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Sample records for sleep disordered breathing

  1. Afternoon serum-melatonin in sleep disordered breathing.

    Science.gov (United States)

    Ulfberg, J; Micic, S; Strøm, J

    1998-08-01

    To study afternoon serum-melatonin values in patients with sleep disordered breathing. Melatonin has a strong circadian rhythm with high values during the night-time and low values in the afternoon. Sleep disordered breathing may change the circadian rhythm of melatonin which may have diagnostic implications. The Sleep Laboratory, The Department of Internal Medicine, Avesta Hospital, Sweden, and the Department of Anaesthesiology, Glostrup University Hospital, Copenhagen, Denmark. We examined 60 consecutive patients admitted for sleep disordered breathing and 10 healthy non snoring controls. The patients underwent a sleep apnoea screening test having a specificity of 100% for the obstructive sleep apnoea syndrome (OSAS) using a combination of static charge sensitive bed and oximetry. Obstructive sleep apnoea syndrome was found in 49 patients, eight patients had borderline sleep disordered breathing (BSDB) and three patients were excluded due to interfering disease. Patients and controls had an afternoon determination of serum-melatonin. The Epworth Sleepiness Scale was used to score day-time sleepiness. In comparison with normal controls patients suffering from OSAS had significantly higher serum-melatonin levels in the afternoon. However, as a diagnostic test for OSAS in patients with sleep disordered breathing serum-melatonin showed a low sensitivity but a high specificity. The results indicate that breathing disorders during sleep in general affect pineal function. Sleep disordered breathing seems to disturb pineal function. Determination of afternoon serum-melatonin alone or together with a scoring of daytime sleepiness does not identify OSAS-patients in a heterogeneous population of patients complaining of heavy snoring and excessive daytime sleepiness.

  2. Sleep-disordered breathing and mortality: a prospective cohort study.

    Directory of Open Access Journals (Sweden)

    Naresh M Punjabi

    2009-08-01

    Full Text Available Sleep-disordered breathing is a common condition associated with adverse health outcomes including hypertension and cardiovascular disease. The overall objective of this study was to determine whether sleep-disordered breathing and its sequelae of intermittent hypoxemia and recurrent arousals are associated with mortality in a community sample of adults aged 40 years or older.We prospectively examined whether sleep-disordered breathing was associated with an increased risk of death from any cause in 6,441 men and women participating in the Sleep Heart Health Study. Sleep-disordered breathing was assessed with the apnea-hypopnea index (AHI based on an in-home polysomnogram. Survival analysis and proportional hazards regression models were used to calculate hazard ratios for mortality after adjusting for age, sex, race, smoking status, body mass index, and prevalent medical conditions. The average follow-up period for the cohort was 8.2 y during which 1,047 participants (587 men and 460 women died. Compared to those without sleep-disordered breathing (AHI: or=30.0 events/h sleep-disordered breathing were 0.93 (95% CI: 0.80-1.08, 1.17 (95% CI: 0.97-1.42, and 1.46 (95% CI: 1.14-1.86, respectively. Stratified analyses by sex and age showed that the increased risk of death associated with severe sleep-disordered breathing was statistically significant in men aged 40-70 y (hazard ratio: 2.09; 95% CI: 1.31-3.33. Measures of sleep-related intermittent hypoxemia, but not sleep fragmentation, were independently associated with all-cause mortality. Coronary artery disease-related mortality associated with sleep-disordered breathing showed a pattern of association similar to all-cause mortality.Sleep-disordered breathing is associated with all-cause mortality and specifically that due to coronary artery disease, particularly in men aged 40-70 y with severe sleep-disordered breathing. Please see later in the article for the Editors' Summary.

  3. Increased Prevalence of Sleep-Disordered Breathing in Adults

    Science.gov (United States)

    Peppard, Paul E.; Young, Terry; Barnet, Jodi H.; Palta, Mari; Hagen, Erika W.; Hla, Khin Mae

    2013-01-01

    Sleep-disordered breathing is a common disorder with a range of harmful sequelae. Obesity is a strong causal factor for sleep-disordered breathing, and because of the ongoing obesity epidemic, previous estimates of sleep-disordered breathing prevalence require updating. We estimated the prevalence of sleep-disordered breathing in the United States for the periods of 1988–1994 and 2007–2010 using data from the Wisconsin Sleep Cohort Study, an ongoing community-based study that was established in 1988 with participants randomly selected from an employed population of Wisconsin adults. A total of 1,520 participants who were 30–70 years of age had baseline polysomnography studies to assess the presence of sleep-disordered breathing. Participants were invited for repeat studies at 4-year intervals. The prevalence of sleep-disordered breathing was modeled as a function of age, sex, and body mass index, and estimates were extrapolated to US body mass index distributions estimated using data from the National Health and Nutrition Examination Survey. The current prevalence estimates of moderate to severe sleep-disordered breathing (apnea-hypopnea index, measured as events/hour, ≥15) are 10% (95% confidence interval (CI): 7, 12) among 30–49-year-old men; 17% (95% CI: 15, 21) among 50–70-year-old men; 3% (95% CI: 2, 4) among 30–49-year-old women; and 9% (95% CI: 7, 11) among 50–70 year-old women. These estimated prevalence rates represent substantial increases over the last 2 decades (relative increases of between 14% and 55% depending on the subgroup). PMID:23589584

  4. Epidemiology of sleep apnoea/hypopnoea syndrome and sleep-disordered breathing

    DEFF Research Database (Denmark)

    Jennum, P; Riha, R L

    2009-01-01

    Epidemiological studies have revealed a high prevalence of sleep-disordered breathing in the community (up to 20%). A subset of these patients has concurrent symptoms of excessive daytime sleepiness attributable to their nocturnal breathing disorder and is classified as having obstructive sleep a...

  5. Sleep-disordered breathing in epilepsy: epidemiology, mechanisms, and treatment.

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    Sivathamboo, Shobi; Perucca, Piero; Velakoulis, Dennis; Jones, Nigel C; Goldin, Jeremy; Kwan, Patrick; O'Brien, Terence J

    2018-04-01

    Epilepsy is a group of neurological conditions in which there is a pathological and enduring predisposition to generate recurrent seizures. Evidence over the last few decades suggests that epilepsy may be associated with increased sleep-disordered breathing, which may contribute towards sleep fragmentation, daytime somnolence, reduced seizure control, and cardiovascular-related morbidity and mortality. Chronic sleep-disordered breathing can result in loss of gray matter and cause deficits to memory and global cognitive function. Sleep-disordered breathing is a novel and independent predictor of sudden cardiac death and, as such, may be involved in the mechanisms leading to sudden unexpected death in epilepsy. Despite this, the long-term consequences of sleep-disordered breathing in epilepsy remain unknown, and there are no guidelines for screening or treating this population. There is currently insufficient evidence to indicate continuous positive airway pressure (CPAP) for the primary or secondary prevention of cardiovascular disease, and recent evidence has failed to show any reduction of fatal or nonfatal cardiovascular endpoints. Treatment of sleep-disordered breathing may potentially improve seizure control, daytime somnolence, and neurocognitive outcomes, but few studies have examined this relationship. In this review, we examine sleep-disordered breathing in epilepsy, and discuss the potential effect of epilepsy treatments. We consider the role of CPAP and other interventions for sleep-disordered breathing and discuss their implications for epilepsy management.

  6. Sex differences in sleep disordered breathing in adults.

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    Lozo, Tijana; Komnenov, Dragana; Badr, M Safwan; Mateika, Jason H

    2017-11-01

    The prevalence of sleep disordered breathing is greater in men compared to women. This disparity could be due to sex differences in the diagnosis and presentation of sleep apnea, and the pathophysiological mechanisms that instigate this disorder. Women tend to report more non-typical symptoms of sleep apnea compared to men, and the presentation of apneic events are more prevalent in rapid compared to non-rapid eye movement sleep. In addition, there is evidence of sex differences in upper airway structure and mechanics and in neural mechanisms that impact on the control of breathing. The purpose of this review is to summarize the literature that addresses sex differences in sleep-disordered breathing, and to discuss the influence that upper airway mechanics, chemoreflex properties, and sex hormones have in modulating breathing during sleep in men and women. Published by Elsevier B.V.

  7. Sleep disordered breathing in spinal cord injury: A systematic review.

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    Chiodo, Anthony E; Sitrin, Robert G; Bauman, Kristy A

    2016-07-01

    Spinal cord injury commonly results in neuromuscular weakness that impacts respiratory function. This would be expected to be associated with an increased likelihood of sleep-disordered breathing. (1) Understand the incidence and prevalence of sleep disordered breathing in spinal cord injury. (2) Understand the relationship between injury and patient characteristics and the incidence of sleep disordered breathing in spinal cord injury. (3) Distinguish between obstructive sleep apnea and central sleep apnea incidence in spinal cord injury. (4) Clarify the relationship between sleep disordered breathing and stroke, myocardial infarction, metabolic dysfunction, injuries, autonomic dysreflexia and spasticity incidence in persons with spinal cord injury. (5) Understand treatment tolerance and outcome in persons with spinal cord injury and sleep disordered breathing. Extensive database search including PubMed, Cochrane Library, CINAHL and Web of Science. Given the current literature limitations, sleep disordered breathing as currently defined is high in patients with spinal cord injury, approaching 60% in motor complete persons with tetraplegia. Central apnea is more common in patients with tetraplegia than in patients with paraplegia. Early formal sleep study in patients with acute complete tetraplegia is recommended. In patients with incomplete tetraplegia and with paraplegia, the incidence of sleep-disordered breathing is significantly higher than the general population. With the lack of correlation between symptoms and SDB, formal study would be reasonable. There is insufficient evidence in the literature on the impact of treatment on morbidity, mortality and quality of life outcomes.

  8. [Prevalence of sleep-related breathing disorders of inpatients with psychiatric disorders].

    Science.gov (United States)

    Behr, M; Acker, J; Cohrs, S; Deuschle, M; Danker-Hopfe, H; Göder, R; Norra, C; Richter, K; Riemann, D; Schilling, C; Weeß, H-G; Wetter, T C; Wollenburg, L M; Pollmächer, T

    2018-06-06

    Sleep-related breathing disorders seriously impair well-being and increase the risk for relevant somatic and psychiatric disorders. Moreover, risk factors for sleep-related breathing disorders are highly prevalent in psychiatric patients. The aim of this study was for the first time in Germany to study the prevalence of obstructive sleep apnea syndrome (OSAS) as the most common form of sleep-related breathing disorder in patients with psychiatric disorders. In 10 psychiatric hospitals in Germany and 1 hospital in Switzerland, a total of 249 inpatients underwent an 8‑channel sleep polygraphy to investigate the prevalence of sleep apnea in this group of patients. With a conspicuous screening result of 23.7% of the subjects, a high prevalence of sleep-related breathing disorders was found to occur among this group of patients. Male gender, higher age and high body mass index (BMI) were identified as positive risk factors for the detection of OSAS. The high prevalence indicates that sleep apnea is a common sleep disorder among psychiatric patients. Although OSAS can lead to substantial disorders of the mental state and when untreated is accompanied by serious somatic health problems, screening procedures are not part of the routine work-up in psychiatric hospitals; therefore, sleep apnea is presumably underdiagnosed in psychiatric patients. In view of the results of this and previous studies, this topic complex should be the subject of further research studies.

  9. Health, social and economical consequences of sleep-disordered breathing

    DEFF Research Database (Denmark)

    Jennum, Poul; Kjellberg, Jakob

    2011-01-01

    The objective direct and indirect costs of sleep-disordered breathing (snoring, sleep apnoea (SA) and obesity hypoventilation syndrome (OHS)) and the treatment are incompletely described.......The objective direct and indirect costs of sleep-disordered breathing (snoring, sleep apnoea (SA) and obesity hypoventilation syndrome (OHS)) and the treatment are incompletely described....

  10. Non-breathing-related sleep disorders following stroke.

    Science.gov (United States)

    Marquez-Romero, J M; Morales-Ramírez, M; Arauz, A

    2014-01-01

    It has been shown that sleep-related breathing disorders, especially sleep apnea, are very common in patients who have had a stroke, and that they also reduce the potential for neurological recovery. Nevertheless, other sleep disorders caused by stroke (excessive daytime sleepiness, insomnia, sleep related movement disorders) can also cause or increase stroke-related disability, and this fact is less commonly known. Studies with polysomnography have shown many abnormalities in sleep architecture during the acute phase of stroke; these abnormalities have a negative impact on the patient's quality of life although they tend to improve with time. This also happens with other sleep disorders occurring as the result of a stroke (insomnia, narcolepsy, restless legs syndrome, periodic limb movement disorder and REM sleep behavior disorder), which are nevertheless potentially treatable. In this article, we briefly review the physiopathology and epidemiology of the disorders listed above in order to raise awareness about the importance of these disorders and the effects they elicit in stroke patients. Sleep disorders that are not breathing-related have scarcely been studied in stroke patients despite the fact that almost all such disorders may present as a result of a cerebrovascular event. Copyright © 2012 Sociedad Española de Neurología. Published by Elsevier Espana. All rights reserved.

  11. Topical review: sleep bruxism, headaches, and sleep-disordered breathing in children and adolescents.

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    Carra, Maria Clotilde; Bruni, Olivero; Huynh, Nelly

    2012-01-01

    Sleep bruxism, a well-known burden for dentists, is commonly observed in pediatric populations. Dentists are responsible for the detection and prevention of the detrimental consequences on the stomatognathic system that may occur in some patients with sleep bruxism. However, sleep bruxism is much more than tooth wear, since it is frequently associated with orofacial pain, headaches, and other more severe sleep disorders, such as sleep-disordered breathing. Although the mechanisms underlying the possible interactions among sleep bruxism, headaches, and sleep-disordered breathing need further research, these conditions are often concomitant. A literature search was performed to identify relevant publications related to the topic, which have been integrated in this topical review. The aim of this article was to provide a brief overview on sleep bruxism, headaches, and sleep-disordered breathing in pediatric patients and to promote a multispecialist approach (including dentists, sleep specialist physicians, and psychologists) in the diagnosis and management of these frequently associated disorders.

  12. Sleep board review questions: sleep disordered breathing that improves in REM

    Directory of Open Access Journals (Sweden)

    Budhiraja R

    2012-08-01

    Full Text Available No abstract available. Article truncated at end of question. Which of the following breathing disorders is usually less severe in rapid eye movement (REM sleep compared to non-rapid eye movement (NREM sleep?1.Sleep-related hypoxemia in COPD2.Obstructive Sleep Apnea3.Cheyne Stokes Breathing4.Hypoxemia in Pulmonary Hypertension

  13. Etiopathogenetic Mechanisms of Pulmonary Hypertension in Sleep-Related Breathing Disorders

    Directory of Open Access Journals (Sweden)

    Ayodeji Adegunsoye

    2012-01-01

    Full Text Available Obstructive sleep apnea syndrome is a common disorder with significant health consequences and is on the rise in consonance with the obesity pandemic. In view of the association between sleep-disordered breathing and pulmonary hypertension as depicted by multiple studies, current clinical practice guidelines categorize obstructive sleep apnea as a risk factor for pulmonary hypertension and recommend an assessment for sleep disordered breathing in evaluating patients with pulmonary hypertension. The dysregulatory mechanisms associated with hypoxemic episodes observed in sleep related breathing disorders contribute to the onset of pulmonary hypertension and identification of these potentially treatable factors might help in the reduction of overall cardiovascular mortality.

  14. Sleep-disordered breathing and mortality: a prospective cohort study.

    OpenAIRE

    Naresh M Punjabi; Brian S Caffo; James L Goodwin; Daniel J Gottlieb; Anne B Newman; George T O'Connor; David M Rapoport; Susan Redline; Helaine E Resnick; John A Robbins; Eyal Shahar; Mark L Unruh; Jonathan M Samet

    2009-01-01

    Editors' Summary Background About 1 in 10 women and 1 in 4 men have a chronic condition called sleep-disordered breathing although most are unaware of their problem. Sleep-disordered breathing, which is commonest in middle-aged and elderly people, is characterized by numerous, brief (10 second or so) interruptions of breathing during sleep. These interruptions, which usually occur when relaxation of the upper airway muscles decreases airflow, lower the level of oxygen in the blood and, as a r...

  15. Sleep-Disordered Breathing in Neuromuscular Disease: Diagnostic and Therapeutic Challenges.

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    Aboussouan, Loutfi S; Mireles-Cabodevila, Eduardo

    2017-10-01

    Normal sleep-related rapid eye movement sleep atonia, reduced lung volumes, reduced chemosensitivity, and impaired airway dilator activity become significant vulnerabilities in the setting of neuromuscular disease. In that context, the compounding effects of respiratory muscle weakness and disease-specific features that promote upper airway collapse or cause dilated cardiomyopathy contribute to various sleep-disordered breathing events. The reduction in lung volumes with neuromuscular disease is further compromised by sleep and the supine position, exaggerating the tendency for upper airway collapse and desaturation with sleep-disordered breathing events. The most commonly identified events are diaphragmatic/pseudo-central, due to a decrease in the rib cage contribution to the tidal volume during phasic rapid eye movement sleep. Obstructive and central sleep apneas are also common. Noninvasive ventilation can improve survival and quality of sleep but should be used with caution in the context of dilated cardiomyopathy or significant bulbar symptoms. Noninvasive ventilation can also trigger sleep-disordered breathing events, including ineffective triggering, autotriggering, central sleep apnea, and glottic closure, which compromise the potential benefits of the intervention by increasing arousals, reducing adherence, and impairing sleep architecture. Polysomnography plays an important diagnostic and therapeutic role by correctly categorizing sleep-disordered events, identifying sleep-disordered breathing triggered by noninvasive ventilation, and improving noninvasive ventilation settings. Optimal management may require dedicated hypoventilation protocols and a technical staff well versed in the identification and troubleshooting of respiratory events. Copyright © 2017 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

  16. Sleep disordered breathing following spinal cord injury

    DEFF Research Database (Denmark)

    Biering-Sørensen, Fin; Jennum, Poul; Laub, Michael

    2009-01-01

    Individuals with spinal cord injury (SCI) commonly complain about difficulty in sleeping. Although various sleep disordered breathing definitions and indices are used that make comparisons between studies difficult, it seems evident that the frequency of sleep disorders is higher in individuals...... with SCI, especially with regard to obstructive sleep apnea. In addition, there is a correlation between the incidence of sleep disturbances and the spinal cord level injured, age, body mass index, neck circumference, abdominal girth, and use of sedating medications. Regulation of respiration is dependent...... on wakefulness and sleep. Thus, it is important to be aware of basic mechanisms in the regulation and control of sleep and awake states. Supine position decreases the vital capacity in tetraplegic individuals, and diminished responsiveness to Pa(CO)(2) may further decrease ventilatory reserve. There also may...

  17. Sleep-disordered breathing in patients with myelomeningocele.

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    Patel, Daxa M; Rocque, Brandon G; Hopson, Betsy; Arynchyna, Anastasia; Bishop, E Ralee'; Lozano, David; Blount, Jeffrey P

    2015-07-01

    OBJECT A paucity of literature examines sleep apnea in patients with myelomeningocele, Chiari malformation Type II (CM-II), and related hydrocephalus. Even less is known about the effect of hydrocephalus treatment or CM-II decompression on sleep hygiene. This study is an exploratory analysis of sleep-disordered breathing in patients with myelomeningocele and the effects of neurosurgical treatments, in particular CM-II decompression and hydrocephalus management, on sleep organization. METHODS The authors performed a retrospective review of all patients seen in their multidisciplinary spina bifida clinic (approximately 435 patients with myelomeningocele) to evaluate polysomnographs obtained between March 1999 and July 2013. They analyzed symptoms prompting evaluation, results, and recommended interventions by using descriptive statistics. They also conducted a subset analysis of 9 children who had undergone polysomnography both before and after neurosurgical intervention. RESULTS Fifty-two patients had polysomnographs available for review. Sleep apnea was diagnosed in 81% of these patients. The most common presenting symptom was "breathing difficulties" (18 cases [43%]). Mild sleep apnea was present in 26 cases (50%), moderate in 10 (19%), and severe in 6 (12%). Among the 42 patients with abnormal sleep architecture, 30 had predominantly obstructive apneas and 12 had predominantly central apneas. The most common pulmonology-recommended intervention was adjustment of peripheral oxygen supplementation (24 cases [57%]), followed by initiation of peripheral oxygen (10 cases [24%]). In a subset analysis of 9 patients who had sleep studies before and after neurosurgical intervention, there was a trend toward a decrease in the mean number of respiratory events (from 34.8 to 15.9, p = 0.098), obstructive events (from 14.7 to 13.9, p = 0.85), and central events (from 20.1 to 2.25, p = 0.15) and in the apnea-hypopnea index (from 5.05 to 2.03, p = 0.038, not significant when

  18. Neuropsychological Function in Patients With Acute Tetraplegia and Sleep Disordered Breathing.

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    Schembri, Rachel; Spong, Jo; Graco, Marnie; Berlowitz, David J

    2017-02-01

    To investigate the relationship between apnea severity and neuropsychological function in patients with acute-onset tetraplegia and sleep disordered breathing. Polysomnography and neuropsychological testing were performed on 104 participants (age M = 45.60, SD = 16.38; 10 female) across 11 international sites, 2 months postinjury (M = 60.70 days, SD = 39.48). Neuropsychological tests assessed attention, information processing, executive function, memory, learning, mood, and quality of life. More severe sleep apnea was associated with poorer attention, information processing, and immediate recall. Deficits did not extend to memory. Higher preinjury intelligence and being younger reduced the associations with sleep disordered breathing; however, these protective factors were insufficient to counter the damage to attention, immediate recall, and information processing associated with sleep disordered breathing. These data suggest that new spinal cord injury may function as a model of "acute sleep apnea" and that more widespread sleep apnea-related deficits, including memory, may only be seen with longer exposure to apnea. These findings have important implications for functioning and skill acquisition during rehabilitation and, as such, highlight the importance of sleep health following tetraplegia. © Sleep Research Society 2016. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

  19. 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

  20. Morbidity prior to a Diagnosis of Sleep-Disordered Breathing

    DEFF Research Database (Denmark)

    Jennum, Poul; Ibsen, Rikke Falkner; Kjellberg, Jakob

    2013-01-01

    Sleep-disordered breathing (SDB) causes burden to the sufferer, the healthcare system, and society. Most studies have focused on cardiovascular diseases (CVDs) after a diagnosis of obstructive sleep apnea (OSA) or obesity hypoventilation syndrome (OHS); however, the overall morbidity prior...

  1. Symptoms of Sleep Disordered Breathing and Risk of Cancer

    DEFF Research Database (Denmark)

    Christensen, Anne Sofie; Clark, Alice; Salo, Paula

    2013-01-01

    Sleep disordered breathing (SDB) has been associated with oxidative stress, inflammation, and altered hormonal levels, all of which could affect the risk of cancer. The aim of the study is to examine if symptoms of SDB including snoring, breathing cessations, and daytime sleepiness affect...

  2. 78 FR 25475 - Certain Sleep-Disordered Breathing Treatment Systems and Components Thereof: Institution of...

