± 5.1. These patients had periodic leg movement (PLM disorder (56.7% had PLM index of 5 or more, mean PLMI: 27.53 ± 4 9.05 that resulted in excessive daytime somnolence. Conclusions: To conclude, sleep macro-architecture is altered in frequently and variably in levodopa-naοve patients of PD and the alterations are possibly due to disease process per se.

  4. Sleep and delirium in unsedated patients in the intensive care unit

    DEFF Research Database (Denmark)

    Boesen, H C; Andersen, J H; Bendtsen, A O

    2016-01-01

    BACKGROUND: Sleep deprivation and delirium are major problems in the ICU. We aimed to assess the sleep quality by polysomnography (PSG) in relation to delirium in mechanically ventilated non-sedated ICU patients. METHODS: Interpretation of 24-h PSG and clinical sleep assessment in 14 patients....... Delirium assessment was done using the confusion assessment method for the intensive care unit (CAM-ICU). RESULTS: Of four patients who were delirium free, only one had identifiable sleep on PSG. Sleep was disrupted with loss of circadian rhythm, and diminished REM sleep. In the remaining three patients...

  5. Association between body mass index and sleep duration assessed by objective methods in a representative sample of the adult population.

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    Moraes, W; Poyares, D; Zalcman, I; de Mello, M T; Bittencourt, L R; Santos-Silva, R; Tufik, S

    2013-04-01

    Sleep duration has been associated with overweight individuals in many epidemiological studies; however, few studies have assessed sleep using objective methods. Our study was designed to evaluate the association between body mass index (BMI) and sleep duration measured by actigraphy (Acti), polysomnography (PSG) and the Pittsburgh sleep quality index questionnaire (PSQIO). Furthermore, we evaluated other biochemical and polysomnographic parameters. A representative sample of 1042 individuals from Sao Paulo, Brazil, including both genders (20-80 yrs), participated in our protocol. Weight and other anthropometric parameters were measured at the onset of the study. Sleep duration was calculated by Acti, PSG, and the PSQIQ. The population was sorted by sleep duration, body, slow wave sleep (SWS) and REM sleep (REMS) duration subsets. In addition, other biochemical and polysomnographic parameters were analyzed. Differences between population subsets were analyzed by one-way analysis of variance (ANOVA). Linear regression analysis was performed between sleep and anthropometric parameters. Shorter sleep duration was associated with higher BMI and waist and neck circumference when measured by Acti and PSG (psleep in normal-weight (BMI>18 and ⩽25) individuals (psleep duration Acti and higher BMI was present when apnea-hypopnea index (AHI) was less than 15 (p=0.049). Shorter REMS and SWS also were associated with higher BMI (psleep longer, have higher sleep efficiency and longer SWS and REMS than obese individuals (Acti, PSG; p=0.05). Sleep duration was negatively correlated with BMI (Acti, PSG; psleep, SWS, and REMS duration were associated with higher BMI, central adiposity measurements, and cardiovascular risk factors when measured by objective methods. Copyright © 2012 Elsevier B.V. All rights reserved.

  6. Accuracy of a smartphone application in estimating sleep in children.

    Science.gov (United States)

    Patel, Pious; Kim, Ji Young; Brooks, Lee J

    2017-05-01

    Chronic sleep problems can lead to difficulties for both the individual and society at large, making it important to effectively measure sleep. This study assessed the accuracy of an iPhone application (app) that could potentially be used as a simple, inexpensive means to measure sleep over an extended period of time in the home. Twenty-five subjects from the ages of 2-14 who were undergoing overnight polysomnography (PSG) were recruited. The phone was placed on the mattress, near their pillow, and recorded data simultaneously with the PSG. The data were then downloaded and certain parameters were compared between the app and PSG, including total sleep time, sleep latency, and time spent in various defined "stages." Although there seemed to be a visual relationship between the graphs generated by the app and PSG, this was not confirmed on numerical analysis. There was no correlation between total sleep time or sleep latency between the app and PSG. Sleep latency from the PSG and latency to "deep sleep" from the app had a significant relationship (p = 0.03). No combination of PSG sleep stages corresponded with app "stages" in a meaningful way. The Sleep Cycle App may have value in increasing the user's awareness of sleep issues, but it is not yet accurate enough to be used as a clinical tool.

  7. Serial macro-architectural alterations with levodopa in Parkinson′s disease: Polysomnography (PSG-based analysis

    Directory of Open Access Journals (Sweden)

    Sanju P Joy

    2015-01-01

    Full Text Available Purpose: We studied the sleep macroarchitecture with polysomnography (PSG in drug naïve patients with Parkinson′s disease (PD and reassessed them following treatment with levodopa. Materials and Methods: This prospective hospital-based study included 15 patients with PD (age: 59 ± 11.2 years, duration of PD: 11.8 ± 12.3 months; and male: female (M:F = 11:4. They were assessed for demography, phenotype, modified Hoehn and Yahr staging (H & Y; Schwab and England and Activities of Daily Living (S and E ADL Scale; and Unified PDRating Scale (UPDRS. Sleep was assessed using Epworth Sleepiness Scale (ESS, Pittsburgh Sleep Quality Index (PSQI, and National Institute of Mental Health and Neurosciences (NIMHANS comprehensive sleep disorder questionnaire. They underwent overnight PSG at baseline and after13.3 ± 5.7 months of levodopa (440 mg/day. Results: Patients with PD had responded to levodopa as indicated by the significant improvement in UPDRS motor score in ON state compared to OFF state. Nocturnal sleep quality indices did not vary significantly, but the excessive daytime somnolence improved (P = 0.04 with levodopa. Sleep efficiency (P = 0.65, latency to sleep onset (P = 0.19, latency to stage 1 (P = 0.12, and duration of stage 1 (P = 0.55 had increased. Duration of ′awake in bed′ (P = 0.24, slow wave sleep (P = 0.29, and rapid eye movement (REM sleep (P = 0.24 decreased with treatment. Periodic leg movements (PLMs had reduced (P = 0.68 and mean oxygen saturation during sleep improved (P = 0.002. Surprisingly, snore index (P < 0.03 during sleep had increased with levodopa. Conclusions: Sleep alterations in PD occur even in early stages due to the disease process. There was improvement in most of the parameters of sleep macroarchitecture with levodopa.

  8. Sleep-Disordered Breathing in Duchenne Muscular Dystrophy: An Assessment of the Literature.

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    Hoque, Romy

    2016-06-15

    The aim of this review is to review the literature on sleep-disordered breathing in Duchenne muscular dystrophy (DMD). PubMed was searched with an array of search terms, including "OSA," "obstructive sleep apnea," "sleep-disordered breathing," "muscular dystrophy," "neuromuscular," "Duchenne muscular dystrophy," "polysomnography," and "portable monitoring." All relevant articles were discussed. Eighteen research articles and 1 consensus statement were reviewed, and assessed with relevant data presented. Three early studies prior to 1990 assessed DMD associated obstructive sleep apnea. Five studies assessed positive airway pressure (PAP) ventilation and/or sleep in varying neuromuscular disorders, including a cohort with DMD. Six studies since 2000 include PSG data in exclusively DMD cohorts. Three studies involved portable monitoring (PM). PSG with transcutaneous CO2 capnography is an important part of the clinical care for those with DMD. The utility of PM in DMD is unclear with only 1 study to date comparing PSG to PM data. Initiation of PAP therapy using bilevel modality may prevent the need for device switching as the disease progresses. © 2016 American Academy of Sleep Medicine.

  9. Alternatives to polysomnography (PSG): A validation of wrist actigraphy and a partial-PSG system

    National Research Council Canada - National Science Library

    Kosmadopoulos, Anastasi; Sargent, Charli; Darwent, David; Zhou, Xuan; Roach, Gregory D

    2014-01-01

    The objective of this study was to assess the validity of a sleep/wake activity monitor, an energy expenditure activity monitor, and a partial-polysomnography system at measuring sleep and wake under...

  10. Sleep Misperception in Chronic Insomnia Patients with Obstructive Sleep Apnea Syndrome: Implications for Clinical Assessment.

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    Choi, Su Jung; Suh, Sooyeon; Ong, Jason; Joo, Eun Yeon

    2016-11-15

    To investigate whether sleep perception (SP), defined by the ratio of subjective and objective total sleep time, and habitual sleep time in various sleep disorders may be based on comorbid insomnia status. We enrolled 420 patients (age 20-79 y) who underwent polysomnography (PSG). They were divided into three groups based on chief complaints: chronic insomnia (CI, n = 69), patients with both obstructive sleep apnea and insomnia (OSA-I, n = 49) or OSA only (OSA, n = 149). Healthy volunteers were also recruited (normal controls [NC], n = 80). We compared differences in PSG parameters and habitual sleep duration and investigated the discrepancy between objective and subjective total sleep time (TST) and sleep latency among four groups. Subjective TST was defined as sleep time perceived by participants the next morning of PSG. SP for TST was highest in the OSA group (median 92.9%), and lowest in the CI group (80.3%). SP of the NC group (91.4%) was higher than the CI, but there was no difference between OSA-I and OSA groups. OSA-I had higher depressive mood compared to the OSA group (p sleep duration and negatively related to the presence of insomnia and arousal index of PSG. Insomnia patients with (OSA-I) or without OSA (CI) reported the smallest discrepancy between habitual sleep duration and objective TST. Patients with OSA with or without insomnia have different PSG profiles, which suggests that objective measures of sleep are an important consideration for differentiating subtypes of insomnia and tailoring proper treatment. A commentary on this articles appears in this issue on page 1437.

  11. Development and Evaluation of a Wearable Device for Sleep Quality Assessment.

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    Kuo, Chih-En; Liu, Yi-Che; Chang, Da-Wei; Young, Chung-Ping; Shaw, Fu-Zen; Liang, Sheng-Fu

    2017-07-01

    In this study, a wearable actigraphy recording device with low sampling rate (1 Hz) for power saving and data reduction and a high accuracy wake-sleep scoring method for the assessment of sleep were developed. The developed actigraphy recorder was successfully applied to overnight recordings of 81 subjects with simultaneous polysomnography (PSG) measurements. The total length of recording reached 639.8 h. A wake-sleep scoring method based on the concept of movement density evaluation and adaptive windowing was proposed. Data from subjects with good (N = 43) and poor (N = 16) sleep efficiency (SE) in the range of 52.7-97.42% were used for testing. The Bland-Altman technique was used to evaluate the concordance of various sleep measurements between the manual PSG scoring and the proposed actigraphy method. For wake-sleep staging, the average accuracy, sensitivity, specificity, and kappa coefficient of the proposed system were 92.16%, 95.02%, 71.30%, and 0.64, respectively. For the assessment of SE, the accuracy of classifying the subject with good or poor SE reached 91.53%. The mean biases of SE, sleep onset time, wake after sleep onset, and total sleep time were -0.95%, 0.74 min, 2.84 min, and -4.3 min, respectively. These experimental results demonstrate the robustness and reliability of our method using limited activity information to estimate wake-sleep stages during overnight recordings. The results suggest that the proposed wearable actigraphy system is practical for the in-home screening of objective sleep measurements and objective evaluation of sleep improvement after treatment.

  12. Convergent validity of actigraphy with polysomnography and parent reports when measuring sleep in children with Down syndrome.

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    Esbensen, A J; Hoffman, E K; Stansberry, E; Shaffer, R

    2018-01-05

    There is a need for rigorous measures of sleep in children with Down syndrome as sleep is a substantial problem in this population and there are barriers to obtaining the gold standard polysomnography (PSG). PSG is cost-prohibitive when measuring treatment effects in some clinical trials, and children with Down syndrome may not cooperate with undergoing a PSG. Minimal information is available on the validity of alternative methods of assessing sleep in children with Down syndrome, such as actigraphy and parent ratings. Our study examined the concurrent and convergent validity of different measures of sleep, including PSG, actigraphy and parent reports of sleep among children with Down syndrome. A clinic (n = 27) and a community (n = 47) sample of children with Down syndrome were examined. In clinic, children with Down syndrome wore an actigraph watch during a routine PSG. In the community, children with Down syndrome wore an actigraph watch for a week at home at night as part of a larger study on sleep and behaviour. Their parent completed ratings of the child's sleep during that same week. Actigraph watches demonstrated convergent validity with PSG when measuring a child with Down syndrome's total amount of sleep time, total wake time after sleep onset and sleep period efficiency. In contrast, actigraph watches demonstrated poor correlations with parent reports of sleep, and with PSG when measuring the total time in bed and total wake episodes. Actigraphy, PSG and parent ratings of sleep demonstrated poor concurrent validity with clinical diagnosis of obstructive sleep apnoea. Our current data suggest that actigraph watches demonstrate convergent validity and are sensitive to measuring certain sleep constructs (duration, efficiency) in children with Down syndrome. However, parent reports, such as the Children's Sleep Habits Questionnaire, may be measuring other sleep constructs. These findings highlight the importance of selecting measures of sleep related to

  13. Clinical predictors of central sleep apnea evoked by positive airway pressure titration

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    Moro, Marilyn; Gannon, Karen; Lovell, Kathy; Merlino, Margaret; Mojica, James; Bianchi, Matt T

    2016-01-01

    Purpose Treatment-emergent central sleep apnea (TECSA), also called complex apnea, occurs in 5%–15% of sleep apnea patients during positive airway pressure (PAP) therapy, but the clinical predictors are not well understood. The goal of this study was to explore possible predictors in a clinical sleep laboratory cohort, which may highlight those at risk during clinical management. Methods We retrospectively analyzed 728 patients who underwent PAP titration (n=422 split-night; n=306 two-night). Demographics and self-reported medical comorbidities, medications, and behaviors as well as standard physiological parameters from the polysomnography (PSG) data were analyzed. We used regression analysis to assess predictors of binary presence or absence of central apnea index (CAI) ≥5 during split-night PSG (SN-PSG) versus full-night PSG (FN-PSG) titrations. Results CAI ≥5 was present in 24.2% of SN-PSG and 11.4% of FN-PSG patients during titration. Male sex, maximum continuous positive airway pressure, and use of bilevel positive airway pressure were predictors of TECSA, and rapid eye movement dominance was a negative predictor, for both SN-PSG and FN-PSG patients. Self-reported narcotics were a positive predictor of TECSA, and the time spent in stage N2 sleep was a negative predictor only for SN-PSG patients. Self-reported history of stroke and the CAI during the diagnostic recording predicted TECSA only for FN-PSG patients. Conclusion Clinical predictors of treatment-evoked central apnea spanned demographic, medical history, sleep physiology, and titration factors. Improved predictive models may be increasingly important as diagnostic and therapeutic modalities move away from the laboratory setting, even as PSG remains the gold standard for characterizing primary central apnea and TECSA. PMID:27555802

  14. Envelope analysis of the airflow signal to improve polysomnographic assessment of sleep disordered breathing.

    Science.gov (United States)

    Díaz, Javier A; Arancibia, José M; Bassi, Alejandro; Vivaldi, Ennio A

    2014-01-01

    Given the detailed respiratory waveform signal provided by the nasal cannula in polysomnographic (PSG) studies, to quantify sleep breathing disturbances by extracting a continuous variable based on the coefficient of variation of the envelope of that signal. Application of an algorithm for envelope analysis to standard nasal cannula signal from actual polysomnographic studies. PSG recordings from a sleep disorders center were analyzed by an algorithm developed on the Igor scientific data analysis software. Recordings representative of different degrees of sleep disordered breathing (SDB) severity or illustrative of the covariation between breathing and particularly relevant factors and variables. The method calculated the coefficient of variation of the envelope for each 30-second epoch. The normalized version of that coefficient was defined as the respiratory disturbance variable (RDV). The method outcome was the all-night set of RDV values represented as a time series. RDV quantitatively reflected departure from normal sinusoidal breathing at each epoch, providing an intensity scale for disordered breathing. RDV dynamics configured itself in recognizable patterns for the airflow limitation (e.g., in UARS) and the apnea/hypopnea regimes. RDV reliably highlighted clinically meaningful associations with staging, body position, oximetry, or CPAP titration. Respiratory disturbance variable can assess sleep breathing disturbances as a gradual phenomenon while providing a comprehensible and detailed representation of its dynamics. It may thus improve clinical diagnosis and provide a revealing descriptive tool for mechanistic sleep disordered breathing modeling. Respiratory disturbance variable may contribute to attaining simplified screening methodologies, novel diagnostic criteria, and insightful research tools.

  15. Sleep in intensive care unit

    DEFF Research Database (Denmark)

    Boyko, Yuliya; Jennum, Poul; Nikolic, Miki

    2017-01-01

    PURPOSE: To determine if improving intensive care unit (ICU) environment would enhance sleep quality, assessed by polysomnography (PSG), in critically ill mechanically ventilated patients. MATERIALS AND METHODS: Randomized controlled trial, crossover design. The night intervention "quiet routine......" protocol was directed toward improving ICU environment between 10pm and 6am. Noise levels during control and intervention nights were recorded. Patients on mechanical ventilation and able to give consent were eligible for the study. We monitored sleep by PSG.The standard (American Association of Sleep...... Medicine) sleep scoring criteria were insufficient for the assessment of polysomnograms. Modified classification for sleep scoring in critically ill patients, suggested by Watson et al. (Crit Care Med 2013;41:1958-1967), was used. RESULTS: Sound level analysis showed insignificant effect...

  16. Multiscale Entropy Analysis of Heart Rate Variability for Assessing the Severity of Sleep Disordered Breathing

    Directory of Open Access Journals (Sweden)

    Wen-Yao Pan

    2015-01-01

    Full Text Available Obstructive sleep apnea (OSA is an independent cardiovascular risk factor to which autonomic nervous dysfunction has been reported to be an important contributor. Ninety subjects recruited from the sleep center of a single medical center were divided into four groups: normal snoring subjects without OSA (apnea hypopnea index, AHI < 5, n = 11, mild OSA (5 ≤ AHI < 15, n = 10, moderate OSA (15 ≤ AHI < 30, n = 24, and severe OSA (AHI ≥ 30, n = 45. Demographic (i.e., age, gender, anthropometric (i.e., body mass index, neck circumference, and polysomnographic (PSG data were recorded and compared among the different groups. For each subject, R-R intervals (RRI from 10 segments of 10-minute electrocardiogram recordings during non-rapid eye movement sleep at stage N2 were acquired and analyzed for heart rate variability (HRV and sample entropy using multiscale entropy index (MEI that was divided into small scale (MEISS, scale 1–5 and large scale (MEILS, scale 6–10. Our results not only demonstrated that MEISS could successfully distinguish normal snoring subjects and those with mild OSA from those with moderate and severe disease, but also revealed good correlation between MEISS and AHI with Spearman correlation analysis (r = −0.684, p < 0.001. Therefore, using the two parameters of EEG and ECG, MEISS may serve as a simple preliminary screening tool for assessing the severity of OSA before proceeding to PSG analysis.

  17. Effect of Lisdexamfetamine Dimesylate on Sleep in Children with ADHD

    Science.gov (United States)

    Giblin, John M.; Strobel, Aaron L.

    2011-01-01

    Objective: This study evaluated the potential effects of short-term treatment with lisdexamfetamine dimesylate (LDX) on both subjective and objective sleep characteristics in children aged 6 to 12 years (n = 24) with ADHD. Method: Polysomnography (PSG) and actigraph measures as well as assessments of subjective sleep parameters were examined in…

  18. Modulation of the Muscle Activity During Sleep in Cervical Dystonia.

    Science.gov (United States)

    Antelmi, Elena; Ferri, Raffaele; Provini, Federica; Scaglione, Cesa M L; Mignani, Francesco; Rundo, Francesco; Vandi, Stefano; Fabbri, Margherita; Pizza, Fabio; Plazzi, Giuseppe; Martinelli, Paolo; Liguori, Rocco

    2017-07-01

    Impaired sleep has been reported as an important nonmotor feature in dystonia, but so far, self-reported complaints have never been compared with nocturnal video-polysomnographic (PSG) recording, which is the gold standard to assess sleep-related disorders. Twenty patients with idiopathic isolated cervical dystonia and 22 healthy controls (HC) underwent extensive clinical investigations, neurological examination, and questionnaire screening for excessive daytime sleepiness and sleep-related disorders. A full-night video PSG was performed in both patients and HC. An ad hoc montage, adding electromyographic leads over the muscle affected with dystonia, was used. When compared to controls, patients showed significantly increased pathological values on the scale assessing self-reported complaints of impaired nocturnal sleep. Higher scores of impaired nocturnal sleep did not correlate with any clinical descriptors but for a weak correlation with higher scores on the scale for depression. On video-PSG, patients had significantly affected sleep architecture (with decreased sleep efficiency and increased sleep latency). Activity over cervical muscles disappears during all the sleep stages, reaching significantly decreased values when compared to controls both in nonrapid eye movements and rapid eye movements sleep. Patients with cervical dystonia reported poor sleep quality and showed impaired sleep architecture. These features however cannot be related to the persistence of muscle activity over the cervical muscles, which disappears in all the sleep stages, reaching significantly decreased values when compared to HC.

  19. Assessment of sleep quality in powernapping

    DEFF Research Database (Denmark)

    Kooravand Takht Sabzy, Bashaer; Thomsen, Carsten E

    2011-01-01

    The purpose of this study is to assess the Sleep Quality (SQ) in powernapping. The contributed factors for SQ assessment are time of Sleep Onset (SO), Sleep Length (SL), Sleep Depth (SD), and detection of sleep events (K-complex (KC) and Sleep Spindle (SS)). Data from daytime nap for 10 subjects, 2...... days each, including EEG and ECG were recorded. The SD and sleep events were analyzed by applying spectral analysis. The SO time was detected by a combination of signal spectral analysis, Slow Rolling Eye Movement (SREM) detection, Heart Rate Variability (HRV) analysis and EEG segmentation using both...... Autocorrelation Function (ACF), and Crosscorrelation Function (CCF) methods. The EEG derivation FP1-FP2 filtered in a narrow band and used as an alternative to EOG for SREM detection. The ACF and CCF segmentation methods were also applied for detection of sleep events. The ACF method detects segment boundaries...

  20. Subjectively and objectively measured sleep with and without posttraumatic stress disorder and trauma exposure.

    Science.gov (United States)

    Kobayashi, Ihori; Huntley, Edward; Lavela, Joseph; Mellman, Thomas A

    2012-07-01

    Although reports of sleep disturbances are common among individuals with posttraumatic stress disorder (PTSD), results of polysomnographic (PSG) studies have inconsistently documented abnormalities and have therefore suggested "sleep state misperception." The authors' study objectives were to compare sleep parameters measured objectively and subjectively in the laboratory and at home in civilians with and without trauma exposure and PTSD. Cross-sectional study. PSG recordings in a sleep laboratory and actigraphic recordings in participants' homes. One hundred three urban-residing African Americans with and without trauma exposure and PTSD who participated in a larger study. N/A. Sleep parameters (total sleep time [TST], sleep onset latency [SOL], and wake after sleep onset [WASO]) were assessed using laboratory PSG and home actigraphy. A sleep diary was completed in the morning after PSG and actigraphy recordings. Habitual TST, SOL, and WASO were assessed using a sleep questionnaire. The Clinician Administered PTSD Scale was administered to assess participants' trauma exposure and PTSD diagnostic status. Participants, regardless of their trauma exposure/PTSD status, underestimated WASO in the diary and questionnaire relative to actigraphy and overestimated SOL in the diary relative to PSG. Among participants with current PTSD, TST diary estimates did not differ from the actigraphy measure in contrast with those without current PTSD who overestimated TST. No other significant group differences in discrepancies between subjective and objective sleep measures were found. Discrepancies between subjectively and objectively measured sleep parameters were not associated with trauma exposure or PTSD. This challenges prior assertions that individuals with PTSD overreport their sleep disturbances.

  1. Predictability of Sleep in Patients with Insomnia

    Science.gov (United States)

    Vallières, Annie; Ivers, Hans; Beaulieu-Bonneau, Simon; Morin, Charles M.

    2011-01-01

    Study Objectives: To evaluate whether the night-to-night variability in insomnia follows specific predictable patterns and to characterize sleep patterns using objective sleep and clinical variables. Design: Prospective observational study. Setting: University-affiliated sleep disorders center. Participants: 146 participants suffering from chronic and primary insomnia. Measurements and Results: Daily sleep diaries were completed for an average of 48 days and self-reported questionnaires once. Three nights were spent in the sleep laboratory for polysomnographic (PSG) assessment. Sleep efficiency, sleep onset latency, wake after sleep onset, and total sleep time were derived from sleep diaries and PSG. Time-series diary data were used to compute conditional probabilities of having an insomnia night after 1, 2, or 3 consecutive insomnia night(s). Conditional probabilities were submitted to a k-means cluster analysis. A 3-cluster solution was retained. One cluster included 38 participants exhibiting an unpredictable insomnia pattern. Another included 30 participants with a low and decreasing probability to have an insomnia night. The last cluster included 49 participants exhibiting a high probability to have insomnia every night. Clusters differed on age, insomnia severity, and mental fatigue, and on subjective sleep variables, but not on PSG sleep variables. Conclusion: These findings replicate our previous study and provide additional evidence that unpredictability is a less prevalent feature of insomnia than suggested previously in the literature. The presence of the 3 clusters is discussed in term of sleep perception and sleep homeostasis dysregulation. Citation: Vallières A; Ivers H; Beaulieu-Bonneau S; Morin CM. Predictability of sleep in patients with insomnia. SLEEP 2011;34(5):609-617. PMID:21532954

  2. Depressive symptoms account for differences between self-reported versus polysomnographic assessment of sleep quality in women with myofascial TMD.

    Science.gov (United States)

    Dubrovsky, B; Janal, M N; Lavigne, G J; Sirois, D A; Wigren, P E; Nemelivsky, L; Krieger, A C; Raphael, K G

    2017-08-29

    Patients with temporomandibular disorder (TMD) report poor sleep quality on the Pittsburgh Sleep Quality Index (PSQI). However, polysomnographic (PSG) studies show meagre evidence of sleep disturbance on standard physiological measures. The present aim was to analyse self-reported sleep quality in TMD as a function of myofascial pain, PSG parameters and depressive symptomatology. PSQI scores from 124 women with myofascial TMD and 46 matched controls were hierarchically regressed onto TMD presence, ratings of pain intensity and pain-related disability, in-laboratory PSG variables and depressive symptoms (Symptoms Checklist-90). Relative to controls, TMD cases had higher PSQI scores, representing poorer subjective sleep and more depressive symptoms (both P myofascial pain. As TMD cases lacked typical PSG features of clinical depression, the results suggest a negative cognitive bias in TMD and caution against interpreting self-report sleep measures as accurate indicators of PSG sleep disturbance. Future investigations should take account of depressive symptomatology when interpreting reports of poor sleep. © 2017 John Wiley & Sons Ltd.

  3. ASSESSING SUBJECTIVE SLEEP QUALITY IN SENIORS

    Directory of Open Access Journals (Sweden)

    Iveta Kukliczová

    2017-03-01

    Full Text Available Aim: The study aimed at assessing the quality of sleep in seniors. Another objective was to determine the impact of gender, age, type of residence and taking sleeping medication on the quality of sleep. Design: A cross-sectional study. Methods: Data were collected using the standardized Pittsburgh Sleep Quality Index (PSQI questionnaire. The sample comprised 146 seniors living in the Moravian-Silesian Region, Czech Republic. The survey was conducted from January 2014 to the end of October 2014 in a long-term chronic care department of a selected hospital, two retirement homes and among seniors living in their own homes. Results: Thirty-five (24% seniors had their global PSQI scores of 5 (i.e. the highest score indication good sleep quality or less. The remaining 111 (76% participants were shown to suffer from impaired sleep quality as their global PSQI scores were 6 or higher. There were statistically significant differences in component scores between seniors with the global PSQI scores of 5 or less and those with higher scores. The best quality of sleep was observed in females, seniors in the 65–74 age category and those sharing their own homes with their spouses or partners. Conclusion: Subjective sleep quality assessment varies significantly with respect to gender, age, type of residence and use of sleeping medication. Keywords: sleep quality, PSQI, subjective assessment, senior.

  4. Utility of the Fitbit Flex to evaluate sleep in major depressive disorder: A comparison against polysomnography and wrist-worn actigraphy.

    Science.gov (United States)

    Cook, Jesse D; Prairie, Michael L; Plante, David T

    2017-08-01

    Sleep disturbance is a common and important component of affective illness. Fitness activity trackers are emerging as alternative means to estimate sleep in psychiatric patients; however, their ability to quantify sleep in mood disorders has not been empirically evaluated. Thus, this study sought to evaluate the utility of the Fitbit Flex (FBF) to estimate sleep in patients with major depressive disorder (MDD) relative to gold standard polysomnography (PSG) and a widely-used actigraph (Actiwatch-2; AW-2). Twenty-one patients with unipolar MDD wore the FBF and AW-2 during in-laboratory PSG. Bland-Altman analysis compared sleep variables among devices. Epoch-by-epoch analysis further evaluated sensitivity, specificity, and accuracy for the FBF and AW-2 relative to PSG. The FBF demonstrated significant limitations in quantifying sleep and wake, relative to PSG. In the normal setting, the FBF significantly overestimated sleep time and efficiency, and displayed poor ability to correctly identify wake epochs (i.e. low specificity). In the sensitive setting, the FBF significantly underestimated sleep time and efficiency relative to PSG. Performance characteristics of the FBF were more similar to the AW-2 in the normal compared to sensitive setting. Participants were young to middle aged and predominantly female, which may limit generalizability of findings. Study design also precluded ability to assess longitudinal performance of FBF. The FBF is not an adequate substitute for PSG when quantifying sleep in MDD, and the settings of the device sizably impact its performance relative to PSG and other standard actigraphs. The limitations and capabilities of the FBF should be carefully considered prior to clinical and research implementation. Copyright © 2017 Elsevier B.V. All rights reserved.

  5. Rotigotine may improve sleep architecture in Parkinson's disease: a double-blind, randomized, placebo-controlled polysomnographic study.

    Science.gov (United States)

    Pierantozzi, Mariangela; Placidi, Fabio; Liguori, Claudio; Albanese, Maria; Imbriani, Paola; Marciani, Maria Grazia; Mercuri, Nicola Biagio; Stanzione, Paolo; Stefani, Alessandro

    2016-05-01

    Growing evidence demonstrates that in Parkinson's Disease (PD) sleep disturbances are frequent and difficult to treat. Since the efficacy of rotigotine on sleep is corroborated by studies lacking polysomnography (PSG), this study explores the possible rotigotine-mediated impact on PSG parameters in PD patients. This is a randomized, double-blind, placebo-controlled, parallel-group study to determine the efficacy of rotigotine vs placebo on PSG parameters in moderately advanced PD patients. An unusual protocol was utilized, since patches were maintained from 18:00 h to awakening, minimizing the possible diurnal impact on motor symptoms. All participants underwent sleep PSG recordings, subjective sleep questionnaires (Parkinson Disease Sleep Scale [PDSS], Pittsburgh Sleep Quality Index [PSQI]), and the assessment of early-morning motor disability. We evaluated 42 PD patients (Hoehn & Yahr stages 2 and 3) with sleep impairment randomly assigned to active branch (N =21) or placebo (N = 21). Rotigotine significantly increased sleep efficiency and reduced both wakefulness after sleep onset and sleep latency compared to placebo. Moreover, the mean change in REM sleep quantity was significantly higher in the rotigotine than placebo group. The improvement of PSG parameters corresponded to the amelioration of PDSS and PSQI scores together with the improvement of patient morning motor symptoms. This study demonstrated the significant effect of rotigotine on sleep quality and continuity in PD patients by promoting sleep stability and increasing REM. The effectiveness of rotigotine on sleep may be ascribed to its pharmacokinetic/pharmacodynamic profile directly on both D1 and D2 receptors. Copyright © 2016 Elsevier B.V. All rights reserved.

  6. Correlation between rating scales and sleep laboratory measurements in restless legs syndrome.

    Science.gov (United States)

    Garcia-Borreguero, Diego; Larrosa, Oscar; de la Llave, Yolanda; Granizo, Juan José; Allen, Richard

    2004-11-01

    The aim of this study was to test the external validity of the International Restless Legs Scale (IRLS) by assessment of the correlation between IRLS scores and objective measures of severity such as polysomnography (PSG) and Suggested Immobilization Test (SIT). Correlation analysis between rating scales for RLS (IRLS and Johns Hopkins RLS Scale--JHRLSS) and sleep laboratory measurements in untreated RLS patients. The study included 30 untreated patients diagnosed with RLS according to the criteria of the International RLS Study Group. Diagnostic procedures included physical exam, laboratory analysis, PSG and a nocturnal SIT. Statistical analysis was performed by means of Spearman's correlations and Kruskal-Wallis test. IRLS correlated significantly with Periodic Leg Movement of Sleep-index (PLMS), and PLMS-arousal index during PSG as well as with Periodic Leg Movement of Wakefulness (PLMW) during SIT (SIT-PLMW) (all r=0.4; p<0.01). There was no correlation between IRLS and the number of PLMW in PSG (PSG-PLMW) or any other sleep variable during PSG. Nor was any correlation found between IRLS scores and ferritin, age, duration of illness or any other clinical variables. This study represents the first demonstration of a correlation between IRLS and objective parameters of motor dysfunction such as PLMS-index or SIT. This finding is particularly relevant for the design of future clinical trials. Furthermore, the association between PLMS and SIT-PLMW supports the view that both PLMS and PLMW might share a common mechanism.

  7. Validation of midsagittal jaw movements to measure sleep in healthy adults by comparison with actigraphy and polysomnography

    Directory of Open Access Journals (Sweden)

    Bassam Chakar

    Full Text Available OBJECTIVE: In a device based on midsagittal jaw movements analysis, we assessed a sleep-wake automatic detector as an objective method to measure sleep in healthy adults by comparison with wrist actigraphy against polysomnography (PSG. METHODS: Simultaneous and synchronized in-lab PSG, wrist actigraphy and jaw movements were carried out in 38 healthy participants. Epoch by epoch analysis was realized to assess the ability to sleep-wake distinction. Sleep parameters as measured by the three devices were compared. This included three regularly reported parameters: total sleep time, sleep onset latency, and wake after sleep onset. Also, two supplementary parameters, wake during sleep period and latency time, were added to measure quiet wakefulness state. RESULTS: The jaw movements showed sensitivity level equal to actigraphy 96% and higher specificity level (64% and 48% respectively. The level of agreement between the two devices was high (87%. The analysis of their disagreement by discrepant resolution analysis used PSG as resolver revealed that jaw movements was right (58.9% more often than actigraphy (41%. In sleep parameters comparison, the coefficient correlation of jaw movements was higher than actigraphy in all parameters. Moreover, its ability to distinct sleep-wake state allowed for a more effective estimation of the parameters that measured the quiet wakefulness state. CONCLUSIONS: Midsagittal jaw movements analysis is a reliable method to measure sleep. In healthy adults, this device proved to be superior to actigraphy in terms of estimation of all sleep parameters and distinction of sleep-wake status.

  8. Assessing sleep in adolescents through a better understanding of sleep physiology.

    Science.gov (United States)

    George, Nancy M; Davis, Jean E

    2013-06-01

    Adolescents need about nine hours of sleep per night, yet most teens get far less. Inadequate sleep has consequences not only for academic performance but also for mental and physical health; it has been linked to lowered resilience and an increased risk of cardiovascular and metabolic diseases. It's imperative that assessment of sleep become a routine part of adolescent health care. An understanding of sleep physiology is essential to helping nurses better assess and manage sleep deprivation in this population. Sleep assessment involves evaluating the three main aspects of sleep: amount, quality, and architecture. The authors provide an overview of sleep physiology, describe sleep changes that occur during adolescence, and discuss the influence of these changes on adolescent health. They also provide simple questions that nurses can use to assess sleep and risk factors for disrupted sleep, and discuss patient education and other interventions.

  9. Exercise Effects on Sleep Physiology

    Directory of Open Access Journals (Sweden)

    Sunao eUchida

    2012-04-01

    Full Text Available This mini-review focuses on the effects of exercise on sleep. In its early days, sleep research largely focused on central nervous system (CNS physiology using standardized tabulations of several sleep-specific landmark electroencephalogram (EEG waveforms. Though coarse, this method has enabled the observation and inspection of numerous uninterrupted sleep phenomena. Thus, research on the effects of exercise on sleep began, in the 1960’s, with a focus primarily on sleep EEG (CNS sleep changes. Those early studies found only small effects of exercise on sleep. More recent sleep research has explored not only CNS functioning, but somatic physiology as well. As physical exercise mostly affects somatic functions, endocrine and autonomic nervous system (ANS changes that occur during sleep should be affected by daytime exercise. Since endocrinological, metabolic and autonomic changes can be measured during sleep, it should be possible to assess exercise effects on somatic physiology in addition to CNS sleep quality, building from standard polysomnographic (PSG techniques. Incorporating measures of somatic physiology in the quantitative assessment of sleep could further our understanding of sleep's function as an auto-regulatory, global phenomenon.

  10. Daytime Ayahuasca administration modulates REM and slow-wave sleep in healthy volunteers.

    Science.gov (United States)

    Barbanoj, Manel J; Riba, Jordi; Clos, S; Giménez, S; Grasa, E; Romero, S

    2008-02-01

    Ayahuasca is a traditional South American psychoactive beverage and the central sacrament of Brazilian-based religious groups, with followers in Europe and the United States. The tea contains the psychedelic indole N,N-dimethyltryptamine (DMT) and beta-carboline alkaloids with monoamine oxidase-inhibiting properties that render DMT orally active. DMT interacts with serotonergic neurotransmission acting as a partial agonist at 5-HT(1A) and 5-HT(2A/2C) receptor sites. Given the role played by serotonin in the regulation of the sleep/wake cycle, we investigated the effects of daytime ayahuasca consumption in sleep parameters. Subjective sleep quality, polysomnography (PSG), and spectral analysis were assessed in a group of 22 healthy male volunteers after the administration of a placebo, an ayahuasca dose equivalent to 1 mg DMT kg(-1) body weight, and 20 mg d-amphetamine, a proaminergic drug, as a positive control. Results show that ayahuasca did not induce any subjectively perceived deterioration of sleep quality or PSG-measured disruptions of sleep initiation or maintenance, in contrast with d-amphetamine, which delayed sleep initiation, disrupted sleep maintenance, induced a predominance of 'light' vs 'deep' sleep and significantly impaired subjective sleep quality. PSG analysis also showed that similarly to d-amphetamine, ayahuasca inhibits rapid eye movement (REM) sleep, decreasing its duration, both in absolute values and as a percentage of total sleep time, and shows a trend increase in its onset latency. Spectral analysis showed that d-amphetamine and ayahuasca increased power in the high frequency range, mainly during stage 2. Remarkably, whereas slow-wave sleep (SWS) power in the first night cycle, an indicator of sleep pressure, was decreased by d-amphetamine, ayahuasca enhanced power in this frequency band. Results show that daytime serotonergic psychedelic drug administration leads to measurable changes in PSG and sleep power spectrum and suggest an

  11. Advanced sleep phase in adolescents born preterm.

    Science.gov (United States)

    Hibbs, Anna Maria; Storfer-Isser, Amy; Rosen, Carol; Ievers-Landis, Carolyn E; Taveras, Elsie M; Redline, Susan

    2014-09-03

    The objective of this article is to evaluate whether sleep patterns and quality differed between adolescents born preterm and term, and to further explore whether differences in sleep patterns were explained by differences in mediating factors such as mood, behavior, or socioeconomic status. Five hundred and one 16- to 19-year-old children in the longitudinal Cleveland Children's Sleep and Health Study cohort underwent overnight polysomnography (PSG), wore wrist actigraphs, and completed sleep logs for 1 week. The modified Epworth Sleepiness Scale, the Adolescent Sleep Hygiene Scale, and the Adolescent Sleep-Wake Scale were used to further assess sleep. Adolescents born preterm demonstrated significantly (p sleep midpoints (approximately 22 min after adjusting for demographic and psychosocial factors) by actigraphy. They also had significantly fewer arousals (by PSG), and reported being more rested and alert in the morning, as well as less sleepiness and fatigue. These findings support a growing body of evidence that perinatal factors may influence sleep phenotypes later in life. These factors may reflect developmental influences, as well as the influence of parenting styles on children's sleep.

  12. Sleep Characteristics of Self-Reported Long Sleepers

    Science.gov (United States)

    Patel, Sanjay R.; Blackwell, Terri; Ancoli-Israel, Sonia; Stone, Katie L.

    2012-01-01

    Background: Self-reported long habitual sleep durations (≥ 9 h per night) consistently predict increased mortality. We compared objective sleep parameters of self-reported long versus normal duration sleepers to determine whether long sleepers truly sleep more or have an underlying sleep abnormality. Methods: Older men participating in the Osteoporotic Fractures in Men Study (MrOS) were recruited for a comprehensive sleep assessment, which included wrist actigraphy, overnight polysomnography (PSG), and a question about usual nocturnal sleep duration. Results: Of the 3134 participants (mean age 76.4 ± 5.6; 89.9% Caucasian), 1888 (60.2%) reported sleeping 7-8 h (normal sleepers) and 174 (5.6%) reported ≥ 9 h (long sleepers). On actigraphy, long sleepers spent on average 63.0 min more per night in bed (P sleep stage distribution did not differ. After adjusting for differences in demographics, comorbidities, and medication usage, self-reported long sleepers continued to spend more time in bed and sleep more, based on both actigraphy and PSG. Each additional 30 min in bed or asleep as measured by actigraphy increased the odds of being a self-reported long-sleeper 1.74-fold and 1.33-fold, respectively (P sleep disorders. Citation: Patel SR; Blackwell T; Ancoli-Israel S; Stone KL. Sleep characteristics of self-reported long sleepers. SLEEP 2012;35(5):641-648. PMID:22547890

  13. New assessment tools that measure sleep vital signs: the SleepMed Insomnia Index and the Sleep Matrix

    OpenAIRE

    Bogan, Richard K.; Turner, Jo Anne

    2007-01-01

    Insomnia is the leading sleep disorder in the US; however, diagnosis is often problematic. This pilot study assessed the clinical value of a novel diagnostic insomnia questionnaire. The SleepMed Insomnia Index (SMI) was administered to 543 consecutive patients and 50 normal control subjects during a pilot study. Mean SMI scores were assessed based on subsequent sleep-related diagnoses. The SMI scores for patients with sleep-related disorders were significantly higher than those for the contro...

  14. Utility of screening questionnaire, obesity, neck circumference, and sleep polysomnography to predict sleep-disordered breathing in children and adolescents.

    Science.gov (United States)

    Raman, Vidya T; Splaingard, Mark; Tumin, Dmitry; Rice, Julie; Jatana, Kris R; Tobias, Joseph D

    2016-06-01

    Polysomnography (PSG) remains the gold standard for diagnosing obstructive sleep apnea (OSA) and sleep-disordered breathing in children. Yet, simple screening tools are needed as it is not feasible to perform PSG in all patients with possible OSA. The study adapted questions from the Pediatric Sleep Questionnaire-Sleep-Related Breathing Disorder (SRBD) Questionnaire to develop a predictive scale for OSA identified on PSG. We also tested whether adding anthropometric measurements (body mass index and neck circumference) improved prediction of OSA. After IRB approval, OSA questionnaires and anthropometric measurements were collected on 948 consecutive patients scheduled for PSG, aged 4 months to 24.5 years (median = 8.5 years). The sample was reduced to 636 patients in the age range (6-18 years old) where normative values for neck circumference are defined. OSA was characterized using the obstructive apnea-hypopnea index (AHI). After identifying questions related to OSA in univariate logistic regression, multivariable models were fitted to select questions for a short scale, and points for exceeding body mass or neck circumference cutoffs were added to assess improvement in predictive value. A long scale of 16 questionnaire items was constructed using univariate models, while six items were selected for the short scale by multivariable regression. The short scale was associated with greater odds of moderate/severe OSA (OR = 1.964; 95% CI = 1.620, 2.381; P children with OSA for determining risk stratification and postoperative disposition. © 2016 John Wiley & Sons Ltd.

  15. Characterizing the NREM/REM sleep specific obstructive sleep apnea severity using snore sounds.

    Science.gov (United States)

    Akhter, S; Abeyratne, U R; Swarnker, V

    2017-07-01

    Obstructive Sleep Apnea (OSA) patients have frequent breathing obstructions and upper airway (UA) collapse during sleep. It is clinically important to estimate OSA severity separately for Rapid Eye Movement (REM) and non-REM (NREM) sleep states, but the task requires Polysomnography (PSG) which uses about 15-20 body contact sensors and subjective assessment. Almost all OSA patients snore. Vibration in narrowed UA muscles cause snoring in OSA. Moreover, as sleep states are associated with distinct breathing patterns and UA muscle tone, REM/NREM specific information must be available via snore/breathing sounds. Our previous works have shown that snoring carries significant information related to REM/NREM sleep states and OSA. We hypothesized that such information from snoring sound could be used to characterize OSA specific to REM/NREM sleep states independent of PSG. We acquired overnight audio recording from 91 patients (56 males and 35 females) undergoing PSG and labeled snore sounds as belonging to REM/NREM stages based on PSG. We then developed features to capture REM/NREM specific information and trained logistic regression (LR) classifier models to map snore features to OSA severity bands. Considering separate LR models for males and females, we achieved 94-100% sensitivity (84-89% specificity) for NREM stages at the OSA severity threshold of 30 events/h. Corresponding sensitivity for REM stages were 92-97% with specificity 83-85%. Results indicate that it is feasible to estimate severe/non-severe OSA in REM/NREM sleep based on snore/breathing sounds alone, acquired using simple bedside sound acquisition devices such as mobile phones.

  16. Processing of signals recorded through smart devices: sleep-quality assessment.

    Science.gov (United States)

    Bianchi, Anna Maria; Mendez, Martin Oswaldo; Cerutti, Sergio

    2010-05-01

    In this paper, we discuss the possibility of performing a sleep evaluation from signals, which are not usually used for this purpose. In particular, we take into consideration the heart rate variability (HRV) and respiratory signals for automatic sleep staging, arousals detection, and apnea recognition. This is particularly useful for wearable or textile devices that could be employed for home monitoring of sleep. The HRV and the respiration were analyzed in the frequency domain, and the statistics on the spectral and cross-spectral parameters put into evidence the possibility of a sleep evaluation on their basis. Comparison with traditional polysomnography (PSG) revealed a classification accuracy of 89.9% in rapid eye movement (REM) non-REM sleep separation and an accuracy of 88% for sleep apnea detection. Additional information can be achieved from the number of microarousals recognized in correspondence of typical modifications in the HRV signal. The obtained results support the idea of automatic sleep evaluation and monitoring through signals that are not traditionally used in clinical PSG, but can be easily recorded at home through wearable devices (for example, a sensorized T-shirt) or systems integrated into the environment (a sensorized bed). This is a first step for the development of systems for sleep screening on large populations that can constitute a complement for the traditional clinical evaluation.

  17. Measuring Treatment Outcomes in Comorbid Insomnia and Fibromyalgia: Concordance of Subjective and Objective Assessments.

    Science.gov (United States)

    Mundt, Jennifer M; Crew, Earl C; Krietsch, Kendra; Roth, Alicia J; Vatthauer, Karlyn; Robinson, Michael E; Staud, Roland; Berry, Richard B; McCrae, Christina S

    2016-02-01

    In insomnia, actigraphy tends to underestimate wake time compared to diaries and PSG. When chronic pain co-occurs with insomnia, sleep may be more fragmented, including more movement and arousals. However, individuals may not be consciously aware of these arousals. We examined the baseline concordance of diaries, actigraphy, and PSG as well as the ability of each assessment method to detect changes in sleep following cognitive behavioral therapy for insomnia (CBT-I). Adults with insomnia and fibromyalgia (n = 113) were randomized to CBT-I, CBT for pain, or waitlist control. At baseline and posttreatment, participants completed one night of PSG and two weeks of diaries/actigraphy. At baseline, objective measures estimated lower SOL, higher TST, and higher SE than diaries (ps treatment-related changes. PSG values did not change significantly for any sleep parameters. However, diaries showed improvements in SOL, WASO, and SE, and actigraphy also detected the WASO and SE improvements (ps insomnia. However, actigraphy showed greater sensitivity to treatment-related changes than PSG; PSG failed to detect any improvements, but actigraphy demonstrated changes in WASO and SE, which were also found with diaries. In comorbid insomnia/fibromyalgia, actigraphy may therefore have utility in measuring treatment outcomes. © 2015 American Academy of Sleep Medicine.

  18. Consistently High Sports/Exercise Activity Is Associated with Better Sleep Quality, Continuity and Depth in Midlife Women: The SWAN Sleep Study

    Science.gov (United States)

    Kline, Christopher E.; Irish, Leah A.; Krafty, Robert T.; Sternfeld, Barbara; Kravitz, Howard M.; Buysse, Daniel J.; Bromberger, Joyce T.; Dugan, Sheila A.; Hall, Martica H.

    2013-01-01

    Study Objectives: To examine relationships between different physical activity (PA) domains and sleep, and the influence of consistent PA on sleep, in midlife women. Design: Cross-sectional. Setting: Community-based. Participants: 339 women in the Study of Women's Health Across the Nation Sleep Study (52.1 ± 2.1 y). Interventions: None. Measurements and Results: Sleep was examined using questionnaires, diaries and in-home polysomnography (PSG). PA was assessed in three domains (Active Living, Household/Caregiving, Sports/Exercise) using the Kaiser Physical Activity Survey (KPAS) up to 4 times over 6 years preceding the sleep assessments. The association between recent PA and sleep was evaluated using KPAS scores immediately preceding the sleep assessments. The association between the historical PA pattern and sleep was examined by categorizing PA in each KPAS domain according to its pattern over the 6 years preceding sleep assessments (consistently low, inconsistent/consistently moderate, or consistently high). Greater recent Sports/Exercise activity was associated with better sleep quality (diary “restedness” [P sleep continuity (diary sleep efficiency [SE; P = 0.02]) and depth (higher NREM delta electroencephalographic [EEG] power [P = 0.04], lower NREM beta EEG power [P activity was also associated with better Pittsburgh Sleep Quality Index scores (P = 0.02) and higher PSG-assessed SE (P sleep and Active Living or Household/Caregiving activity (either recent or historical pattern) were noted. Conclusion: Consistently high levels of recreational physical activity, but not lifestyle- or household-related activity, are associated with better sleep in midlife women. Increasing recreational physical activity early in midlife may protect against sleep disturbance in this population. Citation: Kline CE; Irish LA; Krafty RT; Sternfeld B; Kravitz HM; Buysse DJ; Bromberger JT; Dugan SA; Hall MH. Consistently high sports/exercise activity is associated with better

  19. Bupropion response on sleep quality in patients with depression: implications for increased cardiovascular disease risk.

    Science.gov (United States)

    Schramm, Preetam J; Poland, Russell E; Rao, Uma

    2014-02-01

    Depression could be an independent risk factor for cardiovascular disease. We assessed bupropion response in depressed patients by polysomnography (PSG) and cardiopulmonary coupling (CPC) variables. Nineteen subjects participated in a two-session, two consecutive night PSG protocol. Participants received either placebo or bupropion-SR 150 mg, orally, in a randomized, double-blind cross-over fashion on night two. Outcome variables were: sleep stages, REM latency, stable, unstable sleep and very low frequency coupling (VLFC). CPC analysis uses heart rate variability and the electrocardiogram's R-wave amplitude fluctuations associated with respiration to generate frequency maps. Bupropion increased REM latency (p=0.043) but did not impact PSG sleep continuity, architecture and CPC variables. A trend (p=0.092) was observed towards increasing VLFC duration. Bupropion increased the number of stable-unstable sleep transitions (p=0.036). Moderate to strong correlations between PSG and CPC variables were found on placebo and bupropion nights. Limitations include a small sample size, limited power to detect CPC changes and lack of normal controls for comparison. Increased stable-unstable sleep transitions and VLFC duration may indicate vulnerability to cardiovascular disease due to their association with low heart rate variability that has been associated with increased mortality raising the question whether the beneficial effects of the antidepressant medication outweighs the impact on cardiopulmonary dynamics. © 2013 Elsevier B.V. and ECNP All rights reserved.

  20. Bupropion response on sleep quality in patients with depression: implications for increased cardiovascular disease risk

    Science.gov (United States)

    Schramm, Preetam J.; Poland, Russell E.; Rao, Uma

    2013-01-01

    Depression could be an independent risk factor for cardiovascular disease. We assessed bupropion response in depressed patients by polysomnography (PSG) and cardiopulmonary coupling (CPC) variables. Nineteen subjects participated in a two-session, two consecutive night PSG protocol. Participants received either placebo or bupropion-SR 150 mg, orally, in a randomized, double-blind cross-over fashion on night two. Outcome variables were: sleep stages, REM latency, stable, unstable sleep and very low frequency coupling (VLFC). CPC analysis uses heart rate variability and the electrocardiogram’s R-wave amplitude fluctuations associated with respiration to generate frequency maps. Bupropion increased REM latency (p=0.043) but did not impact PSG sleep continuity, architecture and CPC variables. A trend (p=0.092) was observed towards increasing VLFC duration. Bupropion increased the number of stable-unstable sleep transitions (p=0.036). Moderate to strong correlations between PSG and CPC variables were found on placebo and bupropion nights. Limitations include a small sample size, limited power to detect CPC changes and lack of normal controls for comparison. Increased stable-unstable sleep transitions and VLFC duration may indicate vulnerability to cardiovascular disease due to their association with low heart rate variability that has been associated with increased mortality raising the question whether the beneficial effects of the antidepressant medication outweighs the impact on cardiopulmonary dynamics. PMID:24239431

  1. The Accuracy, Night-to-Night Variability, and Stability of Frontopolar Sleep Electroencephalography Biomarkers

    Science.gov (United States)

    Levendowski, Daniel J.; Ferini-Strambi, Luigi; Gamaldo, Charlene; Cetel, Mindy; Rosenberg, Robert; Westbrook, Philip R.

    2017-01-01

    Study Objectives: To assess the validity of sleep architecture and sleep continuity biomarkers obtained from a portable, multichannel forehead electroencephalography (EEG) recorder. Methods: Forty-seven subjects simultaneously underwent polysomnography (PSG) while wearing a multichannel frontopolar EEG recording device (Sleep Profiler). The PSG recordings independently staged by 5 registered polysomnographic technologists were compared for agreement with the autoscored sleep EEG before and after expert review. To assess the night-to-night variability and first night bias, 2 nights of self-applied, in-home EEG recordings obtained from a clinical cohort of 63 patients were used (41% with a diagnosis of insomnia/depression, 35% with insomnia/obstructive sleep apnea, and 17.5% with all three). The between-night stability of abnormal sleep biomarkers was determined by comparing each night's data to normative reference values. Results: The mean overall interscorer agreements between the 5 technologists were 75.9%, and the mean kappa score was 0.70. After visual review, the mean kappa score between the autostaging and five raters was 0.67, and staging agreed with a majority of scorers in at least 80% of the epochs for all stages except stage N1. Sleep spindles, autonomic activation, and stage N3 exhibited the least between-night variability (P sleep quality biomarkers (P sleep staging and human-scored PSG. One night's recording appeared sufficient to characterize abnormal slow wave sleep, sleep spindle activity, and heart rate variability in patients, but a 2-night average improved the assessment of all other sleep biomarkers. Commentary: Two commentaries on this article appear in this issue on pages 771 and 773. Citation: Levendowski DJ, Ferini-Strambi L, Gamaldo C, Cetel M, Rosenberg R, Westbrook PR. The accuracy, night-to-night variability, and stability of frontopolar sleep electroencephalography biomarkers. J Clin Sleep Med. 2017;13(6):791–803. PMID:28454598

  2. Behaviorally Assessed Sleep and Susceptibility to the Common Cold.

    Science.gov (United States)

    Prather, Aric A; Janicki-Deverts, Denise; Hall, Martica H; Cohen, Sheldon

    2015-09-01

    Short sleep duration and poor sleep continuity have been implicated in the susceptibility to infectious illness. However, prior research has relied on subjective measures of sleep, which are subject to recall bias. The aim of this study was to determine whether sleep, measured behaviorally using wrist actigraphy, predicted cold incidence following experimental viral exposure. A total of 164 healthy men and women (age range, 18 to 55 y) volunteered for this study. Wrist actigraphy and sleep diaries assessed sleep duration and sleep continuity over 7 consecutive days. Participants were then quarantined and administered nasal drops containing the rhinovirus, and monitored over 5 days for the development of a clinical cold (defined by infection in the presence of objective signs of illness). Logistic regression analysis revealed that actigraphy- assessed shorter sleep duration was associated with an increased likelihood of development of a clinical cold. Specifically, those sleeping cold compared to those sleeping > 7 h per night; those sleeping 6.01 to 7 h were at no greater risk (OR = 1.66; 95% CI 0.40-6.95). This association was independent of prechallenge antibody levels, demographics, season of the year, body mass index, psychological variables, and health practices. Sleep fragmentation was unrelated to cold susceptibility. Other sleep variables obtained using diary and actigraphy were not strong predictors of cold susceptibility. Shorter sleep duration, measured behaviorally using actigraphy prior to viral exposure, was associated with increased susceptibility to the common cold. © 2015 Associated Professional Sleep Societies, LLC.

  3. Sleep architecture in patients with Juvenile Myoclonic Epilepsy.

    Science.gov (United States)

    Mekky, Jaidaa F; Elbhrawy, Sonia M; Boraey, Mohamed F; Omar, Horeya M

    2017-10-01

    The aim is to analyze the sleep architecture using polysomnography (PSG) in patients with Juvenile Myoclonic Epilepsy (JME): (newly diagnosed and those on valproate drug) attending epilepsy clinic at Alexandria University Hospitals. This study involved 20 patients with JME on valproate (age: 22.40 ± 5.80 years; M:F = 6:14), 20 newly diagnosed patients (age: 18.55 ± 6.0 years; M:F = 6:14), and 20 matched healthy controls (age: 22.10 ± 5.0 years; M:F = 6:14). Clinical assessment, electroencephalogram (EEG), evaluation with comprehensive sleep questionnaire, and PSG were done for all patients. PSG showed significant alterations in sleep architecture in the total JME group in the form of reduced mean sleep efficiency (p = 0.001 ∗ ), increased mean Rapid eye movement (REM) onset latency (p = 0.046 ∗ ), decrease mean REM percentage (p = 0.011 ∗ ), increased mean wakefulness after sleep onset (p = 0.018 ∗ ), increase the index of total arousal (p = 0.005 ∗ ), increased mean periodic limb movement index (P = 0.001 ∗ ), and reduced apnea hypopnea index (P = architecture was significantly disturbed in JME, with improvement in sleep efficiency in valproate treated patients. Copyright © 2017 Elsevier B.V. All rights reserved.

  4. Sleep abnormalities in juvenile myoclonic epilepsy-A sleep questionnaire and polysomnography based study.

    Science.gov (United States)

    Roshan, Sujata; Puri, Vinod; Chaudhry, Neera; Gupta, Anu; Rabi, Sumit Kumar

    2017-08-01

    To evaluate the quality of sleep, its architecture and occurrence of epileptiform discharges with their distribution across various stages of sleep in patients of Juvenile myoclonic epilepsy (JME), both drug naïve as well as those already on treatment. 99 patients of JME [36 drug naïve, 63 on antiepileptic drug(s) (AED)], and 30 healthy controls were recruited. Sleep quality and daytime sleepiness were evaluated with Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS), respectively.Polysomnography (PSG) was done to assess the sleep architecture. The EDI (Epileptiform Discharge Index) per stage of sleep was calculated. JME patients had significantly poor quality of sleep by PSQI (p=0.02).PSG revealed reduced sleep efficiency [p<0.001], increased sleep latency [p=0.02], increased%WASO [p<0.001], increased%N1 [p=0.01] and decreased% REM sleep [p=0.002] in the patients compared to controls. Epileptiform discharges were frequent among drug naïve JME patients [drug naïve, 868 vs. 727, treatment group]. EDI was higher in N1 (p=0.001) and N2 (p=0.007) in drug naïve compared to JME patients on treatment. EDI in valproate treatment group was relatively lower to other AEDs. JME is associated with poor sleep quality and altered architecture, irrespective of treatment status. REM sleep is significantly decreased in JME patients. Epileptiform discharges are frequent in lighter NREM sleep and EDI is higher in drug naïve patients. Although AEDs disrupt the NREM sleep, their use is associated with arousal stability in lighter stages of sleep and lower EDI, in particular with valproate. Copyright © 2017 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  5. Sleep Education for Paradoxical Insomnia

    OpenAIRE

    Geyer, James D.; Lichstein, Kenneth L.; Ruiter, Megan E.; Ward, L. Charles; Paul R. Carney; Dillard, Stephenie C.

    2011-01-01

    This case study series investigated a new treatment for paradoxical insomnia patients as there is no standard treatment for this patient group at this time. Four paradoxical insomnia patients had a polysomnography (PSG) sleep study, an unsuccessful brief course of behavioral treatment for insomnia, and then a novel sleep education treatment comprising review of their PSG with video and exploration of the discrepancy between their reported and observed sleep experience. Two patients responded ...

  6. REM Sleep Phase Preference in the Crepuscular Octodon degus Assessed by Selective REM Sleep Deprivation

    Science.gov (United States)

    Ocampo-Garcés, Adrián; Hernández, Felipe; Palacios, Adrian G.

    2013-01-01

    Study Objectives: To determine rapid eye movement (REM) sleep phase preference in a crepuscular mammal (Octodon degus) by challenging the specific REM sleep homeostatic response during the diurnal and nocturnal anticrepuscular rest phases. Design: We have investigated REM sleep rebound, recovery, and documented REM sleep propensity measures during and after diurnal and nocturnal selective REM sleep deprivations. Subjects: Nine male wild-captured O. degus prepared for polysomnographic recordings Interventions: Animals were recorded during four consecutive baseline and two separate diurnal or nocturnal deprivation days, under a 12:12 light-dark schedule. Three-h selective REM sleep deprivations were performed, starting at midday (zeitgeber time 6) or midnight (zeitgeber time 18). Measurements and Results: Diurnal and nocturnal REM sleep deprivations provoked equivalent amounts of REM sleep debt, but a consistent REM sleep rebound was found only after nocturnal deprivation. The nocturnal rebound was characterized by a complete recovery of REM sleep associated with an augment in REM/total sleep time ratio and enhancement in REM sleep episode consolidation. Conclusions: Our results support the notion that the circadian system actively promotes REM sleep. We propose that the sleep-wake cycle of O. degus is modulated by a chorus of circadian oscillators with a bimodal crepuscular modulation of arousal and a unimodal promotion of nocturnal REM sleep. Citation: Ocampo-Garcés A; Hernández F; Palacios AG. REM sleep phase preference in the crepuscular Octodon degus assessed by selective REM sleep deprivation. SLEEP 2013;36(8):1247-1256. PMID:23904685

  7. Sleep characteristics of self-reported long sleepers.

    Science.gov (United States)

    Patel, Sanjay R; Blackwell, Terri; Ancoli-Israel, Sonia; Stone, Katie L

    2012-05-01

    Self-reported long habitual sleep durations (≥ 9 h per night) consistently predict increased mortality. We compared objective sleep parameters of self-reported long versus normal duration sleepers to determine whether long sleepers truly sleep more or have an underlying sleep abnormality. Older men participating in the Osteoporotic Fractures in Men Study (MrOS) were recruited for a comprehensive sleep assessment, which included wrist actigraphy, overnight polysomnography (PSG), and a question about usual nocturnal sleep duration. Of the 3134 participants (mean age 76.4 ± 5.6; 89.9% Caucasian), 1888 (60.2%) reported sleeping 7-8 h (normal sleepers) and 174 (5.6%) reported ≥ 9 h (long sleepers). On actigraphy, long sleepers spent on average 63.0 min more per night in bed (P sleep stage distribution did not differ. After adjusting for differences in demographics, comorbidities, and medication usage, self-reported long sleepers continued to spend more time in bed and sleep more, based on both actigraphy and PSG. Each additional 30 min in bed or asleep as measured by actigraphy increased the odds of being a self-reported long-sleeper 1.74-fold and 1.33-fold, respectively (P long sleepers spend more time in bed and more time asleep than normal duration sleepers. This is not explained by differences in comorbidity or sleep disorders.

  8. Chronic Stress is Prospectively Associated with Sleep in Midlife Women: The SWAN Sleep Study.

    Science.gov (United States)

    Hall, Martica H; Casement, Melynda D; Troxel, Wendy M; Matthews, Karen A; Bromberger, Joyce T; Kravitz, Howard M; Krafty, Robert T; Buysse, Daniel J

    2015-10-01

    Evaluate whether levels of upsetting life events measured over a 9-y period prospectively predict subjective and objective sleep outcomes in midlife women. Prospective cohort study. Four sites across the United States. 330 women (46-57 y of age) enrolled in the Study of Women's Health Across the Nation (SWAN) Sleep Study. N/A. Upsetting life events were assessed annually for up to 9 y. Trajectory analysis applied to life events data quantitatively identified three distinct chronic stress groups: low stress, moderate stress, and high stress. Sleep was assessed by self-report and in-home polysomnography (PSG) during the ninth year of the study. Multivariate analyses tested the prospective association between chronic stress group and sleep, adjusting for race, baseline sleep complaints, marital status, body mass index, symptoms of depression, and acute life events at the time of the Sleep Study. Women characterized by high chronic stress had lower subjective sleep quality, were more likely to report insomnia, and exhibited increased PSG-assessed wake after sleep onset (WASO) relative to women with low to moderate chronic stress profiles. The effect of chronic stress group on WASO persisted in the subsample of participants without baseline sleep complaints. Chronic stress is prospectively associated with sleep disturbance in midlife women, even after adjusting for acute stressors at the time of the sleep study and other factors known to disrupt sleep. These results are consistent with current models of stress that emphasize the cumulative effect of stressors on health over time. © 2015 Associated Professional Sleep Societies, LLC.

  9. Success Rate and Technical Quality of Home Polysomnography with Self-Applicable Electrode Set in Subjects with Possible Sleep Bruxism.

    Science.gov (United States)

    Miettinen, Tomi; Myllymaa, Katja; Westeren-Punnonen, Susanna; Ahlberg, Jari; Hukkanen, Taina; Toyras, Juha; Lappalainen, Reijo; Mervaala, Esa; Sipila, Kirsi; Myllymaa, Sami

    2017-08-18

    Using sleep laboratory polysomnography (PSG) is restricted for the diagnosis of only the most severe sleep disorders due to its low availability and high cost. Home PSG is more affordable, but applying conventional electroencephalography (EEG) electrodes increases its overall complexity and lowers the availability. Simple, self-administered single-channel EEG monitors on the other hand suffer from poor reliability. In this study, we aimed to quantify the reliability of self-administrated home PSG recordings conducted with a newly designed ambulatory electrode set (AES) that enables multi-channel EEG, electrooculography, electromyography and electrocardiography recordings. We assessed the sleep study success rate and technical quality of the recordings performed in subjects with possible sleep bruxism (SB). Thirty-two females and five males aged 39.6±11.6 years (mean±SD) with self-reported SB were recruited in the study. Self-administrated home PSG recordings with two AES designs were conducted (n=19 and 21). The technical quality of the recordings was graded based on the proportion of interpretable data. Technical failure rate for AES (both designs) was 5% and SB was scorable for 96.9% of all recorded data. Only one recording failed due to mistakes in self-applying the AES. We found that the proportion of good quality self-administrated EEG recordings is significantly higher when multiple channels are used compared to using a single channel. Sleep study success rates and proportion of recordings with high quality interpretable data from EEG channels of AES were comparable to that of conventional home PSG. Self-applicable AES has potential to become a reliable tool for widely available home PSG.

  10. Very early screening for sleep-disordered breathing in acute coronary syndrome in patients without acute heart failure.

    Science.gov (United States)

    Van den Broecke, Sandra; Jobard, Olivier; Montalescot, Gilles; Bruyneel, Marie; Ninane, Vincent; Arnulf, Isabelle; Similowski, Thomas; Attali, Valérie

    2014-12-01

    Obstructive sleep apnea (OSA) is frequently associated with acute coronary syndrome (ACS). Screening of sleep-disordered breathing (SDB) has not been previously evaluated in ACS within 72 h in intensive care settings and its management could potentially enhance patients' prognosis. This pilot study assessed the feasibility of SDB screening at the early phase of ACS. All consecutive patients admitted to the coronary care unit (CCU) for ACS without acute heart failure underwent one overnight-attended polysomnography (PSG) within 72 h after admission. A telemonitoring (TM) system was set up to remotely monitor the signals and repair faulty sensors. The 27 recordings were analyzed as respiratory polygraphy (RP) and as PSG, and the results were compared. The TM system allowed successful intervention in 48% of recordings, resulting in excellent quality PSG for 89% of cases. The prevalence of SDB [apnea-hypopnea index (AHI) ≥ 15/h] was 82% and mainly consisted of central SDB and periodic breathing, except three patients with OSA. Compared with PSG, RP underestimated AHI, probably due to the poor sleep efficiency, reduction of slow-wave sleep, and alteration of rapid eye movement sleep. An early SDB screening by remote-attended PSG is feasible in ACS patients shortly after admission to CCU. The TM enhanced the quality of PSG. A high prevalence of central SDB was noticed, for which the etiology remains unknown. Further large-scale studies are needed to determine whether central SDB is an incidental finding in early ACS and whether the presence and severity of SDB have a prognostic impact. Copyright © 2014 Elsevier B.V. All rights reserved.

  11. Prevalence and correlates of sleep disorders in Parkinson's disease: a polysomnographic study.

    Science.gov (United States)

    Alatriste-Booth, Vanessa; Rodríguez-Violante, Mayela; Camacho-Ordoñez, Azyadeh; Cervantes-Arriaga, Amin

    2015-03-01

    Sleep disorders in Parkinson's disease are very common. Polysomnography (PSG) is considered the gold standard for diagnosis. The aim of the present study is to assess the prevalence of nocturnal sleep disorders diagnosed by polysomnography and to determine the associated clinical factors. A total of 120 patients with Parkinson's disease were included. All patients underwent a standardized overnight, single night polysomnography. Ninety-four (78.3%) patients had an abnormal PSG. Half of the patients fulfilled criteria for sleep apnea-hypopnea syndrome (SAHS); rapid eye movement behavior disorder (RBD) was present in 37.5%. Characteristics associated with SAHS were age (p = 0.049) and body mass index (p = 0.016). Regarding RBD, age (p sleep disorders. Higher levodopa equivalent dose and body mass index appear to be risk factors for RBD and SAHS, respectively.

  12. Sleep and neurodegenerative diseases.

    Science.gov (United States)

    Chokroverty, Sudhansu

    2009-09-01

    Sleep disturbances are common in neurodegenerative diseases. Disturbed sleep can result in fatigue, irritability, morning headaches, impaired motor and cognitive skills, depression, and daytime somnolence. The major sleep complaints include insomnia, hypersomnia, parasomnia, excessive nocturnal motor activity, circadian sleep-wake rhythm disturbance, and respiratory dysrhythmia. The pathogenetic mechanisms of sleep disturbances may be secondary to direct structural alteration of the sleep-wake generating neurons or from several other indirect mechanisms. At the biochemical level, neurodegenerative diseases may be largely classified as tauopathies, alpha-synucleinopathies, and other diseases. Overnight polysomnography (PSG), Multiple Sleep Latency Test, Maintenance of Wakefulness Test, and actigraphy are some important diagnostic laboratory tests in the evaluation of sleep disturbances. Management of sleep disturbances is complex and is based primarily on the nature of the sleep disturbance. The clinical profiles, pathogenetic mechanisms, PSG findings, and management issues are discussed here with reference to some common neurodegenerative diseases. Thieme Medical Publishers.

  13. Consistently high sports/exercise activity is associated with better sleep quality, continuity and depth in midlife women: the SWAN sleep study.

    Science.gov (United States)

    Kline, Christopher E; Irish, Leah A; Krafty, Robert T; Sternfeld, Barbara; Kravitz, Howard M; Buysse, Daniel J; Bromberger, Joyce T; Dugan, Sheila A; Hall, Martica H

    2013-09-01

    To examine relationships between different physical activity (PA) domains and sleep, and the influence of consistent PA on sleep, in midlife women. Cross-sectional. Community-based. 339 women in the Study of Women's Health Across the Nation Sleep Study (52.1 ± 2.1 y). None. Sleep was examined using questionnaires, diaries and in-home polysomnography (PSG). PA was assessed in three domains (Active Living, Household/Caregiving, Sports/Exercise) using the Kaiser Physical Activity Survey (KPAS) up to 4 times over 6 years preceding the sleep assessments. The association between recent PA and sleep was evaluated using KPAS scores immediately preceding the sleep assessments. The association between the historical PA pattern and sleep was examined by categorizing PA in each KPAS domain according to its pattern over the 6 years preceding sleep assessments (consistently low, inconsistent/consistently moderate, or consistently high). Greater recent Sports/Exercise activity was associated with better sleep quality (diary "restedness" [P sleep continuity (diary sleep efficiency [SE; P = 0.02]) and depth (higher NREM delta electroencephalographic [EEG] power [P = 0.04], lower NREM beta EEG power [P Exercise activity was also associated with better Pittsburgh Sleep Quality Index scores (P = 0.02) and higher PSG-assessed SE (P sleep and Active Living or Household/Caregiving activity (either recent or historical pattern) were noted. Consistently high levels of recreational physical activity, but not lifestyle- or household-related activity, are associated with better sleep in midlife women. Increasing recreational physical activity early in midlife may protect against sleep disturbance in this population.

  14. Evaluation of an automated single-channel sleep staging algorithm

    Directory of Open Access Journals (Sweden)

    Wang Y

    2015-09-01

    , Total Deep Sleep, and Total REM. Results: Sensitivities of Z-PLUS compared to the PSG Consensus were 0.84 for Light Sleep, 0.74 for Deep Sleep, and 0.72 for REM. Similarly, positive predictive values were 0.85 for Light Sleep, 0.78 for Deep Sleep, and 0.73 for REM. Overall, kappa agreement of 0.72 is indicative of substantial agreement. Conclusion: This study demonstrates that Z-PLUS can automatically assess sleep stage using a single A1–A2 EEG channel when compared to the sleep stage scoring by a consensus of polysomnographic technologists. Our findings suggest that Z-PLUS may be used in conjunction with Z-ALG for single-channel EEG-based sleep staging. Keywords: EEG, sleep staging, algorithm, Zmachine, automatic sleep scoring, sleep detection, single channel

  15. Reactivity and sleep in infants: a longitudinal objective assessment.

    Science.gov (United States)

    De Marcas, Gali S; Soffer-Dudek, Nirit; Dollberg, Shaul; Bar-Haim, Yair; Sadeh, Avi

    2015-03-01

    Sleep patterns and temperament in the first year of life are closely related. However, research utilizing objective, rather than subjective measurements of sleep and temperament is scarce and results are inconsistent. In addition, a relative lack of longitudinal data prevents inference of causality between the two constructs. In this study, infant sleep was objectively assessed among 95 infants at 3, 6, and 12 months-of-age with an actigraph in the home setting. Reactivity to sound, light, and touch, a specific aspect of temperament, was behaviorally assessed at 3 and 6 months, both during sleep (at home) and during waking (at the laboratory). Expected maturational trends were recorded in sleep, with a temporal increase in sleep efficiency and percent of motionless sleep. Quadratic (i.e., inverse U shape) relations were found, especially among girls, when predicting change in sleep by reactivity thresholds, suggesting that both hyposensitive and hypersensitive infants are at risk for poor sleep quality. These are the first research findings suggesting that low reactivity in infancy might be associated with compromised sleep quality. The observed nonlinear effects may account for null or inconsistent results in previous studies that explored only linear associations between temperament and sleep. Future studies should address both extremes of the temperament continuum when exploring relations with sleep patterns. © 2015 The Society for Research in Child Development, Inc.