    Science.gov (United States)

    2013-05-01

    ... INTERNATIONAL TRADE COMMISSION [Investigation No. 337-TA-879] Certain Sleep-Disordered Breathing... States after importation of certain sleep-disordered breathing treatment systems and components thereof... (202) 205-1810. Persons with mobility impairments who will need special assistance in gaining access to...

  3. Prevalence of sleep breathing complaints reported by treatment-seeking chronic insomnia disorder patients on presentation to a sleep medical center: a preliminary report.

    Science.gov (United States)

    Krakow, Barry; Ulibarri, Victor A

    2013-03-01

    Few studies have examined the co-morbidity between insomnia and sleep-disordered breathing in the clinical setting. This study evaluated treatment-seeking insomnia patients and their self-report of sleep breathing complaints. A retrospective chart review was conducted on 1,035 consecutive treatment-seeking, chronic insomnia patients who reported insomnia as their primary problem upon seeking care at a private, community-based sleep medical center. Measurements included the insomnia severity index, standard subjective sleep measures as well as rankings, attributions, and self-reports about sleep breathing disorders, problems, and symptoms. A total of 1,035 adult, treatment-seeking insomnia patients indicated insomnia interfered with daytime functioning, and their average insomnia severity was in the range of a clinically relevant problem: total sleep time (5.50 h, SD = 1.60), sleep efficiency (71.05 %, SD = 18.26), wake time after sleep onset (120.70 min, SD = 92.56), and an insomnia severity index (18.81, SD = 5.09). Of these 1,035 insomnia patients, 42 % also ranked a sleep breathing disorder among their list of reasons for seeking treatment, another 13 % revealed a concern about a sleep breathing problem, and another 26 % reported awareness of sleep breathing symptoms. Only 19 % of this clinical insomnia sample reported no awareness or concerns about sleep breathing disorders, problems, or symptoms. A greater proportion of men than women reported significantly more sleep breathing disorders, problems, or symptoms. Sleep breathing complaints were extremely common among a large sample of treatment-seeking, self-identified, adult chronic insomnia patients. Prospective prevalence research is needed to corroborate or revise these findings, and polysomnography should be considered in appropriate cohorts to determine the clinical relevance of treatment-seeking chronic insomnia patients' sleep breathing complaints.

  4. Medical consequences and associations with untreated sleep-related breathing disorders and outcomes of treatments.

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    Norman, Daniel; Haberman, Paul B; Valladares, Edwin M

    2012-02-01

    Sleep-related breathing disorders are a broad group of disorders that include obstructive sleep apnea, central sleep apnea, and periodic breathing disorders. This article reviews the scientific literature that links SRBD to various medical conditions including hypertension, coronary artery disease, cardiac arrhythmias, stroke, diabetes mellitus, obesity, and depression. Pathophysiologic mechanisms by which SRBD may contribute to these disorders will be discussed, as will data on the degree to which treatment of SRBD may improve these conditions.

  5. 78 FR 52563 - Certain Sleep-Disordered Breathing Treatment Systems and Components Thereof; Notice of...

    Science.gov (United States)

    2013-08-23

    ... INTERNATIONAL TRADE COMMISSION [Investigation No. 337-TA-890] Certain Sleep-Disordered Breathing... certain sleep- disordered breathing treatment systems and components thereof by reason of infringement of... terminal on (202) 205-1810. Persons with mobility impairments who will need special assistance in gaining...

  6. Psychomotor development in infants with Prader-Willi syndrome and associations with sleep-related breathing disorders.

    NARCIS (Netherlands)

    Festen, D.A.M.; Wevers, M.; Weerd, A.W. de; Bossche, R.A. van den; Duivenvoorden, H.J.; Otten, B.J.; Wit, J.M.; Hokken-Koelega, A.C.S.

    2007-01-01

    Prader-Willi syndrome (PWS) is a neurogenetic disorder with hypotonia, psychomotor delay, obesity, short stature, and sleep-related breathing disorders. The aim of this study was to evaluate the association between psychomotor development and sleep-related breathing disorders in PWS infants. Bayley

  7. Lung function, diagnosis, and treatment of sleep-disordered breathing in children with achondroplasia.

    Science.gov (United States)

    Julliand, Sébastien; Boulé, Michèle; Baujat, Geneviève; Ramirez, Adriana; Couloigner, Vincent; Beydon, Nicole; Zerah, Michel; di Rocco, Federico; Lemerrer, Martine; Cormier-Daire, Valérie; Fauroux, Brigitte

    2012-08-01

    Children with achondroplasia are at risk of sleep-disordered breathing. The aim of the study was to evaluate lung function and sleep-disordered breathing in children with achondroplasia. An interview, clinical examination, lung function tests with blood gases, and a polygraphic sleep study were obtained as part of routine annual evaluation in consecutive children with achondroplasia. We included 30 children (median age 3.0 years, range: 0.4-17.1) over a period of 21 months. Habitual snoring and witnessed apneas were observed in 77% and 33% of the patients, respectively. Prior to the sleep study, 10/29 (34%) patients had undergone upper airway surgery and 5/29 (17%) craniocervical decompression operation. Arterial blood gases were abnormal in two (7%) patients. Sleep findings were abnormal in 28/30 (93%) patients. Eleven (37%) patients had an apnea index≥1 event/hr and 26 (87%) had an apnea-hypopnea index≥5 events/hr. The ≥3% desaturation index was >5/hr in 22 (73%) patients. Sixteen (53%) patients had a minimal pulse oximetry50 mmHg during sleep. As a consequence, the following therapeutic interventions were performed: upper airway surgery in four patients and noninvasive positive pressure ventilation (NPPV) in five other patients, resulting in an improvement in sleep studies in all nine patients. Systematic sleep studies are recommended in children with achondroplasia because of the high prevalence of sleep-disordered breathing. Upper airway surgery and NPPV are effective treatments of sleep-disordered breathing. Copyright © 2012 Wiley Periodicals, Inc.

  8. Association between maternal symptoms of sleep disordered breathing and fetal telomere length.

    Science.gov (United States)

    Salihu, Hamisu M; King, Lindsey; Patel, Priyanshi; Paothong, Arnut; Pradhan, Anupam; Louis, Judette; Naik, Eknath; Marty, Phillip J; Whiteman, Valerie

    2015-04-01

    Our investigation aims to assess the impact of symptoms of maternal sleep-disordered breathing, specifically sleep apnea risk and daytime sleepiness, on fetal leukocyte telomere length. Pregnant women were recruited upon hospital delivery admission. Sleep exposure outcomes were measured using the Berlin Questionnaire to quantify sleep apnea and the Epworth Sleepiness Scale to measure daytime sleepiness. Participants were classified as "High Risk" or "Low Risk" for sleep apnea based on responses to the Berlin, while "Normal" or "Abnormal" daytime sleepiness was determined based on responses to the Epworth. Neonatal umbilical cord blood samples (N = 67) were collected and genomic DNA was isolated from cord blood leukocytes using Quantitative PCR. A ratio of relative telomere length was derived by telomere repeat copy number and single copy gene copy number (T/S ratio) and used to compare telomere lengths. Bootstrap and ANOVA statistical procedures were employed. On the Berlin, 68.7% of participants were classified as Low Risk while 31.3% were classified as High Risk for sleep apnea. According to the Epworth scale, 80.6% were determined to have Normal daytime sleepiness, and 19.4% were found to have Abnormal daytime sleepiness. The T/S ratio among pregnant women at High Risk for sleep apnea was significantly shorter than for those at Low Risk (P value sleep disordered breathing during pregnancy, and suggest sleep disordered breathing as a possible mechanism of accelerated chromosomal aging. © 2015 Associated Professional Sleep Societies, LLC.

  9. Sleep disordered breathing analysis in a general population using standard pulse oximeter signals.

    Science.gov (United States)

    Barak-Shinar, Deganit; Amos, Yariv; Bogan, Richard K

    2013-09-01

    Obstructive sleep apnea reported as the apnea-hypopnea index (AHI) is usually measured in sleep laboratories using a high number of electrodes connected to the patient's body. In this study, we examined the use of a standard pulse oximeter system with an automated analysis based on the photoplethysmograph (PPG) signal for the diagnosis of sleep disordered breathing. Using a standard and simple device with high accuracy might provide a convenient diagnostic or screening solution for patient evaluation at home or in other out of center testing environments. The study included 140 consecutive patients that were referred routinely to a sleep laboratory [SleepMed Inc.] for the diagnosis of sleep disordered breathing. Each patient underwent an overnight polysomnography (PSG) study according to AASM guidelines in an AASM-accredited sleep laboratory. The automatic analysis is based on photoplethysmographic and saturation signals only. Those two signals were recorded for the entire night as part of the full overnight PSG sleep study. The AHI calculated from the PPG analysis is compared to the AHI calculated from the manual scoring gold standard full PSG. The AHI and total respiratory events measured by the pulse oximeter analysis correlated very well with the corresponding results obtained by the gold standard full PSG. The sensitivity and specificity of AHI = or > 5 and 15 levels measured by the analysis are both above 90 %. The sensitivity and positive predictive value for the detection of respiratory event are both above 84 %. The tested system in this study yielded an acceptable result of sleep disordered breathing compared to the gold standard PSG in patients with moderate to severe sleep apnea. Accordingly and given the convenience and simplicity of the standard pulse oximeter device, the new system can be considered suitable for home and ambulatory diagnosis or screening of sleep disordered breathing patients.

  10. The role of sleep duration and sleep disordered breathing in gestational diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Joshua J. Gooley

    2018-01-01

    Full Text Available Many women experience sleep problems during pregnancy. This includes difficulty initiating and maintaining sleep due to physiologic changes that occur as pregnancy progresses, as well as increased symptoms of sleep-disordered breathing (SDB. Growing evidence indicates that sleep deficiency alters glucose metabolism and increases risk of diabetes. Poor sleep may exacerbate the progressive increase in insulin resistance that normally occurs during pregnancy, thus contributing to the development of maternal hyperglycemia. Here, we critically review evidence that exposure to short sleep duration or SDB during pregnancy is associated with gestational diabetes mellitus (GDM. Several studies have found that the frequency of GDM is higher in women exposed to short sleep compared with longer sleep durations. Despite mixed evidence regarding whether symptoms of SDB (e.g., frequent snoring are associated with GDM after adjusting for BMI or obesity, it has been shown that clinically-diagnosed SDB is prospectively associated with GDM. There are multiple mechanisms that may link sleep deprivation and SDB with insulin resistance, including increased levels of oxidative stress, inflammation, sympathetic activity, and cortisol. Despite emerging evidence that sleep deficiency and SDB are associated with increased risk of GDM, it has yet to be demonstrated that improving sleep in pregnant women (e.g., by extending sleep duration or treating SDB protects against the development of hyperglycemia. If a causal relationship can be established, behavioral therapies for improving sleep can potentially be used to reduce the risk and burden of GDM. Keywords: Pregnancy, Sleep duration, Sleep disordered breathing, Gestational diabetes, Women, Metabolism

  11. Why does adenotonsillectomy not correct enuresis in all children with sleep disordered breathing?

    Science.gov (United States)

    Kovacevic, Larisa; Wolfe-Christensen, Cortney; Lu, Hong; Toton, Monika; Mirkovic, Jelena; Thottam, Prasad J; Abdulhamid, Ibrahim; Madgy, David; Lakshmanan, Yegappan

    2014-05-01

    We analyzed the outcome of nocturnal enuresis after adenotonsillectomy in children with sleep disordered breathing. We also evaluated differences in demographic, clinical, laboratory and polysomnography parameters between responders and nonresponders after adenotonsillectomy. We prospectively evaluated children 5 to 18 years old diagnosed with sleep disordered breathing (snoring or obstructive sleep apnea syndrome) on polysomnography and monosymptomatic primary nocturnal enuresis requiring adenotonsillectomy to release upper airway obstruction. Plasma antidiuretic hormone and brain natriuretic peptide were measured preoperatively and 1 month postoperatively. Sleep studies were done in 46 children and 32 also underwent blood testing preoperatively and postoperatively. Mean ± SD patient age was 8.79 ± 2.41 years and the mean number of wet nights weekly was 6.39 ± 1.26. Polysomnography revealed obstructive sleep apnea syndrome in 71.7% of patients and snoring in 28.3%. After adenotonsillectomy 43.5% of patients became dry. Preoperative polysomnography findings indicated that responders, who were dry, had significantly more arousals and obstructive apnea episodes but fewer awakenings than nonresponders, who were wet. Significant increases in plasma antidiuretic hormone and significant decreases in plasma brain natriuretic peptide were seen in all children with no difference between responders and nonresponders. No difference between the groups was noted in age, gender, race, body mass index, constipation, preoperative number of wet nights weekly or type of sleep disordered breathing. Nocturnal enuresis resolved after adenotonsillectomy in almost half of the children with sleep disordered breathing. Those who became dry had more frequent arousal episodes caused by apnea events than those who remained wet. Copyright © 2014 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  12. Tonsillectomy or adenotonsillectomy versus non-surgical management for obstructive sleep-disordered breathing in children

    NARCIS (Netherlands)

    Venekamp, Roderick P; Hearne, Benjamin J; Chandrasekharan, Deepak; Blackshaw, Helen; Lim, Jerome; Schilder, Anne G M

    2015-01-01

    BACKGROUND: Obstructive sleep-disordered breathing (oSDB) is a condition that encompasses breathing problems when asleep, due to an obstruction of the upper airways, ranging in severity from simple snoring to obstructive sleep apnoea syndrome (OSAS). It affects both children and adults. In children,

  13. Sleep disordered breathing in pregnancy

    Directory of Open Access Journals (Sweden)

    Bilgay Izci Balserak

    2015-12-01

    Sleep disordered breathing (SDB is very common during pregnancy, and is most likely explained by hormonal, physiological and physical changes. Maternal obesity, one of the major risk factors for SDB, together with physiological changes in pregnancy may predispose women to develop SDB. SDB has been associated with poor maternal and fetal outcomes. Thus, early identification, diagnosis and treatment of SDB are important in pregnancy. This article reviews the pregnancy-related changes affecting the severity of SDB, the epidemiology and the risk factors of SDB in pregnancy, the association of SDB with adverse pregnancy outcomes, and screening and management options specific for this population.

  14. Sleep disordered breathing in children with achondroplasia.

    Science.gov (United States)

    Zaffanello, Marco; Cantalupo, Gaetano; Piacentini, Giorgio; Gasperi, Emma; Nosetti, Luana; Cavarzere, Paolo; Ramaroli, Diego Alberto; Mittal, Aliza; Antoniazzi, Franco

    2017-02-01

    Children with achondroplasia often have breathing problems, especially during sleep. The most important treatments are adenotonsillectomy (for treating upper obstruction) and/or neurosurgery (for resolving cervicomedullar junction stenosis). We reviewed the scientific literature on polysomnographic investigations which assessed the severity of respiratory disorders during sleep. Recent findings have highlighted the importance of clinical investigations in patients with achondroplasia, differentiating between those that look for neurological patterns and those that look for respiratory problems during sleep. In particular, magnetic resonance imaging (MRI) and somatosensory evoked potentials are the main tools to evaluate necessary neurosurgery and over myelopathy, respectively. The use of polysomnography enables clinicians to identify children with upper airway obstruction and to quantify disease severity; it is not suitable for MRI and/or neurosurgery considerations.

  15. Psychomotor development in infants with Prader-Willi syndrome and associations with sleep-related breathing disorders.

    Science.gov (United States)

    Festen, Dederieke A M; Wevers, Maaike; de Weerd, Al W; van den Bossche, Renilde A S; Duivenvoorden, Hugo J; Otten, Barto J; Wit, Jan Maarten; Hokken-Koelega, Anita C S

    2007-08-01

    Prader-Willi syndrome (PWS) is a neurogenetic disorder with hypotonia, psychomotor delay, obesity, short stature, and sleep-related breathing disorders. The aim of this study was to evaluate the association between psychomotor development and sleep-related breathing disorders in PWS infants. Bayley Scales of Infant Development were performed in 22 PWS infants, with a median (interquartile range, IQR) age of 1.8 (1.1-3.4) y, and a body mass index SD score (BMISDS) of -0.5 (-1.3 to 1.6). We evaluated psychomotor development in relation to results of polysomnography. Median (IQR) mental and motor development was 73.1% (64.3-79.6%) and 55.2% (46.5-63.1%) of normal children, respectively. All infants had sleep-related breathing disorders, mostly of central origin. The apnea hypopnea index was not associated with psychomotor development. Only four infants had obstructive sleep apnea syndrome (OSAS). They had a significantly delayed mental development of 65.5% (60.0-70.3%) of normal. They had a median BMISDS of 1.4 (0.1-1.6), which tended to be higher than in those without OSAS. Our data indicate that psychomotor development in PWS infants is not related to central sleep-related breathing disorders, but infants with OSAS have more severely delayed mental development, suggesting that PWS infants should be screened for OSAS.

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

    Energy Technology Data Exchange (ETDEWEB)

    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)

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

    International Nuclear Information System (INIS)

    Moriwaki, Hiroto; Uchida, Akira; Chiba, Sachiko; Moriyama, Hiroshi; Tokunaga, Masakazu

    2003-01-01

    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. Adults with ADHD and Sleep Complaints: A Pilot Study Identifying Sleep-Disordered Breathing Using Polysomnography and Sleep Quality Assessment

    Science.gov (United States)

    Surman, Craig B. H.; Thomas, Robert J.; Aleardi, Megan; Pagano, Christine; Biederman, Joseph

    2006-01-01

    Objective: ADHD and sleep-disordered breathing are both prevalent in adulthood. Because both conditions may be responsible for similar symptoms of cognitive impairment, the authors investigate whether their presentation may overlap in adults diagnosed with ADHD. Method: Data are collected from six adults with sleep complaints who were diagnosed…

  19. Diagnostic approaches to respiratory sleep disorders

    OpenAIRE

    Riha, Renata L.

    2015-01-01

    Sleep disordered breathing (SDB) comprises a number of breathing disturbances occurring during sleep including snoring, the obstructive sleep apnoea/hypopnea syndrome (OSAHS), central sleep apnoea (CSA) and hypoventilation syndromes. This review focuses on sleep disordered breathing and diagnostic approaches in adults, in particular clinical assessment and overnight assessment during sleep. Although diagnostic approaches to respiratory sleep disorders are reasonably straightforward, they do r...

  20. Use of an evidence-based protocol to screen for sleep-disordered breathing in a heart failure disease management clinic.

    Science.gov (United States)

    Garner, Shelby L; Traverse, Ramona D

    2014-01-01

    Undiagnosed and untreated sleep-disordered breathing can lead to negative health outcomes and increased utilization of health resources among patients with heart failure. The purpose of this evidence-based practice project was to implement and evaluate a new multifaceted sleep-disordered breathing screening protocol in a heart failure disease management clinic. The combined use of a symptoms questionnaire, the Epworth sleepiness scale, and overnight pulse oximetry was significantly more effective in identifying patients with a positive diagnosis of sleep-disordered breathing than using the Epworth sleepiness scale alone (P < .05).

  1. Stroke and sleep-disordered breathing: A relationship under construction.

    Science.gov (United States)

    Parra, Olga; Arboix, Adrià

    2016-02-16

    The association between sleep-disordered breathing (SDB) and cardiovascular risk has been the focus of attention in recent years. Sleep disorders are emerging risk factors for cardiovascular disease and have been related to the whole spectrum of stroke, including transient ischemic attack, ischemic cerebral infarction and intracerebral haemorrhage. It has been shown that lacunar stroke or lacunar infarctions affecting the internal capsule or the protuberance are associated with a higher frequency of SDB. Acute stroke patients with associated SDB have a worse prognosis and a higher mortality as compared to patients with first-ever stroke without SDB. Preliminary studies provide evidence of the usefulness of treatment with continuous positive airway pressure when SDB is present in stroke patients.

  2. Research Into Childhood Obstructive Sleep-Disordered Breathing : A Systematic Review

    NARCIS (Netherlands)

    Venekamp, Roderick P.; Chandrasekharan, Deepak; Abel, Francois; Blackshaw, Helen; Kreis, Irene A.; E R Evans, Hannah; Schilder, Anne G.M.

    2017-01-01

    Background Despite recent clinical guideline development, the best pathway of care for children with symptoms of obstructive sleep-disordered breathing (oSDB) is still debated. This systematic review aims to map the research in childhood oSDB that has been conducted so far to support further

  3. Impact of microarousal associated with increased negative esophageal pressure in sleep-disordered breathing.

    Science.gov (United States)

    Sukegawa, Mayo; Noda, Akiko; Yasuda, Yoshinari; Nakata, Seiichi; Sugiura, Tatsuki; Miyata, Seiko; Honda, Kumiko; Hasegawa, Yoshinori; Nakashima, Tsutomu; Koike, Yasuo

    2009-11-01

    "Microarousals" during sleep have not been analyzed systematically. We investigated the importance of "microarousals" (lasting 1.5-3 s). Standard polysomnography including esophageal pressure (Pes) assessment was performed on ten patients (aged 54.0 +/- 5.0 years) with respiratory effort-related arousal > or =5/h. We measured the number of arousals per hour (American Sleep Disorders Association (ASDA) arousal index) and the number of microarousals lasting 1.5-3 s per hour (mASDA arousal index). On the night after the baseline sleep study, we performed overnight continuous positive airway pressure (CPAP) titration. mASDA arousals, characterized by lower Pes values, were observed more frequently in patients with sleep-disordered breathing. The Pes results did not differ significantly between ASDA and mASDA arousals (-15.6 +/- -5.0 vs -15.0 +/- -4.4 cmH(2)O). mASDA arousals were significantly improved by CPAP treatment (mASDA arousals, 82.6 +/- 60.1 vs 6.0 +/- 1.4/h). mASDA arousals were characterized by an increase in Pes. mASDA arousals are thus key to our understanding of clinical manifestations in patients with sleep-disordered breathing.

  4. Medication effects on sleep and breathing.

    Science.gov (United States)

    Seda, Gilbert; Tsai, Sheila; Lee-Chiong, Teofilo

    2014-09-01

    Sleep respiration is regulated by circadian, endocrine, mechanical and chemical factors, and characterized by diminished ventilatory drive and changes in Pao2 and Paco2 thresholds. Hypoxemia and hypercapnia are more pronounced during rapid eye movement. Breathing is influenced by sleep stage and airway muscle tone. Patient factors include medical comorbidities and body habitus. Medications partially improve obstructive sleep apnea and stabilize periodic breathing at altitude. Potential adverse consequences of medications include precipitation or worsening of disorders. Risk factors for adverse medication effects include aging, medical disorders, and use of multiple medications that affect respiration. Published by Elsevier Inc.

  5. PREVALENCE OF SLEEP DISORDERED BREATHING IN PATIENTS WITH NEWLY DIAGNOSED ACROMEGALY

    Directory of Open Access Journals (Sweden)

    U. A. Tsoy

    2014-01-01

    Full Text Available Background: Obstructive sleep disordered breathing or obstructive sleep apnea (OSA is the most common respiratory impairment in acromegaly. OSA is bound up with heightened cardiovascular mortality. Aim: Тo study frequency, features, and structure of sleep disordered breathing in patients with newly diagnosed acromegaly and to elucidate the factors influencing their development. Materials and methods: 38 patients (10 men, 28 women, median age 53 (28-76 years, median body mass index (BMI 29 (19.9-44.3 kg/m² with newly diagnosed acromegaly were recruited into the study. All subjects underwent full polysomnography (Embla N7000, Natus, USA and Remlogica software (USA. Results: Sleep disordered breathing was found in 28 (73.7% patients. OSA was revealed in all cases, in 11 (39.3% subjects it was mixed. In 10 (35.7% patients OSA was mild, in 8 (28.6% moderate, and in 10 (35.7% severe. BMI (р<0.01, disease duration (р=0.003, and insulin-like growth factor-1 (IGF-1 level (р=0.04 were different in patients without OSA and patients with moderate-to-severe OSA. No difference was found in sex (р=0.4, age (р=0.064, and growth hormone level (р=0.6. Frequency of arterial hypertension, diabetes mellitus, and other glucose metabolism impairments was the same in subjects without OSA and with severe-to-moderate OSA. Conclusion: All patients with newly diagnosed acromegaly should undergo polysomnography. BMI, disease duration, and IGF-1 level are significant risk factors for OSA development. Correlation OSA with arterial hypertension and glucose metabolism impairments needs to be further investigated.

  6. Analysis of the elderly sleep-disordered breathing and sleep disorders%老年人睡眠呼吸障碍和睡眠障碍调查分析

    Institute of Scientific and Technical Information of China (English)

    徐杰; 郭浩年; 吴晓华; 方贤成; 黄智平; 徐状

    2015-01-01

    目的 调查分析1 768例军队老年人睡眠呼吸障碍和睡眠障碍情况. 方法 采用匹兹堡睡眠质量指数( PSQI) 量表. 调查对象为军队老年人及其配偶, 共1 768例, 平均年龄 ( 82.36 ±13.21 ) 岁. 男性923例、 女性845例. 结果 睡眠呼吸障碍发生率为991/1 768 (56.1%) 例, 睡眠障碍发生率为877/1 768 (49.6%) 例, 睡眠呼吸障碍和睡眠障碍同时并存的有240/1 768 (13.6%) 例. 人群睡眠质量 (2.51 ±0.58) 分、 入睡时间 (2.22 ±0.43) 分、 睡眠时间 (1.85 ±0.84) 分、 睡眠效率 (2.31 ±0.53) 分、 睡眠障碍 (2.73 ±0.51) 分、 催眠药物 (1.86 ±0.52) 分、 日间功能 (2.21 ±0.29) 分. 结论 老年人睡眠呼吸障碍和睡眠障碍发生率高, 且易并发心脑血管疾病.%Objective Analysis of 1 768 cases among military elderly sleep-disordered breathing and sleep disorders. Methods Pittsburgh Sleep Quality Index( PSQI) scale.Survey was conducted among military elderly and their spouses,a total of 1 768 people,with an average age of 82.36 ±13.21 years.Male 923,female 845 people.Results Sleep disordered breathing was 991/1 768(56.1%)cases,sleep disorders was 877/1 768(49.6%)cases,sleep-disordered breathing and sleep disorders coex-ist are 240/1 768(13.6%)cases.People sleep quality 2.51 ±0.58 points,2.22 ±0.43 minutes to fall asleep,sleep 1.85 ±0.84 points,2.31 ±0.53 points sleep efficiency,sleep disturbances 2.73 ±0.51 points,1.86 ±0.52 points hypnotic drugs,daytime func-tion 2.21 ±0.29 points.Conclusion The elderly sleep-disordered breathing and sleep disorders incidence and complicated cardi-ovascular disease.

  7. ROHHAD syndrome and evolution of sleep disordered breathing

    OpenAIRE

    Reppucci, Diana; Hamilton, Jill; Yeh, E Ann; Katz, Sherri; Al-Saleh, Suhail; Narang, Indra

    2016-01-01

    Background Rapid-onset obesity with hypothalamic dysfunction, hypoventilation and autonomic dysregulation (ROHHAD) is a rare disease with a high mortality rate. Although nocturnal hypoventilation (NH) is central to ROHHAD, the evolution of sleep disordered breathing (SDB) is not well studied. The aim of the study was to assess early manifestations of SDB and their evolution in ROHHAD syndrome. Methods Retrospective study of children with ROHHAD at two Canadian centers. All children with suspe...

  8. Sleep-Disordered Breathing and Cognitive Functioning in Preschool Children with and without Down Syndrome

    Science.gov (United States)

    Joyce, A.; Dimitriou, D.

    2017-01-01

    Background: Sleep affects children's cognitive development, preparedness for school and future academic outcomes. People with Down syndrome (DS) are particularly at risk for sleep-disordered breathing (SDB). To our knowledge, the association between SDB and cognition in preschoolers with DS is unknown. Methods: We assessed sleep by using…

  9. Canadian Thoracic Society 2011 Guideline Update: Diagnosis and Treatment of Sleep Disordered Breathing

    Directory of Open Access Journals (Sweden)

    John Fleetham

    2011-01-01

    Full Text Available The Canadian Thoracic Society (CTS published an executive summary of guidelines for the diagnosis and treatment of sleep disordered breathing in 2006/2007. These guidelines were developed during several meetings by a group of experts with evidence grading based on committee consensus. These guidelines were well received and the majority of the recommendations remain unchanged. The CTS embarked on a more rigorous process for the 2011 guideline update, and addressed eight areas that were believed to be controversial or in which new data emerged. The CTS Sleep Disordered Breathing Committee posed specific questions for each area. The recommendations regarding maximum assessment wait times, portable monitoring, treatment of asymptomatic adult obstructive sleep apnea patients, treatment with conventional continuous positive airway pressure compared with automatic continuous positive airway pressure, and treatment of central sleep apnea syndrome in heart failure patients replace the recommendations in the 2006/2007 guidelines. The recommendations on bariatric surgery, complex sleep apnea and optimum positive airway pressure technologies are new topics, which were not covered in the 2006/2007 guidelines.

  10. Childhood obstructive sleep-disordered breathing: a clinical update and discussion of technological innovations and challenges.

    Science.gov (United States)

    Halbower, Ann C; Ishman, Stacey L; McGinley, Brian M

    2007-12-01

    Childhood sleep-disordered breathing (SDB) has been known to be associated with health and cognitive impacts for more than a century, and yet our understanding of this disorder is in its infancy. Neuropsychological consequences in children with snoring or subtle breathing disturbances not meeting the traditional definition of sleep apnea suggest that "benign, or primary snoring" may be clinically significant, and that the true prevalence of SDB might be underestimated. There is no standard definition of SDB in children. The polysomnographic technology used in many sleep laboratories may be inadequate to diagnose serious but subtle forms of clinically important airflow limitation. In the last several years, advances in digital technology as well as new observational studies of respiratory and arousal patterns in large populations of healthy children have led to alternative views of what constitutes sleep-related breathing and arousal abnormalities that may refine our diagnostic criteria. This article reviews our knowledge of childhood SDB, highlights recent advances in technology, and discusses diagnostic and treatment strategies that will advance the management of children with pediatric SDB.

  11. Intra- and interobserver agreement in the diagnosis of malocclusion in sleep-disordered breathing

    Directory of Open Access Journals (Sweden)

    Fernando Rodrigues Carvalho

    2014-02-01

    Full Text Available Sleep-disordered breathing (SDB is often related to malocclusion, and dentists should be able to recognize occlusal changes that may be associated with the development, onset, or persistence of SDB. Although clinical examination is routinely used by specialists in orthodontics and functional jaw orthopedics, differences in diagnosis are very common. Method : Two observers, both dentists specializing in functional jaw orthopedics, examined 56 children aged 7 to 9 years. Intra- and interobserver agreement in identification of functional orthopedic and orthodontic conditions were assessed. Results : Intraobserver agreement was strong for all variables. Interobserver agreement was also strong, except for the variable overbite, which showed good agreement. Conclusion : Diagnostic criteria provide an opportunity for dentists to recognize dental malocclusions that may be associated with sleep-disordered breathing.

  12. Sleep Disordered Breathing in Early Childhood: Quality of Life for Children and Families

    Science.gov (United States)

    Jackman, Angela R.; Biggs, Sarah N.; Walter, Lisa M.; Embuldeniya, Upeka S.; Davey, Margot J.; Nixon, Gillian M.; Anderson, Vicki; Trinder, John; Horne, Rosemary S. C.

    2013-01-01

    Objectives: To characterize health-related quality of life (QOL) in preschool children with sleep disordered breathing (SDB) and their families compared with nonsnoring control patients in the community. It was hypothesized that children with SDB and their families would have poorer QOL than control children, that a relationship would be found between SDB severity and QOL, and that even children with mild SDB and their families would have reduced QOL. Participants and Methods: A clinical sample of preschool children (3-5 y) with SDB diagnosed by gold standard polysomnography (primary snoring, PS = 56, mild obstructive sleep apnea, OSA = 35, moderate/severe OSA = 24) and control children recruited from the community (n = 38) were studied. Parents completed health-related QOL and parenting stress questionnaires. Results: Children and families in the PS and mild OSA groups had consistently poorer QOL than control children (both P Biggs SN; Walter LM; Embuldeniya US; Davey MJ; Nixon GM; Anderson V; Trinder J; Horne RSC. Sleep disordered breathing in early childhood: quality of life for children and families. SLEEP 2013;36(11):1639-1646. PMID:24179296

  13. Sleep Disorders

    Science.gov (United States)

    ... the day, even if you have had enough sleep? You might have a sleep disorder. The most common kinds are Insomnia - a hard time falling or staying asleep Sleep apnea - breathing interruptions during sleep Restless legs syndrome - ...

  14. Sleep Disorders

    DEFF Research Database (Denmark)

    Rahbek Kornum, Birgitte; Mignot, Emmanuel

    2014-01-01

    mediates circadian regulation of sleep. Misalignment with the rhythm of the sun results in circadian disorders and jet lag. The molecular basis of homeostatic sleep regulation is mostly unknown. A network of mutually inhibitory brain nuclei regulates sleep states and sleep-wake transitions. Abnormalities...... in these networks create sleep disorders, including rapid eye movement sleep behavior disorder, sleep walking, and narcolepsy. Physiological changes associated with sleep can be imbalanced, resulting in excess movements such as periodic leg movements during sleep or abnormal breathing in obstructive sleep apneas....... As every organ in the body is affected by sleep directly or indirectly, sleep and sleep-associated disorders are frequent and only now starting to be understood....

  15. Evaluation of Candidate Measures for Home-Based Screening of Sleep Disordered Breathing in Taiwanese Bus Drivers

    Directory of Open Access Journals (Sweden)

    Hua Ting

    2014-05-01

    Full Text Available Background: Sleepiness-at-the-wheel has been identified as a major cause of highway accidents. The aim of our study is identifying the candidate measures for home-based screening of sleep disordered breathing in Taiwanese bus drivers, instead of polysomnography. Methods: Overnight polysomnography accompanied with simultaneous measurements of alternative screening devices (pulse oximetry, ApneaLink, and Actigraphy, heart rate variability, wake-up systolic blood pressure and questionnaires were completed by 151 eligible participants who were long-haul bus drivers with a duty period of more than 12 h a day and duty shifting. Results: 63.6% of professional bus drivers were diagnosed as having sleep disordered breathing and had a higher body mass index, neck circumference, systolic blood pressure, arousal index and desaturation index than those professional bus drivers without evidence of sleep disordered breathing. Simple home-based candidate measures: (1 Pulse oximetry, oxygen-desaturation indices by ≥3% and 4% (r = 0.87~0.92; (2 Pulse oximetry, pulse-rising indices by ≥7% and 8% from a baseline (r = 0.61~0.89; and (3 ApneaLink airflow detection, apnea-hypopnea indices (r = 0.70~0.70, based on recording-time or Actigraphy-corrected total sleep time were all significantly correlated with, and had high agreement with, corresponding polysomnographic apnea-hypopnea indices [(1 94.5%~96.6%, (2 93.8%~97.2%, (3 91.1%~91.3%, respectively]. Conversely, no validities of SDB screening were found in the multi-variables apnea prediction questionnaire, Epworth Sleepiness Scale, night-sleep heart rate variability, wake-up systolic blood pressure and anthropometric variables. Conclusions: The indices of pulse oximetry and apnea flow detection are eligible criteria for home-based screening of sleep disordered breathing, specifically for professional drivers.

  16. Sleep Disordered Breathing During Live High-Train Low in Normobaric Versus Hypobaric Hypoxia.

    Science.gov (United States)

    Saugy, Jonas J; Schmitt, Laurent; Fallet, Sibylle; Faiss, Raphael; Vesin, Jean-Marc; Bertschi, Mattia; Heinzer, Raphaël; Millet, Grégoire P

    2016-09-01

    Saugy, Jonas J., Laurent Schmitt, Sibylle Fallet, Raphael Faiss, Jean-Marc Vesin, Mattia Bertschi, Raphaël Heinzer, and Grégoire P. Millet. Sleep disordered breathing during live high-train low in normobaric versus hypobaric hypoxia. High Alt Med Biol. 17:233-238, 2016.-The present study aimed to compare sleep disordered breathing during live high-train low (LHTL) altitude camp using normobaric hypoxia (NH) and hypobaric hypoxia (HH). Sixteen highly trained triathletes completed two 18-day LHTL camps in a crossover designed study. They trained at 1100-1200 m while they slept either in NH at a simulated altitude of 2250 m or in HH. Breathing frequency and oxygen saturation (SpO 2 ) were recorded continuously during all nights and oxygen desaturation index (ODI 3%) calculated. Breathing frequency was lower for NH than HH during the camps (14.6 ± 3.1 breath × min -1 vs. 17.2 ± 3.4 breath × min -1 , p < 0.001). SpO 2 was lower for HH than NH (90.8 ± 0.3 vs. 91.9 ± 0.2, p < 0.001) and ODI 3% was higher for HH than NH (15.1 ± 3.5 vs. 9.9 ± 1.6, p < 0.001). Sleep in moderate HH is more altered than in NH during a LHTL camp.

  17. Impaired memory consolidation in children with obstructive sleep disordered breathing.

    Directory of Open Access Journals (Sweden)

    Kiran Maski

    Full Text Available Memory consolidation is stabilized and even enhanced by sleep (and particularly by 12-15 Hz sleep spindles in NREM stage 2 sleep in healthy children but it is unclear what happens to these processes when sleep is disturbed by obstructive sleep disordered breathing. This cross-sectional study investigates differences in declarative memory consolidation among children with primary snoring (PS and obstructive sleep apnea (OSA compared to controls. We further investigate whether memory consolidation group differences are associated with NREM stage 2 (N2 sigma (12-15 Hz or NREM slow oscillation (0.5-1 Hz spectral power bands. In this study, we trained and tested participants on a spatial declarative memory task with cued recall. Retest occurred after a period of daytime wake (Wake or a night of sleep (Sleep with in-lab polysomnography. 36 participants ages 5-9 years completed the protocol: 14 with OSA as defined by respiratory disturbance index (RDI > 1/hour, 12 with primary snoring (PS and 10 controls. OSA participants had poorer overall memory consolidation than controls across Wake and Sleep conditions [OSA: mean = -18.7% (5.8, controls: mean = 1.9% (7.2, t = -2.20, P = 0.04]. In contrast, PS participants and controls had comparable memory consolidation across conditions (t = 0.41; P = 0.38. We did not detect a main effect for condition (Sleep, Wake or group x condition interaction on memory consolidation. OSA participants had lower N2 sigma power than PS (P = 0.03 and controls (P = 0.004 and N2 sigma power inversely correlated with percentage of time snoring on the study night (r = -0.33, P<0.05. Across all participants, N2 sigma power modestly correlated with memory consolidation in both Sleep (r = 0.37, P = 0.03 and Wake conditions (r = 0.44, P = 0.009. Further observed variable path analysis showed that N2 sigma power mediated the relationship between group and mean memory consolidation across Sleep and Wake states [Bindirect = 6.76(3.5, z = 2

  18. Proposal of Screening Method of Sleep Disordered Breathing Using Fiber Grating Vision Sensor

    Science.gov (United States)

    Aoki, Hirooki; Nakamura, Hidetoshi; Nakajima, Masato

    Every conventional respiration monitoring technique requires at least one sensor to be attached to the body of the subject during measurement, thereby imposing a sense of restraint that results in aversion against measurements that would last over consecutive days. To solve this problem, we developed a respiration monitoring system for sleepers, and it uses a fiber-grating vision sensor, which is a type of active image sensor to achieve non-contact respiration monitoring. In this paper, we verified the effectiveness of the system, and proposed screening method of the sleep disordered breathing. It was shown that our system could equivalently measure the respiration with thermistor and accelerograph. And, the respiratory condition of sleepers can be grasped by our screening method in one look, and it seems to be useful for the support of the screening of sleep disordered breathing.

  19. [Sleep and sleep disorders in the elderly. Part 2: therapy].

    Science.gov (United States)

    Schlitzer, J; Heubaum, S; Frohnhofen, H

    2014-11-01

    Sleep disorders need to be treated if they affect the quality of life, lead to functional problems in daily life or unfavorably affect self-sufficiency. The large number of sleep disorders is reflected in the number of different and varied available therapeutic procedures. The basic therapeutic procedure for any sleep disorder is the use of sleep hygiene. Sleeplessness (insomnia) is most effectively treated through behavioral therapy, with stimulus control and sleep restriction as the most effective measures, whereas pharmacotherapy is considerably less effective and has side effects. Sleep-disordered breathing is also the most common cause of hypersomnia in the elderly and is most effectively treated by nocturnal positive pressure breathing.

  20. Evaluation of changes in sleep breathing patterns after primary palatoplasty in cleft children

    Directory of Open Access Journals (Sweden)

    Justice E. Reilly

    2014-09-01

    Full Text Available Introduction: There is a need to more clearly understand the characteristics of breathing patterns in children with cleft palate inthe first year of life, as there is little data available to guide current practice. Pierre Robin patients are known to have a higher incidence, however we hypothesised sleep breathing disturbance is not confined to this sub-group of cleft patient. Methods: We conducted a prospective observational study of sleep disordered breathing patterns in a cohort of infants with oronasal clefts (cleft palate with or without cleft lip to describe the spectrum of sleep breathing patterns both pre and post palate repair. Sleep breathing studies were performed pre- and post-operatively in sequential infants referred to a regional cleft lip andpalate unit. Results of sleep breathing studies were analysed according to American Academy of Sleep Medicine scoring guidelines and correlated with clinical history and details of peri-operative respiratory compromise. The degree of sleep disordered breathingwas characterised using desaturation indices (number of desaturations from baseline SpO2 of >=4%, per hour. Results: Thirty-nine infants were included in this study, twenty-five female and fourteen male. Twelve had isolated Cleft Palate aspart of an associated syndrome. Patients were categorised into Isolated Cleft Palate, Isolated Cleft Palate in the context of Pierre Robin Sequence, and those with Cleft Lip and Palate. All groups demonstrated some degree of sleep breathing abnormality. Not unsurprisingly the eight infants with Pierre Robin Sequence had a significantly higher desaturation index before surgicalintervention (p=0.043, and were more likely to require a pre-operative airway intervention (p=0.009. Palate repair in this group did not alter the relative distribution of patients in each severity category of sleep disorder breathing. Surgical repair ofthe secondary palate in the remaining children was associated with some

  1. ROHHAD syndrome and evolution of sleep disordered breathing.

    Science.gov (United States)

    Reppucci, Diana; Hamilton, Jill; Yeh, E Ann; Katz, Sherri; Al-Saleh, Suhail; Narang, Indra

    2016-07-30

    Rapid-onset obesity with hypothalamic dysfunction, hypoventilation and autonomic dysregulation (ROHHAD) is a rare disease with a high mortality rate. Although nocturnal hypoventilation (NH) is central to ROHHAD, the evolution of sleep disordered breathing (SDB) is not well studied. The aim of the study was to assess early manifestations of SDB and their evolution in ROHHAD syndrome. Retrospective study of children with ROHHAD at two Canadian centers. All children with suspected ROHHAD at presentation underwent polysomnography (PSG) to screen for nocturnal hypoventilation. PSG findings at baseline and follow-up were collected. Interventions and diagnostic test results were recorded. Six children were included. The median age of rapid onset obesity and nocturnal hypoventilation (NH) was 3.5 and 7.2 years respectively. On initial screening for ROHHAD 4/6 (66.7 %) children had obstructive sleep apnea (OSA), 1/6 (16.7 %) had NH and 1/6 (16.7 %) had both OSA and NH. Follow up PSGs were performed in 5/6 children as one child died following a cardiorespiratory arrest. All children at follow up had NH and required non-invasive positive pressure ventilation. Additionally, 3/6 (50 %) children demonstrated irregular breathing patterns during wakefulness. Children with ROHHAD may initially present with OSA and only develop NH later as well as dysregulation of breathing during wakefulness. The recognition of the spectrum of respiratory abnormalities at presentation and over time may be important in raising the index of suspicion of ROHHAD. Early recognition and targeted therapeutic interventions may limit morbidity and mortality associated with ROHHAD.

  2. Sleep bruxism and sleep-disordered breathing: a systematic review.

    Science.gov (United States)

    De Luca Canto, Graziela; Singh, Vandana; Gozal, David; Major, Paul W; Flores-Mir, Carlos

    2014-01-01

    To carry out a systematic review to consolidate current knowledge on the potential association between sleep bruxism (SB) and sleep-disordered breathing (SDB). For this systematic review, articles were retained only if they reported studies using full ambulatory polysomnography as "the gold standard" reference test to determine SDB and the international diagnostic criteria proposed by the American Association of Sleep Medicine to determine SB. Detailed individual search strategies from MEDLINE, PubMed, Embase, the Cochrane Library, and LILACS databases were developed. The references cited in the selected articles were also checked, and a partial literature search was undertaken. The selection was completed independently by two reviewers in two phases. The methodology of selected studies was evaluated using the seven-item quality-assessment tool for experimental bruxism studies. During the initial search, 333 different citations were identified across the six electronic databases. After a comprehensive evaluation of the abstracts, and the full papers when considered necessary, only one study was finally selected for the qualitative/quantitative synthesis. This study did not support the putative association between SB and SDB, since SB was not observed during or in temporal conjunction with snoring or apneic events in any of the evaluated patients. In addition, masseter activity was not observed during apneic episodes. There is not sufficient scientific evidence either to confirm or discredit the association between SB and SDB.