  16. Assessment of sleep problems in children with familial Mediterranean fever.

    Science.gov (United States)

    Makay, Balahan; Kiliçaslan, Serdar Kamer; Anik, Ahmet; Bora, Elçin; Bozkaya, Özlem; Çankaya, Tufan; Ünsal, Erbil

    2017-12-01

    This study aimed to investigate sleep patterns, sleep disturbances and possible factors that are associated with sleep disturbances among children with familial Mediterranean fever (FMF). Fifty-one patients with FMF and 84 age- and sex-matched healthy controls were enrolled in the study. The patients who had an attack during the last 2 weeks were not included. Demographic data, FMF symptoms, disease duration, dose of colchicine, disease severity score, number of attacks in the last year, MEFV mutation and serum C-reactive protein (CRP) levels were recorded for each patient. A Children's Sleep Habits Questionnaire was performed. The total sleep scores of the patients with FMF were significantly higher than the control group. Total sleep durations were similar between FMF patients and controls. Children with FMF had significantly higher scores regarding sleep-onset delay, sleep anxiety, night wakings and sleep-disordered breathing when compared to healthy controls. There was a significant positive correlation between number of attacks in the last year and sleep onset delay, night wakings and sleep disordered-breathing. Disease severity score and CRP levels were not associated with any of the subscale scores. The patients with exertional leg pain had significantly higher total sleep scores than the ones without. Furthermore, patients with exertional leg pain had significantly higher subscale scores regarding sleep onset delay, parasomnias and sleep-disordered breathing. This study showed for the first time that children with FMF had more sleep disturbances than their healthy peers. Higher numbers of attacks and exertional leg pain were associated with poor sleep quality. In conclusion, this study underlines the need to assess and manage sleep problems in children with FMF. © 2014 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.

  17. PSG gene expression is up-regulated by lysine acetylation involving histone and nonhistone proteins.

    Directory of Open Access Journals (Sweden)

    Soledad A Camolotto

    Full Text Available BACKGROUND: Lysine acetylation is an important post-translational modification that plays a central role in eukaryotic transcriptional activation by modifying chromatin and transcription-related factors. Human pregnancy-specific glycoproteins (PSG are the major secreted placental proteins expressed by the syncytiotrophoblast at the end of pregnancy and represent early markers of cytotrophoblast differentiation. Low PSG levels are associated with complicated pregnancies, thus highlighting the importance of studying the mechanisms that control their expression. Despite several transcription factors having been implicated as key regulators of PSG gene family expression; the role of protein acetylation has not been explored. METHODOLOGY/PRINCIPAL FINDINGS: Here, we explored the role of acetylation on PSG gene expression in the human placental-derived JEG-3 cell line. Pharmacological inhibition of histone deacetylases (HDACs up-regulated PSG protein and mRNA expression levels, and augmented the amount of acetylated histone H3 associated with PSG 5'regulatory regions. Moreover, PSG5 promoter activation mediated by Sp1 and KLF6, via the core promoter element motif (CPE, -147/-140, was markedly enhanced in the presence of the HDAC inhibitor trichostatin A (TSA. This effect correlated with an increase in Sp1 acetylation and KLF6 nuclear localization as revealed by immunoprecipitation and subcellular fractionation assays. The co-activators PCAF, p300, and CBP enhanced Sp1-dependent PSG5 promoter activation through their histone acetylase (HAT function. Instead, p300 and CBP acetyltransferase domain was dispensable for sustaining co-activation of PSG5 promoter by KLF6. CONCLUSIONS/SIGNIFICANCE: Results are consistent with a regulatory role of lysine acetylation on PSG expression through a relaxed chromatin state and an increase in the transcriptional activity of Sp1 and KLF6 following an augmented Sp1 acetylation and KLF6 nuclear localization.

  18. Sleep disordered breathing and sleep quality in children with bronchiolitis obliterans.

    Science.gov (United States)

    Uyan, Zeynep S; Turan, Ihsan; Ay, Pinar; Cakir, Erkan; Ozturk, Ersin; Gedik, Ahmet H; Gokdemir, Yasemin; Erdem, Ela; Şen, Velat; Karadag, Bulent; Karakoc, Fazilet; Ersu, Refika

    2016-03-01

    The incidence of sleep-disordered breathing (SDB) increases in chronic lung diseases. Our aim was to evaluate SDB and sleep quality in children with postinfectious bronchiolitis obliterans (BO) and assess associated risk factors. We hypothesized that children with BO are at increased risk for SDB and have impaired sleep quality. We also hypothesized that severity of SDB and impairment of sleep quality is related to the severity of lung disease. Sleep Related Breathing Disorder (SRBD) subscale of the Pediatric Sleep Questionnaire (PSQ) and Pittsburgh Sleep Quality Index (PSQI) questionnaires; spirometry, impulse oscillometry (IOS), and overnight polysomnography (PSG) were performed. Twenty-one patients (14 male, median age: 8.3 years) were enrolled. Five patients (25%) had a PSQ score of >0.33, predictive of a SDB. Ten patients (48%) had poor sleep quality. Four patients (19%) had an OAHI of >1/hr. Nineteen patients (90%) had a high desaturation index. Four patients (19%) had a mean oxygen saturation of <93%. Median central apnea time was 7.5 (IQR: 6.9-9.1) seconds. Central apnea index of the patients correlated positively with R5, R10, R15, R20, Z5, and negatively with X10 and X15 at IOS. There was a positive correlation between the lowest oxygen saturation and FVC, FEV1 , X5, X10, X15, X20 while there was a negative correlation between lowest saturation and the central apnea index at PSG, R5, R10, and Z5 at IOS. Mean oxygen saturation during PSG correlated positively with FVC, FEV1, FEF(25-75), X5, X10, X15, X20 results. The risk of nocturnal hypoxia is increased in patients with BO and correlated to the severity of lung disease determined by pulmonary function tests. Although BO patients have a shorter duration of central apneas, they are more prone to desaturate. © 2015 Wiley Periodicals, Inc.

  19. Noninvasive Ventilation Improves Sleep in Amyotrophic Lateral Sclerosis: A Prospective Polysomnographic Study

    Science.gov (United States)

    Vrijsen, Bart; Buyse, Bertien; Belge, Catharina; Robberecht, Wim; Van Damme, Philip; Decramer, Marc; Testelmans, Dries

    2015-01-01

    Study Objective: To evaluate the effects of noninvasive ventilation (NIV) on sleep in patients with amyotrophic lateral sclerosis (ALS) after meticulous titration with polysomnography (PSG). Methods: In this prospective observational study, 24 ALS patients were admitted to the sleep laboratory during 4 nights for in-hospital NIV titration with PSG and nocturnal capnography. Questionnaires were used to assess subjective sleep quality and quality of life (QoL). Patients were readmitted after one month. Results: In the total group, slow wave sleep and REM sleep increased and the arousal-awakening index improved. The group without bulbar involvement (non-bulbar) showed the same improvements, together with an increase in sleep efficiency. Nocturnal oxygen and carbon dioxide levels improved in the total and non-bulbar group. Except for oxygen saturation during REM sleep, no improvement in respiratory function or sleep structure was found in bulbar patients. However, these patients showed less room for improvement. Patient-reported outcomes showed improvement in sleep quality and QoL for the total and non-bulbar group, while bulbar patients only reported improvements in very few subscores. Conclusions: This study shows an improvement of sleep architecture, carbon dioxide, and nocturnal oxygen saturation at the end of NIV titration and after one month of NIV in ALS patients. More studies are needed to identify the appropriate time to start NIV in bulbar patients. Our results suggest that accurate titration of NIV by PSG improves sleep quality. Commentary: A commentary on this article appears in this issue on page 511. Citation: Vrijsen B, Buyse B, Belge C, Robberecht W, Van Damme P, Decramer M, Testelmans D. Noninvasive ventilation improves sleep in amyotrophic lateral sclerosis: a prospective polysomnographic study. J Clin Sleep Med 2015;11(5):559–566. PMID:25766713

  20. Practice Parameters for the Non-Respiratory Indications for Polysomnography and Multiple Sleep Latency Testing for Children

    Science.gov (United States)

    Aurora, R. Nisha; Lamm, Carin I.; Zak, Rochelle S.; Kristo, David A.; Bista, Sabin R.; Rowley, James A.; Casey, Kenneth R.

    2012-01-01

    Background: Although a level 1 nocturnal polysomnogram (PSG) is often used to evaluate children with non-respiratory sleep disorders, there are no published evidence-based practice parameters focused on the pediatric age group. In this report, we present practice parameters for the indications of polysomnography and the multiple sleep latency test (MSLT) in the assessment of non-respiratory sleep disorders in children. These practice parameters were reviewed and approved by the Board of Directors of the American Academy of Sleep Medicine (AASM). Methods: A task force of content experts was appointed by the AASM to review the literature and grade the evidence according to the American Academy of Neurology grading system. Recommendations For PSG and MSLT Use: PSG is indicated for children suspected of having periodic limb movement disorder (PLMD) for diagnosing PLMD. (STANDARD) The MSLT, preceded by nocturnal PSG, is indicated in children as part of the evaluation for suspected narcolepsy. (STANDARD) Children with frequent NREM parasomnias, epilepsy, or nocturnal enuresis should be clinically screened for the presence of comorbid sleep disorders and polysomnography should be performed if there is a suspicion for sleep-disordered breathing or periodic limb movement disorder. (GUIDELINE) The MSLT, preceded by nocturnal PSG, is indicated in children suspected of having hypersomnia from causes other than narcolepsy to assess excessive sleepiness and to aid in differentiation from narcolepsy. (OPTION) The polysomnogram using an expanded EEG montage is indicated in children to confirm the diagnosis of an atypical or potentially injurious parasomnia or differentiate a parasomnia from sleep-related epilepsy (OPTION) Polysomnography is indicated in children suspected of having restless legs syndrome (RLS) who require supportive data for diagnosing RLS. (OPTION) Recommendations Against PSG Use: Polysomnography is not routinely indicated for evaluation of children with sleep

  1. Sleep architecture of consolidated and split sleep due to the dawn (Fajr prayer among Muslims and its impact on daytime sleepiness

    Directory of Open Access Journals (Sweden)

    Ahmed S BaHammam

    2012-01-01

    Full Text Available Background: Muslims are required to wake up early to pray (Fajr at dawn (approximately one and one-half hours before sunrise. Some Muslims wake up to pray Fajr and then sleep until it is time to work (split sleep, whereas others sleep continuously (consolidated sleep until work time and pray Fajr upon awakening. Aim: To objectively assess sleep architecture and daytime sleepiness in consolidated and split sleep due to the Fajr prayer. Setting and Design: A cross-sectional, single-center observational study in eight healthy male subjects with a mean age of 32.0 ± 2.4 years. Methods: The participants spent three nights in the Sleep Disorders Center (SDC at King Khalid University Hospital, where they participated in the study, which included (1 a medical checkup and an adaptation night, (2 a consolidated sleep night, and (3 a split-sleep night. Polysomnography (PSG was conducted in the SDC following the standard protocol. Participants went to bed at 11:30 PM and woke up at 7:00 AM in the consolidated sleep protocol. In the split-sleep protocol, participants went to bed at 11:30 PM, woke up at 3:30 AM for 45 minutes, went back to bed at 4:15 AM, and finally woke up at 7:45 AM. PSG was followed by a multiple sleep latency test to assess the daytime sleepiness of the participants. Results: There were no differences in sleep efficiency, the distribution of sleep stages, or daytime sleepiness between the two protocols. Conclusion: No differences were detected in sleep architecture or daytime sleepiness in the consolidated and split-sleep schedules when the total sleep duration was maintained.

  2. The effects of sleep quality and sleep quantity on concussion baseline assessment.

    Science.gov (United States)

    Mihalik, Jason P; Lengas, Eric; Register-Mihalik, Johna K; Oyama, Sakiko; Begalle, Rebecca L; Guskiewicz, Kevin M

    2013-09-01

    Proper concussion assessment is imperative for properly caring for athletes who sustain traumatic brain injuries. Decreased sleep quality and sleep quantity affect cognition and may threaten the validity of clinical measures often used as a part of the concussion assessment. The purpose of this study was to determine if sleep quality or sleep quantity affects performance on clinical measures of concussion. Prospective cohort design. Clinical research center. One hundred fifty-five college student-athletes (57 females, 98 males; age = 18.8 ± 0.8 years; mass = 78.4 ± 19.6 kg; height = 177.4 ± 12.3 cm). We performed preseason baseline testing by using a well-accepted and multifaceted protocol inclusive of neurocognition, balance performance, and symptom reporting. Information related to sleep quality and sleep quantity was also collected during preseason baseline testing. The CNS Vital Signs battery (computerized neurocognitive test), Sensory Organization Test (computerized dynamic posturography), and a Graded Symptom Checklist (symptom evaluation) were used. Subjects with a low sleep quantity the night before baseline reported both a greater number of symptoms and higher total symptom severity score. No clinically significant effects for sleep quality were observed. Sleep-deprived athletes reporting for baseline testing should be rescheduled for testing after a normal night's sleep.

  3. Short Sleep and Adolescents' Performance on a Concussion Assessment Battery: An Experimental Sleep Manipulation Study.

    Science.gov (United States)

    Beebe, Dean W; Powers, Scott W; Slattery, Eric W; Gubanich, Paul J

    2017-07-21

    Correlational studies have linked short sleep to adolescents' report of postconcussion symptoms and cognitive performance during concussion assessments. This study tested whether those are cause-effect relationships. Three-week randomly counterbalanced, within-subjects, crossover experiment. Adolescents slept at home with weekly visits to an outpatient clinic for sleep monitor uploads and outcome assessments. Twenty-four healthy 14- to 17.9-year-olds. After an initial sleep-stabilization period, adolescents experienced 5-night spans of short sleep (SS; 6.5 hours/night in bed) versus Healthy Sleep Opportunity (HS; 9.5 hours/night in bed). Cognitive indexes and the postconcussion symptom scale (PCSS) from the Immediate PostConcussion Assessment and Cognitive Testing. Adolescents reported significantly worse symptoms on the PCSS after SS than HS, even after excluding items manifestly related to sleep. Verbal memory was also worse after SS than HS, though the effect was small. The manipulation did not significantly affect other cognitive indexes. A realistic "dose" of short sleep, similar to what many adolescents experience regularly on school nights, can cause or contribute to symptom reports during concussion assessments. Consistent with previous sleep research, one-on-one cognitive tests seem to be less sensitive than measures of emotional and behavioral functioning to the effects of short sleep.

  4. Sexsomnia: A case of sleep masturbation documented by video-polysomnography in a young adult male with sleepwalking.

    Science.gov (United States)

    Yeh, Shih-Bin; Schenck, Carlos H

    2016-01-01

    The first case of video-polysomnography (vPSG) documented sleep masturbation in a male is reported, and the second reported case of shift work induced sexsomnia. A 20 y.o. soldier with childhood sleepwalking (SW) developed sleep masturbation and SW triggered by military shift work. vPSG documented two episodes of sleep masturbation from N2 sleep in the fourth sleep cycle and from N3 sleep during the fifth sleep cycle. There was no sleep-disordered breathing nor periodic limb movements. vPSG thus confirmed confusional arousals from NREM sleep as the cause of the masturbation. Bedtime clonazepam therapy controlled the SW but not the masturbation.

  5. Sleep

    Science.gov (United States)

    ... REM sleep? What is the effect of sleep deprivation? What are sleep myths? What are sleep disorders? ... Some hormones produced during sleep affect the body's use of energy. This may be how inadequate sleep ...

  6. Assessment of SOMNOwatch plus EEG for sleep monitoring in healthy individuals.

    Science.gov (United States)

    Voinescu, Bogdan Ioan; Wislowska, Malgorzata; Schabus, Manuel

    2014-06-10

    Polysomnography (PSG) is still the standard in sleep monitoring, with several alternative solutions developed, including simplified electroencephalographic recorders such as SOMNOwatch plus EEG. In this study, we aimed to evaluate the validity of the recordings and of the analysis of the proprietary software of this solution, compared to PSG and semiautomatic scoring, respectively. From thirteen healthy adults, we recorded 27 nights simultaneously with a classical EEG amplifier (NeuroScan system) and the ambulatory SOMNOwatch plus EEG. Thereafter, we performed (semi-) automatic sleep analysis in Somnolyzer 24x7 and DOMINO Light (SOMNOwatch software). AASM scoring sensitivity of SOMNOwatch plus EEG, as revealed by Somnolyzer 24x7, was 97.79%, and specificity 87.19%. Paired T tests revealed no significant differences between the recordings of the two EEG systems, with intraclass correlation coefficients ranging from moderate to very good. When data were analyzed in DOMINO Light, sensitivity was 92.99% and specificity was 80.90%. Our data suggest that SOMNOwatch plus EEG might serve as a reliable instrument for recording sleep in healthy individuals, but its proprietary software, DOMINO Light, still seems to have weaknesses in terms of automatic sleep staging. Copyright © 2014 Elsevier Inc. All rights reserved.

  7. Relationships between Menopausal and Mood Symptoms and EEG Sleep Measures in a Multi-ethnic Sample of Middle-Aged Women: The SWAN Sleep Study

    Science.gov (United States)

    Kravitz, Howard M.; Avery, Elizabeth; Sowers, MaryFran; Bromberger, Joyce T.; Owens, Jane F.; Matthews, Karen A.; Hall, Martica; Zheng, Huiyong; Gold, Ellen B.; Buysse, Daniel J.

    2011-01-01

    Study Objectives: Examine associations of vasomotor and mood symptoms with visually scored and computer-generated measures of EEG sleep. Design: Cross-sectional analysis. Setting: Community-based in-home polysomnography (PSG). Participants: 343 African American, Caucasian, and Chinese women; ages 48–58 years; pre-, peri- or post-menopausal; participating in the Study of Women's Health Across the Nation Sleep Study (SWAN Sleep Study). Interventions: None. Measurements and Results: Measures included PSG-assessed sleep duration, continuity, and architecture, delta sleep ratio (DSR) computed from automated counts of delta wave activity, daily diary-assessed vasomotor symptoms (VMS), questionnaires to collect mood (depression, anxiety) symptoms, medication, and lifestyle information, and menopausal status using bleeding criteria. Sleep outcomes were modeled using linear regression. Nocturnal VMS were associated with longer sleep time. Higher anxiety symptom scores were associated with longer sleep latency and lower sleep efficiency, but only in women reporting nocturnal VMS. Contrary to expectations, VMS and mood symptoms were unrelated to either DSR or REM latency. Conclusions: Vasomotor symptoms moderated associations of anxiety with EEG sleep measures of sleep latency and sleep efficiency and was associated with longer sleep duration in this multi-ethnic sample of midlife women. Citation: Kravitz HM; Avery E; Sowers MF; Bromberger JT; Owens JF; Matthews KA; Hall M; Zheng H; Gold EB; Buysse DJ. Relationships between menopausal and mood symptoms and Eeg sleep measures in a multi-ethnic sample of middle-aged women: the SWAN Sleep Study. SLEEP 2011;34(9):1221-1232. PMID:21886360

  8. Monitoring sleep depth: analysis of bispectral index (BIS) based on polysomnographic recordings and sleep deprivation.

    Science.gov (United States)

    Giménez, Sandra; Romero, Sergio; Alonso, Joan Francesc; Mañanas, Miguel Ángel; Pujol, Anna; Baxarias, Pilar; Antonijoan, Rosa Maria

    2017-02-01

    The assessment and management of sleep are increasingly recommended in the clinical practice. Polysomnography (PSG) is considered the gold standard test to monitor sleep objectively, but some practical and technical constraints exist due to environmental and patient considerations. Bispectral index (BIS) monitoring is commonly used in clinical practice for guiding anesthetic administration and provides an index based on relationships between EEG components. Due to similarities in EEG synchronization between anesthesia and sleep, several studies have assessed BIS as a sleep monitor with contradictory results. The aim of this study was to evaluate objectively both the feasibility and reliability of BIS for sleep monitoring through a robust methodology, which included full PSG recordings at a baseline situation and after 40 h of sleep deprivation. Results confirmed that the BIS index was highly correlated with the hypnogram (0.89 ± 0.02), showing a progressive decrease as sleep deepened, and an increase during REM sleep (awake: 91.77 ± 8.42; stage N1: 83.95 ± 11.05; stage N2: 71.71 ± 11.99; stage N3: 42.41 ± 9.14; REM: 80.11 ± 8.73). Mean and median BIS values were lower in the post-deprivation night than in the baseline night, showing statistical differences for the slow wave sleep (baseline: 42.41 ± 9.14 vs. post-deprivation: 39.49 ± 10.27; p = 0.02). BIS scores were able to discriminate properly between deep (N3) and light (N1, N2) sleep. BIS values during REM overlapped those of other sleep stages, although EMG activity provided by the BIS monitor could help to identify REM sleep if needed. In conclusion, BIS monitors could provide a useful measure of sleep depth in especially particular situations such as intensive care units, and they could be used as an alternative for sleep monitoring in order to reduce PSG-derived costs and to increase capacity in ambulatory care.

  9. Sleep Quality Assessment and Daytime Sleepiness of Liver Transplantation Candidates.

    Science.gov (United States)

    Marques, D M; Teixeira, H R S; Lopes, A R F; Martins-Pedersoli, T A; Ziviani, L C; Mente, Ê D; Castro-E-Silva, O; Galvão, C M; Mendes, K S

    2016-09-01

    The goal of this study was to evaluate the sleep quality and daytime sleepiness of patients eligible for liver transplants. A cross-sectional prospective study was conducted on liver transplant candidates from a transplant center in the interior of São Paulo State. The Pittsburgh Sleep Quality Index and Epworth Sleepiness Scale questionnaires were applied to obtain demographic and clinical characteristics and to assess sleep quality and daytime sleepiness. The mean (±SD) score on the Epworth Sleepiness Scale of the 45 liver transplantation candidates was 7.00 ± 2.83 points, with 28.89% having scores >10 points, indicating excessive daytime sleepiness. The mean score on the Pittsburgh Sleep Quality Index was 6.64 ± 4.95 points, with 60% of the subjects showing impaired sleep quality, with scores >5 points. The average sleep duration was 07:16 h. Regarding sleep quality self-classification, 31.11% reported poor or very poor quality. It is noteworthy that 73.33% of patients had to go to the bathroom, 53.33% woke up in the middle of the night, and 40.00% reported pain related to sleeping difficulties. Comparison of subjects with good and poor sleep quality revealed a significant difference in time to sleep (P = .0002), sleep hours (P = .0003), and sleep quality self-classification (P = .000072). Liver transplant candidates have a compromised quality of sleep and excessive daytime sleepiness. In clinical practice, we recommend the evaluation and implementation of interventions aimed at improving the sleep and wakefulness cycle, contributing to a better quality of life. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Isolated sleep paralysis elicited by sleep interruption.

    Science.gov (United States)

    Takeuchi, T; Miyasita, A; Sasaki, Y; Inugami, M; Fukuda, K

    1992-06-01

    We elicited isolated sleep paralysis (ISP) from normal subjects by a nocturnal sleep interruption schedule. On four experimental nights, 16 subjects had their sleep interrupted for 60 minutes by forced awakening at the time when 40 minutes of nonrapid eye movement (NREM) sleep had elapsed from the termination of rapid eye movement (REM) sleep in the first or third sleep cycle. This schedule produced a sleep onset REM period (SOREMP) after the interruption at a high rate of 71.9%. We succeeded in eliciting six episodes of ISP in the sleep interruptions performed (9.4%). All episodes of ISP except one occurred from SOREMP, indicating a close correlation between ISP and SOREMP. We recorded verbal reports about ISP experiences and recorded the polysomnogram (PSG) during ISP. All of the subjects with ISP experienced inability to move and were simultaneously aware of lying in the laboratory. All but one reported auditory/visual hallucinations and unpleasant emotions. PSG recordings during ISP were characterized by a REM/W stage dissociated state, i.e. abundant alpha electroencephalographs and persistence of muscle atonia shown by the tonic electromyogram. Judging from the PSG recordings, ISP differs from other dissociated states such as lucid dreaming, nocturnal panic attacks and REM sleep behavior disorders. We compare some of the sleep variables between ISP and non-ISP nights. We also discuss the similarities and differences between ISP and sleep paralysis in narcolepsy.

  11. Actigraphy-assessed sleep during school and vacation periods: a naturalistic study of restricted and extended sleep opportunities in adolescents.

    Science.gov (United States)

    Bei, Bei; Allen, Nicholas B; Nicholas, Christian L; Dudgeon, Paul; Murray, Greg; Trinder, John

    2014-02-01

    School-related sleep restriction in adolescents has been identified by studies comparing weekday and weekend sleep. This study compared weekday and vacation sleep to assess restricted and extended sleep opportunities. One-hundred and forty-six adolescents (47.3% male) aged 16.2 ± 1.0 years (M ± SD) from the general community wore an actigraph continuously for 4 weeks: the last week of a school term (Time-E), the following 2-week vacation, and the first week of the next term. Self-reported sleep was assessed for each of the three time intervals, and chronotype was assessed using the Morningness-Eveningness Questionnaire at Time-E. Daily actigraphy bedtime, rise-time, time-in-bed, total sleep time, sleep onset latency, sleep efficiency, and % wake after sleep onset were analysed using latent growth curve modelling. The removal of school-related sleep restriction was associated with an abrupt delay in sleep timing and increase in sleep duration. Subsequently, bedtime and rise-time showed further linear delays throughout the vacation, while changes in time-in-bed were non-significant. Sleep onset latency increased linearly, peaking in the middle of the second vacation week. Across the first vacation week, total sleep time and sleep efficiency linearly decreased, while % wake after sleep onset increased. These changes stabilized during the second vacation week. Older age and eveningness were associated with later bedtime and rise-time, whilst females had longer time-in-bed, total sleep time and sleep onset latency. Compared with school days, sleep during the vacation was characterized by later timing, longer duration, lower quality and greater variability. Recovery from school-related sleep restriction appeared to be completed within the 2 weeks of naturalistic extended sleep. © 2013 European Sleep Research Society.

  12. A descriptive study to assess the impact of surgical stomas on individuals' sleep perceptions & response to sleep hygiene.

    Science.gov (United States)

    Vorbeck, Ellen; Willette-Murphy, Karen; Meiers, Sonja; Rudel, Rebecca; Alakhras, Mazen

    2010-01-01

    Multiple factors affect the sleep quality of individuals with surgically created stomas. Using Rogers' Diffusion of Innovation as the theoretical framework, a study was conducted to: 1) assess subjective sleep quality perceptions and objective sleep measurement in adults with stomas, 2) determine if there is a correlation between subjective and objective measurement of sleep in this group, and 3) implement a stoma-specific sleep hygiene intervention to improve these sleep quality perceptions. Subjective assessment focused on sleep subset questions from the Stoma Quality of Life Index (SQOLI) and the Pittsburgh Sleep Quality Index (PSQI). Respondents' (n = 26) subjective sleep scores were 7.23 mean global score on seven questions (PSQI, range: 0 [no difficulty sleeping] to 3 [severe difficulty sleeping], total 0 to 21) with a mean score of 7.32 on three questions (SQOLI, range 1 [severe difficulty sleeping] to 4 [no difficulty sleeping], total 0 to 12) on sleep subset questions; composite scores of 5 or greater (PSQI) and 3 or less (SQOLI) indicating sleep problems. Scores showed that adults with stomas have increased sleep disruption and poor sleep quality. Five respondents who met intervention enrollment criteria participated in an objective sleep assessment using actigraphy, overnight oxygenation studies, and a 4-week sleep hygiene intervention. Mean PSQI score improved by 1.20 but the difference was not statistically significant. Because the results of this study confirm that sleep problems are common in older adults with a stoma, larger sample size studies of >4 weeks' duration are warranted. Until additional research results are available, the existence of sleep quality and overnight pouching concerns should be recognized and use of the low-cost, easy-to-use, stoma-specific sleep hygiene intervention considered.

  13. Sleep quality assessment using polysomnography in children on regular hemodialysis

    Directory of Open Access Journals (Sweden)

    Ahmed M El-Refaey

    2013-01-01

    Full Text Available Studies examining sleep patterns in children on hemodialysis (HD are lacking. This cross-sectional, control-matched group study was performed to assess the sleep quality in children on HD. The assessment was made using a subjective sleep assessment and sleep questionnaire and objective analysis was made using full night polysomnography. A total of 25 children with end-stage renal disease (ESRD on HD were compared with 15 age- and sex-matched controls. The average age of the cases was 14 ± 4 years, 52% were males and the mean body mass index was 20 ± 3.8 kg/m². The average duration on dialysis was 2.6 ± 2 years. Analysis of subjective data revealed markedly affected sleep quality in HD patients, as evidenced by excessive day time sleepiness (P <0.005, night awakening (P <0.005, difficult morning arousal (P <0.005 and limb pains (P <0.005. Objective analysis showed differences in sleep architecture, less slow wave sleep in HD children, similar rapid eye movement and non-rapid eye movement, more sleep disordered breathing (P <0.0001 and more periodic limb movement disorders (P <0.0001. Our study suggests that children on regular HD have markedly affected objective as well as subjective quality of sleep.

  14. Sleep and melatonin secretion abnormalities in children and adolescents with fetal alcohol spectrum disorders.

    Science.gov (United States)

    Goril, Shery; Zalai, Dora; Scott, Louise; Shapiro, Colin M

    2016-07-01

    Caregivers describe significant sleep disturbances in the vast majority of children and adolescents, which is diagnosed as fetal alcohol spectrum disorders (FASD), but objective data on sleep disorders in this population are almost completely lacking. Animal models suggest that intrauterine alcohol exposure may disrupt sleep wake patterns, cause sleep fragmentation, and specifically affect the suprachiasmatic nucleus, thus disrupting melatonin secretion. The objective of this pioneering study was to evaluate sleep and melatonin abnormalities in children with FASD using objective, gold-standard measures. Children and adolescents (N = 36, 6-18 years) with FASD participated in clinical assessments by sleep specialists, overnight polysomnography (PSG), and a dim light melatonin onset (DLMO) test in a pediatric sleep laboratory. PSG was analyzed according to standardized scoring guidelines and sleep architecture was compared with normative data. DLMOs were determined and melatonin secretion curves were evaluated qualitatively to classify melatonin profiles. Sleep disorders were evaluated according to international diagnostic criteria. There was a high prevalence (58%) of sleep disorders. The most common sleep problems were parasomnias (27.9%) and insomnia (16.8%). The sleep studies showed lower than normal sleep efficiency and high rates of sleep fragmentation. Most participants (79%) had an abnormal melatonin profile. This study led to the recognition that both sleep and melatonin secretion abnormalities are present in children with FASD. Therefore, to be effective in managing the sleep problems in children with FASD, one needs to consider both the sleep per se and a possible malfunction of the circadian regulation. Copyright © 2016 Elsevier B.V. All rights reserved.

  15. Segmented sleep in a nonelectric, small-scale agricultural society in Madagascar.

    Science.gov (United States)

    Samson, David R; Manus, Melissa B; Krystal, Andrew D; Fakir, Efe; Yu, James J; Nunn, Charles L

    2017-07-08

    We studied sleep in a rural population in Madagascar to (i) characterize sleep in an equatorial small-scale agricultural population without electricity, (ii) assess whether sleep is linked to noise levels in a dense population, and (iii) examine the effects of experimentally introduced artificial light on sleep timing. Using actigraphy, sleep-wake patterns were analyzed for both daytime napping and nighttime wakefulness in 21 participants for a sum total of 292 days. Functional linear modeling was used to characterize 24-h time-averaged circadian patterns and to investigate the effect of experimentally introduced mobile field lights on sleep timing. We also obtained the first polysomnography (PSG) recordings of sleep in a traditional population. In every measure of sleep duration and quality, the Malagasy population experienced shorter and lower quality sleep when compared to similarly measured postindustrial values. The population slept for a total of 6.5 h per night and napped during 89% of recorded days. We observed a peak in activity after midnight for both sexes on 49% of nights, consistent with segmented sleep. Access to mobile field lights had no statistical effect on nighttime sleep timing. From PSG, we documented relatively short rapid eye movement (14%), poor sleep efficiency (66%), and high wake after sleep onset (162 min). Sleep in this population is segmented, similar to the "first" sleep and "second" sleep reported in the historical record. Moreover, although average sleep duration and quality were lower than documented in Western populations, circadian rhythms were more stable across days. © 2017 Wiley Periodicals, Inc.

  16. Sleep assessment of children with cerebral palsy: Using validated sleep questionnaire

    Directory of Open Access Journals (Sweden)

    Riad M Elsayed

    2013-01-01

    Full Text Available Background: On the basis of clinical experience, it seems that sleep disturbances are common in children with cerebral palsy (CP; however, there is a lack of research and objective data to support this observation. Aim of Work: Our aim was to assess sleep of children with cerebral palsy, using validated sleep questionnaire. Subjects and Methods: one hundred children with diagnosis of CP were investigated via sleep questionnaires, with their ages from 2-12 years. The 100 children with CP were divided into two groups, pre-school group (52 children had a mean age 2.35 ± 1.04 years and school ages group (48 children had a mean age 10.21 ± 3.75 years. Results: We found high incidence of sleep problem in both pre-school and school age groups. We found that pre-school children have more prevalence of early insomnia (46.2%, P value 0.028 and sleep bruxism (50%, P value 0.000, while school group suffer more sleep disordered breathing (SDB (50%, P value 0.001, more nightmares (50%, P value 0.001, more sleep talking (12.5% P value 0.049, and more excessive daytime sleepiness (EDS (62.5%, P value 0.001. Conclusion: Results of our study indicate that CP children have high incidence of sleep problem in both pre-school and school age groups.

  17. A description of sleep behaviour in healthy late pregnancy, and the accuracy of self-reports.

    Science.gov (United States)

    McIntyre, Jordan P R; Ingham, Cayley M; Hutchinson, B Lynne; Thompson, John M D; McCowan, Lesley M; Stone, Peter R; Veale, Andrew G; Cronin, Robin; Stewart, Alistair W; Ellyett, Kevin M; Mitchell, Edwin A

    2016-05-18

    The importance of maternal sleep and its contribution to maternal and fetal health during pregnancy is increasingly being recognised. However, the ability to accurately recall sleep practices during pregnancy has been questioned. The aim of this study is to test the accuracy of recall of normal sleep practices in late pregnancy. Thirty healthy women between 35 and 38 weeks of gestation underwent level III respiratory polysomnography (PSG) with infrared digital video recordings in their own homes. Data regarding sleep positions, number of times getting out of bed during the night and respiratory measures were collected. A sleep questionnaire was administered the morning after the recorded sleep. Continuous data were assessed using Spearman's Rho and Bland-Altman. Cohen's Kappa was used to assess recall in the categorical variables. Two-thirds of participants went to sleep on their left side. There was good agreement in sleep onset position between video and questionnaire data (Kappa 0.52), however the there was poor agreement on position on wakening (Kappa 0.24). The number of times getting out of bed during the night was accurately recalled (Kappa 0.65). Twenty five out of 30 participants snored as recorded by PSG. Questionnaire data was inaccurate for this measure. Bland-Altman plots demonstrated acceptable agreement between video and questionnaire data for estimated sleep duration, but not the time taken to fall asleep (sleep latency). One participant had mild obstructive sleep apnoea and another probable high upper airways resistance. Sleep onset position, sleep duration and the number of times getting out of bed during the night were accurately recalled, but sleep latency and sleep position on waking were not. This study identifies the sleep variables that can be accurately obtained by questionnaire and those that cannot.

  18. Continuous positive airway pressure improves sleep and daytime sleepiness in patients with Parkinson disease and sleep apnea.

    Science.gov (United States)

    Neikrug, Ariel B; Liu, Lianqi; Avanzino, Julie A; Maglione, Jeanne E; Natarajan, Loki; Bradley, Lenette; Maugeri, Alex; Corey-Bloom, Jody; Palmer, Barton W; Loredo, Jose S; Ancoli-Israel, Sonia

    2014-01-01

    Obstructive sleep apnea (OSA), common in Parkinson disease (PD), contributes to sleep disturbances and daytime sleepiness. We assessed the effect of continuous positive airway pressure (CPAP) on OSA, sleep, and daytime sleepiness in patients with PD. This was a randomized placebo-controlled, crossover design. Patients with PD and OSA were randomized into 6 w of therapeutic treatment or 3 w of placebo followed by 3 w of therapeutic treatment. Patients were evaluated by polysomnography (PSG) and multiple sleep latency test (MSLT) pretreatment (baseline), after 3 w, and after 6 w of CPAP treatment. Analyses included mixed models, paired analysis, and within-group analyses comparing 3 w to 6 w of treatment. Sleep laboratory. Thirty-eight patients with PD (mean age = 67.2 ± 9.2 y; 12 females). Continuous positive airway pressure. PSG OUTCOME MEASURES: sleep efficiency, %sleep stages (N1, N2, N3, R), arousal index, apnea-hypopnea index (AHI), and % time oxygen saturation sleep-onset latency (MSL). There were significant group-by-time interactions for AHI (P treatment of OSA, improvement in nighttime oxygenation, and in deepening sleep. The paired sample analyses revealed that 3 w of therapeutic treatment resulted in significant decreases in arousal index (t = 3.4, P = 0.002). All improvements after 3 w were maintained at 6 w. Finally, 3 w of therapeutic CPAP also resulted in overall decreases in daytime sleepiness (P = 0.011). Therapeutic continuous positive airway pressure versus placebo was effective in reducing apnea events, improving oxygen saturation, and deepening sleep in patients with Parkinson disease and obstructive sleep apnea. Additionally, arousal index was reduced and effects were maintained at 6 weeks. Finally, 3 weeks of continuous positive airway pressure treatment resulted in reduced daytime sleepiness measured by multiple sleep latency test. These results emphasize the importance of identifying and treating obstructive sleep apnea in patients with

  19. Longitudinal evaluation of sleep disordered breathing in infants with Prader-Willi syndrome.

    Science.gov (United States)

    Khayat, Abdullah; Narang, Indra; Bin-Hasan, Saadoun; Amin, Reshma; Al-Saleh, Suhail

    2017-07-01

    To evaluate the course of sleep disordered breathing (SDB) in infants with Prader-Willi syndrome (PWS). Retrospective longitudinal observational study. Sleep laboratory at The Hospital for Sick Children, Toronto, Canada. Infants with PWS. The natural history of SDB in infants with PWS within 2 years from baseline assessment. We identified 28 (12 male) infants with PWS who had a baseline polysomnography (PSG) at a median age (interquartile (IQR)) of 0.9 (0.5, 1.1) years. The median central apnoea index (CAI) at baseline was 6.6 events/hour (IQR 2.6, 12.1). Of these, 15/28 (53%) infants with PWS were diagnosed with significant central sleep apnoea (CSA) (CAI≥5 events/hour). Median age (IQR) at follow-up PSG was 2.1 (1.5, 2.6) years. The median CAI improved from 6.6 to 2.3 events/hour (p<0.0001). Only four infants with PWS had persistent CSA at the time of the follow-up PSG. Furthermore, three infants with PWS were diagnosed with mild-to-moderate obstructive sleep apnoea (OSA) that has improved at follow-up studies whereas two patients with PWS with no evidence of OSA at baseline were diagnosed with severe OSA on the follow-up PSG requiring adenotonsillectomy. The overall median obstructive apnoea-hypopnoea index was similar between baseline and follow-up studies (0.6 and 0.8, respectively, p=0.91). CSA is prevalent in infants with PWS but usually improves with age. However, these patients continue to require ongoing PSG surveillance because some infants will have persistent CSA and others are at risk of developing OSA. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  20. Nocturnal Sleep Dynamics Identify Narcolepsy Type 1.

    Science.gov (United States)

    Pizza, Fabio; Vandi, Stefano; Iloti, Martina; Franceschini, Christian; Liguori, Rocco; Mignot, Emmanuel; Plazzi, Giuseppe

    2015-08-01

    To evaluate the reliability of nocturnal sleep dynamics in the differential diagnosis of central disorders of hypersomnolence. Cross-sectional. Sleep laboratory. One hundred seventy-five patients with hypocretin-deficient narcolepsy type 1 (NT1, n = 79), narcolepsy type 2 (NT2, n = 22), idiopathic hypersomnia (IH, n = 22), and "subjective" hypersomnolence (sHS, n = 52). None. Polysomnographic (PSG) work-up included 48 h of continuous PSG recording. From nocturnal PSG conventional sleep macrostructure, occurrence of sleep onset rapid eye movement period (SOREMP), sleep stages distribution, and sleep stage transitions were calculated. Patient groups were compared, and receiver operating characteristic (ROC) curve analysis was used to test the diagnostic utility of nocturnal PSG data to identify NT1. Sleep macrostructure was substantially stable in the 2 nights of each diagnostic group. NT1 and NT2 patients had lower latency to rapid eye movement (REM) sleep, and NT1 patients showed the highest number of awakenings, sleep stage transitions, and more time spent in N1 sleep, as well as most SOREMPs at daytime PSG and at multiple sleep latency test (MSLT) than all other groups. ROC curve analysis showed that nocturnal SOREMP (area under the curve of 0.724 ± 0.041, P narcolepsy type 1 among central disorders of hypersomnolence. © 2015 Associated Professional Sleep Societies, LLC.

  1. Impact of short sleep on metabolic variables in obese children with obstructive sleep apnea.

    Science.gov (United States)

    Bhushan, Bharat; Ayub, Bushra; Thompson, Dana M; Abdullah, Fizan; Billings, Kathleen R

    2017-09-01

    To analyze the association between sleep duration, metabolic variables, and insulin resistance in obese children with and without obstructive sleep apnea. The decline in sleep duration has paralleled a dramatic increase in the prevalence of obesity and diabetes, suggesting a mechanistic relationship. Retrospective, case series. Consecutive obese patients 3 to 12 years of age who underwent polysomnography (PSG) and a metabolic panel and who completed a 14-item sleep questionnaire were analyzed. All laboratory testing was conducted within 3 months of PSG. Total sleep times were obtained from the PSG and confirmed by the questionnaire. A total of 171 patients (55.0% male) were studied. All patients were obese (body mass index [BMI] z score > 95th percentile). Patients were categorized into three groups: short sleepers, borderline sleepers, and optimal sleepers. Eighty-six (50.3%) patients were short sleepers, 71 (41.5%) were borderline sleepers, and 14 (8.2%) were optimal sleepers. The mean BMI z score was 3.13 ± 1.3 in short sleepers, 3.3 ± 1.1 in borderline sleepers, and 3.5 ± 1.5 in optimal sleepers (P = .39). There was no statistical difference in high- and low-density lipoprotein levels (P = .21 and P = .76, respectively) and total cholesterol (P = .43) among subgroups. Triglycerides, blood glucose, insulin, and homeostasis model assessment-insulin resistance were significantly higher in short sleepers when compared to borderline or normal sleepers (P = .008, P Short sleep duration was correlated with alterations in metabolic variables and insulin resistance in obese patients. This raises concern for development of comorbid conditions that can persist into adulthood. 4 Laryngoscope, 127:2176-2181, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

  2. Clusters of Insomnia Disorder: An Exploratory Cluster Analysis of Objective Sleep Parameters Reveals Differences in Neurocognitive Functioning, Quantitative EEG, and Heart Rate Variability.

    Science.gov (United States)

    Miller, Christopher B; Bartlett, Delwyn J; Mullins, Anna E; Dodds, Kirsty L; Gordon, Christopher J; Kyle, Simon D; Kim, Jong Won; D'Rozario, Angela L; Lee, Rico S C; Comas, Maria; Marshall, Nathaniel S; Yee, Brendon J; Espie, Colin A; Grunstein, Ronald R

    2016-11-01

    To empirically derive and evaluate potential clusters of Insomnia Disorder through cluster analysis from polysomnography (PSG). We hypothesized that clusters would differ on neurocognitive performance, sleep-onset measures of quantitative (q)-EEG and heart rate variability (HRV). Research volunteers with Insomnia Disorder (DSM-5) completed a neurocognitive assessment and overnight PSG measures of total sleep time (TST), wake time after sleep onset (WASO), and sleep onset latency (SOL) were used to determine clusters. From 96 volunteers with Insomnia Disorder, cluster analysis derived at least two clusters from objective sleep parameters: Insomnia with normal objective sleep duration (I-NSD: n = 53) and Insomnia with short sleep duration (I-SSD: n = 43). At sleep onset, differences in HRV between I-NSD and I-SSD clusters suggest attenuated parasympathetic activity in I-SSD (P EEG revealed reduced spectral power also in I-SSD B before (Delta, Alpha, Beta-1) and after sleep-onset (Beta-2) compared to I-SSD A and I-NSD (P ≤ 0.05). Two insomnia clusters derived from cluster analysis differ in sleep onset HRV. Preliminary data suggest evidence for three clusters in insomnia with differences for sustained attention and sleep-onset q-EEG. Insomnia 100 sleep study: Australia New Zealand Clinical Trials Registry (ANZCTR) identification number 12612000049875. URL: https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=347742.

  3. Sleep disorders in children with Attention-Deficit/Hyperactivity Disorder (ADHD) recorded overnight by video-polysomnography.

    Science.gov (United States)

    Silvestri, Rosalia; Gagliano, Antonella; Aricò, Irene; Calarese, Tiziana; Cedro, Clemente; Bruni, Oliviero; Condurso, Rosaria; Germanò, Eva; Gervasi, Giuseppe; Siracusano, Rosamaria; Vita, Giuseppe; Bramanti, Placido

    2009-12-01

    To outline specific sleep disturbances in different clinical subsets of Attention Deficit/Hyperactivity Disorder (ADHD) and to confirm, by means of nocturnal video-polysomnography (video-PSG), a variety of sleep disorders in ADHD besides the classically described periodic leg movement disorder (PLMD), restless legs syndrome (RLS) and sleep related breathing disorder (SRBD). Fifty-five ADHD children (47 M, 8F; mean age=8.9 y) were included: 16 had Inattentive and 39 Hyperactive/Impulsive or Combined ADHD subtype. Behavior assessment by Conners and SNAP-IV Scales, a structured sleep interview and a nocturnal video-PSG were administered. Most children/parents reported disturbed, fragmentary sleep at night; complaints were motor restlessness (50%), sleep walking (47.6%), night terrors (38%), confusional arousals (28.5%), snoring (21.4%), and leg discomfort at night associated with RLS (11.9%). There is a significant difference (p value <0.05 or <0.001) in almost all the studied sleep variables between ADHD children and controls. International RLS Rating Scale scoring, Periodic Limb Movements during Sleep (PLMS) and Wake (PLMW) indexes, hyperactivity and opposition scores and ADHD subtype appear related. Different sleep disorders seem to address specific ADHD phenotypes and correlate with severity of symptoms as in sleep related movement disorders occurring in Hyperactive/Impulsive and Combined ADHD subtypes. Besides, an abnormality of the arousal process in slow wave sleep with consequent abnormal prevalence of disorders of arousal possibly enhanced by SRBD has also been detected in 52% of our sample. This study underlines the opportunity to propose and promote the inclusion of sleep studies, possibly by video-PSG, as part of the diagnostic screening for ADHD. This strategy could address the diagnosis and treatment of different specific ADHD phenotypic expressions that might be relevant to children's symptoms and contribute to ADHD severity.

  4. Reliability of commercially available sleep and activity trackers with manual switch-to-sleep mode activation in free-living healthy individuals.

    Science.gov (United States)

    Gruwez, Alexia; Libert, Walter; Ameye, Lieveke; Bruyneel, Marie

    2017-06-01

    Wearable health devices have become trendy among consumers, but it is not known whether they accurately measure sleep and physical activity parameters. To address this question, we have studied the measured data of two consumer-level activity monitors (Up Move Jawbone(®) (U) and Withings Pulse 02(®) (W)) and compared it with reference methods for sleep and activity recordings, namely the Bodymedia SenseWear Pro Armband(®) actigraph (SWA) and home-polysomnography (H-PSG). Twenty healthy patients were assessed at home, during sleep, with the four devices. An additional 24-h period of recording was then planned during which they wore the 2 trackers and the SWA. Physical activity and sleep parameters obtained with the 4 devices were analyzed. Significant correlations with H-PSG were obtained for total sleep time (TST) for all the devices: r=0.48 for W (p=0.04), r=0.63 for U (p=0.002), r=0.7 for SWA (p=0.0003). The best coefficient was obtained with SWA. Significant correlations were also obtained for time in bed (TIB) for U and SWA vs PSG (r=0.79 and r=0.76, p<0.0001 for both) but not for W (r=0.45, p=0.07). No significant correlations were obtained for deep sleep, light sleep, and sleep efficiency (SE) measurements with W, U and SWA. Sleep latency (SL) correlated with H-PSG only when measured against SWA (r=0.5, p=0.02). Physical activity assessment revealed significant correlations for U and W with SWA for step count (both r=0.95 and p<0.0001) and active energy expenditure (EE) (r=0.65 and 0.54; p=0.0006 and p<0.0001). Total EE was also correctly estimated (r=0.75 and 0.52; p<0.0001 and p=0.001). Sleep and activity monitors are only able to produce a limited set of reliable measurements, such as TST, step count, and active EE, with a preference for U which performs globally better. Despite the manual activation to sleep mode, U and W were not suitable for giving correct data such as sleep architecture, SE, and SL. In the future, to enhance accuracy of such

  5. Widespread divergence of the CEACAM/PSG genes in vertebrates and humans suggests sensitivity to selection.

    Directory of Open Access Journals (Sweden)

    Chia Lin Chang

    Full Text Available In mammals, carcinoembryonic antigen cell adhesion molecules (CEACAMs and pregnancy-specific glycoproteins (PSGs play important roles in the regulation of pathogen transmission, tumorigenesis, insulin signaling turnover, and fetal-maternal interactions. However, how these genes evolved and to what extent they diverged in humans remain to be investigated specifically. Based on syntenic mapping of chordate genomes, we reveal that diverging homologs with a prototypic CEACAM architecture-including an extracellular domain with immunoglobulin variable and constant domain-like regions, and an intracellular domain containing ITAM motif-are present from cartilaginous fish to humans, but are absent in sea lamprey, cephalochordate or urochordate. Interestingly, the CEACAM/PSG gene inventory underwent radical divergence in various vertebrate lineages: from zero in avian species to dozens in therian mammals. In addition, analyses of genetic variations in human populations showed the presence of various types of copy number variations (CNVs at the CEACAM/PSG locus. These copy number polymorphisms have 3-80% frequency in select populations, and encompass single to more than six PSG genes. Furthermore, we found that CEACAM/PSG genes contain a significantly higher density of nonsynonymous single nucleotide polymorphism (SNP compared to the chromosome average, and many CEACAM/PSG SNPs exhibit high population differentiation. Taken together, our study suggested that CEACAM/PSG genes have had a more dynamic evolutionary history in vertebrates than previously thought. Given that CEACAM/PSGs play important roles in maternal-fetal interaction and pathogen recognition, these data have laid the groundwork for future analysis of adaptive CEACAM/PSG genotype-phenotypic relationships in normal and complicated pregnancies as well as other etiologies.

  6. Effects of Adjunctive Brexpiprazole on Sleep Disturbances in Patients With Major Depressive Disorder: An Open-Label, Flexible-Dose, Exploratory Study.

    Science.gov (United States)

    Krystal, Andrew D; Mittoux, Aurélia; Meisels, Peter; Baker, Ross A

    2016-09-08

    Brexpiprazole is a serotonin-dopamine activity modulator. We evaluated the effects of adjunctive treatment with brexpiprazole on sleep disturbances in patients with DSM-IV-TR major depressive disorder (MDD) and inadequate response to antidepressant treatment. This study was conducted between September 27, 2013, and August 19, 2014. Patients with inadequate response to antidepressant treatment and sleep disturbances continued treatment with their current antidepressant for 2 weeks. Patients still having inadequate response and sleep efficiency less than 85% measured by baseline polysomnography (PSG) received 8-week open-label treatment with their current antidepressant treatment and adjunctive brexpiprazole (target dose: 3 mg/d). Assessments included PSG recordings and scales of insomnia severity, depressive symptoms, and daytime alertness and functioning. Changes from baseline to week 8 were analyzed. Forty-four patients were treated. Improvements (P Sleep Diary for Morning, respectively, were observed in sleep efficiency (10.4 and 15.4 percentage points), total sleep time (49.0 and 84.5 min), sleep onset latency (-19.7 and -42.6 min), wake-time after sleep onset (-26.4 and -48.0 min), and latency to persistent sleep (-24.9 min, PSG only). Insomnia Severity Index (ISI) total score was improved (-9.2), as was daytime sleepiness (-2.1) as measured by the Epworth Sleepiness Scale (ESS) total score and morning sleepiness (-9.2) as measured by the Bond-Lader Visual Analog Scale (all P Depressive symptoms improved (Montgomery-Asberg Depression Rating Scale [MADRS]: -16.0 and Clinical Global Impressions-Severity [CGI-S]: -1.8), as did functioning (-8.4) assessed by the Massachusetts General Hospital-Cognitive and Physical Functioning Questionnaire (all P depressive symptoms were dependent on sleep (as assessed by ISI) (P sleep disturbances treated with adjunctive brexpiprazole, physiologic measures of sleep and daytime alertness were improved. Clinical

  7. Objective measures of sleep duration and continuity in major depressive disorder with comorbid hypersomnolence: a primary investigation with contiguous systematic review and meta-analysis.

    Science.gov (United States)

    Plante, David T; Cook, Jesse D; Goldstein, Michael R

    2017-06-01

    Hypersomnolence plays an important role in the presentation, treatment and course of mood disorders. However, there has been relatively little research that examines objective measures of sleep duration and continuity in patients with depression and hypersomnolence, despite the use of these factors in sleep medicine nosological systems. This study compared total sleep time and efficiency measured by naturalistic actigraphic recordings followed by ad libitum polysomnography (PSG; without prescribed wake time) in 22 patients with major depressive disorder and co-occurring hypersomnolence against age- and sex-matched healthy sleeper controls. The major depressive disorder and co-occurring hypersomnolence group demonstrated significantly longer sleep duration compared with healthy sleeper controls quantified by sleep diaries, actigraphy and ad libitum PSG. No between-group differences in sleep efficiency (SE), latency to sleep or wake after sleep onset were observed when assessed using objective measures. To further contextualize these findings within the broader scientific literature, a systematic review was performed to identify other comparable investigations. A meta-analysis of pooled data demonstrated patients with mood disorders and co-occurring hypersomnolence have significantly greater sleep duration and similar SE compared with healthy controls when assessed using ad libitum PSG. These results suggest current sleep medicine nosology that distinguishes hypersomnia associated with psychiatric disorders primarily as a construct characterized by low SE and increased time in bed may not be accurate. Future studies that establish the biological bases hypersomnolence in mood disorders, as well as clarify the accuracy of nosological thresholds to define excessive sleep duration, are needed to refine the diagnosis and treatment of these disorders. © 2017 European Sleep Research Society.

  8. Comparison of actigraphy and polysomnography to assess effects of zolpidem in a clinical research unit.

    Science.gov (United States)

    Peterson, Barry T; Chiao, Ping; Pickering, Eve; Freeman, Jon; Zammit, Gary K; Ding, Yu; Badura, Lori L

    2012-04-01

    This study sought to compare devices that use actigraphy for measuring sleep endpoints in the clinical research unit (CRU) and home environment. The abilities of polysomnography (PSG) and actigraphy monitors to detect drug effects in a CRU were also investigated. Eleven healthy subjects were recruited and monitored with PSG for four consecutive nights in a CRU after receiving no treatment (night 1, N1), and then placebo or 5 mg day(-1) or 10 mg day(-1) zolpidem in a randomised, cross-over design. Subjects wore two devices that use actigraphy (a Respironics® Actiwatch® on the wrist and a BodyMedia® Sensewear® Armband on the upper-arm) on the non-dominant arm for five nights at home and four nights in the CRU during PSG. Wake after sleep onset (WASO) and total sleep time (TST) measured by PSG and estimates of WASO by the Actiwatch decreased significantly with 5mg but not 10mg of zolpidem versus placebo. Direct activity (counts/min) with the Actiwatch decreased in response to zolpidem (both 5 and 10 mg day(-1)) versus placebo. Armband recordings of direct activity were similar to the Actiwatch but not significantly different versus placebo. Both actigraphy device estimates of TST were approximately 1h longer in CRU versus home. Agreement between actigraphy estimates of TST and WASO and PSG values of TST and WASO were closer during nights with zolpidem treatment. PSG can detect the effects of zolpidem on sleep in a CRU setting. Actigraphy can provide useful assessment of sleep, but direct activity endpoints may be more effective than estimates of TST and WASO. Copyright © 2012 Elsevier B.V. All rights reserved.

  9. Effects of music videos on sleep quality in middle-aged and older adults with chronic insomnia: a randomized controlled trial.

    Science.gov (United States)

    Lai, Hui-Ling; Chang, En-Ting; Li, Yin-Ming; Huang, Chiung-Yu; Lee, Li-Hua; Wang, Hsiu-Mei

    2015-05-01

    Listening to soothing music has been used as a complementary therapy to improve sleep quality. However, there is no empirical evidence for the effects of music videos (MVs) on sleep quality in adults with insomnia as assessed by polysomnography (PSG). In this randomized crossover controlled trial, we compared the effects of a peaceful Buddhist MV intervention to a usual-care control condition before bedtime on subjective and objective sleep quality in middle-aged and older adults with chronic insomnia. The study was conducted in a hospital's sleep laboratory. We randomly assigned 38 subjects, aged 50-75 years, to an MV/usual-care sequence or a usual-care/MV sequence. After pretest data collection, testing was held on two consecutive nights, with subjects participating in one condition each night according to their assigned sequence. Each intervention lasted 30 min. Sleep was assessed using PSG and self-report questionnaires. After controlling for baseline data, sleep-onset latency was significantly shorter by approximately 2 min in the MV condition than in the usual-care condition (p = .002). The MV intervention had no significant effects relative to the usual care on any other sleep parameters assessed by PSG or self-reported sleep quality. These results suggest that an MV intervention may be effective in promoting sleep. However, the effectiveness of a Buddhist MV on sleep needs further study to develop a culturally specific insomnia intervention. Our findings also suggest that an MV intervention can serve as another option for health care providers to improve sleep onset in people with insomnia. © The Author(s) 2014.

  10. Comorbid insomnia and obstructive sleep apnea in military personnel: correlation with polysomnographic variables.

    Science.gov (United States)

    Mysliwiec, Vincent; Matsangas, Panagiotis; Baxter, Tristin; McGraw, Leigh; Bothwell, Nici E; Roth, Bernard J

    2014-03-01

    Military personnel undergoing polysomnography are typically diagnosed only with obstructive sleep apnea (OSA). Comorbid insomnia with OSA is a well-established, underappreciated diagnosis. We sought to determine if military personnel with mild OSA met clinical criteria for insomnia and if there was a pattern of polysomnogram (PSG) variables that identified insomnia in these patients. Retrospective chart review of military personnel with mild OSA; cluster analysis to describe PSG variables. 206 personnel assessed, predominately male (96.6%), mean age 36.5 ± 8.14 years, body mass index 30.2 ± 3.66 kg/m(2) and apnea hypopnea index of 8.44 ± 2.92 per hour; 167 (81.1%) met criteria for insomnia. Cluster analysis identified a group of patients (N = 52) with PSG variables of increased wakefulness after sleep onset 77.3 minutes (27.7) (p military personnel with mild OSA meet criteria for insomnia. Roughly one-third of these patients can be identified by a pattern of PSG variables. Recognizing and treating both comorbid insomnia and OSA could improve clinical outcomes. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.

  11. Sleep in cluster headache

    DEFF Research Database (Denmark)

    Barloese, M C J; Jennum, P J; Lund, N T

    2015-01-01

    BACKGROUND AND PURPOSE: Cluster headache (CH) is a primary headache disorder characterized by severe attacks of unilateral pain following a chronobiological pattern. There is a close connection with sleep as most attacks occur during sleep. Hypothalamic involvement and a particular association...... with rapid eye movement (REM) sleep have been suggested. Sleep in a large, well-characterized population of CH patients was investigated. METHODS: Polysomnography (PSG) was performed on two nights in 40 CH patients during active bout and one night in 25 age, sex and body mass index matched controls...... in hospital. Macrostructure and other features of sleep were analyzed and related to phenotype. Clinical headache characterization was obtained by semi-structured interview. RESULTS: Ninety-nine nights of PSG were analyzed. Findings included a reduced percentage of REM sleep (17.3% vs. 23.0%, P = 0...

  12. Sleep depth and continuity before and after chronic exercise in older men: electrophysiological evidence.

    Science.gov (United States)

    Melancon, Michel O; Lorrain, Dominique; Dionne, Isabelle J

    2015-03-01

    During later life sleep depth (slow-wave sleep, SWS) and maintenance exhibit deleterious changes, with possible negative effects on daytime function. This study assessed the effect of chronic, supervised exercise on sleep using laboratory-based polysomnography (PSG) and repeated measures in older adults. Thirteen men aged 64±3served as their own controls and had their sleep measured for a total of 6 nights: 3 before and 3 after the 16-week training intervention. Each sequence involved 1 familiarization trial followed by 2 experimental nights (exercise night; nonexercise night) measured using 13-channel PSG (combined electroencephalography, electromyography, and electro-oculography). The exercise challenges consisted of inclined treadmill brisk walking (60min, 68-69% V˙O2peak). The intervention successfully improved some parameters of aerobic fitness, i.e. ventilatory thresholds 1 and 2 (Pexercise triggered increases in circulating free fatty acids and lactate levels both at baseline and after the intervention (Pexercise following training resulted in a 71% increase in SWS during subsequent sleep in comparison with the nonexercise condition before training, respectively 2.4% and 1.4% (Pexercise reduced total wake time by 30% and REM onset latency by 14% (Pexercise improved sleep continuity by decreasing total wake time. These results show that aerobic training could increase sleep depth and continuity, during active days, in elderly men. In habitual exercisers, these effects of aerobic exercise on sleep, although modest, might counteract those resulting from aging. Copyright © 2015 Elsevier Inc. All rights reserved.

  13. Assessment of physical and mental health in male university students with varying sleep habits.

    Science.gov (United States)

    Matsumoto, Yuuki; Toyomasu, Kouji; Uchimura, Naohisa

    2011-01-01

    Healthy sleep habits entail not only sleeping for a sufficient period (quantity) but also regularity of the sleep cycle and getting sound sleep (quality). University students often have erratic schedules that cause irregular sleep patterns even though sleep durations remain relatively constant. This study compared the physical and mental health of 90 male university students with different sleep habits. We created sleep habit scales using the Tokyo Metropolitan Institute for Neuroscience life habits inventory (TMIN-LHI; Miyashita, 1994) by performing a factor analysis and classifying sleeping habits based on regularity, quality, and quantity. Four types of sleep habits were identified by cluster analysis; good sleep was characterized by regular and high quality sleep but of relatively short sleep duration; long sleep was regular and relatively long but of low quality; short sleep was of high quality but short and irregular, while poor sleep was irregular, of low quality, and relatively long. The good sleep group had a significantly lower average waist circumference, and lower systolic and diastolic blood pressure. The long and poor sleep groups, which both had low quality sleep, scored lower than the national standard on the mental component summary (MCS) calculated from the Social Functioning-36 (SF-36) short-form health survey. Furthermore, the average MCS score of the poor sleep group was significantly lower than that of any other sleep habit group. Subjects with poor sleep also scored lowest on the Self-rating Depression Scale (SDS). In addition, the short and poor sleep groups were prone to glucose or lipid metabolism disorders. Maintaining good physical and mental health without sound sleep and a regular sleep cycle is difficult, even if sleeping hours are kept constant. Therefore, we included the assessment of regularity and quality in addition to hours of sleep in order to develop appropriate sleep guidelines for improved physical and mental health.

  14. Avaliação do processamento auditivo em crianças com síndrome da apnéia/hipopnéia obstrutiva do sono Auditory processing assessment in children with obstructive sleep apnea syndrome

    Directory of Open Access Journals (Sweden)

    Karin Neves Ziliotto

    2006-06-01

    Full Text Available INTRODUÇÃO: síndrome da apnéia/hipopnéia obstrutiva do sono (SAHOS é uma desordem de respiração durante o sono e tem sido descrita como uma condição relativamente comum em crianças. OBJETIVO: Verificar se existe relação entre a presença da Síndrome da Apnéia/Hipopnéia Obstrutiva do Sono e alteração de processamento auditivo. MÉTODOS: Foram avaliados 3 grupos de crianças na faixa etária de 5 a 11 anos, incluindo um grupo controle. Vinte indivíduos que constituíram o grupo de estudo foram submetidos à avaliação otorrinolaringológica e ao exame de polissonografia (PSG e foram divididos em dois grupos: Grupo I (RO constituído por 10 indivíduos respiradores orais e PSG normal e Grupo II (SAS constituído por 10 indivíduos respiradores orais e PSG alterado. O desempenho destes indivíduos foi comparado a um terceiro grupo - Grupo III (REN composto de 10 crianças sem queixas otorrinolaringológicas. Todos os sujeitos foram submetidos à avaliação audiológica básica e à avaliação do PA. RESULTADOS: Quanto à avaliação otorrinolaringológica, houve diferença estatisticamente significante no que se refere à avaliação dos cornetos nasais e das tonsilas palatinas. No grupo II, verificou-se maior número de indivíduos com hipertrofia de cornetos nasais grau II e III (p INTRODUCTION: The obstructive sleep apnea syndrome (OSAS is a respiratory disorder that occurs during sleep and it is relatively common in children. AIM: The goal of this paper is to verify if there is a relationship between the obstructive sleep apnea syndrome (OSAS and auditory processing. METHOD: In order to do that, three groups of children ranging in age from 5 to 11 were studied, including a normal group. Twenty subjects who made up the study group were submitted to ear, nose and throat (ENT exams and to polysomnography (PSG, and were divided in two groups: GROUP I (RO comprised of 10 children who presented oral breathing and displayed normal

  15. How do people with drug-resistant mesial temporal lobe epilepsy sleep? A clinical and video-EEG with EOG and submental EMG for sleep staging study

    Directory of Open Access Journals (Sweden)

    Aline Vieira Scarlatelli-Lima

    2016-09-01

    Full Text Available This study aimed to assess subjective and objective sleep parameters in a homogeneous group of drug-resistant mesial temporal lobe epilepsy (MTLE patients through internationally validated clinical questionnaires, video-electroencephalographic (VEEG and polysomnographic (PSG studies. Fifty-six patients with definite diagnosis of MTLE who were candidates for epilepsy surgery underwent a detailed clinical history, the Pittsburgh Sleep Quality Index (PSQI, Epworth Sleepiness Scale (ESS, Stanford Sleepiness Scale (SSS, neurological examination, 1.5 T brain magnetic resonance imaging, VEEG and PSG. Sixteen percent of patients reported significant daytime sleepiness as measured by ESS and 27% reported low levels of sleep quality as measured by PSQI. Patients with medically resistant epilepsy by MTLE showed increased wakefulness after sleep onset (WASO with mean ± standard deviation of 17.4 ± 15.6, longer non-rapid eye movement (NREM 1 (7.5 ± 4.6% and NREM3 sleep (26.6 ± 11.8%, abnormal rapid eye movement (REM latency in 30/56 patients, shorter REM sleep (16.7 ± 6.6%, and abnormal alpha delta patterns were observed in 41/56 patients. The analysis of interictal epileptic discharges (IEDs evidenced highest spiking rate during NREM3 sleep and higher concordance with imaging data when IEDs were recorded in sleep, mainly during REM sleep. We concluded that patients with MTLE showed disrupted sleep architecture that may result in daytime dysfunction and sleep complaints. Furthermore, NREM sleep activated focal IEDs and them - when recorded during sleep - had higher localizing value.

  16. Sleep during an Antarctic summer expedition: new light on "polar insomnia".

    Science.gov (United States)

    Pattyn, Nathalie; Mairesse, Olivier; Cortoos, Aisha; Marcoen, Nele; Neyt, Xavier; Meeusen, Romain

    2017-04-01

    Sleep complaints are consistently cited as the most prominent health and well-being problem in Arctic and Antarctic expeditions, without clear evidence to identify the causal mechanisms. The present investigation aimed at studying sleep and determining circadian regulation and mood during a 4-mo Antarctic summer expedition. All data collection was performed during the continuous illumination of the Antarctic summer. After an habituation night and acclimatization to the environment (3 wk), ambulatory polysomnography (PSG) was performed in 21 healthy male subjects, free of medication. An 18-h profile (saliva sampling every 2 h) of cortisol and melatonin was assessed. Mood, sleepiness, and subjective sleep quality were assessed, and the psychomotor vigilance task was administered. PSG showed, in addition to high sleep fragmentation, a major decrease in slow-wave sleep (SWS) and an increase in stage R sleep. Furthermore, the ultradian rhythmicity of sleep was altered, with SWS occurring mainly at the end of the night and stage R sleep at the beginning. Cortisol secretion profiles were normal; melatonin secretion, however, showed a severe phase delay. There were no mood alterations according to the Profile of Mood States scores, but the psychomotor vigilance test showed an impaired vigilance performance. These results confirm previous reports on "polar insomnia", the decrease in SWS, and present novel insight, the disturbed ultradian sleep structure. A hypothesis is formulated linking the prolonged SWS latency to the phase delay in melatonin.NEW & NOTEWORTHY The present paper presents a rare body of work on sleep and sleep wake regulation in the extreme environment of an Antarctic expedition, documenting the effects of constant illumination on sleep, mood, and chronobiology. For applied research, these results suggest the potential efficiency of melatonin supplementation in similar deployments. For fundamental research, these results warrant further investigation of the

  17. Microstructures using RF sputtered PSG film as a sacrificial layer in ...

    Indian Academy of Sciences (India)

    Abstract. In this paper, we explore RF magnetron sputtered Phosphor–silicate– glass (PSG) film as a sacrificial layer in surface micromachining technology. For this purpose, a 76mm diameter target of phosphorus-doped silicon dioxide was prepared by conventional solid-state reaction route using P2O5 and SiO2 powders.

  18. Sex Steroid Hormone Profiles are Related to Sleep Measures from Polysomnography and the Pittsburgh Sleep Quality Index

    Science.gov (United States)

    Sowers, Mary Fran; Zheng, Huiyong; Kravitz, Howard M.; Matthews, Karen; Bromberger, Joyce T.; Gold, Ellen B.; Owens, Jane; Consens, Flavia; Hall, Martica

    2008-01-01

    Study Objectives: To relate reproductive hormones (and the preceding 7-year rates of their change) to objectively and subjectively assessed sleep measures, independent of age, vasomotor symptom frequency, depressive symptoms, and body size. Design: A cross-sectional sleep substudy nested in the Study of Women's Health Across the Nation (SWAN), a longitudinal study of the menopausal transition. Setting: Community-based. Participants: 365 Caucasian, African American, and Chinese women. Measurements and Results: Sleep duration, continuity, and architecture were measured during two nights of in-home polysomnography (PSG) studies. Participants completed the Pittsburgh Sleep Quality Index (PSQI) for sleep quality, sleep diaries for medication, vasomotor symptoms, lifestyle information and questionnaires for depressive symptoms. Blood collected annually in the years prior to sleep study was assayed for follicle stimulating hormone (FSH), estradiol (E2), and total testosterone (T). More rapid rate of FSH change was significantly associated with higher delta sleep percent, longer total sleep time (TST), but less favorable self-reported sleep quality (PSQI). Baseline E2 was modestly and negatively associated with sleep quality. Women in the lowest total testosterone quartile at baseline had more wake time after sleep onset (WASO) than women in the highest quartile. Lower E2/T ratio, an index reflecting the increasing androgenic environment with the menopause transition, was associated with less WASO. Conclusions: More rapid rate of FSH change was associated with longer sleep duration but poor sleep quality. Women with higher T or who were closer to the completion of the transition process (as indexed by a lower E2/T) had less sleep discontinuity (less WASO). Citation: Sowers MF; Zheng H; Kravitz HM; Matthews K; Bromberger JT; Gold EB; Owens J; Consens F; Hall M. Sex steroid hormone profiles are related to sleep measures From polysomnography and the pittsburgh sleep quality

  19. Sleep reduces false memory in healthy older adults.

    Science.gov (United States)

    Lo, June C; Sim, Sam K Y; Chee, Michael W L

    2014-04-01

    To investigate the effects of post-learning sleep and sleep architecture on false memory in healthy older adults. Balanced, crossover design. False memory was induced using the Deese-Roediger-McDermott (DRM) paradigm and assessed following nocturnal sleep and following a period of daytime wakefulness. Post-learning sleep structure was evaluated using polysomnography (PSG). Sleep research laboratory. Fourteen healthy older adults from the Singapore-Longitudinal Aging Brain Study (mean age ± standard deviation = 66.6 ± 4.1 y; 7 males). At encoding, participants studied lists of words that were semantically related to non-presented critical lures. At retrieval, they made "remember"/"know" and "new" judgments. Compared to wakefulness, post-learning sleep was associated with reduced "remember" responses, but not "know" responses to critical lures. In contrast, there were no significant differences in the veridical recognition of studied words, false recognition of unrelated distractors, discriminability, or response bias between the sleep and the wake conditions. More post-learning slow wave sleep was associated with greater reduction in false memory. In healthy older adults, sleep facilitates the reduction in false memory without affecting veridical memory. This benefit correlates with the amount of slow wave sleep in the post-learning sleep episode.

  20. The Feasibility and Utility of Continuous Sleep Monitoring in Critically Ill Patients Using a Portable Electroencephalography Monitor.