  3. Periodontitis and Sleep Disordered Breathing in the Hispanic Community Health Study/Study of Latinos

    Science.gov (United States)

    Sanders, Anne E.; Essick, Greg K.; Beck, James D.; Cai, Jianwen; Beaver, Shirley; Finlayson, Tracy L.; Zee, Phyllis C.; Loredo, Jose S.; Ramos, Alberto R.; Singer, Richard H.; Jimenez, Monik C.; Barnhart, Janice M.; Redline, Susan

    2015-01-01

    Study Objectives: To investigate the association between sleep disordered breathing (SDB) and severe chronic periodontitis. Design: Cross-sectional data analysis from the Hispanic Community Health Study/Study of Latinos. Setting: Community-based setting with probability sampling from four urban US communities. Participants: 12,469 adults aged 18–74 y. Interventions: None. Measurements and Results: Severe chronic periodontitis was defined using the Centers for Disease Control and Prevention/American Academy of Periodontology case classification based on full-mouth periodontal assessments performed by calibrated dentists. SDB was evaluated in standardized home sleep tests, and defined as the number of apnea plus hypopnea events associated with ≥ 3% desaturation, per hour of estimated sleep. SDB was quantified using categories of the apnea-hypopnea index (AHI): 0.0 events (nonapneic); 0.1–4.9 (subclinical); 5.0–14.9 (mild); and ≥ 15 (moderate/severe). Covariates were demographic characteristics and established periodontitis risk factors. C-reactive protein was a potential explanatory variable. Using survey estimation, multivariable binary logistic regression estimated odds ratios (OR) and 95% confidence limits (CL). Following adjustment for confounding, the SDB and periodontitis relationship remained statistically significant, but was attenuated in strength and no longer dose-response. Compared with the nonapneic referent, adjusted odds of severe periodontitis were 40% higher with subclinical SDB (OR = 1.4, 95% CL: 1.0, 1.9), 60% higher with mild SDB (OR = 1.6, 95% CL: 1.1, 2.2) and 50% higher with moderate/severe SDB (OR = 1.5, 95% CL: 1.0, 2.3) demonstrating an independent association between SDB and severe periodontitis. Conclusions: This study identifies a novel association between mild sleep disordered breathing and periodontitis that was most pronounced in young adults. Citation: Sanders AE, Essick GK, Beck JD, Cai J, Beaver S, Finlayson TL, Zee PC

  4. Altered Nocturnal Cardiovascular Control in Children With Sleep-Disordered Breathing.

    Science.gov (United States)

    El-Hamad, Fatima; Immanuel, Sarah; Liu, Xiao; Pamula, Yvonne; Kontos, Anna; Martin, James; Kennedy, Declan; Kohler, Mark; Porta, Alberto; Baumert, Mathias

    2017-10-01

    To assess cardiovascular control during sleep in children with sleep-disordered breathing (SDB) and the effect of adenotonsillectomy in comparison to healthy nonsnoring children. Cardiorespiratory signals obtained from overnight polysomnographic recordings of 28 children with SDB and 34 healthy nonsnoring children were analyzed. We employed an autoregressive closed-loop model with heart period (RR) and pulse transit time (PTT) as outputs and respiration as an external input to obtain estimates of respiratory gain and baroreflex gain. Mean and variability of PTT were increased in children with SDB across all stages of sleep. Low frequency power of RR and PTT were attenuated during non-rapid eye movement (REM) sleep. Baroreflex sensitivity was reduced in children with SDB in stage 2 sleep, while respiratory gain was increased in slow wave sleep. After adenotonsillectomy, these indices normalized in the SDB group attaining values comparable to those of healthy children. In children with mild-to-moderate SDB, vasomotor activity is increased and baroreflex sensitivity decreased during quiet, event-free non-REM sleep. Adenotonsillectomy appears to reverse this effect. © Sleep Research Society 2017. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

  5. Association of Sleep Disordered Breathing with Mono-Symptomatic Nocturnal Enuresis: A Study among School Children of Central India.

    Science.gov (United States)

    Choudhary, Bharat; Patil, Rajesh; Bhatt, Girish Chandra; Pakhare, Abhijit P; Goyal, Abhishek; P, Aswin; Dhingra, Bhavna; Tamaria, K C

    2016-01-01

    To study the prevalence of primary monosymptopomatic nocturnal enuresis (PMNE) in children aged 5-10 year and to find its association with sleep disordered breathing (SDB) by using a 22 item pediatric sleep related breathing disorder (SRBD) scale. This was a school based cross sectional epidemiological study from July 2015 to November 2015. A questionnaire seeking information on socio-demographic variables, nocturnal enuresis (NE) frequency, school performance and a validated 22 item pediatric sleep related breathing disorder scale (SRBDs) was distributed to 1820 pupils in three primary schools. A total of 1528(83.95%) questionnaires were retrieved. Out of 1528 forms, 182(11.9%) forms were incomplete for requested information and hence 1346 (73.9%) questionnaires were finally analyzed. The prevalence of NE was found to be 12.7% (95% CI; 11-14.6), whereas prevalence of primary nocturnal enuresis (PMNE) was 8.2% (95% CI; 7.1-10.1). SRBD scale score >0.33 (adjusted OR: 2.87; 95%CI: 1.67-4.92), paternal history of enuresis in childhood (adjusted OR:4.96; 95% CI: 2.36-10.45), and inappropriate toilet training (adjusted OR: 1.64; 95% CI: 1.01-2.66) were independently associated with PMNE. Sleep disordered breathing, inappropriate toilet training and a history of childhood NE in father were found to be significant risk factors for PMNE in the present study. Thus, these findings suggest that it is imperative to rule out SDB in PMNE patients as they may require different therapeutic interventions.

  6. Social consequences of sleep disordered breathing on patients and their partners

    DEFF Research Database (Denmark)

    Jennum, Poul; Ibsen, Rikke Falkner; Kjellberg, Jakob

    2014-01-01

    We aimed to evaluate the total costs to patients and their partners of sleep apnoea and obesity hypoventilation syndrome (OHS) and their treatment, as this is poorly described in families. Using data from the Danish National Patient Registry and other public databases, all patients and their part......, and increased as the disease advanced. Sleep-disordered breathing has major socioeconomic consequences for patients and their spouses years before and after diagnosis.......We aimed to evaluate the total costs to patients and their partners of sleep apnoea and obesity hypoventilation syndrome (OHS) and their treatment, as this is poorly described in families. Using data from the Danish National Patient Registry and other public databases, all patients...... and their partners with a diagnosis of sleep apnoea (n=30,278) or OHS (n=1562) were included. They were compared with age-, sex- and community location-matched citizens at a ratio 1:4 (120,506 and 6241 control subjects, respectively). Direct and indirect costs were evaluated for patients and their partners. Sleep...

  7. Sleep-disordered breathing and its management in children with achondroplasia.

    Science.gov (United States)

    Tenconi, Rossana; Khirani, Sonia; Amaddeo, Alessandro; Michot, Caroline; Baujat, Geneviève; Couloigner, Vincent; De Sanctis, Livio; James, Syril; Zerah, Michel; Cormier-Daire, Valérie; Fauroux, Brigitte

    2017-04-01

    Sleep-disordered breathing is a common feature in children with achondroplasia. The aim of our study was to review the poly(somno)graphic (P(S)G) findings and consequent treatments in children with achondroplasia followed in the national reference center for skeletal dysplasia. A retrospective review of the clinical charts and P(S)G of 43 consecutive children (mean age 3.9 ± 3.5 years) with achondroplasia seen over a period of 2 years was performed. Twenty four (59%) children had obstructive sleep apnea (OSA). Thirteen children had an obstructive apnea-hypopnea index (OAHI) achondroplasia. The observation of a reduced prevalence of OSA after (adeno-)tonsillectomy is in favor of this type of surgery when possible. © 2017 Wiley Periodicals, Inc.

  8. Obstructive Sleep-Disordered Breathing Is More Common than Central in Mild Familial Dysautonomia

    Science.gov (United States)

    Hilz, Max J.; Moeller, Sebastian; Buechner, Susanne; Czarkowska, Hanna; Ayappa, Indu; Axelrod, Felicia B.; Rapoport, David M.

    2016-01-01

    Study Objectives: In familial dysautonomia (FD) patients, sleep-disordered breathing (SDB) might contribute to their high risk of sleep-related sudden death. Prevalence of central versus obstructive sleep apneas is controversial but may be therapeutically relevant. We, therefore, assessed sleep structure and SDB in FD-patients with no history of SDB. Methods: 11 mildly affected FD-patients (28 ± 11 years) without clinically overt SDB and 13 controls (28 ± 10 years) underwent polysomnographic recording during one night. We assessed sleep stages, obstructive and central apneas (≥ 90% air flow reduction) and hypopneas (> 30% decrease in airflow with ≥ 4% oxygen-desaturation), and determined obstructive (oAI) and central (cAI) apnea indices and the hypopnea index (HI) as count of respective apneas/hypopneas divided by sleep time. We obtained the apnea-hypopnea index (AHI4%) from the total of apneas and hypopneas divided by sleep time. We determined differences between FD-patients and controls using the U-test and within-group differences between oAIs, cAIs, and HIs using the Friedman test and Wilcoxon test. Results: Sleep structure was similar in FD-patients and controls. AHI4% and HI were significantly higher in patients than controls. In patients, HIs were higher than oAIs and oAIs were higher than cAIs. In controls, there was no difference between HIs, oAIs, and cAIs. Only patients had apneas and hypopneas during slow wave sleep. Conclusions: In our FD-patients, obstructive apneas were more common than central apneas. These findings may be related to FD-specific pathophysiology. The potential ramifications of SDB in FD-patients suggest the utility of polysomnography to unveil SDB and initiate treatment. Commentary: A commentary on this article appears in this issue on page 1583. Citation: Hilz MJ, Moeller S, Buechner S, Czarkowska H, Ayappa I, Axelrod FB, Rapoport DM. Obstructive sleep-disordered breathing is more common than central in mild familial

  9. Sleep Hygiene Behaviors Among Midlife Women with Insomnia or Sleep-Disordered Breathing: The SWAN Sleep Study

    Science.gov (United States)

    Kline, Christopher E.; Irish, Leah A.; Buysse, Daniel J.; Kravitz, Howard M.; Okun, Michele L.; Owens, Jane F.

    2014-01-01

    Abstract Background: Insomnia and sleep-disordered breathing (SDB) are the most common sleep disorders among midlife women. Although promoting sleep hygiene behaviors may be a useful behavioral approach for the management of insomnia or SDB, the frequency with which women engage in these behaviors is unclear. Methods: Participants were from the Study of Women's Health Across the Nation (SWAN) Sleep Study (N=321; age range=48–58 years). Out of the full sample, 10.3% (n=33) met Diagnostic and Statistical Manual of Mental Disorders—Fourth Edition diagnostic criteria for insomnia, 15.3% (n=49) had clinically significant SDB (apnea–hypopnea index ≥15), and 4.7% (n=15) met criteria for both insomnia and SDB, resulting in an overall prevalence of 15.0% (n=48) for insomnia and 19.9% (n=64) for SDB. Participants provided diary-based assessments of sleep hygiene behaviors for 14–35 days. Two positive behaviors (sufficient exercise, regular morning out-of-bed time) and four negative behaviors (taking long daytime naps, caffeine consumption near bedtime, alcohol consumption near bedtime, smoking) were examined. These behaviors were compared between women with and without insomnia or SDB following adjustment for sociodemographic factors and mental and physical health indices. Results: Women with insomnia engaged in significantly fewer negative sleep hygiene behaviors than women without insomnia (1.61±0.15 vs. 2.09±0.09 behaviors; phygiene behaviors were observed. Conclusions: These data suggest that insomnia in midlife women is not associated with poor sleep hygiene. Increasing physical activity may be a valuable recommendation for midlife women with SDB. PMID:25353709

  10. Sleep Disordered Breathing in Children and Adolescents with Chiari Malformation Type I

    Science.gov (United States)

    Losurdo, Anna; Dittoni, Serena; Testani, Elisa; Di Blasi, Chiara; Scarano, Emanuele; Mariotti, Paolo; Paternoster, Giovanna; Di Rocco, Concezio; Massimi, Luca; Della Marca, Giacomo

    2013-01-01

    Study Objectives: Chiari malformation Type I (CM-I) has been associated with sleep disordered breathing (SDB). The aim of this study was to evaluate the prevalence of SDB in CM-I and its clinical correlates in a population of children and adolescents. Methods: Fifty-three consecutive children and adolescents affected by CM-I were enrolled (27 girls and 26 boys, mean age 10.3 ± 4.3, range: 3-18 years). All patients underwent neurological examination, MRI, and polysomnography (PSG). Otorhinolaryngologic clinical evaluation was performed in patients with polysomnographic evidence of sleep-related upper airway obstruction. Results: Mean size of the herniation was 9.5 ± 5.4 mm. Fourteen patients had syringomyelia, 5 had hydrocephalus, 31 presented neurological signs, 14 had epileptic seizures, and 7 reported poor sleep. PSG revealed SDB in 13 subjects. Patients with SDB, compared to those without SDB, had a higher prevalence hydrocephalus (p = 0.002), syringomyelia (p = 0.001), and neurological symptoms (p = 0.028). No significant difference was observed in age, gender, prevalence of epilepsy, and size of the herniation. Obstructive SDB was associated with syringomyelia (p = 0.004), whereas central SDB was associated with hydrocephalus (p = 0.034). Conclusions: In our population of CM-I patients the prevalence of SDB was 24%, lower than that reported in literature. Moreover, our findings suggest that abnormalities in cerebrospinal fluid dynamics in CM-I, particularly syringomyelia and hydro-cephalus, are associated with SDB. Citation: Losurdo A; Dittoni S; Testani E; Di Blasi C; Scarano E; Mariotti P; Paternoster G; Di Rocco C; Massimi L; Della Marca G. Sleep disordered breathing in children and adolescents with Chiari malformation Type I. J Clin Sleep Med 2013;9(4):371-377. PMID:23585753

  11. Attention deficit hyperactivity disorder and sleep disordered breathing in pediatric populations: a meta-analysis.

    Science.gov (United States)

    Sedky, Karim; Bennett, David S; Carvalho, Karen S

    2014-08-01

    A relationship between attention deficit hyperactivity disorder (ADHD) and sleep disordered breathing (SDB) in children and adolescents has been suggested by some authors. Yet, this topic remains highly controversial in the literature. A meta-analysis was conducted in order to examine the extent of relationship between SDB and ADHD symptoms in pediatric populations and whether there are differences in ADHD symptoms pre- versus post-adenotonsillectomy in pediatric populations. PubMed/Medline, PsychInfo and Cochrane databases were searched using the key words "attention deficit hyperactivity disorder" or "ADHD" and "obstructive sleep apnea" or "OSA" or "sleep disordered breathing" (SDB) or "SDB". English language publications through September 2012 were surveyed. Meta-analysis was conducted to assess the relationship between SDB and ADHD symptoms in the first part of the study, and the extent of change in ADHD symptoms before and after adenotonsillectomy in the second part. Eighteen studies satisfied the inclusion criteria for the first part of the study. This represented 1113 children in the clinical group (874 diagnosed with SDB who were examined for ADHD symptoms; 239 diagnosed with ADHD who were examined for SDB) and 1405 in the control-group. Findings indicate that there is a medium relationship between ADHD symptoms and SDB (Hedges' g = 0.57, 95% confidence interval: 0.36-0.78; p = 0.000001). A high apnea hypopnea index (AHI) cutoff was associated with lower effect sizes, while child age, gender and body mass index did not moderate the relationship between SDB and ADHD. Study quality was associated with larger effect sizes. In the second part of the study, twelve studies were identified assessing pre- versus post-surgery ADHD symptoms. Hedges' g was 0.43 (95% confidence interval = 0.30-0.55; p ADHD symptoms at 2-13 months post-surgery. The findings of this meta-analysis suggest that ADHD symptoms are related to SDB and improve after adenotonsillectomy

  12. Treatment of sleep-disordered breathing with positive airway pressure devices: technology update.

    Science.gov (United States)

    Johnson, Karin Gardner; Johnson, Douglas Clark

    2015-01-01

    Many types of positive airway pressure (PAP) devices are used to treat sleep-disordered breathing including obstructive sleep apnea, central sleep apnea, and sleep-related hypoventilation. These include continuous PAP, autoadjusting CPAP, bilevel PAP, adaptive servoventilation, and volume-assured pressure support. Noninvasive PAP has significant leak by design, which these devices adjust for in different manners. Algorithms to provide pressure, detect events, and respond to events vary greatly between the types of devices, and vary among the same category between companies and different models by the same company. Many devices include features designed to improve effectiveness and patient comfort. Data collection systems can track compliance, pressure, leak, and efficacy. Understanding how each device works allows the clinician to better select the best device and settings for a given patient. This paper reviews PAP devices, including their algorithms, settings, and features.

  13. The Effect of Sleep Disordered Breathing on the Outcome of Stroke and Transient Ischemic Attack

    DEFF Research Database (Denmark)

    Birkbak, Johannes; Clark, Alice J; Rod, Naja Hulvej

    2014-01-01

    The primary objective was to systematically review the literature on how sleep disordered breathing (SDB) affects recurrence and death among stroke or transient ischemic attack (TIA) patients. A secondary objective was to evaluate how treatment of SDB with continuous positive airway pressure (CPAP...

  14. Sleep-Disordered Breathing in Heart Failure - A Therapeutic Dilemma.

    Science.gov (United States)

    Haruki, Nobuhiko; Floras, John S

    2017-06-23

    Sleep-disordered breathing (SDB) occurs in approximately 50% of patients with reduced left ventricular ejection fraction receiving contemporary heart failure (HF) therapies. Obstructive (OSA) and central sleep apneas (CSA) interrupt breathing by different mechanisms but impose qualitatively similar autonomic, chemical, mechanical, and inflammatory burdens on the heart and circulation. Because contemporary evidence-based drug and device HF therapies have little or no mitigating effect on the acute or long-term consequences of such stimuli, there is a sound mechanistic rationale for targeting SDB to reduce cardiovascular event rates and prolong life. However, the promise of observational studies and randomized trials of small size and duration describing a beneficial effect of treating SDB in HF via positive airway pressure was not realized in 2 recent randomized outcome-driven trials: SAVE, which evaluated the cardiovascular effect of treating OSA in a cohort without HF, and SERVE-HF, which reported the results of a strategy of random allocation of minute-ventilation-triggered adaptive servo-ventilation (ASV) for HF patients with CSA. Whether effective treatment of either OSA or CSA improves the HF trajectory by reducing cardiovascular morbidity or mortality has yet to be definitively established. ADVENT-HF, designed to determine the effect of treating both CSA and non-sleepy OSA HF patients with a peak-airflow triggered ASV algorithm, could resolve this present clinical equipoise concerning the treatment of SDB.

  15. Polysomnography test and sleep disordered breathing in Prader-Willi syndrome

    Directory of Open Access Journals (Sweden)

    Andreea- Iulia Dobrescu1,

    2016-12-01

    Full Text Available INTRODUCTION Prader Willi syndrome (PWS is a rare condition and represents the most frequent cause of syndromic obesity. Sleep apnea is a life-threatening affection and is documented as the main cause of sudden death in PWS. OBJECTIVES AND BACKGROUND The aim of our study was to evaluate sleep disorders in PWS patients. MATERIALS AND METHODS We used a portable monitor that recorded time in bed (TIB, the air flow in the upper airways, oxygen saturation, heart rate and snoring. The included patients had a positive clinical and molecular diagnosis of PWS. RESULTS The mean of TIB was 439.3±117.19 minutes. We recorded obstructive, central and mixed apnea, hypopnea and short wakes caused by respiratory events that were variable number and duration, in all patients. cardiovascular morbidity and mortality and improved life quality. Moreover, small doses of these drugs proved to be effective even in patients where hemodialysis alone was enough to control blood pressure. CONCLUSIONS Sleep disorders are present in most PWS patients, not only obese ones according to their anatomical particularities. These events prevent the use of growth hormone therapy, the only available treatment that decreases the adipose mass and increase both prognosis and life quality in PWS patients. Graphical abstract: Polysomnography Test in a PWS patient. REFERENCES 1. Vandeleur M, Davey MJ, Nixon GM. Are sleep studies helpful in children with Prader-Willi syndrome prior to commencement of growth hormone therapy? J Paediatr Child Health. 2013;49:238–41. 2. Giordano L, Toma S, Palonta F, Teggi R, Zucconi M, Candia SD, et al. Obstructive sleep apnea in Prader-Willi syndrome: risks and advantages of adenotonsillectomy. Pediatr Med Chir. 2015;37(2. 3. Pavone M, Caldarelli V, Khirani S, Colella M, Ramirez A, Aubertin G, et al. Sleep disordered breathing in patients with Prader-Willi syndrome: A multicenter study. Pediatr Pulmonol. 2015;50:1354–9

  16. Diagnosis and treatment of sleep related breathing disorders in children: 2007 to 2011.

    LENUS (Irish Health Repository)

    Walsh, A

    2015-03-01

    Sleep related breathing disorders (SRBD) have historically been under-recognised and under-treated. Obstructive sleep apnoea (OSA) affects approximately 3% of children. In line with the increased recognition of SRBD there has been an increase in demand for diagnostic services. We determined the awareness of SRBD amongst Irish paediatricians, examined the provision of sleep services to children throughout the country between 2007 and 2011 and audited diagnostic sleep services in a tertiary centre in 2011. Amongst respondents there was an awareness of SRBD but a poor understanding of diagnostic evaluation with 31\\/46 (67) referring to inappropriate services. There has been a sharp increase in both diagnostic sleep tests (433-1793 [414]) and in the use of non-invasive ventilation (NIV) (31-186 [627]) for treatment of SRBD between 2007 and 2011. Paediatric sleep services are organized in an ad-hoc manner nationally with significant service variation. The use of domiciliary overnight oximetry reduced the requirement for more formal polysomnography by 70%.

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

    Science.gov (United States)

    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.

  18. Sleep-disordered breathing, behavior, and academic performance in Taiwan schoolchildren.

    Science.gov (United States)

    Ting, Hua; Wong, Ruey-Hong; Yang, Hao-Jan; Lee, Shu-Ping; Lee, Shin-Da; Wang, Lee

    2011-01-01

    The behaviors of children may be affected by sleep-disordered breathing (SDB). This study adopts a cross-sectional approach to investigate the relationship between the sleep apneas-hypopneas index during sleep and the behavioral and academic performance of schoolchildren in Taiwan. A total of 138 children (85 boys and 53 girls), ages 6-11, were recruited from two elementary schools to participate in this study. Overnight polysomnographic examinations in hospital were performed to assess sleep quality, including total sleep time, arousal index, apneas-hypopneas index, desaturation index, and lowest oxygen saturation, as well as the percentage of total sleep time spent in rapid eye movement, stage 1, stage 2, stage 3, and stage 4. The children's parents and teachers were required to complete a Chinese version of the Child Behavior Checklist and Teacher's Report Form to assess child behavior and academic achievement. Compared with children without SDB (apneas-hypopneas index ≤1), those with severe SDB (apneas-hypopneas index >15) exhibited more irregular behavioral performance in somatic complaints (odds ratio (OR) = 9.43; 95% confidence interval (CI) = 1.04-85.71) and attention (OR = 9.95; 95% CI = 1.02-97.00). However, different severities of SDB groups did not show significant associations in academic performance. Our study suggests that children with severe SDB may predispose to somatic complaints and attention problems so that sleep examination or medical intervention might be provided at an early age in these children.

  19. Sleepiness and sleep-disordered breathing in truck drivers : risk analysis of road accidents.

    Science.gov (United States)

    Catarino, Rosa; Spratley, Jorge; Catarino, Isabel; Lunet, Nuno; Pais-Clemente, Manuel

    2014-03-01

    Portugal has one of the highest road traffic fatality rates in Europe. A clear association between sleep-disordered breathing (SDB) and traffic accidents has been previously demonstrated. This study aimed to determine prevalence of excessive daytime sleepiness (EDS) and other sleep disorder symptoms among truck drivers and to identify which individual traits and work habits are associated to increased sleepiness and accident risk. We evaluated a sample of 714 truck drivers using a questionnaire (244 face-to-face interviews, 470 self-administered) that included sociodemographic data, personal habits, previous accidents, Epworth Sleepiness Scale (ESS), and the Berlin questionnaire (BQ). Twenty percent of drivers had EDS and 29 % were at high risk for having obstructive sleep apnea syndrome (OSAS). Two hundred sixty-one drivers (36.6 %) reported near-miss accidents (42.5 % sleep related) and 264 (37.0 %), a driving accident (16.3 % sleep related). ESS score ≥ 11 was a risk factor for both near-miss accidents (odds ratio (OR)=3.84, paccidents (OR=2.25, paccidents (OR=3.30, p=0.03). We found an association between high Mallampati score (III-IV) and near misses (OR=1.89, p=0.04). In this sample of Portuguese truck drivers, we observed a high prevalence of EDS and other sleep disorder symptoms. Accident risk was related to sleepiness and antidepressant use. Identifying drivers at risk for OSAS should be a major priority of medical assessment centers, as a public safety policy.

  20. Somatic syndromes, insomnia, anxiety, and stress among sleep disordered breathing patients.

    Science.gov (United States)

    Amdo, Tshering; Hasaneen, Nadia; Gold, Morris S; Gold, Avram R

    2016-05-01

    We tested the hypothesis that the prevalence of somatic syndromes, anxiety, and insomnia among sleep disordered breathing (SDB) patients is correlated with their levels of somatic arousal, the symptoms of increased sympathetic nervous system tone under conditions of stress. We administered the Body Sensation Questionnaire (BSQ; a 17-item questionnaire with increasing levels of somatic arousal scored 17-85) to 152 consecutive upper airway resistance syndrome (UARS) patients and 150 consecutive obstructive sleep apnea/hypopnea (OSA/H) patients. From medical records, we characterized each patient in terms of the presence of syndromes and symptoms into three categories: somatic syndromes (six syndromes), anxiety (anxiety disorders, nightmares, use of benzodiazepines), and insomnia (sleep onset, sleep maintenance, and use of hypnotics). For the pooled sample of SDB patients, we modeled the correlation of the BSQ score with the presence of each syndrome/symptom parameter within each of the three categories, with adjustment for male vs. female. Mean BSQ scores in females were significantly higher than those in males (32.5 ± 11.1 vs. 26.9 ± 8.2; mean ± SD). Increasing BSQ scores significantly correlated with increasing prevalence rates of somatic syndromes (p insomnia (p ≤ 0.0001). In general, females had higher prevalence rates of somatic syndromes and symptoms of anxiety than males at any BSQ score while rates of insomnia were similar. In patients with SDB, there is a strong association between the level of somatic arousal and the presence of stress-related disorders like somatic syndromes, anxiety, and insomnia.

  1. Sleep disordered breathing and depression among U.S. adults: National Health and Nutrition Examination Survey, 2005-2008.

    Science.gov (United States)

    Wheaton, Anne G; Perry, Geraldine S; Chapman, Daniel P; Croft, Janet B

    2012-04-01

    To determine if symptoms of sleep disordered breathing (SDB) are associated with depression symptomology in a national sample. National Health and Nutrition Examination Survey. U.S., 2005-2008. 9,714 adults (≥ 18 years). Respondents were asked about frequency of snoring and snorting, gasping, or stopping breathing while asleep and completed the PHQ-9 (a 9-item depression screener). Odds ratios (OR) and 95% confidence intervals (CI) for SDB symptom-associated probable major depression (defined as a PHQ-9 score ≥ 10) were obtained from sex-specific logistic regression analyses adjusted for body mass index, age, race/ethnicity, and education. Among men, 6.0% reported physician-diagnosed sleep apnea, 37.2% snored ≥ 5 nights/week, 7.1% snorted/stopped breathing ≥ 5 nights/week, and 5.0% had PHQ-9 scores ≥ 10. Among women, 3.1% reported sleep apnea, 22.4% snored ≥ 5 nights/week, 4.3% snorted/stopped breathing ≥ 5 nights/week, and 8.4% had PHQ-9 scores ≥ 10. Sleep apnea was associated with probable major depression (OR = 2.4; 95% CI: 1.5, 3.6 among men; OR = 5.2; 95% CI: 2.7, 9.9 among women). Snoring was not associated with depression symptoms in men or women. Snorting/stopping breathing ≥ 5 nights/week compared to never was strongly associated with probable major depression in men (OR = 3.1; 95% CI: 1.8, 5.2) and women (OR = 3.0; 95% CI: 1.6, 5.4). Frequent snorting/stopping breathing was associated with probable major depression by the PHQ-9 in a national sample of adults. Additional research may be needed to determine whether regular screening for these conditions by mental health professionals and sleep specialists should be recommended.

  2. Epidemiologia dos distúrbios respiratórios do sono Epidemiology of sleep-disordered breathing

    Directory of Open Access Journals (Sweden)

    Carlos Alberto de Assis Viegas

    2010-06-01

    Full Text Available Os principais distúrbios respiratórios do sono, ronco e SAOS, são muito prevalentes na população geral, embora se acredite que a maioria dos casos continue não diagnosticada. Devemos estar atentos para os principais fatores de risco que favorecem o aparecimento desses distúrbios, como gênero masculino, obesidade, envelhecimento e características crânio-faciais. Da mesma forma, a presença de hipertensão arterial sistêmica, enfermidades cardiovasculares e metabólicas deve nos alertar para a possibilidade da concomitância de SAOS.The principal types of sleep-disordered breathing-snoring and obstructive sleep apnea syndrome-are highly prevalent in the general population, although it is believed that the majority of cases continue to go undiagnosed. We should be aware of the principal risk factors that favor the onset of these disorders, such as male gender, obesity, aging and craniofacial features. Similarly, systemic arterial hypertension, cardiovascular diseases and metabolic disorders should alert us to the possibility of obstructive sleep apnea syndrome.

  3. Is sleep-disordered breathing an independent risk factor for hypertension in the general population (13,057 subjects)?

    NARCIS (Netherlands)

    Ohayon, MM; Guilleminault, C; Priest, RG; Zulley, J; Smirne, S

    Objective: Sleep-disordered breathing has been hypothesized to have a close relationship with hypertension but previous studies have reported mixed results. This is an important health issue that requires further clarification because of the potential impact on the prevention and control of

  4. Treatment of sleep-disordered breathing with positive airway pressure devices: technology update

    Directory of Open Access Journals (Sweden)

    Johnson KG

    2015-10-01

    Full Text Available Karin Gardner Johnson, Douglas Clark Johnson Department of Medicine, Baystate Medical Center, Springfield, MA, USA Abstract: Many types of positive airway pressure (PAP devices are used to treat sleep-disordered breathing including obstructive sleep apnea, central sleep apnea, and sleep-related hypoventilation. These include continuous PAP, autoadjusting CPAP, bilevel PAP, adaptive servoventilation, and volume-assured pressure support. Noninvasive PAP has significant leak by design, which these devices adjust for in different manners. Algorithms to provide pressure, detect events, and respond to events vary greatly between the types of devices, and vary among the same category between companies and different models by the same company. Many devices include features designed to improve effectiveness and patient comfort. Data collection systems can track compliance, pressure, leak, and efficacy. Understanding how each device works allows the clinician to better select the best device and settings for a given patient. This paper reviews PAP devices, including their algorithms, settings, and features. Keywords: BiPAP, CPAP, iVAPS, AVAPS, ASV, positive pressure respiration, instrumentation, treatment algorithm

  5. Parents of children referred to a sleep laboratory for disordered breathing reported anxiety, daytime sleepiness and poor sleep quality.

    Science.gov (United States)

    Cadart, Marion; De Sanctis, Livio; Khirani, Sonia; Amaddeo, Alessandro; Ouss, Lisa; Fauroux, Brigitte

    2018-07-01

    We evaluated the impact that having a child with sleep-disordered breathing had on their parents, including their own sleep quality. Questionnaires were completed by 96 parents of 86 children referred for a sleep study or control of continuous positive airway pressure (CPAP) or noninvasive ventilation (NIV) at the sleep laboratory of the Necker Hospital, Paris, France, between October 2015 and January 2016. The questionnaires evaluated anxiety and depression, family functioning, the parents' quality of life, daytime sleepiness and sleep quality. The children had a mean age of seven ±five years and most of the responses (79%) came from their mothers. These showed that 26% of parents showed moderate-to-severe anxiety, 8% moderate-to-severe depression, 6% complex family cohesion, 59% moderate-to-severe daytime sleepiness and 54% poor sleep quality. Anxiety was higher in mothers than in fathers (p parents of children referred to a sleep laboratory reported frequent anxiety, daytime sleepiness and poor sleep quality. ©2018 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  6. Sleep breathing disorders and cognitive function in the elderly: an 8-year follow-up study. the proof-synapse cohort.

    Science.gov (United States)

    Martin, Magali Saint; Sforza, Emilia; Roche, Frédéric; Barthélémy, Jean Claude; Thomas-Anterion, Catherine

    2015-02-01

    Sleep breathing disorder (SBD) may be an important factor in age-related cognitive decline. In a cohort of healthy elderly subjects, we performed an 8-y longitudinal study to assess whether changes in cognitive function occur in untreated elderly patients with SBD and without dementia and the factors implicated in these changes. A population-based longitudinal study. Clinical research settings. A total of 559 participants of the PROOF study aged 67 y at the study entry and free from neurological disorders were examined. N/A. Abnormal breathing events were defined by an apnea-hypopnea index (AHI) > 15. The raw cognitive data and averaged Z-scores for the attentional, executive, and memory functions were collected at the baseline and follow-up. At baseline, AHI > 15 was found in 54% of subjects with 18% having an AHI > 30. At follow-up, the presence of abnormal breathing events was associated with a slight but significant decline in the attentional domain (P = 0.01), which was more evident in the subjects with an AHI > 30 (P = 0.004). No significant changes over time were observed in the executive and memory functions. Several indices of chronic hypoxemia, defined either as a cumulative peripheral oxygen saturation (SpO2) sleep breathing disorder at baseline were associated with small changes in selected cognitive functions specific to the attention domain after controlling for multiple comorbidities, such as sleepiness, hypertension, diabetes, anxiety, and depression. ClinicalTrials.gov identifiers NCT 00759304 and NCT 00766584. © 2015 Associated Professional Sleep Societies, LLC.

  7. Text Mining of Journal Articles for Sleep Disorder Terminologies.

    Directory of Open Access Journals (Sweden)

    Calvin Lam

    Full Text Available Research on publication trends in journal articles on sleep disorders (SDs and the associated methodologies by using text mining has been limited. The present study involved text mining for terms to determine the publication trends in sleep-related journal articles published during 2000-2013 and to identify associations between SD and methodology terms as well as conducting statistical analyses of the text mining findings.SD and methodology terms were extracted from 3,720 sleep-related journal articles in the PubMed database by using MetaMap. The extracted data set was analyzed using hierarchical cluster analyses and adjusted logistic regression models to investigate publication trends and associations between SD and methodology terms.MetaMap had a text mining precision, recall, and false positive rate of 0.70, 0.77, and 11.51%, respectively. The most common SD term was breathing-related sleep disorder, whereas narcolepsy was the least common. Cluster analyses showed similar methodology clusters for each SD term, except narcolepsy. The logistic regression models showed an increasing prevalence of insomnia, parasomnia, and other sleep disorders but a decreasing prevalence of breathing-related sleep disorder during 2000-2013. Different SD terms were positively associated with different methodology terms regarding research design terms, measure terms, and analysis terms.Insomnia-, parasomnia-, and other sleep disorder-related articles showed an increasing publication trend, whereas those related to breathing-related sleep disorder showed a decreasing trend. Furthermore, experimental studies more commonly focused on hypersomnia and other SDs and less commonly on insomnia, breathing-related sleep disorder, narcolepsy, and parasomnia. Thus, text mining may facilitate the exploration of the publication trends in SDs and the associated methodologies.

  8. Text Mining of Journal Articles for Sleep Disorder Terminologies.

    Science.gov (United States)

    Lam, Calvin; Lai, Fu-Chih; Wang, Chia-Hui; Lai, Mei-Hsin; Hsu, Nanly; Chung, Min-Huey

    2016-01-01

    Research on publication trends in journal articles on sleep disorders (SDs) and the associated methodologies by using text mining has been limited. The present study involved text mining for terms to determine the publication trends in sleep-related journal articles published during 2000-2013 and to identify associations between SD and methodology terms as well as conducting statistical analyses of the text mining findings. SD and methodology terms were extracted from 3,720 sleep-related journal articles in the PubMed database by using MetaMap. The extracted data set was analyzed using hierarchical cluster analyses and adjusted logistic regression models to investigate publication trends and associations between SD and methodology terms. MetaMap had a text mining precision, recall, and false positive rate of 0.70, 0.77, and 11.51%, respectively. The most common SD term was breathing-related sleep disorder, whereas narcolepsy was the least common. Cluster analyses showed similar methodology clusters for each SD term, except narcolepsy. The logistic regression models showed an increasing prevalence of insomnia, parasomnia, and other sleep disorders but a decreasing prevalence of breathing-related sleep disorder during 2000-2013. Different SD terms were positively associated with different methodology terms regarding research design terms, measure terms, and analysis terms. Insomnia-, parasomnia-, and other sleep disorder-related articles showed an increasing publication trend, whereas those related to breathing-related sleep disorder showed a decreasing trend. Furthermore, experimental studies more commonly focused on hypersomnia and other SDs and less commonly on insomnia, breathing-related sleep disorder, narcolepsy, and parasomnia. Thus, text mining may facilitate the exploration of the publication trends in SDs and the associated methodologies.

  9. Disorders of Sleep and Ventilatory Control in Prader-Willi Syndrome

    Directory of Open Access Journals (Sweden)

    Emily S. Gillett

    2016-07-01

    Full Text Available Prader-Willi syndrome (PWS is an imprinted genetic disorder conferred by loss of paternal gene expression from chromosome 15q11.2-q13. Individuals with PWS have impairments in ventilatory control and are predisposed toward sleep disordered breathing due to a combination of characteristic craniofacial features, obesity, hypotonia, and hypothalamic dysfunction. Children with PWS progress from failure to thrive during infancy to hyperphagia and morbid obesity during later childhood and onward. Similarly, the phenotype of sleep disordered breathing in PWS patients also evolves over time from predominantly central sleep apnea in infants to obstructive sleep apnea (OSA in older children. Behavioral difficulties are common and may make establishing effective therapy with continuous positive airway pressure (CPAP more challenging when OSA persists after adenotonsillectomy. Excessive daytime sleepiness (EDS is also common in patients with PWS and may continue after OSA is effectively treated. We describe here the characteristic ventilatory control deficits, sleep disordered breathing, and excessive daytime sleepiness seen in individuals with PWS. We review respiratory issues that may contribute to sudden death events in PWS patients during sleep and wakefulness. We also discuss therapeutic options for treating sleep disordered breathing including adenotonsillectomy, weight loss, and CPAP. Lastly, we discuss the benefits and safety considerations related to growth hormone therapy.

  10. Helicobacter pylori seroprevalence in children with sleep-disordered breathing.

    Science.gov (United States)

    Wasilewska, J; Klukowski, M; Debkowska, K; Kilon, J; Citko, D; Flisiak, M; Oleksinska, M; Kaczmarski, M

    2016-08-01

    Chronic Helicobacter pylori (HP) infection is considered to be a factor involved in obstructive sleep apnea syndrome (OSAS). This cross-sectional study examined the seroprevalence of HP in children with sleep-disordered breathing (SDB) in respect to OSAS severity and in reference to other common pediatric medical conditions. Overnight polysomnography with pH-metry (PSG) was performed at a Sleep Laboratory (in the years 2008-2011). OSAS severity was determined based on Obstructive Apnea Index (OAI). Subjects were classified into primary snoring group (OAI system, food hypersensitivity, and gastrointestinal tract]. Analyses were performed by nonparametric statistical tests. HP seropositivity was 10.4% (12/115) in the SDB group and 11.6% (45/387) in the reference group. HP positive and negative subjects did not differ in PSG, acid gastro-esophageal reflux index nor in age, sex, nutritional status (BMI-z score), and hematological indices in the SDB group. Seropositivity was found in 16.7% of the primary snoring group, 10.2% of mild-moderate OSAS, and in 11.1% of severe OSAS (chi(2) p = 0.832). Children with SDB are not more predisposed to a chronic HP infection than children with other common chronic pediatric conditions. HP seropositivity does not influence OSAS severity but possible infection should none-the-less be considered on a case-by-case basis. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  11. Observations on sleep-disordered breathing in idiopathic Parkinson's disease.

    Directory of Open Access Journals (Sweden)

    Philipp O Valko

    Full Text Available BACKGROUND: This study has two main goals: 1. to determine the potential influence of dopaminergic drugs on sleep-disordered breathing (SDB in Parkinson's disease (PD and 2. to elucidate whether NREM and REM sleep differentially impact SDB severity in PD. METHODS: Retrospective clinical and polysomnographic study of 119 consecutive PD patients and comparison with age-, sex- and apnea-hypopnea-index-matched controls. RESULTS: SDB was diagnosed in 57 PD patients (48%. Apnea-hypopnea index was significantly higher in PD patients with central SDB predominance (n = 7; 39.3±16.7/h than obstructive SDB predominance (n = 50; 20.9±16.8/h; p = 0.003. All PD patients with central SDB predominance appeared to be treated with both levodopa and dopamine agonists, whereas only 56% of those with obstructive SDB predominance were on this combined treatment (p = 0.03. In the whole PD group with SDB (n = 57, we observed a significant decrease of apnea-hypopnea index from NREM to REM sleep (p = 0.02, while controls revealed the opposite tendency. However, only the PD subgroup with SDB and treatment with dopamine agonists showed this phenomenon, while those without dopamine agonists had a similar NREM/REM pattern as controls. CONCLUSIONS: Our findings suggest an ambiguous impact of dopamine agonists on SDB. Medication with dopamine agonists seems to enhance the risk of central SDB predominance. Loss of normal muscle atonia may be responsible for decreased SDB severity during REM sleep in PD patients with dopamine agonists.

  12. Craniofacial changes and symptoms of sleep-disordered breathing in healthy children

    Directory of Open Access Journals (Sweden)

    Maria Christina Thomé Pacheco

    2015-06-01

    Full Text Available INTRODUCTION: The main cause of mouth breathing and sleep-disordered breathing (SDB in childhood is associated with upper airway narrowing to varying degrees. OBJECTIVE: The aim of this study was to assess the prevalence of morphological and functional craniofacial changes and the main clinical symptoms of SDB in healthy children. METHODS: A cross-sectional observational study was conducted. A sample comprising 687 healthy schoolchildren, aged 7-12 years old and attending public schools, was assessed by medical history, clinical medical and dental examination, and respiratory tests. The self-perceived quality of life of mouth breathing children was obtained by a validated questionnaire. RESULTS: Out of the total sample, 520 children were nose breathers (NB while 167 (24.3% were mouth breathers (MB; 32.5% had severe hypertrophy of the palatine tonsils, 18% had a Mallampati score of III or IV, 26.1% had excessive overjet and 17.7% had anterior open bite malocclusion. Among the MB, 53.9% had atresic palate, 35.9% had lip incompetence, 33.5% reported sleepiness during the day, 32.2% often sneezed, 32.2% had a stuffy nose, 19.6% snored, and 9.4% reported having the feeling to stop breathing while asleep. However, the self-perception of their quality of life was considered good. CONCLUSION: High prevalence of facial changes as well as signs and symptoms of mouth breathing were found among health children, requiring early diagnosis and treatment to reduce the risk of SDB.

  13. Management of Sleep Disordered Breathing in Patients with Heart Failure.

    Science.gov (United States)

    Oates, Connor P; Ananthram, Manjula; Gottlieb, Stephen S

    2018-04-03

    This paper reviews treatment options for sleep disordered breathing (SDB) in patients with heart failure. We sought to identify therapies for SDB with the best evidence for long-term use in patients with heart failure and to minimize uncertainties in clinical practice by examining frequently discussed questions: what is the role of continuous positive airway pressure (CPAP) in patients with heart failure? Is adaptive servo-ventilation (ASV) safe in patients with heart failure? To what extent is SDB a modifiable risk factor? Consistent evidence has demonstrated that the development of SDB in patients with heart failure is a poor prognostic indicator and a risk factor for cardiovascular mortality. However, despite numerous available interventions for obstructive sleep apnea and central sleep apnea, it remains unclear what effect these therapies have on patients with heart failure. To date, all major randomized clinical trials have failed to demonstrate a survival benefit with SDB therapy and one major study investigating the use of adaptive servo-ventilation demonstrated harm. Significant questions persist regarding the management of SDB in patients with heart failure. Until appropriately powered trials identify a treatment modality that increases cardiovascular survival in patients with SDB and heart failure, a patient's heart failure management should remain the priority of medical care.

  14. Sleep disturbances in children with attention-deficit/hyperactivity disorder

    Science.gov (United States)

    Spruyt, Karen; Gozal, David

    2011-01-01

    In this article, we advocate the need for better understanding and treatment of children exhibiting inattentive, hyperactive, impulsive behaviors, by in-depth questioning on sleepiness, sleep-disordered breathing or problematic behaviors at bedtime, during the night and upon awakening, as well as night-to-night sleep duration variability. The relationships between sleep and attention-deficit/hyperactivity disorder (ADHD) are complex and are routinely overlooked by practitioners. Motricity and somnolence, the most consistent complaints and objectively measured sleep problems in children with ADHD, may develop as a consequence of multidirectional and multifactorial pathways. Therefore, subjectively perceived or reported restless sleep should be evaluated with specific attention to restless legs syndrome or periodic limb movement disorder, and awakenings should be queried with regard to parasomnias, dyssomnias and sleep-disordered breathing. Sleep hygiene logs detailing sleep onset and offset quantitatively, as well as qualitatively, are required. More studies in children with ADHD are needed to reveal the 24-h phenotype, or its sleep comorbidities. PMID:21469929

  15. Decision aid prototype development for parents considering adenotonsillectomy for their children with sleep disordered breathing

    OpenAIRE

    Maguire, Erin; Hong, Paul; Ritchie, Krista; Meier, Jeremy; Archibald, Karen; Chorney, Jill

    2016-01-01

    Background To describe the process involved in developing a decision aid prototype for parents considering adenotonsillectomy for their children with sleep disordered breathing. Methods A paper-based decision aid prototype was developed using the framework proposed by the International Patient Decision Aids Standards Collaborative. The decision aid focused on two main treatment options: watchful waiting and adenotonsillectomy. Usability was assessed with parents of pediatric patients and prov...