    Science.gov (United States)

    Vacas, Susana; McInrue, Erin; Gropper, Michael A; Maze, Mervyn; Zak, Rochelle; Lim, Eunjung; Leung, Jacqueline M

    2016-07-01

    Sleep disruption in critically ill adults can result in acute decrements in cognitive function, including delirium, but it is underdiagnosed in the setting of the intensive care unit (ICU). Although sleep stages can be assessed by polysomnography (PSG), acquisition and interpretation of PSG is costly, is labor intensive, is difficult to do over an extended period of time with critically ill patients (multiple days of continuous recording), and may interfere with patient care. In this pilot study, we investigated the feasibility and utility of monitoring sleep in the ICU setting using a portable electroencephalography (EEG) monitor, the SedLine brain monitor. We first performed a baseline comparison study of the SedLine brain monitor by comparing its recordings to PSG recorded in a sleep laboratory (n = 3). In a separate patient cohort, we enrolled patients in the ICU who were monitored continuously with the SedLine monitor for sleep disruption (n = 23). In all enrolled patients, we continuously monitored their EEG. The raw EEG was retrieved and sleep stages and arousals were analyzed by a board-certified technologist. Delirium was measured by a trained research nurse using the Confusion Assessment Method developed for the ICU. For all enrolled patients, we continuously monitored their EEGs and were able to retrieve the raw EEGs for analysis of sleep stages. Overall, the SedLine brain monitor was able to differentiate sleep stages, as well as capture arousals and transitions between sleep stages compared with the PSG performed in the sleep laboratory. The percentage agreement was 67% for the wake stage, 77% for the non-rapid eye movement (REM) stage (N1 = 29%, N2 = 88%, and N3 = 6%), and 89% for the REM stage. The overall agreement was measured with the use of weighted kappa, which was 0.61, 95% confidence interval, 0.58 to 0.64. In the ICU study, the mean recording time for the 23 enrolled patients was 19.10 hours. There were several signs indicative of poor

  1. Developmental changes in brain connectivity assessed using the sleep EEG.

    Science.gov (United States)

    Tarokh, L; Carskadon, M A; Achermann, P

    2010-12-01

    Adolescence represents a time of significant cortical restructuring. Current theories posit that during this period connections between frequently utilized neural networks are strengthened while underutilized synaptic connections are discarded. The aim of the present study was to examine the developmental evolution of connectivity between brain regions using the sleep EEG. All-night sleep EEG recordings in two longitudinal cohorts (children and teens) followed at 1.5-3 year intervals and one cross-sectional cohort (adults) were analyzed. The children and teen cohorts were 9/10 and 15/16 years at the initial assessment; ages of the adults were 20 to 23 years. Intrahemispheric, interhemispheric, and diagonal coherence was measured between all six possible pairings of two central (C3/A2 and C4/A1) and two occipital (O2/A1 and O1/A2) derivations during slow wave, stage 2, and, REM sleep. Within-subjects analyses were performed for the children and teen cohorts, and a linear regression analysis was performed across every assessment of all cohorts. Within-subject analyses revealed a maturational increase in coherence for both age cohorts, though the frequencies, sleep states, and regions differed between cohorts. Regression analysis across all age cohorts showed an overall linear increase in left and right intrahemispheric coherence for all sleep states across frequencies. Furthermore, coherence between diagonal electrode pairs also increased in a linear manner for stage 2 and REM sleep. No age-related trend was found in interhemispheric coherence. Our results indicate that sleep EEG coherence increases with age and that these increases are confined to specific brain regions. This analysis highlights the utility of the sleep EEG to measure developmental changes in brain maturation. Copyright © 2010 IBRO. Published by Elsevier Ltd. All rights reserved.

  2. The effect of exercise training on obstructive sleep apnea and sleep quality: a randomized controlled trial.

    Science.gov (United States)

    Kline, Christopher E; Crowley, E Patrick; Ewing, Gary B; Burch, James B; Blair, Steven N; Durstine, J Larry; Davis, J Mark; Youngstedt, Shawn D

    2011-12-01

    To evaluate the efficacy of a 12-week exercise training program for reducing obstructive sleep apnea (OSA) severity and improving sleep quality, and to explore possible mechanisms by which exercise may reduce OSA severity. Randomized controlled trial. Clinical exercise physiology center, sleep laboratory. Forty-three sedentary and overweight/obese adults aged 18-55 years with at least moderate-severity untreated OSA (screening apnea-hypopnea index [AHI] ≥ 15). Participants randomized to exercise training (n = 27) met 4 times/week for 12 weeks and performed 150 min/week of moderate-intensity aerobic activity, followed by resistance training twice/week. Participants randomized to a stretching control (n = 16) met twice weekly for 12 weeks to perform low-intensity exercises designed to increase whole-body flexibility. OSA severity was assessed with one night of laboratory polysomnography (PSG) before and following the 12-week intervention. Measures of sleep quality included PSG, actigraphy (7-10 days), and the Pittsburgh Sleep Quality Index. Compared with stretching, exercise resulted in a significant AHI reduction (exercise: 32.2 ± 5.6 to 24.6 ± 4.4, stretching: 24.4 ± 5.6 to 28.9 ± 6.4; P sleep (P = 0.03). Reductions in AHI and ODI were achieved without a significant decrease in body weight. Improvements in actigraphic sleep and subjective sleep quality were also noted following exercise compared with stretching. Exercise training had moderate treatment efficacy for the reduction of AHI in sedentary overweight/obese adults, which suggests that exercise may be beneficial for the management of OSA beyond simply facilitating weight loss. Clinicaltrials.gov identification number NCT00956423.

  3. Effects of different sleep deprivation protocols on sleep perception in healthy volunteers.

    Science.gov (United States)

    Goulart, Leonardo I; Pinto, Luciano R; Perlis, Michael L; Martins, Raquel; Caboclo, Luis Otavio; Tufik, Sergio; Andersen, Monica L

    2014-10-01

    To investigate whether different protocols of sleep deprivation modify sleep perception. The effects of total sleep deprivation (TD) and selective rapid eye movement (REM) sleep deprivation (RD) on sleep perception were analyzed in normal volunteers. Thirty-one healthy males with normal sleep were randomized to one of three conditions: (i) normal uninterrupted sleep; (ii) four nights of RD; or (iii) two nights of TD. Morning perception of total sleep time was evaluated for each condition. Sleep perception was estimated using total sleep time (in hours) as perceived by the volunteer divided by the total sleep time (in hours) measured by polysomnography (PSG). The final value of this calculation was defined as the perception index (PI). There were no significant differences among the three groups of volunteers in the total sleep time measured by PSG or in the perception of total sleep time at baseline condition. Volunteers submitted to RD exhibited lower sleep PI scores as compared with controls during the sleep deprivation period (P sleep deprivation reduced the ability of healthy young volunteers to perceive their total sleep time when compared with time measured by PSG. The data reinforce the influence of sleep deprivation on sleep perception. Copyright © 2014 Elsevier B.V. All rights reserved.

  4. Healthcare Providers’ Knowledge of Disordered Sleep, Sleep Assessment Tools, and Nonpharmacological Sleep Interventions for Persons Living with Dementia: A National Survey

    Directory of Open Access Journals (Sweden)

    Cary A. Brown

    2014-01-01

    Full Text Available A large proportion of persons with dementia will also experience disordered sleep. Disordered sleep in dementia is a common reason for institutionalization and affects cognition, fall risk, agitation, self-care ability, and overall health and quality of life. This report presents findings of a survey of healthcare providers’ awareness of sleep issues, assessment practices, and nonpharmacological sleep interventions for persons with dementia. There were 1846 participants, with the majority being from nursing and rehabilitation. One-third worked in long-term care settings and one-third in acute care. Few reported working in the community. Findings revealed that participants understated the incidence of sleep deficiencies in persons with dementia and generally lacked awareness of the relationship between disordered sleep and dementia. Their knowledge of sleep assessment tools was limited to caregiver reports, self-reports, and sleep diaries, with few using standardized tools or other assessment methods. The relationship between disordered sleep and comorbid conditions was not well understood. The three most common nonpharmacological sleep interventions participants identified using were a regular bedtime routine, increased daytime activity, and restricted caffeine. Awareness of other evidence-based interventions was low. These findings will guide evidence-informed research to develop and test more targeted and contextualized sleep and dementia knowledge translation strategies.

  5. Assessing sleep consciousness within subjects using a serial awakening paradigm

    Directory of Open Access Journals (Sweden)

    Francesca eSiclari

    2013-08-01

    Full Text Available Dreaming - a particular form of consciousness that occurs during sleep - undergoes major changes in the course of the night. We aimed to outline state-dependent features of consciousness using a paradigm with multiple serial awakenings/questionings that allowed for within as well as between subject comparisons. Seven healthy participants who spent 44 experimental study nights in the laboratory were awakened by a computerized sound at 15-30 minute intervals, regardless of sleep stage, and questioned for the presence or absence of sleep consciousness. Recall without content (‘I was experiencing something but do not remember what’ was considered separately. Subjects had to indicate the content of the most recent conscious experience prior to the alarm sound and to estimate its duration and richness. We also assessed the degree of thinking and perceiving, self- and environment-relatedness and reflective consciousness of the experiences. Of the 778 questionings, 5% were performed during wakefulness, 2% in stage N1, 42% in N2, 33% in N3 and 17% in rapid eye movement (REM sleep. Recall with content was reported in 34% of non-REM and in 77% of REM sleep awakenings. Sleep fragmentation inherent to the study design appeared to only minimally affect the recall of conscious experiences. Each stage displayed a unique combination of characteristic features of sleep consciousness. In conclusion, our serial awakening paradigm allowed us to collect a large and representative sample of conscious experiences across states of being. It represents a time-efficient method for the study of sleep consciousness that may prove particularly advantageous when combined with techniques such as functional MRI and high-density EEG.

  6. Sleep spindles predict stress-related increases in sleep disturbances

    Directory of Open Access Journals (Sweden)

    Thien Thanh eDang-Vu

    2015-02-01

    Full Text Available Background and Aim: Predisposing factors place certain individuals at higher risk for insomnia, especially in the presence of precipitating conditions such as stressful life events. Sleep spindles have been shown to play an important role in the preservation of sleep continuity. Lower spindle density might thus constitute an objective predisposing factor for sleep reactivity to stress. The aim of this study was therefore to evaluate the relationship between baseline sleep spindle density and the prospective change in insomnia symptoms in response to a standardized academic stressor. Methods: 12 healthy students had a polysomnography (PSG recording during a period of lower stress at the beginning of the academic semester, along with an assessment of insomnia complaints using the Insomnia Severity Index (ISI. They completed a second ISI assessment at the end of the semester, a period coinciding with the week prior to final examinations and thus higher stress. Spindle density, amplitude, duration and frequency, as well as sigma power were computed from C4-O2 electroencephalography (EEG derivation during stages N2-N3 of non-rapid-eye-movement (NREM sleep, across the whole night and for each NREM sleep period. To test for the relationship between spindle density and changes in insomnia symptoms in response to academic stress, spindle measurements at baseline were correlated with changes in ISI across the academic semester.Results: Spindle density (as well as spindle amplitude and sigma power, particularly during the first NREM sleep period, negatively correlated with changes in ISI (p < 0.05. Conclusion: Lower spindle activity, especially at the beginning of the night, prospectively predicted larger increases in insomnia symptoms in response to stress. This result indicates that individual differences in sleep spindle activity contribute to the differential vulnerability to sleep disturbances in the face of precipitating factors.

  7. Contributions of circadian tendencies and behavioral problems to sleep onset problems of children with ADHD

    Directory of Open Access Journals (Sweden)

    Gruber Reut

    2012-11-01

    Full Text Available Abstract Background Children with attention-deficit/hyperactivity disorder (ADHD are two to three times more likely to experience sleep problems. The purpose of this study is to determine the relative contributions of circadian preferences and behavioral problems to sleep onset problems experienced by children with ADHD and to test for a moderation effect of ADHD diagnosis on the impact of circadian preferences and externalizing problems on sleep onset problems. Methods After initial screening, parents of children meeting inclusion criteria documented child bedtime over 4 nights, using a sleep log, and completed questionnaires regarding sleep, ADHD and demographics to assess bedtime routine prior to PSG. On the fifth night of the study, sleep was recorded via ambulatory assessment of sleep architecture in the child’s natural sleep environment employing portable polysomnography equipment. Seventy-five children (26 with ADHD and 49 controls aged 7–11 years (mean age 8.61 years, SD 1.27 years participated in the present study. Results In both groups of children, externalizing problems yielded significant independent contributions to the explained variance in parental reports of bedtime resistance, whereas an evening circadian tendency contributed both to parental reports of sleep onset delay and to PSG-measured sleep-onset latency. No significant interaction effect of behavioral/circadian tendency with ADHD status was evident. Conclusions Sleep onset problems in ADHD are related to different etiologies that might require different interventional strategies and can be distinguished using the parental reports on the CSHQ.

  8. The impact of sleep on neuropsychological performance in cognitively intact older adults using a novel in-home sensor based sleep assessment approach

    OpenAIRE

    Seelye, Adriana; Mattek, Nora; Howieson, Diane; Riley, Thomas; Wild, Katherine; Kaye,Jeffrey

    2015-01-01

    The relationship between recent episodes of poor sleep and cognitive testing performance in healthy cognitively intact older adults is not well understood. In this exploratory study, we examined the impact of recent sleep disturbance, sleep duration, and sleep variability on cognitive performance in 63 cognitively intact older adults using a novel unobtrusive in-home sensor based sleep assessment methodology. Specifically, we examined the impact of sleep the night prior, the week prior, and t...

  9. Symptoms of sleep apnea and polysomnography as predictors of poor quality of life in overweight children and adolescents.

    Science.gov (United States)

    Carno, Margaret-Ann; Ellis, Ethan; Anson, Elizabeth; Kraus, Rachel; Black, Jonathan; Short, Renee; Connolly, Heidi V

    2008-04-01

    The goal of this study was to examine the relationship between quality of life (QOL) and symptoms of obstructive sleep apnea (OSA) as well as objectively measured severity of OSA using polysomnography (PSG) in a cohort of overweight and at risk for overweight children and adolescents. One hundred and fifty-one overweight subjects [90 males, average ages of 12.52, mean body mass index (BMI) Z-score of 2.27) and their parent/guardian completed surveys assessing QOL and symptoms of OSA syndrome. The subjects also underwent overnight PSG. Overweight patients reported poor QOL. Polysomnographic variables did not correlate with QOL. However, symptoms of OSA as reported on the Pediatric Sleep Questionnaire significantly correlated with QOL from both the parent and the subject. Overweight youth with symptoms of OSA have a lower QOL both by their report and parental report. Interestingly, objective measures of OSA did not correlate with QOL.

  10. Sleeping under the Ocean: Despite Total Isolation, Nuclear Submariners Maintain Their Sleep and Wake Patterns throughout Their Under Sea Mission.

    Science.gov (United States)

    Trousselard, Marion; Leger, Damien; van Beers, Pascal; Coste, Olivier; Vicard, Arnaud; Pontis, Julien; Crosnier, Sylvain-Nicolas; Chennaoui, Mounir

    2015-01-01

    To assess the effects of isolation, inadequate exposure to light and specific shift work on the subjective and objective measurements of sleep and alertness of submariners. A strictly controlled randomized crossover study with the polysomnography recorded twice during the mission. Setting: Shift and night work with prolonged (70 days) social isolation from the real world (with no phone or Internet contact with families or friends during a routine mission aboard the "Téméraire" French Strategic Submarine with Ballistic Nuclear missiles (SSBN). Participants: 19 submariners working on a 24-hour shift for three days in a row schedule. Interventions: The participants attended two polysomnographic (PSG) recordings of night sleep on Day 21 (D21) and Day 51 (D51) of the 70-day patrol; urine cortisol levels were also taken after sleep, and subjective assessments of sleep, sleepiness, mood and anxiety on D21 and D51. The light and temperature on board were also recorded. PSG analyses showed that sleep did not significantly vary in length (total sleep time) or in quality between D21 and D51. The mariners reported the same subjective sleep, sleepiness, anxiety or mood (except for a slightly worse score for confusion on D51). Blood cortisol levels did not vary significantly. These results show that humans living in an isolated environment for more than two months with this specific shift schedule do not suffer from any significant effects on sleep, sleepiness and confusion between D21 and D51, when they follow an organized regular shift pattern with controlled light and temperature.

  11. Sleeping under the Ocean: Despite Total Isolation, Nuclear Submariners Maintain Their Sleep and Wake Patterns throughout Their Under Sea Mission.

    Directory of Open Access Journals (Sweden)

    Marion Trousselard

    Full Text Available To assess the effects of isolation, inadequate exposure to light and specific shift work on the subjective and objective measurements of sleep and alertness of submariners.A strictly controlled randomized crossover study with the polysomnography recorded twice during the mission.Setting: Shift and night work with prolonged (70 days social isolation from the real world (with no phone or Internet contact with families or friends during a routine mission aboard the "Téméraire" French Strategic Submarine with Ballistic Nuclear missiles (SSBN. Participants: 19 submariners working on a 24-hour shift for three days in a row schedule. Interventions: The participants attended two polysomnographic (PSG recordings of night sleep on Day 21 (D21 and Day 51 (D51 of the 70-day patrol; urine cortisol levels were also taken after sleep, and subjective assessments of sleep, sleepiness, mood and anxiety on D21 and D51. The light and temperature on board were also recorded.PSG analyses showed that sleep did not significantly vary in length (total sleep time or in quality between D21 and D51. The mariners reported the same subjective sleep, sleepiness, anxiety or mood (except for a slightly worse score for confusion on D51. Blood cortisol levels did not vary significantly.These results show that humans living in an isolated environment for more than two months with this specific shift schedule do not suffer from any significant effects on sleep, sleepiness and confusion between D21 and D51, when they follow an organized regular shift pattern with controlled light and temperature.

  12. Assessment of subjective sleep quality in iron deficiency anaemia

    African Journals Online (AJOL)

    HAD) scale and pittsburgh sleep quality index. (PSQI). ... sleeping. Conclusion: IDA affects sleep quality irrespective of psychological symptoms such as depression and anxiety. ..... sleep: genetics, cellular physiology and subcortical net- works.

  13. Latina adolescent sleep and mood: an ecological momentary assessment pilot study.

    Science.gov (United States)

    Garcia, Carolyn; Zhang, Lei; Holt, Katie; Hardeman, Rachel; Peterson, Barbara

    2014-08-01

    Sleep and mood represent two important malleable opportunities for adolescent health. This study investigated the sleep-mood relationship in adolescent girls. Short-term, longitudinal design. Latina adolescents (N = 19, mean age 15) completed ecological momentary assessments on sleep (perceived quality, self-report quantity) and mood (negative affect, positive affect, and positivity ratio). Adolescents sent 1,598 texts on sleep and mood. Bidirectional sleep-mood relationships were in expected directions; negative affect and the positivity ratio affect predicted adolescents' sleep quality. Interventions should encourage sleep-mood relationship awareness, and further research should identify significant differences to inform tailored interventions with adolescents. © 2014 Wiley Periodicals, Inc.

  14. Sleep disturbances in Malaysian patients with Parkinson's disease using polysomnography and PDSS.

    Science.gov (United States)

    Norlinah, M I; Afidah, K Nor; Noradina, A T; Shamsul, A S; Hamidon, B B; Sahathevan, R; Raymond, A A

    2009-11-01

    Sleep disturbances such as sleep fragmentation, sleep disordered breathing (SDB), periodic limb movements (PLM), excessive daytime somnolence (EDS) and insomnia are prevalent in Parkinson's disease (PD). However, studies in the Asian population are limited. This was a cross-sectional study involving 46 Malaysians with PD using polysomnography (PSG) and standardized translated Parkinson's disease sleep scale (PDSS). Overnight PSG recordings, UPDRS and PDSS scores, and baseline demographic data were obtained. Data from 44 patients were analysed. Thirty-six patients (81.8%) had PSG-quantified sleep disorders. Twenty-three (52.3%) had sleep fragmentation, 24 (54.6%) had SDB and 14 (32%) had PLM. EDS was present in 9.1%. Insomnia was reported by 31.8%. Patients with sleep fragmentation had significantly higher UPDRS scores and lower PDSS insomnia sub-scores. The UPDRS scores correlated negatively with the TST and sleep efficiency. All patients with EDS had SDB (p=0.056). The PDSS insomnia sub-items correlated with sleep fragmentation on PSG. : The prevalence of sleep disorders based on PSG and PDSS in our PD patients was high, the commonest being sleep fragmentation and SDB, while EDS was the least prevalent. Problem specific sub-items of the PDSS were more accurate in predicting the relevant PSG-related changes compared to the PDSS as a whole.

  15. Sleep disturbances in chronic progressive external ophthalmoplegia.

    Science.gov (United States)

    Smits, B W; Westeneng, H J; van Hal, M A; van Engelen, B G; Overeem, S

    2012-01-01

    Chronic progressive external ophthalmoplegia (CPEO) is a relatively common mitochondrial disorder. In addition to extraocular muscle weakness, various other organs can typically be affected, including laryngeal and limb muscles, cerebrum, cerebellum, and peripheral nerves. Given this multi-organ involvement, patients are likely to be prone to sleep disturbances. Here, we determined the nature, prevalence, and determinants of sleep disturbances in CPEO. We used validated questionnaires for various sleep disorders and possible determinants such as mood and anxiety, and we performed ambulant polysomnography (PSG) in 20 patients with genetically confirmed CPEO. Three quarters of patients reported nocturnal sleep dysfunction. Thirty-five percent of patients fulfilled the criteria for restless legs syndrome, 30% excessive daytime sleepiness, and 70% significant periodic limb movements. PSG recordings revealed several indicators of a disrupted sleep architecture. Obstructive sleep disordered breathing was present in only one patient. However, four patients had an increased central sleep apnea index, all of whom had a polymerase gamma-1 mutation and a SANDO phenotype (sensoric atactic neuropathy, dysarthria, ophthalmoplegia). Physical examination and questionnaire outcomes were poor predictors of PSG results. Several specific sleep disturbances are part of the phenotype of CPEO. Given that the disease is otherwise incurable, symptomatic treatment of sleep disturbances may be an important tool to improve quality of life. Therefore, patients with CPEO should be actively screened for sleep disorders, with a low threshold to perform PSG. © 2011 The Author(s). European Journal of Neurology © 2011 EFNS.

  16. Wrist actigraphic measures of sleep in space

    Science.gov (United States)

    Monk, T. H.; Buysse, D. J.; Rose, L. R.

    1999-01-01

    STUDY OBJECTIVES: To determine whether wrist actigraphy is useful as a tool for space-based sleep research. Specifically, to determine whether bedtimes and waketimes can be identified from the actigraphic record, and whether actigraphic measures of sleep in space are related to polysomnographic (PSG) ones. DESIGN AND SETTING: Actigraphy, sleep diary, and Polysomnographic (PSG) measures of sleep were obtained from four subjects in two 72h measurement blocks occurring 2d and 12d into a 17d Space Shuttle mission in orbiting the earth in microgravity. PATIENTS: Four healthy male astronauts aged 38y - 47y. INTERVENTIONS: NA. MEASUREMENTS AND RESULTS: Sleep onset and offset at "night" could be quite clearly identified from the actigraphic record and were better estimated by actigraph than by diary. There was a high correlation between actigraphic and PSG estimates of sleep duration (r = 0.96) and sleep efficiency (r = 0.88), and a similarity in the mean estimates obtained. On a minute-by-minute basis, there was a good correlation between sleep stage and actigraphic movement counts, with a higher level of counts per minute recorded in epochs with lighter PSG sleep stages. There was also a high correlation (r = 0.90) between minutes of stage 0 (wake) occurring between bedtime and wake time, and number of non-zero actigraph epochs during the same interval. CONCLUSIONS: Actigraphy worked well in space both as a way of detecting bedtimes and waketimes, and as an indicant of sleep restlessness.

  17. The association between Disruptive Mood Dysregulation Disorder symptoms and sleep problems in children with and without ADHD.

    Science.gov (United States)

    Waxmonsky, James G; Mayes, Susan D; Calhoun, Susan L; Fernandez-Mendoza, Julio; Waschbusch, Daniel A; Bendixsen, Brianna H; Bixler, Edward O

    2017-09-01

    Many youth experience persistent irritability and recurrent temper outbursts, conceptualized by DSM-5 as Disruptive Mood Dysregulation Disorder (DMDD). Sleep deprivation impairs emotion regulation which could increase rates of DMDD symptoms, especially in those with preexisting regulatory impairments, as seen with ADHD. However, there has been little examination of the relationship between chronic sleep problems and DMDD symptoms. Associations between DMDD symptoms and sleep parameters in children were assessed using parent-report and objective measures of sleep in a general population sample (N = 665) and an ADHD sample (N = 784). Irritability, temper outbursts, sleep problems and other psychological problems were assessed with the Pediatric Behavior Scale. The general population study also completed overnight polysomnography (PSG). DMDD symptoms were reported in 9.2% of the community sample and 31.4% of the ADHD sample. In both samples, children with DMDD symptoms had significantly higher parent-reported sleep problems than children without DMDD symptoms. Children with sleep problems had significantly higher DMDD scores than children without sleep problems. However, DMDD symptoms were most strongly associated with oppositional behavior. Sleep problems were not a significant contributor. Hyperactivity-impulsivity was most strongly associated with sleep problems, and DMDD was not a significant contributor. Children with and without DMDD symptoms did not differ significantly on any PSG parameter. Associations between parent-reported sleep problems and DMDD symptoms were due to their shared relationship with other behavioral problems. Therefore, chronic sleep problems do not appear to be a primary source of DMDD symptoms in children with or without ADHD. Copyright © 2017 Elsevier B.V. All rights reserved.

  18. [Evaluation of a portable device based on peripheral arterial tone in the detection of obstructive sleep apnea].

    Science.gov (United States)

    Zhang, Juan; Wang, Chun-yan; Wang, Ning-yu; Liu, Jun-qing; Du, Jing-yan; Zhou, Guo-xia; Yan, Zhan-feng; Wen, Xiao-hui; Li, Li; Liu, Jin-feng

    2012-02-01

    To assess the accuracy of a wrist-worn device (Watch-PAT 200) in the diagnosis of obstructive sleep apnea syndrome (OSAHS). Forty-three adult subjects with suspected OSAHS simultaneously had a standard in-laboratory polysomnogram (PSG) and wore the Watch-PAT 200 during a full-night recording. PSG sleep and respiratory events were scored according to standard criteria. The PSG recordings were blindly manually analyzed, while Watch-PAT data were scored automatically based on the algorithm developed previously. The mean age of the subjects was (42.2 ± 12.2) years (x(-) ± s), and mean body mass index was (28.0 ± 3.9) kg/m(2). Mean PSG apnea hypopnea index (AHI) was (34.9 ± 29.9) events per hour, and mean PAT-AHI was (36.0 ± 29.2) events per hour. There was a significant correlation between PAT AHI and AHI by PSG (r = 0.931, P disease severity, while at higher levels of AHI, Watch-PAT underestimated severity. To assess sensitivity and specificity of Watch-PAT, constructed receiver operator characteristic curves using a variety of AHI threshold values (5, 15 and 30 events per hour). For AHI ≥ 5 events per hour as threshold value, the Watch-PAT diagnosing rate was 93%, and sensitivity as well as specificity were 94.7% and 80.0%. The misdiagnosis rate and missed diagnosis rate were 20.0% and 5.3%. Optimal combinations of sensitivity and specificity for the AHI threshold values (15 and 30 events per hour) were 82.6% and 100.0%, 95.0% and 95.7% respectively. The Watch-PAT 200 may offer an accurate, robust, and reliable ambulatory method for the detection of OSAHS, with minimal patient discomfort.

  19. Development and Validation of the Sleep Inertia Questionnaire (SIQ) and Assessment of Sleep Inertia in Analogue and Clinical Depression.

    Science.gov (United States)

    Kanady, Jennifer C; Harvey, Allison G

    2015-10-01

    Sleep inertia is the transitional state from sleep to wake. Research on sleep inertia is important in depression because many people with depression report having difficulty getting out of bed, which contributes to impairment and can impede the implementation of interventions. The first aim was to develop and validate the first self-report measure of sleep inertia, the Sleep Inertia Questionnaire (SIQ). The second aim was to compare reports of sleep inertia across three groups: (1) No-to-Mild-Depression, (2) Analogue-Depression, and (3) Syndromal-Depression. The SIQ demonstrates strong psychometric properties; it has good to excellent internal consistency, strong construct validity, and SIQ severity is associated with less prior sleep duration. Sleep inertia is more severe in the Analogue-Depression and Syndromal-Depression groups compared to the No-to-Mild-Depression group. In conclusion, the SIQ is a reliable measure of sleep inertia and has potential for improving the assessment of sleep inertia in clinical and research settings.

  20. Reliability of SleepStrip as a screening test in obstructive sleep apnea patients.

    Science.gov (United States)

    Dinç, Aykut Erdem; Yılmaz, Metin; Tutar, Hakan; Aydil, Utku; Kızıl, Yusuf; Damar, Murat; Kemaloğlu, Yusuf K

    2014-10-01

    Obstructive sleep apnea syndrome (OSAS) is a common sleep disorder and related to multiple conditions that cause mortality in adults. In the present study, reliability of SleepStrip, a disposable screening device for detection of OSAS, is tested. In this prospective, nonrandomized double-blinded single cohort study at an academic health center, the performance of the SleepStrip in detecting respiratory events and establishing an SleepStrip score (Sscore) in domestic use were compared to the apnea-hypopnea index (AHI) obtained by the standard polysomnography (PSG) recordings in the sleep laboratory. Forty-one patients who have the PSG results participated the study and wore the SleepStrips at home. Test efficiency rate was 75% and there was a positive correlation between PSG-AHI scores and Sscores (r = 0.71, p 30 levels. The SleepStrip has 100% specificity and positive predictive values, but it also has low negative predictive and sensitivity values. The SleepStrip is not a reliable screening test in differential diagnosis among simple snorers, mild, moderate and severe OSAS patients. However, high Sscores highly indicate the presence of moderate-severe OSAS. We can safely send these patients to split-night PSG and continuous, automatic, bi-level positive airway pressure (CPAP/BPAP/APAP) titration at the same night. The SleepStrip may increase the effective use of the sleep laboratories.

  1. Validity of Actigraphy in Measurement of Sleep in Young Adults With Type 1 Diabetes.

    Science.gov (United States)

    Farabi, Sarah S; Quinn, Lauretta; Carley, David W

    2017-05-15

    Accurate objective measurement of sleep, an important health behavior, is needed. Individuals with type 1 diabetes mellitus (T1DM) have altered sleep architecture and reduced sleep quality in comparison with healthy controls. The aim of this investigation was to compare a commonly used actigraphy device, Actiwatch2, with polysomnography (PSG)-based measures of sleep in young adults with T1DM, and to determine which Actiwatch2 threshold setting provides the best correspondence. Subjects age 18-30 years with T1DM wore the Actiwatch2 while simultaneously undergoing in-laboratory PSG. Sleep parameters were derived from the Actiwatch2 using the three different sensitivity thresholds (low, medium, and high) provided by the manufacturer and compared with sleep parameters from PSG. Statistical analysis included intraclass correlation coefficients and Bland-Altman plots for comparison of sleep parameters. Cohen kappa and the prevalence-adjusted and bias-adjusted kappa (PABAK) were calculated to determine agreement between epoch-by-epoch sleep and wake data measured by the PSG versus Actiwatch2. Twenty-seven subjects were included in the analysis. The low threshold setting provided the greatest agreement and least bias in comparison with PSG for sleep parameters (intraclass correlation coefficient range 0.38 to 0.77). Mean differences between the low setting and PSG were nonsignificant ( P > .65) for all sleep parameters except sleep onset latency ( P = .04). All three settings provided approximately equivalent and moderate epoch-by-epoch agreement with the PSG (PABAK coefficients ranging from 0.56 to 0.63). When measuring sleep with the Actiwatch2 in young adults with T1DM, the low threshold setting provides the most accurate estimates of sleep parameters in comparison with PSG.

  2. A Prospective Video-Polysomnographic Analysis of Movements during Physiological Sleep in 100 Healthy Sleepers.

    Science.gov (United States)

    Stefani, Ambra; Gabelia, David; Mitterling, Thomas; Poewe, Werner; Högl, Birgit; Frauscher, Birgit

    2015-09-01

    Video-polysomnography (v-PSG) is the gold standard for the diagnosis of sleep disorders. Quantitative assessment of type and distribution of physiological movements during sleep for the differentiation between physiological and pathological motor activity is lacking. We performed a systematic and detailed analysis of movements during physiological sleep using v-PSG technology. Prospective v-PSG investigation. Academic referral center sleep laboratory. One hundred healthy sleepers aged 19-77 years recruited from a representative population sample after a two-step screening. N/A. All subjects underwent v-PSG. In all cases where electromyographic activity > 100 msec duration was visible during sleep in the mentalis, submentalis, flexor digitorum superficialis, or anterior tibialis muscles, the time-synchronized video was analyzed. Visible movements were classified according to movement type and topography, and movement rates were computed for the different sleep stages. A total of 9,790 movements (median 10.2/h, IQR 4.6-16.2) were analyzed: 99.7% were elementary, 0.3% complex. Movement indices were higher in men than women (men: median 13/h, interquartile range 7.1-29.3, women: median 7.9/h, interquartile range 3.4-14.5; P = 0.006). The majority of movements involved the extremities (87.9%) and were classified as focal (53.3%), distal (79.6%), and unilateral (71.5%); 15.3% of movements were associated with arousals. REM-related movements (median 0.8 sec, IQR 0.5-1.2) were shorter than NREM-related movements (median 1.1 sec, IQR 0.8-1.6; P = 0.001). Moreover, REM-related movements were predominantly myocloniform (86.6%), whereas NREM-related movements were more often non-myocloniform (59.1%, P sleep, and are associated with low arousal rates. REM-related movements were predominantly myocloniform and shorter than NREM movements, indicating different influences on motor control during both sleep states. © 2015 Associated Professional Sleep Societies, LLC.

  3. Subjective and objective assessment of sleep in adolescents with mild traumatic brain injury.

    Science.gov (United States)

    Tham, See Wan; Fales, Jessica; Palermo, Tonya M

    2015-06-01

    There is increased recognition that sleep problems may develop in children and adolescents after mild traumatic brain injury (mTBI). However, few studies have utilized both subjective and objective measures to comprehensively assess sleep problems in the pediatric population following the acute post-TBI period. The aims of this study were to compare sleep in adolescents with mTBI to healthy adolescents using subjective and objective measures, and to identify the clinical correlates associated with sleep problems. One hundred adolescents (50 adolescents with mTBI recruited from three to twelve months post-injury and 50 healthy adolescents) completed questionnaires assessing sleep quality, depression, and pain symptoms, and underwent 10 day actigraphic assessment of sleep patterns. Adolescents with mTBI reported poorer sleep quality and demonstrated significantly shorter actigraphic-measured sleep duration, poorer sleep efficiency, and more wake time after onset of sleep, compared with healthy adolescents (all, padolescents, poorer self-reported sleep quality was predicted by greater depressive symptoms. Poorer actigraphic sleep efficiency was predicted by membership in the mTBI group after controlling for age, sex, depressive symptoms, and presence of pain. Our findings suggest that adolescents may experience subjective and objective sleep disturbances up to one year following mTBI. These findings require further replication in larger samples. Additionally, research is needed to identify possible mechanisms for poor sleep in youth with mTBI.

  4. The effect of memantine on sleep architecture and psychiatric symptoms in patients with Alzheimer's disease.

    Science.gov (United States)

    Ishikawa, Ichiro; Shinno, Hideto; Ando, Nobuo; Mori, Takahiro; Nakamura, Yu

    2016-06-01

    Behavioural and psychological symptoms of dementia (BPSD) are commonly present in patients with Alzheimer's disease (AD). Disturbed sleep quality is also observed in AD patients. However, the effects of memantine on sleep architecture have not been investigated. The purpose of this study was to investigate the effects of memantine on polysomnography (PSG) variables and BPSD. In total, 12 patients with AD (mean age: 79.0±4.1 years old) were enrolled in this study. The following tests were performed: the Neuropsychiatric Inventory for the assessment of BPSD, the Mini-Mental State Examination (MMSE) for cognitive function, and PSG for evaluation of sleep architecture. After baseline examinations, patients were treated with memantine according to a standard prescription protocol. After being treated with 20 mg/day of memantine for 4 weeks, examinations were carried out again. All subjects completed the trial. The mean MMSE and NPI scores were 22.6±3.4 and 13.8±12.9, respectively. Treatment with memantine significantly decreased the NPI score (5.8±4.3, p<0.01). There were significant decreases in the scores of subscales for anxiety (p=0.04) and irritability/lability (p=0.04). PSG demonstrated a longer total sleep time (TST) (p<0.01), increases in sleep efficiency (p<0.01) and time spent in stage II (% TST, p=0.02), and decreases in nocturnal awakening (p<0.01), the periodic limb movement index (p<0.01), and time spent in stage I (% TST, p=0.02). Memantine was effective for reducing fragmented sleep and improving BPSD, and was well tolerated.

  5. 77 FR 21587 - Bayer Cropscience, LP, Including On-Site Leased Workers From Jacobs PSG, Middough Associates, Inc...

    Science.gov (United States)

    2012-04-10

    ... Employment and Training Administration Bayer Cropscience, LP, Including On-Site Leased Workers From Jacobs PSG, Middough Associates, Inc., Adecco, CDI Engineering Solutions, Becht Engineering, Engineering... Engineering Solutions, Becht Engineering, Engineering Support Systems, Manufacturing Management Services, US...

  6. Quantitative assessment of isolated rapid eye movement (REM) sleep without atonia without clinical REM sleep behavior disorder: clinical and research implications.

    Science.gov (United States)

    Sasai-Sakuma, Taeko; Frauscher, Birgit; Mitterling, Thomas; Ehrmann, Laura; Gabelia, David; Brandauer, Elisabeth; Inoue, Yuichi; Poewe, Werner; Högl, Birgit

    2014-09-01

    Rapid eye movement (REM) sleep without atonia (RWA) is observed in some patients without a clinical history of REM sleep behavior disorder (RBD). It remains unknown whether these patients meet the refined quantitative electromyographic (EMG) criteria supporting a clinical RBD diagnosis. We quantitatively evaluated EMG activity and investigated its overnight distribution in patients with isolated qualitative RWA. Fifty participants with an incidental polysomnographic finding of RWA (isolated qualitative RWA) were included. Tonic, phasic, and 'any' EMG activity during REM sleep on PSG were quantified retrospectively. Referring to the quantitative cut-off values for a polysomnographic diagnosis of RBD, 7/50 (14%) and 6/50 (12%) of the patients showed phasic and 'any' EMG activity in the mentalis muscle above the respective cut-off values. No patient was above the cut-off value for tonic EMG activity or phasic EMG activity in the anterior tibialis muscles. Patients with RWA above the cut-off value showed higher amounts of RWA during later REM sleep periods. This is the first study showing that some subjects with incidental RWA meet the refined quantitative EMG criteria for a diagnosis of RBD. Future longitudinal studies must investigate whether this subgroup with isolated qualitative RWA is at an increased risk of developing fully expressed RBD and/or neurodegenerative disease. Copyright © 2014 Elsevier B.V. All rights reserved.

  7. Parasomnias and sleep disordered breathing in Caucasian and Hispanic children – the Tucson children's assessment of sleep apnea study

    Science.gov (United States)

    Goodwin, James L; Kaemingk, Kris L; Fregosi, Ralph F; Rosen, Gerald M; Morgan, Wayne J; Smith, Terry; Quan, Stuart F

    2004-01-01

    Background Recent studies in children have demonstrated that frequent occurrence of parasomnias is related to increased sleep disruption, mental disorders, physical harm, sleep disordered breathing, and parental duress. Although there have been several cross-sectional and clinical studies of parasomnias in children, there have been no large, population-based studies using full polysomnography to examine the association between parasomnias and sleep disordered breathing. The Tucson Children's Assessment of Sleep Apnea study is a community-based cohort study designed to investigate the prevalence and correlates of objectively measured sleep disordered breathing (SDB) in pre-adolescent children six to 11 years of age. This paper characterizes the relationships between parasomnias and SDB with its associated symptoms in these children. Methods Parents completed questionnaires pertaining to their child's sleep habits. Children had various physiological measurements completed and then were connected to the Compumedics PS-2 sleep recording system for full, unattended polysomnography in the home. A total of 480 unattended home polysomnograms were completed on a sample that was 50% female, 42.3% Hispanic, and 52.9% between the ages of six and eight years. Results Children with a Respiratory Disturbance Index of one or greater were more likely to have sleep walking (7.0% versus 2.5%, p sleep talking (18.3% versus 9.0%, p sleep disturbances as well as learning problems was observed in children with parasomnia. Those with parasomnias associated with arousal were observed to have increased number of stage shifts. Small alterations in sleep architecture were found in those with enuresis. Conclusions In this population-based cohort study, pre-adolescent school-aged children with SDB experienced more parasomnias than those without SDB. Parasomnias were associated with a higher prevalence of other sleep disturbances and learning problems. Clinical evaluation of children with

  8. High self-perceived exercise exertion before bedtime is associated with greater objectively assessed sleep efficiency.

    Science.gov (United States)

    Brand, Serge; Kalak, Nadeem; Gerber, Markus; Kirov, Roumen; Pühse, Uwe; Holsboer-Trachsler, Edith

    2014-09-01

    To assess the association between self-perceived exercise exertion before bedtime and objectively measured sleep. Fifty-two regularly exercising young adults (mean age, 19.70 years; 54% females) underwent sleep electroencephalographic recordings 1.5 h after completing moderate to vigorous exercise in the evening. Before sleeping, participants answered questions regarding degree of exertion of the exercise undertaken. Greater self-perceived exertion before bedtime was associated with higher objectively assessed sleep efficiency (r = 0.69, P exercise exertion was associated with more deep sleep, shortened sleep onset time, fewer awakenings after sleep onset, and shorter wake duration after sleep onset. Multiple linear regression analysis showed that objective sleep efficiency was predicted by increased exercise exertion, shortened sleep onset time, increased deep sleep, and decreased light sleep. Against expectations and general recommendations for sleep hygiene, high self-perceived exercise exertion before bedtime was associated with better sleep patterns in a sample of healthy young adults. Further studies should also focus on elderly adults and adults suffering from insomnia. Copyright © 2014 Elsevier B.V. All rights reserved.

  9. Effects of salmeterol on sleeping oxygen saturation in chronic obstructive pulmonary disease.

    LENUS (Irish Health Repository)

    Ryan, Silke

    2012-02-01

    BACKGROUND: Sleep is associated with important adverse effects in patients with chronic obstructive pulmonary disease (COPD), such as disturbed sleep quality and gas exchange, including hypoxemia and hypercapnia. The effects of inhaled long-acting beta(2)-agonist therapy (LABA) on these disturbances are unclear. OBJECTIVES: The aim of the study was to assess the effect of inhaled salmeterol on nocturnal sleeping arterial oxygen saturation (SaO(2)) and sleep quality. METHODS: In a randomized, double-blind, placebo-controlled, crossover study of moderate\\/severe stable COPD patients, we compared the effects of 4 weeks of treatment with salmeterol 50 microg b.d. and matching placebo on sleeping SaO(2) and sleep quality. Overnight polysomnography (PSG) was performed at baseline, and after 4 and 8 weeks in addition to detailed pulmonary function testing. Of 15 patients included, 12 completed the trial (median age 69 years, forced expiratory volume in 1 s, FEV(1): 39%). RESULTS: Both mean SaO(2) [salmeterol vs. placebo: 92.9% (91.2, 94.7) vs. 91.0% (88.9, 94.8); p = 0.016] and the percentage of sleep spent below 90% of SaO(2) [1.8% (0.0, 10.8) vs. 25.6% (0.5, 53.5); p = 0.005] improved significantly with salmeterol. Sleep quality was similar with both salmeterol and placebo on PSG. Static lung volumes, particularly trapped gas volume, tended to improve with salmeterol. CONCLUSION: We conclude that inhaled LABA therapy improves sleeping SaO(2) without significant change in sleep quality.

  10. Association between sleep architecture and glucose tolerance in children and adolescents.

    Science.gov (United States)

    Zhu, Yin; Li, Albert Martin; Au, Chun Ting; Kong, Alice Pik Shan; Zhang, Jihui; Wong, Chun Kwok; Chan, Juliana Chung Ngor; Wing, Yun Kwok

    2015-01-01

    Short sleep duration is a contributing factor for decreased insulin sensitivity and hyperglycemia. Sleep architecture represents a cyclical pattern of sleep that shifts between sleep Stages N1, N2, N3 (slow wave sleep) and Stage R (rapid eye movement sleep). The aim of the present study was to examine the association between sleep architecture and glucose and insulin metabolism in both normal weight and overweight/obese children and adolescents. A total of 118 subjects participated in the study. Subjects under-went overnight polysomnography (PSG) when the percentage of total sleep time (% TST) spent at each sleep stage was recorded and an oral glucose tolerance test together was performed the next morning. We assessed glucose tolerance, insulin sensitivity and pancreatic β-cell function using 2-h glucose levels, the Matsuda index (IS(OGTT)), and insulin secretion-sensitivity index-2 (ISSI-2), respectively. After adjustment for age, gender, body mass index z-score, pubertal status, and obstructive apnea hypopnea index, Stage N3 (% TST) was positively associated with IS(OGTT), whereas Stage N1 (%TST) exerted an opposite effect on IS(OGTT). Higher sleep efficiency and longer TST were independently associated with lower 2-h glucose levels, higher ISSI-2 and/or higher IS(OGTT). Stage N3, sleep efficiency and TST were protective factors in maintaining glucose and insulin homeostasis; however, Stage N1 functioned in the opposite direction.

  11. Increased self-reported and objectively assessed physical activity predict sleep quality among adolescents.

    Science.gov (United States)

    Lang, Christin; Brand, Serge; Feldmeth, Anne Karina; Holsboer-Trachsler, Edith; Pühse, Uwe; Gerber, Markus

    2013-08-15

    Both scientists and the general public assume that physical activity (PA) is an effective, non-pharmacological approach to improvement in sleep quality. However, objective and reliable data on this relationship are scarce, particularly for adolescents. Therefore, the aims of the present study were to test the relationship by assessing both PA and sleep subjectively and objectively. A total of 56 adolescent vocational school students (Mean age=17.98, SD=1.36; 28 males, 28 females) participated in the study. Sleep and PA were subjectively assessed via questionnaires. Accelerometers objectively assessed PA, while sleep-EEG devices objectively assessed sleep. The data supported our prediction that adolescents with high PA levels would have longer TST, fewer wakening at night (WASO), fewer symptoms of insomnia, and higher sleep quality. However, gender influenced this pattern of results in that significant findings were only found between high self-reported PA levels and shorter perceived sleep onset latency (SOL). Though self-reported PA levels were a better predictor of good sleep than objectively assessed PA levels, gender was associated with sleep complaints; females reported more sleep complaints. Results indicate that among a non-clinical sample of adolescents increased PA is favorably associated with restoring sleep. Therefore, PA seems beneficial not only for physical and mental health, but also for sleep restoration. © 2013.

  12. Is There a Clinical Role For Smartphone Sleep Apps? Comparison of Sleep Cycle Detection by a Smartphone Application to Polysomnography.

    Science.gov (United States)

    Bhat, Sushanth; Ferraris, Ambra; Gupta, Divya; Mozafarian, Mona; DeBari, Vincent A; Gushway-Henry, Neola; Gowda, Satish P; Polos, Peter G; Rubinstein, Mitchell; Seidu, Huzaifa; Chokroverty, Sudhansu

    2015-07-15

    Several inexpensive, readily available smartphone apps that claim to monitor sleep are popular among patients. However, their accuracy is unknown, which limits their widespread clinical use. We therefore conducted this study to evaluate the validity of parameters reported by one such app, the Sleep Time app (Azumio, Inc., Palo Alto, CA, USA) for iPhones. Twenty volunteers with no previously diagnosed sleep disorders underwent in-laboratory polysomnography (PSG) while simultaneously using the app. Parameters reported by the app were then compared to those obtained by PSG. In addition, an epoch-by-epoch analysis was performed by dividing the PSG and app graph into 15-min epochs. There was no correlation between PSG and app sleep efficiency (r = -0.127, p = 0.592), light sleep percentage (r = 0.024, p = 0.921), deep sleep percentage (r = 0.181, p = 0.444) or sleep latency (rs = 0.384, p = 0.094). The app slightly and nonsignificantly overestimated sleep efficiency by 0.12% (95% confidence interval [CI] -4.9 to 5.1%, p = 0.962), significantly underestimated light sleep by 27.9% (95% CI 19.4-36.4%, p sleep by 11.1% (CI 4.7-17.4%, p = 0.008) and significantly overestimated sleep latency by 15.6 min (CI 9.7-21.6, p sleep-wake detection (85.9%). The app had high sensitivity but poor specificity in detecting sleep (89.9% and 50%, respectively). Our study shows that the absolute parameters and sleep staging reported by the Sleep Time app (Azumio, Inc.) for iPhones correlate poorly with PSG. Further studies comparing app sleep-wake detection to actigraphy may help elucidate its potential clinical utility. A commentary on this article appears in this issue on page 695. © 2015 American Academy of Sleep Medicine.

  13. Examination of wrist and hip actigraphy using a novel sleep estimation procedure☆

    Science.gov (United States)

    Ray, Meredith A.; Youngstedt, Shawn D.; Zhang, Hongmei; Robb, Sara Wagner; Harmon, Brook E.; Jean-Louis, Girardin; Cai, Bo; Hurley, Thomas G.; Hébert, James R.; Bogan, Richard K.; Burch, James B.

    2014-01-01

    Objective Improving and validating sleep scoring algorithms for actigraphs enhances their usefulness in clinical and research applications. The MTI® device (ActiGraph, Pensacola, FL) had not been previously validated for sleep. The aims were to (1) compare the accuracy of sleep metrics obtained via wrist- and hip-mounted MTI® actigraphs with polysomnographic (PSG) recordings in a sample that included both normal sleepers and individuals with presumed sleep disorders; and (2) develop a novel sleep scoring algorithm using spline regression to improve the correspondence between the actigraphs and PSG. Methods Original actigraphy data were amplified and their pattern was estimated using a penalized spline. The magnitude of amplification and the spline were estimated by minimizing the difference in sleep efficiency between wrist- (hip-) actigraphs and PSG recordings. Sleep measures using both the original and spline-modified actigraphy data were compared to PSG using the following: mean sleep summary measures; Spearman rank-order correlations of summary measures; percent of minute-by-minute agreement; sensitivity and specificity; and Bland–Altman plots. Results The original wrist actigraphy data showed modest correspondence with PSG, and much less correspondence was found between hip actigraphy and PSG. The spline-modified wrist actigraphy produced better approximations of interclass correlations, sensitivity, and mean sleep summary measures relative to PSG than the original wrist actigraphy data. The spline-modified hip actigraphy provided improved correspondence, but sleep measures were still not representative of PSG. Discussion The results indicate that with some refinement, the spline regression method has the potential to improve sleep estimates obtained using wrist actigraphy. PMID:25580202

  14. Sleep and Fasciculations in Amyothropic Lateral Sclerosis

    Czech Academy of Sciences Publication Activity Database

    Šonka, K.; Fiksa, J.; Horváth, E.; Kemlink, D.; Süssová, J.; Böhm, J.; Šebesta, Václav; Volná, J.; Nevšímalová, S.

    2004-01-01

    Roč. 8, č. 1 (2004), s. 25-30 ISSN 1432-9123 R&D Projects: GA MZd NF5999 Keywords : amyothropic lateral sclerosis ALS * fasciculation * fragmentary myoclonus * periodic leg movements in sleep PLMS * polysomnography PSG * electromyography EMG * REM sleep Subject RIV: BD - Theory of Information

  15. Diagnosis of sleep-disordered breathing by half-night polysomnography.

    Science.gov (United States)

    Sanders, M H; Black, J; Costantino, J P; Kern, N; Studnicki, K; Coates, J

    1991-12-01

    We hypothesized that sleep-disordered breathing (SDB), defined by the apnea index (AI), the apnea + hypopnea index (A + H/I), or the desaturation event frequency (number of desaturations greater than 5%/h slept) (DEF), could be diagnosed after less than full-night polysomnography (PSG). Forty-eight consecutive full-night PSG sessions were evaluated by separately analyzing the first half (PSG-1/2) and the total (PSG-T) sleep time: 134.42 +/- 35.7 and 277.15 +/- 56.5 min (mean +/- SD), respectively. PSG-1/2 and PSG-T were not different with respect to AI. The DEF was statistically but not clinically higher during PSG-1/2 (41.72 +/- 41 versus 37.95 +/- 35.8, p = 0.04). Sensitivities, specificities, and predictive values of each PSG-1/2 parameter were determined by comparing the values with those measured during PSG-T, using cutoff frequencies of both 5 and 10 events/h slept to define SDB. At a cutoff frequency of 10, sensitivities and positive predictive values were high for all PSG-1/2 parameters (range, 94.6 to 96.9%). The specificities of the DEF and AI during PSG-1/2 were also high (93.75 and 95%, respectively), but the negative predictive value of the DEF was substantially better (93.75 versus 83.3%). With SDB defined by 5 events/h slept, there also were high sensitivities (87.9 to 93%), positive predictive values (93.6 to 100%), and specificities (86.7 to 100%) for all parameters. Negative predictive values, however, were substantially reduced (62.5 to 76.5%). We conclude that PSG during 2 h of sleep is an appropriate method for evaluating SDB.(ABSTRACT TRUNCATED AT 250 WORDS)

  16. Conservation of pregnancy-specific glycoprotein (PSG N domains following independent expansions of the gene families in rodents and primates

    Directory of Open Access Journals (Sweden)

    Zimmermann Wolfgang

    2005-06-01

    Full Text Available Abstract Background Rodent and primate pregnancy-specific glycoprotein (PSG gene families have expanded independently from a common ancestor and are expressed virtually exclusively in placental trophoblasts. However, within each species, it is unknown whether multiple paralogs have been selected for diversification of function, or for increased dosage of monofunctional PSG. We analysed the evolution of the mouse PSG sequences, and compared them to rat, human and baboon PSGs to attempt to understand the evolution of this complex gene family. Results Phylogenetic tree analyses indicate that the primate N domains and the rodent N1 domains exhibit a higher degree of conservation than that observed in a comparison of the mouse N1 and N2 domains, or mouse N1 and N3 domains. Compared to human and baboon PSG N domain exons, mouse and rat PSG N domain exons have undergone less sequence homogenisation. The high non-synonymous substitution rates observed in the CFG face of the mouse N1 domain, within a context of overall conservation, suggests divergence of function of mouse PSGs. The rat PSG family appears to have undergone less expansion than the mouse, exhibits lower divergence rates and increased sequence homogenisation in the CFG face of the N1 domain. In contrast to most primate PSG N domains, rodent PSG N1 domains do not contain an RGD tri-peptide motif, but do contain RGD-like sequences, which are not conserved in rodent N2 and N3 domains. Conclusion Relative conservation of primate N domains and rodent N1 domains suggests that, despite independent gene family expansions and structural diversification, mouse and human PSGs retain conserved functions. Human PSG gene family expansion and homogenisation suggests that evolution occurred in a concerted manner that maintains similar functions of PSGs, whilst increasing gene dosage of the family as a whole. In the mouse, gene family expansion, coupled with local diversification of the CFG face, suggests

  17. REM sleep phase preference in the crepuscular Octodon degus assessed by selective REM sleep deprivation.

    Science.gov (United States)

    Ocampo-Garcés, Adrián; Hernández, Felipe; Palacios, Adrian G

    2013-08-01

    To determine rapid eye movement (REM) sleep phase preference in a crepuscular mammal (Octodon degus) by challenging the specific REM sleep homeostatic response during the diurnal and nocturnal anticrepuscular rest phases. We have investigated REM sleep rebound, recovery, and documented REM sleep propensity measures during and after diurnal and nocturnal selective REM sleep deprivations. Nine male wild-captured O. degus prepared for polysomnographic recordings. Animals were recorded during four consecutive baseline and two separate diurnal or nocturnal deprivation days, under a 12:12 light-dark schedule. Three-h selective REM sleep deprivations were performed, starting at midday (zeitgeber time 6) or midnight (zeitgeber time 18). Diurnal and nocturnal REM sleep deprivations provoked equivalent amounts of REM sleep debt, but a consistent REM sleep rebound was found only after nocturnal deprivation. The nocturnal rebound was characterized by a complete recovery of REM sleep associated with an augment in REM/total sleep time ratio and enhancement in REM sleep episode consolidation. Our results support the notion that the circadian system actively promotes REM sleep. We propose that the sleep-wake cycle of O. degus is modulated by a chorus of circadian oscillators with a bimodal crepuscular modulation of arousal and a unimodal promotion of nocturnal REM sleep

  18. Influence of the right- versus left-sided sleeping position on the apnea-hypopnea index in patients with sleep apnea.

    Science.gov (United States)

    Ozeke, Ozcan; Erturk, Ozcan; Gungor, Mutlu; Hızel, Serap Bılen; Aydın, Dilek; Celenk, Mehmet Kutlu; Dıncer, Hazim; Ilıcın, Gurler; Ozgen, Fuat; Ozer, Can

    2012-09-01

    Sleep and sleep position have a significant impact on physical, cardiac and mental health, and have been evaluated in numerous studies particularly in terms of lateral sleeping positions and their association with diseases. We retrospectively examined the relationship between the sleeping position and position-specific apnea-hypopnea index (AHI) in obstructive sleep apnea-hypopnea (OSA) patients. We assessed the sleeping body position and the body position-specific AHI score in patients who were referred for suspected OSA and underwent diagnostic nocturnal polysomnography. In order to eliminate inter-individual differences, only those who had a similar percentage of time spent in the LSSP and RSSP for each patient were enrolled. To provide this validity, only subjects that had a similar percentage of left and right lateral sleep time (±10%) were included in the analysis. A total of 864 patients had nocturnal diagnostic PSG. Of them, 131 patients met the inclusion criteria. The percent rate spent in the supine sleeping position (SSP) was 31.3 ± 18.7%, in the LSSP was 31.8 ± 10% and in the RSSP was 32.6 ± 10.8%. Whereas the SSP-specific AHI score was the highest with 60.4 ± 36.2/h among all the sleeping position-specific AHI scores (p sleeping position had a significant influence on apneic events and RSSP decreased the frequency of obstructive respiratory events in patients with moderate and severe disease.

  19. The Effect of Exercise Training on Obstructive Sleep Apnea and Sleep Quality: A Randomized Controlled Trial

    Science.gov (United States)

    Kline, Christopher E.; Crowley, E. Patrick; Ewing, Gary B.; Burch, James B.; Blair, Steven N.; Durstine, J. Larry; Davis, J. Mark; Youngstedt, Shawn D.

    2011-01-01

    Study Objectives: To evaluate the efficacy of a 12-week exercise training program for reducing obstructive sleep apnea (OSA) severity and improving sleep quality, and to explore possible mechanisms by which exercise may reduce OSA severity. Design: Randomized controlled trial. Setting: Clinical exercise physiology center, sleep laboratory. Participants: Forty-three sedentary and overweight/obese adults aged 18-55 years with at least moderate-severity untreated OSA (screening apnea-hypopnea index [AHI] ≥ 15). Interventions: Participants randomized to exercise training (n = 27) met 4 times/week for 12 weeks and performed 150 min/week of moderate-intensity aerobic activity, followed by resistance training twice/week. Participants randomized to a stretching control (n = 16) met twice weekly for 12 weeks to perform low-intensity exercises designed to increase whole-body flexibility. Measurements and Results: OSA severity was assessed with one night of laboratory polysomnography (PSG) before and following the 12-week intervention. Measures of sleep quality included PSG, actigraphy (7-10 days), and the Pittsburgh Sleep Quality Index. Compared with stretching, exercise resulted in a significant AHI reduction (exercise: 32.2 ± 5.6 to 24.6 ± 4.4, stretching: 24.4 ± 5.6 to 28.9 ± 6.4; P sleep (P = 0.03). Reductions in AHI and ODI were achieved without a significant decrease in body weight. Improvements in actigraphic sleep and subjective sleep quality were also noted following exercise compared with stretching. Conclusions: Exercise training had moderate treatment efficacy for the reduction of AHI in sedentary overweight/obese adults, which suggests that exercise may be beneficial for the management of OSA beyond simply facilitating weight loss. Trial Registration: Clinicaltrials.gov identification number NCT00956423. Citation: Kline CE; Crowley EP; Ewing GB; Burch JB; Blair SN; Durstine JL; Davis JM; Youngstedt SD. The effect of exercise training on obstructive sleep

  20. Sleep estimation using BodyMedia′s SenseWear™ armband in patients with obstructive sleep apnea

    Directory of Open Access Journals (Sweden)

    Munir M Sharif

    2013-01-01

    Conclusion: The current data suggest that BSA is a reliable method for determining sleep in patients with OSA when compared against the gold standard test (PSG. BSA can be a useful tool in determining sleep in patients with OSA and can be combined with portable sleep studies to determine TST.

  1. The sleep of children with attention deficit hyperactivity disorder on and off methylphenidate: a matched case-control study.

    Science.gov (United States)

    Galland, Barbara C; Tripp, E Gail; Taylor, Barry J

    2010-06-01

    In the present study, we assessed the effects of regular use of methylphenidate medication in children diagnosed with attention deficit hyperactivity disorder (ADHD) on sleep timing, duration and sleep architecture. Twenty-seven children aged 6-12 years meeting diagnostic criteria for Diagnostic and Statistical Manual version IV ADHD and 27 control children matched for age (+/-3 months) and gender. Two nights of standard polysomnographic (PSG) recordings were conducted. ADHD children were allocated randomly to an on- or 48 h off-methylphenidate protocol for first or second recordings. Control children's recordings were matched for night, but no medication was used. Mixed modelling was employed in the analyses so that the full data set was used to determine the degree of medication effects. Methylphenidate in ADHD children prolonged sleep onset by an average of 29 min [confidence interval (CI) 11.6, 46.7], reduced sleep efficiency by 6.5% (CI 2.6, 10.3) and shortened sleep by 1.2 h (CI 0.65, 1.9). Arousal indices were preserved. Relative amounts of stages 1, 2 and slow wave sleep were unchanged by medication. Rapid eye movement sleep was reduced (-2.4%) on the medication night, an effect that became non-significant when control data were incorporated in the analyses. PSG data from ADHD children off-medication were similar to control data. Our findings suggest that methylphenidate reduces sleep quantity but does not alter sleep architecture in children diagnosed with ADHD. An adequate amount of sleep is integral to good daytime functioning, thus the sleep side effects of methylphenidate may affect adversely the daytime symptoms the drug is targeted to control.

  2. Big data in sleep medicine: prospects and pitfalls in phenotyping.

    Science.gov (United States)

    Bianchi, Matt T; Russo, Kathryn; Gabbidon, Harriett; Smith, Tiaundra; Goparaju, Balaji; Westover, M Brandon

    2017-01-01

    Clinical polysomnography (PSG) databases are a rich resource in the era of "big data" analytics. We explore the uses and potential pitfalls of clinical data mining of PSG using statistical principles and analysis of clinical data from our sleep center. We performed retrospective analysis of self-reported and objective PSG data from adults who underwent overnight PSG (diagnostic tests, n=1835). Self-reported symptoms overlapped markedly between the two most common categories, insomnia and sleep apnea, with the majority reporting symptoms of both disorders. Standard clinical metrics routinely reported on objective data were analyzed for basic properties (missing values, distributions), pairwise correlations, and descriptive phenotyping. Of 41 continuous variables, including clinical and PSG derived, none passed testing for normality. Objective findings of sleep apnea and periodic limb movements were common, with 51% having an apnea-hypopnea index (AHI) >5 per hour and 25% having a leg movement index >15 per hour. Different visualization methods are shown for common variables to explore population distributions. Phenotyping methods based on clinical databases are discussed for sleep architecture, sleep apnea, and insomnia. Inferential pitfalls are discussed using the current dataset and case examples from the literature. The increasing availability of clinical databases for large-scale analytics holds important promise in sleep medicine, especially as it becomes increasingly important to demonstrate the utility of clinical testing methods in management of sleep disorders. Awareness of the strengths, as well as caution regarding the limitations, will maximize the productive use of big data analytics in sleep medicine.

  3. Adequacy of prescribing positive airway pressure therapy by mask for sleep apnea on the basis of a partial-night trial.

    Science.gov (United States)

    Sanders, M H; Kern, N B; Costantino, J P; Stiller, R A; Studnicki, K; Coates, J; Orris, S; Schimerman, S

    1993-05-01

    We tested the hypothesis that a prescription for positive-pressure therapy (including pressure level, patient-device interface, and positive-pressure modality, e.g., CPAP or BiPAP) for obstructive sleep apnea (OSA) can be developed on the same night as the polysomnographic (PSG) diagnosis is made. Fifty consecutive patients with OSA in whom a partial-night PSG diagnosis was made (PSGD) underwent a therapeutic trial of positive-pressure therapy during the remainder of the night (PSG-PPP). The average apnea index during PSGD was 54.96 +/- 36.3 (mean +/- SD). On a subsequent full-night PSG (PSG-PPF), the prescription was tested. Thirty-one of the 50 patients were satisfactorily treated with CPAP, without variation of the interface during both PSG-PPP and PSG-PPF. In these patients the average pressure prescription while receiving PSG-PPF was statistically higher than during PSG-PPP (11.77 +/- 3.6 versus 10.56 +/- 3.6 cm H2O, respectively, p = 0.002). In 14 of these 31 patients (45%) some alteration in pressure requirement was necessary during PSG-PPF. Eleven patients required 2.5 cm H2O higher pressure and three patients required 5 cm H2O higher pressure during PSG-PPF than during PSG-PPP. There was a change of interface across the two therapeutic trials in 15 patients.(ABSTRACT TRUNCATED AT 250 WORDS)

  4. In search of objective components for sleep quality indexing in normal sleep

    OpenAIRE

    Rosipal, Roman; Lewandowski, Achim; Dorffner, Georg

    2013-01-01

    The main goal of this study was to investigate to what extent polysomnographic (PSG) recordings of nocturnal human sleep can provide information about sleep quality in terms of correlation with a set of daytime measures. These measures were designed with the aim of comprising selected quality of night sleep and consist of subjective sleep quality ratings, neuropsychological tests and physiological parameters. First, a factor analysis model was applied to the large number of daytime measures o...

  5. Sleep disorders in children: a national assessment of primary care pediatrician practices and perceptions.

    Science.gov (United States)

    Faruqui, Firoza; Khubchandani, Jagdish; Price, James H; Bolyard, Dawn; Reddy, Ramalinga

    2011-09-01

    To assess general pediatricians' screening practices for sleep-related issues and assess their knowledge on common sleep complaints in children, their perceived barriers to screening for sleep issues, and whether they have received training regarding sleep issues. A national random sample (n = 700) of general pediatricians who were members of the American Academy of Pediatrics were sent a valid and reliable questionnaire on sleep problems in youth. A total of 346 pediatricians (49%) responded. The vast majority (96%) indicated that they believed it was their job to counsel patients/guardians regarding sleep hygiene, yet few pediatricians (18%) had ever received formal training on sleep disorders. Those who did not screen for sleep problems spent significantly less time with each patient and perceived significantly more barriers to screening. Pediatricians who had received training about sleep disorders had significantly higher knowledge scores on sleep problems, perceived significantly fewer barriers to screening, and reported significantly higher confidence scores regarding counseling patients/guardians on sleep problems. These findings support the need for formal education on sleep disorders for all pediatricians.

  6. Sawtooth waves during REM sleep after administration of haloperidol combined with total sleep deprivation in healthy young subjects

    Directory of Open Access Journals (Sweden)

    L.R. Pinto Jr.

    2002-05-01

    Full Text Available We sought to examine the possible participation of dopaminergic receptors in the phasic events that occur during rapid eye movement (REM sleep, known as sawtooth waves (STW. These phasic phenomena of REM sleep exhibit a unique morphology and, although they represent a characteristic feature of REM sleep, little is known about the mechanisms which generate them and which are apparently different from rapid eye movements. STW behavior was studied in 10 male volunteers aged 20 to 35 years, who were submitted to polysomnographic monitoring (PSG. On the adaptation night they were submitted to the first PSG and on the second night, to the basal PSG. On the third night the volunteers received placebo or haloperidol and spent the whole night awake. On the fourth night they were submitted to the third PSG. After a 15-day rest period, the volunteers returned to the sleep laboratory and, according to a double-blind crossover randomized design, received haloperidol or placebo and spent the whole night awake, after which they were submitted to the fourth PSG. The volunteers who were given haloperidol combined with sleep deprivation exhibited an elevation of the duration and density of the STW, without significant alterations of the other REM sleep phasic phenomena such as rapid eye movement. These findings suggest that sawtooth waves must have their own generating mechanisms and that the dopaminergic receptors must exert a modulating role since REM sleep deprivation, as well as administration of neuroleptics, produces supersensitivity of dopaminergic receptors.

  7. Ecological momentary assessment of sleep, symptoms, and mood during chemotherapy for breast cancer.

    Science.gov (United States)

    Ratcliff, Chelsea G; Lam, Cho Y; Arun, Banu; Valero, Vincente; Cohen, Lorenzo

    2014-11-01

    This study examined the association of sleep before and during a chemotherapy (CT) cycle for breast cancer with symptoms and mood during a CT cycle. Twenty women undergoing CT for breast cancer completed the Pittsburgh Sleep Quality Index (PSQI) 1 h prior to a CT infusion. For 3 weeks following infusion, participants estimated sleep efficiency, minutes to sleep (sleep latency), number of nocturnal awakenings (sleep fragmentation (SF)), and sleep quality (SQ) each morning and rated symptoms (nausea, fatigue, numbness, and difficulty thinking) and mood three times daily (morning, afternoon, and evening) via ecological momentary assessments using automated handheld computers. The results showed that disturbed sleep (PSQI score > 5) prior to CT infusion was associated with greater fatigue, and more negative and anxious mood throughout the 3-week CT cycle, and good pre-CT infusion sleep (PSQI score mood in the first days following infusion. Time-lagged analyses controlling for mood/symptom ratings reported the previous evening revealed that longer sleep latency and greater SF were associated with greater daytime fatigue; poorer SQ and greater SF were antecedents of worse morning negative mood, and greater SF was associated with feeling more passive and drowsy. No evening symptom or mood ratings were related to subsequent SQ. These findings suggest that disturbed sleep before and after a CT infusion exacerbates fatigue, and negative, anxious, and drowsy mood during a CT cycle. Reducing sleep disturbance may be an important way to improve quality of life during CT. Copyright © 2014 John Wiley & Sons, Ltd.

  8. Parasomnias and sleep disordered breathing in Caucasian and Hispanic children – the Tucson children's assessment of sleep apnea study

    Directory of Open Access Journals (Sweden)

    Fregosi Ralph F

    2004-04-01

    Full Text Available Abstract Background Recent studies in children have demonstrated that frequent occurrence of parasomnias is related to increased sleep disruption, mental disorders, physical harm, sleep disordered breathing, and parental duress. Although there have been several cross-sectional and clinical studies of parasomnias in children, there have been no large, population-based studies using full polysomnography to examine the association between parasomnias and sleep disordered breathing. The Tucson Children's Assessment of Sleep Apnea study is a community-based cohort study designed to investigate the prevalence and correlates of objectively measured sleep disordered breathing (SDB in pre-adolescent children six to 11 years of age. This paper characterizes the relationships between parasomnias and SDB with its associated symptoms in these children. Methods Parents completed questionnaires pertaining to their child's sleep habits. Children had various physiological measurements completed and then were connected to the Compumedics PS-2 sleep recording system for full, unattended polysomnography in the home. A total of 480 unattended home polysomnograms were completed on a sample that was 50% female, 42.3% Hispanic, and 52.9% between the ages of six and eight years. Results Children with a Respiratory Disturbance Index of one or greater were more likely to have sleep walking (7.0% versus 2.5%, p p p Conclusions In this population-based cohort study, pre-adolescent school-aged children with SDB experienced more parasomnias than those without SDB. Parasomnias were associated with a higher prevalence of other sleep disturbances and learning problems. Clinical evaluation of children with parasomnias should include consideration of SDB.

  9. Reliability of the American Academy of Sleep Medicine Rules for Assessing Sleep Depth in Clinical Practice.

    Science.gov (United States)

    Younes, Magdy; Kuna, Samuel T; Pack, Allan I; Walsh, James K; Kushida, Clete A; Staley, Bethany; Pien, Grace W

    2018-02-15

    The American Academy of Sleep Medicine has published manuals for scoring polysomnograms that recommend time spent in non-rapid eye movement sleep stages (stage N1, N2, and N3 sleep) be reported. Given the well-established large interrater variability in scoring stage N1 and N3 sleep, we determined the range of time in stage N1 and N3 sleep scored by a large number of technologists when compared to reasonably estimated true values. Polysomnograms of 70 females were scored by 10 highly trained sleep technologists, two each from five different academic sleep laboratories. Range and confidence interval (CI = difference between the 5th and 95th percentiles) of the 10 times spent in stage N1 and N3 sleep assigned in each polysomnogram were determined. Average values of times spent in stage N1 and N3 sleep generated by the 10 technologists in each polysomnogram were considered representative of the true values for the individual polysomnogram. Accuracy of different technologists in estimating delta wave duration was determined by comparing their scores to digitally determined durations. The CI range of the ten N1 scores was 4 to 39 percent of total sleep time (% TST) in different polysomnograms (mean CI ± standard deviation = 11.1 ± 7.1 % TST). Corresponding range for N3 was 1 to 28 % TST (14.4 ± 6.1 % TST). For stage N1 and N3 sleep, very low or very high values were reported for virtually all polysomnograms by different technologists. Technologists varied widely in their assignment of stage N3 sleep, scoring that stage when the digitally determined time of delta waves ranged from 3 to 17 seconds. Manual scoring of non-rapid eye movement sleep stages is highly unreliable among highly trained, experienced technologists. Measures of sleep continuity and depth that are reliable and clinically relevant should be a focus of clinical research.

  10. Assessment of sleep and circadian rhythm disorders in the very old: the Newcastle 85+ Cohort Study.

    Science.gov (United States)

    Anderson, Kirstie N; Catt, Michael; Collerton, Joanna; Davies, Karen; von Zglinicki, Thomas; Kirkwood, Thomas B L; Jagger, Carol

    2014-01-01

    to examine the association between subjective and objective measures of sleep and wake and other health parameters in a cohort of the very old. a population-based cohort study. primary care, North East England. four hundred and twenty-one men and women, aged 87-89, recruited to the Newcastle 85+ Study cohort. sleep questionnaires were administered and sleep-wake patterns were assessed over 5-7 days with a novel wrist triaxial accelerometer. Associations between sleep measures and various health parameters, including mortality at 24 months, were examined. only 16% of participants perceived their sleep as severely disturbed as assessed with questionnaire responses. Wrist accelerometry showed marked variation between normal and abnormal sleep-wake cycles that did not correlate with the participants' perception of sleep. Impaired sleep-wake cycles were significantly associated with cognitive impairment, disability, depression, increased falls, body mass index and arthritis but not with any other specific disease markers and with decreased survival. commonly used sleep questionnaires do not differentiate well between those with objectively determined disturbance of sleep-wake cycles and those with normal cycles. Abnormal sleep-wake patterns are associated with institutionalisation, cognitive impairment, disability, depression and arthritis but not with other diseases; there is also an association with reduced survival.

  11. Polysomnography reveals unexpectedly high rates of organic sleep disorders in patients with prediagnosed primary insomnia.