  16. AASM standards of practice compliant validation of actigraphic sleep analysis from SOMNOwatch(TM) versus polysomnographic sleep diagnostics shows high conformity also among subjects with sleep disordered breathing

    International Nuclear Information System (INIS)

    Dick, R; Schulz, J; Penzel, T; Fietze, I; Partinen, M; Hein, H

    2010-01-01

    In recent AASM practice, parameter actimetry is cited to measure total sleep time in obstructive sleep apnoea patients, when polysomnography is not available. An actigraph was therefore compared to polysomnographic data in 28 subjects with known sleep disordered breathing. Total sleep time (TST), sleep period time (SPT), sleep efficiency (SE), sustained sleep efficiency (SSE), sleep onset latency (SL) and sleep/wake pattern were compared to gold standard polysomnography. The results of an epoch-by-epoch comparison of sleep/wake from actigraphy to sleep stages from polysomnography gave a sensitivity of 90.2%, a specificity of 95.2% and an overall accuracy of 85.9%. Correlations were moderately strong for SE (0.71, p < 0.001) and SSE (0.65, p < 0.001) and high for TST (0.89, p < 0.001), SPT (0.91, p < 0.001) and SL (0.89, p < 0.001). It was concluded that actigraphy is not identical with PSG recording but gives good results in sleep/wake patterns and predicting TST, SPT, SSE, SE and SL also in sleep apnoea patients not suffering from other sleep disorders. The difficult detection of correct sleep onset causes SSE and SL to be less predictable. Therefore a 15-epoch criterion was introduced and resulted in high correlation of 0.89 for sleep latency, but has to be tested on a bigger population

  17. Prevalence and Phenotype of Sleep Disorders in 60 Adults With Prader-Willi Syndrome.

    Science.gov (United States)

    Ghergan, Adelina; Coupaye, Muriel; Leu-Semenescu, Smaranda; Attali, Valérie; Oppert, Jean-Michel; Arnulf, Isabelle; Poitou, Christine; Redolfi, Stefania

    2017-12-01

    Excessive sleepiness is a common symptom in Prader-Willi syndrome (PWS), and it negatively impacts the quality of life. Obstructive sleep apnea and narcolepsy phenotypes have been reported in PWS. We characterized sleep disorders in a large cohort of adults with PWS. All consecutive patients with genetically confirmed PWS unselected for sleep-related symptoms, underwent a clinical interview, polysomnography, and multiple sleep latency tests (MSLT, n = 60), followed by long-term (24 hours) polysomnography (n = 22/60). Among 60 adults evaluated (57% female, aged 25 ± 10 years, body mass index: 39 ± 12 kg/m2), 67% reported excessive sleepiness. According to the sleep study results, 43% had a previously unrecognized hypersomnia disorder, 15% had an isolated sleep breathing disorder, 12% had combined hypersomnia disorder and untreated breathing sleep disorder, and only 30% had normal sleep. Isolated hypersomnia disorder included narcolepsy in 35% (type 1, n = 1, and type 2, n = 8), hypersomnia in 12% (total sleep time >11 hours, n = 2, and MSLT sleep onset in REM periods and MSLT >8 minutes, n = 10, and 8 minutes Sleep breathing disorders, isolated and combined, included obstructive sleep apnea (n = 14, already treated in seven), sleep hypoxemia (n = 1) and previously undiagnosed hypoventilation (n = 5). Modafinil was taken by 16 patients (well tolerated in 10), resulting in improved sleepiness over a mean 5-year follow-up period. Sleepiness affects more than half of adult patients with PWS, with a variety of hypersomnia disorder (narcolepsy, hypersomnia, and borderline phenotypes) and breathing sleep disorders. Earlier diagnosis and management of sleep disorders may improve sleepiness, cognition, and behavior in these patients. © Sleep Research Society 2017. Published by Oxford University Press [on behalf of the Sleep Research Society]. All rights reserved. For permissions, please email: journals.permissions@oup.com

  18. Sleep-disordered breathing in patients with COPD and mild hypoxemia: prevalence and predictive variables.

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    Silva, José Laerte Rodrigues; Conde, Marcus Barreto; Corrêa, Krislainy de Sousa; Rabahi, Helena; Rocha, Arthur Alves; Rabahi, Marcelo Fouad

    2017-01-01

    To infer the prevalence and variables predictive of isolated nocturnal hypoxemia and obstructive sleep apnea (OSA) in patients with COPD and mild hypoxemia. This was a cross-sectional study involving clinically stable COPD outpatients with mild hypoxemia (oxygen saturation = 90-94%) at a clinical center specializing in respiratory diseases, located in the city of Goiânia, Brazil. The patients underwent clinical evaluation, spirometry, polysomnography, echocardiography, arterial blood gas analysis, six-minute walk test assessment, and chest X-ray. The sample included 64 patients with COPD and mild hypoxemia; 39 (61%) were diagnosed with sleep-disordered breathing (OSA, in 14; and isolated nocturnal hypoxemia, in 25). Correlation analysis showed that PaO2 correlated moderately with mean sleep oxygen saturation (r = 0.45; p = 0.0002), mean rapid eye movement (REM) sleep oxygen saturation (r = 0.43; p = 0.001), and mean non-REM sleep oxygen saturation (r = 0.42; p = 0.001). A cut-off point of PaO2 ≤ 70 mmHg in the arterial blood gas analysis was significantly associated with sleep-disordered breathing (OR = 4.59; 95% CI: 1.54-13.67; p = 0.01). The model showed that, for identifying sleep-disordered breathing, the cut-off point had a specificity of 73.9% (95% CI: 51.6-89.8%), a sensitivity of 63.4% (95% CI: 46.9-77.9%), a positive predictive value of 81.3% (95% CI: 67.7-90.0%), and a negative predictive value of 53.1% (95% CI: 41.4-64.4%), with an area under the ROC curve of 0.69 (95% CI: 0.57-0.80), correctly classifying the observations in 67.2% of the cases. In our sample of patients with COPD and mild hypoxemia, the prevalence of sleep-disordered breathing was high (61%), suggesting that such patients would benefit from sleep studies. Inferir a prevalência e as variáveis preditivas de hipoxemia noturna e apneia obstrutiva do sono (AOS) em pacientes portadores de DPOC com hipoxemia leve. Estudo transversal realizado em pacientes ambulatoriais, clinicamente est

  19. Recognition and Management of Sleep-Disordered Breathing in Chronic Heart Failure

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    Kikta, Donald; Khayat, Rami

    2013-01-01

    It is increasingly recognized that sleep-disordered breathing (SDB) is a common modifiable risk factor for cardiovascular disease with significant impact on morbidity and potentially mortality. SDB is highly prevalent in patients with systolic or diastolic heart failure. A high index of suspicion is necessary to diagnose SDB in patients with heart failure because the vast majority of affected patients do not report daytime symptoms. Recent clinical trials have demonstrated improvement in heart function, exercise tolerance, and quality of life after treatment of SDB in patients with heart failure. Accumulating evidence suggests that treatment of SDB should complement the established pharmacologic therapy for chronic heart failure. However, mortality benefit has yet to be demonstrated. PMID:21086079

  20. Association between sleep-disordered breathing, sleep-wake pattern, and cognitive impairment among patients with chronic heart failure.

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    Hjelm, Carina; Strömberg, Anna; Arestedt, Kristofer; Broström, Anders

    2013-05-01

    Chronic heart failure (CHF) and sleep-disordered breathing (SDB) are often co-existing problems among the elderly. Apnoeic events may cause cognitive impairment. The aim of the study was to compare sleep and wake patterns, insomnia, daytime sleepiness, and cognitive function in community-dwelling CHF patients, with and without SDB, and to investigate the association between sleep-related factors and cognitive dysfunction. In this cross-sectional observational study, SDB was measured with an ApneaLink device and defined as an apnoea-hypopnoea index (AHI) ≥15/h of sleep. Sleep and wake patterns were measured with actigraphy for 1 week. Insomnia was measured with the Minimal Insomnia Symptom Scale, daytime sleepiness with the Epworth Sleepiness Scale, and cognitive function with a neuropsychological test battery. A total of 137 patients (68% male, median age 72 years, 58% NYHA functional class II) were consecutively included. Forty-four per cent had SDB (AHI ≥15). The SDB group had significantly higher saturation time below 90%, more difficulties maintaining sleep, and lower levels of daytime sleepiness compared with the non-SDB group. Cognitive function and sleep and wake patterns did not differ between the SDB and the non-SDB group. Insomnia was associated with decreased global cognition. The prevalence of cognitive dysfunction was low in this population with predominantly mild to moderate CHF. This might have influenced the lack of associations between cognitive function and SDB. Insomnia was the only sleep-related factor significantly influencing cognition.

  1. Symptoms of sleep disorders and objective academic performance.

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    de Carvalho, Luciane Bizari Coin; do Prado, Lucila Bizari Fernandes; Ferrreira, Vanessa Ruotolo; da Rocha Figueiredo, Mariana Bezerra; Jung, Aline; de Morais, José Fausto; do Prado, Gilmar Fernandes

    2013-09-01

    We aimed to compare the academic performance of children with and without symptoms of sleep disorders (SSD). We distributed 5400 questionnaires (Sleep Disturbance Scale for Children [SDSC], Brazilian version) to 7- to 10-year-old children at public elementary schools in São Paulo, Brazil. We analyzed the academic grades of Portuguese (Port) and Mathematics (Math) in 2384 children (1224 girls; 51%). Grades were assigned on a scale of 0-10 and five was considered a passing grade. Children with symptoms of sleep disorders (SSD) and symptoms of sleep-breathing disorders (SSBD) were compared to children with no symptoms of SSD (no-SSD). Mean Port (6.6±2.2) and Math (6.3±2.2) grades were lower in children with SSD or sleep-breathing disorders (SBD) than those among children with no-SSD (Port, 7.1±2.1 and Math, 7.1±2.1; Pacademic performance in Math and Port. Copyright © 2013 Elsevier B.V. All rights reserved.

  2. Sleep-disordered breathing in children with asthma: a systematic review on the impact of treatment

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    Sánchez T

    2016-04-01

    Full Text Available Trinidad Sánchez,1 José A Castro-Rodríguez,2 Pablo E Brockmann2,3 1Division of Pediatrics, School of Medicine, 2Department of Pediatric Cardiology and Pulmonology, Division of Pediatrics, School of Medicine, 3Sleep Medicine Center, Department of Neurology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile Background: The objective was to perform a systematic review in order to describe the relationship between asthma and sleep-disordered breathing (SDB in children, especially regarding the impact of treatment and management. Methods: We performed an electronic search in MEDLINE, EMBASE, and LILACS database. Study inclusion criteria were the following: 1 studies that examined the relationship between asthma/wheezing and SDB/obstructive sleep apnea (OSA; and 2 studies conducted in children <18 years of age. Primary outcomes were the prevalence of asthma and SDB, the tests used for diagnosis, and the influence of their treatment and management. Results: One thousand and twenty studies were identified, among which 32 were selected (n=143,343 children; 51% males; age [mean ± standard deviation] 8.4±2.5 years. Most studies (n=26 diagnosed SDB using questionnaires or clinical history. Nine studies performed a sleep study for diagnosing OSA. The diagnosis of asthma was based on clinical history (n=16, previous medical diagnosis (n=4, questionnaires (n=12, and spirometry (n=5. Children with asthma were more likely to develop habitual snoring and OSA, and children with SDB were more likely to develop asthma. Moreover, asthma was associated with more severe OSA, and the presence of SDB was associated with severe asthma. Treatment of SDB with adenotonsillectomy was associated with significant asthma improvement. Conclusion: The relationship between asthma and SDB appears to be bidirectional, and adenotonsillectomy appears to improve asthma control. Future trials on how asthma treatment could impact on SDB are needed

  3. Marital status and sleep-disordered breathing in a sample of middle-aged French men.

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    Teculescu, D; Hannhart, B; Virion, J M; Montaut-Verient, B; Michaely, J P

    2004-01-01

    The aim of the present study was to test the hypothesis that unmarried (single) men have more sleep-disordered breathing symptoms due to a higher prevalence of obesity and a less healthy lifestyle than men living with a partner. Men (499) aged 23-66 years completed a structured questionnaire, had standard anthropometric measurements and a simple, noninvasive nose-throat examination. Of the 499,496 subjects answered the question concerning their marital status; 86% of them were married or lived with a partner (reference group) and the other 14% had never been married, divorced, or widowed ("single" group, considered at risk). Single subjects were younger, included slightly more smokers (30 vs. 23%) and more subjects with a history of chronic bronchitis, and less frequently had a large soft palate. The prevalence of sleep-disordered symptoms was not significantly different between the two groups. However, a study involving a larger number of subjects with information regarding alcoholic consumption may be needed to further evaluate this question.

  4. Sleep-related breathing disorders and non-invasive ventilation

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    Agata Lax

    2015-05-01

    Full Text Available Non-invasive mechanical ventilation (NPPV was originally used in patients with acute respiratory impairment or exacerbations of chronic respiratory diseases, as an alternative to the endotracheal tube. Over the last thirty years NPPV has been also used at night in patients with stable chronic lung disease such as obstructive sleep apnea, the overlap syndrome (chronic obstructive pulmonary disease and obstructive sleep apnea, neuromuscular disorders, obesity-hypoventilation syndrome, and in other conditions such as sleep disorders associated with congestive heart failure (Cheyne-Stokes respiration. In this no-systematic review we discuss the different types of NPPV, the specific conditions in which they can be used and the indications, recommendations and evidence supporting the efficacy of NPPV. Optimizing patient acceptance and adherence to non-invasive ventilation treatment is challenging. The treatment of sleep-related disorders is a life-threatening condition. The optimal level of treatment should be determined in a sleep laboratory. Side effects directly affecting the patient’s adherence to treatment are known. The most common are nasopharyngeal symptoms including increased congestion and rhinorrhea; these effects are related to reduced humidity of inspired gas. Humidification of delivered gas may improve these symptoms.

  5. SLEEP AND CIRCADIAN RHYTHM DISORDERS IN PARKINSON'S DISEASE.

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    Gros, Priti; Videnovic, Aleksandar

    2017-09-01

    Sleep disorders are among the most challenging non-motor features of Parkinson's disease (PD) and significantly affect quality of life. Research in this field has gained recent interest among clinicians and scientists and is rapidly evolving. This review is dedicated to sleep and circadian dysfunction associated with PD. Most primary sleep disorders may co-exist with PD; majority of these disorders have unique features when expressed in the PD population. We discuss the specific considerations related to the common sleep problems in Parkinson's disease including insomnia, rapid eye movement sleep behavior disorder, restless legs syndrome, sleep disordered breathing, excessive daytime sleepiness and circadian rhythm disorders. Within each of these sleep disorders, we present updated definitions, epidemiology, etiology, diagnosis, clinical implications and management. Furthermore, areas of potential interest for further research are outlined.

  6. The Impact of Sleep-Disordered Breathing on Body Mass Index (BMI): The Sleep Heart Health Study (SHHS).

    Science.gov (United States)

    Brown, Mark A; Goodwin, James L; Silva, Graciela E; Behari, Ajay; Newman, Anne B; Punjabi, Naresh M; Resnick, Helaine E; Robbins, John A; Quan, Stuart F

    2011-12-08

    INTRODUCTION: It is well known that obesity is a risk factor for sleep-disordered breathing (SDB). However, whether SDB predicts increase in BMI is not well defined. Data from the Sleep Heart Health Study (SHHS) were analyzed to determine whether SDB predicts longitudinal increase in BMI, adjusted for confounding factors. METHODS: A full-montage unattended home polysomnogram (PSG) and body anthropometric measurements were obtained approximately five years apart in 3001 participants. Apnea-hypopnea index (AHI) was categorized using clinical thresholds: sleep apnea), and ≥ 15 (moderate to severe sleep apnea). Linear regression was used to examine the association between the three AHI groups and increased BMI. The model included age, gender, race, baseline BMI, and change in AHI as covariates. RESULTS: Mean (SD) age was 62.2 years (10.14), 55.2% were female and 76.1% were Caucasian. Five-year increase in BMI was modest with a mean (SD) change of 0.53 (2.62) kg/m(2) (p=0.071). A multivariate regression model showed that subjects with a baseline AHI between 5-15 had a mean increase in BMI of 0.22 kg/m(2) (p=0.055) and those with baseline AHI ≥ 15 had a BMI increase of 0.51 kg/m(2) (plosing weight.

  7. Sleep Disorders Associated With Alzheimer's Disease: A Perspective

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    Anna Brzecka

    2018-05-01

    Full Text Available Sleep disturbances, as well as sleep-wake rhythm disturbances, are typical symptoms of Alzheimer's disease (AD that may precede the other clinical signs of this neurodegenerative disease. Here, we describe clinical features of sleep disorders in AD and the relation between sleep disorders and both cognitive impairment and poor prognosis of the disease. There are difficulties of the diagnosis of sleep disorders based on sleep questionnaires, polysomnography or actigraphy in the AD patients. Typical disturbances of the neurophysiological sleep architecture in the course of the AD include deep sleep and paradoxical sleep deprivation. Among sleep disorders occurring in patients with AD, the most frequent disorders are sleep breathing disorders and restless legs syndrome. Sleep disorders may influence circadian fluctuations of the concentrations of amyloid-β in the interstitial brain fluid and in the cerebrovascular fluid related to the glymphatic brain system and production of the amyloid-β. There is accumulating evidence suggesting that disordered sleep contributes to cognitive decline and the development of AD pathology. In this mini-review, we highlight and discuss the association between sleep disorders and AD.

  8. The Association between Sleep-Disordered Breathing and Magnetic Resonance Imaging Findings in a Pediatric Cohort with Chiari 1 Malformation

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    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.

  9. Clinical and polysomnographic characteristics of patients with REM sleep disordered breathing

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    Cláudia Chaves Loureiro

    2009-09-01

    Full Text Available There is a 10–36% rate of obstructive sleep apnoea syndrome (OSAS associated with rapid eye movement (REM in the OSAS population. Prior studies have suggested an increased prevalence of psychiatric disorders and an effect of gender and age on these patients.Our aim was to study the clinical and polysomnograph (PSG characteristics of our patients with REM-related sleep disordered breathing (REM SDB.Inclusion criteria was the identification of REM SDB detected by PSG defined as apnea-hypopnea index (AHI in REM sleep ≥ 5 h, AHI in non-REM sleep (NREM ≤ 15 h and REM/NREM AHI ≥ 2.Several Sleep Disorders Questionnaire (SDQ version 1.02 parameters were analysed.The study comprised 19 patients with a mean age of 54.0 (SD ± 13.97, a mean BMI of 29.01 (SD ± 4.10 and a 0.58 female / male ratio. The mean Epworth Sleepiness Scale score was 12.74 (SD ± 4.86. Mean AHI was 9.16/h (SD 4.09; mean AHI in REM sleep 37.08/h (SD 25.87 and mean REM-AHI/NREM-AHI 8.86 (SD 8.63.The anxiety disorder rate was 33.3%; 44.4% in females, 16.7% in males.The average deep sleep was 20.7% (SD 10.42 and REM sleep 15.45% (SD 9.96, with a sleep efficiency of 85.3 (SD 8.70.No significant statistical correlation was found between the REM/NREM AHI index and anxiety symptoms, daytime sleepiness and sleep quality (REM and deep sleep percentages.These patients differ from the general OSAS population: on average, they are not obese, there are a greater number of females affected and they do not present a very significant diurnal hypersomnia. Reduced deep sleep and increased REM sleep were also present versus general population data, and sleep efficiency was just below the normal limit.Anxiety disorders were more prevalent in this group than described for the general population (3% and OSAS patients. Resumo: A síndroma de apneia obstrutiva do sono (SAOS associada ao sono REM tem uma incidência de 10–36% na

  10. Interactions between sleep disorders and oral diseases.

    Science.gov (United States)

    Huynh, N T; Emami, E; Helman, J I; Chervin, R D

    2014-04-01

    Dental sleep medicine is a rapidly growing field that is in close and direct interaction with sleep medicine and comprises many aspects of human health. As a result, dentists who encounter sleep health and sleep disorders may work with clinicians from many other disciplines and specialties. The main sleep and oral health issues that are covered in this review are obstructive sleep apnea, chronic mouth breathing, sleep-related gastroesophageal reflux, and sleep bruxism. In addition, edentulism and its impact on sleep disorders are discussed. Improving sleep quality and sleep characteristics, oral health, and oral function involves both pathophysiology and disease management. The multiple interactions between oral health and sleep underscore the need for an interdisciplinary clinical team to manage oral health-related sleep disorders that are commonly seen in dental practice. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  11. Emotional content of dreams in obstructive sleep apnea hypopnea syndrome patients and sleepy snorers attending a sleep-disordered breathing clinic.

    Science.gov (United States)

    Fisher, Samantha; Lewis, Keir E; Bartle, Iona; Ghosal, Robin; Davies, Lois; Blagrove, Mark

    2011-02-15

    To assess prospectively the emotional content of dreams in individuals with the obstructive sleep apnea hypopnea syndrome (OSAHS) and sleepy snorers. Prospective observational study. Forty-seven patients with sleepiness and snoring attending a sleep-disordered breathing clinic, completed a morning diary concerning pleasantness/unpleasantness of their dreams for 10 days, and then had AHI assessed by a limited-channel home sleep study. Participants and groups: Sleepy snorers, AHI dreams and nightmares during the diary period. The AHI ≥ 15 group were significantly higher on dream unpleasantness than were the sleepy snorers (p dream emotions (Levene test for homogeneity of variance between the 3 groups, p = 0.018). Mean daytime anxiety and daytime depression were significantly correlated with mean dream unpleasantness and with mean number of nightmares over the diary period. Patients with AHI ≥ 15 had more emotionally negative dreams than patients with AHI dream emotion decreased with increasing AHI, possibly because sleep fragmentation with increasing AHI results in fewer and shorter dreams, in which emotions are rarer.

  12. Sleep-induced periodic breathing and apnea: a theoretical study.

    Science.gov (United States)

    Khoo, M C; Gottschalk, A; Pack, A I

    1991-05-01

    To elucidate the mechanisms that lead to sleep-disordered breathing, we have developed a mathematical model that allows for dynamic interactions among the chemical control of respiration, changes in sleep-waking state, and changes in upper airway patency. The increase in steady-state arterial PCO2 accompanying sleep is shown to be inversely related to the ventilatory response to CO2. Chemical control of respiration becomes less stable during the light stage of sleep, despite a reduction in chemoresponsiveness, due to a concomitant increase in "plant gain" (i.e., responsiveness of blood gases to ventilatory changes). The withdrawal of the "wakefulness drive" during sleep onset represents a strong perturbation to respiratory control: higher magnitudes and rates of withdrawal of this drive favor instability. These results may account for the higher incidence of periodic breathing observed during light sleep and sleep onset. Periodic ventilation can also result from repetitive alternations between sleep onset and arousal. The potential for instability is further compounded if the possibility of upper airway occlusion is also included. In systems with high controller gains, instability is mediated primarily through chemoreflex overcompensation. However, in systems with depressed chemoresponsiveness, rapid sleep onset and large blood gas fluctuations trigger repetitive episodes of arousal and hyperpnea alternating with apneas that may or may not be obstructive. Between these extremes, more complex patterns can arise from the interaction between chemoreflex-mediated oscillations of shorter-cycle-duration (approximately 36 s) and longer-wavelength (approximately 60-80 s) state-driven oscillations.