    Science.gov (United States)

    Crönlein, Tatjana; Geisler, Peter; Langguth, Berthold; Eichhammer, Peter; Jara, Cecilia; Pieh, Christoph; Zulley, Jürgen; Hajak, Göran

    2012-12-01

    It is a matter of debate whether patients with primary insomnia require a polysomnographic examination in order to exclude specific sleep disorders such as sleep apnea syndrome (SAS) or periodic limb movements (PLM). Using a prospective design, we investigated the prevalence of organic sleep disorders by means of polysomnography (PSG) in a series of patients who were previously diagnosed with primary insomnia. This diagnosis was based on a clinical exam and an ambulatory monitoring device or previous PSG. Seventy-seven women and 16 men (mean age 55.12 ± 13.21 years) who were admitted for cognitive behavioral therapy for insomnia were evaluated by PSG including cardiorespiratory parameters and tibialis EMG. Among them, 50 patients had undergone a clinical exam by a sleep specialist; in 18 patients, actigraphy or portable monitoring had been performed to exclude SAS or PLM; 25 patients had undergone PSG in another sleep lab previously. In 32 patients (34% of the sample), a PSG revealed a specific sleep disorder (SAS 16; PLMD 11; both 5), resulting in therapeutic consequences for 21 patients (SAS 10; PLMD 9; both 2). SAS and PLM patients were older and SAS patients had a higher body mass index than insomnia patients without additional findings. Indications for a PSG should be handled less restrictively in the diagnostic workup of older insomnia patients since they have a higher risk of comorbid sleep disorders even in the absence of the clinical signs of SAS or PLM.

  12. Data-driven modeling of sleep EEG and EOG reveals characteristics indicative of pre-Parkinson's and Parkinson's disease

    DEFF Research Database (Denmark)

    Christensen, Julie Anja Engelhard; Zoetmulder, Marielle; Koch, Henriette

    2014-01-01

    approach to identify sleep topics directly from electroencephalography (EEG) and electrooculography (EOG). PSG data from control subjects were used to develop an EOG and an EEG topic model. The models were applied to PSG data from 23 control subjects, 25 patients with periodic leg movements (PLMs), 31...

  13. A Nomogram for Predicting the Likelihood of Obstructive Sleep Apnea to Reduce the Unnecessary Polysomnography Examinations

    Directory of Open Access Journals (Sweden)

    Miao Luo

    2015-01-01

    Conclusions: The established clinical nomogram provides high accuracy in predicting the individual risk of OSA. This tool may help physicians better make decisions on PSG arrangement for the patients referred to sleep centers.

  14. Validation of Sleep-Tracking Technology Compared with Polysomnography in Adolescents.

    Science.gov (United States)

    de Zambotti, Massimiliano; Baker, Fiona C; Colrain, Ian M

    2015-09-01

    To evaluate the accuracy in measuring nighttime sleep of a fitness tracker (Jawbone UP) compared to polysomnography (PSG). Jawbone UP and PSG data were simultaneously collected from adolescents during an overnight laboratory recording. Agreements between Jawbone UP and PSG sleep outcomes were analyzed using paired t tests and Bland-Altman plots. Multiple regressions were used to investigate which PSG sleep measures predicted Jawbone UP "Sound sleep" and "Light sleep." SRI International Human Sleep Laboratory. Sixty-five healthy adolescents (28 females, mean age ± standard deviation [SD]: 15.8 ± 2.5 y). N/A. Outcomes showed good agreements between Jawbone UP and PSG for total sleep time (mean differences ± SD: -10.0 ± 20.5 min), sleep efficiency (mean differences ± SD: -1.9 ± 4.2 %), and wake after sleep onset (WASO) (mean differences ± SD: 10.6 ± 14.7 min). Overall, Jawbone UP overestimated PSG total sleep time and sleep efficiency and underestimated WASO but differences were small and, on average, did not exceed clinically meaningful cutoffs of > 30 min for total sleep time and > 5% for sleep efficiency. Multiple regression models showed that Jawbone UP "Sound sleep" measure was predicted by PSG time in N2 (β = 0.25), time in rapid eye movement (β = 0.29), and arousal index (β = -0.34). Jawbone UP "Light sleep" measure was predicted by PSG time in N2 (β = 0.48), time in N3 (β = 0.49), arousal index (β = 0.38) and awakening index (β = 0.28). Jawbone UP showed a progression from slight overestimation to underestimation of total sleep time and sleep efficiency with advancing age. All relationships were similar in boys and girls. Jawbone UP shows good agreement with polysomnography in measures of total sleep time and wake after sleep onset in adolescent boys and girls. Further validation is needed in other age groups and clinical populations before advocating use of these inexpensive and easy-to-use devices in clinical sleep medicine and research.

  15. Individual Differences in Response to Sleep Deprivation: Assessment of Fatigue Following Sleep Loss

    Science.gov (United States)

    Carskadon, Mary A.

    1997-01-01

    Previous work has indicated that a small but significant number of participants in sleep deprivation studies or in simulated shift work experiments manifests an exaggerated performance decrement when they reach a critical point in the experiment, usually near the trough of the circadian cycle or the middle of the night. Those who show this exaggerated response do not appear to differ from other normal volunteers in any substantial way according to usual screening criteria or baseline values. The present study aims to examine factors that may provide the basis for this extreme response. We propose that a preexisting sleep deficit-as manifested by low values on the Multiple Sleep Latency Test (MSLT)-may account for extreme responders. Roth and colleagues (1993) have shown that among normal volunteers screened for a variety of studies, approximately 20 to 25 percent show low ( or = 13 minutes). Additionally, studies by this group have indicated that subjects with low MSLT scores may suffer from chronic insufficient sleep (Roth et al., 1993), as further substantiated by the finding that they have consistently higher nocturnal sleep efficiency and that their MSLT scores rise to normal values when sleep is extended (Roehrs et al., 1996). We hypothesize that the short MSLT subjects have a significant long-term sleep deficit that leads to a marked intolerance for sleep deprivation or shift work. We further suggest that this sleep debt may signify an increased sleep need in these individuals that is not met either due to personal preference or to societal pressures (or both). If this speculation is accurate, then we predict that the tolerance for sleep deprivation in such individuals can be increased by "pretreatment" with sleep extension. Thus, the present study is designed to test the following two hypotheses: subjects with nominal sleep patterns who have low MSLT scores (e.g., Sleepy subjects) will show an exaggerated response (performance decrement) to sleep loss

  16. Beyond fatigue: Assessing variables associated with sleep problems and use of sleep medications in multiple sclerosis

    Directory of Open Access Journals (Sweden)

    Alyssa M Bamer

    2010-05-01

    Full Text Available Alyssa M Bamer, Kurt L Johnson, Dagmar A Amtmann, George H KraftDepartment of Rehabilitation Medicine, University of Washington, Seattle, WA, USABackground: Recent research indicates that sleep disturbances are common in persons with multiple sclerosis (MS, though research to date has primarily focused on the relationship between fatigue and sleep. In order to improve treatment of sleep disorders in MS, a better understanding of other factors that contribute to MS sleep disturbance and use of sleep medications in this population is needed.Methods: Individuals with MS (N = 473 involved in an ongoing self-report survey study were asked to report on use of over-the-counter and prescription sleep medications. Participants completed the Medical Outcomes Study Sleep (MOSS scale and other common self-report symptom measures. Multiple regression was used to evaluate factors associated with sleep problems and descriptive statistics were generated to examine use of sleep medications.Results: The mean score on the MOSS scale was 35.9 (standard deviation, 20.2 and 46.8% of the sample had moderate or severe sleep problems. The majority of participants did not use over-the-counter (78% or prescription (70% sleep medications. In a regression model variables statistically significantly associated with sleep problems included depression, nighttime leg cramps, younger age, pain, female sex, fatigue, shorter duration of MS, and nocturia. The model explained 45% of the variance in sleep problems. Of the variance explained, depression accounted for the majority of variance in sleep problems (33%, with other variables explaining significantly less variance.Conclusions: Regression results indicate that fatigue may play a minor role in sleep disturbance in MS and that clinicians should consider the interrelationship between depression and sleep problems when treating either symptom in this population. More research is needed to explore the possibility of under

  17. Validation of the Parkinson's disease sleep scale in Japanese patients: a comparison study using the Pittsburgh Sleep Quality Index, the Epworth Sleepiness Scale and Polysomnography.

    Science.gov (United States)

    Uemura, Yusuke; Nomura, Takashi; Inoue, Yuichi; Yamawaki, Mika; Yasui, Kenichi; Nakashima, Kenji

    2009-12-15

    Characteristic sleep disturbance in patients with Parkinson's disease (PD) was evaluated using a subjective questionnaire called the PD sleep scale (PDSS). In this study we sought to examine the relationship between the results from the PDSS with those from the Pittsburgh Sleep Quality Index (PSQI), the Epworth Sleepiness Scale (ESS), and polysomnography (PSG) in Japanese PD patients. Subjects were 79 PD patients and 79 age and gender matched controls. The length of morbidity in patients with PD was 8.4+/-8.0 years, and their Hoehn and Yahr grade was 2.9+/-1.0. All subjects completed the PDSS, PSQI, and ESS questionnaires, and we compared the results from patients with PD to controls. We also evaluated the correlation among the PDSS, PSQI, and ESS in patients with PD. Moreover, we performed PSG on 33 of 79 PD patients, and examined the correlation between the PDSS and PSG. PDSS total scores and subscales from patients with PD were significantly lower than those in controls, except for items 3, 8, and 14. PDSS scores had significant internal consistency and significant correlation with PSQI and ESS scores. The total PDSS score also correlated with sleep efficiency as measured by PSG. In subscales of the PDSS, night psychosis was negatively correlated with percentage of REM sleep without atonia on PSG. Based on our comparisons with PSQI, ESS, and PSG, the PDSS appears to be a reliable tool to evaluate the characteristics of sleep disturbances in PD patients.

  18. To Assess Sleep Quality among Pakistani Junior Physicians (House ...

    African Journals Online (AJOL)

    effects on one's work and performance, and also predisposes an individual ... Background: Sleep deprivation among junior physicians (house officers) is of growing concern. In developed ..... survey study at an academic institution. Sleep Med.

  19. Short- and Long-Term Sleep Stability in Insomniacs and Healthy Controls.

    Science.gov (United States)

    Gaines, Jordan; Vgontzas, Alexandros N; Fernandez-Mendoza, Julio; Basta, Maria; Pejovic, Slobodanka; He, Fan; Bixler, Edward O

    2015-11-01

    Assess the short- and long-term stability of sleep duration in patients with insomnia and normal-sleeping controls. Observational short-term and prospective studies. Sleep laboratory. Patients with insomnia (n = 150) and controls (n = 151) were recruited from the local community or sleep disorders clinic. A subsample of 95 men from the Penn State Adult Cohort (PSAC) were followed up 2.6 y after their initial visit. Participants underwent a physical examination and 8-h polysomnography (PSG) recording for 3 consecutive nights (controls and insomniacs), or 2 single nights separated by several years (PSAC). Intraclass correlation coefficients (ICCs) assessed the stability of the variables total sleep time (TST), sleep onset latency (SOL), and wake after sleep onset (WASO). We also examined persistence of the first-night classification of "short" versus "normal" sleep duration on subsequent nights. Stability of TST, SOL, and WASO based on 1 night were slight to moderate in both patients with insomnia (ICC = 0.37-0.57) and controls (ICC = 0.39-0.59), and became substantial to almost perfect when based on the average of 3 nights (ICC = 0.64-0.81). We observed similar degrees of stability for TST and WASO in the longitudinal sample, with moderate stability based on a single night and substantial stability based on both nights. In examining the persistence of "short" and "normal" sleep duration, 71.4% (controls), 74.7% (patients with insomnia), and 72.6% (longitudinal sample) of participants retained their first-night classifications over subsequent nights. Sleep duration variables, particularly total sleep time based on 3 consecutive nights in both patients with insomnia and controls or two single-night recordings separated by several years, are stable and reflect a person's habitual sleep. Furthermore, a single night in the laboratory may be useful for reliably classifying one's sleep duration. © 2015 Associated Professional Sleep Societies, LLC.

  20. Assessing periodicity of periodic leg movements during sleep.

    Science.gov (United States)

    Rummel, Christian; Gast, Heidemarie; Schindler, Kaspar; Müller, Markus; Amor, Frédérique; Hess, Christian W; Mathis, Johannes

    2010-01-01

    Periodic leg movements (PLM) during sleep consist of involuntary periodic movements of the lower extremities. The debated functional relevance of PLM during sleep is based on correlation of clinical parameters with the PLM index (PLMI). However, periodicity in movements may not be reflected best by the PLMI. Here, an approach novel to the field of sleep research is used to reveal intrinsic periodicity in inter movement intervals (IMI) in patients with PLM. Three patient groups of 10 patients showing PLM with OSA (group 1), PLM without OSA or RLS (group 2) and PLM with RLS (group 3) are considered. Applying the "unfolding" procedure, a method developed in statistical physics, enhances or even reveals intrinsic periodicity of PLM. The degree of periodicity of PLM is assessed by fitting one-parameter distributions to the unfolded IMI distributions. Finally, it is investigated whether the shape of the IMI distributions allows to separate patients into different groups. Despite applying the unfolding procedure, periodicity is neither homogeneous within nor considerably different between the three clinically defined groups. Data-driven clustering reveals more homogeneous and better separated clusters. However, they consist of patients with heterogeneous demographic data and comorbidities, including RLS and OSA. The unfolding procedure may be necessary to enhance or reveal periodicity. Thus this method is proposed as a pre-processing step before analyzing PLM statistically. Data-driven clustering yields much more reasonable results when applied to the unfolded IMI distributions than to the original data. Despite this effort no correlation between the degree of periodicity and demographic data or comorbidities is found. However, there are indications that the nature of the periodicity might be determined by long-range interactions between LM of patients with PLM and OSA.

  1. Comprehensive assessments of long-term sleep habits in epidemiological study: Validity and reliability of sleep factors questionnaire (SFQ) among Chinese women.

    Science.gov (United States)

    Yang, Wan-Shui; Fu, Wen-Xue; Wang, Xin; Deng, Qin; Wang, Ling; Wang, Lin-Yan; Zhao, Hao; Fan, Wen-Yan; Huang, Shao-Xin

    2017-04-01

    Epidemiological studies suggested that poor sleep is a potentially novel risk factor for several health outcomes currently; however, there are no validated questionnaires that can systematically measure sleep parameters within these studies. We evaluated the reliability and validity of 17-item sleep factors questionnaire (SFQ), which was developed to comprehensively assess long-term sleep habits for the Jiujiang Breast Cancer Study (JBCS), Jiujiang, China. The participants included 100 women aged 18-74years, who were randomly selected from the JBCS project, and completed a SFQ at baseline and again 1year later, and 4 quarterly 30 consecutive days (a total of 120days) sleep diaries over this same year. Reliability was tested by comparing the 2 SFQs; validity by comparing the average measures between the SFQ and the 4 sleep diaries. Validity analysis showed moderate correlation (γ=0.41) for sleep duration with the adjusted concordance correlation coefficient (CCCadj) of 0.54; the weighted κ statistics indicated an excellent agreement for night/shift work and sleep medication use; fair-to-moderate for sleep quality, light at night (LAN), nighttime sleeping with light on, sleep noise and nap time; slight-to-fair for sleep quality and nighttime wakings frequency. Reliability analysis showed excellent correlation for night/shift work and sleep medication use; fair-to-moderate for LAN, nighttime wakings frequency, insomnia frequency, sleep noise and nap time; but slight-to-fair for insomnia frequency and nighttime sleeping with light on; the CCCadj for sleep duration was 0.61. The SFQ showed reasonable reliability and validity for sleep assessments in most domains. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. To Assess Sleep Quality among Pakistani Junior Physicians (House ...

    African Journals Online (AJOL)

    poor communication and less empathy.[4-6]. Junior physicians (house officers) in particular are at a higher risk of having poorer sleep quality. Long working hours, rotating shifts, and on-call duties make them more susceptible to develop sleep disturbances.[7] Several studies have demonstrated sleep impairment among ...

  3. Genetic variation in a wild population of the 'sleep' passion fruit (Passiflora setacea) based on molecular markers.

    Science.gov (United States)

    Cerqueira-Silva, C B M; Santos, E S L; Conceição, L D H C S; Cardoso-Silva, C B; Pereira, A S; Oliveira, A C; Corrêa, R X

    2012-03-22

    Little is known about the molecular genetic diversity of most Passiflora species. We used RAPD markers to evaluate the genetic diversity of 24 genotypes of the 'sleep' passion fruit (Passiflora setacea). Twelve primers generated 95 markers, 88% of which were polymorphic. The genetic distance estimated by the complement of the Dice index ranged from 0.29 (among accessions Ps-G1 and Ps-G13) to 0.69 (among accessions Ps-G21 and Ps-G23). Genotype grouping based on the UPGMA algorithm showed considerable variability among genotypes. We conclude that P. setacea has a broad genetic base that could be exploited in breeding programs.

  4. Sleep continuity is positively correlated with sleep duration in laboratory nighttime sleep recordings

    Science.gov (United States)

    Van Dongen, Hans P. A.; Natelson, Benjamin H.; Bender, Amy M.; Palombini, Luciana O.; Bittencourt, Lia; Tufik, Sergio; Ayappa, Indu; Rapoport, David M.

    2017-01-01

    Sleep duration varies widely across individuals and appears to be trait-like. Differences in the stability of underlying sleep processes may underlie this phenomenon. To investigate underlying mechanisms, we examined the relationship between sleep duration and sleep continuity in baseline polysomnography (PSG) recordings from three independently collected datasets: 1) 134 healthy controls (ages 37 ± 13 years) from the São Paulo Epidemiologic Sleep Study, who spent one night in a sleep laboratory, 2) 21 obstructive sleep apnea (OSA) patients who were treated with continuous positive airway pressure for at least 2 months (45 ± 12 years, respiratory disturbance index <15), who spent one night in a sleep laboratory with previous experience of multiple PSG studies, and 3) 62 healthy controls (28 ± 6 years) who, as part of larger experiments, spent 2 consecutive nights in a sleep laboratory. For each dataset, we used total sleep time (TST) to separate subjects into those with shorter sleep (S-TST) and those with longer sleep (L-TST). In all three datasets, survival curves of continuous sleep segments showed greater sleep continuity in L-TST than in S-TST. Correlation analyses with TST as a continuous variable corroborated the results; and the results also held true after controlling for age. There were no significant differences in baseline waking performance and sleepiness between S-TST and L-TST. In conclusion, in both healthy controls and treated OSA patients, sleep continuity was positively correlated with sleep duration. These findings suggest that S-TST may differ from L-TST in processes underlying sleep continuity, shedding new light on mechanisms underlying individual differences in sleep duration. PMID:28394943

  5. Sleep and Cognitive Function in Multiple Sclerosis.

    Science.gov (United States)

    Braley, Tiffany J; Kratz, Anna L; Kaplish, Neeraj; Chervin, Ronald D

    2016-08-01

    To examine associations between cognitive performance and polysomnographic measures of obstructive sleep apnea in patients with multiple sclerosis (MS). Participants underwent a comprehensive MS-specific cognitive testing battery (the Minimal Assessment of Cognitive Function in MS, or MACFIMS) and in-laboratory overnight PSG. In adjusted linear regression models, the oxygen desaturation index (ODI) and minimum oxygen saturation (MinO2) were significantly associated with performance on multiple MACFIMS measures, including the Paced Auditory Serial Addition Test (PASAT; 2-sec and 3-sec versions), which assesses working memory, processing speed, and attention, and on the Brief Visuospatial Memory Test-Revised, a test of delayed visual memory. The respiratory disturbance index (RDI) was also significantly associated with PASAT-3 scores as well as the California Verbal Learning Test-II (CVLT-II) Discriminability Index, a test of verbal memory and response inhibition. Among these associations, apnea severity measures accounted for between 12% and 23% of the variance in cognitive test performance. Polysomnographic measures of sleep fragmentation (as reflected by the total arousal index) and total sleep time also showed significant associations with a component of the CVLT-II that assesses response inhibition, explaining 18% and 27% of the variance in performance. Among patients with MS, obstructive sleep apnea and sleep disturbance are significantly associated with diminished visual memory, verbal memory, executive function (as reflected by response inhibition), attention, processing speed, and working memory. If sleep disorders degrade these cognitive functions, effective treatment could offer new opportunities to improve cognitive functioning in patients with MS. A commentary on this article appears in this issue on page 1489. © 2016 Associated Professional Sleep Societies, LLC.

  6. Assessing severity of obstructive sleep apnea by fractal dimension sequence analysis of sleep EEG

    Science.gov (United States)

    Zhang, J.; Yang, X. C.; Luo, L.; Shao, J.; Zhang, C.; Ma, J.; Wang, G. F.; Liu, Y.; Peng, C.-K.; Fang, J.

    2009-10-01

    Different sleep stages are associated with distinct dynamical patterns in EEG signals. In this article, we explored the relationship between the sleep architecture and fractal dimension (FD) of sleep EEG. In particular, we applied the FD analysis to the sleep EEG of patients with obstructive sleep apnea-hypopnea syndrome (OSAHS), which is characterized by recurrent oxyhemoglobin desaturation and arousals from sleep, a disease which received increasing public attention due to its significant potential impact on health. We showed that the variation of FD reflects the macrostructure of sleep. Furthermore, the fast fluctuation of FD, as measured by the zero-crossing rate of detrended FD (zDFD), is a useful indicator of sleep disturbance, and therefore, correlates with apnea-hypopnea index (AHI), and hourly number of blood oxygen saturation (SpO 2) decreases greater than 4%, as obstructive apnea/hypopnea disturbs sleep architecture. For practical purpose, a modified index combining zDFD of EEG and body mass index (BMI) may be useful for evaluating the severity of OSAHS symptoms.

  7. Ventricular dysfunction in children with obstructive sleep apnea: radionuclide assessment

    Energy Technology Data Exchange (ETDEWEB)

    Tal, A.; Leiberman, A.; Margulis, G.; Sofer, S.

    1988-01-01

    Ventricular function was evaluated using radionuclide ventriculography in 27 children with oropharyngeal obstruction and clinical features of obstructive sleep apnea. Their mean age was 3.5 years (9 months to 7.5 years). Conventional clinical assessment did not detect cardiac involvement in 25 of 27 children; however, reduced right ventricular ejection fraction (less than 35%) was found in 10 (37%) patients (mean: 19.5 +/- 2.3% SE, range: 8-28%). In 18 patients wall motion abnormality was detected. In 11 children in whom radionuclide ventriculography was performed before and after adenotonsillectomy, right ventricular ejection fraction rose from 24.4 +/- 3.6% to 46.7 +/- 3.4% (P less than 0.005), and in all cases wall motion showed a definite improvement. In five children, left ventricular ejection fraction rose greater than 10% after removal of oropharyngeal obstruction. It is concluded that right ventricular function may be compromised in children with obstructive sleep apnea secondary to adenotonsillar hypertrophy, even before clinical signs of cardiac involvement are present.

  8. A Novel, Open Access Method to Assess Sleep Duration Using a Wrist-Worn Accelerometer

    Science.gov (United States)

    Anderson, Kirstie N.; Denton, Sarah J.; Oliver, James; Catt, Michael; Abell, Jessica G.; Kivimäki, Mika; Trenell, Michael I.; Singh-Manoux, Archana

    2015-01-01

    Wrist-worn accelerometers are increasingly being used for the assessment of physical activity in population studies, but little is known about their value for sleep assessment. We developed a novel method of assessing sleep duration using data from 4,094 Whitehall II Study (United Kingdom, 2012–2013) participants aged 60–83 who wore the accelerometer for 9 consecutive days, filled in a sleep log and reported sleep duration via questionnaire. Our sleep detection algorithm defined (nocturnal) sleep as a period of sustained inactivity, itself detected as the absence of change in arm angle greater than 5 degrees for 5 minutes or more, during a period recorded as sleep by the participant in their sleep log. The resulting estimate of sleep duration had a moderate (but similar to previous findings) agreement with questionnaire based measures for time in bed, defined as the difference between sleep onset and waking time (kappa = 0.32, 95%CI:0.29,0.34) and total sleep duration (kappa = 0.39, 0.36,0.42). This estimate was lower for time in bed for women, depressed participants, those reporting more insomnia symptoms, and on weekend days. No such group differences were found for total sleep duration. Our algorithm was validated against data from a polysomnography study on 28 persons which found a longer time window and lower angle threshold to have better sensitivity to wakefulness, while the reverse was true for sensitivity to sleep. The novelty of our method is the use of a generic algorithm that will allow comparison between studies rather than a “count” based, device specific method. PMID:26569414

  9. A longitudinal assessment of sleep timing, circadian phase, and phase angle of entrainment across human adolescence.

    Science.gov (United States)

    Crowley, Stephanie J; Van Reen, Eliza; LeBourgeois, Monique K; Acebo, Christine; Tarokh, Leila; Seifer, Ronald; Barker, David H; Carskadon, Mary A

    2014-01-01

    The aim of this descriptive analysis was to examine sleep timing, circadian phase, and phase angle of entrainment across adolescence in a longitudinal study design. Ninety-four adolescents participated; 38 (21 boys) were 9-10 years ("younger cohort") and 56 (30 boys) were 15-16 years ("older cohort") at the baseline assessment. Participants completed a baseline and then follow-up assessments approximately every six months for 2.5 years. At each assessment, participants wore a wrist actigraph for at least one week at home to measure self-selected sleep timing before salivary dim light melatonin onset (DLMO) phase - a marker of the circadian timing system - was measured in the laboratory. Weekday and weekend sleep onset and offset and weekend-weekday differences were derived from actigraphy. Phase angles were the time durations from DLMO to weekday sleep onset and offset times. Each cohort showed later sleep onset (weekend and weekday), later weekend sleep offset, and later DLMO with age. Weekday sleep offset shifted earlier with age in the younger cohort and later in the older cohort after age 17. Weekend-weekday sleep offset differences increased with age in the younger cohort and decreased in the older cohort after age 17. DLMO to sleep offset phase angle narrowed with age in the younger cohort and became broader in the older cohort. The older cohort had a wider sleep onset phase angle compared to the younger cohort; however, an age-related phase angle increase was seen in the younger cohort only. Individual differences were seen in these developmental trajectories. This descriptive study indicated that circadian phase and self-selected sleep delayed across adolescence, though school-day sleep offset advanced until no longer in high school, whereupon offset was later. Phase angle changes are described as an interaction of developmental changes in sleep regulation interacting with psychosocial factors (e.g., bedtime autonomy).

  10. A longitudinal assessment of sleep timing, circadian phase, and phase angle of entrainment across human adolescence.

    Directory of Open Access Journals (Sweden)

    Stephanie J Crowley

    Full Text Available The aim of this descriptive analysis was to examine sleep timing, circadian phase, and phase angle of entrainment across adolescence in a longitudinal study design. Ninety-four adolescents participated; 38 (21 boys were 9-10 years ("younger cohort" and 56 (30 boys were 15-16 years ("older cohort" at the baseline assessment. Participants completed a baseline and then follow-up assessments approximately every six months for 2.5 years. At each assessment, participants wore a wrist actigraph for at least one week at home to measure self-selected sleep timing before salivary dim light melatonin onset (DLMO phase - a marker of the circadian timing system - was measured in the laboratory. Weekday and weekend sleep onset and offset and weekend-weekday differences were derived from actigraphy. Phase angles were the time durations from DLMO to weekday sleep onset and offset times. Each cohort showed later sleep onset (weekend and weekday, later weekend sleep offset, and later DLMO with age. Weekday sleep offset shifted earlier with age in the younger cohort and later in the older cohort after age 17. Weekend-weekday sleep offset differences increased with age in the younger cohort and decreased in the older cohort after age 17. DLMO to sleep offset phase angle narrowed with age in the younger cohort and became broader in the older cohort. The older cohort had a wider sleep onset phase angle compared to the younger cohort; however, an age-related phase angle increase was seen in the younger cohort only. Individual differences were seen in these developmental trajectories. This descriptive study indicated that circadian phase and self-selected sleep delayed across adolescence, though school-day sleep offset advanced until no longer in high school, whereupon offset was later. Phase angle changes are described as an interaction of developmental changes in sleep regulation interacting with psychosocial factors (e.g., bedtime autonomy.

  11. A Longitudinal Assessment of Sleep Timing, Circadian Phase, and Phase Angle of Entrainment across Human Adolescence

    Science.gov (United States)

    Crowley, Stephanie J.; Van Reen, Eliza; LeBourgeois, Monique K.; Acebo, Christine; Tarokh, Leila; Seifer, Ronald; Barker, David H.; Carskadon, Mary A.

    2014-01-01

    The aim of this descriptive analysis was to examine sleep timing, circadian phase, and phase angle of entrainment across adolescence in a longitudinal study design. Ninety-four adolescents participated; 38 (21 boys) were 9–10 years (“younger cohort”) and 56 (30 boys) were 15–16 years (“older cohort”) at the baseline assessment. Participants completed a baseline and then follow-up assessments approximately every six months for 2.5 years. At each assessment, participants wore a wrist actigraph for at least one week at home to measure self-selected sleep timing before salivary dim light melatonin onset (DLMO) phase – a marker of the circadian timing system – was measured in the laboratory. Weekday and weekend sleep onset and offset and weekend-weekday differences were derived from actigraphy. Phase angles were the time durations from DLMO to weekday sleep onset and offset times. Each cohort showed later sleep onset (weekend and weekday), later weekend sleep offset, and later DLMO with age. Weekday sleep offset shifted earlier with age in the younger cohort and later in the older cohort after age 17. Weekend-weekday sleep offset differences increased with age in the younger cohort and decreased in the older cohort after age 17. DLMO to sleep offset phase angle narrowed with age in the younger cohort and became broader in the older cohort. The older cohort had a wider sleep onset phase angle compared to the younger cohort; however, an age-related phase angle increase was seen in the younger cohort only. Individual differences were seen in these developmental trajectories. This descriptive study indicated that circadian phase and self-selected sleep delayed across adolescence, though school-day sleep offset advanced until no longer in high school, whereupon offset was later. Phase angle changes are described as an interaction of developmental changes in sleep regulation interacting with psychosocial factors (e.g., bedtime autonomy). PMID:25380248

  12. Clinical significance of mobile health assessed sleep duration and variability in bipolar disorder.

    Science.gov (United States)

    Kaufmann, Christopher N; Gershon, Anda; Eyler, Lisa T; Depp, Colin A

    2016-10-01

    Sleep disturbances are prevalent, persistent, and impairing features of bipolar disorder. However, the near-term and cumulative impact of the severity and variability of sleep disturbances on symptoms and functioning remains unclear. We examined self-reported daily sleep duration and variability in relation to mood symptoms, medication adherence, cognitive functioning, and concurrent daily affect. Forty-one outpatients diagnosed with bipolar disorder were asked to provide daily reports of sleep duration and affect collected via ecological momentary assessment with smartphones over eleven weeks. Measures of depressive and manic symptoms, medication adherence, and cognitive function were collected at baseline and concurrent assessment of affect were collected daily. Analyses examined whether sleep duration or variability were associated with baseline measures and changes in same-day or next-day affect. Greater sleep duration variability (but not average sleep duration) was associated with greater depressive and manic symptom severity, and lower medication adherence at baseline, and with lower and more variable ratings of positive affect and higher ratings of negative affect. Sleep durations shorter than 7-8 h were associated with lower same-day ratings of positive and higher same-day ratings of negative affect, however this did not extend to next-day affect. Greater cumulative day-to-day sleep duration variability, but not average sleep duration, was related to more severe mood symptoms, lower self-reported medication adherence and higher levels of negative affect. Bouts of short- or long-duration sleep had transient impact on affect. Day-to-day sleep variability may be important to incorporate into clinical assessment of sleep disturbances in bipolar disorder. Copyright © 2016 Elsevier Ltd. All rights reserved.

  13. A Novel, Open Access Method to Assess Sleep Duration Using a Wrist-Worn Accelerometer.

    Directory of Open Access Journals (Sweden)

    Vincent T van Hees

    Full Text Available Wrist-worn accelerometers are increasingly being used for the assessment of physical activity in population studies, but little is known about their value for sleep assessment. We developed a novel method of assessing sleep duration using data from 4,094 Whitehall II Study (United Kingdom, 2012-2013 participants aged 60-83 who wore the accelerometer for 9 consecutive days, filled in a sleep log and reported sleep duration via questionnaire. Our sleep detection algorithm defined (nocturnal sleep as a period of sustained inactivity, itself detected as the absence of change in arm angle greater than 5 degrees for 5 minutes or more, during a period recorded as sleep by the participant in their sleep log. The resulting estimate of sleep duration had a moderate (but similar to previous findings agreement with questionnaire based measures for time in bed, defined as the difference between sleep onset and waking time (kappa = 0.32, 95%CI:0.29,0.34 and total sleep duration (kappa = 0.39, 0.36,0.42. This estimate was lower for time in bed for women, depressed participants, those reporting more insomnia symptoms, and on weekend days. No such group differences were found for total sleep duration. Our algorithm was validated against data from a polysomnography study on 28 persons which found a longer time window and lower angle threshold to have better sensitivity to wakefulness, while the reverse was true for sensitivity to sleep. The novelty of our method is the use of a generic algorithm that will allow comparison between studies rather than a "count" based, device specific method.

  14. Quantitative sleep EEG and polysomnographic predictors of driving simulator performance in obstructive sleep apnea.

    Science.gov (United States)

    Vakulin, Andrew; D'Rozario, Angela; Kim, Jong-Won; Watson, Brooke; Cross, Nathan; Wang, David; Coeytaux, Alessandra; Bartlett, Delwyn; Wong, Keith; Grunstein, Ronald

    2016-02-01

    To improve identification of obstructive sleep apnea (OSA) patients at risk of driving impairment, this study explored predictors of driving performance impairment in untreated OSA patients using clinical PSG metrics, sleepiness questionnaires and quantitative EEG markers from routine sleep studies. Seventy-six OSA patients completed sleepiness questionnaires and driving simulator tests in the evening of their diagnostic sleep study. All sleep EEGs were subjected to quantitative power spectral analysis. Correlation and multivariate linear regression were used to identify the strongest predictors of driving simulator performance. Absolute EEG spectral power across all frequencies (0.5-32 Hz) throughout the entire sleep period and separately in REM and NREM sleep, (r range 0.239-0.473, all psleep onset latency (r=0.273, pEEG power during NREM and REM sleep, greater beta EEG power in NREM and greater delta EEG power in REM (range of variance explained 5-17%, t range 2.29-4.0, all psleep onset latency (range of variance explained 4-9%, t range 2.15-2.5, all pEEG power, especially in the faster frequency (beta) range during NREM sleep and slower frequency (delta) range in REM sleep were associated with worse driving performance, while no relationships were observed with clinical metrics e.g. apnea, arousal or oxygen indices. Quantitative EEG analysis in OSA may provide useful markers of driving impairment risk. Future studies are necessary to confirm these findings and assess the clinical significance of quantitative EEG as predictors of driving impairment in OSA. Copyright © 2015 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

  15. Assessment and treatment of common pediatric sleep disorders

    Science.gov (United States)

    Avis, Kristin

    2010-01-01

    Current evidence indicates that chronically disrupted sleep in children and adolescents can lead to problems in cognitive functioning. Behavioral interventions for pediatric sleep problems (e.g., graduated extinction, parent education, positive bedtime routines), especially in young children, have been shown to produce clinically significant improvements. This review describes a few pertinent conditions of sleep disorders in children and adolescents as well as provides clinically useful approaches to sleep complaints and both pharmacologic and nonpharmacological treatments of some common pediatric sleep disorders. PMID:20622943

  16. Characteristics of sleep dysfunction and sleep - disordered breathing in amyotrophic lateral sclerosis patients

    Directory of Open Access Journals (Sweden)

    Fang WANG

    2017-10-01

    Full Text Available Objective To study the characteristics of sleep architecture and sleep - disordered breathing (SDB in patients with amyotrophic lateral sclerosis (ALS using polysomnography (PSG. Methods A total of 36 patients with ALS were recruited in this study. According to symptoms of medulla oblongata, the patients were divided into limb involvement group (N = 14 and bulbar palsy group (N = 22. Detailed record of the patients was made including general information and chief complaints of sleep dysfunction and SDB, which covered sleep initiation and maintenance disorders, arousals, difficulty in breathing and snoring, nocturnal polyuria, restless legs syndrome (RLS and muscle soreness. Appel Amyotrophic Lateral Sclerosis (AALS Scores were used to assess bulbar function, breathing function,myodynamia and limbs function. PSG was performed to monitor EEG, EOG, EMG, ECG, position, snore, gas flow of mouth and nose, chest breathing, pulse oxygen saturation (SpO2 and sleep-related parameters including total sleep time (TST, sleep efficiency (SE, sleep latency (SL, awakening times, percentage of different non-rapid eye movement (NREM and rapial eye movement (REM, and apnea hypopnea index (AHI. Pearson correlation analysis evaluated the relationship between AHI of REM, periodic limb movements (PLM and clinical information, AALS Scores. Results Bulbar palsy group had higher scores in AALS Scores (P = 0.007, bulbar function (P = 0.000 and breathing function (P = 0.000, and lower score in upper limb myodynamia (P = 0.016 than limb involvement group. Both 2 groups showed disturbed sleep architecture in the performance of sleep fragmentation. Bulbar palsy group had more awakening times (P = 0.027, lower percentage of REM sleep (P = 0.009 and less PLM (P = 0.020 than limb involvement group. The main respiratory event of 2 groups was hypopnea. Bulbar palsy group had higher AHI (P = 0.038 and AHI of REM and NREM (P = 0.031, 0.049 than limb involvement group. Pearson

  17. Rapid eye movement sleep behavior disorder in treatment-naïve Parkinson disease patients.

    Science.gov (United States)

    Plomhause, Lucie; Dujardin, Kathy; Duhamel, Alain; Delliaux, Marie; Derambure, Philippe; Defebvre, Luc; Monaca Charley, Christelle

    2013-10-01

    Rapid eye movement (REM) sleep behavior disorder (RBD) is a risk factor for dementia in Parkinson disease (PD) patients. The objectives of our study were to prospectively evaluate the frequency of RBD in a sample of treatment-naïve, newly diagnosed PD patients and compare sleep characteristics and cognition in RBD and non-RBD groups. Fifty-seven newly diagnosed PD patients were consecutively recruited in a university medical center. All patients underwent two overnight polysomnography (PSG) sessions and were diagnosed with RBD according to the International Classification of Sleep Disorders, Second Revision criteria. Daytime sleepiness was measured in a multiple sleep latency test (MSLT). Cognition was assessed in a standard neuropsychologic examination. Seventeen PD patients (30%) met the criteria for RBD. The RBD patients and non-RBD patients did not significantly differ in mean age, gender ratio, disease duration, motor symptom subtype and severity, total sleep time, percentage of REM sleep, apnea-hypopnea index, mean oxygen saturation, and importantly cognitive performance. However, non-RBD patients had a significantly shorter mean daytime sleep latency than RBD patients (15 vs. 18 min, respectively; P=.014). A high frequency of RBD was found in our sample of 57 newly diagnosed PD patients. At this stage in the disease, RBD was not found to be associated with other sleep disorders or cognitive decline. Follow-up is needed to assess the risk for developing dementia in early-stage PD patients with RBD. Copyright © 2013 Elsevier B.V. All rights reserved.

  18. To Assess Sleep Quality among Pakistani Junior Physicians (House Officers): A Cross-sectional Study

    OpenAIRE

    Surani, AA; Surani, A; Zahid, S; Ali, S; Farhan, R; Surani, S

    2015-01-01

    Background: Sleep deprivation among junior physicians (house officers) is of growing concern. In developed countries, duty hours are now mandated, but in developing countries, junior physicians are highly susceptible to develop sleep impairment due to long working hours, on-call duties and shift work schedule. Aim: We undertook the study to assess sleep quality among Pakistani junior physicians. Subjects and Methods: A cross-sectional study was conducted at private and public hospitals in Kar...

  19. Sleep/wake estimation using only anterior tibialis electromyography data

    Directory of Open Access Journals (Sweden)

    Hwang SuHwan

    2012-05-01

    Full Text Available Abstract Background In sleep efficiency monitoring system, actigraphy is the simplest and most commonly used device. However, low specificity to wakefulness of actigraphy was revealed in previous studies. In this study, we assumed that sleep/wake estimation using actigraphy and electromyography (EMG signals would show different patterns. Furthermore, each EMG pattern in two states (sleep, wake during sleep was analysed. Finally, we proposed two types of method for the estimation of sleep/wake patterns using only EMG signals from anterior tibialis muscles and the results were compared with PSG data. Methods Seven healthy subjects and five patients (2 obstructive sleep apnea, 3 periodic limb movement disorder participated in this study. Night time polysomnography (PSG recordings were conducted, and electrooculogram, EMG, electroencephalogram, electrocardiogram, and respiration data were collected. Time domain analysis and frequency domain analysis were applied to estimate the sleep/wake patterns. Each method was based on changes in amplitude or spectrum (total power of anterior tibialis electromyography signals during the transition from the sleep state to the wake state. To obtain the results, leave-one-out-cross-validation technique was adopted. Results Total sleep time of the each group was about 8 hours. For healthy subjects, the mean epoch-by-epoch results between time domain analysis and PSG data were 99%, 71%, 80% and 0.64 (sensitivity, specificity, accuracy and kappa value, respectively. For frequency domain analysis, the corresponding values were 99%, 73%, 81% and 0.67, respectively. Absolute and relative differences between sleep efficiency index from PSG and our methods were 0.8 and 0.8% (for frequency domain analysis. In patients with sleep-related disorder, our proposed methods revealed the substantial agreement (kappa > 0.61 for OSA patients and moderate or fair agreement for PLMD patients. Conclusions The results of our proposed

  20. Assessing the Effect of Shipboard Motion and Sleep Surface on Sleep Effectiveness

    Science.gov (United States)

    2009-12-01

    Seat (from: Dobbins, Rowley, and Campbell, 2008)....................34 Figure 20. SAFTE Model (from: Hursh et al., 2004...Postgraduate School NSWW Navy Standard Work Week OPTEMPO Operational Tempo REM Rapid Eye Movement RMS Root Mean Square SAFTE Sleep Activity... frequency vibration is capable of causing sleep disturbance in that it can make a person more conscious of other environmental factors. Nakashima (2004

  1. Validation of a multi-sensor activity monitor for assessing sleep in children and adolescents.

    Science.gov (United States)

    Soric, Maroje; Turkalj, Mirjana; Kucic, Darija; Marusic, Ivana; Plavec, Davor; Misigoj-Durakovic, Marjeta

    2013-02-01

    To assess the validity of a multi-sensor activity monitor in estimating sleep and wake compared to polysomnography in children and adolescents. A total of 43 children and adolescents (29 boys, 14 girls), aged 7-17years (mean age [SD] = 11.0 [2.4] years) participated in the study. Participants wore the SenseWear Pro(3) Armband™ (SWA) body monitor (BodyMedia Inc) during an overnight polysomnographic assessment in a paediatric sleep laboratory. Sleep measures included sleep onset latency (SOL), wake after sleep onset (WASO), total sleep time (TST) and sleep efficiency (SE). No systematic bias of the SWA was noted for any of the sleep measures assessed, but limits of agreement were wide and amounted to -76 to +58min for SOL, -75 to 102min for WASO, -109 to +99min for TST and -22 to +20% for SE. In addition, no effect of gender, age group (children versus adolescents) or overweight on the accuracy of the SWA was found. The SenseWear Armband™ showed good agreement with polysomnography at the group level, while at the individual level rather, poor agreement between the two methods was observed. Consequently, at this point the use of the SWA in the clinical evaluation of sleep cannot be advocated. Copyright © 2012 Elsevier B.V. All rights reserved.

  2. Prevalence and risk factors of excessive daytime sleepiness in a community sample of young children: the role of obesity, asthma, anxiety/depression, and sleep.

    Science.gov (United States)

    Calhoun, Susan L; Vgontzas, Alexandros N; Fernandez-Mendoza, Julio; Mayes, Susan D; Tsaoussoglou, Marina; Basta, Maria; Bixler, Edward O

    2011-04-01

    We investigated the prevalence and association of excessive daytime sleepiness (EDS) with a wide range of factors (e.g., medical complaints, obesity, objective sleep [including sleep disordered breathing], and parent-reported anxiety/depression and sleep difficulties) in a large general population sample of children. Few studies have researched the prevalence and predictors of EDS in young children, none in a general population sample of children, and the results are inconsistent. Cross-sectional Population -based. 508 school-aged children from the general population. N/A. Children underwent a 9-hour polysomnogram (PSG), physical exam, and parent completed health, sleep and psychological questionnaires. Children were divided into 2 groups: those with and without parent reported EDS. The prevalence of subjective EDS was approximately 15%. Significant univariate relationships were found between children with EDS and BMI percentile, waist circumference, heartburn, asthma, and parent reported anxiety/depression, and sleep difficulties. The strongest predictors of EDS were waist circumference, asthma, and parent-reported symptoms of anxiety/depression and trouble falling asleep. All PSG sleep variables including apnea/hypopnea index, caffeine consumption, and allergies were not significantly related to EDS. It appears that the presence of EDS is more strongly associated with obesity, asthma, parent reported anxiety/depression, and trouble falling asleep than with sleep disordered breathing (SDB) or objective sleep disruption per se. Our findings suggest that children with EDS should be thoroughly assessed for anxiety/depression, nocturnal sleep difficulties, asthma, obesity, and other metabolic factors, whereas objective sleep findings may not be as clinically useful.

  3. Concordance of polysomnographic and actigraphic measurement of sleep and wake in older women with insomnia.

    Science.gov (United States)

    Taibi, Diana M; Landis, Carol A; Vitiello, Michael V

    2013-03-15

    The objective of this secondary analysis was to evaluate concurrent validity of actigraphy and polysomnography (PSG) in older women with insomnia. Concurrent validity of actigraphy and PSG was examined through (1) comparison of sleep outcomes from each recording method; (2) calculation of sensitivity, specificity, accuracy, and predictive values from epoch-by-epoch data; and (3) statistical and graphical exploration of the relationship between sleep disturbance severity and concordance of actigraphy and PSG. Subjects were 16 community-dwelling older women (mean age 69.4 ± 8.1) with insomnia who underwent 8 nights of concurrent actigraphy and PSG. Sleep efficiency reflected much greater sleep disturbance on PSG (66.9%) than actigraphy (84.4%). Based on generalized linear models, the parameter estimates for agreement between actigraphy and PSG were statistically significant (p sleep time and sleep latency, verged on significance for WASO (p = 0.052), but was not significant for sleep efficiency (p = 0.20). Epoch-by-epoch analysis showed high sensitivity (96.1%), low specificity (36.4%), and modest values on agreement (75.4%) and predictive values of sleep (74.7%) and wake (80.2%). Generalized linear models showed that overall accuracy of actigraphy declined as sleep efficiency declined (unstandardized Beta = 0.741, p sleep efficiency of 73% was the point at which accuracy declined below an acceptable accuracy value of 80%. Actigraphy offers a relatively inexpensive and unobtrusive method for measuring sleep, but it appears to underestimate sleep disturbance, particularly at sleep efficiency levels below 73%, in older women with insomnia.

  4. To Assess Sleep Quality among Pakistani Junior Physicians (House Officers): A Cross-sectional Study.

    Science.gov (United States)

    Surani, A A; Surani, A; Zahid, S; Ali, S; Farhan, R; Surani, S

    2015-01-01

    Sleep deprivation among junior physicians (house officers) is of growing concern. In developed countries, duty hours are now mandated, but in developing countries, junior physicians are highly susceptible to develop sleep impairment due to long working hours, on-call duties and shift work schedule. We undertook the study to assess sleep quality among Pakistani junior physicians. A cross-sectional study was conducted at private and public hospitals in Karachi, Pakistan, from June 2012 to January 2013. The study population comprised of junior doctors (house physicians and house surgeons). A consecutive sample of 350 physicians was drawn from the above-mentioned study setting. The subject underwent two validated self-administered questionnaires, that is, Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS). A total of 334 physicians completely filled out the questionnaire with a response rate of 95.4% (334/350). Of 334 physicians, 36.8% (123/334) were classified as "poor sleepers" (global PSQI score > 5). Poor sleep quality was associated with female gender (P = 0.01), excessive daytime sleepiness (P sleep time (P sleep onset latency (P sleep disturbances (P 10) were more prevalent among poor sleepers (P Sleep quality among Pakistani junior physicians is significantly poor. Efforts must be directed towards proper sleep hygiene education. Regulations regarding duty hour limitations need to be considered.

  5. Assessing the Influence of Sleep-Wake Variables on Body Mass Index (BMI in Adolescents

    Directory of Open Access Journals (Sweden)

    Christoph Randler

    2013-05-01

    Full Text Available Recent work has established an association between overweight/obesity and sleep duration, suggesting that short sleep duration and timing of sleeping may lead to overweight. Most of these studies considered sleep-length rather than any other aspects associated with the sleep and wake rhythm, e.g. chronotype, which is a measure of timing of sleeping (‘when to sleep’; based on the midpoint of sleep. The objective of this study was to assess the influence of different factors of the sleep-wake cycle and of co-variates on the Body Mass Index in a cross-sectional questionnaire study. Nine hundred and thirteen pupils (406 boys, 507 girls from Southwestern Germany participated in this study. Mean age was 13.7 ± 1.5 (SD years and range was between 11 – 16 years. We found that chronotype (β = .079 and social jetlag (β = .063 showed a significant influence on Body Mass Index (BMI, while sleep duration did not. Social jetlag is the absolute difference between mid-sleep time on workdays and free days. Further, screen time (in front of TV, computer, β = .13 was positively related with BMI. Self-efficacy on nutrition (β = -.11, a psychological variable important in health-behaviour models, showed an influence with high scores on self-efficacy related to lower BMI. A high BMI was correlated with low fast-food consumption (β = -.12 suggesting that adolescents with high BMI may exert some control over their eating.

  6. Decreased sleep spindle density in patients with idiopathic REM sleep behavior disorder and patients with Parkinson’s disease

    DEFF Research Database (Denmark)

    Christensen, Julie Anja Engelhard; Kempfner, Jacob; Zoetmulder, Marielle

    2014-01-01

    ObjectiveTo determine whether sleep spindles (SS) are potentially a biomarker for Parkinson’s disease (PD). MethodsFifteen PD patients with REM sleep behavior disorder (PD+RBD), 15 PD patients without RBD (PD−RBD), 15 idiopathic RBD (iRBD) patients and 15 age-matched controls underwent...... polysomnography (PSG). SS were scored in an extract of data from control subjects. An automatic SS detector using a Matching Pursuit (MP) algorithm and a Support Vector Machine (SVM) was developed and applied to the PSG recordings. The SS densities in N1, N2, N3, all NREM combined and REM sleep were obtained...

  7. Assessment and treatment of common pediatric sleep disorders

    OpenAIRE

    Moturi, Sricharan; Avis, Kristin

    2010-01-01

    Current evidence indicates that chronically disrupted sleep in children and adolescents can lead to problems in cognitive functioning. Behavioral interventions for pediatric sleep problems (e.g., graduated extinction, parent education, positive bedtime routines), especially in young children, have been shown to produce clinically significant improvements. This review describes a few pertinent conditions of sleep disorders in children and adolescents as well as provides clinically useful appro...

  8. Sleep and neurocognitive functioning in children with eczema.

    Science.gov (United States)

    Camfferman, Danny; Kennedy, J Declan; Gold, Michael; Simpson, Carol; Lushington, Kurt

    2013-08-01

    Sleep disruption in childhood is associated with clearly defined deficits in neurocognition and behaviour. Childhood eczema is also a potent cause of sleep disruption though it is unknown whether it too results in neurocognitive deficits. To test this hypothesis, neurocognitive (WISC-IV), parental-reported sleep quality (Sleep Disturbance Scale of Children (SDSC)) and overnight polysomnographic (PSG) data were collected in 21 children with eczema and 20 healthy controls (age range 6-16 years). Children with eczema had worse sleep quality on both PSG (notably increased nocturnal wakefulness, a higher number of stage shifts and a longer latency to REM onset) and parental report. In addition, they demonstrated significant neurocognitive deficits (especially verbal comprehension, perceptual reasoning and to a lesser extent working memory) with a composite Full Scale IQ 16 points lower than controls. Parental reported sleep problems but not PSG parameters were correlated with reduced neurocognitive performance. However, hierarchical regression analyses revealed that eczema status was predictive while sleep fragmentation (parental or PSG) was not predictive of neurocognitive performance. As this is the first study to systematically examine neurocognitive functioning in children with eczema and given the finding of significant deficits it merits replication especially given the prevalence of the condition. The unanswered question is whether these cognitive deficits normalise with effective eczema treatment and if this is mediated by improvements in sleep architecture. Crown Copyright © 2013. Published by Elsevier B.V. All rights reserved.

  9. Assessing periodicity of periodic leg movements during sleep

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    Christian eRummel

    2010-09-01

    Full Text Available Background: Periodic leg movements during sleep (PLMS consist of involuntary periodic movements of the lower extremities. The debated functional relevance of PLMS is based on correlation of clinical parameters with the PLMS index (PLMI. However, periodicity in movements may not be reflected best by the PLMI. Here, an approach novel to the field of sleep research is used to reveal intrinsic periodicity in inter movement intervals (IMI in patients with PLMS. Methods: Three patient groups of 10 patients showing PLMS with OSA (group 1, PLMS without OSA or RLS (group 2 and PLMS with RLS (group 3 were considered. Applying the ``unfolding'' procedure, a method developed in statistical physics, enhanced or even revealed intrinsic periodicity of PLMS. The degree of periodicity of PLMS was assessed by fitting one-parameter distributions to the unfolded IMI distributions. Finally, it was investigated whether the shape of the IMI distributions allows to separate patients into different groups. Results: Despite applying the unfolding procedure, periodicity was neither homogeneous within nor considerably different between the three clinically defined groups. Data-driven clustering revealed more homogeneous and better separated clusters. However, they consisted of patients with heterogeneous demographic data and comorbidities, including RLS {em and} OSA. Conclusions: The unfolding procedure may be necessary to enhance or reveal periodicity. Thus this method is proposed as a pre-processing step before analyzing PLMS statistically. Data-driven clustering yields much more reasonable results when applied to the unfolded IMI distributions than to the original data. Despite this effort no correlation between the {em degree} of periodicity and demographic data or comorbidities was found. However, there were indications that the {em nature} of the periodicity might be determined by long-range interactions between LM of patients with PLMS and OSA.

  10. The Role of Daytime Sleepiness in Psychosocial Outcomes after Treatment for Obstructive Sleep Apnea

    Directory of Open Access Journals (Sweden)

    Esther Yuet Ying Lau

    2013-01-01

    Full Text Available We investigated the role of daytime sleepiness and sleep quality in psychosocial outcomes of patients with obstructive sleep apnea (OSA treated with continuous positive airway pressure (CPAP. Thirty-seven individuals with moderate to severe OSA and compliant with CPAP treatment for at least 3 months were compared to 27 age- and education-matched healthy controls. The OSA group and the control group were studied with overnight polysomnography (PSG and compared on measures of daytime sleepiness (Epworth Sleepiness Scale, sleep quality (Pittsburg Sleep Quality Index, mood (Beck Depression Inventory, Profile of Mood States, and functional outcomes (Functional Outcomes of Sleep Questionnaire. After CPAP treatment, the OSA group improved on sleep quality and sleepiness. As a group, they did not differ from controls on sleep architecture after CPAP. The OSA group also showed significant improvements in functional outcomes and was comparable to controls on mood and functional outcomes. Persistent difficulties included lowered activity level and residual sleepiness in some individuals. Sleepiness was found to be a significant predictor of mood and affective states, while both sleepiness and sleep quality predicted functional outcomes. These results highlight the importance of assessment and intervention targeting psychosocial functioning and sleepiness in individuals with OSA after treatment.

  11. Effectiveness of Oral Appliances in Obstructive Sleep Apnea with Respiratory Arousals.

    Science.gov (United States)

    Nerfeldt, Pia; Friberg, Danielle

    2016-08-15

    To compare adherence and treatment effects with an oral appliance (OA) in patients with different types of obstructive sleep apnea (OSA): those with mainly respiratory arousals ("arousers"), and those with oxygen desaturations ("desaturaters") at polysomnography (PSG). A prospective intervention study on 72 "tired snorers" with "normal" home sleep study (HSS), but later diagnosed as OSA with PSG, who accepted OA treatment. They were offered evaluation with a follow-up PSG and questionnaires, including the Epworth Sleepiness Scale (ESS), general health (GH), satisfaction, and side effects. Sixty-six patients, 33 arousers and 33 desaturaters, were adapted to OA. The 1-year adherence rate was significantly higher among arousers (85%) than desaturaters (55%) (p = 0.034). Thirty-six of 66 patients underwent follow-up PSG; the apnea-hypopnea index was significantly reduced in 22 arousers from a median of 14 to 3 (p Sleep Medicine.

  12. The study of subjective and objective evaluation of sleep disturbances in Parkinson's disease

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    LIU Chun-feng

    2013-08-01

    Full Text Available Background Sleep disorder is one of the most common non-motor symptoms in Parkinson's disease (PD patients. At present, there are subjective and objective tools to evaluate sleepdisorders. Nevertheless, previous studies commonly used single subjective questionnaires or objective examinations. Therefore, we used the combinations of subjective and objective tools to analyze clinical characteristics of sleep disturbances in PD and investigated differences and consistence between subjective and objective tools. Methods One hundred and sixteen PD patients were eligible to participate into this study. All participants were evaluated by Pittsburgh Sleep Quality Index (PSQI, Unified Parkinson's Disease Rating Scale (UPDRS in "on" condition, Hoehn-Yahr (H-Y stage, Hamilton Depression Rating Scale (HAMD 24 items, Montreal Cognitive Assessment (MoCA, Epworth Sleepiness Scale (ESS, and underwent a video-polysomnography (Video-PSG. Results According to PSQI score of 116 PD patients, the proportion of PD patients with sleep disturbances (PSQI ≥ 7 was 50% (N = 58. Compared to PD patients without sleep disturbances, PD patients with sleep disturbances had lower score of MoCA (23.34 ± 3.50 vs 24.89 ± 3.52; t = 2.377, P = 0.019, higher score of UPDRSⅠ[4.00 (2.00, 5.00 vs 3.00 (2.00, 5.00; U = - 2.306, P = 0.021], UPDRSⅡ[12.00 (9.00, 16.00 vs 10.00 (6.00, 13.00; U = - 1.995, P = 0.046], higher levodopa equivalent daily dose [LED, (508.14 ± 335.85 vs (394.06 ± 236.40 mg/d; t = - 2.115, P = 0.037]. Although PD patients with sleep disturbances had more score of UPDSR Ⅲ and higher H-Y stage, the differences were not significant (P > 0.05. On the other hand, decreased total sleep time (TST, reduced sleep efficiency (SE, increased sleep latency (SL, decreased non-rapid eye movement (NREM sleep stage Ⅱ time were found for PD patients with sleep disturbances (P 0.05, for all. The score of PSQI was positively correlated with the score of ESS (r = 0.200, P = 0

  13. Effects of surgical weight loss for treating obstructive sleep apnea.

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    Bae, Eun-Kee; Lee, Yeon Ji; Yun, Chang-Ho; Heo, Yoonseok

    2014-12-01

    Weight loss has been reported to reduce the severity of obstructive sleep apnea (OSA), particularly in the obese population. However, prospective studies with polysomnography (PSG) for the precise evaluation of OSA are lacking especially in Asian countries. We evaluated the effects of surgical weight loss for treating OSA using PSG data obtained before and after surgery. We performed a prospective study analyzing the clinical and PSG data obtained from our cohort of bariatric surgical candidates with moderate to severe OSA, as confirmed by preoperative PSG. The patients underwent follow-up PSG at least 12 months after bariatric surgery (laparoscopic Roux-en-Y gastric bypass). Of the 47 patients (70.1%) with moderate to severe OSA among 67 patients who underwent preoperative PSG, 10 patients underwent postoperative PSG. The mean apnea-hypopnea index (AHI) of these 10 patients significantly reduced from 51.0±34.2 to 9.3±12.9 events/h, while their mean body mass index (BMI) loss was from 39.9±8.3 to 26.9±4.4 kg/m2. Although the severity of OSA improved considerably, OSA resolution was achieved in only five patients (50%). When compared to the patients who achieved OSA resolution, the patients with residual OSA showed a tendency to have lower minimum arterial oxygen saturation (SaO2) levels and higher supine AHI values in preoperative PSG. Surgical weight loss resulted in the significant improvement of OSA associated with obesity. However, OSA remained in a considerable proportion of patients even after substantial weight loss. We recommend that postoperative PSG be considered for the evaluation of residual OSA, especially in patients with low minimum SaO2 levels and high supine AHI in preoperative PSG.

  14. Design of a Novel Flexible Capacitive Sensing Mattress for Monitoring Sleeping Respiratory

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    Wen-Ying Chang

    2014-11-01

    Full Text Available In this paper, an algorithm to extract respiration signals using a flexible projected capacitive sensing mattress (FPCSM designed for personal health assessment is proposed. Unlike the interfaces of conventional measurement systems for poly-somnography (PSG and other alternative contemporary systems, the proposed FPCSM uses projected capacitive sensing capability that is not worn or attached to the body. The FPCSM is composed of a multi-electrode sensor array that can not only observe gestures and motion behaviors, but also enables the FPCSM to function as a respiration monitor during sleep using the proposed approach. To improve long-term monitoring when body movement is possible, the FPCSM enables the selection of data from the sensing array, and the FPCSM methodology selects the electrodes with the optimal signals after the application of a channel reduction algorithm that counts the reversals in the capacitive sensing signals as a quality indicator. The simple algorithm is implemented in the time domain. The FPCSM system is used in experimental tests and is simultaneously compared with a commercial PSG system for verification. Multiple synchronous measurements are performed from different locations of body contact, and parallel data sets are collected. The experimental comparison yields a correlation coefficient of 0.88 between FPCSM and PSG, demonstrating the feasibility of the system design.

  15. Sleep opstructive apnea syndrome in children

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    Čukalović M.

    2014-01-01

    Full Text Available Sleep opstructive apnea syndrome (SOAS is respiration disorder which leads to partial or complete opstruction of upper respiratory pathways, preventing normal lung aeration and obstructing normal sleep pattern. Clinically, it's manifested by habitual snoring, often joined with sleep malfunction, and signs of strenuous breathing during sleep, and also with different neurobehavioral problems which occurs during daytime. Unrecognized and untreated SOAS can leads to permanent, even life-threatening consequences. Every patient with respiration problems during sleep should be subjected to polysomnographic (PSG examination during night.

  16. To Assess Sleep Quality among Pakistani Junior Physicians (House ...

    African Journals Online (AJOL)

    Background: Sleep deprivation among junior physicians (house officers) is of growing concern. In developed countries, duty hours are now mandated, but in developing countries, junior physicians are highly susceptible to develop sleep impairment due to long working hours, on‑call duties and shift work schedule. Aim: We ...

  17. [Efficacies of continuous positive airway pressure on mixed sleep respiratory events in patients with sleep apnea].

    Science.gov (United States)

    Wu, Yingxin; He, Baiting; Yan, Huichan; Hong, Jiaxu; Luo, Jiaying; Luo, Yuanming

    2014-10-21

    To explore the efficacies of continuous positive airway pressure (CPAP) for mixed sleep apnea (MSA) events in patients with sleep apnea. A total of 21 patients with sleep apnea whose MSA events >10 events/h on overnight polysomnography (PSG) were studied. They were selected from the Sleep Center, Guangzhou Institute of Respiratory Disease. Ten of them were diagnosed only by conventional polysomnography (PSG group) while the diagnosis of another 11 patients was further confirmed by diaphragm electromyogram (EMG) (EMG group). All of them were treated by CPAP titrated manually on PSG. Manual CPAP titrating pressure in PSG group was (8.1 ± 2.2) cmH2O (1 cmH2O = 0.098 kPa) and it was similar to that in EMG group ((8.9 ± 1.5) cmH2O). Apnea-hypopnea index (AHI) decreased significantly after CPAP in both PSG group (6.9 (3.5, 10.2) vs 62.2 (54.7, 71.4) events/h) and EMG group (1.5 (0.5, 5.5) vs 71.3 (59.5, 79.5) events/h) (both P < 0.01). CPAP could eliminate MSA diagnosed either by conventional PSG (0.1 (0.0, 0.4) vs 29.6 (19.6, 32.4) events/h) or by diaphragm EMG (0.0 (0.0, 0.2) vs 18.1 (9.1, 19.3) events/h) (both P < 0.01). CPAP can effectively treat MSA events in patients with sleep apnea.

  18. Prospective Assessment of Sleep Quality Before and After Primary Total Joint Replacement.

    Science.gov (United States)

    Manning, Blaine T; Kearns, Sean M; Bohl, Daniel D; Edmiston, Tori; Sporer, Scott M; Levine, Brett R

    2017-07-01

    Sleep disruption is a common, yet rarely addressed, complaint among patients who have undergone total joint arthroplasty (TJA). This study assessed sleep quality before and after primary TJA. A total of 105 patients who underwent primary total hip arthroplasty (THA) or total knee arthroplasty (TKA) prospectively completed questionnaires during the preoperative, early postoperative, and late postoperative periods. The survey included the Epworth Sleepiness Scale, current sleeping habits, and patient perspectives of sleep quality and duration. In the early postoperative period (4.7±2.0 weeks), patients reported significant increases in sleep disturbance as denoted by increased length of time to fall asleep (P=.006) and mean nightly awakenings (P=.002) compared with the preoperative baseline. At late postoperative follow-up (40.8±19.5 weeks), patients' sleep quality subsequently improved above the preoperative baseline. Approximately 40% of patients tried a new sleeping method postoperatively, the most common being new pillow placement. No significant differences in pre- or postoperative sleeping trends were noted between THA and TKA patients. These findings suggest transient sleep disturbance is common in the early postoperative period, with subsequent improvement by 10-month follow-up after a primary TJA. Given the growing importance of patient satisfaction in health care systems, orthopedic surgeons must manage patients' expectations while working with them to optimize sleep quality after TJA. A multimodal approach with preoperative counseling, early postoperative sleep modifications, and possibly preemptive use of medications may improve transient sleep disturbance among TJA patients. [Orthopedics. 2017; 40(4):e636-e640.]. Copyright 2017, SLACK Incorporated.

  19. Clinically significant discrepancies between sleep problems assessed by standard clinical tools and actigraphy

    Directory of Open Access Journals (Sweden)

    Kjersti Marie Blytt

    2017-10-01

    Full Text Available Abstract Background Sleep disturbances are widespread among nursing home (NH patients and associated with numerous negative consequences. Identifying and treating them should therefore be of high clinical priority. No prior studies have investigated the degree to which sleep disturbances as detected by actigraphy and by the sleep-related items in the Cornell Scale for Depression in Dementia (CSDD and the Neuropsychiatric Inventory – Nursing Home version (NPI-NH provide comparable results. Such knowledge is highly needed, since both questionnaires are used in clinical settings and studies use the NPI-NH sleep item to measure sleep disturbances. For this reason, insight into their relative (disadvantages is valuable. Method Cross-sectional study of 83 NH patients. Sleep was objectively measured with actigraphy for 7 days, and rated by NH staff with the sleep items in the CSDD and the NPI-NH, and results were compared. McNemar's tests were conducted to investigate whether there were significant differences between the pairs of relevant measures. Cohen's Kappa tests were used to investigate the degree of agreement between the pairs of relevant actigraphy, NPI-NH and CSDD measures. Sensitivity and specificity analyses were conducted for each of the pairs, and receiver operating characteristics (ROC curves were designed as a plot of the true positive rate against the false positive rate for the diagnostic test. Results Proxy-raters reported sleep disturbances in 20.5% of patients assessed with NPI-NH and 18.1% (difficulty falling asleep, 43.4% (multiple awakenings and 3.6% (early morning awakenings of patients had sleep disturbances assessed with CSDD. Our results showed significant differences (p<0.001 between actigraphy measures and proxy-rated sleep by the NPI-NH and CSDD. Sensitivity and specificity analyses supported these results. Conclusions Compared to actigraphy, proxy-raters clearly underreported NH patients' sleep disturbances as assessed

  20. Three-dimensional Evaluation of Nasal Surgery in Patients with Obstructive Sleep Apnea.

    Science.gov (United States)

    Cui, Dan-Mo; Han, De-Min; Nicolas, Busaba; Hu, Chang-Long; Wu, Jun; Su, Min-Min

    2016-03-20

    Obstructive sleep apnea (OSA) is a common sleep disorder and is characterized by airway collapse at multiple levels of upper airway. The effectiveness of nasal surgery has been discussed in several studies and shows a promising growing interest. In this study, we intended to evaluate the effects of nasal surgery on the upper airway dimensions in patients with OSA using three-dimensional (3D) reconstruction of cone-beam computed tomography (CT). Twelve patients with moderate to severe OSA who underwent nasal surgery were included in this study. All patients were diagnosed with OSA using polysomnography (PSG) in multi sleep health centers associated with Massachusetts General Hospital, Massachusetts Eye and Ear Infirmary and the Partners Health Care from May 31, 2011 to December 14, 2013. The effect of nasal surgery was evaluated by the examination of PSG, subjective complains, and 3D reconstructed CT scan. Cross-sectional area was measured in eleven coronal levels, and nasal cavity volume was evaluated from anterior nasal spine to posterior nasal spine. The thickness of soft tissue in oral pharynx region was also measured. Five out of the 12 patients were successfully treated by nasal surgery, with more than 50% drop of apnea-hypopnea index. All the 12 patients showed significant increase of cross-sectional area and volume postoperatively. The thickness of soft tissue in oral pharynx region revealed significant decrease postoperatively, which decreased from 19.14 ± 2.40 cm 2 and 6.11 ± 1.76 cm 2 to 17.13 ± 1.91 cm 2 and 5.22 ± 1.20 cm 2 . Nasal surgery improved OSA severity as measured by PSG, subjective complaints, and 3D reconstructed CT scan. 3D assessment of upper airway can play an important role in the evaluation of treatment outcome.

  1. Validity of a commercial wearable sleep tracker in adult insomnia disorder patients and good sleepers.

    Science.gov (United States)

    Kang, Seung-Gul; Kang, Jae Myeong; Ko, Kwang-Pil; Park, Seon-Cheol; Mariani, Sara; Weng, Jia

    2017-06-01

    To compare the accuracy of the commercial Fitbit Flex device (FF) with polysomnography (PSG; the gold-standard method) in insomnia disorder patients and good sleepers. Participants wore an FF and actigraph while undergoing overnight PSG. Primary outcomes were intraclass correlation coefficients (ICCs) of the total sleep time (TST) and sleep efficiency (SE), and the frequency of clinically acceptable agreement between the FF in normal mode (FFN) and PSG. The sensitivity, specificity, and accuracy of detecting sleep epochs were compared among FFN, actigraphy, and PSG. The ICCs of the TST between FFN and PSG in the insomnia (ICC=0.886) and good-sleepers (ICC=0.974) groups were excellent, but the ICC of SE was only fair in both groups. The TST and SE were overestimated for FFN by 6.5min and 1.75%, respectively, in good sleepers, and by 32.9min and 7.9% in the insomnia group with respect to PSG. The frequency of acceptable agreement of FFN and PSG was significantly lower (p=0.006) for the insomnia group (39.4%) than for the good-sleepers group (82.4%). The sensitivity and accuracy of FFN in an epoch-by-epoch comparison with PSG was good and comparable to those of actigraphy, but the specificity was poor in both groups. The ICC of TST in the FFN-PSG comparison was excellent in both groups, and the frequency of agreement was high in good sleepers but significantly lower in insomnia patients. These limitations need to be considered when applying commercial sleep trackers for clinical and research purposes in insomnia. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. [Multiple sleep latency test, maintenance of wakefulness test and suggestive immobilization test].

    Science.gov (United States)

    Tanaka, Haruhito

    2015-06-01

    In clinical practice, assessment usually involves self-report; however, objective measures are available. The multiple sleep latency test(MSLT) is performed during the main period of wakefulness and is designed to determine a patient's propensity to fall asleep. To be valid, the MSLT should be performed the day after nocturnal polysomnography (PSG). It is the standard test for the assessment of objective sleepiness and diagnosis of narcolepsy, that is a mean sleep latency equal to or under 8 minutes and equal to or greater than two sleep onset REM periods (SOREMPs). As opposed to the MSLT, the maintenance of wakefulness test (MWT) is designed to test the patient's ability to stay awake. The MWT is a 40-minutes protocol consisting of four trials separated by 2-hour intervals and is performed in much the same way as the MSLT. The MWT may be indicated in assessment of individuals in whom the inability to remain awake constitutes a safety issue, or in patients with narcolepsy or idiopathic hypersomnia to assess response to treatment with medications. There is little evidence linking mean sleep latency on the MWT with risk of accidents in real world circumstances. The suggestive immobilization test(SIT) was designed during which sensor and motor symptoms of restless legs syndrome are quantified during a period of immobility taking place in the evening before PSG. The patient is instructed to avoid moving voluntary for the entire duration of the test, which is designed to last 1 hour. The subjective leg discomfort evaluation and periodic leg movement by surface electromyograms from right and left anterior tibialis support diagnosis for restless legs syndrome. Many factors, such as clinical setting, pretest condition or aging effects etc. can alter the findings of the test and considerable clinical judgment is needed to avoid an error in interpretation. Above those three sleep-wake related tests provide us useful information.

  3. Big data in sleep medicine: prospects and pitfalls in phenotyping

    Directory of Open Access Journals (Sweden)

    Bianchi MT

    2017-02-01

    Full Text Available Matt T Bianchi,1,2 Kathryn Russo,1 Harriett Gabbidon,1 Tiaundra Smith,1 Balaji Goparaju,1 M Brandon Westover1 1Neurology Department, Massachusetts General Hospital, 2Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA Abstract: Clinical polysomnography (PSG databases are a rich resource in the era of “big data” analytics. We explore the uses and potential pitfalls of clinical data mining of PSG using statistical principles and analysis of clinical data from our sleep center. We performed retrospective analysis of self-reported and objective PSG data from adults who underwent overnight PSG (diagnostic tests, n=1835. Self-reported symptoms overlapped markedly between the two most common categories, insomnia and sleep apnea, with the majority reporting symptoms of both disorders. Standard clinical metrics routinely reported on objective data were analyzed for basic properties (missing values, distributions, pairwise correlations, and descriptive phenotyping. Of 41 continuous variables, including clinical and PSG derived, none passed testing for normality. Objective findings of sleep apnea and periodic limb movements were common, with 51% having an apnea–hypopnea index (AHI >5 per hour and 25% having a leg movement index >15 per hour. Different visualization methods are shown for common variables to explore population distributions. Phenotyping methods based on clinical databases are discussed for sleep architecture, sleep apnea, and insomnia. Inferential pitfalls are discussed using the current dataset and case examples from the literature. The increasing availability of clinical databases for large-scale analytics holds important promise in sleep medicine, especially as it becomes increasingly important to demonstrate the utility of clinical testing methods in management of sleep disorders. Awareness of the strengths, as well as caution regarding the limitations, will maximize the productive use of big data analytics in sleep

  4. The impact of sleep on neuropsychological performance in cognitively intact older adults using a novel in-home sensor-based sleep assessment approach.

    Science.gov (United States)

    Seelye, Adriana; Mattek, Nora; Howieson, Diane; Riley, Thomas; Wild, Katherine; Kaye, Jeffrey

    2015-01-01

    The relationship between recent episodes of poor sleep and cognitive testing performance in healthy cognitively intact older adults is not well understood. In this exploratory study we examined the impact of recent sleep disturbance, sleep duration, and sleep variability on cognitive performance in 63 cognitively intact older adults using a novel unobtrusive in-home sensor-based sleep assessment methodology. Specifically, we examined the impact of sleep the night prior, the week prior, and the month prior to a neuropsychological evaluation on cognitive performance. Results showed that mildly disturbed sleep the week prior and month prior to cognitive testing was associated with reduced working memory on cognitive evaluation. One night of mild sleep disturbance was not associated with decreased cognitive performance the next day. Sleep duration was unrelated to cognition. In-home, unobtrusive, sensor monitoring technologies provide a novel method for objective, long-term, and continuous assessment of sleep behavior and other everyday activities that might contribute to decreased or variable cognitive performance in healthy older adults.

  5. A Systematic Review Assessing Bidirectionality between Sleep Disturbances, Anxiety, and Depression.

    Science.gov (United States)

    Alvaro, Pasquale K; Roberts, Rachel M; Harris, Jodie K

    2013-07-01

    To investigate whether sleep disturbances are bidirectionally related to anxiety and depression, and thus identify potential risk factors for each problem. A systematic review was conducted on 9 studies (8 longitudinal, 1 retrospective) that assessed bidirectionality between a sleep disturbance, and anxiety or depression. Treatment studies were excluded, along with those solely based on clinical samples or cohorts at high risk of suffering from a sleep disturbance, anxiety and depression. Eligible studies were identified by searching PubMed, PsychINFO, Embase, and Scopus databases, and reference lists of eligible studies. Publication dates ranged from the beginning of each database to December 2011. Syntheses of longitudinal studies suggested insomnia and sleep quality were bidirectionally related to anxiety and depression, and depression/anxiety, respectively. Childhood sleep problems significantly predicted higher levels of depression and a combined depression/anxiety variable, but not vice-versa. A one-way relationship was found where anxiety predicted excessive daytime sleepiness, but excessive daytime sleepiness was not associated with depression. Definitive conclusions regarding bidirectionality cannot be made for most sleep disturbances due to the small number and heterogeneity of cohort samples used across studies. Nevertheless, best available evidence suggests insomnia is bidirectionally related to anxiety and depression. Clinical and theoretical implications are discussed. Alvaro PK; Roberts RM; Harris JK. A systematic review assessing bidirectionality between sleep disturbances, anxiety, and depression. SLEEP 2013;36(7):1059-1068.

  6. Assessment of sleep quality post-hospital discharge in survivors of critical illness.

    Science.gov (United States)

    Solverson, Kevin J; Easton, Paul A; Doig, Christopher J

    2016-05-01

    Sleep quality is impaired during critical illness and may remain abnormal after discharge from hospital. Sleep dysfunction in patients after critical illness may impair recovery and health related quality of life. The purpose of this study was to use objective and subjective measures to evaluate sleep quality in critical illness survivors 3 months after hospital discharge. This was a prospective cohort study of 55 patients admitted to a multidisciplinary intensive care unit (ICU) between April 1st, 2009 and March 31, 2010. Patients enrolled were over 17 years of age and stayed a minimum of 4 days in the ICU. Patients were assessed in an outpatient clinic 3-months after hospital discharge. Sleep quality was measured using multi-night sleep actigraphy and the Pittsburgh Sleep Quality Index (PSQI). A total of 62% of patients had poor sleep quality measured with the PSQI. The average (SD) sleep time, sleep efficiency and number of sleep disruptions per night was 6.15 h (3.4), 78% (18), and 11 disruptions (5) respectively. The APACHE II score was correlated with total sleep time (β = -12.6, P = 0.019) and sleep efficiency (β = -1.18, P = 0.042). The PSQI score was associated with anxiety (β = 4.00, p = 0.001), reduced mobility (β = 3.39, p = 0.002) and EuroQol-5D visual analogue scale score (β = -0.85, p = 0.003) and low Physical Composite Scores (β = -0.13, p = 0.004) and Mental Composite Scores (β = -0.15, p = 0.002) of the Short-Form 36 survey. Reduced sleep quality following critical illness is common and associated with reduced health related quality of life. Critical illness severity is a predictor of reduced sleep duration and sleep disruption 3 months after hospital discharge. This cohort study highlights the important role sleep may contribute to the long-term recovery from critical illness. Copyright © 2016 Elsevier Ltd. All rights reserved.

  7. Perception of sleep in recovering alcohol-dependent patients with insomnia: relationship with future drinking.

    Science.gov (United States)

    Conroy, Deirdre A; Todd Arnedt, J; Brower, Kirk J; Strobbe, Stephen; Consens, Flavia; Hoffmann, Robert; Armitage, Roseanne

    2006-12-01

    Subjective and objective measures of poor sleep in alcoholic insomniacs predict relapse to drinking. Nonalcoholic insomniacs underestimate their total sleep time (TST) and overestimate their sleep onset latency (SOL) and wake time after sleep onset (WASO) compared with polysomnography (PSG). This study evaluated 3 hypotheses: (1) subjective SOL would predict frequency of future drinking; (2) participants would overestimate SOL and WASO and underestimate TST; and (3) higher amounts of over- and underestimates of sleep at baseline would predict worse drinking outcomes prospectively. Participants (N=18), mean age 44.6 years (+/-13.2), underwent an adaptation night and then 2 nights of PSG 3 weeks apart. They also provided morning estimates of SOL, WASO, TST, and sleep efficiency (SE). Following the baseline PSG, participants were followed over 12 weeks. A 2-way ANOVA (night x method of measuring sleep) compared results and regression analyses predicted drinking. Drinking outcomes were defined as number of days drinking (DD) and number of heavy-drinking days (HDD) during 2 consecutive 6-week follow-up periods. Most participants (72%) overestimated SOL by a mean of 21.3 (+/-36) minutes compared with PSG [F(1, 14)=7.1, pDrinking during the first 6-week study period was predicted by both subjective estimates of WASO and their accuracy, whereas drinking during the second 6-week period was predicted by both subjective estimations of sleep and rapid eye movement sleep latency. Greater subjective accuracy of wakefulness at night provided by the patient predicted drinking during the study. Unlike nonalcoholic insomniacs, this alcoholic sample significantly underestimated WASO compared with PSG values. The predictive ability of sleep parameters depended on the selected measure of drinking outcomes and when outcomes were measured. Subjective sleep measures were better predictors of future drinking than corresponding PSG measures.

  8. Sleep assessment in a population-based study of chronic fatigue syndrome

    Directory of Open Access Journals (Sweden)

    Reyes Michele

    2004-04-01

    Full Text Available Abstract Background Chronic fatigue syndrome (CFS is a disabling condition that affects approximately 800,000 adult Americans. The pathophysiology remains unknown and there are no diagnostic markers or characteristic physical signs or laboratory abnormalities. Most CFS patients complain of unrefreshing sleep and many of the postulated etiologies of CFS affect sleep. Conversely, many sleep disorders present similarly to CFS. Few studies characterizing sleep in unselected CFS subjects have been published and none have been performed in cases identified from population-based studies. Methods The study included 339 subjects (mean age 45.8 years, 77% female, 94.1% white identified through telephone screen in a previously described population-based study of CFS in Wichita, Kansas. They completed questionnaires to assess fatigue and wellness and 2 self-administered sleep questionnaires. Scores for five of the six sleep factors (insomnia/hypersomnia, non-restorative sleep, excessive daytime somnolence, sleep apnea, and restlessness in the Centre for Sleep and Chronobiology's Sleep Assessment Questionnaire© (SAQ© were dichotomized based on threshold. The Epworth Sleepiness Scale score was used as a continuous variable. Results 81.4% of subjects had an abnormality in at least one SAQ© sleep factor. Subjects with sleep factor abnormalities had significantly lower wellness scores but statistically unchanged fatigue severity scores compared to those without SAQ© abnormality. CFS subjects had significantly increased risk of abnormal scores in the non-restorative (adjusted odds ratio [OR] = 28.1; 95% confidence interval [CI]= 7.4–107.0 and restlessness (OR = 16.0; 95% CI = 4.2–61.6 SAQ© factors compared to non-fatigued, but not for factors of sleep apnea or excessive daytime somnolence. This is consistent with studies finding that, while fatigued, CFS subjects are not sleepy. A strong correlation (0.78 of Epworth score was found only for the excessive

  9. Validation of Actiwatch for Assessment of Sleep-wake States in Preterm Infants

    Directory of Open Access Journals (Sweden)

    Shu-Chen Yang, RN, MSN

    2014-09-01

    Conclusion: Results of this study suggest that high activity thresholds are the most accurate for determining sleep state in preterm infants, and health care professionals must take the limitations into consideration while using the Actiwatch to assess wake states.

  10. Altered Sleep Mechanisms following Traumatic Brain Injury and Relation to Waking Function

    Directory of Open Access Journals (Sweden)

    Kimberly A Cote

    2015-10-01

    Full Text Available Sleep difficulties are commonly reported following traumatic brain injury (TBI, but few studies have systematically examined the neurophysiological characteristics of sleep. Sleep EEG was quantified over multiple nights to examine mechanisms underlying sleep disruption in individuals who had sustained a TBI and to explore the relationship between sleep disruption and waking function. Sleep was recorded from 20 individuals with a TBI (18-64 years and 20 age-matched controls over two uninterrupted nights, as well as during a night where auditory stimuli were delivered. All participants underwent neuropsychological testing and waking performance assessment. Compared to controls, the TBI group had subjective complaints of falling asleep, delayed sleep onset on polysomnography (PSG, less Slow Wave (< 1 Hz and delta (1-4 Hz EEG power in non-REM sleep, fewer spontaneous and evoked k-complexes, reduced periodicity of spontaneous k-complexes, and lower amplitude of evoked k-complexes. While for controls, the density, duration and periodicity of sleep spindles diminished with deepening of non-REM as typically observed, this pattern was disrupted in the TBI group with peak spindle presentation occurring in Stage 3 sleep. Night-to-night-stability of Stage 2 spindles was high for controls but absent for the TBI group. Greater injury severity was related to fewer evoked k-complexes and lower spindle density. Greater spindle production predicted better waking function in the TBI group. Taken together, these data demonstrate impairment in sleep regulatory and inhibitory mechanisms as factors underlying sleep complaints following a TBI. Spindle generation may be adaptive or a marker of resiliency following TBI.

  11. A Narrative Review: Actigraphy as an Objective Assessment of Perioperative Sleep and Activity in Pediatric Patients.

    Science.gov (United States)

    Conrad, Nicole; Karlik, Joelle; Lewandowski Holley, Amy; Wilson, Anna C; Koh, Jeffrey

    2017-04-18

    Sleep is an important component of pediatric health and is crucial for cognitive development. Actigraphy is a validated, objective tool to capture sleep and movement data that is increasingly being used in the perioperative context. The aim of this review is to present recent pediatric studies that utilized actigraphy in the perioperative period, highlight gaps in the literature, and provide recommendations for future research. A literature search was completed using OVID and PubMed databases and articles were selected for inclusion based on relevance to the topic. The literature search resulted in 13 papers that utilized actigraphic measures. Results of the review demonstrated that actigraphy has been used to identify predictors and risk factors for poor postoperative sleep, examine associations among perioperative pain and sleep patterns, and assess activity and energy expenditure in both inpatient and outpatient settings. We propose expansion of actigraphy research to include assessment of sleep via actigraphy to: predict functional recovery in pediatric populations, to study postoperative sleep in high-risk pediatric patients, to test the efficacy of perioperative interventions, and to assess outcomes in special populations for which self-report data on sleep and activity is difficult to obtain.

  12. A Narrative Review: Actigraphy as an Objective Assessment of Perioperative Sleep and Activity in Pediatric Patients

    Directory of Open Access Journals (Sweden)

    Nicole Conrad

    2017-04-01

    Full Text Available Sleep is an important component of pediatric health and is crucial for cognitive development. Actigraphy is a validated, objective tool to capture sleep and movement data that is increasingly being used in the perioperative context. The aim of this review is to present recent pediatric studies that utilized actigraphy in the perioperative period, highlight gaps in the literature, and provide recommendations for future research. A literature search was completed using OVID and PubMed databases and articles were selected for inclusion based on relevance to the topic. The literature search resulted in 13 papers that utilized actigraphic measures. Results of the review demonstrated that actigraphy has been used to identify predictors and risk factors for poor postoperative sleep, examine associations among perioperative pain and sleep patterns, and assess activity and energy expenditure in both inpatient and outpatient settings. We propose expansion of actigraphy research to include assessment of sleep via actigraphy to: predict functional recovery in pediatric populations, to study postoperative sleep in high-risk pediatric patients, to test the efficacy of perioperative interventions, and to assess outcomes in special populations for which self-report data on sleep and activity is difficult to obtain.

  13. Sleep quality assessment in 35 Parkinson's disease patients in the Fann Teaching Hospital, Dakar, Senegal.

    Science.gov (United States)

    Maiga, B; Diop, M S; Sangare, M; Dembele, K; Cisse, L; Kone, O; Seck, L B; Landoure, G; Guinto, C O; Ndiaye, M; Ndiaye, M M

    2016-03-01

    Sleep disorders are diverse in Parkinson's disease. We aimed to assess the quality of sleep in patients with Parkinson's disease in an African population. In a transversal and prospective study from April to June 2014, all parkinsonian patients followed at the Fann Teaching Hospital Neurology Clinic (Dakar, Senegal) were assessed using the Hoehn and Yahr's scale and filled out the following questionnaires: Parkinson's disease sleep scale (PDSS), the Pittsburgh Sleep Quality Index (PSQI), and the Epworth Sleepiness Scale (ESS). A PDSS score5 indicated poor quality or impaired sleep. An ESS score>10 indicated excessive daytime sleepiness. We used the Pearson coefficient to search for correlation between age, disease stage, disease duration, and the importance of sleep impairment. Hoehn and Yahr staging was 2.42±0.90 in the 35 patients (60% male, mean age 65.7±7.4years, disease duration 32.4±23.4months). The mean total PDSS score was 99.5±24.1 and 74.3% of the patients had an abnormally high PSQI score, indicating high frequency and intensity of sleep disorders. Most frequent disorders were pain or cramps interrupting sleep, night waking to urinate and fatigue or sleepiness on waking. Patients exhibited excessive diurnal sleepiness in 22.9% of the cases; they often had an abnormal PSQI score. Both the total PDSS score and the difficulty to sleep increased with disease stage, but not with age or disease duration. We found evidence of major alteration of sleep quality in Senegalese Parkinson patients. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  14. Assessment of the effects of antihistamine drugs on mood, sleep quality, sleepiness, and dream anxiety.

    Science.gov (United States)

    Ozdemir, Pinar Guzel; Karadag, Ayşe Serap; Selvi, Yavuz; Boysan, Murat; Bilgili, Serap Gunes; Aydin, Adem; Onder, Sevda

    2014-08-01

    There are limited comparative studies on classic and new-generation antihistamines that affect sleep quality and mood. The purpose of this study was to determine and compare the effects of classic and new-generation antihistamines on sleep quality, daytime sleepiness, dream anxiety, and mood. Ninety-two patients with chronic pruritus completed study in the dermatology outpatient clinic. Treatments with regular recommended therapeutic doses were administered. The effects of antihistaminic drugs on mood, daytime sleepiness, dream anxiety, and sleep quality were assessed on the first day and 1 month after. Outpatients who received cetirizine and hydroxyzine treatments reported higher scores on the depression, anxiety, and fatigue sub-scales than those who received desloratadine, levocetirizine, and rupatadine. Pheniramine and rupatadine were found to be associated with daytime sleepiness and better sleep quality. UKU side effects scale scores were significantly elevated among outpatients receiving pheniramine. Classic antihistamines increased daytime sleepiness and decreased the sleep quality scores. New-generation antihistamines reduced sleep latency and dream anxiety, and increased daytime sleepiness and sleep quality. Both antihistamines, significantly increased daytime sleepiness and nocturnal sleep quality. Daytime sleepiness was significantly predicted by rupadatine and pheniramine treatment. Cetirizine and hydroxyzine, seem to have negative influences on mood states. Given the extensive use of antihistamines in clinical settings, these results should be more elaborately examined in further studies.

  15. Evaluation of Sleeping Comfort of Bed Mattresses using Physiological and Psychological Response Measurements

    Science.gov (United States)

    Aoi, Masataka; Kamijo, Masayoshi; Yoshida, Hiroaki

    The purpose of this study is to create a method of evaluating the quality of sleep based on the elastic properties of bed mattresses through measurement of physiological and psychological responses while sleeping. We gathered Profile of Mood States (POMS) results before and after sleep, and investigated changes in subjects' moods according to sleep. A total of 4 bed mattresses with different degrees of elasticity were prepared. They were all pocket coil mattresses. We conducted polysomnography (PSG) testing on subjects with a bioamplifier while they slept in each bed mattress, so that sleeping depth indicating the quality of sleep could be estimated. PSG is a comprehensive recording of the biophysiological changes that occur during sleep. As a result, the sleep depth of bed mattress with a high degree of elasticity increased in the PSG evaluation. Because the hip sinks in deeply from the waist, it is not easy to turn over on mattresses with a low degree of elasticity. We have therefore considered that the sleep depth of the subjects became shallow as a result. We have concluded that it is possible to estimate the quality of sleep through analysis of PSG and POMS results.

  16. Is there a First Night Effect on Sleep Bruxism? A Sleep Laboratory Study

    Science.gov (United States)

    Hasegawa, Yoko; Lavigne, Gilles; Rompré, Pierre; Kato, Takafumi; Urade, Masahiro; Huynh, Nelly

    2013-01-01

    Study Objectives: Sleep bruxism (SB) is reported to vary in frequency over time. The aim of this study was to assess the first night effect on SB. Methods: A retrospective polysomnographic (PSG) analysis was performed of data from a sample of SB patients (12 females, 4 males; age range: 17-39 years) recorded in a sleep laboratory over 2 consecutive nights. Sleep parameters and jaw muscle activity variables (i.e., rhythmic masticatory muscle activity [RMMA]) for SB were quantified and compared between the 2 nights. Subjects were classified into groups according to severity of RMMA frequency, such as low frequency (2-4 episodes/h and/or bruxism time index, and mean burst duration (repeated measure ANOVAs, p ≤ 0.05). Five patients of 8 in the low frequency group were classified into the moderate-high frequency group on the second night, whereas only one patient in the moderate-high frequency group moved to the low frequency group. Conclusions: The results showed no overall first night effect on severity of RMMA frequency in young and healthy patients with SB. In clinical practice, one-night sleep recording may be sufficient for moderate-high frequency SB patients. However, low RMMA frequency in the first night could be confirmed by a second night based on the patient's medical and dental history. Citation: Hasegawa Y; Lavigne G; Rompré P; Kato T; Urade M; Huynh N. Is there a first night effect on sleep bruxism? A sleep laboratory study. J Clin Sleep Med 2013;9(11):1139-1145. PMID:24235894

  17. The usefulness of dynamic MRI for diagnosing and assessing sleep breathing disorder

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    Moriwaki, Hiroto; Uchida, Akira; Chiba, Sachiko; Moriyama, Hiroshi [Jikei Univ., Tokyo (Japan). School of Medicine; Chiba, Shintarou; Yagi, Asako; Ohta, Masaji [Ohta General Hospital, Kawasaki, Kanagawa (Japan); Tokunaga, Masakazu [Kanagawa Prefecture Midwives and Nurses Training School (Japan). Hospital

    2003-04-01

    Polysomnography is useful for assessing the severity of sleep breathing disorder, including obstructive sleep apnea hypopnea syndrome. The clinical condition is difficult to understand completely, however, based on the apnea hypopnea index (AHI) alone, however, and longitudinal change of shape in the upper airway must be clarified. Most diagnoses of obstructive sites in the upper airway were diagnosed statically, so we attempted to assess changes in upper airway shape using dynamic magnetic resonance imaging (MRI), emphasizing the movement of tongue and lower chin, to analyze the relationship between AHI. Subjects were 62 patients with sleep breathing disorder examined by nocturnal polysomnography and dynamic MRI, assessing the change of shape in the upper airway. We concluded that: the group whose rotation angle of the tongue exceeded 6 deg and that the group whose distance of lower chin movement was longer during sleep than while awake were severe cases. (author)

  18. A Comparative Study between SVM and Fuzzy Inference System for the Automatic Prediction of Sleep Stages and the Assessment of Sleep Quality

    Directory of Open Access Journals (Sweden)

    John Gialelis

    2015-11-01

    Full Text Available This paper compares two supervised learning algorithms for predicting the sleep stages based on the human brain activity. The first step of the presented work regards feature extraction from real human electroencephalography (EEG data together with its corresponding sleep stages that are utilized for training a support vector machine (SVM, and a fuzzy inference system (FIS algorithm. Then, the trained algorithms are used to predict the sleep stages of real human patients. Extended comparison results are demonstrated which indicate that both classifiers could be utilized as a basis for an unobtrusive sleep quality assessment.

  19. Comparison of Sleep Disorders between Real and Simulated 3,450-m Altitude.

    Science.gov (United States)

    Heinzer, Raphaël; Saugy, Jonas J; Rupp, Thomas; Tobback, Nadia; Faiss, Raphael; Bourdillon, Nicolas; Rubio, José Haba; Millet, Grégoire P

    2016-08-01

    Hypoxia is known to generate sleep-disordered breathing but there is a debate about the pathophysiological responses to two different types of hypoxic exposure: normobaric hypoxia (NH) and hypobaric hypoxia (HH), which have never been directly compared. Our aim was to compare sleep disorders induced by these two types of altitude. Subjects were exposed to 26 h of simulated (NH) or real altitude (HH) corresponding to 3,450 m and a control condition (NN) in a randomized order. The sleep assessments were performed with nocturnal polysomnography (PSG) and questionnaires. Thirteen healthy trained males subjects volunteered for this study (mean ± SD; age 34 ± 9 y, body weight 76.2 ± 6.8 kg, height 179.7 ± 4.2 cm). Mean nocturnal oxygen saturation was further decreased during HH than in NH (81.2 ± 3.1 versus 83.6 ± 1.9%; P sleep time was longer in HH than in NH (351 ± 63 versus 317 ± 65 min, P sleep quality was similar between hypoxic conditions but lower than in NN. Our results suggest that HH has a greater effect on nocturnal breathing and sleep structure than NH. In HH, we observed more periodic breathing, which might arise from the lower saturation due to hypobaria, but needs to be confirmed. © 2016 Associated Professional Sleep Societies, LLC.

  20. Validity of the Sleep Subscale of the Diagnostic Assessment for the Severely Handicapped-II (DASH-II)

    Science.gov (United States)

    Matson, Johnny L.; Malone, Carrie J.

    2006-01-01

    Currently there are no available sleep disorder measures for individuals with severe and profound intellectual disability. We, therefore, attempted to establish the external validity of the "Diagnostic Assessment for the Severely Handicapped-II" (DASH-II) sleep subscale by comparing daily observational sleep data with the responses of…

  1. Sleep Duration and Obesity in Adults: What Are the Connections?

    Science.gov (United States)

    Theorell-Haglöw, Jenny; Lindberg, Eva

    2016-09-01

    Collectively, cross-sectional and longitudinal studies on self-reported sleep duration and obesity do not show a clear pattern of association with some showing a negative linear relationship, some showing a U-shaped relationship, and some showing no relationship. Associations between sleep duration and obesity seem stronger in younger adults. Cross-sectional studies using objectively measured sleep duration (actigraphy or polysomnography (PSG)) also show this mixed pattern whereas all longitudinal studies to date using actigraphy or PSG have failed to show a relationship with obesity/weight gain. It is still too early and a too easy solution to suggest that changing the sleep duration will cure the obesity epidemic. Given novel results on emotional stress and poor sleep as mediating factors in the relationship between sleep duration and obesity, detection and management of these should become the target of future clinical efforts as well as future research.

  2. Short-Term Effects of Electroconvulsive Therapy on Subjective and Actigraphy-Assessed Sleep Parameters in Severely Depressed Inpatients

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    Alexander Hoogerhoud

    2015-01-01

    Full Text Available Background. Sleep disturbances are a key feature of major depression. Electroconvulsive treatment (ECT may improve polysomnography-assessed sleep characteristics, but its short-term effects on actigraphy-assessed and subjective sleep characteristics are unknown. We therefore aimed to assess the effects of ECT on subjective and objective sleep parameters in a proof-of-principle study. Methods. We assessed subjective and objective sleep parameters in 12 severely depressed patients up to 5 consecutive days during their ECT course, corresponding to a total of 43 nights (including 19 ECT sessions. The 12 patients were 83% female and on average 62 (standard deviation (SD 14 years old and had an average MADRS score of 40 at baseline (SD 21. Results. Subjective and objective sleep parameters were not directly affected by ECT. The subjective sleep efficiency parameter was similar on the day after ECT and other days. ECT did not affect the number of errors in the Sustained Attention to Response Task. Patients subjectively underestimated their total sleep time by 1.4 hours (P<0.001 compared to actigraphy-assessed sleep duration. Conclusion. ECT did not affect subjective and actigraphy-assessed sleep in the short term. Depressed patients profoundly underestimated their sleep duration.

  3. Beyond standard polysomnography: advantages and indications for use of extended 10-20 EEG montage during laboratory sleep study evaluations.

    Science.gov (United States)

    Bubrick, Ellen J; Yazdani, Saad; Pavlova, Milena K

    2014-10-01

    Standard polysomnography (PSG) typically utilizes 4-6 channels of electroencephalography (EEG), which is inadequate to evaluate focal epileptiform activity. Though technical capability has long existed for more extensive EEG recording, few sleep laboratories have utilized this technique. The objective of this study was to determine the utility of combining PSG with 18-channel EEG in select patients with paroxysmal nocturnal events or other symptoms concerning for sleep disorders, nocturnal seizures or both. Consecutive combined PSG-EEG studies (n=237) were performed between 10/1/2005 and 8/1/2009. Demographics, referral source, indications, and results were reviewed and analyzed. Of the 237 consecutive combined PSG-EEG studies performed, 93% revealed the presence of a primary sleep disorder, 38% were shown to have abnormal EEGs, and 37% had both. Among the 221 subjects (93%) shown to have sleep disorders, the majority of these cases were obstructive sleep apnea (OSA) 89%, followed by periodic limp movements of sleep (PLMS) 22% and rapid eye movement behavior disorder (RBD) 6%. Significantly more patients with known epilepsy were diagnosed with OSA then were patients without a seizure history. Combined PSG-EEG, utilizing 18-channel EEG, is an under-utilized technique which can assist in diagnosing paroxysmal nocturnal events, and differentiate between the presence of a primary sleep disorder, seizure activity, or both. Our study further illustrates the importance of considering sleep disorders in epilepsy patients. Copyright © 2014 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  4. Development and Validation of the Sleep Inertia Questionnaire (SIQ) and Assessment of Sleep Inertia in Analogue and Clinical Depression

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    Kanady, Jennifer C.; Harvey, Allison G.

    2015-01-01

    Sleep inertia is the transitional state from sleep to wake. Research on sleep inertia is important in depression because many people with depression report having difficulty getting out of bed, which contributes to impairment and can impede the implementation of interventions. The first aim was to develop and validate the first self-report measure of sleep inertia, the Sleep Inertia Questionnaire (SIQ). The second aim was to compare reports of sleep inertia across three groups: (1) No-to-Mild...

  5. Persistent insomnia: the role of objective short sleep duration and mental health.

    Science.gov (United States)

    Vgontzas, Alexandros N; Fernandez-Mendoza, Julio; Bixler, Edward O; Singareddy, Ravi; Shaffer, Michele L; Calhoun, Susan L; Liao, Duanping; Basta, Maria; Chrousos, George P

    2012-01-01

    Few population-based, longitudinal studies have examined risk factors for persistent insomnia, and the results are inconsistent. Furthermore, none of these studies have examined the role of polysomnographic (PSG) variables such as sleep duration or sleep apnea on the persistence of insomnia. Representative longitudinal study. Sleep laboratory. From a random, general population sample of 1741 individuals of the adult Penn State Cohort, 1395 were followed-up after 7.5 years. Individuals underwent one-night PSG and full medical evaluation at baseline and a telephone interview at follow-up. PSG sleep duration was analyzed as a continuous variable and as a categorical variable: sleep (short sleep duration) and ≥ 6 h sleep (longer sleep duration). The rates of insomnia persistence, partial remission, and full remission were 44.0%, 30.0%, and 26.0%, respectively. Objective short sleep duration significantly increased the odds of persistent insomnia as compared to normal sleep (OR = 3.19) and to fully remitted insomnia (OR = 4.92). Mental health problems at baseline were strongly associated with persistent insomnia as compared to normal sleep (OR = 9.67) and to a lesser degree compared to fully remitted insomnia (OR = 3.68). Smoking, caffeine, and alcohol consumption and sleep apnea did not predict persistent insomnia. Objective short sleep duration and mental health problems are the strongest predictors of persistent insomnia. These data further support the validity and clinical utility of objective short sleep duration as a novel marker of the biological severity of insomnia.

  6. Assess Sleep Stage by Modern Signal Processing Techniques

    CERN Document Server

    Wu, Hau-tieng; Lo, Yu-Lun

    2014-01-01

    In this paper, two modern adaptive signal processing techniques, Empirical Intrinsic Geometry and Synchrosqueezing transform, are applied to quantify different dynamical features of the respiratory and electroencephalographic signals. We show that the proposed features are theoretically rigorously supported, as well as capture the sleep information hidden inside the signals. The features are used as input to multiclass support vector machines with the radial basis function to automatically classify sleep stages. The effectiveness of the classification based on the proposed features is shown to be comparable to human expert classification -- the proposed classification of awake, REM, N1, N2 and N3 sleeping stages based on the respiratory signal (resp. respiratory and EEG signals) has the overall accuracy $81.7\\%$ (resp. $89.3\\%$) in the relatively normal subject group. In addition, by examining the combination of the respiratory signal with the electroencephalographic signal, we conclude that the respiratory s...

  7. Sensitivity and validity of psychometric tests for assessing driving impairment: effects of sleep deprivation.

    Science.gov (United States)

    Jongen, Stefan; Perrier, Joy; Vuurman, Eric F; Ramaekers, Johannes G; Vermeeren, Annemiek

    2015-01-01

    To assess drug induced driving impairment, initial screening is needed. However, no consensus has been reached about which initial screening tools have to be used. The present study aims to determine the ability of a battery of psychometric tests to detect performance impairing effects of clinically relevant levels of drowsiness as induced by one night of sleep deprivation. Twenty four healthy volunteers participated in a 2-period crossover study in which the highway driving test was conducted twice: once after normal sleep and once after one night of sleep deprivation. The psychometric tests were conducted on 4 occasions: once after normal sleep (at 11 am) and three times during a single night of sleep deprivation (at 1 am, 5 am, and 11 am). On-the-road driving performance was significantly impaired after sleep deprivation, as measured by an increase in Standard Deviation of Lateral Position (SDLP) of 3.1 cm compared to performance after a normal night of sleep. At 5 am, performance in most psychometric tests showed significant impairment. As expected, largest effect sizes were found on performance in the Psychomotor Vigilance Test (PVT). Large effects sizes were also found in the Divided Attention Test (DAT), the Attention Network Test (ANT), and the test for Useful Field of View (UFOV) at 5 and 11 am during sleep deprivation. Effects of sleep deprivation on SDLP correlated significantly with performance changes in the PVT and the DAT, but not with performance changes in the UFOV. From the psychometric tests used in this study, the PVT and DAT seem most promising for initial evaluation of drug impairment based on sensitivity and correlations with driving impairment. Further studies are needed to assess the sensitivity and validity of these psychometric tests after benchmark sedative drug use.

  8. Sensitivity and validity of psychometric tests for assessing driving impairment: effects of sleep deprivation.

    Directory of Open Access Journals (Sweden)

    Stefan Jongen

    Full Text Available To assess drug induced driving impairment, initial screening is needed. However, no consensus has been reached about which initial screening tools have to be used. The present study aims to determine the ability of a battery of psychometric tests to detect performance impairing effects of clinically relevant levels of drowsiness as induced by one night of sleep deprivation.Twenty four healthy volunteers participated in a 2-period crossover study in which the highway driving test was conducted twice: once after normal sleep and once after one night of sleep deprivation. The psychometric tests were conducted on 4 occasions: once after normal sleep (at 11 am and three times during a single night of sleep deprivation (at 1 am, 5 am, and 11 am.On-the-road driving performance was significantly impaired after sleep deprivation, as measured by an increase in Standard Deviation of Lateral Position (SDLP of 3.1 cm compared to performance after a normal night of sleep. At 5 am, performance in most psychometric tests showed significant impairment. As expected, largest effect sizes were found on performance in the Psychomotor Vigilance Test (PVT. Large effects sizes were also found in the Divided Attention Test (DAT, the Attention Network Test (ANT, and the test for Useful Field of View (UFOV at 5 and 11 am during sleep deprivation. Effects of sleep deprivation on SDLP correlated significantly with performance changes in the PVT and the DAT, but not with performance changes in the UFOV.From the psychometric tests used in this study, the PVT and DAT seem most promising for initial evaluation of drug impairment based on sensitivity and correlations with driving impairment. Further studies are needed to assess the sensitivity and validity of these psychometric tests after benchmark sedative drug use.

  9. Subjective reports versus objective measurement of sleep latency and sleep duration in pregnancy.

    Science.gov (United States)

    Wilson, Danielle L; Fung, Alison; Walker, Susan P; Barnes, Maree

    2013-01-01

    This study compared self-reported sleep latency (SL) and total sleep time (TST) to objective measures on polysomnography (PSG) during pregnancy. Thirty-three women in the third trimester (T3) of pregnancy, 16 women in the first trimester (T1) of pregnancy, and 15 non-pregnant women underwent overnight PSG, and shortly after awakening reported their perceived SL and TST. Results showed that, on average, the T3 group slightly overestimated their TSTs, whereas the T1 and non-pregnant groups underestimated TSTs when compared with objective measurement. All groups overestimated SL, and perceived SL was closest to the first epoch of 10 min of uninterrupted sleep or the first epoch of slow-wave sleep, rather than the first epoch of sleep (the current definition used for diagnostic sleep studies). The wide variation in discrepancies between estimation and PSG measurement for both TST and SL shows that self-reports made by both pregnant and non-pregnant women tend to be unreliable, which has important implications both clinically and for the many studies based on self-reported sleep patterns in pregnancy.

  10. Sleep spindle and slow wave frequency reflect motor skill performance in primary school-age children

    Science.gov (United States)

    Astill, Rebecca G.; Piantoni, Giovanni; Raymann, Roy J. E. M.; Vis, Jose C.; Coppens, Joris E.; Walker, Matthew P.; Stickgold, Robert; Van Der Werf, Ysbrand D.; Van Someren, Eus J. W.

    2014-01-01

    Background and Aim: The role of sleep in the enhancement of motor skills has been studied extensively in adults. We aimed to determine involvement of sleep and characteristics of spindles and slow waves in a motor skill in children. Hypothesis: We hypothesized sleep-dependence of skill enhancement and an association of interindividual differences in skill and sleep characteristics. Methods: 30 children (19 females, 10.7 ± 0.8 years of age; mean ± SD) performed finger sequence tapping tasks in a repeated-measures design spanning 4 days including 1 polysomnography (PSG) night. Initial and delayed performance were assessed over 12 h of wake; 12 h with sleep; and 24 h with wake and sleep. For the 12 h with sleep, children were assigned to one of three conditions: modulation of slow waves and spindles was attempted using acoustic perturbation, and compared to yoked and no-sound control conditions. Analyses: Mixed effect regression models evaluated the association of sleep, its macrostructure and spindles and slow wave parameters with initial and delayed speed and accuracy. Results and Conclusions: Children enhance their accuracy only over an interval with sleep. Unlike previously reported in adults, children enhance their speed independent of sleep, a capacity that may to be lost in adulthood. Individual differences in the dominant frequency of spindles and slow waves were predictive for performance: children performed better if they had less slow spindles, more fast spindles and faster slow waves. On the other hand, overnight enhancement of accuracy was most pronounced in children with more slow spindles and slower slow waves, i.e., the ones with an initial lower performance. Associations of spindle and slow wave characteristics with initial performance may confound interpretation of their involvement in overnight enhancement. Slower frequencies of characteristic sleep events may mark slower learning and immaturity of networks involved in motor skills. PMID:25426055

  11. The evaluation of sleep quality and response to anti-tumor necrosis factor α therapy in rheumatoid arthritis patients.

    Science.gov (United States)

    Karatas, Gulsah; Bal, Ajda; Yuceege, Melike; Yalcin, Elif; Firat, Hikmet; Dulgeroglu, Deniz; Karataş, Fatih; Sahin, Suleyman; Cakci, Aytul; Ardic, Sadik

    2017-01-01

    Poor sleep quality (SQ) is increasingly recognized as giving rise to decreased quality of life, and raising pain perception. Our aim is to evaluate the SQ in rheumatoid arthritis (RA) patients treated with anti-tumor necrosis factor alpha (anti-TNF-α) therapy. This was a prospective observational and open-label study of RA patients. A total of 35 patients with RA were enrolled in this study. Of the 35 patients, 22 had high disease activity (DA), and 13 were in remission. High DA group was initiated an anti TNF-α therapy. Clinical and objective parameters of SQ were assessed by using the Pittsburgh Sleep Quality Index (PSQI) and polysomnography (PSG). The total PSQI score and the frequency of poor SQ were high in 60 % of the RA patients. The median PSQI score was significantly higher in the high DA group than in the remission group (P = 0.026). Following an anti-TNF-α therapy initiation, significant improvements were observed in the high DA group by PSQI test (P = 0.012). However, no statistically significant difference was found by PSG (P > 0.05). Although an improvement in DA with anti-TNF-alpha therapy did not provide an amelioration in laboratory parameters, we found a significant improvement in SQ by subjective PSQI test. These findings may support that sleep disorders in RA are likely to be associated with a complex pathophysiology.

  12. Sleep-wake difficulties in community-dwelling cancer patients receiving palliative care: subjective and objective assessment.

    Science.gov (United States)

    Bernatchez, Marie Solange; Savard, Josée; Savard, Marie-Hélène; Aubin, Michèle; Ivers, Hans

    2017-09-21

    Prevalence rates of sleep difficulties in advanced cancer patients have varied widely across studies (12 to 96%), and none of these employed a diagnostic interview to distinguish different types of sleep-wake disorders. Moreover, very limited information is available on subjective and objective sleep parameters in this population. Our study was conducted in palliative cancer patients and aimed to assess rates of sleep-wake disorders and subsyndromal symptoms and to document subjective and objective sleep-wake parameters across various types of sleep-wake difficulties. The sample was composed of 51 community-dwelling cancer patients receiving palliative care and having an Eastern Cooperative Oncology Group score of 2 or 3. Relevant sections of the Duke Interview for Sleep Disorders were administered over the phone. An actigraphic recording and a daily sleep diary were completed for 7 consecutive days. Overall, 68.6% of the sample had at least one type of sleep-wake difficulty (disorder or symptoms): 31.4% had insomnia and 29.4% had hypersomnolence as their main sleep-wake problem. Participants with insomnia as their main sleep difficulty had greater disruptions of subjective sleep parameters, while objectively-assessed sleep was more disrupted in patients with hypersomnolence comorbid with another sleep-wake difficulty. Significance of the Results: The high rates of sleep-wake difficulties found in this study indicate a need to screen more systematically for sleep-wake disorders, including insomnia and hypersomnolence, in both palliative care research and clinical practice, and to develop effective nonpharmacological interventions specifically adapted to this population.

  13. Sleep Restriction Therapy for Insomnia is Associated with Reduced Objective Total Sleep Time, Increased Daytime Somnolence, and Objectively Impaired Vigilance: Implications for the Clinical Management of Insomnia Disorder

    Science.gov (United States)

    Kyle, Simon D.; Miller, Christopher B.; Rogers, Zoe; Siriwardena, A. Niroshan; MacMahon, Kenneth M.; Espie, Colin A.

    2014-01-01

    Study Objectives: To investigate whether sleep restriction therapy (SRT) is associated with reduced objective total sleep time (TST), increased daytime somnolence, and impaired vigilance. Design: Within-subject, noncontrolled treatment investigation. Setting: Sleep research laboratory. Participants: Sixteen patients [10 female, mean age = 47.1 (10.8) y] with well-defined psychophysiological insomnia (PI), reporting TST ≤ 6 h. Interventions: Patients were treated with single-component SRT over a 4-w protocol, sleeping in the laboratory for 2 nights prior to treatment initiation and for 3 nights (SRT night 1, 8, 22) during the acute interventional phase. The psychomotor vigilance task (PVT) was completed at seven defined time points [day 0 (baseline), day 1,7,8,21,22 (acute treatment) and day 84 (3 mo)]. The Epworth Sleepiness Scale (ESS) was completed at baseline, w 1-4, and 3 mo. Measurement and results: Subjective sleep outcomes and global insomnia severity significantly improved before and after SRT. There was, however, a robust decrease in PSG-defined TST during acute implementation of SRT, by an average of 91 min on night 1, 78 min on night 8, and 69 min on night 22, relative to baseline (P treatment (at four of five assessment points, all P sleep restriction therapy is associated with reduced objective total sleep time, increased daytime sleepiness, and objective performance impairment. Our data have important implications for implementation guidelines around the safe and effective delivery of cognitive behavioral therapy for insomnia. Citation: Kyle SD; Miller CB; Rogers Z; Siriwardena AN; MacMahon KM; Espie CA. Sleep restriction therapy for insomnia is associated with reduced objective total sleep time, increased daytime somnolence, and objectively impaired vigilance: implications for the clinical management of insomnia disorder. SLEEP 2014;37(2):229-237. PMID:24497651

  14. Assess sleep stage by modern signal processing techniques.

    Science.gov (United States)

    Wu, Hau-Tieng; Talmon, Ronen; Lo, Yu-Lun

    2015-04-01

    In this paper, two modern adaptive signal processing techniques, empirical intrinsic geometry and synchrosqueezing transform, are applied to quantify different dynamical features of the respiratory and electroencephalographic signals. We show that the proposed features are theoretically rigorously supported, as well as capture the sleep information hidden inside the signals. The features are used as input to multiclass support vector machines with the radial basis function to automatically classify sleep stages. The effectiveness of the classification based on the proposed features is shown to be comparable to human expert classification-the proposed classification of awake, REM, N1, N2, and N3 sleeping stages based on the respiratory signal (resp. respiratory and EEG signals) has the overall accuracy 81.7% (resp. 89.3%) in the relatively normal subject group. In addition, by examining the combination of the respiratory signal with the electroencephalographic signal, we conclude that the respiratory signal consists of ample sleep information, which supplements to the information stored in the electroencephalographic signal.

  15. Prospective assessment of the risk of obstructive sleep apnea in ...

    African Journals Online (AJOL)

    Introduction: The impact of Obstructive sleep apnea (OSA) in worsening outcomes is profound, especially in the presence of comorbid conditions. This study aimed to describe the proportion of patients at a high risk of OSA in our practice setting. Methods: The STOP BANG questionnaire and the Epworth Sleepiness scale ...

  16. Assessment of subjective sleep quality in iron deficiency anaemia ...

    African Journals Online (AJOL)

    All participants were requested to fill 3 forms: a socio-demographic form (age, gender, marital status, income level and educational status), hospital anxiety and depression (HAD) scale and pittsburgh sleep quality index (PSQI). Results: According to the HAD scale, the average anxiety score was found 9.24±4.37 in patients ...

  17. Prevalence of Parasomnia in Autistic Children with Sleep Disorders

    Directory of Open Access Journals (Sweden)

    Xue Ming

    2009-01-01

    Full Text Available The prevalence of sleep related complaints is reported by questionnaire studies to be as high as 83.3% in children with autism spectrum disorders (ASD. Questionnaire studies report the presence of various parasomnia in ASD. However, no polysomnographic study reports non-REM parasomnias and only a single study reports REM related parasomnias in ASD. We investigated the prevalence and characteristics of sleep disorders by polysomnographic study and questionnaires in a cohort of 23 children with ASD and 23 age-matched children of a non-autistic comparison group. The results showed significantly more non-REM parasomnias in 14 children with ASD on polysomnograms (PSG and 16 ASD children by questionnaire, a finding that was not associated with medication use, other comorbid medical or psychiatric disorders, or sleep disordered breathing. Of the 14 children with ASD who had PSG evidence of parasomnia, 11 of them had a history suggestive of parasomnia by questionnaire. There was a high sensitivity but a low specificity of parasomnia in ASD by questionnaire in predicting the presence of parasomnia in the PSG. Of the parasomnias recorded in the laboratory, 13 ASD children had Disorders of Partial Arousal, consistent with sleep terrors or confusional arousals. Furthermore, multiple episodes of partial arousal occurred in 11 of the 13 ASD children who had PSG evidence of Disorders of Partial Arousal. Of the 11 ASD children with multiple episodes of partial arousal, 6 ASD children had multiple partial arousals during both nights’ PSG study. Sleep architecture was abnormal in children with ASD, characterized by increased spontaneous arousals, prolonged REM latency and reduced REM percentage. These results suggest a high prevalence of parasomnia in this cohort of children with ASD and a careful history intake of symptoms compatible with parasomnia could be prudent to diagnose parasomnia in ASD children when performing a PSG is not possible.

  18. Mandibular Movements As Accurate Reporters of Respiratory Effort during Sleep: Validation against Diaphragmatic Electromyography

    Directory of Open Access Journals (Sweden)

    Jean-Benoît Martinot

    2017-07-01

    Full Text Available ContextMandibular movements (MM are considered as reliable reporters of respiratory effort (RE during sleep and sleep disordered breathing (SDB, but MM accuracy has never been validated against the gold standard diaphragmatic electromyography (EMG-d.ObjectivesTo assess the degree of agreement between MM and EMG-d signals during different sleep stages and abnormal respiratory events.MethodsTwenty-five consecutive adult patients with SDB were studied by polysomnography (PSG that also included multipair esophageal diaphragm electromyography and a magnetometer to record MM. EMG-d activity (microvolt and MM (millimeter amplitudes were extracted by envelope processing. Agreement between signals amplitudes was evaluated by mixed linear regression and cross-correlation function and in segments of PSG including event-free and SDB periods.ResultsThe average total sleep time was 370 ± 18 min and the apnea hypopnea index was 24.8 ± 5.2 events/h. MM and EMG-d amplitudes were significantly cross-correlated: median r (95% CI: 0.67 (0.23–0.96. A mixed linear model showed that for each 10 µV of increase in EMG-d activity, MM amplitude increased by 0.28 mm. The variations in MM amplitudes (median range: 0.11–0.84 mm between normal breathing, respiratory effort-related arousal, obstructive, mixed, and central apnea periods closely corresponded to those observed with EMG-d activity (median range: 2.11–8.23 µV.ConclusionMM amplitudes change proportionally to diaphragmatic EMG activity and accurately identify variations of RE during normal sleep and SDB.

  19. An Assessment of Sleep Architecture as a Function of Degree of Handedness in College Women Using a Home Sleep Monitor

    Science.gov (United States)

    Propper, Ruth E.; Lawton, Nicole; Przyborski, Matt; Christman, Stephen D.

    2004-01-01

    The present study examined sleep architecture as a function of handedness in a population of undergraduate college women using a home sleep monitor. Compared to strongly handed individuals, participants with a tendency toward mixed-handedness had a shorter sleep latency and spent a greater percentage of their sleep period asleep and less awake.…

  20. Effects of esomeprazole on sleep in patients with gastroesophageal reflux disease as assessed on actigraphy.

    Science.gov (United States)

    Hiramoto, Keiko; Fujiwara, Yasuhiro; Ochi, Masahiro; Okuyama, Masatsugu; Tanigawa, Tetsuya; Yamagami, Hirokazu; Shiba, Masatsugu; Watanabe, Kenji; Watanabe, Toshio; Tominaga, Kazunari; Arakawa, Tetsuo

    2015-01-01

    Gastroesophageal reflux disease (GERD) is strongly associated with sleep disturbances. Although treatment with proton pump inhibitors (PPIs) helps to improve GERD symptoms and subjective sleep parameters, the effects of PPI therapy on objective sleep parameters are conflicting. The aim of this study was to examine the effects of esomeprazole treatment on GERD symptoms and sleep parameters assessed using actigraphs and questionnaires. Thirteen patients with GERD received 20 mg of esomeprazole once daily for two weeks. The patients wore actigraphs from three days before the initiation of PPI treatment to the end of therapy. They were also asked to answer the following self-reported questionnaires: Frequency Scale for the Symptoms of GERD (FSSG), Pittsburg Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS). Objective sleep parameters were evaluated using actigraphy. Treatment with esomeprazole significantly decreased the total FSSG score, including the scores for reflux and dysmotility, as well as the ESS score, although it had no effect on the PSQI score. After the second week of treatment, esomeprazole significantly decreased the wake time (from 47.5±39.6 min to 36.0±27.1 min) and sleep latency period (from 19.5±19.8 min to 9.9±10.2 min) and increased the percentage of sleep time (from 89.1±8.8% to 91.9±6.3%); however, improvements were not noted in all objective parameters. Esomeprazole treatment significantly improves various objective sleep parameters in Japanese patients with GERD. Further placebo-controlled randomized trials are needed to obtain detailed results.

  1. A pilot study: portable out-of-center sleep testing as an early sleep apnea screening tool in acute ischemic stroke

    Directory of Open Access Journals (Sweden)

    Chernyshev OY

    2015-10-01

    Full Text Available Oleg Y Chernyshev,1 David E McCarty,1 Douglas E Moul,2 Cesar Liendo,1 Gloria C Caldito,1 Sai K Munjampalli,1 Roger E Kelley,3 Andrew L Chesson Jr1 1Division of Sleep Medicine, Department of Neurology, Louisiana State University Health Sciences Center at Shreveport, LA 2Sleep Disorders Center, Cleveland Clinic, Cleveland, OH, 3Department of Neurology, Tulane University, New Orleans, LA, USA Introduction: Prompt diagnosis of obstructive sleep apnea (OSA after acute ischemic stroke (AIS is critical for optimal clinical outcomes, but in-laboratory conventional polysomnograms (PSG are not routinely practical. Though portable out-of-center type III cardiopulmonary sleep studies (out-of-center cardiopulmonary sleep testing [OCST] are widely available, these studies have not been validated in patients who have recently suffered from AIS. We hypothesized that OCST in patients with AIS would yield similar results when compared to conventional PSG. Methods: Patients with AIS had simultaneous type III OCST and PSG studies performed within 72 hours from symptom onset. The accuracy of OCST was compared to PSG using: chi-square tests, receiver operatory characteristic curves, Bland–Altman plot, paired Student's t-test/Wilcoxon signed-rank test, and calculation of sensitivity, specificity, positive predictive value (PPV, and negative predictive value (NPV. Results: Twenty-one out of 23 subjects with AIS (age 61±9.4 years; 52% male; 58% African-American successfully completed both studies (9% technical failure. Nearly all (95% had Mallampati IV posterior oropharynx; the mean neck circumference was 16.8±1.6 in. and the mean body mass index (BMI was 30±7 kg/m2. The apnea hypopnea index (AHI provided by OCST was similar to that provided by PSG (19.8±18.0 vs 22.0±22.7, respectively; P=0.49. On identifying subjects by OCST with an AHI ≥5 on PSG, OCST had the following parameters: sensitivity 100%, specificity 85.7%, PPV 93%, and NPV 100%. On identifying

  2. Sleep-wake evaluation from whole-night non-contact audio recordings of breathing sounds.

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    Eliran Dafna

    Full Text Available To develop and validate a novel non-contact system for whole-night sleep evaluation using breathing sounds analysis (BSA.Whole-night breathing sounds (using ambient microphone and polysomnography (PSG were simultaneously collected at a sleep laboratory (mean recording time 7.1 hours. A set of acoustic features quantifying breathing pattern were developed to distinguish between sleep and wake epochs (30 sec segments. Epochs (n = 59,108 design study and n = 68,560 validation study were classified using AdaBoost classifier and validated epoch-by-epoch for sensitivity, specificity, positive and negative predictive values, accuracy, and Cohen's kappa. Sleep quality parameters were calculated based on the sleep/wake classifications and compared with PSG for validity.University affiliated sleep-wake disorder center and biomedical signal processing laboratory.One hundred and fifty patients (age 54.0±14.8 years, BMI 31.6±5.5 kg/m2, m/f 97/53 referred for PSG were prospectively and consecutively recruited. The system was trained (design study on 80 subjects; validation study was blindly performed on the additional 70 subjects.Epoch-by-epoch accuracy rate for the validation study was 83.3% with sensitivity of 92.2% (sleep as sleep, specificity of 56.6% (awake as awake, and Cohen's kappa of 0.508. Comparing sleep quality parameters of BSA and PSG demonstrate average error of sleep latency, total sleep time, wake after sleep onset, and sleep efficiency of 16.6 min, 35.8 min, and 29.6 min, and 8%, respectively.This study provides evidence that sleep-wake activity and sleep quality parameters can be reliably estimated solely using breathing sound analysis. This study highlights the potential of this innovative approach to measure sleep in research and clinical circumstances.

  3. Sleep-Wake Evaluation from Whole-Night Non-Contact Audio Recordings of Breathing Sounds

    Science.gov (United States)

    Dafna, Eliran; Tarasiuk, Ariel; Zigel, Yaniv

    2015-01-01

    Study Objectives To develop and validate a novel non-contact system for whole-night sleep evaluation using breathing sounds analysis (BSA). Design Whole-night breathing sounds (using ambient microphone) and polysomnography (PSG) were simultaneously collected at a sleep laboratory (mean recording time 7.1 hours). A set of acoustic features quantifying breathing pattern were developed to distinguish between sleep and wake epochs (30 sec segments). Epochs (n = 59,108 design study and n = 68,560 validation study) were classified using AdaBoost classifier and validated epoch-by-epoch for sensitivity, specificity, positive and negative predictive values, accuracy, and Cohen's kappa. Sleep quality parameters were calculated based on the sleep/wake classifications and compared with PSG for validity. Setting University affiliated sleep-wake disorder center and biomedical signal processing laboratory. Patients One hundred and fifty patients (age 54.0±14.8 years, BMI 31.6±5.5 kg/m2, m/f 97/53) referred for PSG were prospectively and consecutively recruited. The system was trained (design study) on 80 subjects; validation study was blindly performed on the additional 70 subjects. Measurements and Results Epoch-by-epoch accuracy rate for the validation study was 83.3% with sensitivity of 92.2% (sleep as sleep), specificity of 56.6% (awake as awake), and Cohen's kappa of 0.508. Comparing sleep quality parameters of BSA and PSG demonstrate average error of sleep latency, total sleep time, wake after sleep onset, and sleep efficiency of 16.6 min, 35.8 min, and 29.6 min, and 8%, respectively. Conclusions This study provides evidence that sleep-wake activity and sleep quality parameters can be reliably estimated solely using breathing sound analysis. This study highlights the potential of this innovative approach to measure sleep in research and clinical circumstances. PMID:25710495

  4. Reduced Sleep Spindle Activity in Early-Onset and Elevated Risk for Depression

    Science.gov (United States)

    Lopez, Jorge; Hoffmann, Robert; Armitage, Roseanne

    2010-01-01

    Objective: Sleep disturbances are common in major depressive disorder (MDD), although polysomnographic (PSG) abnormalities are more prevalent in adults than in children and adolescents with MDD. Sleep spindle activity (SPA) is associated with neuroplasticity mechanisms during brain maturation and is more abundant in childhood and adolescence than…

  5. Actigraphy as a diagnostic aid for REM sleep behavior disorder in Parkinson's disease

    NARCIS (Netherlands)

    Louter, M.; Arends, J.B.; Bloem, B.R.; Overeem, S.

    2014-01-01

    BACKGROUND: Rapid eye movement (REM) sleep behavior disorder (RBD) is a common parasomnia in Parkinson's disease (PD) patients. The current International Classification of Sleep Disorders (ICSD-II) requires a clinical interview combined with video polysomnography (video-PSG) to diagnose. The latter

  6. Prediagnosis of obstructive sleep apnea via multiclass MTS.

    Science.gov (United States)

    Su, Chao-Ton; Chen, Kun-Huang; Chen, Li-Fei; Wang, Pa-Chun; Hsiao, Yu-Hsiang

    2012-01-01

    Obstructive sleep apnea (OSA) has become an important public health concern. Polysomnography (PSG) is traditionally considered an established and effective diagnostic tool providing information on the severity of OSA and the degree of sleep fragmentation. However, the numerous steps in the PSG test to diagnose OSA are costly and time consuming. This study aimed to apply the multiclass Mahalanobis-Taguchi system (MMTS) based on anthropometric information and questionnaire data to predict OSA. Implementation results showed that MMTS had an accuracy of 84.38% on the OSA prediction and achieved better performance compared to other approaches such as logistic regression, neural networks, support vector machine, C4.5 decision tree, and rough set. Therefore, MMTS can assist doctors in prediagnosis of OSA before running the PSG test, thereby enabling the more effective use of medical resources.

  7. An assessment of a sedative algorithm for sleep in an intensive care unit.

    Science.gov (United States)

    Brown, G; Scott, W

    1998-01-01

    The difficulty for intensive care unit (ICU) patients to obtain frequent and extensive sleep has been well-documented. This project assessed the benefit of an algorithm of pharmacological assistance (lorazepam and methotrimeprazine) on sedation level and sleep duration in the ICU. The setting was a 15-bed closed ICU dealing with medical and surgical patients in a tertiary care, teaching hospital. Desired and actual levels of sedation for individual patients were determined hourly by the bedside nurse. Medications could be administered to facilitate achieving the desired level of sedation. Our results should no difference occurred in the achievement of the target sedation or duration of sleep with the implementation of the sedation algorithm. The amount of additional medication required during the night did change with the implementation of the sedation algorithm. A reduction in the amount of diazepam, morphine, and additional methotrimeprazine was noted. Efforts to change nursing practice will be required to improve the quality and quantity of sleep in ICU patients. This clinical evaluation demonstrates that the implementation of an algorithm for medication use is not effective alone in obtaining the desired level and duration of sleep in ICU patients. Nursing practice should continue to look at non-pharmacological factors, such as environmental noise, patient interruptions, and patient care practice to determine strategies in addition to medications which would aid the critically ill patient in achieving adequate sleep.

  8. ASSESSING THE SLEEP QUALITY AND DEPRESSION-ANXIETY-STRESS IN IRRITABLE BOWEL SYNDROME PATIENTS

    Directory of Open Access Journals (Sweden)

    Nadieh BANIASADI

    2017-02-01

    Full Text Available ABSTRACT BACKGROUND Irritable bowel syndrome (IBS is one of the most common functional gastrointestinal disorders with chronic abdominal pain and altered bowel habit without any organic reason. Sleep disorders may be associated to IBS. OBJECTIVE We aimed to assess sleep disturbances and depression-anxiety-stress in IBS patients. METHODS In this analytical cross sectional study from November 2013 to May 2014, A total of 123 IBS patients were recruited by simple random sampling. IBS was diagnosed using ROME-III criteria. Demographic and basic data were driven from all patients then Pittsburg Sleep Quality Index questionnaire was utilized to estimate sleep quality and DASS (depression anxiety stress scale questionnaire was filled out for depression, anxiety and stress. RESULTS The mean age of patients was 29±9, where 48 cases (39% were male. Twelve cases (10% had a background disease. Types of IBS in patients were included 38% diarrhea, 42% constipation and 20% mixed. From all IBS patients 87 (71% cases had depression, 97 (79% patients stress, 94 (76% patients had anxiety. Seventy-six (62% cases of IBS patients had poor sleep quality. Simultaneously employing predictors demonstrate that gender, background disease, and type of IBS did not statistically significant. On the other hand, depression (P=0.034, OR=2.35, anxiety (P=0.011, OR=3.022, and stress (P=0.029, OR=2.77 were significantly effect on sleep quality in poor sleepers. CONCLUSION Many of IBS patients is suffering from poor sleep quality. It seems that sleep disorder should be considered and treated in this patients.

  9. ASSESSING THE SLEEP QUALITY AND DEPRESSION-ANXIETY-STRESS IN IRRITABLE BOWEL SYNDROME PATIENTS.

    Science.gov (United States)

    Baniasadi, Nadieh; Dehesh, Mohammad Moein; Mohebbi, Elham; Hayatbakhsh Abbasi, Mahdy; Oghabian, Zohreh

    2017-01-01

    Irritable bowel syndrome (IBS) is one of the most common functional gastrointestinal disorders with chronic abdominal pain and altered bowel habit without any organic reason. Sleep disorders may be associated to IBS. We aimed to assess sleep disturbances and depression-anxiety-stress in IBS patients. In this analytical cross sectional study from November 2013 to May 2014, A total of 123 IBS patients were recruited by simple random sampling. IBS was diagnosed using ROME-III criteria. Demographic and basic data were driven from all patients then Pittsburg Sleep Quality Index questionnaire was utilized to estimate sleep quality and DASS (depression anxiety stress scale) questionnaire was filled out for depression, anxiety and stress. The mean age of patients was 29±9, where 48 cases (39%) were male. Twelve cases (10%) had a background disease. Types of IBS in patients were included 38% diarrhea, 42% constipation and 20% mixed. From all IBS patients 87 (71%) cases had depression, 97 (79%) patients stress, 94 (76%) patients had anxiety. Seventy-six (62%) cases of IBS patients had poor sleep quality. Simultaneously employing predictors demonstrate that gender, background disease, and type of IBS did not statistically significant. On the other hand, depression (P=0.034, OR=2.35), anxiety (P=0.011, OR=3.022), and stress (P=0.029, OR=2.77) were significantly effect on sleep quality in poor sleepers. Many of IBS patients is suffering from poor sleep quality. It seems that sleep disorder should be considered and treated in this patients.

  10. Multi-method assessments of sleep over the transition to college and the associations with depression and anxiety symptoms.

    Science.gov (United States)

    Doane, Leah D; Gress-Smith, Jenna L; Breitenstein, Reagan S

    2015-02-01

    A growing body of research has demonstrated links between sleep problems and symptoms of depression and anxiety in community and clinical samples of adolescents and young adults. Scant longitudinal research, however, has examined reciprocal associations over socio-contextual shifts such as the transition to college. Using multiple methods of assessment (e.g., actigraphy, subjective report), the current study assessed whether sleep quantity, quality or variability changed over the transition to college and investigated the potential cross-lagged relationships between adolescents' sleep and symptoms of anxiety and depression. The participants (N = 82; 24% male) were studied at three time points over approximately 1 year: spring of their senior year of high school (T1), fall of their first year of college (T2), and spring of their first year of college (T3). Sleep minutes, sleep efficiency, wake time variability and anxiety increased over the transition to college. Subjective reports of sleep problems decreased. Cross-lagged panel models indicated significant relationships between subjective sleep quality and anxiety symptoms over time where subjective sleep problems at T1 were associated with anxiety at T2, and anxiety at T2 was associated with subjective sleep problems at T3. In contrast, greater depressive symptoms at T1 preceded increases in subjective sleep problems, sleep latency and sleep start time variability at T2. Importantly, there were concurrent associations between symptoms of anxiety or depression at T2 and sleep efficiency, sleep start time variability, and subjective sleep problems. These findings suggest that, overall, sleep quantity and quality improved over the transition to college, although the overall amounts of sleep were still below developmental recommendations. However, for some youth, the first semester of college may be a sensitive period for both sleep problems and symptoms of anxiety. In contrast, depressive symptoms were stable across

  11. [Reliability and validity of the 3 Dimensional Sleep Scale (3DSS)--day workers version--in assessing sleep phase, quality, and quantity].

    Science.gov (United States)

    Matsumoto, Yuuki; Uchimura, Naohisa; Ishida, Tetsuya; Toyomasu, Kouji; Kushino, Nanae; Mori, Mihoko; Morimatsu, Yoshitaka; Hoshiko, Michiko; Ishitake, Tatsuya

    2014-01-01

    Most sleep scales assess sleep quantity (e.g., sleep duration and daytime sleepiness) or sleep quality (e.g., sleep latency and maintenance); the Pittsburgh Sleep Quality Index (PSQI) is an exceptional example. However, the prevalence of 24-hour operations presents the need for a scale that can also measure sleep phase (e.g., sleep onset and offset). Furthermore, we have to assess the phase, quality and quantity respectively to understand which of them has a problem. Thus, the 3 Dimensional Sleep Scale (3DSS) - day workers version - was developed to assess each of them related to sleep, and this study attempted to verify its reliability and validity. Subjects were 635 day workers (461 men, 174 women; average age = 40.5 years) from the manufacturing and service industries. A scale was created based on a pre-study and discussions with specialists. The scale consisted of 17 sleep-related items. The skew of the data was assessed, and the construct validity and reliability were verified using exploratory and confirmatory factor analysis and Cronbach's alpha, respectively. The scale was scored and G-P analysis was performed. The items measuring phase, quality, and quantity of sleep were selected from the PSQI and SDS, and their correlation with the three scales of 3DSS were measured to verify the convergent and discriminant validity. In addition, the total scores obtained on the PSQI were compared with each scale of the 3DSS. No skew was found in the data. Exploratory factor analysis revealed a three-factor structure--quality, quantity, and phase. Each factor consisted of five items, therefore two items were excluded. The fitness of the 15-item model was better than that of the 17-item model according to confirmatory factor analysis. Cronbach's alpha for phase, quality and quantity score were 0.685, 0.768 and 0.716, respectively. The hypothesis tests were almost accepted, therefore convergent and discriminant validity were sufficiently established. The present study

  12. Comparison of home sleep apnea testing versus laboratory polysomnography for the diagnosis of obstructive sleep apnea in children.

    Science.gov (United States)

    Scalzitti, Nicholas; Hansen, Shana; Maturo, Stephen; Lospinoso, Joshua; O'Connor, Peter

    2017-09-01

    Obstructive sleep apnea (OSA) affects 1-5% of pediatric patients. Laboratory polysomnography is expensive, not always available, and is inconvenient for patients. Our study investigates the diagnostic ability of an unattended ambulatory monitor for the diagnosis of pediatric OSA. A prospective study was conducted in children, ages 2-17. Subjects completed in-lab polysomnography simultaneously with ambulatory monitoring. Caregivers attempted home studies on two subsequent nights to compare the home monitor and the laboratory polysomnogram (PSG). Thirty-three subjects completed simultaneous laboratory polysomnogram with portable monitoring. Twenty patients completed home studies, with 16 completing 2 nights of monitoring. The measurement of AHI by the portable monitor was different than that obtained by the PSG with statistical significance for the comparisons of PSG vs. In-Lab (p = 0.0026), PSG vs. Home 1 (p = 0.033), and PSG vs. Home 2 (p = 0.033). The sensitivity of the portable monitor for diagnosing OSA was best for the In-lab use at 81%, but only 69% and 70% for the uses at home on the 2 nights respectively. Interestingly, the comparison of AHI and lowest oxygen saturation measurements from the home sleep test in children age 6 and older did not differ significantly from the PSG. This pilot study demonstrated differences between home sleep testing and in-lab polysomnography for the diagnosis of pediatric sleep apnea. These differences were predominantly found to exist in younger children. Larger prospective studies are needed prior to widespread use, but home studies may alleviate issues of access to care and higher costs of laboratory polysomnography. Published by Elsevier B.V.

  13. Reliability of a Scale Assessing Depressed Mood in the Context of Sleep.

    Science.gov (United States)

    Roane, Brandy M; Seifer, Ronald; Sharkey, Katherine M; Van Reen, Eliza; Bond, Tamara L Y; Raffray, Tifenn; Carskadon, Mary A

    2013-03-01

    The current study assessed the reliability of Kandel & Davies mood scale with and without sleep-related items. 178 Brown University first-year students (mean age=18.1 years; 108 females) completed online biweekly surveys after weeks 2, 6, 8, and 10 and on 2 consecutive days after weeks 4 and 12 of their first semester. The scale was examined as a 1) full 6-item scale, 2) 5-item scale excluding the sleep item, and 3) 4-item scale excluding the sleep and tired items. Intraclass correlations (ICC) values for consecutive-day assessments and 6 biweekly surveys were similar and not a function of the weeks evaluated. Total-item correlations and inter-measure correlations with the Center for Epidemiologic Studies - Depressed Mood Scale (CES-D) supported the removal of the sleep-related items from the 6-item scale. These analyses confirm the reliability of the original Kandel and Davies depressed mood scale as well as without the sleep-related items.

  14. Assessment of the relationship between postural stability and sleep quality in patients with fibromyalgia.

    Science.gov (United States)

    Akkaya, Nuray; Akkaya, Semih; Atalay, Nilgun Simsir; Acar, Merve; Catalbas, Necdet; Sahin, Fusun

    2013-03-01

    The aim of this study is to investigate the relationship of postural stability and sleep disorders in patients with fibromyalgia syndrome. Frequency of falls in the last 6 months in 48 fibromyalgia and 32 control subjects were recorded. Postural stability was assessed by static posturography device (Tetrax, Sunlight Medical Ltd., Israel). Functional assessment consisted of lower-body strength; one-leg stance test were applied to all subjects. Fibromyalgia impact questionnaire (FIQ), sleep quality numeric rating scale (NRS), and Pittsburgh Sleep Quality Index were inquired. The number of falls in the last 6 months was significantly higher in the fibromyalgia group. Mean total value of stability indexes was 201.7 ± 70.9 vs. 162.6 ± 29.6 in fibromyalgia and control subjects (p < 0.05). NRS and Pittsburgh Sleep Quality Index were significantly higher in fibromyalgia patients. It was detected that there were significant relationships between fall risk and NRS scores (r = 0.565), and FIQ fatigue subscores (r = 0.560) (both p < 0.05). Worse postural performance and fall risk found in the fibromyalgia patients compared to controls were related with the sleep quality in the last 24 h and level of fatigue.

  15. Insomnia and sleep misperception.

    Science.gov (United States)

    Bastien, C H; Ceklic, T; St-Hilaire, P; Desmarais, F; Pérusse, A D; Lefrançois, J; Pedneault-Drolet, M

    2014-10-01

    Sleep misperception is often observed in insomnia individuals (INS). The extent of misperception varies between different types of INS. The following paper comprised sections which will be aimed at studying the sleep EEG and compares it to subjective reports of sleep in individuals suffering from either psychophysiological insomnia or paradoxical insomnia and good sleeper controls. The EEG can be studied without any intervention (thus using the raw data) via either PSG or fine quantitative EEG analyses (power spectral analysis [PSA]), identifying EEG patterns as in the case of cyclic alternating patterns (CAPs) or by decorticating the EEG while scoring the different transient or phasic events (K-Complexes or sleep spindles). One can also act on the on-going EEG by delivering stimuli so to study their impact on cortical measures as in the case of event-related potential studies (ERPs). From the paucity of studies available using these different techniques, a general conclusion can be reached: sleep misperception is not an easy phenomenon to quantify and its clinical value is not well recognized. Still, while none of the techniques or EEG measures defined in the paper is available and/or recommended to diagnose insomnia, ERPs might be the most indicated technique to study hyperarousal and sleep quality in different types of INS. More research shall also be dedicated to EEG patterns and transient phasic events as these EEG scoring techniques can offer a unique insight of sleep misperception. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  16. Assessment of the sleep parameters in patients with obstructive sleep apnea syndrome with a

    Directory of Open Access Journals (Sweden)

    Özlem Abakay

    2013-06-01

    Full Text Available Objective: In this study, traffic accident with a history ofobstructive sleep apnea syndrome (OSAS in patientswith polysomnographic parameters was investigated.Methods: A total of 77 OSAS patients were included inthe study. All-night polysomnographic recordings obtainedfrom patients with enuresis parameters and thepresence of traffic accidents recorded in standard form.Results: The mean age of patients was 45.15 ± 11.53years. 53% of the patients were male and 47% female.The mean apnea hypopnea index (AHI in patients was13.54 events/h. History of traffic accidents was found in12% patients. Apnea hypopnea index, supine AHI, arousalindex and oxygen desaturation index were found significantlydifferent parameters between history of trafficaccidents group and non-history of traffic accidents group(p <0.05.Conclusion: In this study, patients with OSAS severity ofthe disease with a history of traffic accidents were associatedthe relationship between the parameters. This relationshipwith the severity of the disease might be due tothe negative effects on attention. J Clin Exp Invest 2013;4 (2: 204-207Key words: OSAS, traffic accident, AHI

  17. Development of a brief, self-administered instrument for assessing sleep knowledge in medical education: "the ASKME Survey".

    Science.gov (United States)

    Zozula, R; Bodow, M; Yatcilla, D; Cody, R; Rosen, R C

    2001-03-15

    This report describes the construction and validation of a brief self-administered scale to assess sleep knowledge in medical education ("ASKME Survey"). Few measures of this type have been developed previously; none have been validated or widely adopted. The current instrument was designed as a standardized assessment measure for use in medical education in sleep. Instrument was developed in four phases: initial item selection, expert panel review, reliability and construct validity assessment, and final item selection. Content validity was assessed in six general domains: basic sleep principles; circadian sleep/wake regulation; normal sleep architecture; sleep disorders; effects of drugs and alcohol on sleep; and sleep in medical disorders. N/A. Medical students at Robert Wood Johnson Medical School (RWJMS) and University of Kentucky College of Medicine; students in clinical psychology, nursing and other health-related professions at Rutgers University; school nurses at Texas Christian University; practicing physicians; accredited sleep specialists. N/A. Individual item analysis of 30-item survey demonstrated a high degree of discriminant validity. Internal consistency for test items was relatively high (KR-20=0.89). Overall mean percentage correct was highest for accredited sleep specialists (85.3%+/-10.8%) and lowest for school nurses (53.1%+/-13.7%). Significant group differences were observed across all question categories (p students scored significantly higher than the nurses on questions related to sleep architecture (59.5% vs. 42.5%) and narcolepsy (36.4% vs. 21.3%). "ASKME" demonstrates a high degree of internal consistency and reliability among survey items. It discriminates between samples with varied levels of education, experience, and specialty training. The survey is currently available via the American Academy of Sleep Medicine website (http://www.aasmnet.org).