  13. Cerebrovascular pulsatility in patients with sleep-disordered breathing.

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    Ramos, Alberto R; Cabral, Digna; Lee, David J; Sacco, Ralph L; Rundek, Tatjana

    2013-05-01

    The aim of our study is to determine the association between the pulsatility index (PI), a surrogate of cerebral small vessel disease and sleep-disordered breathing (SDB). We conducted a transcranial Doppler ultrasound (TCD) study of 19 consecutive patients free of stroke and cardiovascular disease, referred for the evaluation of SDB. TCD was performed by a certified technologist. Subsequent polysomnography was performed according to the practice parameters of the American Academy of Sleep Medicine. We evaluated the association between the apnea-hypopnea index (AHI), the oxygen nadir, the blood flow velocities, and the Gosling PI, for the middle cerebral artery. We performed Spearman's rank correlation and nonparametric regression to evaluate the relationship between AHI, oxygen levels, and the PI. Median age was 48 years (range 37-83), with 52 % male sex (n = 10), and median BMI of 29.9 (range 25-40.4). The median AHI was 16.4 (0.2-69). The median PI was 0.97 (0.72-1.89) cm/s. The PI correlated with the AHI (rho = 0.44; p = 0.004) and with age (rho = 0.57; p = 0.001). Nonparametric regression adjusting for age showed a positive association between the AHI and the PI (standardized estimate = 0.88; p = 0.002). There was no relation between the oxygen nadir and the PI. We observed increased PI in patients with SDB during wakefulness. The PI could potentially be an estimate of cerebral small vessel disease in patients with SDB and hence allow evaluating cerebral hemodynamics during wakefulness with a clinically relevant device.

  14. Sleep-Related Breathing Disorders in Chiari Malformation Type 1: A Prospective Study of 90 Patients.

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    Ferré, Álex; Poca, Maria A; de la Calzada, Maria D; Moncho, Dulce; Romero, Odile; Sampol, Gabriel; Sahuquillo, Juan

    2017-06-01

    The aim of the present study is to describe the prevalence of sleep disorders in a large group of patients with Chiari malformation type 1 (CM-1) and determine the presence of risk factors associated with these abnormalities. Prospective study with consecutive patient selection. We included 90 adult patients with CM-1, defined by the presence of a cerebellar tonsillar descent (TD) ≥3 mm. Clinical, neuroradiological studies, and nocturnal polysomnography (PSG) was carried out. In addition, patients were also subclassified into 2 CM subtypes: CM-1, with the obex above the foramen magnum (FM) and CM-1.5, in which along with a TD ≥3 mm, the obex was located below the FM. We observed a high prevalence (50%) of sleep-related breathing disorders (SRBDs) with predominant hypopnea. Only six patients showed a central apnea index of ≥5. Hypoventilation was observed in only three patients. SRBD severity was associated with male sex, older age, excess weight, and the presence of hydrocephalus. No differences in clinical or PSG parameters were found when comparing CM subtypes (CM-1 and CM-1.5). Sleep architecture study showed decreased sleep efficiency with an increase in arousal and waking after sleep onset. The presence of SRBDs was found to be associated with poorer sleep architecture parameters. This study confirms a high prevalence of SRBDs in patients with CM-1 and CM-1.5, with a predominant obstructive component. Nocturnal PSG recordings should be systematically conducted in these patients, especially those who are male, older, or overweight or those who present hydrocephalus. © Sleep Research Society 2017. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

  15. SNORAP: A Device for the Correction of Impaired Sleep Health by Using Tactile Stimulation for Individuals with Mild and Moderate Sleep Disordered Breathing

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    Mete Yağanoğlu

    2017-09-01

    Full Text Available Sleep physiology and sleep hygiene play significant roles in maintaining the daily lives of individuals given that sleep is an important physiological need to protect the functions of the human brain. Sleep disordered breathing (SDB is an important disease that disturbs this need. Snoring and Obstructive Sleep Apnea Syndrome (OSAS are clinical conditions that affect all body organs and systems that intermittently, repeatedly, with at least 10 s or more breathing stops that decrease throughout the night and disturb sleep integrity. The aim of this study was to produce a new device for the treatment of patients especially with position and rapid eye movement (REM-dependent mild and moderate OSAS. For this purpose, the main components of the device (the microphone (snore sensor, the heart rate sensor, and the vibration motor, which we named SNORAP were applied to five volunteer patients (male, mean age: 33.2, body mass index mean: 29.3. After receiving the sound in real time with the microphone, the snoring sound was detected by using the Audio Fingerprint method with a success rate of 98.9%. According to the results obtained, the severity and the number of the snoring of the patients using SNORAP were found to be significantly lower than in the experimental conditions in the apnea hypopnea index (AHI, apnea index, hypopnea index, in supine position’s AHI, and REM position’s AHI before using SNORAP (Paired Sample Test, p < 0.05. REM sleep duration and nocturnal oxygen saturation were significantly higher when compared to the group not using the SNORAP (Paired Sample Test, p < 0.05.

  16. Longitudinal assessment of sleep disordered breathing in Vietnam veterans with post-traumatic stress disorder

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    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

  17. A review of sleep disorders and melatonin.

    Science.gov (United States)

    Xie, Zizhen; Chen, Fei; Li, William A; Geng, Xiaokun; Li, Changhong; Meng, Xiaomei; Feng, Yan; Liu, Wei; Yu, Fengchun

    2017-06-01

    Sleep disorders are a group of conditions that affect the ability to sleep well on a regular basis and cause significant impairments in social and occupational functions. Although currently approved medications are efficacious, they are far from satisfactory. Benzodiazepines, antidepressants, antihistamines and anxiolytics have the potential for dependence and addiction. Moreover, some of these medications can gradually impair cognition. Melatonin (N-acetyl-5-methoxytryptamine) is an endogenous hormone produced by the pineal gland and released exclusively at night. Exogenous melatonin supplementation is well tolerated and has no obvious short- or long-term adverse effects. Melatonin has been shown to synchronize the circadian rhythms, and improve the onset, duration and quality of sleep. It is centrally involved in anti-oxidation, circadian rhythmicity maintenance, sleep regulation and neuronal survival. This narrative review aims to provide a comprehensive overview of various therapeutic functions of melatonin in insomnia, sleep-related breathing disorders, hypersomnolence, circadian rhythm sleep-wake disorders and parasomnias. Melatonin offers an alternative treatment to the currently available pharmaceutical therapies for sleep disorders with significantly less side effects.

  18. Sleep disordered breathing in a cohort of patients with sporadic inclusion body myositis.

    Science.gov (United States)

    Della Marca, Giacomo; Sancricca, Cristina; Losurdo, Anna; Di Blasi, Chiara; De Fino, Chiara; Morosetti, Roberta; Broccolini, Aldobrando; Testani, Elisa; Scarano, Emanuele; Servidei, Serenella; Mirabella, Massimiliano

    2013-08-01

    The aims of the study were: (1) to evaluate subjective sleep quality and daytime sleepiness in patients affected by sporadic inclusion-body myositis (IBM); (2) to define the sleep and sleep-related respiratory pattern in IBM patients. Thirteen consecutive adult patients affected by definite IBM were enrolled, six women and seven men, mean age 66.2 ± 11.1 years (range: 50-80). Diagnosis was based on clinical and muscle biopsy studies. All patients underwent subjective sleep evaluation (Pittsburgh Sleep Quality Index, PSQI and Epworth Sleepiness Scale, ESS), oro-pharingo-esophageal scintigraphy, pulmonary function tests, psychometric measures, anatomic evaluation of upper airways, and laboratory-based polysomnography. Findings in IBM patients were compared to those obtained from a control group of 25 healthy subjects (13 men and 12 women, mean age 61.9 ± 8.6 years). Disease duration was >10 years in all. Mean IBM severity score was 28.8 ± 5.4 (range 18-36). Dysphagia was present in 10 patients. Nine patients had PSQI scores ≥ 5; patients had higher mean PSQI score (IBM: 7.2 ± 4.7, CONTROLS: 2.76 ± 1.45, p=0.005); one patient (and no controls) had EES>9. Polysomnography showed that IBM patients, compared to controls, had lower sleep efficiency (IBM: 78.8 ± 12.0%, 94.0 ± 4.5%, p<0.001), more awakenings (IBM: 11.9 ± 11.0, CONTROLS: 5.2 ± 7.5, p=0.009) and increased nocturnal time awake (IBM: 121.2 ± 82.0 min., 46.12 ± 28.8 min., p=0.001). Seven Patients (and no controls) had polysomnographic findings consistent with sleep disordered breathing (SDB). Data suggest that sleep disruption, and in particular SDB, might be highly prevalent in IBM. Data indicate that IBM patients have poor sleep and high prevalence of SDB. Copyright © 2013 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

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

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    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.

  20. Tracheal sound parameters of respiratory cycle phases show differences between flow-limited and normal breathing during sleep

    International Nuclear Information System (INIS)

    Kulkas, A; Huupponen, E; Virkkala, J; Saastamoinen, A; Rauhala, E; Tenhunen, M; Himanen, S-L

    2010-01-01

    The objective of the present work was to develop new computational parameters to examine the characteristics of respiratory cycle phases from the tracheal breathing sound signal during sleep. Tracheal sound data from 14 patients (10 males and 4 females) were examined. From each patient, a 10 min long section of normal and a 10 min section of flow-limited breathing during sleep were analysed. The computationally determined proportional durations of the respiratory phases were first investigated. Moreover, the phase durations and breathing sound amplitude levels were used to calculate the area under the breathing sound envelope signal during inspiration and expiration phases. An inspiratory sound index was then developed to provide the percentage of this type of area during the inspiratory phase with respect to the combined area of inspiratory and expiratory phases. The proportional duration of the inspiratory phase showed statistically significantly higher values during flow-limited breathing than during normal breathing and inspiratory pause displayed an opposite difference. The inspiratory sound index showed statistically significantly higher values during flow-limited breathing than during normal breathing. The presented novel computational parameters could contribute to the examination of sleep-disordered breathing or as a screening tool

  1. Does Suspected Sleep Disordered Breathing Impact on the Sleep and Performance of Firefighting Volunteers during a Simulated Fire Ground Campaign?

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    Sarah M. Jay

    2016-01-01

    Full Text Available Adequate sleep is fundamental to workplace performance. For volunteer firefighters who work in safety critical roles, poor performance at work can be life threatening. Extended shifts and sleeping conditions negatively impact sleep during multi-day fire suppression campaigns. Having sleep disordered breathing (SDB could contribute further to sleep deficits. Our aim was to investigate whether those with suspected SDB slept and performed more poorly during a fire ground simulation involving sleep restriction. Participants, n = 20 participated in a 3-day-4-night fire ground simulation. Based on oximetry desaturation index data collected during their participation, participants were retrospectively allocated to either a SDB (n = 8 or a non-SDB group (n = 12. The simulation began with an 8 h Baseline sleep (BL followed by two nights of restricted (4 h sleep and an 8 h recovery sleep (R. All sleeps were recorded using a standard electroencephalography (EEG montage as well as oxygen saturation. During the day, participants completed neurobehavioral (response time, lapses and subjective fatigue tasks. Mixed effects ANOVA were used to compare differences in sleep and wake variables. Analyses revealed a main effect of group for Total sleep (TST, REM , wake after sleep onset (WASO and Arousals/h with the SDB group obtaining less TST and REM and greater WASO and Arousals/h. The group × night interaction was significant for N3 with the SDB group obtaining 42 min less during BL. There was a significant main effect of day for RRT, lapses and subjective fatigue and a significant day × group interaction for RRT. Overall, the SDB group slept less, experienced more disturbed sleep and had poorer response time performance, which was exacerbated by the second night of sleep restriction. This could present a safety concern, particularly during longer campaigns and is worthy of further investigation. In addition, we would recommend promotion of awareness of SDB, its

  2. Long-term neurophysiologic impact of childhood sleep disordered breathing on neurocognitive performance

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    Quan SF

    2013-09-01

    Full Text Available Study Objective. To determine the impact of sleep disordered breathing (SDB in children on neurocognitive function 5 years later.Design, Setting, and Participants. A subgroup of 43 children from the Tucson Children’s Assessment of Sleep Apnea Study (TuCASA who had SDB (RDI > 6 events/hour at their initial exam (ages 6-11 years were matched on the basis of age (within 1 year, gender and ethnicity (Anglo/Hispanic to 43 children without SDB (Control, RDI < 4 events/hour. The Sustained Working Memory Task (SWMT which combines tests of working memory (1-Back Task, reaction time (Simple Reaction Time and attention (Multiplexing Task with concurrent electroencephalographic monitoring was administered approximately 5 years later.Results. There were no differences in performance on the working memory, reaction time and attention tests between the SDB and Control groups. However, the SDB group exhibited lower P300 evoked potential amplitudes during the Simple Reaction Time and Multiplexing Tasks. Additionally, peak alpha power during the Multiplexing Task was lower in the SDB Group with a similar trend in the Simple Reaction Time Task (p=0.08.Conclusions. SDB in children may cause subtle long-term changes in executive function that are not detectable with conventional neurocognitive testing and are only evident during neuroelectrophysiologic monitoring.

  3. Reports on Polysomnograph Combined with Long-term Video Electroencephalogram for Monitoring Nocturnal Sleep-breath Events in 82 Epileptic Patients

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    Hongliang Li

    2013-06-01

    Full Text Available Objective: To investigate the effects of epileptic discharges in sleep of epileptic patients on sleepbreath events. Methods: Polysomnograph (PSG and long-term video electroencephalogram (LTVEEG were used to monitor 82 adult epileptic patients. The condition of paroxysmal events in nocturnal sleep was analyzed, and the epileptiform discharge and effects of antiepileptic drugs were explored. Results: In epileptic group, latency to persistent sleep (LPS and REM sleep latency increased, the proportion of light sleep increased while that of deep sleep decreased, sleep efficiency reduced, nocturnal arousal times increased and apnea hyponea indexes (AHI improved, which demonstrated significant differences by comparison to control group. Periodic leg movements (PLM had no conspicuous differences compared with control group. There were no specific effects of epileptiform discharge and antiepileptic drugs on AHI and PLM indexes. Conclusion: Epileptic patients have sleep structure disorders and sleep-disordered breathing, and arousal, respiratory and leg movement events influence mutually. Synchronous detection of PSG combined with LTVEEG is in favor of comprehensively analyzing the relationship between sleep structures and epilepsy-breath events.

  4. Body Fat Composition: A Predictive Factor for Sleep Related Breathing Disorder in Obese Children.

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    Bhatia, Rajeev; Lesser, Daniel J; Oliveira, Flavia G S A; Tran, Winston H; Keens, Thomas G; Khoo, Michael C K; Davidson Ward, Sally L

    2015-09-15

    The association between body fat composition as measured by dual energy x-ray absorptiometry (DEXA) scanning and pediatric sleep related breathing disorder (SRBD) is not well established. We investigated the relationship between body mass index (BMI) and DEXA parameters and their association with SRBD in obese children. Overnight polysomnography was performed on obese/overweight children (10-17 years) with habitual snoring. Total body fat mass (g), trunk fat mass (g), total body % fat, and trunk % fat were determined by DEXA. Forty-one subjects were studied. Logarithm (Log) total arousal index correlated with BMI (p fat mass (p fat mass (p fat mass (p fat mass (p fat mass (p fat (p fat mass (p fat (p fat mass and trunk fat mass as well as BMI correlated with total arousal index and desaturation index. BMI correlated with DEXA parameters in 10-12 year old males but not in 13-17 year old males. The value of using DEXA scanning to study the relationship between obesity and SRBD may depend on age and pubertal stage. © 2015 American Academy of Sleep Medicine.

  5. Sleep fragmentation and sleep-disordered breathing in individuals living close to main roads: results from a population-based study.

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    Gerbase, M W; Dratva, J; Germond, M; Tschopp, J M; Pépin, J L; Carballo, D; Künzli, N; Probst-Hensch, N M; Adam, M; Zemp Stutz, E; Roche, F; Rochat, T

    2014-03-01

    Nighttime traffic noise is associated with sleep disturbances, but sleep fragmentation and sleep-disordered breathing (SDB) have not been demonstrated in individuals living near busy roads. We asked 1383 participants to answer a health questionnaire and to undergo 24-h electrocardiogram (ECG). Nocturnal ECG records were used to calculate the very low frequency index (VLFI) interval, a surrogate marker of sleep fragmentation. Distances of participants' addresses to roadways were calculated using the VECTOR25© Swisstopo roads classification, a traffic noise proxy. Distances of homes within 100 or 50 m of major roads defined proximity to busy roads. Adjusted multivariate logistic regressions analyzed associations between the distance of home to main roads and VLFI or self-reported SDB. Distance of participants' homes to main roads was significantly associated with the VLFI in women (odds ratio [OR], 1.58 [confidence interval {CI}, 1.03-2.42]; P = .038) but not in men (OR, 1.35 [CI, 0.77-2.35]; P = .295). Women under hormonal replacement therapy (HRT) were at higher risk for increased VLFI when living close to main roads (OR, 2.10 [CI, 1.20-3.68]; P = .01) than untreated women (P = .584). Associations with self-reported SDB were not statistically relevant. In our large population, women living close to main roads were at significantly higher risk for sleep fragmentation than men. The 2-fold higher risk for menopausal women under HRT underscores the vulnerability of this group. Copyright © 2014 Elsevier B.V. All rights reserved.

  6. The impact of sleep-disordered breathing on body mass index (BMI: the sleep heart health study (SHHS

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    Robbins JA

    2011-12-01

    Full Text Available Introduction: It is well known that obesity is a risk factor for sleep-disordered breathing (SDB. However, whether SDB predicts increase in BMI is not well defined. Data from the Sleep Heart Health Study (SHHS were analyzed to determine whether SDB predicts longitudinal increase in BMI, adjusted for confounding factors.Methods: A full-montage unattended home polysomnogram (PSG and body anthropometric measurements were obtained approximately five years apart in 3001 participants. Apnea-hypopnea index (AHI was categorized using clinical thresholds: < 5 (normal, ≥ 5 to <15 (mild sleep apnea, and ³ 15 (moderate to severe sleep apnea. Linear regression was used to examine the association between the three AHI groups and increased BMI. The model included age, gender, race, baseline BMI, and change in AHI as covariates.Results: Mean (SD age was 62.2 years (10.14, 55.2% were female and 76.1% were Caucasian. Five-year increase in BMI was modest with a mean (SD change of 0.53 (2.62 kg/m2 (p=0.071. A multivariate regression model showed that subjects with a baseline AHI between 5-15 had a mean increase in BMI of 0.22 kg/m2 (p=0.055 and those with baseline AHI ≥ 15 had a BMI increase of 0.51 kg/m2 (p<0.001 compared to those with baseline AHI of <5.Conclusion: Our findings suggest that there is a positive association between severity of SDB and subsequent increased BMI over approximately 5 years. This observation may help explain why persons with SDB have difficulty losing weight.

  7. The Sleep Disorder in Anti-lgLON5 Disease.

    Science.gov (United States)

    Gaig, Carles; Iranzo, Alex; Santamaria, Joan; Graus, Francesc

    2018-05-23

    To review the clinical and polysomnographic features of the sleep disorder occurring in the recently described anti-IgLON5 disease. The hallmark of the disease is the presence of antibodies against IgLON5, a neural cell adhesion molecule of unknown function. The disease presents a robust HLA association, and the neuropathological examination shows a novel neuronal tauopathy with predominant hypothalamic and brainstem involvement. Most patients (> 80%) present sleep-related vocalizations with movements and behaviors and sleep-disordered breathing. Polysomnographic studies show (1) a complex NREM sleep parasomnia at sleep initiation characterized by undifferentiated NREM or poorly structured N2 sleep with sleep-talking or mumbling, and simple or finalistic movements followed by normal periods of N3 or N2 NREM sleep, (2) REM sleep behavior disorder (RBD), and (3) obstructive sleep apnea with stridor. The last two features appear mainly in periods where NREM sleep normalizes. Identification of the anti-IgLON5 sleep disorder is important to suspect the disease. The combination of abnormal NREM sleep initiation, followed by normal periods of NREM sleep and RBD, represents a novel parasomnia.

  8. prevalence of sleep disorders in khorramabad 7-12 year old elementary school children in school year 2006-2007

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    azam Mohsenzadeh

    2009-11-01

    Full Text Available The most important consequence of sleep disorders in children is cognitive dysfunction that leads to study, family and social disturbances. This study was carried out to evaluate the prevalence of sleep disorders in Khorramabad 7-12 year old elementary school children in school year 2006-2007. Materials and Methods: In this cross sectional study, 364 students were selected randomly in both sexes male and female with equal numbers. Data were collected using TUCASA questionnaire. Results: Results showed the revalence of sleep disorders as follows: mouth breathing 35/7%, sleep talking 24/7%, habitual snoring 20/3%, nightmare 19/8%, sleep teeth grinding 15/9%, secondary enuresis 8/2%, primary nocturnal enuresis 7/1%, sleep apnea 6/6%, sleep walking 6/6% and excessive daytime sleepiness 10%. Statistical tests showed that there is a significant relation between primary and secondary nocturnal enuresis and male sex, and both disorders were more in boys (p-value=0. 004. Between other disorders, and sex and age there was not significant relation. In this study between teeth grinding and snoring, sleep apnea and snoring, open mouth breathing and snoring, excessive daytime sleepiness and sleep apnea, sleep duration and time of sleep of parents, there was significant relation (p-value<0. 001. Conclusion: According to findings, mouth breathing was the most common sleep disorder in our subjects and had a significant relation with sleep snoring. So due to treating ability of nonmedical therapy in sleep disorders, it is recommended to increase parents information about necessity of medication and its effect on children cognition.

  9. Sleep disorders in Parkinson's disease: a narrative review of the literature.

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    Raggi, Alberto; Bella, Rita; Pennisi, Giovanni; Neri, Walter; Ferri, Raffaele

    2013-01-01

    Parkinson's disease (PD) is classically considered to be a motor system affliction; however, also non-motor alterations, including sleep disorders, are important features of the disease. The aim of this review is to provide data on sleep disturbances in PD in the following grouping: difficulty initiating sleep, frequent night-time awakening and sleep fragmentation, nocturia, restless legs syndrome/periodic limb movements, sleep breathing disorders, drug induced symptoms, parasomnias associated with rapid eye movements (REM) sleep, sleep attacks, reduced sleep efficiency and excessive daytime sleepiness. Research has characterized some of these disturbances as typical examples of dissociated states of wakefulness and sleep that are admixtures or incomplete declarations of wakefulness, REM sleep, and non-REM (NREM) sleep. Moreover, sleep disorders may precede the typical motor system impairment of PD and their ability to predict disease has important implications for development of neuroprotective treatment; in particular, REM sleep behavior disorder may herald any other clinical manifestation of PD by more than 10 years.

  10. Physician Perspectives on Decision Making for Treatment of Pediatric Sleep-Disordered Breathing.

    Science.gov (United States)

    Boss, Emily F; Links, Anne R; Saxton, Ron; Cheng, Tina L; Beach, Mary Catherine

    2017-10-01

    Sleep-disordered breathing (SDB) is prevalent in children and most commonly treated by surgery with adenotonsillectomy. We aimed to learn physician perspectives of social and communication factors that influence decision making for treatment of pediatric SDB. Purposive sampling identified 10 physician key informants across disciplines and practice settings, who participated in semistructured interviews regarding SDB care experiences and communication with parents. Interviews were analyzed using directed qualitative content analysis. Physicians provided a variety of perspectives on decision making for treatment that fell into 3 overarching themes: approach to surgery and alternatives, communication and decision making with families, and sociocultural factors/barriers to care. Perspectives were moderately heterogeneous, suggesting that individual social and relational elements may significantly influence how physicians refer patients and recommend treatment, and how parents choose surgery for this prevalent condition. These findings will inform development of culturally competent communication strategies and support tools to enhance shared decision making for physicians treating children with SDB.