  18. New data on psychological traits and sleep profiles of patients affected by nocturnal eating.

    Science.gov (United States)

    Vinai, Piergiuseppe; Ferri, Raffaele; Anelli, Matteo; Ferini-Strambi, Luigi; Zucconi, Marco; Oldani, Alessandro; Manconi, Mauro

    2015-06-01

    Nocturnal eating behavior is shared by patients affected by a parasomnia, sleep-related eating disorder (SRED), and several eating disorders such as night eating syndrome (NES) and binge-eating disorder (BED); however, the differential clinical features of these patients have been poorly studied, with persisting difficulties in defining the borders between these pathologies. The aim of this study was to evaluate polysomnographic and personality characteristics of nocturnal eaters to further differentiate the syndromes. During a period of six months, consecutive patients complaining of nocturnal eating were asked to participate to the study. Twenty-four patients who were found to eat during the polysomnographic recording (PSG) study, and gender-matched control subjects were included. All subjects underwent a full-night video-PSG study and a psychometric assessment including the Eating Disorder Inventory (EDI-2), the self-rating Bulimic Investigatory Test-Edinburgh (BITE), the Temperament and Character Inventory (TCI), and the Barratt Impulsivity Scale (BIS). Nocturnal eaters showed a mild reduction in sleep efficiency and duration due to a moderate sleep fragmentation, whereas the percentage of each sleep stage was not significantly affected. Nocturnal eaters scored higher at many subscales of the EDI-2, at the BITE symptoms subscale, and at the BIS attentional impulsivity subscale. The psychological characteristics found in our patients with NES seem to be typical for patients affected by eating disorders, and support the hypothesis that the nocturnal behavior of these individuals is due to an eating disorder; however, specific traits also allow differentiation of NES from BED. Copyright © 2014 Elsevier B.V. All rights reserved.

  19. Short- and Long-Term Sleep Stability in Insomniacs and Healthy Controls

    Science.gov (United States)

    Gaines, Jordan; Vgontzas, Alexandros N.; Fernandez-Mendoza, Julio; Basta, Maria; Pejovic, Slobodanka; He, Fan; Bixler, Edward O.

    2015-01-01

    Study Objectives: Assess the short- and long-term stability of sleep duration in patients with insomnia and normal-sleeping controls. Design: Observational short-term and prospective studies. Setting: Sleep laboratory. Participants: Patients with insomnia (n = 150) and controls (n = 151) were recruited from the local community or sleep disorders clinic. A subsample of 95 men from the Penn State Adult Cohort (PSAC) were followed up 2.6 y after their initial visit. Measurements: Participants underwent a physical examination and 8-h polysomnography (PSG) recording for 3 consecutive nights (controls and insomniacs), or 2 single nights separated by several years (PSAC). Intraclass correlation coefficients (ICCs) assessed the stability of the variables total sleep time (TST), sleep onset latency (SOL), and wake after sleep onset (WASO). We also examined persistence of the first-night classification of “short” versus “normal” sleep duration on subsequent nights. Results: Stability of TST, SOL, and WASO based on 1 night were slight to moderate in both patients with insomnia (ICC = 0.37–0.57) and controls (ICC = 0.39–0.59), and became substantial to almost perfect when based on the average of 3 nights (ICC = 0.64–0.81). We observed similar degrees of stability for TST and WASO in the longitudinal sample, with moderate stability based on a single night and substantial stability based on both nights. In examining the persistence of “short” and “normal” sleep duration, 71.4% (controls), 74.7% (patients with insomnia), and 72.6% (longitudinal sample) of participants retained their first-night classifications over subsequent nights. Conclusions: Sleep duration variables, particularly total sleep time based on 3 consecutive nights in both patients with insomnia and controls or two single-night recordings separated by several years, are stable and reflect a person's habitual sleep. Furthermore, a single night in the laboratory may be useful for reliably

  20. Assessment of the depression, anxiety, and stress scale (DASS-21) in untreated obstructive sleep apnea (OSA)

    DEFF Research Database (Denmark)

    Nanthakumar, Shenooka; Bucks, Romola S.; Skinner, Timothy C.

    2017-01-01

    The assessment of depression in obstructive sleep apnea (OSA) is confounded by symptom overlap. The Depression, Anxiety, and Stress Scale-short form (DASS-21) is a commonly used measure of negative affect, but it not known whether the DASS-21 is suitable for use in an OSA sample. This study...

  1. Sleep Disorders Associated With Mild Traumatic Brain Injury Using Sport Concussion Assessment Tool 3.

    Science.gov (United States)

    Tkachenko, Nataliya; Singh, Kanwaljit; Hasanaj, Lisena; Serrano, Liliana; Kothare, Sanjeev V

    2016-04-01

    Sleep problems affect 30% to 80% of patients with mild traumatic brain injury. We assessed the prevalence of sleep disorders after mild traumatic brain injury and its correlation with other symptoms. Individuals with mild traumatic brain injury were assessed at the New York University Concussion Center during 2013-2014 with the Sports Concussion Assessment Tool, third edition, data following mild traumatic brain injury. The relationship between sleep problems (drowsiness, difficulty falling asleep, fatigue or low energy), psychiatric symptoms (sadness, nervousness or anxiousness), headache, and dizziness were analyzed by Spearman correlation and logistic regression using moderate to severe versus none to mild categorization. Ninety-three patients were retrospectively considered. The most common injury causes were falls (34.4%) and motor vehicle accidents (21.5%). There was a positive correlation between dizziness, headache, psychiatric problems (sadness, anxiety, irritability), and sleep problems (fatigue, drowsiness, and difficulty falling asleep) (P brain injury to Sport Concussion Assessment Tool 3 administration (odds ratio = 1.005, 1.006, and 1.008, P brain injury and should be counseled and initiated with early interventions. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Methods for Assessing Sleep in Children with Autism Spectrum Disorders: A Review

    Science.gov (United States)

    Hodge, Danelle; Parnell, Andrea M. N.; Hoffman, Charles D.; Sweeney, Dwight P.

    2012-01-01

    A literature review completed by Bauer and Blunden (2008) determined that compared to objective measures, subjective assessments of sleep for typically developing children (e.g., parental reports) were of limited utility. No comparable literature review has been undertaken to determine whether subjective measures are appropriate for assessing…

  3. Truckers drive their own assessment for obstructive sleep apnea: a collaborative approach to online self-assessment for obstructive sleep apnea.

    Science.gov (United States)

    Smith, Ben; Phillips, Barbara A

    2011-06-15

    Commercial motor vehicle drivers are at an increased risk for obstructive sleep apnea (OSA). The Federal Motor Carrier Safety Administration (FMCSA) Medical Review Board has recommended that commercial motor vehicle drivers undergo testing for OSA if they have a positive Berlin Questionnaire or a BMI ≥ 30 kg/m(2). We developed an online screening tool based on the Berlin Questionnaire for anonymous use by commercial drivers to assess their risk of OSA prior to their required FMCSA physicals. We based the survey on the Berlin Sleep Questionnaire. The survey was hosted on the Truckers for a Cause Chapter of Alert Well and Keeping Energetic of the American Sleep Apnea Association (TFAC-AWAKE) organization website, and was promoted through the TFAC's XM radio, word of mouth, and trucking industry press contacts. A total of 595 individuals completed the survey. Of these, 55.9% were positive on the Berlin, 78.3% had either hypertension or obesity, 69.6% were obese, 47.6% had a BMI > 33 kg/m(2), and 20.5% reported falling asleep at stoplights. Some commercial drivers willingly assess their OSA risk anonymously online, and a majority of those who do so are obese, have positive Berlin screening questionnaires, and would be required to undergo polysomnography if recommendations made to the FMCSA became regulation. In contrast to reported behavior during actual Commercial Driver Medical Examinations physicals, some commercial drivers will report OSA symptoms if it is "safe" to do so. Sleep health professionals need expedient, non-punitive methods to keep commercial motor vehicle drivers healthy and driving and to raise drivers' awareness of the dangers of drowsy driving and unhealthy lifestyles.

  4. Polysomnographic study of the prevalence of sleep bruxism in a population sample.

    Science.gov (United States)

    Maluly, M; Andersen, M L; Dal-Fabbro, C; Garbuio, S; Bittencourt, L; de Siqueira, J T T; Tufik, S

    2013-07-01

    The goal of the current study was to estimate the prevalence of sleep bruxism (SB) in the general population using a representative sample of 1,042 individuals who answered questionnaires and underwent polysomnography (PSG) examinations. After PSG, the individuals were classified into 3 groups: absence of SB, low-frequency SB, and high-frequency SB. The results indicated that the prevalence of SB, indicated by questionnaires and confirmed by PSG, was 5.5%. With PSG used exclusively as the criterion for diagnosis, the prevalence was 7.4% regardless of SB self-reported complaints. With questionnaires alone, the prevalence was 12.5%. Of the 5.5% (n = 56) with confirmed SB, 26 were classified as low-frequency SB, and 30 as high-frequency. The episodes of SB were more frequent in stage 2 sleep, and the phasic bruxism events were more frequent than tonic or mixed events in all sleep stages in individuals with SB. A positive association was observed between SB and insomnia, higher degree of schooling, and a normal/overweight body mass index (BMI). These findings demonstrate the prevalence of SB in a population sampled by PSG, the gold standard methodology in the investigation of sleep disorders, combined with validated questionnaires.

  5. Short-term stability of sleep and heart rate variability in good sleepers and patients with insomnia: for some measures, one night is enough.

    Science.gov (United States)

    Israel, Benjamin; Buysse, Daniel J; Krafty, Robert T; Begley, Amy; Miewald, Jean; Hall, Martica

    2012-09-01

    Quantify the short-term stability of multiple indices of sleep and nocturnal physiology in good sleeper controls and primary insomnia patients. Intra-class correlation coefficients (ICC) were used to quantify the short-term stability of study outcomes. Sleep laboratory. Fifty-four adults with primary insomnia (PI) and 22 good sleeper controls (GSC). Visually scored sleep outcomes included indices of sleep duration, continuity, and architecture. Quantitative EEG outcomes included power in the delta, theta, alpha, sigma, and beta bands during NREM sleep. Power spectral analysis was used to estimate high-frequency heart rate variability (HRV) and the ratio of low- to high-frequency HRV power during NREM and REM sleep. With the exception of percent stage 3+4 sleep; visually scored sleep outcomes did not exhibit short-term stability across study nights. Most QEEG outcomes demonstrated short-term stability in both groups. Although power in the beta band was stable in the PI group (ICC = 0.75), it tended to be less stable in GSCs (ICC = 0.55). Both measures of cardiac autonomic tone exhibited short-term stability in GSCs and PIs during NREM and REM sleep. Most QEEG bandwidths and HRV during sleep show high short-term stability in good sleepers and patients with insomnia alike. One night of data is, thus, sufficient to derive reliable estimates of these outcomes in studies focused on group differences or correlates of QEEG and/or HRV. In contrast, one night of data is unlikely to generate reliable estimates of PSG-assessed sleep duration, continuity or architecture, with the exception of slow wave sleep.

  6. Assessing EEG sleep spindle propagation. Part 1: theory and proposed methodology.

    Science.gov (United States)

    O'Reilly, Christian; Nielsen, Tore

    2014-01-15

    A convergence of studies has revealed sleep spindles to be associated with sleep-related cognitive processing and even with fundamental waking state capacities such as intelligence. However, some spindle characteristics, such as propagation direction and delay, may play a decisive role but are only infrequently investigated because of technical complexities. A new methodology for assessing sleep spindle propagation over the human scalp using noninvasive electroencephalography (EEG) is described. This approach is based on the alignment of time-frequency representations of spindle activity across recording channels. This first of a two-part series concentrates on framing theoretical considerations related to EEG spindle propagation and on detailing the methodology. A short example application is provided that illustrates the repeatability of results obtained with the new propagation measure in a sample of 32 night recordings. A more comprehensive experimental investigation is presented in part two of the series. Compared to existing methods, this approach is particularly well adapted for studying the propagation of sleep spindles because it estimates time delays rather than phase synchrony and it computes propagation properties for every individual spindle with windows adjusted to the specific spindle duration. The proposed methodology is effective in tracking the propagation of spindles across the scalp and may thus help in elucidating the temporal aspects of sleep spindle dynamics, as well as other transient EEG and MEG events. A software implementation (the Spyndle Python package) is provided as open source software. Copyright © 2013 Elsevier B.V. All rights reserved.

  7. Total sleep time in Muslim football players is reduced during Ramadan: a pilot study on the standardized assessment of subjective sleep-wake patterns in athletes.

    Science.gov (United States)

    Herrera, Christopher P

    2012-01-01

    Ramadan is a period in which Muslims fast during daylight hours and is associated with disturbances in sleep-wake behaviour and adverse effects on physical and mental health in normal volunteers. Studies using athletes are rare and remain equivocal as to whether Ramadan influences sleep-wake patterns. Notably, the standardized assessment of subjective sleep quality and daytime sleepiness in athletes has not been established. This study employed the Arabic version of the Pittsburgh Sleep Quality Index, Insomnia Severity Index, and Epworth Sleepiness Scale in nine football players aged 20-35 years (mean ± s: 26 ± 4) one week before and during the last week of Ramadan. Compliance rates with self-administration were high (71%) and the results demonstrated a robust decline in total sleep time (before Ramadan: 6.6 ± 2 h; at the end of Ramadan: 5.3 ± 1 h; P effect size 0.81). Compared with previous research, the study questionnaires offer improved methodology, including less time constraints plus standardization in scoring. Thus, this study demonstrates a framework for greater reproducibility and reliability in the assessment of subjective sleep-wake patterns in athletes before and during Ramadan.

  8. The effects of Ramadan fasting on sleep patterns and daytime sleepiness: An objective assessment

    Directory of Open Access Journals (Sweden)

    Ahmed S BaHammam

    2013-01-01

    Full Text Available Background: Ramadan fasting and its associated lifestyle changes have been linked to changes in sleep and daytime sleepiness. This study was designed to assess the effects of Ramadan fasting on patterns of sleep and daytime sleepiness. Methods: The SenseWear Pro Armband™ was used to assess the duration and distribution of sleep in eight Muslim and eight non-Muslim volunteers during the last week of Shaaban [baseline (BL and the first (R1 and second (R2 weeks of Ramadan (1430 H]. OPTALERT™ was used to assess daytime drowsiness objectively using the John Drowsiness Scale (JDS to assess sleepiness, and a visual reaction time test was used to assess mean reaction time (MRT. Results: The mean ages of Muslims and non-Muslims were 36.25 ± 4.46 and 34.75 ± 3.33 years, respectively. Although the start of work was delayed for Muslims from 0730 to 1000 hours, there was no change in working hours for non-Muslims. During Ramadan, bedtime and wake-up time were delayed, and there was a significant reduction in total sleep time for Muslims (5.91 ± 1.36 hours, 4.95 ± 1.46 hours, and 4.78 ± 1.36 hours during BL, R1, and R2, respectively, P < 0.001, but not for non-Muslims. JDS values in both Muslims and non-Muslims were normal at BL (1.70 ± 1.16 and 1.68 ± 1.07, respectively, and no changes occurred during Ramadan (R1 or R2, indicating no increase in daytime sleepiness. There were no significant changes in MRT during R1 and R2 from BL in either group. Conclusion: Although the sleep cycle of the studied sample shifted during Ramadan among fast observers, there was no objective evidence for increased sleepiness during fasting.

  9. Side Effects: Sleep Problems

    Science.gov (United States)

    Sleep problems are a common side effect during cancer treatment. Learn how a polysomnogram can assess sleep problems. Learn about the benefits of managing sleep disorders in men and women with cancer.

  10. What Is Sleep Apnea?

    Science.gov (United States)

    ... have type 2 diabetes. Hormonal changes in sleep deprivation. We know that sleep deprivation decreases the response of the body to insulin , ... with sleep apnea who finds it hard to use your CPAP machine? This study is assessing whether ...

  11. Sleep-wake Cycle Assessment in Type 2 Diabetes and Salivary Melatonin Correlates

    Science.gov (United States)

    Cavalcanti, Paula Regina Aguiar

    The aim of this study was to analyze the sleep-wake cycle of T2DM subjects and compare it to healthy controls using the nonparametric approach and to assess the changes in the circadian and homeostatic control of the sleep-wake cycle in type 2 diabetic (T2DM) and correlate it with melatonin concentration. The sample consisted of 21 subjects with diagnosis of T2DM for more than a year and 21 healthy controls matched for gender and age. Subjects were assessed using the Beck's Depression Inventory (BDI), the Apnea Risk Evaluation System (ARES), hemoglobin A1c (HbA1c), actigraphy and melatonin levels. The findings revealed that T2DM subjects demonstrate lower IS (p=.03), higher IV (p=.046) and lower rhythm amplitude (p=.02) when compared to healthy controls. Mean melatonin concentrations collected at bed time were significantly lower in the diabetic subjects than that of controls (11.7+/-7.27 pg/ml vs. 24.13+/-10.80pg/ml; psleep duration (p=.03), efficiency (p=.02); and higher activity counts during the sleep phase (p=.02) in the diabetic group. Sleep efficiency was significantly correlated with melatonin collected two hours before bed time (rho=.61; p=.047). Additionally, there were significant inverse relationships between melatonin collected at two hours before bed time and latency (rho=-.87; p=.001), wake after sleep onset (rho=-.69; p=.02) and nocturnal activity (rho=-.67; p=.03). Latency was inversely correlated with melatonin collected at bed time (rho=-.69; p=.02). These findings suggest that T2DM presents disturbances in the homeostatic and circadian drives, mainly characterized by less consistency across days of the daily circadian signal, higher rhythm fragmentation and lower rhythm amplitude. In addition to the lower melatonin levels, the decrease in the amplitude of the activity rhythm may also be involved in circadian alterations of the sleep-wake cycle.

  12. Sleep and mental disorders: A meta-analysis of polysomnographic research.

    Science.gov (United States)

    Baglioni, Chiara; Nanovska, Svetoslava; Regen, Wolfram; Spiegelhalder, Kai; Feige, Bernd; Nissen, Christoph; Reynolds, Charles F; Riemann, Dieter

    2016-09-01

    Investigating sleep in mental disorders has the potential to reveal both disorder-specific and transdiagnostic psychophysiological mechanisms. This meta-analysis aimed at determining the polysomnographic (PSG) characteristics of several mental disorders. Relevant studies were searched through standard strategies. Controlled PSG studies evaluating sleep in affective, anxiety, eating, pervasive developmental, borderline and antisocial personality disorders, attention-deficit-hyperactivity disorder (ADHD), and schizophrenia were included. PSG variables of sleep continuity, depth, and architecture, as well as rapid-eye movement (REM) sleep were considered. Calculations were performed with the "Comprehensive Meta-Analysis" and "R" software. Using random effects modeling, for each disorder and each variable, a separate meta-analysis was conducted if at least 3 studies were available for calculation of effect sizes as standardized means (Hedges' g). Sources of variability, that is, sex, age, and mental disorders comorbidity, were evaluated in subgroup analyses. Sleep alterations were evidenced in all disorders, with the exception of ADHD and seasonal affective disorders. Sleep continuity problems were observed in most mental disorders. Sleep depth and REM pressure alterations were associated with affective, anxiety, autism and schizophrenia disorders. Comorbidity was associated with enhanced REM sleep pressure and more inhibition of sleep depth. No sleep parameter was exclusively altered in 1 condition; however, no 2 conditions shared the same PSG profile. Sleep continuity disturbances imply a transdiagnostic imbalance in the arousal system likely representing a basic dimension of mental health. Sleep depth and REM variables might play a key role in psychiatric comorbidity processes. Constellations of sleep alterations may define distinct disorders better than alterations in 1 single variable. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  13. Relationship between sleep parameters, insulin resistance and age-adjusted insulin like growth factor-1 score in non diabetic older patients.

    Directory of Open Access Journals (Sweden)

    Sarah Damanti

    Full Text Available Sleep complaints are prevalent in older patients. Sleepiness, short or long sleep duration and obstructive sleep apnea (OSA are associated with insulin resistance (IR. These parameters have not yet been considered together in the same study exploring the possible association between IR and sleep in older patients. IR is involved in cardiovascular and metabolic diseases, pathologies which are highly prevalent in older patients. Here we assess, in older non-diabetic patients with sleep complaints, the associations between IR and sleep parameters objectively recorded by polysomnography (PSG rather than self-report. The Growth Hormone/Insulin like growth factor-1 axis could play a role in the development of IR during sleep disorders. The second objective of this study was to analyze the association between sleep parameters and age-adjusted IGF-1 score, which could explain the association between OSA and IR.72 non-diabetic older patients, mean age 74.5 ± 7.8 years, were included in this observational study. We evaluated anthropometric measures, subjective and objective sleepiness, polysomnography, Homeostatic Model Assessment for IR (HOMA-IR and age-adjusted IGF-1 score. A multivariate regression was used to determine factors associated with HOMA-IR.The 47 OSA patients were over-weight but not obese and had higher IR than the non-OSA patients. In multilinear regression analysis, apnea-hypopnea index was independently associated with IR after adjustment for several confounding factors. Neither IGF-1 level nor IGF-1 score were different in the two groups.We demonstrate that in non-diabetic older patients with sleep complaints, OSA is independently associated with IR, regardless of anthropometric measurements and sleep parameters (sleep duration/sleepiness/arousals. Targeting OSA to reduce IR could be useful in the elderly, although further exploration is required.

  14. An integrated video-analysis software system designed for movement detection and sleep analysis. Validation of a tool for the behavioural study of sleep.

    Science.gov (United States)

    Scatena, Michele; Dittoni, Serena; Maviglia, Riccardo; Frusciante, Roberto; Testani, Elisa; Vollono, Catello; Losurdo, Anna; Colicchio, Salvatore; Gnoni, Valentina; Labriola, Claudio; Farina, Benedetto; Pennisi, Mariano Alberto; Della Marca, Giacomo

    2012-02-01

    The aim of the present study was to develop and validate a software tool for the detection of movements during sleep, based on the automated analysis of video recordings. This software is aimed to detect and quantify movements and to evaluate periods of sleep and wake. We applied an open-source software, previously distributed on the web (Zoneminder, ZM), meant for video surveillance. A validation study was performed: computed movement analysis was compared with two standardised, 'gold standard' methods for the analysis of sleep-wake cycles: actigraphy and laboratory-based video-polysomnography. Sleep variables evaluated by ZM were not different from those measured by traditional sleep-scoring systems. Bland-Altman plots showed an overlap between the scores obtained with ZM, PSG and actigraphy, with a slight tendency of ZM to overestimate nocturnal awakenings. ZM showed a good degree of accuracy both with respect to PSG (79.9%) and actigraphy (83.1%); and had very high sensitivity (ZM vs. PSG: 90.4%; ZM vs. actigraphy: 89.5%) and relatively lower specificity (ZM vs. PSG: 42.3%; ZM vs. actigraphy: 65.4%). The computer-assisted motion analysis is reliable and reproducible, and it can allow a reliable esteem of some sleep and wake parameters. The motion-based sleep analysis shows a trend to overestimate wakefulness. The possibility to measure sleep from video recordings may be useful in those clinical and experimental conditions in which traditional PSG studies may not be performed. Copyright © 2011 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

  15. The effects of aging on sleep architecture in healthy subjects.

    Science.gov (United States)

    Dorffner, Georg; Vitr, Martin; Anderer, Peter

    2015-01-01

    This chapter presents normative data on healthy sleep, as measured by polysomnography (PSG), from "supernormal" subjects across the age range from 20 to about 90 years. The data originates from the SIESTA project database established in the late 1990s. While that data has been published and used in research in many ways, the novelty of the current analysis is (a) the focus on normative data following the latest sleep staging standard (AASM 2012), and (b) the results after narrowing down the data set by excluding outliers due to disturbed sleep pattern that can occur in a sleep lab and are thus not examples of "normal" sleep. Results demonstrate interesting dependencies of sleep architecture on age, in particular a reduction in total sleep time and changes in sleep stage distributions toward lighter sleep, which differ in detail between the two genders.

  16. Shift work sleep disorder is associated with an attenuated brain response of sensory memory and an increased brain response to novelty: an ERP study.

    Science.gov (United States)

    Gumenyuk, Valentina; Roth, Thomas; Korzyukov, Oleg; Jefferson, Catherine; Kick, Ashley; Spear, Laura; Tepley, Norman; Drake, Christopher L

    2010-05-01

    To study the neurophysiological changes in attention and memory functions in shift work sleep disorder (SWSD), using event-related brain potentials (ERPs). 9 healthy night workers (NW) (mean age = 40 y; SD +/- 8.9 y); 8 night workers meeting diagnostic criteria for SWSD (mean age = 37 y +/- 9.4 y) and 9 healthy day workers (DW) (mean age = 35 y +/- 7.3 y). Using standard PSG the sleep related measures (TIB, TST, SOL, SE, and sleep stage distribution) were obtained prior to EEG/ERP study. Measures of habitual sleep were obtained from 2 week sleep logs and sleepiness was assessed with standardized measures. Using 32-EEG leads the ERPs to 3 types of sounds (novel, duration deviant, and simple tone) were obtained. The mismatch negativity (MMN) reflecting memory processing and P3a-reflecting the shift of involuntary attention were obtained. The statistical comparisons of ERPs and sleep related parameters were performed using repeated measured ANOVAs and t-tests where appropriate. Patients with SWSD had reduced TST and increased WASO relative to healthy workers. ERP results demonstrated significant attenuation of MMN amplitude over frontal regions in SWSD patients relative to NW and DW. In the SWSD patients, the P3a was increased to novelty across frontocentral brain regions with respect to the same locations in healthy controls. The ERP evidence of sensory memory reduction and attentional hyper-reaction to novel sound in conjunction with disturbed sleep suggests the need for more neurophysiological studies in SWSD workers.

  17. Sleep Onset Problems in Two Children with Mild Intellectual Disability and Epilepsy: Assessment and Treatment in the Home Setting

    Science.gov (United States)

    Maas, A. P. H. M.; Didden, R.; de Moor, J. M. H.; Renier, W. O.; Curfs, L. M. G.

    2005-01-01

    Sleep problems such as bedtime difficulties, frequent night waking and excessive daytime sleepiness are prevalent in children with epilepsy. In the present study, functional assessment of sleep onset problems in two young children with epilepsy was performed. Effects of bedtime fading and antipsychotic medication (pipamperon) in a 6-year-old boy,…

  18. Sleep Onset Problems in Two Children with Mild Intellectual Disability and Epilepsy: Assessment and Treatment in the Home Setting

    NARCIS (Netherlands)

    Maas, A.P.H.M.; Didden, H.C.M.; Moor, J.M.H. de; Renier, W.O.; Curfs, L.M.G.

    2005-01-01

    Sleep problems such as bedtime difficulties, frequent night waking and excessive daytime sleepiness are prevalent in children with epilepsy. In the present study, functional assessment of sleep onset problems in two young children with epilepsy was performed. Effects of bedtime fading and

  19. Sleep quality, sleep propensity and academic performance.

    Science.gov (United States)

    Howell, Andrew J; Jahrig, Jesse C; Powell, Russell A

    2004-10-01

    We examined associations between measures of sleep propensity on the Epworth Sleepiness Scale, sleep quality on the Pittsburgh Sleep Quality Index and academic performance by GPA and grades in introductory psychology for 414 students. In the total sample, neither sleep propensity nor sleep quality correlated with GPA or introductory psychology grades. However, among students carrying a full course load, those reporting poor sleep quality performed less well on academic measures than those reporting a better quality of sleep. Further research is needed to assess the moderating influence of overall demands of daytime functioning on the association between sleep quality and academic performance.

  20. The relationship between mood and sleep in different female reproductive states.

    Science.gov (United States)

    Toffol, Elena; Kalleinen, Nea; Urrila, Anna Sofia; Himanen, Sari-Leena; Porkka-Heiskanen, Tarja; Partonen, Timo; Polo-Kantola, Päivi

    2014-06-16

    Sleep is disrupted in depressed subjects, but it also deteriorates with age and possibly with the transition to menopause. The nature of interaction between mood, sleep, age and reproductive state is not well-defined. The aim of this study was to evaluate the relationship between mood and sleep among healthy women in different reproductive states. We analyzed data from 11 younger (20-26 years), 21 perimenopausal (43-51 years) and 29 postmenopausal (58-71 years) healthy women who participated in a study on menopause, sleep and cognition. The 21-item Beck Depression Inventory (BDI) was administered to assess mood. Subjective sleep quality was assessed with the Basic Nordic Sleep Questionnaire (BNSQ). Objective sleep was measured with all-night polysomnography (PSG) recordings. Perimenopausal and younger women were examined during the first days of their menstrual cycle at the follicular phase. Among younger women, less arousals associated with higher BDI total scores (p = 0.026), and higher SWS percentages with more dissatisfaction (p = 0.001) and depressive-somatic symptoms (p = 0.025), but with less depressive-emotional symptoms (p = 0.001). In specific, less awakenings either from REM sleep or SWS, respectively, associated with more punishment (p = 0.005; p = 0.036), more dissatisfaction (p sleep efficiencies (p = 0.022) and shorter total sleep times (p = 0.024) associated with higher BDI scores, longer sleep latencies with more depressive-somatic symptoms (p = 0.032) and longer REM latencies with more dissatisfaction (p = 0.017). In postmenopausal women, higher REM percentages associated with higher BDI total scores (p = 0.019) and more depressive-somatic symptoms (p = 0.005), and longer SWS latencies with more depressive-somatic symptoms (p = 0.030). Depressive symptoms measured with the total BDI scores associated with sleep impairment in both perimenopausal and postmenopausal women. In younger women, specific BDI factors revealed minor associations, suggesting

  1. Sleep apnea headaches

    Directory of Open Access Journals (Sweden)

    Reza Boostani

    2016-12-01

    Full Text Available Obstructive sleep apnea syndrome (OSAS is a common disorder characterized by recurrent apnea during sleep. Nocturnal laboratory-based polysomnography (PSG is the gold standard test for diagnosis of OSA. The sufferers may complain from daytime sleepiness, snoring or occasional headaches. Serious consequences such as cardiovascular complications, stroke or symptoms of depression may complicate the syndrome. Headache prevalence due to sleep apnea is estimated 1%-2% in general population and affects 2%-8% of middle age population. Morning headache is more common in the OSAS patients. OSAS patients present with various characteristics of morning headache. Treatment with continuous positive airway pressure usually reduces headache. The pathophysiologic background for a relation between obstructive sleep apnea and morning headache is multifactorial. Some theories have been proposed for OSAS-related headaches such as changing oxygen saturation during sleep, cerebral vasodilation and increased intracranial pressure due to cerebral vasodilation, sleep disruption and depression but the definite cause of headaches in OSAS patients is not yet clear.

  2. Speech Signal and Facial Image Processing for Obstructive Sleep Apnea Assessment

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    Fernando Espinoza-Cuadros

    2015-01-01

    Full Text Available Obstructive sleep apnea (OSA is a common sleep disorder characterized by recurring breathing pauses during sleep caused by a blockage of the upper airway (UA. OSA is generally diagnosed through a costly procedure requiring an overnight stay of the patient at the hospital. This has led to proposing less costly procedures based on the analysis of patients’ facial images and voice recordings to help in OSA detection and severity assessment. In this paper we investigate the use of both image and speech processing to estimate the apnea-hypopnea index, AHI (which describes the severity of the condition, over a population of 285 male Spanish subjects suspected to suffer from OSA and referred to a Sleep Disorders Unit. Photographs and voice recordings were collected in a supervised but not highly controlled way trying to test a scenario close to an OSA assessment application running on a mobile device (i.e., smartphones or tablets. Spectral information in speech utterances is modeled by a state-of-the-art low-dimensional acoustic representation, called i-vector. A set of local craniofacial features related to OSA are extracted from images after detecting facial landmarks using Active Appearance Models (AAMs. Support vector regression (SVR is applied on facial features and i-vectors to estimate the AHI.

  3. Changes in sleep architecture and quality in minimal hepatic encephalopathy patients and relationship to psychological dysfunction.

    Science.gov (United States)

    Liu, Changyun; Zhou, Jianguang; Yang, Xuedong; Lv, Jiao; Shi, Yunxing; Zeng, Xiaohong

    2015-01-01

    We examined changes in sleep quality and architecture in patients with minimal hepatic encephalopathy (MHE) and the impacts of sleep disruption on patient physical and psychological health. Ninety-eight MHE patients were examined by polysomnography (PSG) and the Pittsburg sleep quality inventory (PSQI). In addition, patients completed the SAS, SDS, and SCL-90 to examine the relationship between sleep quality and psychological health. Mean relative durations of Stage 1 and Stage 2, sleep latency, microarousal frequency, and total sleep time (TST) were all lower in MHE patients compared to healthy controls (Parchitecture that are strongly correlated with psychological dysfunction.

  4. An audit of the sleep medicine service in Oman.

    Science.gov (United States)

    Al-Abri, Mohammed A; Al-Hashmi, Khamis M; Jaju, Deepali; Al-Rawas, Omar A; Al-Riyami, Bazdawi M; Hassan, Mohammed O

    2008-11-01

    To audit the sleep service at Sultan Qaboos University Hospital (SQUH), Muscat, Oman, and to explore deficiencies to introduce new measures of improvement. Polysomnography (PSG) reports and SQUH medical records of all patients who underwent sleep studies from January 1995 to December 2006 in the sleep laboratory at SQUH were reviewed and analyzed. Out of a total of 1042 sleep studies conducted in the specified period, 768 PSG recordings were valid for analysis. The audit showed that the Otolaryngology Department was the main referring specialty for PSG (43%). Snoring was the main symptom for 33% of the subjects referred, but suspicion of obstructive sleep apnea was the main reason for referral (38%). Three quarters of the patients were males who were also younger, and with lower body mass index compared to females (p=0.0001 for all). Despite large number of patients with an apnea-hypopnea index of >15 (n=261), only 94 (36%) patients received continuous positive airway pressure titrations and treatment. The sleep medicine service in SQUH provided the basic service, and raised the awareness of the importance of this specialty. However, substantial effort is required to bring it to international standards.

  5. Objective and subjective assessment of sleep in chronic low back pain patients compared with healthy age and gender matched controls: a pilot study

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    Heneghan Conor

    2009-10-01

    Full Text Available Abstract Background While approximately 70% of chronic low back pain (CLBP sufferers complain of sleep disturbance, current literature is based on self report measures which can be prone to bias and no objective data of sleep quality, based exclusively on CLBP are available. In accordance with the recommendations of The American Sleep Academy, when measuring sleep, both subjective and objective assessments should be considered as the two are only modestly correlated, suggesting that each modality assesses different aspects of an individual's sleep experience. Therefore, the purpose of this study was to expand previous research into sleep disturbance in CLBP by comparing objective and subjective sleep quality in participants with CLBP and healthy age and gender matched controls, to identify correlates of poor sleep and to test logistics and gather information prior to a larger study. Methods 15 CLBP participants (mean age = 43.8 years (SD = 11.5, 53% female and 15 healthy controls (mean age = 41.5 years (SD = 10.6, 53% female consented. All participants completed the Pittsburgh Sleep Quality Index, Insomnia Severity Index, Pittsburgh Sleep Diary and the SF36v2. CLBP participants also completed the Oswestry Disability Index. Sleep patterns were assessed over three consecutive nights using actigraphy. Total sleep time (TST, sleep efficiency (SE, sleep latency onset (SL and number of awakenings after sleep onset (WASO were derived. Statistical analysis was conducted using unrelated t-tests and Pearson's product moment correlation co-efficients. Results CLBP participants demonstrated significantly poorer overall sleep both objectively and subjectively. They demonstrated lower actigraphic SE (p = .002 and increased WASO (p = .027 but no significant differences were found in TST (p = .43 or SL (p = .97. Subjectively, they reported increased insomnia (p = Conclusion CLBP participants demonstrated poorer overall sleep, increased insomnia symptoms and

  6. Knowledge-based Identification of Sleep Stages based on Two Forehead Electroencephalogram Channels

    Directory of Open Access Journals (Sweden)

    Chih-Sheng eHuang

    2014-09-01

    Full Text Available Sleep quality is important, especially given the considerable number of sleep-related pathologies. The distribution of sleep stages is a highly effective and objective way of quantifying sleep quality. As a standard multi-channel recording used in the study of sleep, polysomnography (PSG is a widely used diagnostic scheme in sleep medicine. However, the standard process of sleep clinical test, including PSG recording and manual scoring, is complex, uncomfortable, and time-consuming. This process is difficult to implement when taking the whole PSG measurements at home for general healthcare purposes. This work presents a novel sleep stage classification system, based on features from the two forehead EEG channels FP1 and FP2. By recording EEG from forehead, where there is no hair, the proposed system can monitor physiological changes during sleep in a more practical way than previous systems. Through a headband or self-adhesive technology, the necessary sensors can be applied easily by users at home. Analysis results demonstrate that classification performance of the proposed system overcomes the individual differences between different participants in terms of automatically classifying sleep stages. Additionally, the proposed sleep stage classification system can identify kernel sleep features extracted from forehead EEG, which are closely related with sleep clinician’s expert knowledge. Moreover, forehead EEG features are classified into five sleep stages by using the relevance vector machine. In a leave-one-subject-out cross validation analysis, we found our system to correctly classify five sleep stages at an average accuracy of 76.7 ± 4.0 (SD % (average kappa 0.68 ± 0.06 (SD. Importantly, the proposed sleep stage classification system using forehead EEG features is a viable alternative for measuring EEG signals at home easily and conveniently to evaluate sleep quality reliably, ultimately improving public healthcare.

  7. Study on the correlation between two common sleep disorders in Parkinson's disease

    Directory of Open Access Journals (Sweden)

    Li-jing MA

    2017-01-01

    Full Text Available Background Obstructive sleep apnea-hypopnea syndrome (OSAHS and rapid eye movement sleep behavior disorder (RBD are two common sleep disorders in Parkinson's disease (PD. This paper aims to explore the changes of clinical features and sleep parameters, as well as the mutual effect in PD patients with concurrent OSAHS and RBD. Methods Unified Parkinson's Disease Rating Scale (UPDRS, Mini-Mental State Examination (MMSE, Montreal Cognitive Assessment (MoCA Chinese Version, Epworth Sleepiness Scale (ESS, Pittsburgh Sleep Quality Index (PSQI, Non-Motor Symptoms Questionnaire (NMSQuest, Scales for Outcomes in Parkinson's Disease-Autonomic (SCOPA-AUT, 39-Item Parkinson's Disease Questionnaire (PDQ-39 and Hoehn-Yahr stage were used to assess the motor symptoms, non-motor symptoms (cognitive function, sleep quality, autonomic function, and the severity of disease of 190 PD patients. Polysomnography (PSG monitoring was done to record sleep parameters. Results Among those patients, 73 patients were accompanied by OSAHS, among whom 22 patients also suffered from RBD (PD + OSAHS + RBD, and 51 patients did not present RBD (PD + OSAHS - RBD. The scores of UPDRSⅠ (P = 0.015, UPDRSⅡ (P = 0.023, ESS (P = 0.002, PSQI (P = 0.048, NMSQuest (P = 0.001 and SCOPA - AUT (P = 0.026 in PD + OSAHS + RBD group were significantly higher than those in PD + OSAHS - RBD group, while MoCA score was significantly lower (P = 0.013. PSG monitoring showed mean artery oxygen saturation (SaO2, P = 0.029, mini SaO2 (P = 0.001, mini SaO2 in REM (P = 0.000, tonic EMG activity (P = 0.000 and phasic EMG activity (P = 0.000 in REM in PD + OSAHS + RBD group were significantly higher than those in PD + OSAHS - RBD group. Correlation analysis showed that apnea hypopnea index (AHI and oxygen desaturation index (ODI were positively correlated with the scores of NMSQuest (rs = 0.252, P = 0.032; rs = 0.229, P = 0.010, SCOPA-AUT (rs = 0.322, P = 0.005; rs = 0.247, P = 0.037 and PDQ-39 (rs = 0

  8. An assessment of quality of sleep and the use of drugs with sedating properties in hospitalized adult patients

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    Naumann Terryn

    2004-03-01

    Full Text Available Abstract Background Hospitalization can significantly disrupt sleeping patterns. In consideration of the previous reports of insomnia and apparent widespread use of benzodiazepines and other hypnotics in hospitalized patients, we conducted a study to assess quality of sleep and hypnotic drug use in our acute care adult patient population. The primary objectives of this study were to assess sleep disturbance and its determinants including the use of drugs with sedating properties. Methods This single-centre prospective study involved an assessment of sleep quality for consenting patients admitted to the general medicine and family practice units of an acute care Canadian hospital. A validated Verran and Snyder-Halpern (VSH Sleep Scale measuring sleep disturbance, sleep effectiveness, and sleep supplementation was completed daily by patients and scores were compared to population statistics. Patients were also asked to identify factors influencing sleep while in hospital, and sedating drug use prior to and during hospitalization was also assessed. Results During the 70-day study period, 100 patients completed at least one sleep questionnaire. There was a relatively even distribution of males versus females, most patients were in their 8th decade of life, retired, and suffered from multiple chronic diseases. The median self-reported pre-admission sleep duration for participants was 8 hours and our review of PharmaNetR profiles revealed that 35 (35% patients had received a dispensed prescription for a hypnotic or antidepressant drug in the 3-month period prior to admission. Benzodiazepines were the most common sedating drugs prescribed. Over 300 sleep disturbance, effective and supplementation scores were completed. Sleep disturbance scores across all study days ranged 16–681, sleep effectiveness scores ranged 54–402, while sleep supplementation scores ranged between 0–358. Patients tended to have worse sleep scores as compared to healthy non

  9. Well-Being and Self-Assessment of Change: Secondary Analysis of an RCT That Demonstrated Benefit of Inhaled Lavender and Sleep Hygiene in College Students with Sleep Problems.

    Science.gov (United States)

    Lillehei, Angela Smith; Halcón, Linda; Gross, Cynthia R; Savik, Kay; Reis, Reilly

    Sleep issues are prevalent and affect health and well-being. The aspects of well-being that are impacted by sleep interventions have not been well studied. To investigate the impact of lavender and sleep hygiene (LSH) compared to sleep hygiene (SH) alone on well-being as measured by the Self-assessment of Change questionnaire (SAC) at post-intervention and two-week follow-up, and secondarily to compare the SAC sleep item to results from standardized sleep surveys. Secondary analysis of a randomized controlled trial (RCT) where one group received a lavender inhalation patch and practiced sleep hygiene (LSH) and the other group received a placebo inhalation patch and practiced sleep hygiene (SH) for five consecutive nights. Usual sleep setting. Seventy-nine college students with self-reported sleep issues. The SAC was completed at post-intervention and follow-up. Exploratory analysis showed significantly improved well-being for the LSH group at post-intervention for well-being domains of sleep, energy, and vibrancy (P = .01, .03, and .05, respectively) and an overall trend of improved well-being in comparison to the SH group at post-intervention and follow-up. The SAC sleep item showed a similar pattern of change to the standardized sleep surveys with a statistically significant improvement in sleep for the LSH group at follow-up (P = .02). Findings demonstrate the positive impact of the lavender intervention on three domains of self-assessed well-being are energy, vibrancy, and sleep. SAC results extend and complement prior findings of improved sleep quality. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Electroencephalographic findings related with mild cognitive impairment in idiopathic rapid eye movement sleep behavior disorder.

    Science.gov (United States)

    Sasai, Taeko; Matsuura, Masato; Inoue, Yuichi

    2013-12-01

    Mild cognitive impairment (MCI) and electroencephalographic (EEG) slowing have been reported as common findings of idiopathic rapid eye movement (REM) sleep behavior disorder (iRBD) and α-synucleinopathies. The objective of this study is to clarify the relation between MCI and physiological markers in iRBD. Cross-sectional study. Yoyogi Sleep Disorder Center. Thirty-one patients with iRBD including 17 younger patients with iRBD (younger than 70 y) and 17 control patients for the younger patients with iRBD. N/A. Montreal Cognitive Assessment (MoCA) and n-polysomnogram (PSG) were conducted of all participants. In patients with iRBD, the factors associated with MCI were explored among parameters of REM sleep without atonia (RWA), score of Sniffin' Sticks Test (threshold-discrimination-identification [TDI] score), RBD morbidity, and RBD severity evaluated with the Japanese version of the RBD questionnaire (RBDQ-JP). The younger iRBD group showed significantly lower alpha power during wake and lower MoCA score than the age-matched control group. MCI was detected in 13 of 17 patients (76.5%) on MoCA in this group. Among patients wtih iRBD, the MoCA score negatively correlated with age, proportion of slow wave sleep, TDI score, and EEG spectral power. Multiple regression analysis provided the following equation: MoCA score = 50.871-0.116*age -5.307*log (δ power during REM sleep) + 0.086*TDI score (R² = 0.598, P sleep), and 0.357 for TDI score (F = 9.900, P sleep and olfactory dysfunction, was revealed to be associated with cognitive decline in idiopathic rapid eye movement sleep behavior disorder.

  11. Associations of Self-Reported and Actigraphy-Assessed Sleep Characteristics with Body Mass Index and Waist Circumference in Adults: Moderation by Gender

    Science.gov (United States)

    Mezick, Elizabeth J.; Wing, Rena R.; McCaffery, Jeanne M.

    2013-01-01

    Objectives Self-reported sleep duration has been linked to body mass index (BMI) and waist circumference in previous work; however, data regarding whether these associations are stronger in men or women have been mixed, and few studies have measured sleep objectively. We investigated self-reported and actigraphy-assessed sleep characteristics in relation to BMI and waist circumference, and examined the extent to which these associations differ by gender. Design Archived, cross-sectional data from the National Survey of Midlife Development in the United States (MIDUS) Biomarkers Study, collected in 2004–2006, were used. Participants included 1248 adults (43% male) who reported their habitual sleep duration, and a subset of participants (n = 441, 40% male) who underwent seven nights of wrist actigraphy. Results Self-reported total sleep time, actigraphy-assessed total sleep time, and actigraphy-assessed sleep efficiency were inversely associated with BMI in the full sample of both men and women. Gender moderated associations between actigraphy assessments of sleep and anthropometric variables, however, such that total sleep time and sleep efficiency were related to BMI and waist circumference in women only. Associations between sleep and waist circumference were independent of BMI. Conclusions Sleep duration and sleep continuity are associated with body weight and distribution of body fat, but these associations are stronger, or only present, in women. PMID:24239499

  12. Assessing learning outcomes and cost effectiveness of an online sleep curriculum for medical students.

    Science.gov (United States)

    Bandla, Hari; Franco, Rose A; Simpson, Deborah; Brennan, Kimberly; McKanry, Jennifer; Bragg, Dawn

    2012-08-15

    Sleep disorders are highly prevalent across all age groups but often remain undiagnosed and untreated, resulting in significant health consequences. To overcome an inadequacy of available curricula and learner and instructor time constraints, this study sought to determine if an online sleep medicine curriculum would achieve equivalent learner outcomes when compared with traditional, classroom-based, face-to-face instruction at equivalent costs. Medical students rotating on a required clinical clerkship received instruction in 4 core clinical sleep-medicine competency domains in 1 of 2 delivery formats: a single 2.5-hour face-to-face workshop or 4 asynchronous e-learning modules. Immediate learning outcomes were assessed in a subsequent clerkship using a multiple-choice examination and standardized patient station, with long-term outcomes assessed through analysis of students' patient write-ups for inclusion of sleep complaints and diagnoses before and after the intervention. Instructional costs by delivery format were tracked. Descriptive and inferential statistical analyses compared learning outcomes and costs by instructional delivery method (face-to-face versus e-learning). Face-to-face learners, compared with online learners, were more satisfied with instruction. Learning outcomes (i.e., multiple-choice examination, standardized patient encounter, patient write-up), as measured by short-term and long-term assessments, were roughly equivalent. Design, delivery, and learner-assessment costs by format were equivalent at the end of 1 year, due to higher ongoing teaching costs associated with face-to-face learning offsetting online development and delivery costs. Because short-term and long-term learner performance outcomes were roughly equivalent, based on delivery method, the cost effectiveness of online learning is an economically and educationally viable instruction platform for clinical clerkships.

  13. Maxillomandibular Advancement in Obstructive Sleep Apnea Syndrome Patients: a Restrospective Study on the Sagittal Cephalometric Variables

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    Paolo Ronchi

    2013-06-01

    Full Text Available Objectives: The present retrospective study analyzes sagittal cephalometric changes in patients affected by obstructive sleep apnea syndrome submitted to maxillomandubular advancement. Material and Methods: 15 adult sleep apnea syndrome (OSAS patients diagnosed by polysomnography (PSG and treated with maxillomandubular advancement (MMA were included in this study. Pre- (T1 and postsurgical (T2 PSG studies assessing the apnea/hypopnea index (AHI and the lowest oxygen saturation (LSAT level were compared. Lateral cephalometric radiographs at T1 and T2 measuring sagittal cephalometric variables (SNA, SNB, and ANB were analyzed, as were the amount of maxillary and mandibular advancement (Co-A and Co-Pog, the distance from the mandibular plane to the most anterior point of the hyoid bone (Mp-H, and the posterior airway space (PAS.Results: Postoperatively, the overall mean AHI dropped from 58.7 ± 16 to 8.1 ± 7.8 events per hour (P < 0.001. The mean preoperative LSAT increased from 71% preoperatively to 90% after surgery (P < 0.001. All the patients in our study were successfully treated (AHI < 20 or reduced by 50%. Cephalometric analysis performed after surgery showed a statistically significant correlation between the mean SNA variation and the decrease in the AHI (P = 0.01. The overall mean SNA increase was 6°.Conclusions: Our findings suggest that the improvement observed in the respiratory symptoms, namely the apnea/hypopnea episodes, is correlated with the SNA increase after surgery. This finding may help maxillofacial surgeons to establish selective criteria for the surgical approach to sleep apnea syndrome patients.

  14. Sleep stability and transitions in patients with idiopathic REM sleep behavior disorder and patients with Parkinson's disease

    DEFF Research Database (Denmark)

    Christensen, Julie Anja Engelhard; Jennum, Poul; Koch, Henriette

    2016-01-01

    Objective: Patients with idiopathic rapid eye movement (REM) sleep behavior disorder (iRBD) are at high risk of developing Parkinson's disease (PD). As wake/sleep-regulation is thought to involve neurons located in the brainstem and hypothalamic areas, we hypothesize that the neurodegeneration in i......RBD/PD is likely to affect wake/sleep and REM/non-REM (NREM) sleep transitions. Methods: We determined the frequency of wake/sleep and REM/NREM sleep transitions and the stability of wake (W), REM and NREM sleep as measured by polysomnography (PSG) in 27 patients with PD, 23 patients with iRBD, 25 patients...... with periodic leg movement disorder (PLMD) and 23 controls. Measures were computed based on manual scorings and data-driven labeled sleep staging. Results: Patients with PD showed significantly lower REM stability than controls and patients with PLMD. Patients with iRBD had significantly lower REM stability...

  15. Somnofluoroscopy, computed tomography, and cephalometry in the assessment of the airway in obstructive sleep apnoea.

    Science.gov (United States)

    Pepin, J L; Ferretti, G; Veale, D; Romand, P; Coulomb, M; Brambilla, C; Lévy, P A

    1992-01-01

    BACKGROUND: Assessments of the upper airways in patients with the obstructive sleep apnoea syndrome are usually carried out on awake patients who are upright. The dynamics of the airway in a patient who is asleep and lying down may be different. METHODS: Somnofluoroscopy, computed tomography of the upper airway, and cephalometry were carried out in 11 patients with the obstructive sleep apnoea syndrome (10 male; mean (SD) age 53 (10) years) to examine the airway while they were awake and asleep. RESULTS: At somnofluoroscopy 10 patients were in stage 2 sleep and only one in REM sleep. At least five obstructive events were visualised by lateral fluoroscopy in each patient. Imaging allowed observation of the dynamics of airway collapse, which began in the oropharynx in all cases, progressing to the hypopharynx in 10 cases and to the laryngopharynx in five. At fluoroscopy the soft palate was seen to hook up during airway occlusion in 10 patients, thereby increasing its cross sectional area. It was then sucked down into the hypopharynx. Somnofluoroscopic and cephalometric findings agreed, eight of the 10 patients with hypopharyngeal collapse shown by somnofluoroscopy having an inferiorly placed hyoid bone according to cephalometry (distance from the mandibular plane to the hyoid bone (MP-H distance) increased); the one patient with no hypopharyngeal collapse had a normal MP-H. By contrast, six of the 11 patients had a normal or supranormal hypopharyngeal cross sectional area of the airway on the computed tomogram. CONCLUSIONS: Somnofluoroscopy allows examination of the dynamics of airway closure in this disorder and shows the important role of the soft palate in acting as a plug in the oropharynx. Dynamic studies are required to determine the pattern of pharyngeal obstruction in obstructive sleep apnoea. Images PMID:1519190

  16. CPAP compliance in sleep apnea patients with and without laboratory CPAP titration.

    Science.gov (United States)

    Means, Melanie K; Edinger, Jack D; Husain, Aatif M

    2004-03-01

    Advances in auto-adjusting positive airway pressure technology for obstructive sleep apnea now permit this treatment to be initiated outside of the sleep laboratory environment, bypassing the need for laboratory-based titration studies. Thus far, little research has addressed how such developments may affect compliance to continuous positive airway pressure (CPAP). We tested the effect of laboratory CPAP exposure and technologist support in a retrospective chart review of 98 veterans with obstructive sleep apnea to determine whether patients who received standard laboratory CPAP titration complied better with CPAP than did patients who received no laboratory CPAP titration. Fifty patients underwent standard technician-attended polysomnography (PSG) with CPAP titration, and 48 patients underwent unattended PSG with no laboratory trial of CPAP (first CPAP exposure was at home). Objective CPAP compliance measures were obtained from CPAP units at follow-up visits. Attended-PSG patients wore CPAP significantly longer per night on average (5.0 hours vs 3.9 hours) and tended to wear CPAP on more nights (76.5% vs 64.2%) compared with unattended-PSG patients. These findings suggest that patients' sleep laboratory experience with CPAP and the support and education provided by sleep technologists are important factors in facilitating CPAP compliance.

  17. Sedative music facilitates deep sleep in young adults.

    Science.gov (United States)

    Chen, Chih-Kuang; Pei, Yu-Cheng; Chen, Ning-Hung; Huang, Li-Ting; Chou, Shih-Wei; Wu, Katie P; Ko, Pei-Chih; Wong, Alice M K; Wu, Chih-Kuan

    2014-04-01

    To investigate the effect of sedative music on the different stages of the sleep cycle in young adults with various sleep latencies by using polysomnography (PSG). Prospective, randomized, controlled, crossover study. Sleep center of a teaching hospital. Young adults with different sleep latencies. Poor sleepers (Pittsburgh Sleep Quality Index score ≥5) were excluded. Each participant stayed one night in the sleep center for adaptation and on each of the following two nights was assigned to (1) music and (2) control (without music) conditions in random order. In the music condition, sedative music composed by certified music therapists was played on a compact disc player for the first hour the participant was in bed. Sleep measures recorded with PSG, including sleep latency and durations of sleep stages. Twenty-four young adults (mean±standard deviation, 24.5±2.6 years) participated. They were classified into the short sleep latency (SL) group if the baseline SL of the adaptation night was shorter than 10 minutes or into the long SL group if the baseline SL was 10 minutes or longer. Sedative music did not alter the SL in either group. Sedative music reduced stage II sleep in both SL groups (main effect of music, p=0.03; interaction effect, p=0.87) but increased the duration of deep sleep (stages III and IV) only in the long SL group (main effect of music, p=0.15; interaction effect, p=0.02). In participants with long SL, sedative music improved the quality of sleep by prolonging the duration of deep sleep. This effect provides an alternative and noninvasive way to improve sleep in selected persons experiencing sleep problems.

  18. Relationship between obstructive sleep apnoea syndrome and sleep bruxism: a systematic review.

    Science.gov (United States)

    Jokubauskas, L; Baltrušaitytė, A

    2017-02-01

    Obstructive sleep apnoea syndrome (OSAS) is a clinical risk factor for sleep bruxism (SB). Both OSAS and SB are reported to be associated with sleep-related arousal reactions, although no clear causative link has been established. An electronic literature search was conducted of the MEDLINE, ScienceDirect, Wiley Online Library, SAGE Journals and EBSCOhost databases covering the period January 2006 and September 2016. Sequential screenings at the title, abstract and full-text levels were performed. The review included observational studies in the English language with a clearly established aim to assess the relationship between OSAS and SB using full-night PSG. The seven-item quality-assessment tool for experimental bruxism studies was used to assess the methodology across the studies. After a comprehensive screening of titles, abstracts and full texts, only three studies that met the pre-defined criteria were finally included in this systematic review. Two studies gave evidence that OSAS is associated with the occurrence of SB events: (i) SB events frequently occur during micro-arousal events consequent on apnoea-hypopnoea (AH) events and (ii) most SB events occur in temporal conjunction with AH events termination. However, one study did not report a strong association between AH and SB events. It can be concluded that there are not enough scientific data to define a clear causative link between OSAS and SB. However, they appear to share common clinical features. Further studies should focus on the intermediate mechanisms between respiratory and SB events. © 2016 John Wiley & Sons Ltd.

  19. Novel method for detection of Sleep Apnoea using respiration signals

    DEFF Research Database (Denmark)

    Nielsen, Kristine Carmes; Kempfner, Lykke; Sørensen, Helge Bjarup Dissing

    2014-01-01

    Polysomnography (PSG) studies are considered the “gold standard” for the diagnosis of Sleep Apnoea (SA). Identifying cessations of breathing from long-lasting PSG recordings manually is a labour-intensive and time-consuming task for sleep specialist, associated with inter-scorer variability....... In this study a simplified, semi-automatic, three-channel method for detection of SA patients is proposed in order to increase analysis reliability and diagnostic accuracy in the clinic. The method is based on characteristic features, such as respiration stoppages pr. hour and the total number of oxygen...... desaturations > 3%, extracted from the thorax and abdomen respiration effort belts, and the oxyhemoglobin saturation (SaO2), fed to an Elastic Net classifier and validated according to American Academy of Sleep Medicine (AASM) using the patients' AHI value. The method was applied to 109 patient recordings...

  20. Genome-wide association study identifies a maternal copy-number deletion in PSG11 enriched among preeclampsia patients

    Directory of Open Access Journals (Sweden)

    Zhao Linlu

    2012-06-01

    Full Text Available Abstract Background Specific genetic contributions for preeclampsia (PE are currently unknown. This genome-wide association study (GWAS aims to identify maternal single nucleotide polymorphisms (SNPs and copy-number variants (CNVs involved in the etiology of PE. Methods A genome-wide scan was performed on 177 PE cases (diagnosed according to National Heart, Lung and Blood Institute guidelines and 116 normotensive controls. White female study subjects from Iowa were genotyped on Affymetrix SNP 6.0 microarrays. CNV calls made using a combination of four detection algorithms (Birdseye, Canary, PennCNV, and QuantiSNP were merged using CNVision and screened with stringent prioritization criteria. Due to limited DNA quantities and the deleterious nature of copy-number deletions, it was decided a priori that only deletions would be selected for assay on the entire case-control dataset using quantitative real-time PCR. Results The top four SNP candidates had an allelic or genotypic p-value between 10-5 and 10-6, however, none surpassed the Bonferroni-corrected significance threshold. Three recurrent rare deletions meeting prioritization criteria detected in multiple cases were selected for targeted genotyping. A locus of particular interest was found showing an enrichment of case deletions in 19q13.31 (5/169 cases and 1/114 controls, which encompasses the PSG11 gene contiguous to a highly plastic genomic region. All algorithm calls for these regions were assay confirmed. Conclusions CNVs may confer risk for PE and represent interesting regions that warrant further investigation. Top SNP candidates identified from the GWAS, although not genome-wide significant, may be useful to inform future studies in PE genetics.

  1. Evaluation of Inflammatory Markers in a Large Sample of Obstructive Sleep Apnea Patients without Comorbidities

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    Izolde Bouloukaki

    2017-01-01

    Full Text Available Systemic inflammation is important in obstructive sleep apnea (OSA pathophysiology and its comorbidity. We aimed to assess the levels of inflammatory biomarkers in a large sample of OSA patients and to investigate any correlation between these biomarkers with clinical and polysomnographic (PSG parameters. This was a cross-sectional study in which 2983 patients who had undergone a polysomnography for OSA diagnosis were recruited. Patients with known comorbidities were excluded. Included patients (n=1053 were grouped according to apnea-hypopnea index (AHI as mild, moderate, and severe. Patients with AHI < 5 served as controls. Demographics, PSG data, and levels of high-sensitivity C-reactive protein (hs-CRP, fibrinogen, erythrocyte sedimentation rate (ESR, and uric acid (UA were measured and compared between groups. A significant difference was found between groups in hs-CRP, fibrinogen, and UA. All biomarkers were independently associated with OSA severity and gender (p<0.05. Females had increased levels of hs-CRP, fibrinogen, and ESR (p<0.001 compared to men. In contrast, UA levels were higher in men (p<0.001. Our results suggest that inflammatory markers significantly increase in patients with OSA without known comorbidities and correlate with OSA severity. These findings may have important implications regarding OSA diagnosis, monitoring, treatment, and prognosis. This trial is registered with ClinicalTrials.gov number NCT03070769.

  2. Sleep architecture in Sheehan's syndrome before and 6 months after growth hormone replacement therapy.

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    Ismailogullari, Sevda; Tanriverdi, Fatih; Kelestimur, Fahrettin; Aksu, Murat

    2009-02-01

    To characterize the sleep parameters in patients with growth hormone (GH) deficiency in Sheehan's syndrome adults and to assess the effects of 6-month GH replacement therapy (GHRT). Twenty-two women with Sheehan's syndrome, (mean age; 49.1+/-2.2 years), and 12 women with similar age (mean age; 51.3+/-3.8 years) and body mass index as control subjects were included in the study. Under baseline conditions, women received adequate hormone replacement therapy for all hormonal deficiencies other than GH. Twelve patients received recombinant GH (Genotropin; Pfizer Stockholm, Sweden) (treatment group) and eight patients received placebo (placebo group) for 6 months. Two patients had only baseline evaluation and were not followed up prospectively. Two polysomnography (PSG) recordings were performed on the patients group, one in the baseline period and the other at the sixth month of treatment (either GH or placebo). Control group had only baseline PSG. GH deficient females with Sheehan's syndrome have more NREM (95.9+/-1.5% and 88.6+/-0.9%, respectively; psyndrome patients under baseline conditions.

  3. Sleep following alcohol intoxication in healthy, young adults: effects of sex and family history of alcoholism.

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    Arnedt, J Todd; Rohsenow, Damaris J; Almeida, Alissa B; Hunt, Sarah K; Gokhale, Manjusha; Gottlieb, Daniel J; Howland, Jonathan

    2011-05-01

    This study evaluated sex and family history of alcoholism as moderators of subjective ratings of sleepiness/sleep quality and polysomnography (PSG) following alcohol intoxication in healthy, young adults. Ninety-three healthy adults [mean age 24.4 ± 2.7 years, 59 women, 29 subjects with a positive family history of alcoholism (FH+)] were recruited. After screening PSG, participants consumed alcohol (sex/weight adjusted dosing) to intoxication [peak breath alcohol concentration (BrAC) of 0.11 ± 0.01 g% for men and women] or matching placebo between 20:30 and 22:00 hours. Sleep was monitored using PSG between 23:00 and 07:00 hours. Participants completed the Stanford Sleepiness Scale and Karolinska Sleepiness Scale at bedtime and on awakening and a validated post-sleep questionnaire. Following alcohol, total sleep time, sleep efficiency, nighttime awakenings, and wake after sleep onset were more disrupted in women than men, with no differences by family history status. Alcohol reduced sleep onset latency, sleep efficiency, and rapid eye movement sleep while increasing wakefulness and slow wave sleep across the entire night compared with placebo. Alcohol also generally increased sleep consolidation in the first half of the night, but decreased it during the second half. Sleepiness ratings were higher following alcohol, particularly in women at bedtime. Morning sleep quality ratings were lower following alcohol than placebo. Alcohol intoxication increases subjective sleepiness and disrupts sleep objectively more in healthy women than in men, with no differences evident by family history of alcoholism status. Evaluating moderators of alcohol effects on sleep may provide insight into the role of sleep in problem drinking. Copyright © 2011 by the Research Society on Alcoholism.

  4. Polysaccharides PS-G and protein LZ-8 from Reishi (Ganoderma lucidum) exhibit diverse functions in regulating murine macrophages and T lymphocytes.

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    Yeh, Chen-Hao; Chen, Hsiao-Chin; Yang, Jeng-Je; Chuang, Wen-I; Sheu, Fuu

    2010-08-11

    Bioactive components in Ganoderma lucidum mainly include polysaccharides (PS-G) and immunomodulatory protein Ling Zhi-8 (LZ-8). These components may have diverse regulatory functions in the immune system. However, the PS-G preparations from different procedures still contained partial LZ-8 residue, indicating that the specific target and regulating function of PS-G and LZ-8 were not fully understood. In the present study, PS-G was subjected to 15% TCA for removing proteins and the LZ-8 detection using anti-LZ-8 monoclonal antibodies showed a remarkable 89.7% protein reduction of the deproteinized PS-G (dpPS-G). The Saccharomyces cerevisiae which expressed recombinant LZ-8 protein (rLZ-8) without glycosylation was generated and then compared with dpPS-G in the induction toward murine primary macrophage and T lymphocytic cells. The peritoneal macrophages from TLR4-deficient and wild type mice revealed that TLR4 was a putative receptor of dpPS-G, mediating the TNF-alpha, IL-1beta and IL-12p70 cytokine production and CD86, MHC II expression on macrophages, while rLZ-8 enhanced the production of IL-1beta, IL-12p70, CD86, and MHC II expression by another obscure route. rLZ-8-treated macrophages enhanced the release of IFN-gamma and IL-2 by murine CD4(+) and CD8(+) T cells, whereas dpPS-G treatment did not enhance the release of IFN-gamma and IL-2. Furthermore, although the direct rLZ-8-treatment conduced dramatic CD154, CD44 expression on CD3(+) T cells and increased IL-2, IFN-gamma secretion on CD4(+) and CD8(+) T cells, the dpPS-G was incapable of priming CD3(+), CD4(+) or CD8(+) T cells unitarily. Taken together, these results demonstrated that LZ-8 could activate murine macrophages and T lymphocytes but PS-G was merely the activator for macrophages, suggesting their diverse roles in activating the innate and adaptive immunity.

  5. Poor Sleep in Multiple Sclerosis Correlates with Beck Depression Inventory Values, but Not with Polysomnographic Data

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    Christian Veauthier

    2016-01-01

    Full Text Available Objectives. Pittsburgh Sleep Quality Index (PSQI values correlate with depression, but studies investigating the relationship between PSQI values and polysomnographic (PSG data showed inconsistent findings. Methods. Sixty-five consecutive patients with multiple sclerosis (MS were retrospectively classified as “good sleepers” (GS (PSQI ≤ 5 and “poor sleepers” (PS (PSQI > 5. The PSG data and the values of the Visual Analog Scale (VAS of fatigue, Modified Fatigue Impact Scale (MFIS, Fatigue Severity Scale (FSS, Epworth Sleepiness Scale (ESS, and the Beck Depression Inventory (BDI were compared. Results. No significant differences were found either for PSG data or for ESS, MFIS, and FSS values; but PS showed significantly increased BDI and VAS values. Conclusions. Poor sleep is associated with increased depression and fatigue scale values.

  6. Cardiac autonomic control and complexity during sleep are preserved after chronic sleep restriction in healthy subjects.

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    Tobaldini, Eleonora; Covassin, Naima; Calvin, Andrew; Singh, Prachi; Bukartyk, Jan; Wang, Shiang; Montano, Nicola; Somers, Virend K

    2017-04-01

    Acute sleep deprivation (SD) alters cardiovascular autonomic control (CAC) and is associated with an increased risk of cardiovascular disorders. However, the effects of partial SD on CAC are unclear. Thus, we aimed to investigate the effects of partial SD on CAC during sleep. We randomized seventeen healthy subjects to a restriction group (RES, n = 8, subjects slept two-thirds of normal sleep time based on individual habitual sleep duration for 8 days and 8 nights) or a Control group (CON, n = 9, subjects were allowed to sleep their usual sleep time). Attended polysomnographic (PSG) studies were performed every night; a subset of them was selected for the analysis at baseline (day 3-D3), the first night after sleep restriction (day 5-D5), at the end of sleep restriction period (day 11-D11), and at the end of recovery phase (day 14-D14). We extracted electrocardiogram (ECG) and respiration from the PSG and divided into wakefulness (W), nonrapid eye movements (REM) sleep (N2 and N3) and REM sleep. CAC was evaluated by means of linear spectral analysis, nonlinear symbolic analysis and complexity indexes. In both RES and CON groups, sympathetic modulation decreased and parasympathetic modulation increased during N2 and N3 compared to W and REM at D3, D5, D11, D14. Complexity analysis revealed a reduction in complexity during REM compared to NREM sleep in both DEP and CON After 8 days of moderate SD, cardiac autonomic dynamics, characterized by decreased sympathetic, and increased parasympathetic modulation, and higher cardiac complexity during NREM sleep, compared to W and REM, are preserved. © 2017 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on behalf of The Physiological Society and the American Physiological Society.

  7. Natural history of excessive daytime sleepiness: role of obesity, weight loss, depression, and sleep propensity.

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    Fernandez-Mendoza, Julio; Vgontzas, Alexandros N; Kritikou, Ilia; Calhoun, Susan L; Liao, Duanping; Bixler, Edward O

    2015-03-01

    Excessive daytime sleepiness (EDS) is highly prevalent in the general population and is associated with occupational and public safety hazards. However, no study has examined the clinical and polysomnographic (PSG) predictors of the natural history of EDS. Representative longitudinal study. Sleep laboratory. From a random, general population sample of 1,741 individuals of the Penn State Adult Cohort, 1,395 were followed up after 7.5 years. Full medical evaluation and 1-night PSG at baseline and standardized telephone interview at follow-up. The incidence of EDS was 8.2%, while its persistence and remission were 38% and 62%, respectively. Obesity and weight gain were associated with the incidence and persistence of EDS, while weight loss was associated with its remission. Significant interactions between depression and PSG parameters on incident EDS showed that, in depressed individuals, incident EDS was associated with sleep disturbances, while in non-depressed individuals, incident EDS was associated with increased physiologic sleep propensity. Diabetes, allergy/ asthma, anemia, and sleep complaints also predicted the natural history of EDS. Obesity, a disorder of epidemic proportions, is a major risk factor for the incidence and chronicity of EDS, while weight loss is associated with its remission. Interestingly, objective sleep disturbances predict incident EDS in depressed individuals, whereas physiologic sleep propensity predicts incident EDS in those without depression. Weight management and treatment of depression and sleep disorders should be part of our public health policies. © 2015 Associated Professional Sleep Societies, LLC.

  8. Objective sleep structure and cardiovascular risk factors in the general population: the HypnoLaus Study.

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    Haba-Rubio, José; Marques-Vidal, Pedro; Andries, Daniela; Tobback, Nadia; Preisig, Martin; Vollenweider, Peter; Waeber, Gérard; Luca, Gianina; Tafti, Mehdi; Heinzer, Raphaël

    2015-03-01

    To evaluate the association between objective sleep measures and metabolic syndrome (MS), hypertension, diabetes, and obesity. Cross-sectional study. General population sample. There were 2,162 patients (51.2% women, mean age 58.4 ± 11.1). Patients were evaluated for hypertension, diabetes, overweight/obesity, and MS, and underwent a full polysomnography (PSG). PSG measured variables included: total sleep time (TST), percentage and time spent in slow wave sleep (SWS) and in rapid eye movement (REM) sleep, sleep efficiency and arousal index (ArI). In univariate analyses, MS was associated with decreased TST, SWS, REM sleep, and sleep efficiency, and increased ArI. After adjustment for age, sex, smoking, alcohol, physical activity, drugs that affect sleep and depression, the ArI remained significantly higher, but the difference disappeared in patients without significant sleep disordered breathing (SDB). Differences in sleep structure were also found according to the presence or absence of hypertension, diabetes, and overweight/obesity in univariate analysis. However, these differences were attenuated after multivariate adjustment and after excluding subjects with significant SDB. In this population-based sample we found significant associations between sleep structure and MS, hypertension, diabetes, and obesity. However, these associations were cancelled after multivariate adjustment. We conclude that normal variations in sleep contribute little if any to MS and associated disorders. © 2015 Associated Professional Sleep Societies, LLC.

  9. The role of serotonin in sleep disordered breathing associated with Parkinson disease: a correlative [11C]DASB PET imaging study.

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    Irene M Lelieveld

    Full Text Available Sleep dysfunction and excessive daytime sleepiness are common in Parkinson disease (PD. Several studies suggest that PD patients exhibit high prevalence of sleep-disordered breathing (SDB. PD has a complex profile of neurochemical deficits in which abnormalities of different neurotransmitter systems may play significant and differing roles in the development of non-motor features. In the present study, we investigated whether SDB in PD is related to serotoninergic neuron degeneration. We used a cross-sectional design to assess the correlation between SDB and measures of caudal brainstem serotonin neuron integrity. Fifty one PD participants with mean disease duration of 6.0 (SD 3.7 years and mean age of 63.9 (SD 6.2 years were studied. We measured caudal brainstem serotoninergic innervation with [(11C]DASB positron emission tomography (PET imaging and striatal dopaminergic innervation with [(11C]DTBZ PET imaging. SDB was assessed with polysomnography (PSG and sleepiness with multiple sleep latency tests. Greater than half of participants exhibited PSG evidence of significant SDB; 12 participants had normal PSGs, 6 had mild SDB, 20 had moderate SDB, and 13 had severe SDB. We found no association between severity of SDB and caudal brainstem serotoninergic innervation in PD participants. Striatal dopaminergic denervation did not correlate with severity of SDB. We did find significant correlations between measures of motor function impairment and sleep quantity and quality in PD. Neither serotoninergic nor dopaminergic neuron degeneration is likely to play a major role in SDB observed in PD patients.

  10. Polysomnographic Features of Sleep Disturbances and REM Sleep Behavior Disorder in the Unilateral 6-OHDA Lesioned Hemiparkinsonian Rat

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    Quynh Vo

    2014-01-01

    Full Text Available Sleep pattern disruption, specifically REM sleep behavior disorder (RBD, is a major nonmotor cause of disability in PD. Understanding the pathophysiology of these sleep pattern disturbances is critical to find effective treatments. 24-hour polysomnography (PSG, the gold standard for sleep studies, has never been used to test sleep dysfunction in the standard 6-OHDA lesioned hemiparkinsonian (HP rat PD model. In this study, we recorded 24-hour PSG from normal and HP rats. Recordings were scored into wake, rapid eye movement (REM, and non-REM (NREM. We then examined EEG to identify REM periods and EMG to check muscle activity during REM. Normal rats showed higher wakefulness (70–80% during the dark phase and lower wakefulness (20% during the light phase. HP rats showed 30–50% sleep in both phases, less modulation and synchronization to the light schedule (P<0.0001, and more long run lengths of wakefulness (P<0.05. HP rats also had more REM epochs with muscle activity than control rats (P<0.05. Our findings that the sleep architecture in the HP rat resembles that of PD patients demonstrate the value of this model in studying the pathophysiological basis of PD sleep disturbances and preclinical therapeutics for PD related sleep disorders including RBD.

  11. Psychometric properties of parent and child reported sleep assessment tools in children with cerebral palsy: a systematic review.

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    Bautista, Manuel; Whittingham, Koa; Edwards, Priya; Boyd, Roslyn N

    2018-02-01

    To determine whether any parent and child report sleep measure tools have been validated in children aged 0-18 years with cerebral palsy (CP). A systematic search of five databases was performed up to June 2017. Studies were included if a sleep measure tool was used to evaluate sleep in children 0-18 years with CP based on international classifications of sleep. Sleep measures were assessed for psychometric data in children with CP. Only one paper which used the Schlaffragebogen für Kinder mit Neurologischen und Anderen Komplexen Erkrankungen (SNAKE) questionnaire met the study criteria. The four other measures frequently used in children with CP had no psychometric data available for their use in children with CP. The SNAKE questionnaire has been validated only in children with CP in Gross Motor Function Classification System level V. The Sleep Disturbance Scale for Children and the Pediatric Sleep Questionnaire had the strongest psychometric properties in typically developing children, but has not yet been validated in children with CP. Current sleep measures being administered in typically developing children are also often used in children with CP, but have not been well validated in this group of children. There are no condition specific measures of sleep in children with cerebral palsy (CP). The Schlaffragebogen für Kinder mit Neurologischen und Anderen Komplexen Erkrankungen (SNAKE) questionnaire is validated for children with CP in Gross Motor Function Classification System level V. A framework to design a CP specific sleep questionnaire is provided. © 2017 Mac Keith Press.

  12. A pilot study: portable out-of-center sleep testing as an early sleep apnea screening tool in acute ischemic stroke.

    Science.gov (United States)

    Chernyshev, Oleg Y; McCarty, David E; Moul, Douglas E; Liendo, Cesar; Caldito, Gloria C; Munjampalli, Sai K; Kelley, Roger E; Chesson, Andrew L

    2015-01-01

    Prompt diagnosis of obstructive sleep apnea (OSA) after acute ischemic stroke (AIS) is critical for optimal clinical outcomes, but in-laboratory conventional polysomnograms (PSG) are not routinely practical. Though portable out-of-center type III cardiopulmonary sleep studies (out-of-center cardiopulmonary sleep testing [OCST]) are widely available, these studies have not been validated in patients who have recently suffered from AIS. We hypothesized that OCST in patients with AIS would yield similar results when compared to conventional PSG. Patients with AIS had simultaneous type III OCST and PSG studies performed within 72 hours from symptom onset. The accuracy of OCST was compared to PSG using: chi-square tests, receiver operatory characteristic curves, Bland-Altman plot, paired Student's t-test/Wilcoxon signed-rank test, and calculation of sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Twenty-one out of 23 subjects with AIS (age 61±9.4 years; 52% male; 58% African-American) successfully completed both studies (9% technical failure). Nearly all (95%) had Mallampati IV posterior oropharynx; the mean neck circumference was 16.8±1.6 in. and the mean body mass index (BMI) was 30±7 kg/m(2). The apnea hypopnea index (AHI) provided by OCST was similar to that provided by PSG (19.8±18.0 vs 22.0±22.7, respectively; P=0.49). On identifying subjects by OCST with an AHI ≥5 on PSG, OCST had the following parameters: sensitivity 100%, specificity 85.7%, PPV 93%, and NPV 100%. On identifying subjects with an AHI ≥15 on PSG, OCST parameters were as follows: sensitivity 100%, specificity 83.3%, PPV 81.8%, and NPV 100%. Bland-Altman plotting showed an overall diagnostic agreement between OCST and PSG modalities for an AHI cutoff >5, despite fine-grained differences in estimated AHIs. Compared with PSG, OCST provides similar diagnostic information when run simultaneously in AIS patients. OCST is a reliable screening tool

  13. Assessment of human sleep depth is being de-standardized by recently advised EEG electrode locations.

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    Bob Kemp

    Full Text Available Human sleep depth was traditionally assessed by scoring electro-encephalographic slow-wave amplitudes at the globally standardized C4-M1 electrode derivation. Since 2007, the American Association of Sleep Medicine (AASM has accepted three additional derivations for the same purpose. These might well differ in slow wave amplitudes which would bias the scorings. Some derivations might also introduce large inter-individual variability. We compared mean and variability of slow wave amplitudes between six derivations including the four AASM ones. Slow wave amplitudes in those derivations were simultaneously measured using automated analysis in 29 patients. Each amplitude was divided by the average from the six derivations, thus removing shared factors such as age, gender and sleep depth while retaining factors that differ between the derivations such as caused by local skull characteristics, electrode distance and neuronal dipole orientation. The remaining inter-individual variability differed significantly and up to a factor of two between the AASM derivations. The amplitudes differed significantly and up to 60% between the AASM derivations, causing substantial scoring bias between centres using different derivations. The resulting de-standardization most likely affects any patient group because the amplitude differences were consistent over diagnoses, genders, and age. Derivation-dependent amplitude thresholds were proposed to reduce the scoring bias. However, it would be better to settle on just one derivation, for instance Cz-Oz or Fpz-Cz because these have lowest variability while matching the traditional C4-M1 amplitudes.

  14. Impediment in upper airway stabilizing forces assessed by phrenic nerve stimulation in sleep apnea patients

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    Vérin E

    2005-09-01

    Full Text Available Abstract Background The forces developed during inspiration play a key role in determining upper airway stability and the occurrence of nocturnal breathing disorders. Phrenic nerve stimulation applied during wakefulness is a unique tool to assess Upper airway dynamic properties and to measure the overall mechanical effects of the inspiratory process on UA stability. Objectives To compare the flow/pressure responses to inspiratory and expiratory twitches between sleep apnea subjects and normal subjects. Methods Inspiratory and expiratory twitches using magnetic nerve stimulation completed in eleven untreated sleep apnea subjects and ten normal subjects. Results In both groups, higher flow and pressure were reached during inspiratory twitches. The two groups showed no differences in expiratory twitch parameters. During inspiration, the pressure at which flow-limitation occurred was more negative in normals than in apneic subjects, but not reaching significance (p = 0.07. The relationship between pharyngeal pressure and flow adequately fitted with a polynomial regression model providing a measurement of upper airway critical pressure during twitch. This pressure significantly decreased in normals from expiratory to inspiratory twitches (-11.1 ± 1.6 and -15.7 ± 1.0 cm H2O respectively, 95% CI 1.6–7.6, p Conclusion Inspiratory-related upper airway dilating forces are impeded in sleep apnea patients.

  15. Cardiovascular risk and obesity in sleep apnea syndrome assessed with the Stop-Bang questionnaire.

    Science.gov (United States)

    Vicente-Herrero, María Teófila; Capdevila García, Luisa; Bellido Cambrón, María Del Carmen; Ramírez Iñiguez de la Torre, María Victoria; Lladosa Marco, Silvia

    2017-12-01

    Sleep disorders include a number of different processes, of which the most prevalent is the sleep apnea-hypopnea syndrome (SAHS). Prevalence of SAHS has increased worldwide, and has a significant social and health impact because of the increased cardiometabolic risk attributed to obesity and the associated metabolic syndrome. A cross-sectional epidemiological study of 1110 workers from public service companies in the Spanish Mediterranean area (Balearic Islands and Valencian Community) was conducted between January and December 2015. Cardiovascular risk was calculated using the Castelli, Kannel and TG/HDL indices, and prevalence of obesity using body mass index, waist circumference, waist-height ratio, and visceral fat. SAHS risk was assessed using the Stop-Bang questionnaire. Risk of SAHS was low in 77% of patients and intermediate-high in 23% of patients. All obesity parameters showed a statistically significant association (p value <.001) with intermediate/high risk of SAHS. Obesity prevalence is higher the worse the quality of sleep. There was a statistically significant relationship between risk of SAHS and cardiovascular risk with the atherogenic indexes found. Twenty-three percent of workers had intermediate/high SAHS risk. The results of this study support the relationship of SAHS with an increased CVR and with obesity parameters. Further prospective studies in different productive sectors may be useful to confirm the results of this research. Copyright © 2017 SEEN y SED. Publicado por Elsevier España, S.L.U. All rights reserved.

  16. Risk assessment of sleeping disorder breathing based on upper airway centerline evaluation

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    Alsufyani, Noura; Shen, Rui; Cheng, Irene; Major, Paul

    2013-02-01

    One of the most important breathing disorders in childhood is obstructive sleep apnea syndrome which affects 2-3% of children, and the reported failure rate of surgical treatment was as high as 54%. A possible reason in respiratory complications is having reduced dimensions of the upper airway which are further compressed when muscle tone is decreased during sleep. In this study, we use Cone-beam computed tomography (CBCT) to assess the location or cause of the airway obstruction. To date, all studies analyzing the upper airway in subjects with Sleeping Disorder Breathing were based on linear, area, or volumetric measurements, which are global computations and can easily ignore local significance. Skeletonization was initially introduced as a 3D modeling technique by which representative medial points of a model are extracted to generate centerlines for evaluations. Although centerlines have been commonly used in guiding surgical procedures, our novelty lies in comparing its geometric properties before and after surgeries. We apply 3D data refinement, registration and projection steps to quantify and localize the geometric deviation in target airway regions. Through cross validation with corresponding subjects' therapy data, we expect to quantify the tolerance threshold beyond which reduced dimensions of the upper airway are not clinically significant. The ultimate goal is to utilize this threshold to identify patients at risk of complications. Outcome from this research will also help establish a predictive model for training and to estimate treatment success based on airway measurements prior to intervention. Preliminary results demonstrate the feasibility of our approach.

  17. "Silent" Sleep Apnea in Dentofacial Deformities and Prevalence of Daytime Sleepiness After Orthognathic and Intranasal Surgery.

    Science.gov (United States)

    Posnick, Jeffrey C; Adachie, Anayo; Singh, Neeru; Choi, Elbert

    2017-09-11

    The purposes of this study were to determine the occurrence of undiagnosed "silent" obstructive sleep apnea (OSA) in dentofacial deformity (DFD) patients at initial surgical presentation and to report on the level of daytime sleepiness in DFD patients with OSA and chronic obstructive nasal breathing (CONB) after undergoing bimaxillary, chin, and intranasal surgery. A retrospective cohort study of patients with a bimaxillary DFD and CONB was implemented. Patients were divided into those with no OSA (group I) and those with OSA (group II). Group II was further subdivided into patients referred with polysomnogram (PSG)-confirmed OSA (group IIa) and those with a diagnosis of OSA only after surgical consultation, airway evaluation, and a positive PSG (group IIb). Group II patients were analyzed at a minimum of 1 year after surgery (range, 1 to 10 years) for daytime sleepiness with the Epworth Sleepiness Scale. Patients with postoperative excessive daytime sleepiness were assessed for risk factors and continued need for OSA treatment. Patients in group II were studied to determine which DFD patterns were most associated with OSA. We compared the prevalence of OSA between our study population and the general population. Two hundred sixty-two patients met the inclusion criteria. Of these, 23% (60 of 262) had PSG-confirmed OSA (group II). This rate was much higher than that found in the general population. Of the patients, 7% (19 of 262) were known to have OSA at initial surgical consultation (group IIa). An additional 16% (41 of 262) were later confirmed by PSG to have OSA (group IIb). Patients with primary mandibular deficiency and short face DFDs were most likely to have OSA (P surgery. A significant association was found between group II patients with postoperative excessive daytime sleepiness ("sleepy" or "very sleepy") and a preoperative body mass index category of overweight (P = .026). Our study found silent OSA to be frequent in the DFD population. The

  18. Sleep technologists educational needs assessment: a survey of polysomnography, electroneurodiagnostic technology, and respiratory therapy education program directors.

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    Wells, Mary Ellen; Vaughn, Bradley V

    2013-10-15

    In this study, we assessed the community and educational needs for sleep technologists by surveying program directors of nationally accredited polysomnography, electroneurodiagnostic technology, and respiratory care educational programs. Currently, little is known about our educational capacity and the need for advanced degrees for sleep medicine technical support. A questionnaire was developed about current and future community and educational needs for sleep technologists. The questionnaire was sent to directors of CAAHEP-accredited polysomnography and electroneurodiagnostic technology programs (associate degree and certificate programs), and directors of CoARC-accredited respiratory therapy associate degree and bachelor degree programs (n = 358). Qualitative and quantitative data were collected via an internet survey tool. Data analysis was conducted with the IBM SPSS statistical package and included calculating means and standard deviations of the frequency of responses. Qualitative data was analyzed and classified based on emerging themes. One hundred seven of 408 program directors completed the survey. Seventy-four percent agreed that demand for qualified sleep technologists will increase, yet 50% of those surveyed believe there are not enough educational programs to meet the demand. Seventy-eight percent of those surveyed agreed that the educational requirements for sleep technologists will soon increase; 79% of those surveyed believe sleep centers have a need for technologists with advanced training or specialization. Our study shows educators of associate and certificate degree programs believe there is a need for a bachelor's degree in sleep science and technology.

  19. Prion diseases and sleep disorders

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    ZHAN Shu-qin

    2013-06-01

    Full Text Available Prion diseases (PrD are a group of encephalopathies with neurodegenerative changes caused by prion protein (PrP whose characteristic datum is transmissibility. In most cases they occur in a sporadic form although a group of them are familial associated with mutations in PrP gene. Phenotypicvariability of fatal familial insomnia (FFI versus familial Creutzfeldt-Jakob disease178 (fCJD178 seems to determine the different methionine-valine polymorphism at codon 129 of the PrP gene. Sleep disorders is one of the important clinical features for the diagnosis and definition of PrD. FFI, a hereditary disorder characterized by loss of physiological sleep with oneiric stupor, autonomic and motor hyperactivity. The polysomnography (PSG shows disappearance of the physiological pattern of non-rapid eye movement (NREM and rapid eye movement (REM sleep, as well as sleep spindles and K-complexes were absent. The hypothesis of the origin of these disorders is thalamic neuronal loss, especially in the anterior and dorsomedial nuclei, described in the neuropathology of these patients; besides, PET reveals hypofunction of thalamic nuclei, centres responsible for controlling wake-sleep. In CJD the wake-sleep disorders is not considered characteristic; nonetheless, frequent alterations have been found in the electroencephalographic registers of sleep. Besides thalamic neurodegeneration, there could be common etiopathogenic mechanisms in PrD in relation to the biological function of PrP.

  20. Association of Sleep Deprivation With Reduction in Insulin Sensitivity as Assessed by the Hyperglycemic Clamp Technique in Adolescents.

    Science.gov (United States)

    De Bernardi Rodrigues, Ana Maria; da Silva, Cleliani de Cassia; Vasques, Ana Carolina Junqueira; Camilo, Daniella Fernandes; Barreiro, Francieli; Cassani, Roberta Soares Lara; Zambon, Mariana Porto; Antonio, Maria Ângela Reis de Góes Monteiro; Geloneze, Bruno

    2016-05-01

    The association between short sleep duration and decreased insulin sensitivity in adolescents has been described. However, to our knowledge, no studies have investigated this association measuring insulin sensitivity by the hyperglycemic clamp technique. To compare the distributions of parameters of insulin resistance in adolescents with sleep deprivation vs adequate sleep, and to investigate the association between sleep deprivation and insulin sensitivity. Cross-sectional multicenter study using data from the Brazilian Metabolic Syndrome Study conducted from June 29, 2011, to December 3, 2014, at an obesity outpatient clinic at the University of Campinas and public schools, with a convenience sample of 615 adolescents aged 10 to 19.9 years with a body mass index (BMI; calculated as weight in kilograms divided by height in meters squared) for age and sex at the fifth percentile or higher. A subsample of 81 adolescents underwent the hyperglycemic clamp technique. The self-reported sleep duration was used to classify the population into 2 groups: adolescents with sleep deprivation (adolescents with adequate sleep (≥8 hours/night). Insulin sensitivity was assessed using the hyperglycemic clamp technique. Among the 615 adolescents (56.3% female; median age, 15.9 years [interquartile range, 12.9-17.8 years]) included in the sample, the mean (SD) sleep duration was 7.9 (1.7) hours/night. The adolescents with sleep deprivation (n = 257) compared with those with adequate sleep (n = 358) had a higher median (interquartile range) age (17.0 [15.4-18.3] vs 14.1 [11.8-16.9] years), BMI (25.0 [21.2-29.3] vs 23.1 [19.5-27.6]), waist circumference (83.0 [73.5-95.4] vs 79.0 [68.5-91.0] cm), sagittal abdominal diameter (17.9 [15.8-20.8] vs 17.0 [15.0-19.8] cm), neck circumference (35.2 [33.0-38.0] vs 33.0 [30.0-35.5] cm), uric acid level (4.9 [4.0-5.8] vs 4.5 [3.7-5.5] mg/dL), and white blood cell count (7000 [5900-8200] vs 6600 [5600-7800] cells/μL) (all P

  1. Impact of sleep on the localizing value of video EEG in patients with refractory focal seizures - a prospective video-EEG with EOG and submental EMG study.

    Science.gov (United States)

    Singh, Shaily; Shukla, Garima; Goyal, Vinay; Srivastava, Achal K; Singh, Mamta B; Vibha, Deepti; Behari, Madhuri

    2014-12-01

    To examine the role of sleep and its stages on the localizing value of video EEG in the evaluation of refractory focal seizures. Video-electroencephalographic (VEEG) evaluation with additional polygraphic recording was carried out for 70 consecutive patients with refractory focal epilepsy, undergoing pre-surgical evaluation, over a two-year period. Localization of video EEG for each seizure was made based on clinical, ictal and interictal data. Seizure localization in each patient was assessed for concordance with MRI and other imaging data (SPECT, PET) for both wake and sleep seizures. Interictal discharges in sleep and wake were similarly compared for concordance with imaging data. A total of 608 seizures were recorded in 70 patients, 289 in sleep. Overall, concordance with imaging data was found in 218 out of 322 wake seizures (67.8%) and in 157 out of 286 sleep seizures (54.8%) (p=0.0314). On analyzing the subset of patients with seizures recorded in both wake and sleep states (total 279 seizures recorded, 113 out of sleep), concordance was observed in 93 out of 166 (56%) wake seizures and in 80 out of 113 (70.7%) sleep seizures (OR 2.03, 95% CI 1.17 to 3.56; p 0.007). Interictal discharges were more common and more precisely localizing in sleep, mostly in stage N2. This prospective VEEG-PSG study demonstrates the role of sleep versus wake state in the localizing value of different components of long-term VEEG recording for patients with medically refractory epilepsy. Our findings show that while wake state ictal EEG has more localizing value in a mixed group of patients, sleep ictal and interictal EEG is significantly more useful in patients who have seizures recorded both during wake and sleep states. In addition, interictal discharges recorded during NREM sleep have high localizing value. This is only the second study elucidating the effect of sleep on the localizing value of video-electroencephalographic evaluation of patients with medically refractory

  2. Treatment of moderate obstructive sleep apnea syndrome with acupuncture: a randomised, placebo-controlled pilot trial.

    Science.gov (United States)

    Freire, Anaflávia O; Sugai, Gisele C M; Chrispin, Fernanda Silveira; Togeiro, Sônia Maria; Yamamura, Ysao; Mello, Luiz Eugênio; Tufik, Sérgio

    2007-01-01

    To investigate the efficacy of acupuncture in the treatment of moderate obstructive sleep apnea syndrome (OSAS), assessed by polysomnography (PSG) and questionnaires of functional quality of life (SF-36) and excessive daytime sleepiness (Epworth). We performed a randomised, placebo-controlled, single-blinded study, with blinded evaluation on 36 patients presenting an apnea/hypopnea index (AHI) of 15-30/h, assessed by PSG. The study took place at the Public Hospital of the Universidade Federal de São Paulo, Brazil, in the Division of Sleep Disorders of the Department of Psychobiology, between January, 2002 and August, 2004. Patients were randomly assigned to three groups: the acupuncture group (n=12); the sham group, submitted to needle insertion in non-acupoints (n=12); and the control group, receiving no treatment (n=12). Patients received acupuncture or sham acupuncture once a week for 10 weeks. Twenty-six patients completed the study. The AHI (P=0.005), the apnea index (AI) (P=0.008) and the number of respiratory events (P=0.005) decreased significantly in the acupuncture group but not in the sham group. On the other hand, the control group displayed significant deterioration in some of the polysomnographic parameters, with a significant increase in the number of respiratory events (P=0.025). Acupuncture treatment significantly improved (before vs. after treatment) several dimensions of the SF-36 and Epworth questionnaires. There was no significant association between changes in the body mass index (BMI) and AHI. Acupuncture is more effective than sham acupuncture in ameliorating the respiratory events of patients presenting with moderate OSAS.

  3. [Diagnostic value of respiratory polygraphy in patients with low probability of obstructive sleep apnea syndrome].

    Science.gov (United States)

    Hernandez Voth, Ana; Mora Ortega, Gemma; Moreno Zabaleta, Raul; Montoro Zulueta, Javier; Verdugo Cartas, Maria I; Rojo Moreno-Arrones, Blas; Lores Gutierrez, Vanesa; Ramirez Prieto, María T

    2016-03-04

    Polysomnography (PSG) is the gold standard technic for the diagnosis of obstructive sleep apnea syndrome (OSAS). It is an expensive, complex and not always available technic, meaning that respiratory polygraphy (RP) has become usual. Although RP is not validated in low probability patients, Spanish guidelines recommend conservative treatment in patients with negative RP. We intended to study the prevalence and severity of OSAS through PSG in a sample of patients with low probability and negative RP. Retrospective, observational, descriptive and analytic study of low probability OSAS patients with negative RP in whom a PSG was performed. Anthropometric, clinical and sleep data were collected. Eighty-two patients were included. After PSG, a greater number of hypopneas (137.8±70.1 vs. 51.2±38.4 [P<.05]) and apnea hypopnea index (27.8±15.6 vs. 11.7±7.1 [P<.05]) was observed, as well as an increment in OSAS prevalence of 17%, which was 35% in severe OSAS. In mild OSAS, there was a decrement of 41%. According with the results of this study, RP significantly underestimates the prevalence and severity of OSAS in low probability patients. While it is necessary to adequately stratify the OSAS probability in order to correctly indicate diagnosis tests, we recommend performing a PSG in low probability patients with negative RP. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

  4. Management of sleep bruxism in adults: a qualitative systematic literature review

    NARCIS (Netherlands)

    Manfredini, D.; Ahlberg, J.; Winocur, E.; Lobbezoo, F.

    2015-01-01

    This paper updates the bruxism management review published by Lobbezoo et al. in 2008 (J Oral Rehabil 2008; 35: 509-23). The review focuses on the most recent literature on management of sleep bruxism (SB) in adults, as diagnosed with polysomnography (PSG) with audio-video (AV) recordings, or with

  5. The 2007 AASM Recommendations for EEG Electrode Placement in Polysomnography: Impact on Sleep and Cortical Arousal Scoring

    Science.gov (United States)

    Ruehland, Warren R.; O'Donoghue, Fergal J.; Pierce, Robert J.; Thornton, Andrew T.; Singh, Parmjit; Copland, Janet M.; Stevens, Bronwyn; Rochford, Peter D.

    2011-01-01

    Study Objective: To examine the impact of using American Academy of Sleep Medicine (AASM) recommended EEG derivations (F4/M1, C4/M1, O2/M1) vs. a single derivation (C4/M1) in polysomnography (PSG) on the measurement of sleep and cortical arousals, including inter- and intra-observer variability. Design: Prospective, non-blinded, randomized comparison. Setting: Three Australian tertiary-care hospital clinical sleep laboratories. Patients or Participants: 30 PSGs from consecutive patients investigated for obstructive sleep apnea (OSA) during December 2007 and January 2008. Interventions: N/A Measurements and Results: To examine the impact of EEG derivations on PSG summary statistics, 3 scorers from different Australian clinical sleep laboratories each scored separate sets of 10 PSGs twice, once using 3 EEG derivations and once using 1 EEG derivation. To examine the impact on inter- and intra-scorer reliability, all 3 scorers scored a subset of 10 PSGs 4 times, twice using each method. All PSGs were de-identified and scored in random order according to the 2007 AASM Manual for the Scoring of Sleep and Associated Events. Using 3 referential EEG derivations during PSG, as recommended in the AASM manual, instead of a single central EEG derivation, as originally suggested by Rechtschaffen and Kales (1968), resulted in a mean ± SE decrease in N1 sleep of 9.6 ± 3.9 min (P = 0.018) and an increase in N3 sleep of 10.6 ± 2.8 min (P = 0.001). No significant differences were observed for any other sleep or arousal scoring summary statistics; nor were any differences observed in inter-scorer or intra-scorer reliability for scoring sleep or cortical arousals. Conclusion: This study provides information for those changing practice to comply with the 2007 AASM recommendations for EEG placement in PSG, for those using portable devices that are unable to comply with the recommendations due to limited channel options, and for the development of future standards for PSG scoring and

  6. Assessing the benefits of napping and short rest breaks on processing speed in sleep-restricted adolescents.

    Science.gov (United States)

    Lim, Julian; Lo, June C; Chee, Michael W L

    2017-04-01

    Achievement-oriented adolescents often study long hours under conditions of chronic sleep restriction, adversely affecting cognitive function. Here, we studied how napping and rest breaks (interleaved off-task periods) might ameliorate the negative effects of sleep restriction on processing speed. Fifty-seven healthy adolescents (26 female, age = 15-19 years) participated in a 15-day live-in protocol. All participants underwent sleep restriction (5 h time-in-bed), but were then randomized into two groups: one of these groups received a daily 1-h nap opportunity. Data from seven of the study days (sleep restriction days 1-5, and recovery days 1-2) are reported here. The Blocked Symbol Decoding Test, administered once a day, was used to assess time-on-task effects and the effects of rest breaks on processing speed. Controlling for baseline differences, participants who took a nap demonstrated faster speed of processing and greater benefit across testing sessions from practice. These participants were also affected significantly less by time-on-task effects. In contrast, participants who did not receive a nap benefited more from the rest breaks that were permitted between blocks of the test. Our results indicate that napping partially reverses the detrimental effects of sleep restriction on processing speed. However, rest breaks have a greater effect as a countermeasure against poor performance when sleep pressure is higher. These data add to the growing body of evidence showing the importance of sleep for good cognitive functioning in adolescents, and suggest that more frequent rest breaks might be important in situations where sleep loss is unavoidable. © 2017 European Sleep Research Society.

  7. Let there be no light: the effect of bedside light on sleep quality and background electroencephalographic rhythms.

    Science.gov (United States)

    Cho, Jounhong Ryan; Joo, Eun Yeon; Koo, Dae Lim; Hong, Seung Bong

    2013-12-01

    Artificial lighting has been beneficial to society, but unnecessary light exposure at night may cause various health problems. We aimed to investigate how whole-night bedside light can affect sleep quality and brain activity. Ten healthy sleepers underwent two polysomnography (PSG) sessions, one with the lights off and one with the lights on. PSG variables related to sleep quality were extracted and compared between lights-off and lights-on sleep. Spectral analysis was performed to rapid eye movement (REM) sleep and non-REM (NREM) sleep epochs to reveal any light-induced differences in background brain rhythms. Lights-on sleep was associated with increased stage 1 sleep (N1), decreased slow-wave sleep (SWS), and increased arousal index. Spectral analysis revealed that theta power (4-8Hz) during REM sleep and slow oscillation (0.5-1Hz), delta (1-4Hz), and spindle (10-16Hz) power during NREM sleep were decreased in lights-on sleep conditions. Sleeping with the light on not only causes shallow sleep and frequent arousals but also has a persistent effect on brain oscillations, especially those implicated in sleep depth and stability. Our study demonstrates additional hazardous effect of light pollution on health. Copyright © 2013 Elsevier B.V. All rights reserved.

  8. Exercise effects on night-to-night fluctuations in self-rated sleep among older adults with sleep complaints.

    Science.gov (United States)

    Buman, Matthew P; Hekler, Eric B; Bliwise, Donald L; King, Abby C

    2011-03-01

    Sleep interventions have rarely explored reductions in night-to-night fluctuations [i.e. intra-individual variability (IIV)] in sleep, despite the negative impacts of such fluctuations on affective states and cognitive and physical symptoms. In a community-based randomized controlled trial we evaluated whether physical exercise reduced IIV in self-rated sleep outcomes among middle-aged and older adults with sleep complaints. Under-active adults 55 years and older (n = 66, 67% women) with mild to moderate sleep complaints were randomized to 12 months of a moderate-intensity endurance exercise (n = 36) or a health education control group (n = 30). Daily sleep logs, Pittsburgh Sleep Quality Index (PSQI) and in-home polysomnographic sleep recordings (PSG) were collected at baseline, 6 months and 12 months. Sleep log-derived means and IIV were computed for sleep-onset latency (SOL), time in bed, feeling rested in the morning, number of nighttime awakenings, and wake after final awakening (WAFA). Using intent-to-treat methods, at 6 months no differences in IIV were observed by group. At 12 months, SOL-based IIV was reduced in the exercise group compared with the control (difference = 23.11, 95% CI: 3.04-47.18, P = 0.025, Cohen's d = 0.57). This change occurred without mean-level or IIV changes in sleep-wake schedules. For all sleep variables, except SOL and WAFA, IIV changes and mean-level changes in each variable were negatively correlated (r = -0.312 to -0.691, P Sleep log-derived IIV changes were modestly correlated with mean-level PSQI and PSG-based changes at 12 months. Twelve months of moderate-intensity exercise reduced night-to-night fluctuations in self-rated time to fall asleep, and this relationship was independent of mean-level time to fall asleep. © 2010 European Sleep Research Society.

  9. [Guidelines for the fitness to drive assessment in people with obstructive sleep apnoea syndrome (OSAS) and narcolepsy].

    Science.gov (United States)

    Garbarino, S; Bonanni, E; Ingravallo, F; Mondini, S; Plazzi, G; Sanna, A

    2011-01-01

    Given the prevalence of sleep disorders and sleep deprivation in modern societies, and the correlation between sleepiness and work and driving accidents, the excessive daytime sleepiness is an important issue. Although many studies showed that patients with untreated Obstructive sleep apnoea syndrome (OSAS) and narcolepsy have an higher risk for driving accidents, neither the European Community regulation nor the Italian law of the driving licence mention restrictions for these disorders. In 2010 the scientific association COMLAS (Association of legal medicine professionals of the Italian National Health Service) published the Guidelines for the examination by the Local Medical Commissions. The author presented the guidelines to assess the fitness to drive of people with OSAS or narcolepsy. The proposed criteria, set up in collaboration with the Commission "Sleepiness, Safety and Transportation" of the Italian Association of Sleep Medicine (AIMS), can be considered among the most advanced internationally.

  10. Sleep and breathing disorders in myotonic dystrophy type 2.

    Science.gov (United States)

    Leonardis, L; Blagus, R; Dolenc Groselj, L

    2015-07-01

    In patients who exhibit myotonic dystrophy type 1 (DM1), sleep disorders and breathing impairments are common; however, in those with DM type 2 (DM2), limited studies on polysomnography (PSG) and none on phrenic compound motor action potential (CMAP) have been performed, which is the aim of this study. Sixteen patients with DM2 were questioned about respiratory symptoms. They underwent PSG with morning arterial gas analyses (AGA). Respiratory functions and phrenic CMAPs were studied. The data were compared to those of 16 healthy controls and 25 patients with DM1. Daytime tiredness is the most common symptom, but orthopnea was reported in 13% of patients with DM2. A detailed sleep architecture analysis revealed a significantly greater proportion of time in stage 3 and REM sleep, and a shorter time in stage 2 in the DM2 than in controls. Lower respiratory volumes and pressures, abnormalities in AGA, night oxygen desaturation and higher EtCO2 are present in DM2, but are less pronounced than in the DM1 population. Small CMAP amplitudes were presented in 12% of patients with DM2, correlating with smaller respiratory functions and poorer sleep quality. AHI was abnormal in 38% of DM2, mainly due to obstructive apneas. PSG did not reveal hypoventilation. Diaphragm weakness and sleep apneas might be present in patients with DM2; therefore, we suggest regular questioning about symptoms of respiratory insufficiency and monitoring of phrenic CMAP. PSG should be recorded, when patients have suggestive symptoms, abnormalities in AGA or higher BMI. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  11. Actigraphic assessment of sleep disorders in children with chronic fatigue syndrome.

    Science.gov (United States)

    Ohinata, Junko; Suzuki, Nao; Araki, Akiko; Takahashi, Satoru; Fujieda, Kenji; Tanaka, Hajime

    2008-05-01

    Children with chronic fatigue syndrome (CFS) often suffer from sleep disorders, which cause many physiological and psychological problems. Understanding sleep characteristics in children with CFS is important for establishing a therapeutic strategy. We conducted an actigraphic study to clarify the problems in sleep/wake rhythm and physical activity in children with CFS. Actigraphic recordings were performed for 1-2 weeks in 12 CFS children. The obtained data were compared with those of healthy age-matched children used as the control. Sleep patterns were divided into two groups based on subjects' sleep logs: irregular sleep type and delayed sleep phase type. Compared to the control group, total sleep time was longer and physical activity was lower in both groups of CFS. Continuous sleep for more than 10h was not uncommon in CFS. In the irregular sleep type, impaired daily sleep/wake rhythms and disrupted sleep were observed. Using actigraphy, we could identify several characteristics of the sleep patterns in CFS children. Actigraphic analysis proved to be useful in detecting sleep/wake problems in children with CFS.

  12. The AASM recommended and acceptable EEG montages are comparable for the staging of sleep and scoring of EEG arousals.

    Science.gov (United States)

    Duce, Brett; Rego, Conchita; Milosavljevic, Jasmina; Hukins, Craig

    2014-07-15

    To examine the measurement differences in sleep and EEG arousal statistics between the American Academy of Sleep Medicine (AASM) recommended EEG montage (F4-M1, C4-M1, O2-M1) and acceptable EEG montage (Fz-Cz, C4-M1, Oz-Cz). Prospective, blinded, randomized comparison. Australian clinical sleep laboratory in a tertiary hospital. 50 consecutive patients undertaking polysomnography (PSG) for the clinical suspicion of sleep disordered breathing. N/A. Patient EEGs were recorded using both the AASM recommended and acceptable EEG montages during the PSG. Two scorers were used to examine the difference in PSG statistics using the two EEG montages. The scorers analyzed the 50 studies using the two EEG montages. Ten of the studies were scored twice for each montage by each scorer to calculate intra-scorer and inter-scorer agreement. No statistically significant differences were observed between the PSG statistics of the recommended and acceptable EEG montages. The recommended EEG montage had greater inter-scorer agreement but no difference in intra-scorer agreement. This study demonstrates that the two EEG montages endorsed by the AASM Manual produce similar sleep and EEG arousal statistics.

  13. Three-dimensional Evaluation of Nasal Surgery in Patients with Obstructive Sleep Apnea

    Directory of Open Access Journals (Sweden)

    Dan-Mo Cui

    2016-01-01

    Conclusions: Nasal surgery improved OSA severity as measured by PSG, subjective complaints, and 3D reconstructed CT scan. 3D assessment of upper airway can play an important role in the evaluation of treatment outcome.

  14. Relationship between Sleep and Pain in Adolescents with Juvenile Primary Fibromyalgia Syndrome

    Science.gov (United States)

    Olsen, Margaret N.; Sherry, David D.; Boyne, Kathleen; McCue, Rebecca; Gallagher, Paul R.; Brooks, Lee J.

    2013-01-01

    Study Objectives: To investigate sleep quality in adolescents with juvenile primary fibromyalgia syndrome (JPFS) and determine whether sleep abnormalities, including alpha-delta sleep (ADS), correlate with pain intensity. We hypothesized that successful treatment for pain with exercise therapy would reduce ADS and improve sleep quality. Design: Single-center preintervention and postintervention (mean = 5.7 ± 1.0 weeks; range = 4.0-7.3 weeks) observational study. Patients: Ten female adolescents (mean age = 16.2 ± 0.65 SD yr) who met criteria for JPFS and completed treatment. Interventions: Multidisciplinary pain treatment, including intensive exercise therapy. Measurements and Results: Pain and disability were measured by a pain visual analog scale (VAS) and the Functional Disability Inventory. Subjective sleep measures included a sleep VAS, an energy VAS, and the School Sleep Habits Survey. Objective sleep measures included actigraphy, polysomnography (PSG), and the Multiple Sleep Latency Test. Baseline PSG was compared with that of healthy age- and sex-matched control patients. At baseline, patients had poorer sleep efficiency, more arousals/awakenings, and more ADS (70.3% of total slow wave sleep [SWS] versus 21.9% SWS, P = 0.002) than controls. ADS was unrelated to pain, disability, or subjective sleep difficulty. After treatment, pain decreased (P = 0.000) and subjective sleep quality improved (P = 0.008). Objective sleep quality, including the amount of ADS, did not change. Conclusions: Although perceived sleep quality improved in adolescents with JPFS after treatment, objective measures did not. Our findings do not suggest exercise therapy for pain improves sleep by reducing ADS, nor do they support causal relationships between ADS and chronic pain or subjective sleep quality. Citation: Olsen MN; Sherry DD; Boyne K; McCue R; Gallagher PR; Brooks LJ. Relationship between sleep and pain in adolescents with juvenile primary fibromyalgia syndrome. SLEEP 2013

  15. Assessing insomnia in adolescents: comparison of Insomnia Severity Index, Athens Insomnia Scale and Sleep Quality Index.

    Science.gov (United States)

    Chung, Ka-Fai; Kan, Katherine Ka-Ki; Yeung, Wing-Fai

    2011-05-01

    To compare the psychometric properties of the Chinese versions of Insomnia Severity Index (ISI), Athens Insomnia Scale (AIS) and Sleep Quality Index (SQI) for assessment and screening of insomnia in adolescents. This is a school-based survey of 1516 adolescents aged 12-19 years. Sleep-wake habit questionnaire, ISI, AIS, SQI, Epworth Sleepiness Scale (ESS) and 12-item General Health Questionnaire (GHQ-12) were administered. Insomnia Interview Schedule was used to assess the severity of insomnia symptoms and DSM-IV-TR diagnosis of insomnia. The Cronbach's alpha of ISI, AIS and SQI were 0.83, 0.81 and 0.65, respectively, and the 2-week test-retest reliability were 0.79, 0.80 and 0.72. All three scales had a 2-factor structure, and their scores were significantly correlated with sleep-wake variables, ESS and GHQ-12 scores, smoking and drinking habits, and academic performance. The areas under curve of ISI, AIS and SQI for detecting clinical insomnia were 0.85, 0.80 and 0.85, respectively. The optimal cut-offs for ISI, AIS and SQI were a total score of nine (sensitivity/specificity: 0.87/0.75), seven (sensitivity/specificity: 0.78/0.74) and five (sensitivity/specificity: 0.83/0.79), respectively. The Chinese versions of ISI, AIS and SQI are reliable and valid instruments. The ISI and AIS appear to have better psychometric properties than the SQI. Copyright © 2011 Elsevier B.V. All rights reserved.

  16. Extraction of features from sleep EEG for Bayesian assessment of brain development.

    Directory of Open Access Journals (Sweden)

    Vitaly Schetinin

    Full Text Available Brain development can be evaluated by experts analysing age-related patterns in sleep electroencephalograms (EEG. Natural variations in the patterns, noise, and artefacts affect the evaluation accuracy as well as experts' agreement. The knowledge of predictive posterior distribution allows experts to estimate confidence intervals within which decisions are distributed. Bayesian approach to probabilistic inference has provided accurate estimates of intervals of interest. In this paper we propose a new feature extraction technique for Bayesian assessment and estimation of predictive distribution in a case of newborn brain development assessment. The new EEG features are verified within the Bayesian framework on a large EEG data set including 1,100 recordings made from newborns in 10 age groups. The proposed features are highly correlated with brain maturation and their use increases the assessment accuracy.

  17. Assessing Individual Differences in Adaptation to Extreme Environments: A 36-Hour Sleep Deprivation Study

    Science.gov (United States)

    Martinez, Jacqueline; Cowings, Patricia S.; Toscano, William B.

    2012-01-01

    In space, astronauts may experience effects of cumulative sleep loss due to demanding work schedules that can result in cognitive performance impairments, mood state deteriorations, and sleep-wake cycle disruption. Individuals who experience sleep deprivation of six hours beyond normal sleep times experience detrimental changes in their mood and performance states. Hence, the potential for life threatening errors increases exponentially with sleep deprivation. We explored the effects of 36-hours of sleep deprivation on cognitive performance, mood states, and physiological responses to identify which metrics may best predict fatigue induced performance decrements of individuals.

  18. Sleep-related breathing disorders in patients with Prader-Willi syndrome depending on the period of growth hormone treatment.

    Science.gov (United States)

    Lecka-Ambroziak, Agnieszka; Jędrzejczak, Małgorzata; Wysocka-Mincewicz, Marta; Szalecki, Mieczysław

    2017-10-12

    Sleep-related breathing disorders (SRBD) are commonly present in patients with Prader-Willi syndrome (PWS). Recombinant human growth hormone (rhGH) treatment is reported to improve breathing function in PWS, but the findings are not explicit. Screening polysomnography- polygraphy (PSG), assessing nasal respiratory flow, respiratory effort, and blood oxygen saturation, was used. Group 1 - before rhGH therapy (n = 11, mean age 3.0 years); PSG was repeated after the start of rhGH therapy in a mean time of 0.9 years in six patients (Group 1a). Group 2 - on rhGH treatment, for a mean time of four years (n = 17, mean age 8.8 years). Group 3 - without rhGH therapy due to severe obesity (n = 8, mean age 13.1 years). Group 1 - mean apnoea-hypopnoea index (AHI) was 10.2, oxygen desaturation index (ODI)- 36.3, Group 1a- AHI 12.0, ODI 60.9, Group 2-AHI 9.0, ODI 25.1, Group 3- AHI 8.2, ODI 22.0. ODI was significantly higher in Group 1a than in the other groups (p < 0.005), but not strictly related to SRBD. The results in Group 2 did not differ significantly from those of Group 1. Our study proves the high frequency of SRBD among PWS patients, with worsening of ODI after short-term rhGH therapy.

  19. Polysomnographic evaluation of sleep quality and quantitative variables in women as a function of mood, reproductive status, and age.

    Science.gov (United States)

    Orff, Henry J; Meliska, Charles J; Lopez, Ana; Martinez, Fernando; Sorenson, Diane; Parry, Barbara L

    2012-12-01

    This archival cross-sectional investigation examined the impact of mood, reproductive status (RS), and age on polysomnographic (PSG) measures in women. PSG was performed on 73 normal controls (NC) and 64 depressed patients (DP), in the course of studies in menstruating, pregnant, postpartum, and peri- and postmenopausal women. A two-factor, between-subjects multivariate analysis of variance (MANOVA) was used to test the main effects of reproductive status (RS: menstrual vs pregnant vs postpartum vs menopausal) and diagnosis (NC vs DP), and their interaction, on PSG measures. To further refine the analyses, a two-factor, between subjects MANOVA was used to test the main effects of age (19 to 27 vs 28 to 36 vs 37 to 45 vs 46+ years) and diagnosis on the PSG data. Analyses revealed that in DP women, rapid eye movement (REM) sleep percentage was significantly elevated relative to NC across both RS and age. Significant differences in sleep efficiency, Stage 1%, and REM density were associated with RS; differences in total sleep time, Stage 2 percentage, and Stage 4 percentage were associated with differences in age. Both RS and age were related to differences in sleep latency, Stage 3 percentage, and Delta percentage. Finally, wake after sleep onset time, REM percentage, and REM latency did not vary with respect to RS or age. Overall, this investigation examined three major variables (mood, RS, and age) that are known to impact sleep in women. Of the variables, age appeared to have the greatest impact on PSG sleep measures, reflecting changes occurring across the lifespan.

  20. Associations of self-reported and actigraphy-assessed sleep characteristics with body mass index and waist circumference in adults: moderation by gender.

    Science.gov (United States)

    Mezick, Elizabeth J; Wing, Rena R; McCaffery, Jeanne M

    2014-01-01

    Self-reported sleep duration has been linked to body mass index (BMI) and waist circumference in previous work; however, data regarding if these associations are stronger in men or women have been mixed, and few studies have objectively measured sleep. We investigated self-reported and actigraphy-assessed sleep characteristics in relation to BMI and waist circumference and examined the extent to which these associations differ by gender. Archived cross-sectional data collected from 2004 to 2006 from the National Survey of Midlife Development in the United States (MIDUS) Biomarkers Study were used. Participants included 1248 adults (43% men) who reported their habitual sleep duration, and a subset of participants (N=441; 40% men) who underwent seven nights of wrist actigraphy. Self-reported total sleep time (TST), actigraphy-assessed TST, and actigraphy-assessed sleep efficiency (SE) were inversely associated with BMI in the full sample of both men and women. Gender moderated associations between actigraphy assessments of sleep and anthropometric variables; however, TST and SE were related to BMI and waist circumference in women only. Associations between sleep and waist circumference were independent of BMI. Sleep duration and sleep continuity are associated with body weight and distribution of body fat, but these associations were stronger or were only present in women. Copyright © 2013 Elsevier B.V. All rights reserved.

  1. Correlation of salivary cortisol level with obstructive sleep apnea syndrome in pediatric subjects.

    Science.gov (United States)

    Park, Chan-Soon; Guilleminault, Christian; Hwang, Se-Hwan; Jeong, Jong-Hyun; Park, Dong-Sun; Maeng, Jae-Hwan

    2013-10-01

    Obstructive sleep apnea syndrome (OSAS) is associated with stress system activation involving the hypothalamic-pituitary-adrenocortical (HPA) axis. The relationships among salivary cortisol, a measure of the HPA axis, and objective parameters of polysomnography (PSG) and subjective sleep symptoms were examined. Our prospective study enrolled 80 children who had a physical examination, underwent overnight PSG, and completed the Korean version of the modified pediatric Epworth sleepiness scale (KMPESS) and OSA-18 (KOSA-18) questionnaires. Saliva was collected at night before PSG and in the early morning after PSG. Subjects (N=80) were divided into control (n=32, apnea-hypopnea index [AHI] or =1) groups; the OSAS group was subdivided into mild (1 or =5) groups. Although salivary cortisol before PSG (n-sCor) did not show a significant change with OSAS severity, salivary cortisol after PSG (m-sCor) significantly decreased with OSAS severity. This decrease resulted in a salivary cortisol ratio (r-sCor) that was significantly different between the control group and the two OSAS subgroups. The m-sCor and sub-sCor of the total group as well as the m-sCor, sub-sCor, and r-sCor of the OSAS group were negatively related to the oxygen desaturation index (ODI). The m-sCor and r-sCor in the OSAS group also were related to subjective sleep symptoms (quality of life [QOL] by KOSA-18). Among the four salivary cortisol parameters, r-sCor was negatively associated with OSAS severity, ODI, and QOL (KOSA-18), which may indicate a chronically stressed HPA axis. These results demonstrate that salivary cortisol may be a useful biomarker of OSAS. Copyright © 2013 Elsevier B.V. All rights reserved.

  2. Firing a loaded gun during sleep in an elderly man with a "perfect storm" of risk factors including severe obstructive sleep apnea.

    Science.gov (United States)

    Ingravallo, Francesca; Schenck, Carlos H; D'Aloja, Ernesto; Puligheddu, Monica

    2017-10-16

    We report a case of firing a loaded gun during sleep in a geriatric patient with undiagnosed major sleep disorders and multiple risk factors for sleep violence. Polysomnographic findings, diagnostic challenges, and forensic implications in this unprecedented geriatric case are discussed. A 75-year-old employed man, married for 32 years, presented to a sleep center reporting to having fired a shot in his bedroom during sleep while his wife was away, without memory of hearing the gunshot. The day before the event, the patient had a normal life, apart from serious worries about recent nearby burglaries that prompted his sleeping with a loaded gun placed behind his bed. The patient underwent a sleep medicine workup, including nocturnal video polysomnography (vPSG). The patient and his wife were unaware of any sleep problems. Upon careful questioning, only mild daytime sleepiness and rare episodes of minor abnormal motor behavior were reported. At vPSG, sleep structure was markedly disrupted with only one clear sleep cycle with REM sleep that had preserved REM-atonia; severe obstructive sleep apnea and moderately severe periodic limb movement activity were documented. Brief abnormal movements from REM sleep without apparent precipitant were recorded. CPAP therapy was effective. In this case, there was a "perfect storm" of sleep and psychological risk factors that converged to strongly promote precipitous arousals with sleep-related violence in a patient with documented sleep motor dyscontrol. Primary care physicians, including geriatric specialists, should question patients and their spouses about any symptoms of sleep disorders.

  3. Assessment of carotid artery intima-media thickness in patients with obstructive sleep apnoea.

    Science.gov (United States)

    Liao, L-J; Cho, T-Y; Huang, T-W

    2017-10-01

    This study compares the carotid intima-media thickness (CIMT) in different severity of obstructive sleep apnoea (OSA) patients and assesses the role of OSA in carotid artery vasculopathy with control of multiple co-morbidities. Prospective case-control study. Tertiary referral centre. This study recruited 36 volunteers without the complaints of sleep-disordered breathing, 27 patients with mild-moderate OSA and 39 patients with severe OSA. The CIMT was measured using a Toshiba Aplio 500 ultrasound system (Otawara, Japan) with a 5-14 MHz L probe. Bilateral and mean CIMT in healthy control, mild-moderate OSA and severe OSA were 0.69 ± 0.14, 0.72 ± 0.24 and 0.94 ± 0.33, respectively (P 0.05) after adjusting age, hypertension and body mass index. Automated measurement of the CIMT can be a useful tool for CVD risk assessment in patients with OSA. Severity of OSA may be an intermediate factor between multiple co-morbidities and carotid atherosclerotic change. © 2017 John Wiley & Sons Ltd.

  4. Agreement between two different approaches to assess parent-reported sleep bruxism in children

    Directory of Open Access Journals (Sweden)

    Joyce Duarte

    Full Text Available Introduction: Parents' report is the most used method for the study of sleep bruxism (SB in children, especially in research with large samples. However, there is no consensus about the questions used to assess SB, what may difficult the comparisons between studies. Objective: The aim of this research was to evaluate the agreement between two different approaches to assess possible sleep bruxism (PSB in children using parents' report. Methods: This cross-sectional study was conducted with 201 parents/caregivers. Prior to the questionnaire completion, all participants received a standard explanation of SB concept. Subsequently, the parents/caregivers answered a general question (GQ and a frequency-time question (FTQ about SB, and the answers were compared. Results: The majority of the participants were the children's mothers (73% and the childrens mean age was 7.5 years (SD: 2.25. PSB frequency in children did not differ statistically through the two questions [GQ: 30.7% (CI95%: 24.2 - 37.1 and FTQ: 26.6% (CI95%: 20.4 - 32.8], and an almost perfect agreement was observed between the answers (kp=0.812. Nevertheless, the FTQ showed a more coherent relation with the factors already recognized as associated with childhood bruxism than GQ. Conclusions: Different approaches result in similar PSB frequency, however, they show different ability to identify PSB associated factors and suggest the need of questions including frequency and time in further studies.

  5. Sleep architecture and EEG power spectra in recently detoxified alcohol dependent patients.

    Science.gov (United States)

    Singh, Lokesh Kumar; Nizamie, S Haque; Tikka, Sai Krishna

    2018-02-01

    Persistent sleep abnormalities during abstinence are a harbinger for relapse in patients with chronic alcohol dependence. The present study aimed to compare polysomnography (PSG) data between 'recently detoxified' patients with chronic alcohol dependence and healthy controls. Both conventional sleep architectural and power spectral analyses were conducted. Twenty subjects in each of the groups were enrolled. A 2 nights' sleep (first-habituation and second-experimental) PSG data was collected. Computer assisted scoring supplemented by manual method using the Rechtschaffen and Kales criteria were used for sleep staging. Twenty eight channels were used for the EEG recording. Spectral power across early NREM (Non-rapid-eye-movement), Slow Wave Sleep and REM was computed using the Welch's averaged periodogram method. Results on conventional sleep staging showed that patients had significantly lesser total sleep time, sleep efficiency and stage shifts and longer sleep onset latency; while duration of each NREM stages were significantly lower, and latency of stage 2 NREM was significantly longer in patients. After controlling for multiple comparisons, spectral power analysis revealed significant differences only during REM sleep and specifically in high frequency (beta and gamma) bands. Stating the mutually complementary role of conventional and spectral analyses of polysomnography EEG data, we conclude that sleep abnormalities are fairly evident in recently detoxified alcohol dependent patients. Copyright © 2017 Elsevier B.V. All rights reserved.

  6. Sleep-mediated heart rate variability after bilateral carotid body tumor resection.

    Science.gov (United States)

    Niemeijer, Nicolasine D; Corssmit, Eleonora P M; Reijntjes, Robert H A M; Lammers, Gert Jan; van Dijk, J Gert; Thijs, Roland D

    2015-04-01

    The carotid bodies are thought to play an important role in sleep-dependent autonomic changes. Patients who underwent resection of bilateral carotid body tumors have chronically attenuated baroreflex sensitivity. These subjects provide a unique opportunity to investigate the role of the baroreflex during sleep. One-night ambulatory polysomnography (PSG) recording. Participants' homes. Nine patients with bilateral carotid body tumor resection (bCBR) (four women, mean age 50.4 ± 7.2 years) and nine controls matched for age, gender, and body mass index. N/A. Sleep parameters were obtained from PSG. Heart rate (HR) and its variability were calculated using 30-s epochs. In bCBR patients, HR was slightly but not significantly increased during wake and all sleep stages. The effect of sleep on HR was similar for patients and controls. Low frequency (LF) power of the heart rate variability spectrum was significantly lower in bCBR patients in active wakefulness, sleep stage 1 and REM sleep. No differences were found between patients and controls for high frequency (HF) power and the LF/HF ratio. Bilateral carotid body tumor resection (bCBR) is associated with decreased low frequency power during sleep, suggesting impaired baroreflex function. Despite this, sleep-related heart rate changes were similar between bCBR patients and controls. These findings suggest that the effects of sleep on heart rate are predominantly generated through central, non-baroreflex mediated pathways. © 2015 Associated Professional Sleep Societies, LLC.

  7. Exercise Effects on Night-to-Night Fluctuations in Self-rated Sleep among Older Adults with Sleep Complaints

    Science.gov (United States)

    Buman, Matthew P.; Hekler, Eric B.; Bliwise, Donald L.; King, Abby C.

    2010-01-01

    Sleep interventions have rarely explored reductions in night-to-night fluctuations (i.e., intra-individual variability [IIV]) in sleep, despite the negative impacts of such fluctuations on affective states and cognitive and physical symptoms. In a community-based randomized controlled trial we evaluated whether physical exercise reduced IIV in self-rated sleep outcomes among middle-aged and older adults with sleep complaints. Under-active adults 55 years and older (N=66, 67% women) with mild to moderate sleep complaints were randomized to 12mos of a moderate-intensity endurance exercise (n=36) or a health education control group (n=30). Daily sleep logs, Pittsburgh Sleep Quality Index (PSQI), and in-home polysomnographic sleep recordings (PSG) were collected at baseline, 6mos, and 12mos. Sleep log-derived means and IIV were computed for sleep-onset latency (SOL), time in bed (TIB), feeling rested in the morning, number of nighttime awakenings, and wake after final awakening (WAFA). Using intent-to-treat methods, at 6mos no differences in IIV were observed by group. At 12mos, SOL-based IIV was reduced in the exercise group compared to the control (difference=23.11, 95% CI: 3.04–47.18, p=.025, Cohen’s d=0.57). This change occurred without mean-level or IIV changes in sleep-wake schedules. For all sleep variables except SOL and WAFA, IIV changes and mean-level changes in each variable were negatively correlated (r’s=−.312 to −.691, p’sSleep log-derived IIV changes were modestly correlated with mean-level PSQI and PSG-based changes at 12mos. Twelve months of moderate-intensity exercise reduced night-to-night fluctuations in self-rated time to fall asleep, and this relationship was independent of mean-level time to fall asleep. PMID:20629937

  8. Insomnia Phenotypes Based on Objective Sleep Duration in Adolescents: Depression Risk and Differential Behavioral Profiles

    OpenAIRE

    Fernandez-Mendoza, Julio; Calhoun, Susan L.; Vgontzas, Alexandros N.; Li, Yun; Gaines, Jordan; Liao, Duanping; Bixler, Edward O.

    2016-01-01

    Based on previous studies on the role of objective sleep duration in predicting morbidity in individuals with insomnia, we examined the role of objective sleep duration in differentiating behavioral profiles in adolescents with insomnia symptoms. Adolescents from the Penn State Child Cohort (n = 397, ages 12–23, 54.7% male) underwent a nine-hour polysomnography (PSG), clinical history, physical examination and psychometric testing, including the Child or Adult Behavior Checklist and Pediatric...

  9. Objective short sleep duration is associated with the activity of the hypothalamic-pituitary-adrenal axis in insomnia

    Directory of Open Access Journals (Sweden)

    Carolina D’Aurea

    2015-06-01

    Full Text Available Objective To evaluate the association between objective short sleep duration in patients with insomnia and changes in blood parameters related to hypothalamic-pituitary-adrenal (HPA axis activity.Method A cross-sectional pilot study was conducted in 30 middle-aged adults with chronic insomnia who were divided into 2 groups according to polysomnography (PSG total sleep time (TST (TST > 5h and < 5h. All patients underwent subjective analysis of sleep quality, anthropometric measurements, PSG, and determination off asting blood parameters.Results The results revealed lower sleep efficiency and higher sleep latency for those with a TST < 5h. The subjective sleep quality was worse in the TST < 5h. Significantly, higher glucose and cortisol levels were observed with a TST < 5h. Glucose, cortisol and ACTH levels were inversely correlated with the PSG total sleep time.Conclusion Patients with insomnia with objective short sleep duration had HPA-associated endocrine and metabolic imbalances chronically linked to increases in cardiovascular risk observed with this more severe insomnia phenotype.

  10. Sleep patterns and school performance of Korean adolescents assessed using a Korean version of the pediatric daytime sleepiness scale

    Directory of Open Access Journals (Sweden)

    Seon kyeong Rhie

    2011-01-01

    Full Text Available Purpose: Korean adolescents have severe nighttime sleep deprivation and daytime sleepiness because of their competitive educational environment. However, daytime sleep patterns and sleepiness have never been studied using age-specific methods, such as the pediatric daytime sleepiness scale (PDSS. We surveyed the daytime sleepiness of Korean adolescents using a Korean translation of the PDSS. Methods: We distributed the 27-item questionnaire, including the PDSS and questions related to sleep pattern, sleep satisfaction, and emotional state, to 3,370 students in grades 5-12. Results: The amount of nighttime sleep decreased significantly with increasing age. During weekday nights, 5- 6th graders slept for 7.95¡?#?.05; h, 7-9th graders for 7.57¡?#?.05; h, and 10-12th graders for 5.78¡?#?.13; h. However, the total amounts of combined daytime and nighttime sleep during weekdays were somewhat greater, 8.15¡?#?.12; h for 5- 6th graders, 8.17¡?#?.20; h for 7-9th graders, and 6.87¡?#?.40; h for 10-12th graders. PDSS scores increased with age, 11.89¡?#?.56; for 5- 6th graders, 16.57¡?#?.57; for 7-9th graders, and 17.71¡?#?.24; for 10-12th graders. Higher PDSS scores were positively correlated with poor school performance and emotional instability. Conclusion: Korean teenagers sleep to an unusual extent during the day because of nighttime sleep deprivation. This negatively affects school performance and emotional stability. A Korean translation of the PDSS was effective in evaluating the severity of daytime sleepiness and assessing the emotional state and school performance of Korean teenagers.

  11. Sleep patterns and school performance of Korean adolescents assessed using a Korean version of the pediatric daytime sleepiness scale.

    Science.gov (United States)

    Rhie, Seonkyeong; Lee, Sihyoung; Chae, Kyu Young

    2011-01-01

    Korean adolescents have severe nighttime sleep deprivation and daytime sleepiness because of their competitive educational environment. However, daytime sleep patterns and sleepiness have never been studied using age-specific methods, such as the pediatric daytime sleepiness scale (PDSS). We surveyed the daytime sleepiness of Korean adolescents using a Korean translation of the PDSS. We distributed the 27-item questionnaire, including the PDSS and questions related to sleep pattern, sleep satisfaction, and emotional state, to 3,370 students in grades 5-12. The amount of nighttime sleep decreased significantly with increasing age. During weekday nights, 5-6(th) graders slept for 7.95±1.05 h, 7-9(th) graders for 7.57±1.05 h, and 10-12(th) graders for 5.78±1.13 h. However, the total amounts of combined daytime and nighttime sleep during weekdays were somewhat greater, 8.15±1.12 h for 5-6(th) graders, 8.17±1.20 h for 7-9(th) graders, and 6.87±1.40 h for 10-12(th) graders. PDSS scores increased with age, 11.89±5.56 for 5-6(th) graders, 16.57±5.57 for 7-9(th) graders, and 17.71±5.24 for 10-12(th) graders. Higher PDSS scores were positively correlated with poor school performance and emotional instability. Korean teenagers sleep to an unusual extent during the day because of nighttime sleep deprivation. This negatively affects school performance and emotional stability. A Korean translation of the PDSS was effective in evaluating the severity of daytime sleepiness and assessing the emotional state and school performance of Korean teenagers.

  12. The Glasgow Sleep Impact Index (GSII): a novel patient-centred measure for assessing sleep-related quality of life impairment in Insomnia Disorder.

    Science.gov (United States)

    Kyle, Simon D; Crawford, Megan R; Morgan, Kevin; Spiegelhalder, Kai; Clark, Ailie A; Espie, Colin A

    2013-06-01

    Daytime dysfunction and quality of life impairment are important and salient consequences of poor sleep in those with insomnia. Existing measurement approaches to functional impact tend to rely on non-specific generic tools, non-validated scales, or ad hoc single scale items. Here we report the development and validation of the Glasgow Sleep Impact Index (GSII), a novel self-report measure which asks patients to generate, and assess, three domains of impairment unique to their own individual context. These three patient-generated areas of impairment are ranked in order of concern (1-3; i.e. 1=the most concerning impairment), and then rated on a visual analogue scale with respect to impact in the past two weeks. Patients re-rate these specified areas of impairment, post-intervention, permitting both individual and group-level analyses. One-hundred and eight patients (71% female; Mean age=45 yrs) meeting Research Diagnostic Criteria for Insomnia Disorder completed the GSII, resulting in the generation of 324 areas (ranks) of sleep-related daytime and quality of life impairment. Fifty-five patients also completed the GSII pre- and post-sleep restriction therapy. The following psychometric properties were assessed: content validity of generated domains; relationship between ranks of impairment; and sensitivity to change post-behavioural intervention. Content analysis of generated domains support recent DSM-5 proposals for specification of daytime consequences of insomnia; with the most commonly cited areas reflecting impairments in energy/motivation, work performance, cognitive functioning, emotional regulation, health/well-being, social functioning and relationship/family functioning. Preliminary results with 108 patients indicate the GSII to have excellent face and construct validity. The GSII was found to be sensitive to change, post-behavioural treatment (psleep-related quality of life impairment in a valid and meaningful way. Further psychometric and clinical

  13. Clinical and Polysomnographic Predictors of the Natural History of Poor Sleep in the General Population

    Science.gov (United States)

    Fernandez-Mendoza, Julio; Vgontzas, Alexandros N.; Bixler, Edward O.; Singareddy, Ravi; Shaffer, Michele L.; Calhoun, Susan L.; Karataraki, Maria; Vela-Bueno, Antonio; Liao, Duanping

    2012-01-01

    Study Objectives: Approximately 8-10% of the general population suffers from chronic insomnia, whereas another 20-30% of the population has insomnia symptoms at any given time (i.e., poor sleep). However, few longitudinal studies have examined risk factors of the natural history of poor sleep, and none have examined the role of polysomnographic (PSG) variables. Design: Representative longitudinal study. Setting: Sleep laboratory. Participants: From a random, general population sample of 1,741 individuals of the adult Penn State Cohort, 1,395 were followed up after 7.5 yr. Measurements: Full medical evaluation and 1-night PSG at baseline and telephone interview at follow-up. Results: The rate of incident poor sleep was 18.4%. Physical (e.g., obesity, sleep apnea, and ulcer) and mental (e.g., depression) health conditions and behavioral factors (e.g., smoking and alcohol consumption) increased the odds of incident poor sleep as compared to normal sleep. The rates of persistent, remitted, and poor sleepers who developed chronic insomnia were 39%, 44%, and 17%, respectively. Risk factors for persistent poor sleep were physical health conditions combined with psychologic distress. Shorter objective sleep duration and a family history of sleep problems were risk factors for poor sleep evolving into chronic insomnia. Conclusions: Poor sleep appears to be primarily a symptom of physical and mental health conditions, whereas the persistence of poor sleep is associated with psychologic distress. Importantly, sleep apnea appears to be associated with incident poor sleep but not with chronic insomnia. Finally, this study suggests that objective short sleep duration in poor sleepers is a biologic marker of genetic predisposition to chronic insomnia. Citation: Fernandez-Mendoza J; Vgontzas AN; Bixler EO; Singareddy R; Shaffer ML; Calhoun SL; Karataraki M; Vela-Bueno A; Liao D. Clinical and polysomnographic predictors of the natural history of poor sleep in the general population

  14. Effects of Sleep Loss on Subjective Complaints and Objective Neurocognitive Performance as Measured by the Immediate Post-Concussion Assessment and Cognitive Testing.

    Science.gov (United States)

    Stocker, Ryan P J; Khan, Hassen; Henry, Luke; Germain, Anne

    2017-05-01

    This study examined the effects of total and partial sleep deprivation on subjective symptoms and objective neurocognitive performance, as measured by the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) in a sample of healthy adults. One-hundred and two, right-handed, healthy participants (between ages 18 and 30 years old) completed three consecutive nights in the sleep laboratory with concurrent continuous polysomnography monitoring. Night 1 served as a baseline night. Prior to Night 2, they were randomly assigned to one of three sleep conditions: undisrupted normal sleep (N = 34), sleep restriction (50% of habitual sleep, N = 37), or total sleep deprivation (N = 31). Participants slept undisturbed on Night 3. ImPACT was administered on three separate occasions. Sleep loss was associated with increased severity of subjectively reported affective, cognitive, physical, and sleep symptoms. Although objective neurocognitive task scores derived from the ImPACT battery did not corroborate subjective complaints, sleep loss was associated with significant differences on tasks of visual memory, reaction time, and visual motor speed over time. While self-report measures suggested marked impairments following sleep loss, deficits in neurocognitive performance were observed only on three domains measured with ImPACT. ImPACT may capture subtle changes in neurocognitive performance following sleep loss; however, independent and larger validation studies are needed to determine its sensitivity to acute sleep loss and recovery sleep. Neurocognitive screening batteries may be useful for detecting the effects of more severe or chronic sleep loss under high-stress conditions that mimic high-risk occupations.

  15. A 6-Month Assessment of Sleep During Naval Deployment: A Case Study of a Commanding Officer

    Science.gov (United States)

    2015-05-01

    research showing that crewmembers on U.S. Navy ships suffer from chronic sleep restriction . During a typical deployment, personnel accrue a...considerable sleep debt even during normal operations. Should critical events with additional sleep restriction occur, the ship has limited reserve capacity, potentially placing her crew and their mission in grave jeopardy.

  16. Assessment of respiratory effort during sleep: Esophageal pressure versus noninvasive monitoring techniques

    NARCIS (Netherlands)

    Vandenbussche, N.L.; Overeem, S.; Dijk, J.P. van; Simons, P.J.; Pevernagie, D.A.

    2015-01-01

    Monitoring of respiratory effort is paramount in the clinical diagnostic recording of sleep. Increased respiratory effort is a sign of obstructive sleep-disordered breathing and is associated with arousals from sleep. Respiration is the result of muscle activity that induces negative intrathoracic

  17. Criterion validity of the Pittsburgh Sleep Quality Index and Epworth Sleepiness Scale for the diagnosis of sleep disorders.

    Science.gov (United States)

    Nishiyama, Takeshi; Mizuno, Tomoki; Kojima, Masayo; Suzuki, Sadao; Kitajima, Tsuyoshi; Ando, Kayoko Bhardwaj; Kuriyama, Shinichi; Nakayama, Meiho

    2014-04-01

    (1) To examine criterion validity of the Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS) using obstructive sleep apnea (OSA), periodic limb movement disorder (PLMD), rapid eye movement sleep behavior disorder (RBD), and narcolepsy as criterion standard. (2) To summarize the evidence for criterion validity of the ESS for the diagnosis of OSA by a meta-analysis that combines the current and previous studies. (3) To investigate the determinants of the PSQI and ESS scores. The PSQI and ESS as well as the Hospital Anxiety and Depression Scale (HADS), which measures anxiety and depression levels, were administered to 367 patients consecutively referred to a sleep clinic. They underwent overnight polysomnography (PSG) and the multiple sleep latency test if narcolepsy was suspected. The area under the receiver operating characteristic curves for the ESS and PSQI (and its subscale) were <0.9, meaning that these questionnaires were not highly accurate for predicting the four sleep disorders. The meta-analysis found that the ESS had no value in identifying OSA. The variable that most strongly influenced PSQI or ESS scores was the HADS score. The PSQI and ESS should no longer be used as a screening or diagnostic instrument for the four PSG-defined sleep disorders, especially in a low-risk population. Copyright © 2014 Elsevier B.V. All rights reserved.

  18. Assessment: Cinderella or Sleeping Beauty? Evolution of final examinations at the Royal Veterinary College.

    Science.gov (United States)

    Pead, Matthew J

    2008-01-01

    Teachers of veterinary medicine frequently regard assessment as a Cinderella subject. Consciously or unconsciously, they allow assessment systems to become faithful slaves, brought out and dusted off when required, out of sight and out of mind at other times. This often means that assessment is last on the priority list when educational development is considered. Pedagogical literature is full of references to the power of appropriate assessment systems and the role that they can play in shaping and driving the learning environment. "Assessment drives learning" and "Students respect what is inspected" are the headlines associated with such references, and this viewpoint places assessment much more in the role of a Sleeping Beauty, requiring only a simple touch to become a vehicle for modernizing an educational system. This article uses an example of change to a UK veterinary final examination to present the tensions between these contrasting views, and some solutions for them, in an effort to fuel the debate on improving the use of assessment.

  19. The Prioritization of Clinical Risk Factors of Obstructive Sleep Apnea Severity Using Fuzzy Analytic Hierarchy Process.

    Science.gov (United States)

    Maranate, Thaya; Pongpullponsak, Adisak; Ruttanaumpawan, Pimon

    2015-01-01

    Recently, there has been a problem of shortage of sleep laboratories that can accommodate the patients in a timely manner. Delayed diagnosis and treatment may lead to worse outcomes particularly in patients with severe obstructive sleep apnea (OSA). For this reason, the prioritization in polysomnography (PSG) queueing should be endorsed based on disease severity. To date, there have been conflicting data whether clinical information can predict OSA severity. The 1,042 suspected OSA patients underwent diagnostic PSG study at Siriraj Sleep Center during 2010-2011. A total of 113 variables were obtained from sleep questionnaires and anthropometric measurements. The 19 groups of clinical risk factors consisting of 42 variables were categorized into each OSA severity. This study aimed to array these factors by employing Fuzzy Analytic Hierarchy Process approach based on normalized weight vector. The results revealed that the first rank of clinical risk factors in Severe, Moderate, Mild, and No OSA was nighttime symptoms. The overall sensitivity/specificity of the approach to these groups was 92.32%/91.76%, 89.52%/88.18%, 91.08%/84.58%, and 96.49%/81.23%, respectively. We propose that the urgent PSG appointment should include clinical risk factors of Severe OSA group. In addition, the screening for Mild from No OSA patients in sleep center setting using symptoms during sleep is also recommended (sensitivity = 87.12% and specificity = 72.22%).

  20. The Prioritization of Clinical Risk Factors of Obstructive Sleep Apnea Severity Using Fuzzy Analytic Hierarchy Process

    Directory of Open Access Journals (Sweden)

    Thaya Maranate

    2015-01-01

    Full Text Available Recently, there has been a problem of shortage of sleep laboratories that can accommodate the patients in a timely manner. Delayed diagnosis and treatment may lead to worse outcomes particularly in patients with severe obstructive sleep apnea (OSA. For this reason, the prioritization in polysomnography (PSG queueing should be endorsed based on disease severity. To date, there have been conflicting data whether clinical information can predict OSA severity. The 1,042 suspected OSA patients underwent diagnostic PSG study at Siriraj Sleep Center during 2010-2011. A total of 113 variables were obtained from sleep questionnaires and anthropometric measurements. The 19 groups of clinical risk factors consisting of 42 variables were categorized into each OSA severity. This study aimed to array these factors by employing Fuzzy Analytic Hierarchy Process approach based on normalized weight vector. The results revealed that the first rank of clinical risk factors in Severe, Moderate, Mild, and No OSA was nighttime symptoms. The overall sensitivity/specificity of the approach to these groups was 92.32%/91.76%, 89.52%/88.18%, 91.08%/84.58%, and 96.49%/81.23%, respectively. We propose that the urgent PSG appointment should include clinical risk factors of Severe OSA group. In addition, the screening for Mild from No OSA patients in sleep center setting using symptoms during sleep is also recommended (sensitivity = 87.12% and specificity = 72.22%.

  1. Relationship between Obstructive Sleep Apnea and Self-assessed Oral Health Status: An Internet Survey.

    Science.gov (United States)

    Suzuki, Seitaro; Kojima, Yuki; Takayanagi, Atsushi; Yoshino, Koichi; Ishizuka, Yoichi; Satou, Ryouichi; Takahashi, Naoko; Tazaki, Masakazu; Kamijo, Hideyuki; Sugihara, Naoki

    2016-01-01

    The purpose of this study based on a cross-sectional internet survey was to investigate the relationship between risk of obstructive sleep apnea (OSA) and self-assessed oral health status. The participants, who comprised individuals registered with an online research company, were required to complete a self-reported questionnaire. Those answering in the affirmative to both of the following two questions were placed in the OSA-risk group, while those answering in the negative were assigned to the control group: 'Have other people noticed pauses in your breathing while you are sleeping?' and 'Do you feel excessively sleepy during the daytime?'. A total of 493 were included in the OSA-risk group and 2,560 in the control group. Among the total 3,053 respondents, the highest prevalence for OSA risk in men was in the 50-59-year age range, although this tended to level off after age 60 years. No such trend was observed in women, however. Multiple logistic regression analysis was performed to identify the relationship between risk of OSA and self-assessed oral health status. Significant correlations were observed with the following parameters: difficulty in opening mouth (odds ratio [OR]: 2.66; 95% confidence interval [CI]: 1.647-4.311), dry mouth (OR: 2.11; CI: 1.544-2.876), bad breath (OR: 1.69; CI: 1.309-2.186), gingival bleeding (OR: 1.48; CI: 1.134-1.932), and gingival swelling (OR: 1.44; CI: 1.046-1.981). These results suggest a relationship between risk of OSA and self-assessed oral health status, indicating that treating OSA might improve oral health status. Further study is needed to demonstrate a causal relationship between OSA and self-assessed oral health status, however.

  2. The 2007 AASM recommendations for EEG electrode placement in polysomnography: impact on sleep and cortical arousal scoring.

    Science.gov (United States)

    Ruehland, Warren R; O'Donoghue, Fergal J; Pierce, Robert J; Thornton, Andrew T; Singh, Parmjit; Copland, Janet M; Stevens, Bronwyn; Rochford, Peter D

    2011-01-01

    To examine the impact of using American Academy of Sleep Medicine (AASM) recommended EEG derivations (F4/M1, C4/M1, O2/M1) vs. a single derivation (C4/M1) in polysomnography (PSG) on the measurement of sleep and cortical arousals, including inter- and intra-observer variability. Prospective, non-blinded, randomized comparison. Three Australian tertiary-care hospital clinical sleep laboratories. 30 PSGs from consecutive patients investigated for obstructive sleep apnea (OSA) during December 2007 and January 2008. N/A. To examine the impact of EEG derivations on PSG summary statistics, 3 scorers from different Australian clinical sleep laboratories each scored separate sets of 10 PSGs twice, once using 3 EEG derivations and once using 1 EEG derivation. To examine the impact on inter- and intra-scorer reliability, all 3 scorers scored a subset of 10 PSGs 4 times, twice using each method. All PSGs were de-identified and scored in random order according to the 2007 AASM Manual for the Scoring of Sleep and Associated Events. Using 3 referential EEG derivations during PSG, as recommended in the AASM manual, instead of a single central EEG derivation, as originally suggested by Rechtschaffen and Kales (1968), resulted in a mean ± SE decrease in N1 sleep of 9.6 ± 3.9 min (P = 0.018) and an increase in N3 sleep of 10.6 ± 2.8 min (P = 0.001). No significant differences were observed for any other sleep or arousal scoring summary statistics; nor were any differences observed in inter-scorer or intra-scorer reliability for scoring sleep or cortical arousals. This study provides information for those changing practice to comply with the 2007 AASM recommendations for EEG placement in PSG, for those using portable devices that are unable to comply with the recommendations due to limited channel options, and for the development of future standards for PSG scoring and recording. As the use of multiple EEG derivations only led to small changes in the distribution of derived sleep

  3. [Identification and evaluation of obstructive sleep apnea in children before adenotonsillectomy using evaluative surveys].

    Science.gov (United States)

    Fischer, Yvonne; Gronau, Silke

    2005-02-01

    Sleep-disordered breathing (SDB) caused by enlarged tonsils and adnoids is common in early childhood. SDB without alterations in alveolar ventilation or sleep architecture is called primary snoring and affects up to 3-12 % of young children. In contrast, SDB with associated apneas or hypopneas affects between 0.7-3 % and is called obstructive sleep apnea syndrome (OSAS). OSAS and primary snoring should be distinguished with polysomnography (PSG). Despite the large number of patients undergoing tonsillectomy and adenoidectomy, the ability to assess patients-based preoperative diagnosis and surgical outcomes polysomnographically is limited. As a consequence it remains difficult which children will or will not benefit from surgical intervention. In the context of OSAS diagnosis, a discriminative survey is desired, one that cold classify differences before surgery as small, moderate or large. A promising office based surrogate measure are disease-specific quality-of-life surveys. Change within patients can be measured using an evaluative survey, administered before and after an intervention.

  4. Polysomnographic measures of sleep in cocaine dependence and alcohol dependence: Implications for age‐related loss of slow wave, stage 3 sleep

    Science.gov (United States)

    Bjurstrom, Martin F.; Olmstead, Richard

    2016-01-01

    Abstract Background and aims Sleep disturbance is a prominent complaint in cocaine and alcohol dependence. This controlled study evaluated differences of polysomnographic (PSG) sleep in cocaine‐ and alcohol‐dependent subjects, and examined whether substance dependence interacts with age to alter slow wave sleep and rapid eye movement (REM) sleep. Design Cross‐sectional comparison. Setting Los Angeles and San Diego, CA, USA. Participants Abstinent cocaine‐dependent subjects (n = 32), abstinent alcohol‐dependent subjects (n = 73) and controls (n = 108); mean age 40.3 years recruited 2005–12. Measurements PSG measures of sleep continuity and sleep architecture primary outcomes of Stage 3 sleep and REM sleep. Covariates included age, ethnicity, education, smoking, body mass index and depressive symptoms. Findings Compared with controls, both groups of substance dependent subjects showed loss of Stage 3 sleep (P < 0.001). A substance dependence × age interaction was found in which both cocaine‐ and alcohol‐dependent groups showed loss of Stage 3 sleep at an earlier age than controls (P < 0.05 for all), and cocaine‐dependent subjects showed loss of Stage 3 sleep at an earlier age than alcoholics (P < 0.05). Compared with controls, REM sleep was increased in both substance‐dependent groups (P < 0.001), and cocaine and alcohol dependence were associated with earlier age‐related increase in REM sleep (P < 0.05 for all). Conclusions Cocaine and alcohol dependence appear to be associated with marked disturbances of sleep architecture, including increased rapid eye movement sleep and accelerated age‐related loss of slow wave, Stage 3 sleep. PMID:26749502

  5. Longitudinal assessment of sleep disordered breathing in Vietnam veterans with post-traumatic stress disorder.

    Science.gov (United States)

    Yesavage, Jerome A; Kinoshita, Lisa M; Noda, Art; Lazzeroni, Laura C; Fairchild, Jennifer Kaci; Friedman, Leah; Sekhon, Gundeep; Thompson, Stephanie; Cheng, Jauhtai; Zeitzer, Jamie M

    2014-01-01

    Previous work has demonstrated the relatively high prevalence of risk factors for cognitive impairment, such as sleep disordered breathing (SDB) and obesity, in Vietnam War era veterans with post-traumatic stress disorder (PTSD). No data are currently available on the longitudinal stability of SDB as a risk factor for cognitive decline in that population, which this study now reports. Sample consisted of 48 veterans of the Vietnam War with PTSD who completed longitudinal sleep assessments over a 3-year period. The primary outcome measure, the Apnea-Hypopnea Index (AHI) indicator, was determined during standard overnight polysomnography. Body mass index (BMI) was calculated using standard measurements. Measures of cognitive function tapped auditory verbal memory as measured by the Rey Auditory Verbal Learning Test and executive functioning as measured by the Color-Word Interference Test of the Delis-Kaplan Executive Function System battery. Statistical analyses included mixed effects modeling. In this sample, AHI increased significantly by 2.19 points per year (β=2.19; PVietnam War with PTSD over a 3-year period. The worsening of SDB over time suggests the need for appropriate countermeasures in populations at risk for progression of the condition.

  6. Where are the Behavioral Sleep Medicine Providers and Where are They Needed? A Geographic Assessment.

    Science.gov (United States)

    Thomas, Arthur; Grandner, Michael; Nowakowski, Sara; Nesom, Genevieve; Corbitt, Charles; Perlis, Michael L

    2016-01-01

    Although it is widely acknowledged that there are not enough clinicians trained in either Behavioral Sleep Medicine (BSM) in general or in Cognitive Behavioral Therapy for Insomnia (CBT-I) in specific, what is unclear is whether this problem is more acute in some regions relative to others. Accordingly, a geographic approach was taken to assess this issue. Using national directories as well as e-mail listservs (Behavioral Sleep Medicine group and Behavioral Treatment for Insomnia Roster), the present study evaluated geographic patterning of CBSM and BSM providers by city, state, and country. Overall, 88% of 752 BSM providers worldwide live in the United States (n = 659). Of these, 58% reside in 12 states with ≥ 20 providers (CA, NY, PA, IL, MA, TX, FL, OH, MI, MN, WA, and CO), and 19% reside in just 2 states (NY and CA). There were 4 states with no BSM providers (NH, HI, SD, and WY). Of the 167 U.S. cities with a population of > 150,000, 105 cities have no BSM providers. These results clearly suggest that a targeted effort is needed to train individuals in both the unserved and underserved areas.

  7. Sleep patterns of co-sleeping and solitary sleeping infants and mothers: a longitudinal study.

    Science.gov (United States)

    Volkovich, Ella; Ben-Zion, Hamutal; Karny, Daphna; Meiri, Gal; Tikotzky, Liat

    2015-11-01

    Controversies exist regarding the impact of co-sleeping on infant sleep quality. In this context, the current study examined: (a) the differences in objective and subjective sleep patterns between co-sleeping (mostly room-sharing) and solitary sleeping mother-infant dyads; (b) the predictive links between maternal sleep during pregnancy and postnatal sleeping arrangement; (c) the bi-directional prospective associations between sleeping arrangement and infant/maternal sleep quality at three and six months postpartum. The sample included 153 families recruited during pregnancy. Data were obtained in home settings during the third trimester of pregnancy and at three and six months postpartum. Mothers were asked to monitor their own sleep and their infants' sleep for five nights using actigraphy and sleep diaries. Questionnaires were used to assess sleeping arrangements, feeding methods, socio-demographic characteristics, and maternal depressive and anxiety symptoms. Mothers of co-sleeping infants reported more infant night-wakings than mothers of solitary sleeping infants. However, none of the objective sleep measures was significantly different between co-sleeping and solitary sleeping infants, after controlling for feeding techniques. Co-sleeping mothers had significantly more objective and subjective sleep disturbances than mothers in the solitary sleeping group. Moreover, poorer maternal sleep during pregnancy and at three months postpartum predicted higher levels of co-sleeping at six months. Mothers of co-sleeping infants report more infant night-wakings, and experience poorer sleep than mothers of solitary sleeping infants. The quality of maternal sleep should be taken into clinical consideration when parents consult about co-sleeping. Copyright © 2015 Elsevier B.V. All rights reserved.

  8. Development of a screening tool for sleep disordered breathing in children using the phone Oximeter™.

    Science.gov (United States)

    Garde, Ainara; Dehkordi, Parastoo; Karlen, Walter; Wensley, David; Ansermino, J Mark; Dumont, Guy A

    2014-01-01

    Sleep disordered breathing (SDB) can lead to daytime sleepiness, growth failure and developmental delay in children. Polysomnography (PSG), the gold standard to diagnose SDB, is a highly resource-intensive test, confined to the sleep laboratory. To combine the blood oxygen saturation (SpO2) characterization and cardiac modulation, quantified by pulse rate variability (PRV), to identify children with SDB using the Phone Oximeter, a device integrating a pulse oximeter with a smartphone. Following ethics approval and informed consent, 160 children referred to British Columbia Children's Hospital for overnight PSG were recruited. A second pulse oximeter sensor applied to the finger adjacent to the one used for standard PSG was attached to the Phone Oximeter to record overnight pulse oximetry (SpO2 and photoplethysmogram (PPG)) alongside the PSG. We studied 146 children through the analysis of the SpO2 pattern, and PRV as an estimate of heart rate variability calculated from the PPG. SpO2 variability and SpO2 spectral power at low frequency, was significantly higher in children with SDB due to the modulation provoked by airway obstruction during sleep (p-value Phone Oximeter will provide an improved portable, at-home screening tool, with the capability of monitoring patients over multiple nights.

  9. The impact of atypical antipsychotic use on obstructive sleep apnea: A pilot study and literature review

    Science.gov (United States)

    Shirani, Afshin; Paradiso, Sergio; Dyken, Mark Eric

    2013-01-01

    Background Limited evidence links atypical antipsychotics (AAs) use to sleep related respiratory dysfunction and greater severity of obstructive sleep apnea (OSA). The present paper reviews the published evidence and examines the impact of AA use on the presence and severity of OSA among subjects with clinically suspected OSA after adjusting for several confounds. Methods Archives of the University of Iowa Sleep Laboratory from 2005 to 2009 were searched for patients using AAs at the time of diagnostic polysomnogram (PSG). PSG data of the 84 AA users with heterogeneous psychiatric disorders (of these 20 diagnosed only with depression) were subsequently compared to PSG data of two randomly selected, non-AA user groups from the same patient pool: (i) 200 subjects with a depressive disorder as the only psychiatric diagnosis, and (ii) 331 mentally healthy controls. PSG data were analyzed adjusting for known demographic, medical, and psychiatric risk factors for OSA. Results Prevalence and severity of OSA did not differ significantly across three groups. Sex, age, body mass index (BMI), and neck circumference (NC) independently predicted OSA. Odds ratio for OSA in the subset of AA users carrying the diagnosis of depression (n = 20) compared with subjects without mental illness was 4.53 (p depression or those with multiple psychiatric diagnoses including depression did not show a statistically significantly elevated OSA risk. Conclusions AA use in subjects with depression appears to increase the risk of OSA after controlling for known predisposing factors. PMID:21645873

  10. Cumulative Hypoxemia During Sleep Predicts Vascular Endothelial Dysfunction in Patients With Sleep-Disordered Breathing.

    Science.gov (United States)

    Sawatari, Hiroyuki; Chishaki, Akiko; Nishizaka, Mari; Tokunou, Tomotake; Adachi, Sonomi; Yoshimura, Chikara; Ohkusa, Tomoko; Ando, Shin-ichi

    2016-04-01

    Sleep-disordered breathing (SDB) is associated with repeated intermittent hypoxemia, and it is known as one of the risk factors for cardiovascular diseases. Previous studies assessing the effects of frequency and depth of hypoxemia on cardiovascular diseases have shown conflicting results. The aim of the current study was to clarify what SDB-related parameters most predict endothelial dysfunction to better understand the pathogenesis of endothelial dysfunction in patients with SDB. We conducted polysomnography (PSG) and measured flow-mediated vasodilation response (%FMD) in 50 outpatients suspected of SDB. Evaluated indices included: apnea-hypopnea index (AHI), 3% oxygen desaturation index (3%ODI), averaged arterial oxygen saturation (averaged SpO2), lowest arterial oxygen saturation (lowest SpO2), ratio of arterial oxygen saturation hypoxemia, rather than the frequency of hypoxemic events presented as AHI, may be a greater contributing factor in causing endothelial dysfunction. A simple index like TDS may be a useful and novel indicator of the influence of SDB on the vasculature. © American Journal of Hypertension, Ltd 2015. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  11. An automated algorithm to identify and reject artefacts for quantitative EEG analysis during sleep in patients with sleep-disordered breathing.

    Science.gov (United States)

    D'Rozario, Angela L; Dungan, George C; Banks, Siobhan; Liu, Peter Y; Wong, Keith K H; Killick, Roo; Grunstein, Ronald R; Kim, Jong Won

    2015-05-01

    Large quantities of neurophysiological electroencephalogram (EEG) data are routinely collected in the sleep laboratory. These are underutilised due to the burden of managing artefact contamination. The aim of this study was to develop a new tool for automated artefact rejection that facilitates subsequent quantitative analysis of sleep EEG data collected during routine overnight polysomnography (PSG) in subjects with and without sleep-disordered breathing (SDB). We evaluated the accuracy of an automated algorithm to detect sleep EEG artefacts against artefacts manually scored by three experienced technologists (reference standard) in 40 PSGs. Spectral power was computed using artefact-free EEG data derived from (1) the reference standard, (2) the algorithm and (3) raw EEG without any prior artefact rejection. The algorithm showed a high level of accuracy of 94.3, 94.7 and 95.8% for detecting artefacts during the entire PSG, NREM sleep and REM sleep, respectively. There was good to moderate sensitivity and excellent specificity of the algorithm detection capabilities during sleep. The EEG spectral power for the reference standard and algorithm was significantly lower than that of the raw, unprocessed EEG signal. These preliminary findings support an automated way to process EEG artefacts during sleep, providing the opportunity to investigate EEG-based markers of neurobehavioural impairment in sleep disorders in future studies.

  12. Sleep characteristics and health-related quality of life among a national sample of American young adults: assessment of possible health disparities.

    Science.gov (United States)

    Chen, Xiaoli; Gelaye, Bizu; Williams, Michelle A

    2014-03-01

    The aim of the study is to examine the associations of sleep characteristics with health-related quality of life (HRQOL) and sleep health disparities among US young adults using national survey data. The study sample consisted of 2,391 young adults aged 20-39 years from the National Health and Nutrition Examination Survey 2005-2008. HRQOL was assessed using the Centers for Disease Control and Prevention's HRQOL-4 scale. Multivariable logistic regression models were applied to evaluate the sleep-HRQOL associations. Stratified analyses were conducted to examine whether the associations varied by sociodemographic characteristics. Approximately 35.6 % of young adults slept sleep disorder, and 8.5 % had sleep apnea. More females had insomnia than males (48.6 vs. 35.9 %, P sleep disturbances than their foreign-born counterparts. Compared with those sleeping 7-8 h, the adjusted odds ratio of poor general health was 1.60 (95 % confidence interval, 1.08-2.35) for individuals sleeping 6-7 h and 1.88 (1.23-2.86) for those sleeping mental HRQOL and overall HRQOL. Insomnia, long sleep latency, troubling falling asleep, daytime sleepiness, and frequent sleeping pill use were significantly associated with low mental HRQOL and overall HRQOL. The associations between sleep disturbances and low HRQOL varied little by sex, race/ethnicity, and country of birth. Sleep disturbances are common among US young adults and are significantly associated with low HRQOL. Objective measures of sleep are warranted to confirm our findings.

  13. Efficacy of a Topical Aromatic Rub (Vicks VapoRub®) on Effects on Self-Reported and Actigraphically Assessed Aspects of Sleep in Common Cold Patients

    OpenAIRE

    Santhi, Nayantara; Ramsey, D; Phillipson, G; Hull, D; Revell, Victoria; Dijk, Derk-Jan

    2017-01-01

    Common cold sufferers frequently report sleep disruption during the symptomatic period of infections. We examined the effects of treatment with a topical aromatic pharmaceutical ointment (Vicks VapoRub®), on associated sleep disturbances. The effects of Vicks VapoRub® versus placebo (petrolatum ointment) on subjective and objective measured sleep parameters were assessed in an exploratory study of 100 common cold patients, in a randomized, single blind, controlled, two-arm, ...

  14. The Association between Sleep-Disordered Breathing and Magnetic Resonance Imaging Findings in a Pediatric Cohort with Chiari 1 Malformation

    Directory of Open Access Journals (Sweden)

    Reshma Amin

    2015-01-01

    Full Text Available BACKGROUND: The prevalence of sleep-disordered breathing (SDB reported in the literature for Chiari malformation type 1 (CM1 is uniformly high (24% to 70%. In Canada, there is limited access to pediatric polysomnography (PSG. Therefore, the identification of clinical features would be invaluable for triaging these children.

  15. Diagnostic accuracy of portable instrumental devices to measure sleep bruxism: a systematic literature review of polysomnographic studies

    NARCIS (Netherlands)

    Manfredini, D.; Ahlberg, J.; Castroflorio, T.; Poggio, C.E.; Guarda-Nardini, L.; Lobbezoo, F.

    2014-01-01

    This study systematically reviews the sleep bruxism (SB) literature published in the MEDLINE and Scopus databases to answer the following question: What is the validity of the different portable instrumental devices that have been proposed to measure SB if compared with polysomnographic (PSG)

  16. Subjective sleep complaints indicate objective sleep problems in psychosomatic patients: a prospective polysomnographic study

    Directory of Open Access Journals (Sweden)

    Linden M

    2016-08-01

    Full Text Available Michael Linden,1,2 Marie Dietz,1 Christian Veauthier,3 Ingo Fietze3 1Research Group Psychosomatic Rehabilitation, Charité University Medicine Berlin, 2Department of Psychosomatic Medicine, Rehabilitation Centre Seehof, Teltow, 3Interdisciplinary Center of Sleep Medicine, Charité University Medicine Berlin, Berlin, Germany Objective: To elucidate the relationship between subjective complaints and polysomnographical parameters in psychosomatic patients.Method: A convenience sample of patients from a psychosomatic inpatient unit were classified according to the Pittsburgh Sleep Quality Index (PSQI as very poor sleepers (PSQI >10, n=80 and good sleepers (PSQI <6, n=19. They then underwent a polysomnography and in the morning rated their previous night’s sleep using a published protocol (Deutschen Gesellschaft für Schlafforschung und Schlafmedizin morning protocol [MP].Results: In the polysomnography, significant differences were found between very poor and good sleepers according to the PSQI with respect to sleep efficiency and time awake after sleep onset. When comparing objective PSG and subjective MP, the polysomnographical sleep onset latency was significantly positively correlated with the corresponding parameters of the MP: the subjective sleep onset latency in minutes and the subjective evaluation of sleep onset latency (very short, short, normal, long, very long were positively correlated with the sleep latency measured by polysomnography. The polysomnographical time awake after sleep onset (in minutes was positively correlated with the subjective time awake after sleep onset (in minutes, evaluation of time awake after sleep onset (seldom, normal often, and subjective restfulness. The polysomnographical total sleep time (TST was positively correlated with the subjective TST. Conversely, the polysomnographical TST was negatively correlated with the evaluation of TST (high polysomnographical TST was correlated with the subjective

  17. Assessment of Sleep Quality and Effects of Relaxation Exercise on Sleep Quality in Patients Hospitalized in Internal Medicine Services in a University Hospital: The Effect of Relaxation Exercises in Patients Hospitalized.

    Science.gov (United States)

    Alparslan, Güler Balci; Orsal, Özlem; Unsal, Alaettin

    2016-01-01

    This study aims to assess sleep quality and determine the effects of relaxation exercise on sleep quality in patients hospitalized in internal medicine services. In total, 47 patients comprised the control group and did not engage in the exercise intervention--the progressive muscle relaxation exercise, whereas 235 patients were assigned to the intervention group (N = 282). In this study, Description Questionnaire Form and the Pittsburg Sleep Quality Index (PSQI) were used. Most patients (73.8%) had poor sleep quality. The mean pre- and postexercise PSQI scores of the patients in the interventional group were 8.7 ± 4.0 and 6.1 ± 3.3, respectively. The mean pre- and postexercise PSQI scores of the control patients were 6.6 ± 3.5 and 5.6 ± 2.7, respectively. According to this study, the exercises significantly enhanced the quality of sleep. Patients should be encouraged by nurses to perform relaxation exercises.

  18. The Stimulation Effect of Auricular Magnetic Press Pellets on Older Female Adults with Sleep Disturbance Undergoing Polysomnographic Evaluation

    Directory of Open Access Journals (Sweden)

    Chyi Lo

    2013-01-01

    Full Text Available Study Objectives. To examine the stimulation effect of auricular magnetic press pellet therapy on older female adults with sleep disturbance as determined by polysomnography (PSG. Design. Randomized, single-blind, experimental-controlled, parallel-group. Setting. Community. Participants. Twenty-seven older female adults with sleep disturbance according to the Pittsburgh Sleep Quality Index (PSQI >5 for at least 3 months were recruited. Participants were screened by both the Hospital Anxiety and Depression Scale (HADS and the Mini-Mental State Examination (MMSE, as well as polysomnography prior to randomization. Interventions. All eligible participants were randomly allocated into the experimental or control group. Both groups were taped with magnetic press pellet on auricular points for 3 weeks. The experimental group was treated by applying pressure on the magnetic press pellets 3 times per day while no stimulation was applied on the control group. Measurements and Results. Both groups were measured by PSG and PSQI at the beginning of the study and 3 weeks after the study. Both groups showed improvements on PSQI scores compared to the baseline. One-way analysis of covariance adjusted for baseline scores showed that significant improvements of PSG-derived sleep parameters, such as sleep efficiency, were found in the experimental group. However, no significant differences between groups were observed in the proportion of sleep stages with the exception of Stage 2. Conclusions. Auricular therapy using magnetic pellets and stimulation by pressing was more effective in improving the sleep quality compared to auricular therapy without any stimulation.

  19. Sleep architecture in school-aged children with primary snoring.

    Science.gov (United States)

    Zhu, Yin; Au, Chun-Ting; Lam, Hugh S; Chan, Ching-Ching K; Ho, Crover; Wing, Yun-Kwok; Li, Albert M

    2014-03-01

    We aimed to examine if sleep architecture was altered in school-aged children with primary snoring (PS). Children ages 6 to 13 years from 13 primary schools were randomly recruited. A validated obstructive sleep apnea (OSA) screening questionnaire was completed by their parents. Children at high risk for OSA and a randomly chosen low-risk group were invited to undergo overnight polysomnography (PSG) and clinical examination. Participants were classified into healthy controls, PS, mild OSA, and moderate to severe OSA (MS OSA) groups for comparison. A total of 619 participants underwent PSG (mean age, 10.0 ± 1.8 years; 396 (64.0%) boys; 524 (84.7%) prepubertal). For the cohort as a whole, there were no significant differences in measures of sleep architecture between PS and nonsnoring healthy controls. In the multiple regression model, percentage of nonrapid eye movement (NREM) stage 1 (N1) sleep had a significantly positive association, whereas percentage of slow-wave sleep (SWS) had a significantly negative association with sleep-disordered breathing (SDB) severity after controlling for age, gender, body mass index (BMI) z score, and pubertal status. In prepubertal children with PS, no significant disruption of sleep architecture was found. However, pubertal adolescent PS participants had significantly higher adjusted percentage of N1 sleep and wake after sleep onset (WASO) compared to healthy controls. PS did not exert significant adverse influences on normal sleep architecture in prepubertal school-aged children. Nevertheless, pubertal adolescents with PS had increased N1 sleep and WASO. Copyright © 2013 Elsevier B.V. All rights reserved.

  20. Genetic Dissociation of Daily Sleep and Sleep Following Thermogenetic Sleep Deprivation in Drosophila.

    Science.gov (United States)

    Dubowy, Christine; Moravcevic, Katarina; Yue, Zhifeng; Wan, Joy Y; Van Dongen, Hans P A; Sehgal, Amita

    2016-05-01

    Sleep rebound-the increase in sleep that follows sleep deprivation-is a hallmark of homeostatic sleep regulation that is conserved across the animal kingdom. However, both the mechanisms that underlie sleep rebound and its relationship to habitual daily sleep remain unclear. To address this, we developed an efficient thermogenetic method of inducing sleep deprivation in Drosophila that produces a substantial rebound, and applied the newly developed method to assess sleep rebound in a screen of 1,741 mutated lines. We used data generated by this screen to identify lines with reduced sleep rebound following thermogenetic sleep deprivation, and to probe the relationship between habitual sleep amount and sleep following thermogenetic sleep deprivation in Drosophila. To develop a thermogenetic method of sleep deprivation suitable for screening, we thermogenetically stimulated different populations of wake-promoting neurons labeled by Gal4 drivers. Sleep rebound following thermogenetically-induced wakefulness varies across the different sets of wake-promoting neurons that were stimulated, from very little to quite substantial. Thermogenetic activation of neurons marked by the c584-Gal4 driver produces both strong sleep loss and a substantial rebound that is more consistent within genotypes than rebound following mechanical or caffeine-induced sleep deprivation. We therefore used this driver to induce sleep deprivation in a screen of 1,741 mutagenized lines generated by the Drosophila Gene Disruption Project. Flies were subjected to 9 h of sleep deprivation during the dark period and released from sleep deprivation 3 h before lights-on. Recovery was measured over the 15 h following sleep deprivation. Following identification of lines with reduced sleep rebound, we characterized baseline sleep and sleep depth before and after sleep deprivation for these hits. We identified two lines that consistently exhibit a blunted increase in the duration and depth of sleep after

  1. A Polysomnographic Study of Parkinson's Disease Sleep Architecture

    Science.gov (United States)

    De Jesus, Sol; Peng-Chen, Zhongxing; Okun, Michael S.; Alatriste-Booth, Vanessa

    2015-01-01

    Sleep disturbance is a common nonmotor phenomenon in Parkinson's disease (PD) affecting patient's quality of life. In this study, we examined the association between clinical characteristics with sleep disorders and sleep architecture patterns in a PD cohort. Patients underwent a standardized polysomnography study (PSG) in their “on medication” state. We observed that male gender and disease duration were independently associated with obstructive sleep apnea (OSA). Only lower levodopa equivalent dose (LED) was associated with periodic limb movement disorders (PLMD). REM sleep behavior disorder (RBD) was more common among older patients, with higher MDS-UPDRS III scores, and LED. None of the investigated variables were associated with the awakenings/arousals (A/A). Sleep efficiency was predicted by amantadine usage and age, while sleep stage 1 was predicted by dopamine agonists and Hoehn & Yahr severity. The use of MAO-B inhibitors and MDS-UPDRS part III were predictors of sleep stages 2 and 3. Age was the only predictor of REM sleep stage and gender for total sleep time. We conclude that sleep disorders and architecture are poorly predictable by clinical PD characteristics and other disease related factors must also be contributing to these sleep disturbances. PMID:26504612

  2. A Polysomnographic Study of Parkinson’s Disease Sleep Architecture

    Directory of Open Access Journals (Sweden)

    Daniel Martinez-Ramirez

    2015-01-01

    Full Text Available Sleep disturbance is a common nonmotor phenomenon in Parkinson’s disease (PD affecting patient’s quality of life. In this study, we examined the association between clinical characteristics with sleep disorders and sleep architecture patterns in a PD cohort. Patients underwent a standardized polysomnography study (PSG in their “on medication” state. We observed that male gender and disease duration were independently associated with obstructive sleep apnea (OSA. Only lower levodopa equivalent dose (LED was associated with periodic limb movement disorders (PLMD. REM sleep behavior disorder (RBD was more common among older patients, with higher MDS-UPDRS III scores, and LED. None of the investigated variables were associated with the awakenings/arousals (A/A. Sleep efficiency was predicted by amantadine usage and age, while sleep stage 1 was predicted by dopamine agonists and Hoehn & Yahr severity. The use of MAO-B inhibitors and MDS-UPDRS part III were predictors of sleep stages 2 and 3. Age was the only predictor of REM sleep stage and gender for total sleep time. We conclude that sleep disorders and architecture are poorly predictable by clinical PD characteristics and other disease related factors must also be contributing to these sleep disturbances.

  3. Sleep and sleep disorders in children and adolescents.

    Science.gov (United States)

    Meltzer, Lisa J; Mindell, Jodi A

    2006-12-01

    Pediatric sleep disorders are common, affecting approximately 25% to 40% of children and adolescents. Although there are several different types of sleep disorders that affect youth, each disorder can have a significant impact on daytime functioning and development, including learning, growth, behavior, and emotion regulation. Researchers are only beginning to uncover the interaction between sleep and psychiatric disorders in children and adolescents, including depression, attention-deficit/hyperactivity disorder, and autism. This article reviews normal sleep and sleep disorders in children and adolescents, the assessment of sleep in pediatric populations, common pediatric sleep disorders, and sleep in children who have common psychiatric disorders.

  4. Longer self-reported sleep duration is associated with decreased performance on the montreal cognitive assessment in older adults.

    Science.gov (United States)

    Malek-Ahmadi, Michael; Kora, Krishna; O'Connor, Kathy; Schofield, Sharon; Coon, David; Nieri, Walter

    2016-04-01

    Previous studies investigating the relationship between sleep duration and cognitive function in older adults have suggested that longer sleep durations are associated with decreased cognitive performance. The intent of this study is to determine if performance on the Montreal Cognitive Assessment (MoCA) and the Mini Mental State Exam (MMSE) is associated with self-reported sleep duration in older adults. Data from 189 cognitively normal older adults aged 75 and older (mean age 89.29 ± 7.62) and free of severe depression were used for this analysis. Individuals were grouped based on their self-reported hours of sleep (short duration = 9, and long duration = ≥9). The Kruskal-Wallis test was used to discern group differences on the MoCA scores, while multinomial logistic regression was used to assess the association between MoCA and MMSE scores and sleep group. The long duration group had significantly lower MoCA scores than the normal duration group (p = 0.02). The short duration group was not significantly different from the normal duration group (p = 0.33). Individuals in the short duration group were more likely to have higher MoCA scores than those in long duration group after adjusting for age, gender, and presence of depressive symptoms [OR 0.86, 95 % CI (0.76, 0.98), p = 0.02]. The results of this study suggest that in a group of non-demented, very old subjects, self-reported sleep duration of nine or more hours is associated with decreased cognitive performance on the MoCA in older adults, even after accounting for age, gender, and presence of depressive symptoms.

  5. Regional cerebral glucose metabolic rate in human sleep assessed by positron emission tomography

    Energy Technology Data Exchange (ETDEWEB)

    Buchsbaum, M.S.; Wu, J.; Hazlett, E.; Sicotte, N.; Bunney, W.E. Jr. (Univ. of California, Irvine (USA)); Gillin, J.C. (Univ. of California, San Diego (USA))

    1989-01-01

    The cerebral metabolic rate of glucose was measured during nighttime sleep in 36 normal volunteers using positron emission tomography and fluorine-18-labeled 2-deoxyglucose (FDG). In comparison to waking controls, subjects given FDG during non-rapid eye movement (NREM) sleep showed about a 23% reduction in metabolic rate across the entire brain. This decrease was greater for the frontal than temporal or occipital lobes, and greater for basal ganglia and thalamus than cortex. Subjects in rapid eye movement (REM) sleep tended to have higher cortical metabolic rates than walking subjects. The cingulate gyrus was the only cortical structure to show a significant increase in glucose metabolic rate in REM sleep in comparison to waking. The basal ganglia were relatively more active on the right in REM sleep and symmetrical in NREM sleep.

  6. Risk factors for automobile accidents caused by falling asleep while driving in obstructive sleep apnea syndrome.

    Science.gov (United States)

    Arita, Aki; Sasanabe, Ryujiro; Hasegawa, Rika; Nomura, Atsuhiko; Hori, Reiko; Mano, Mamiko; Konishi, Noriyuki; Shiomi, Toshiaki

    2015-12-01

    We examined the risk factors for automobile accidents caused by falling asleep while driving in subjects with obstructive sleep apnea syndrome (OSAS). We asked licensed drivers with history of snoring and excessive daytime sleepiness who had undergone polysomnography (PSG) at the Department of Sleep Medicine/Sleep Disorders Center at Aichi Medical University Hospital to complete the questionnaires on accidents caused by falling asleep while driving. As a subjective measure of sleepiness, we used the Epworth sleepiness scale (ESS). Based on PSG results, 2387 subjects diagnosed with OSAS were divided into three groups according to apnea-hypopnea index (AHI): mild-to-moderate (5 ≤ AHI driving when drowsy and having accidents in the past 5 years due to falling asleep. Our multivariate analysis suggests that scores on the ESS and patient-reported frequency of feeling drowsy while regular driving and working are related to automobile accidents caused by falling asleep while driving.

  7. Sex Effect on Obesity Indices and Metabolic Outcomes in Patients with Obese Obstructive Sleep Apnea and Type 2 Diabetes After Laparoscopic Roux-en-Y Gastric Bypass Surgery: a Preliminary Study.

    Science.gov (United States)

    Xu, Huajun; Zhang, Pin; Han, Xiaodong; Yu, Haoyong; Di, Jianzhong; Zou, Jianyin; Wang, Yuyu; Qian, Yingjun; Tu, Yinfang; Bao, Yuqian; Yi, Hongliang; Guan, Jian; Yin, Shankai; Jia, Weiping

    2016-11-01

    Roux-en-Y gastric bypass (RYGB) surgery is an effective therapy for obstructive sleep apnea (OSA). However, little attention has been paid to the treatment goals systematically stratified by sex. The objective of this study was to assess how sex differences affect obesity indices and metabolic outcomes after RYGB surgery. A sleep questionnaire was conducted and medical histories were taken. Full-night polysomnography (PSG), anthropometric variables, and blood samples were collected. Thirty-five consecutive patients with OSA who underwent laparoscopic RYGB surgery were prospectively examined for at least 6 months were included in the study. Significant improvements (p sleep parameters (except for micro-arousal), obesity indices, and metabolic outcomes [except low-density lipoprotein in men and high-density lipoprotein (HDL) in women] were obtained in men and women with OSA. Men had higher baseline triglyceride (TG) (p Sleep parameters, obesity indices, and metabolic outcomes after RYGB surgery were of similar magnitude in women and men with OSA. Alleviating sleep and obesity problems was correlated with metabolic outcomes in men and women.

  8. Sleep Apnea

    Science.gov (United States)

    ... repeated awakenings associated with sleep apnea make normal, restorative sleep impossible. People with sleep apnea often experience ... et al. Sleep breathing disorders. In: Principles and Practice of Sleep Medicine. 5th ed. St. Louis, Mo.: ...

  9. Global Gene Expression Profiles and Proteomic Assessments in Adult Females with Obstructive Sleep Apnea Syndrome

    OpenAIRE

    Newsome, Laura Jean

    2012-01-01

    Obstructive sleep apnea syndrome (OSAS) is a complex disorder characterized by repetitive bouts of upper airway collapse during sleep, causing subsequent intermittent hypoxia, hypercapnia, and fragmented sleep and is also associated with significant morbidity including daytime sleepiness, hypertension, and elevated cardiovascular risk. OSAS affects at least 4% of men and 2% of women; unfortunately, it is estimated that 80% to 90% of adults with OSAS remain undiagnosed. Both clinical character...

  10. The validation of a new actigraphy system for the measurement of periodic leg movements in sleep.

    Science.gov (United States)

    King, Martin A; Jaffre, Marc-Olivier; Morrish, Emma; Shneerson, John M; Smith, Ian E

    2005-11-01

    To determine the accuracy of a new actigraphy system for the measurement of periodic leg movements (PLMs). Continuous measurements of leg movements, made overnight, are essential to diagnose and monitor treatment for PLMs. We have developed the Actiwatch with Cambridge Neuro-Technology Ltd (Cambridge, UK) to detect leg movements consistent with PLMs, to record these movements from both feet over three consecutive nights and to report standard indices of PLMs. We describe three studies designed to validate this device. The Actiwatch was assessed on a bench model across a range of movement amplitudes. The level of agreement on individual movements between the Actiwatch and bilateral anterior tibialis electromyography (BATEMG) measures was assessed in 199 epochs from five patients with known PLMs. The ability of the Actiwatch to correctly identify patients with PLMs was assessed in a comparison with polysomnography (PSG) in 50 consecutive patients investigated in the sleep laboratory. The Actiwatch detected all mechanically generated movements (100% sensitivity and 100% specificity) on the bench test. On individual movements BATEMG measurement and the Actiwatch agreed on 94% of epochs. The sensitivity and specificity of the Actiwatch to detect leg movements in severe PLMs as defined by BATEMG (PLMI>or=25) are high (100% sensitive and 97% specific). Our bilateral system gave better agreement with BATEMG than previous systems but the two measures are still not interchangeable. EMG is only a surrogate measure of limb movement and indices measured in this way correlate poorly with symptoms. We have demonstrated that the Actiwatch faithfully records movement, which offers the potential to reassess the relationships between limb movement indices and symptoms. This which offers a convenient and economical alternative to PSG in the study of large populations to increase our understanding of the epidemiology and clinical significance of PLMs.

  11. Longitudinal assessment of sleep disordered breathing in Vietnam veterans with post-traumatic stress disorder

    Directory of Open Access Journals (Sweden)

    Yesavage JA

    2014-10-01

    Full Text Available Jerome A Yesavage,1,2 Lisa M Kinoshita,1,2 Art Noda,2 Laura C Lazzeroni,2 Jennifer Kaci Fairchild,1,2 Leah Friedman,1,2 Gundeep Sekhon,1,2 Stephanie Thompson,1,2 Jauhtai Cheng,1,2 Jamie M Zeitzer1,2 1Department of Veterans Affairs Health Care System, Palo Alto, CA, USA; 2Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA Purpose: Previous work has demonstrated the relatively high prevalence of risk factors for cognitive impairment, such as sleep disordered breathing (SDB and obesity, in Vietnam War era veterans with post-traumatic stress disorder (PTSD. No data are currently available on the longitudinal stability of SDB as a risk factor for cognitive decline in that population, which this study now reports. Methods: Sample consisted of 48 veterans of the Vietnam War with PTSD who completed longitudinal sleep assessments over a 3-year period. The primary outcome measure, the Apnea-Hypopnea Index (AHI indicator, was determined during standard overnight polysomnography. Body mass index (BMI was calculated using standard measurements. Measures of cognitive function tapped auditory verbal memory as measured by the Rey Auditory Verbal Learning Test and executive functioning as measured by the Color-Word Interference Test of the Delis–Kaplan Executive Function System battery. Statistical analyses included mixed effects modeling. Results: In this sample, AHI increased significantly by 2.19 points per year (β=2.19; P<0.005. AHI worsened over the 3-year period, increasing from a mean of 18.7±15.7 to 24.7±17.4 points. Neither BMI nor cognition showed significant change over the 3-year period. Conclusion: SDB worsened in a group of veterans of the Vietnam War with PTSD over a 3-year period. The worsening of SDB over time suggests the need for appropriate countermeasures in populations at risk for progression of the condition. Keywords: SDB, PTSD, sleep apnea, BMI, obesity, cognition

  12. PREVALENCE AND FACTORS AFFECTING REM AND SLOW WAVE SLEEP REBOUND ON CPAP TITRATION STUDY IN PATIENTS WITH OBSTRUCTIVE SLEEP APNEA Prevalencia de los factores que afectan el sueño REM y el brote de ondas lentas en los estudios con CPAP en apnea obstructiva del sueño

    Directory of Open Access Journals (Sweden)

    Edgar Osuna S

    2008-03-01

    Full Text Available Background. In patients with obstructive sleep apnea syndrome (OSAS treatment with CPAP results in an increase of REM sleep and slow wave sleep, but there is limited information about the prevalence of REM rebound in patients with OSAS and possible factors related to the rebound. Objective. REM rebound (RR and slow wave sleep rebound (SWSR has been described as a frequent phenomenon that occurs during CPAP titration, but the quantity that qualify for RR has not been mentioned in literature. The objective of our study was to determine the prevalence of REM rebound and slow wave sleep rebound in our sleep disorders center, to attempt to define RR and look for factors that may affect RR and SWSR on the first night of CPAP titration. Materials and methods. We included patients who had both baseline polysomnogram (bPSG and CPAP polysomnogram (cPSG studies done in the same laboratory. We included 179 patients>18 years with Apnea hypopnea index (AHI>10/hr on the baseline study, with an adequate CPAP titration study. We compared the percentages of REM sleep and slow wave sleep during bPSG and cPSG. We analyzed the frequency of presentation and looked for the factors affecting RR and SWSR. Results. 179 patients were enrolled (M/F:118/61, with a mean age of 48.6±4 for men, and 51.6±12.9 for women. The mean interval between the bPSG and cPSG was 45 days. The mean REM percentage during the bPSG was 15.55 percent and during cPSG study it was 21.57 percent. We took 6 percent as our differential point as the results became statistically significant at this point (p:0001. We therefore present our data by dividing our patients population with RR6%. The mean SWS percentage during the bPSG was 8.11±9.68 and during the cPSG was 13.17±10, with a p:0.35 which is not statistically significant. The multiple regression model showed that the variables that contribute more to the REM change are: REM sleep during bPSG (-0.56, bAHI (0.24 and the body mass index (0

  13. Sleep-Related Breathing Disorders in Patients With Tumors in the Head and Neck Region

    Science.gov (United States)

    Balachandran, Diwakar; Hessel, Amy C.; Lei, Xiudong; Beadle, Beth M.; William, William N.; Bashoura, Lara

    2014-01-01

    Background. Sleep disturbance is a prominent complaint of cancer patients. Most studies have focused on insomnia and cancer-related fatigue. Obstructive sleep apnea (OSA) has been reported in small studies and case reports. Methods. In a retrospective review of patients who underwent formal sleep evaluation and polysomnography (PSG) from 2006 to 2011, 56 patients with tumors in the head and neck region were identified. Clinical characteristics, sleep-related history, and PSG data were reviewed. Results. Most patients had active cancer (80%), and the majority had squamous pathology (68%). Prominent symptoms included daytime fatigue (93%), daytime sleepiness (89%), and snoring (82%). Comorbid conditions primarily included hypertension (46%) and hypothyroidism (34%). Significant sleep-related breathing disorder was noted in 93% of patients, and 84% met clinical criteria for OSA. A male predominance (77%) was noted, and patients were not obese (body mass index <30 kg/m2 in 52%). The majority of patients (79%) underwent radiation prior to sleep study, of which 88% had OSA, and in the group without prior radiation, 67% had OSA. Adherence to positive airway pressure (PAP) therapy was slightly better when compared with the general population. A subset of patients with persistent hypoxia despite advanced forms of PAP required tracheostomy. Multivariate analysis revealed that patients with active disease and radiation prior to PSG were more likely to have OSA. Conclusion. Sleep-related breathing disorder was common in patients with tumors in the head and neck region referred for evaluation of sleep disruption, and most met clinical criteria for OSA. Daytime fatigue and sleepiness were the most common complaints. OSA was prevalent in male patients, and most with OSA were not obese. Architectural distortion from the malignancy and/or treatment may predispose these patients to OSA by altering anatomic and neural factors. A heightened clinical suspicion for sleep

  14. Assessment Of Noise-induced Sleep Fragility In Two Age Ranges By Means Of Polysomnographic Microstructure

    Science.gov (United States)

    Terzano, M. G.; Parrino, L.; Spaggiari, M. C.; Buccino, G. P.; Fioriti, G.; Depoortere, H.

    1993-04-01

    The microstructure of sleep, which translates the short-lived fluctuations of the arousal level, is a commonly neglected feature in polysomnographic studies. Specifically arranged microstructural EEG events may provide important information on the dynamic characteristics of the sleep process. CAP (cyclic alternating pattern) and non-CAP are complementary modalities in which arousal-related "phasic" EEG phenomena are organized in non-REM sleep, and they correspond to opposite conditions of unstable and stable sleep depth, respectively. Thus, arousal instability can be measured by the CAP rate, the percentage ratio of total CAP time to total non-REM sleep time. The CAP rate, an age-related physiological variable that increases in several pathological conditions, is highly sensitive to acoustic perturbation. In the present study, two groups of healthy subjects without complaints about sleep, belonging to different age ranges (six young adults, three males and three females, between 20 and 30 years, and six middle-aged individuals, three males and three females, between 40 and 55 years) slept, after adaptation to the sleep laboratory, in a random sequence for two non-consecutive nights either under silent baseline (27·3 dB(A) Lcq) or noise-disturbed (continuous 55 dB(A) white noise) conditions. Age-related and noise-related effects on traditional sleep parameters and on the CAP rate were statistically evaluated by a split-plot test. Compared to young adults, the middle-aged individuals showed a significant reduction of total sleep time, stage 2 and REM sleep and significantly higher values of nocturnal awakenings and the CAP rate. The noisy nights were characterized by similar alterations. The disruptive effects of acoustic perturbation were greater on the more fragile sleep architecture of the older group. The increased fragility of sleep associated with aging probably reflects the decreased capacity of the sleeping brain to maintain steady states of vigilance. Total

  15. Relationship between actigraphy-assessed sleep quality and fat mass in college students.

    Science.gov (United States)

    Kahlhöfer, Julia; Karschin, Judith; Breusing, Nicolle; Bosy-Westphal, Anja

    2016-02-01

    Only a few studies have used objective measurements to investigate the relationship between sleep quality and obesity. These studies showed controversial results. Sleep efficiency was measured by Actiwatch 2 in 132 healthy students (age 23.3 ± 3.7 years, BMI 23.1 ± 4.1 kg/m(2) ) for 12 ± 3 nights, differentiating between work and free days. Physical activity, dietary habits, and autonomic function (heart rate variability, HRV) were analyzed as potential determinants of sleep quality and its relationship with body composition. Sleep efficiency was 87.0% in women and 84.9% in men (P sleep efficiency was associated with a higher fat mass. This was true for sleep efficiency on work days in women [fat mass index (FMI): r = -0.35, P sleep efficiency was associated with less physical activity (r = 0.29, P sleep efficiency was associated with higher fat mass. The relationship between sleep quality and fat mass differs between work and free days and may be explained by physical activity and autonomic function in women and dietary habits in men. © 2015 The Obesity Society.

  16. Assessing Whether the Association Between Sleep Apnea and Diabetes is Bidirectional.

    Science.gov (United States)

    Liu, Chia-Lin; Wu, Chi-Shin

    2017-04-01

    To determine whether there is a bidirectional association between sleep apnea and diabetes mellitus. We conducted longitudinal analyses of a population-based cohort over 12 years using Taiwan's national universal health insurance database. In analysis I, we included 102 355 individuals without type 2 diabetes mellitus at baseline and estimated the hazard ratio of incident diagnosis of type 2 diabetes mellitus for patients with and those without sleep apnea. In analysis II, we included 258 053 participants without sleep apnea at baseline and calculated the hazard ratio of developing sleep apnea for patients with and those without type 2 diabetes. In analysis I, the incidence rates of type 2 diabetes were 17.7 and 11.1 per 1000 person-years for patients with and those without sleep apnea, respectively. Patients with sleep apnea had an increased risk for diabetes (adjusted hazard ratio [aHR] = 1.33; 95% confidence interval [CI], 1.22 to 1.46). In analysis II, the risk for sleep apnea with diabetes was not statistically significant (aHR = 1.06; 95% CI, 0.98 to 1.16). These associations in both analyses did not substantively change after accounting for various latent periods. Baseline sleep apnea is associated with incident type 2 diabetes; however, the presence of type 2 diabetes cannot predict the development of sleep apnea. Copyright © 2016 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

  17. Insomnia Phenotypes Based on Objective Sleep Duration in Adolescents: Depression Risk and Differential Behavioral Profiles

    Directory of Open Access Journals (Sweden)

    Julio Fernandez-Mendoza

    2016-12-01

    Full Text Available Based on previous studies on the role of objective sleep duration in predicting morbidity in individuals with insomnia, we examined the role of objective sleep duration in differentiating behavioral profiles in adolescents with insomnia symptoms. Adolescents from the Penn State Child Cohort (n = 397, ages 12–23, 54.7% male underwent a nine-hour polysomnography (PSG, clinical history, physical examination and psychometric testing, including the Child or Adult Behavior Checklist and Pediatric Behavior Scale. Insomnia symptoms were defined as a self-report of difficulty falling and/or staying asleep and objective “short” sleep duration as a PSG total sleep time ≤7 h. A significant interaction showed that objective short sleep duration modified the association of insomnia symptoms with internalizing problems. Consistently, adolescents with insomnia symptoms and short sleep duration were characterized by depression, rumination, mood dysregulation and social isolation, while adolescents with insomnia symptoms and normal sleep duration were characterized by rule-breaking and aggressive behaviors and, to a lesser extent, rumination. These findings indicate that objective sleep duration is useful in differentiating behavioral profiles among adolescents with insomnia symptoms. The insomnia with objective short sleep duration phenotype is associated with an increased risk of depression earlier in the lifespan than previously believed.

  18. Sleep Quality Estimation based on Chaos Analysis for Heart Rate Variability

    Science.gov (United States)

    Fukuda, Toshio; Wakuda, Yuki; Hasegawa, Yasuhisa; Arai, Fumihito; Kawaguchi, Mitsuo; Noda, Akiko

    In this paper, we propose an algorithm to estimate sleep quality based on a heart rate variability using chaos analysis. Polysomnography(PSG) is a conventional and reliable system to diagnose sleep disorder and to evaluate its severity and therapeatic effect, by estimating sleep quality based on multiple channels. However, a recording process requires a lot of time and a controlled environment for measurement and then an analyzing process of PSG data is hard work because the huge sensed data should be manually evaluated. On the other hand, it is focused that some people make a mistake or cause an accident due to lost of regular sleep and of homeostasis these days. Therefore a simple home system for checking own sleep is required and then the estimation algorithm for the system should be developed. Therefore we propose an algorithm to estimate sleep quality based only on a heart rate variability which can be measured by a simple sensor such as a pressure sensor and an infrared sensor in an uncontrolled environment, by experimentally finding the relationship between chaos indices and sleep quality. The system including the estimation algorithm can inform patterns and quality of own daily sleep to a user, and then the user can previously arranges his life schedule, pays more attention based on sleep results and consult with a doctor.

  19. Blood count values and ratios for predicting sleep apnea in obese children.

    Science.gov (United States)

    Erdim, Ibrahim; Erdur, Omer; Oghan, Fatih; Mete, Fatih; Celik, Mustafa

    2017-07-01

    To detect whether the mean platelet volume (MPV), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) are contributing factors in the diagnosis and severity of sleep apnea in obese children. Obesity is a public health problem, and its prevalence increases daily. Although PSG is the gold standard test in the investigation of sleep apnea, the application of this test requires equipment, personnel, time, and cost. There is no simple laboratory test for diagnosing and determining the severity of sleep apnea. Recently, MPV, NLR, and PLR, known as the inflammatory markers in CBC test parameters, have been investigated in some studies. We aim to investigate whether these parameters could provide a method for diagnosing and determining the severity of OSAS in obese children. Clinical records of 180 patients were evaluated. All subjects had venous blood samples collected from the antecubital vein in the morning, after an overnight fasting, one day before PSG. Hemoglobin, RDW, MPV, PLT, platelet distribution width (PDW), and WBC count were measured. After anthropometric and laboratory analysis, 127 obese children were assessed for sleep study. Eighty-three patients who met the required polysomnographic criteria were divided into three groups as follows: group A [non-OSAS, apnea-plus-hypopnea index (AHI) values were not statistically significant among groups. However, the number of awakenings, AHI, oxygen desaturation events, mean oxygen saturation, lowest oxygen saturation, average desaturation, and snoring time values had significant difference among the groups. There was no statistically significant difference among the groups in terms of WBC, Hemoglobin, platelets, PDW, neutrophil, and lymphocyte values. However, RDW values showed a statistically significant difference between groups A and C. Although there was no statistically significant difference of MPV values among groups, NLR and PLR values were statistically significant between groups A

  20. Assessment of ventilatory neuromuscular drive in patients with obstructive sleep apnea

    Directory of Open Access Journals (Sweden)

    L.R.A. Bittencourt

    1998-04-01

    Full Text Available The presence of abnormalities of the respiratory center in obstructive sleep apnea (OSA patients and their correlation with polysomnographic data are still a matter of controversy. Moderately obese, sleep-deprived OSA patients presenting daytime hypersomnolence, with normocapnia and no clinical or spirometric evidence of pulmonary disease, were selected. We assessed the ventilatory control and correlated it with polysomnographic data. Ventilatory neuromuscular drive was evaluated in these patients by measuring the ventilatory response (VE, the inspiratory occlusion pressure (P.1 and the ventilatory pattern (VT/TI, TI/TTOT at rest and during submaximal exercise, breathing room air. These analyses were also performed after inhalation of a hypercapnic mixture of CO2 (DP.1/DPETCO2, DVE/DPETCO2. Average rest and exercise ventilatory response (VE: 12.2 and 32.6 l/min, respectively, inspiratory occlusion pressure (P.1: 1.5 and 4.7 cmH2O, respectively, and ventilatory pattern (VT/TI: 0.42 and 1.09 l/s; TI/TTOT: 0.47 and 0.46 l/s, respectively were within the normal range. In response to hypercapnia, the values of ventilatory response (DVE/DPETCO2: 1.51 l min-1 mmHg-1 and inspiratory occlusion pressure (DP.1/DPETCO2: 0.22 cmH2O were normal or slightly reduced in the normocapnic OSA patients. No association or correlation between ventilatory neuromuscular drive and ventilatory pattern, hypersomnolence score and polysomnographic data was found; however a significant positive correlation was observed between P.1 and weight. Our results indicate the existence of a group of normocapnic OSA patients who have a normal awake neuromuscular ventilatory drive at rest or during exercise that is partially influenced by obesity

  1. Validation of a clinical assessment score for pediatric sleep-disordered breathing.

    Science.gov (United States)

    Goldstein, Nira A; Stefanov, Dimitre G; Graw-Panzer, Katharina D; Fahmy, Samir A; Fishkin, Sherry; Jackson, Alison; Sarhis, Jennifer S; Weedon, Jeremy

    2012-09-01

    To validate a clinical assessment score for pediatric sleep-disordered breathing. Prospective instrument validation. One hundred children scheduled for overnight polysomnography were evaluated by a standardized history and physical examination and assigned a clinical assessment score. Parents completed the Obstructive Sleep Apnea (OSA)-18, the Pediatric Quality of Life Inventory (PedsQL) 4.0, and the Child Behavior Checklist questionnaires. Children with positive polysomnography underwent adenotonsillectomy or adenoidectomy. The identical assessments were performed at a mean follow-up of 8 months. Item reduction yielded a score of 15 items (Clinical Assessment Score-15 [CAS-15]) that demonstrated the best internal consistency and predictive utility (Cronbach α = .80). Intraclass correlation (ICC) demonstrated good intrarater (ICC, 0.78; 95% confidence interval [CI], 0.58 to 0.89) and inter-rater agreement (ICC, 0.65; 95% CI, 0.26 to 0.84). All change scores were significantly improved after surgery. Effect sizes were large for the CAS-15 (2.6), OSA-18 (2.4), and apnea-hypopnea index (1.4), and moderate for the Child Behavior Checklist (0.7) and PedsQL 4.0 (-0.5). Moderate to strong correlation was found between the initial CAS-15 scores and the external measures (|r| between 0.32 and 0.65). Receiver operating characteristic curves were constructed to determine the optimal initial CAS-15 score for predicting positive polysomnography. The area under the curve was 0.77 (95% CI, 0.67 to 0.87); and a score ≥32 yielded a sensitivity of 77.3% (95% CI, 65.3 to 86.7) and a specificity of 60.7% (95% CI, 40.6 to 78.5). The CAS-15 proved useful in an office setting and correctly diagnosed 72% of referred children when compared to polysomnography. It correlated well with external measures and demonstrated a good response to clinical change. Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc.

  2. Automatic sleep scoring in normals and in individuals with neurodegenerative disorders according to new international sleep scoring criteria

    DEFF Research Database (Denmark)

    Jensen, Peter S.; Sørensen, Helge Bjarup Dissing; Jennum, P. J.

    2010-01-01

    Introduction: Reliable polysomnographic classification is the basis for evaluation of sleep disorders in neurological diseases. Aim: To develop a fully automatic sleep scoring algorithm on the basis of a reproduction of new international sleep scoring criteria from the American Academy of Sleep...... Medicine (AASM). Methods: A biomedical signal processing algorithm was developed, allowing for automatic sleep depth quantification of routine polysomnographic (PSG) recordings through feature extraction, supervised probabilistic Bayesian classification, and heuristic rule-based smoothing. The performance...... of the algorithm was tested using 28 manually classified day-night PSGs from 18 normal subjects and 10 patients with Parkinson's disease (PD) or multiple system atrophy (MSA). This led to quantification of automaticversus- manual epoch-by-epoch agreement rates for both normal and abnormal recordings. Results...

  3. Evaluation of a 2-channel portable device and a predictive model to screen for obstructive sleep apnea in a laboratory environment.

    Science.gov (United States)

    Zou, Jianyin; Meng, Lili; Liu, Yupu; Xu, Xiaoxi; Liu, Suru; Guan, Jian; Yin, Shankai; Yi, Hongliang

    2015-03-01

    Various portable monitors for identifying obstructive sleep apnea (OSA) have been investigated and reported to enable accurate recording of OSA severity. However, more information is needed from different populations. This study was conducted to evaluate the efficiency of a portable 2-channel sleep apnea device (SleepView) for screening OSA in the Chinese population. Ninety-three consecutive subjects underwent simultaneous SleepView testing and laboratory polysomnography (PSG) monitoring. Data were collected and blindly analyzed. The efficiency of the SleepView device and a newly established predictive model for identifying OSA was evaluated in comparison with PSG. Good agreement was evident between the SleepView and PSG based on the apnea-hypopnea index (AHI; r(2) = 0.84, P 15, and > 30 was 0.923, 0.924, and 0.979, respectively. When the AHI and oxygen desaturation index calculated by the SleepView were combined with waist circumference, the new predictive model showed a higher sensitivity of 92.96% and a specificity of 95.45% for a PSG AHI of ≥ 5, and the corresponding area under the receiver operating curve was 0.983. The SleepView device exhibited acceptable diagnostic accuracy for OSA in the Chinese population, especially in the severe OSA group. A practical predictive model comprising waist circumference, AHI, and oxygen desaturation index obtained with the SleepView was highly effective for screening even mild OSA. This simple and practical device may serve as a useful tool to screen for OSA. Further studies are required to validate the diagnostic efficiency of the SleepView in the home environment and in different populations. Copyright © 2015 by Daedalus Enterprises.

  4. Impact of dronabinol on quantitative electroencephalogram (qEEG) measures of sleep in obstructive sleep apnea syndrome.

    Science.gov (United States)

    Farabi, Sarah S; Prasad, Bharati; Quinn, Lauretta; Carley, David W

    2014-01-15

    To determine the effects of dronabinol on quantitative electroencephalogram (EEG) markers of the sleep process, including power distribution and ultradian cycling in 15 patients with obstructive sleep apnea (OSA). EEG (C4-A1) relative power (% total) in the delta, theta, alpha, and sigma bands was quantified by fast Fourier transformation (FFT) over 28-second intervals. An activation ratio (AR = [alpha + sigma] / [delta + theta]) also was computed for each interval. To assess ultradian rhythms, the best-fitting cosine wave was determined for AR and each frequency band in each polysomnogram (PSG). Fifteen subjects were included in the analysis. Dronabinol was associated with significantly increased theta power (p = 0.002). During the first half of the night, dronabinol decreased sigma power (p = 0.03) and AR (p = 0.03), and increased theta power (p = 0.0006). At increasing dronabinol doses, ultradian rhythms accounted for a greater fraction of EEG power variance in the delta band (p = 0.04) and AR (p = 0.03). Females had higher amplitude ultradian rhythms than males (theta: p = 0.01; sigma: p = 0.01). Decreasing AHI was associated with increasing ultradian rhythm amplitudes (sigma: p < 0.001; AR: p = 0.02). At the end of treatment, lower relative power in the theta band (p = 0.02) and lower AHI (p = 0.05) correlated with a greater decrease in sleepiness from baseline. This exploratory study demonstrates that in individuals with OSA, dronabinol treatment may yield a shift in EEG power toward delta and theta frequencies and a strengthening of ultradian rhythms in the sleep EEG.

  5. What's Keeping Teenagers Up? Prebedtime Behaviors and Actigraphy-Assessed Sleep Over School and Vacation.

    Science.gov (United States)

    Harbard, Emily; Allen, Nicholas B; Trinder, John; Bei, Bei

    2016-04-01

    Technology-related behaviors (e.g., computer use) before bedtime (BT) have been associated with poorer and shorter sleep in adolescents; however, less is known about other behaviors in relation to sleep. This study characterized a range of behaviors in the hour before bed (i.e., pre-BT behaviors [PBBs]) and examined their relationship with sleep parameters during school and vacation periods (i.e., restricted and extended sleep opportunities, respectively). Mechanistic roles of chronotype and cognitive presleep arousal (PSAcog) were also examined. During the last week of a school term and throughout a 2-week vacation, 146 adolescents (47.26% male, age M ± standard deviation = 16.2 ± 1.0 years) from the general community completed daily sleep measure using actigraphy, self-report measures on PBBs and PSAcog (Presleep Arousal Scale) for both school and vacation periods, and chronotype (Morningness-Eveningness Questionnaire). Adolescents engaged in a variety of behaviors before bed. Notably, playing video games was associated with significantly later school and vacation BT and shorter school sleep duration (controlling for chronotype). During vacation, online social media was associated with significantly longer sleep onset latency, and this relationship was mediated by higher PSAcog. In contrast, on school nights, spending time with family was associated with significantly earlier BT and longer sleep duration. Technology-related PBBs video games and online social media were risk factors for shorter and poorer sleep, whereas time with family was protective of sleep duration. In addressing sleep problems in adolescents, therapeutic procedures that target the potentially addictive nature of technology use and reduce PSAcog were implicated. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  6. Therapeutic efficacy of a hybrid mandibular advancement device in the management of obstructive sleep apnea assessed with acoustic reflection technique

    Directory of Open Access Journals (Sweden)

    S S Agarwal

    2015-01-01

    Full Text Available Obstructive sleep apnea (OSA is one of the most common forms of sleep-disordered breathing. Various treatment modalities include behavior modification therapy, nasal continuous positive airway pressure (CPAP, oral appliance therapy, and various surgical modalities. Oral appliances are noninvasive and recommended treatment modality for snoring, mild to moderate OSA cases and severe OSA cases when patient is not compliant to CPAP therapy and unwilling for surgery. Acoustic reflection technique (ART is a relatively new modality for three-dimensional assessment of airway caliber in various clinical situations. The accuracy and reproducibility of acoustic rhinometry and acoustic pharyngometry assessment are comparable to computerized tomography and magnetic resonance imaging. This case report highlights the therapeutic efficacy of an innovative customized acrylic hybrid mandibular advancement device in the management of polysomnography diagnosed OSA cases, and the treatment results were assessed by ART.

  7. Inflammation Is an Important Covariate for the Crosstalk of Sleep and the HPA Axis in Rheumatoid Arthritis.

    Science.gov (United States)

    Straub, Rainer H; Detert, Jaqueline; Dziurla, René; Fietze, Ingo; Loeschmann, Peter-Andreas; Burmester, Gerd R; Buttgereit, Frank

    2017-01-01

    Rheumatoid arthritis (RA) patients have sleep problems, and inflammation influences sleep. We demonstrated that sleep quality improves during intensified treatment with methotrexate (MTX) or etanercept (ETA). Since the hypothalamic-pituitary-adrenal (HPA) axis is involved in sleep regulation, this study investigated the interrelation between sleep parameters, inflammation as objectified by C-reactive protein (CRP), and serum cortisol and adrenocorticotropic hormone (ACTH) levels. Thirty-one eligible patients (disease activity score, DAS28CRP ≥3.2) participated in a 16-week, open, prospective study of HPA axis outcomes. MTX was initiated in 15 patients (female-to-male ratio 9/6) and ETA in 16 patients (14/2). Clinical, laboratory (after polysomnography [PSG] between 8 and 9 a.m.), sleep (PSG), and HPA axis outcome parameters (after PSG between 8 and 9 a.m.) were recorded at baseline and week 16. Clinical characteristics of patients markedly improved throughout the study (e.g., DAS28CRP: p HPA axis. © 2017 S. Karger AG, Basel.

  8. Systematic literature review of patient-reported outcome measures used in assessment and measurement of sleep disorders in chronic obstructive pulmonary disease.

    Science.gov (United States)

    Garrow, Adam P; Yorke, Janelle; Khan, Naimat; Vestbo, Jørgen; Singh, Dave; Tyson, Sarah

    2015-01-01

    Sleep problems are common in patients with chronic obstructive pulmonary disease (COPD), but the validity of patient-reported outcome measures (PROMs) that measure sleep dysfunction has not been evaluated. We have reviewed the literature to identify disease-specific and non-disease-specific sleep PROMs that have been validated for use in COPD patients. The review also examined the psychometric properties of identified sleep outcome measures and extracted point and variability estimates of sleep instruments used in COPD studies. The online EMBASE, MEDLINE, PsycINFO, and SCOPUS databases for all years to May 2014 were used to source articles for the review. The review was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Criteria from the Medical Outcomes Trust Scientific Advisory Committee guidelines were used to evaluate the psychometric properties of all sleep PROMs identified. One COPD-specific and six non-COPD-specific sleep outcome measures were identified and 44 papers met the review selection criteria. We only identified one instrument, the COPD and Asthma Sleep Impact Scale, which was developed specifically for use in COPD populations. Ninety percent of the identified studies used one of two non-disease-specific sleep scales, ie, the Pittsburgh Sleep Quality Index and/or the Epworth Sleep Scale, although neither has been tested for reliability or validity in people with COPD. The results highlight a need for existing non-disease-specific instruments to be validated in COPD populations and also a need for new disease-specific measures to assess the impact of sleep problems in COPD.

  9. [Risk assessment for sleep apnea syndrome and excessive daytime sleepiness in patients with chronic obstructive pulmonary disease].

    Science.gov (United States)

    Maricić, Lana; Visević, Roberta; Vceva, Andrijana; Vcev, Aleksandar; Labor, Slavica

    2013-06-01

    (57%), and cessation of breathing during sleep in every other person in 4 cases (8.5% of patients). The t-test showed no significant differences in oxygen saturation, partial O2 and CO2 pressures between the groups of non-risk and high-risk patients according to the STOP questionnaire. For assessing the risk of sleep apnea syndrome in patients with COPD, the STOP questionnaire as a screening method has a significant role. Because of the high risk of sleep apnea syndrome in patients with COPD and considering the high level of associated cardiovascular comorbidity, it is necessary to perform polysomnography in patients at risk for timely detection and treatment of the syndrome, thus preventing its harmful consequences, with special reference to reduction of mortality in this population.

  10. Characterization of Sleep During Military Operations and the Impact of Deployment-Related Factors: The Behavioral Health Needs Assessment Survey

    Science.gov (United States)

    2014-09-11

    disruption (Durmer & Dinges, 2005). Perhaps surprisingly, even chronic partial sleep restriction (6 hours/night) produces serious deficits in working...Russo, M. B., & Balkin, T. J. (2003). Patterns of performance degradation and restoration during sleep restriction and subsequent recovery: A sleep dose...wakefulness: Dose-response effects on neurobehavioral functions and sleep physiology from chronic sleep restriction and total sleep deprivation. Sleep, 26

  11. Natural History of Excessive Daytime Sleepiness: Role of Obesity, Weight Loss, Depression, and Sleep Propensity

    Science.gov (United States)

    Fernandez-Mendoza, Julio; Vgontzas, Alexandros N.; Kritikou, Ilia; Calhoun, Susan L.; Liao, Duanping; Bixler, Edward O.

    2015-01-01

    Study Objectives: Excessive daytime sleepiness (EDS) is highly prevalent in the general population and is associated with occupational and public safety hazards. However, no study has examined the clinical and polysomnographic (PSG) predictors of the natural history of EDS. Design: Representative longitudinal study. Setting: Sleep laboratory. Participants: From a random, general population sample of 1,741 individuals of the Penn State Adult Cohort, 1,395 were followed up after 7.5 years. Measurements and Results: Full medical evaluation and 1-night PSG at baseline and standardized telephone interview at follow-up. The incidence of EDS was 8.2%, while its persistence and remission were 38% and 62%, respectively. Obesity and weight gain were associated with the incidence and persistence of EDS, while weight loss was associated with its remission. Significant interactions between depression and PSG parameters on incident EDS showed that, in depressed individuals, incident EDS was associated with sleep disturbances, while in non-depressed individuals, incident EDS was associated with increased physiologic sleep propensity. Diabetes, allergy/asthma, anemia, and sleep complaints also predicted the natural history of EDS. Conclusions: Obesity, a disorder of epidemic proportions, is a major risk factor for the incidence and chronicity of excessive daytime sleepiness (EDS), while weight loss is associated with its remission. Interestingly, objective sleep disturbances predict incident EDS in depressed individuals, whereas physiologic sleep propensity predicts incident EDS in those without depression. Weight management and treatment of depression and sleep disorders should be part of public health policies. Citation: Fernandez-Mendoza J, Vgontzas AN, Kritikou I, Calhoun SL, Liao D, Bixler EO. Natural history of excessive daytime sleepiness: role of obesity, weight loss, depression, and sleep propensity. SLEEP 2015;38(3):351–360. PMID:25581913

  12. REM Sleep Behavioral Events and Dreaming.

    Science.gov (United States)

    Muntean, Maria-Lucia; Trenkwalder, Claudia; Walters, Arthur S; Mollenhauer, Brit; Sixel-Döring, Friederike

    2015-04-15

    To clarify whether motor behaviors and/ or vocalizations during REM sleep, which do not yet fulfill diagnostic criteria for REM sleep behavior disorder (RBD) and were defined as REM sleep behavioral events (RBEs), correspond to dream enactments. 13 subjects (10 patients with Parkinson disease [PD] and 3 healthy controls) originally identified with RBE in a prospective study (DeNoPa cohort) were reinvestigated 2 years later with 2 nights of video-supported polysomnography (vPSG). The first night was used for sleep parameter analysis. During the 2nd night, subjects were awakened and questioned for dream recall and dream content when purposeful motor behaviors and/or vocalizations became evident during REM sleep. REM sleep without atonia (RWA) was analyzed on chin EMG and the cutoff set at 18.2% as specific for RBD. At the time of this investigation 9 of 13 subjects with previous RBE were identified with RBD based upon clinical and EMG criteria. All recalled vivid dreams, and 7 subjects were able to describe dream content in detail. Four of 13 subjects with RBE showed RWA values below cutoff values for RBD. Three of these 4 subjects recalled having non-threatening dreams, and 2 (of these 3) were able to describe these dreams in detail. RBE with RWA below the RBD defining criteria correlate to dreaming in this selected cohort. There is evidence that RBEs are a precursor to RBD. © 2015 American Academy of Sleep Medicine.

  13. Computing sleep deficiency.

    Science.gov (United States)

    Erren, Thomas C; Groß, J Valerie; Lewis, Philip

    2017-11-20

    Sleep deficiency is a major public health concern. Since epidemiological studies play an important role in public health evaluations, this theoretical paper pursues answers to the question: 'How can we compute sleep deficiency as informative measures of exposures or doses in observational research?' Starting from the social jetlag concept and based on the chronodisruption rationale, we illustrate and discuss five approaches (one established and four untested, each with unique strengths and limitations) to quantify sleep deficiency by focusing on the timing and duration of sleep. Hitherto, social jetlag and chronodisruption rationale were neither explicitly proposed nor developed as assessments of sleep deficiency but, as we suggest, could potentially be utilized to this end. This first foray into computing sleep deficiency in epidemiological studies makes clear that laboratory, field and epidemiological collaboration is pre-requisite to elucidating potential (co-)causal roles of sleep deficiency in disease endpoints. © 2017 European Sleep Research Society.

  14. A new approach for assessing sleep duration and postures from ambulatory accelerometry.

    Directory of Open Access Journals (Sweden)

    Cornelia Wrzus

    Full Text Available Interest in the effects of sleeping behavior on health and performance is continuously increasing-both in research and with the general public. Ecologically valid investigations of this research topic necessitate the measurement of sleep within people's natural living contexts. We present evidence that a new approach for ambulatory accelerometry data offers a convenient, reliable, and valid measurement of both people's sleeping duration and quality in their natural environment. Ninety-two participants (14-83 years wore acceleration sensors on the sternum and right thigh while spending the night in their natural environment and following their normal routine. Physical activity, body posture, and change in body posture during the night were classified using a newly developed classification algorithm based on angular changes of body axes. The duration of supine posture and objective indicators of sleep quality showed convergent validity with self-reports of sleep duration and quality as well as external validity regarding expected age differences. The algorithms for classifying sleep postures and posture changes very reliably distinguished postures with 99.7% accuracy. We conclude that the new algorithm based on body posture classification using ambulatory accelerometry data offers a feasible and ecologically valid approach to monitor sleeping behavior in sizable and heterogeneous samples at home.

  15. Assessment of sleep quality in post-graduate residents in a tertiary hospital and teaching institute

    Directory of Open Access Journals (Sweden)</