  11. Role of the gluten-free diet on neurological-EEG findings and sleep disordered breathing in children with celiac disease.

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    Parisi, P; Pietropaoli, N; Ferretti, A; Nenna, R; Mastrogiorgio, G; Del Pozzo, M; Principessa, L; Bonamico, M; Villa, M P

    2015-02-01

    To determine whether celiac children are at risk for EEG-neurological features and sleep disordered breathing (SDB), and whether an appropriate gluten-free diet (GFD) influences these disorders. We consecutively enrolled 19 children with a new biopsy-proven celiac disease (CD) diagnosis. At CD diagnosis and after 6 months of GFD, each patient underwent a general and neurological examination, an electroencephalogram, a questionnaire about neurological features, and a validated questionnaire about SDB: OSA (obstructive sleep apnea) scores0 predict OSA. At CD diagnosis, 37% of patients complained headache that affected daily activities and 32% showed positive OSA score. The EEG examinations revealed abnormal finding in 48% of children. After 6 months of GFD headache disappeared in 72% of children and EEG abnormalities in 78%; all children showed negative OSA score. According to our preliminary data, in the presence of unexplained EEG abnormalities and/or other neurological disorders/SDB an atypical or silent CD should also be taken into account. Copyright © 2014 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  12. Primary sleep disorders seen at a Neurology service-based sleep clinic in India: Patterns over an 8-year period

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    Piyush Kumar Sharma

    2013-01-01

    Full Text Available There is an increasing awareness for recognition of sleep disorders in India; however, there is still a huge gap in the number of people suffering from various sleep disorders, in the community versus those visiting hospital clinics for the same. Ours is a neurology services-based sleep disorders clinic, which has evolved successfully over the last decade. In this study, we aimed to evaluate the changes in referral patterns and distribution of various sleep disorders in the patients presenting to the clinic. Materials and Methods: This is a retrospective chart review-based study on all patients seen over an 8-year period, divided into 2 groups comprising of patients seen during the first 4 years versus those seen over the next 4 years. Only those patients who had the sleep disorder as their presenting manifestation and those who had been formally interviewed with a pre-structured questionnaire detailing about the main features of the common sleep disorders according to the ICSD-R were included. Patients, in whom the sleep disorder could be clearly attributable to another neurological or systemic disorder, were excluded. Statistical analysis was carried out to identify the differences between the two groups as regards the distribution of various sleep disorders and other clinical data. Results: Among 710 patients registered in the clinic, 469 were included for analysis and 222 patients formed group 1 while 247 formed group 2. The main differences observed were in the form of a clear increase in the percentage of patients with sleep-related breathing disorders, sleep-related movement disorder, and the hypersomnias on comparison of distribution over the first 4 years versus the last 4 years; while a clear decline was seen in the number of patients with insomnia and parasomnias. A 3-fold increase was observed in the number of patients in whom polysomnography was obtained. Conclusion: The distribution of various sleep disorders as seen in a neurology

  13. Sleep Disordered Breathing in Four Resource-Limited Settings in Peru: Prevalence, Risk Factors, and Association with Chronic Diseases.

    Science.gov (United States)

    Schwartz, Noah G; Rattner, Adi; Schwartz, Alan R; Mokhlesi, Babak; Gilman, Robert H; Bernabe-Ortiz, Antonio; Miranda, J Jaime; Checkley, William

    2015-09-01

    Sleep disordered breathing (SDB) is a highly prevalent condition in high-income countries, with major consequences for cardiopulmonary health, public safety, healthcare utilization, and mortality. However, its prevalence and effect in low- and middle-income countries are less well known. We sought to determine the prevalence, risk factors, and comorbidities of SDB symptoms in four resource-limited settings. Cross-sectional analysis of the CRONICAS Cohort, a population-based age- and sex-stratified sample. Four resource-limited settings in Peru varying in altitude, urbanization, and air pollution. There were 2,682 adults aged 35 to 92 y. Self-reported SDB symptoms (habitual snoring, observed apneas, Epworth Sleepiness Scale), sociodemographics, medical history, anthropometrics, spirometry, blood biomarkers were reported. We found a high prevalence of habitual snoring (30.2%, 95% confidence interval [CI] 28.5-32.0%), observed apneas (20.9%, 95% CI 19.4-22.5%) and excessive daytime sleepiness (18.6%, 95% CI 17.1-20.1%). SDB symptoms varied across sites; prevalence and adjusted odds for habitual snoring were greatest at sea level, whereas those for observed apneas were greatest at high altitude. In multivariable analysis, habitual snoring was associated with older age, male sex, body mass index (BMI), and higher socioeconomic status; observed apneas were associated with BMI; and excessive daytime sleepiness was associated with older age, female sex, and medium socioeconomic status. Adjusted odds of cardiovascular disease, depression, and hypertension and total chronic disease burden increased progressively with the number of SDB symptoms. A threefold increase in the odds of having an additional chronic comorbid disease (adjusted odds ratio 3.57, 95% CI 2.18-5.84) was observed in those with all three versus no SDB symptoms. Sleep disordered breathing symptoms were highly prevalent, varied widely across four resource-limited settings in Peru, and exhibited strong

  14. Intraoral pH and temperature during sleep with and without mouth breathing.

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    Choi, J E; Waddell, J N; Lyons, K M; Kieser, J A

    2016-05-01

    To measure and compare the intraoral pH and temperature of individuals during sleep with and without mouth breathing. Ten healthy participants [mean age = 25·8 (± 4·3)] wore a custom-made appliance fitted with a pH probe and thermocouple for two sets of 48 h. Continuous pH and temperature measurements were taken from the palatal aspect of the upper central incisors. To simulate mouth breathing during sleep, participants wore a nose clip for two nights of the four, with the first group (n = 5) wearing the nose clip during the first night and the rest (n = 5) wearing the nose clip during the second night of sleep to balance any potential bias from the wearing sequence. Both qualitative and quantitative analyses were conducted. The mean intraoral pH during daytime was 7·3 (± 0·4) and during sleep was 7·0 (± 0·5). The mean intraoral pH during sleep with mouth breathing was 6·6 (± 0·5), which was statistically significant compared with the normal sleep condition (P pH decreased slowly over the hours of sleep in all participants. When sleeping with forced mouth breathing, intraoral pH showed a greater fall over a longer period of time. The mean intraoral temperature was 33·1 °C (± 5·2) during daytime and 33·3 °C (± 6·1) during sleep, with no statistical significance between sleep with and without mouth breathing (P > 0·05). The results suggest that mouth breathing during sleep is related to a decrease in intraoral pH compared with normal breathing during sleep, and this has been proposed as a causal factor for dental erosion and caries. © 2015 John Wiley & Sons Ltd.

  15. Sleep Disordered Breathing and Academic Performance: A Meta-analysis.

    Science.gov (United States)

    Galland, Barbara; Spruyt, Karen; Dawes, Patrick; McDowall, Philippa S; Elder, Dawn; Schaughency, Elizabeth

    2015-10-01

    Sleep-disordered breathing (SDB) in children is associated with daytime functioning decrements in cognitive performance and behavioral regulation. Studies addressing academic achievement are underrepresented. This study aimed to evaluate the strength of the relationships between SDB and achievement in core domains and general school performance. Data sources included PubMed, Web of Science, CINAHL, and PsycINFO. Studies of school-aged children investigating the relationships between SDB and academic achievement were selected for inclusion in a systematic literature review using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Data extracted were converted into standardized mean differences; effect sizes (ES) and statistics were calculated by using random-effects models. Heterogeneity tests (I(2)) were conducted. Of 488 studies, 16 met eligibility criteria. SDB was significantly associated with poorer academic performance for core academic domains related to language arts (ES -0.31; P performance. Variable definitions of both academic performance and SDB likely contributed to the heterogeneity among published investigations. Clear links between SDB and poorer academic performance in school-age children are demonstrated. ES statistics were in the small to medium range, but nevertheless the findings serve to highlight to parents, teachers, and clinicians that SDB in children may contribute to academic difficulties some children face. Copyright © 2015 by the American Academy of Pediatrics.

  16. Phenotypes of sleep-disordered breathing symptoms to two years of age based on age of onset and duration of symptoms.

    Science.gov (United States)

    Kamal, Muna; Tamana, Sukhpreet K; Smithson, Lisa; Ding, Linda; Lau, Amanda; Chikuma, Joyce; Mariasine, Jennifer; Lefebvre, Diana L; Subbarao, Padmaja; Becker, Allan B; Turvey, Stuart E; Sears, Malcolm R; Pei, Jacqueline; Mandhane, Piush J

    2018-05-03

    Childhood sleep-disordered breathing (SDB) symptoms may comprise multiple phenotypes depending on craniofacial anatomy, tonsil and adenoid growth, body habitus, and rhinitis symptoms. The primary objective of this study is to identify and characterize the different SDB phenotypes to two years of age. Data from 770 infants in the Edmonton sub-cohort of the Canadian Healthy Infant Longitudinal Study (CHILD) were analyzed to identify SDB phenotypes based on age of onset and duration of symptoms. Parents completed the 22-item sleep-related breathing disorder (SRBD) scale. Children with a SRBD ratio greater than 0.33 were considered positive for SDB at each quarterly assessment between three months and two years. The STATA Proc trajectory extension identified SDB phenotypes based on their age of onset and duration of symptoms and attributed the percentage chance of a participant being assigned to each phenotype. Multivariate linear regression identified factors associated with increased risk of being assigned to each SDB phenotype. Trajectory analysis identified four phenotypes: no SDB (65.7%), early-onset SDB (15.7%) with peak symptoms at nine months, late-onset SDB (14.2%) with peak symptoms at 18 months, and persistent SDB (5.3%) with symptoms from 3 to 24 months. Rhinitis was associated with all three SDB symptom trajectories (p sleep apnea syndrome (OSAS) was associated with persistent (p = 0.01) and late SDB (p < 0.001). Atopy (positive skin prick test at one year) was associated with persistent SDB (p = 0.04). Infants born prior to 36.5 weeks gestational age were more likely to present with late SDB (p = 0.03). Childhood SDB symptoms, rather than being a homogenous disorder, may comprise multiple overlapping phenotypes each with unique risk factors. Copyright © 2018 Elsevier B.V. All rights reserved.

  17. 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.

  18. Cardiometabolic risk is associated with the severity of sleep-disordered breathing in children with obesity.

    Science.gov (United States)

    Isacco, Laurie; Roche, Johanna; Quinart, Sylvain; Thivel, David; Gillet, Valérie; Nègre, Véronique; Mougin, Fabienne

    2017-03-01

    The alarming progression of pediatric obesity is associated with the development of sleep-disordered breathing (SDB), and both exhibit similar adverse cardiometabolic health outcomes. Physical activity level (PAL) may counteract sleep and metabolic disturbances. The present study investigates i) the association between the metabolic syndrome in childhood obesity and SDB, ii) the impact of SDB severity on cardiometabolic risk scores and PAL in children with obesity. Maturation status (Tanner stages), anthropometric (height, weight, body mass index, waist circumference, body adiposity index) and cardiometabolic characteristics (systolic and diastolic blood pressure, lipid and glycemic profiles) were assessed in 83 obese children (mean±SD, age: 10.7±2.7years). PAL and SDB were investigated with a step test and interviews, and an overnight sleep monitor, respectively. The presence or absence of metabolic syndrome (MS) was established and continuous cardiometabolic risk scores were calculated (MetScore BMI and MetScore WC ). Obese children with (61.4%) and without (38.6%) MS present similar SDB. SDB severity is associated with increased insulin concentrations, MetScore BMI and MetScore WC (pobese children. There is no association between SDB and PAL. In a context where no consensus exists for SDB diagnosis in children, our results suggest the influence of SDB severity on cardiometabolic risk factors. Further studies are needed to explore the association between PAL and both metabolic and sleep alterations in obese children. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Sleep and gastrointestinal disturbances in autism spectrum disorder in children.

    Science.gov (United States)

    Klukowski, Mark; Wasilewska, Jolanta; Lebensztejn, Dariusz

    2015-01-01

    Autism spectrum disorder (ASD), a neurodevelopmental disorder with a prevalence of 1 in 68 children, commonly presents with comorbid conditions which include sleep disorders. Sleep disorders reported in ASD include, among others, increased bedtime resistance, insomnia, parasomnia, sleep disordered breathing, morning rise problems, and daytime sleepiness. Polysomnography studies show that children with ASD have altered sleep architecture including shorter total sleep time and longer sleep latency than typically developing peers. Sleep-related problems have been shown to affect overall autism scores, social skills decits, stereotypic behavior, and cognitive performance. Additionally, problematic sleep in children with ASD has been associated with higher levels of parental stress. Underlying causes specically related to sleep disorders are not fully known. Gastrointestinal (GI) disorders are commonly associated with sleep problems in these patients. Children with ASD and GI symptoms have been found to have a higher prevalence of sleep disturbances compared with typically developing peers who do not have GI symptoms. Treatment approaches to children with sleep disorders are varied and range from lifestyle modications and behavioral interventions to drug therapies and surgical interventions. Physicians should take into account GI disorders as possible underlying causes of sleep-related problems in children with ASD. Therapeutic interventions should begin with less invasive methods before progressing to more invasive options such as pharmacotherapy and should be based on medical indications in order to provide effective care while minimizing potential adverse health effects. Evidence-based studies concerning GI and sleep disorders in children with ASD are limited and further studies are warranted.

  20. Nasal obstruction and sleep-disordered breathing: the effect of supine body position on nasal measurements in snorers.

    Science.gov (United States)

    Virkkula, Paula; Maasilta, Paula; Hytönen, Maija; Salmi, Tapani; Malmberg, Henrik

    2003-06-01

    Nasal obstruction is considered to be a potential etiological factor in sleep-disordered breathing. However, a significant correlation between nasal measurements and obstructive sleep apnea has not been demonstrated so far. The aim of this study was to investigate the relationships between nasal resistance, nasal volumes and selected sleep parameters using nasal measurements performed in both seated and supine positions. We also investigated whether snoring patients in our clinical sample showed increased positional or decongestive nasal mucosal changes. Forty-one snoring men on a waiting list for correction of nasal obstruction underwent polysomnography, anterior rhinomanometry and acoustic rhinometry. Nineteen non-snoring control subjects were also recruited. Nasal measurements were performed in a seated position, after lying down in a supine position and, after decongestion of nasal mucosa, in a seated position again. In the overall patient group, nasal volume at a distance 2-4 cm from the nares in the supine position correlated inversely with apnea-hypopnea index (AHI) (r = -0.32, p patients, total nasal resistance measured in a supine position correlated with AHI (r = 0.50, p position and sleep parameters. Postural or decongestive changes in nasal measurements were not increased in snoring patients compared with control subjects. The relationship found between nasal measurements and sleep parameters suggests that nasal obstruction does augment airway collapse.

  1. The Impact of Altitude on Sleep-Disordered Breathing in Children Dwelling at High Altitude: A Crossover Study.

    Science.gov (United States)

    Hughes, Benjamin H; Brinton, John T; Ingram, David G; Halbower, Ann C

    2017-09-01

    Sleep-disordered breathing (SDB) is prevalent among children and is associated with adverse health outcomes. Worldwide, approximately 250 million individuals reside at altitudes higher than 2000 meters above sea level (masl). The effect of chronic high-altitude exposure on children with SDB is unknown. This study aims to determine the impact of altitude on sleep study outcomes in children with SDB dwelling at high altitude. A single-center crossover study was performed to compare results of high-altitude home polysomnography (H-PSG) with lower altitude laboratory polysomnography (L-PSG) in school-age children dwelling at high altitude with symptoms consistent with SDB. The primary outcome was apnea-hypopnea index (AHI), with secondary outcomes including obstructive AHI; central AHI; and measures of oxygenation, sleep quality, and pulse rate. Twelve participants were enrolled, with 10 included in the final analysis. Median altitude was 1644 masl on L-PSG and 2531 masl on H-PSG. Median AHI was 2.40 on L-PSG and 10.95 on H-PSG. Both obstructive and central respiratory events accounted for the difference in AHI. Oxygenation and sleep fragmentation were worse and pulse rate higher on H-PSG compared to L-PSG. These findings reveal a clinically substantial impact of altitude on respiratory, sleep, and cardiovascular outcomes in children with SDB who dwell at high altitude. Within this population, L-PSG underestimates obstructive sleep apnea and central sleep apnea compared to H-PSG. Given the shortage of high-altitude pediatric sleep laboratories, these results suggest a role for home sleep apnea testing for children residing at high altitude. © Sleep Research Society 2017. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

  2. Sleep Apnea

    Science.gov (United States)

    Sleep apnea is a common disorder that causes your breathing to stop or get very shallow. Breathing ... an hour. The most common type is obstructive sleep apnea. It causes your airway to collapse or ...

  3. An Ultrasonic Contactless Sensor for Breathing Monitoring

    Directory of Open Access Journals (Sweden)

    Philippe Arlotto

    2014-08-01

    Full Text Available The monitoring of human breathing activity during a long period has multiple fundamental applications in medicine. In breathing sleep disorders such as apnea, the diagnosis is based on events during which the person stops breathing for several periods during sleep. In polysomnography, the standard for sleep disordered breathing analysis, chest movement and airflow are used to monitor the respiratory activity. However, this method has serious drawbacks. Indeed, as the subject should sleep overnight in a laboratory and because of sensors being in direct contact with him, artifacts modifying sleep quality are often observed. This work investigates an analysis of the viability of an ultrasonic device to quantify the breathing activity, without contact and without any perception by the subject. Based on a low power ultrasonic active source and transducer, the device measures the frequency shift produced by the velocity difference between the exhaled air flow and the ambient environment, i.e., the Doppler effect. After acquisition and digitization, a specific signal processing is applied to separate the effects of breath from those due to subject movements from the Doppler signal. The distance between the source and the sensor, about 50 cm, and the use of ultrasound frequency well above audible frequencies, 40 kHz, allow monitoring the breathing activity without any perception by the subject, and therefore without any modification of the sleep quality which is very important for sleep disorders diagnostic applications. This work is patented (patent pending 2013-7-31 number FR.13/57569.

  4. Pulmonary functions and sleep-related breathing disorders in lipid storage disease.

    Science.gov (United States)

    Bingöl, Züleyha; Tekce, Hacer Durmuş; Sağcan, Gülseren; Serdaroğlu, Piraye; Kıyan, Esen

    2018-03-01

    Pulmonary function abnormalities and sleep-related breathing disorders (SRBD) are frequent in subjects with several neuromuscular diseases but there is no data about lipid storage diseases (LSD). Therefore, we aimed to evaluate pulmonary functions and SRBD in adults with LSD. Pulmonary functions (forced expiratory volume (FEV 1 ), forced vital capacity (FVC), supine FVC, upright-supine FVC% change, maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), peak cough flow (PCF)), arterial blood gases, and polysomnographic data of all subjects were evaluated. Twenty-five subjects with LSD were evaluated [17 males, 8 females; age 34.9 ± 15 years; BMI 26.5 ± 3.4 kg/m 2 ]. MIP was - 72.2 ± 32.7 cmH 2 O ( 45 mmHg). REM sleep had decreased in all subjects (10.2% ± 6.1). Obstructive sleep apnea (OSA) was found in 80% of the subjects (n = 20; 9 mild, 9 moderate, 2 severe). For subjects with OSA, apnea-hypopnea index (AHI) was 20.8 ± 15.9/h, oxygen desaturation index (ODI) was 11.9 ± 15.4/h, AHI REM was 30.6 ± 19.7/h, AHI NREM was 19.7 ± 16.6/h, ODI REM was 27.2 ± 26.1/h, and ODI NREM was 11.4 ± 15/h. Five subjects (20%) diagnosed as REM-related OSA. Nocturnal mean SpO 2 was 94.9% ± 1.7, lowest SpO 2 was 73.3% ± 13.9, and time spent with SpO 2 < 90% was 2.4% ± 7.2. In subjects with LSD, pulmonary function impairment, daytime hypercapnia and hypoxemia, and OSA, especially REM-related OSA, are frequent. Therefore, pulmonary functions and polysomnography should be performed routinely.

  5. Association between sleep-related breathing disorders and academic performance among children from Concepción, Chile.

    Science.gov (United States)

    Gatica, Darwin; Rodríguez-Núñez, Iván; Zenteno, Daniel; Elso, María J; Montesinos, Juan J; Manterola, Carlos

    2017-10-01

    The objective of this study was to establish an association between academic performance in Math, Language Arts, and Science and the presence of sleep-related breathing disorders (SRBDs) among healthy schoolchildren from the city of Concepción, Chile. Healthy children were defined as those without comorbidities. Outcome measures of interest included the analysis of academic performance in Math, Language Arts, and Science and the presence of SRBD assessed using the Pediatric Sleep Questionnaire. Two-hundred and fifty-six children were included in the study (59.8% were boys). In the studied sample, SRBD prevalence was 24.6%. A significant association was observed between SRBD and a low performance in Math (odds ratio |-#91;OR|-#93;: 3.1, 1.5-6.8), Language Arts (OR:2.5, 1.1-5.5), and Science (OR: 4.2, 1.7-10.0). To conclude, in the studied sample, the presence of SRBD was associated with a low academic performance in Language Arts, Math, and Science. Sociedad Argentina de Pediatría.

  6. Emotional and behavioral problems associated with sleep disorders in children

    Directory of Open Access Journals (Sweden)

    I. A. Kelmanson

    2014-01-01

    Full Text Available The paper considers whether parasomnia may be associated with emotional and behavioral problems. It gives data on the relationship of impaired sleep duration and integrity to increased emotional responsiveness and lability, high levels of anxiety, and depression symptoms. Whether the clinical symptoms of attention-deficit/hyperactivity disorder, aggression, and academic underachievement are related to sleep disorders, including those in the presence of sleep disordered breathing, restless legs syndrome and periodic limb movement disorder, is discussed. There are data on the characteristic polysomnographic changes detected in the presence of the discussed emotional and behavioral disorders in children. A possible pathophysiological rationale is provided for the found associations. Practical guidelines for examination of children with complaints about emotional and behavioral disorders for possible concomitant parasomnias are substantiated. 

  7. Associations of sedentary time and moderate-vigorous physical activity with sleep-disordered breathing and polysomnographic sleep in community-dwelling adults.

    Science.gov (United States)

    Kline, Christopher E; Krafty, Robert T; Mulukutla, Suresh; Hall, Martica H

    2017-05-01

    The purpose of this study was to evaluate the relationship between daytime activity (sedentary time, moderate- to vigorous-intensity physical activity [MVPA]) and indices of polysomnographically (PSG) assessed sleep, including sleep-disordered breathing (SDB). One hundred and thirty-six adults (65% female, 59.8 ± 9.1 years, body mass index [BMI] 30.3 ± 6.9 kg m -2 ) provided daily estimates of time spent in light-, moderate-, and vigorous-intensity activity for 6-14 days (mean 9.9 ± 1.8 days) prior to laboratory PSG. Daily sedentary time was calculated as the amount of time spent awake and not in light-, moderate-, or vigorous-intensity activity; time spent in moderate- and vigorous-intensity activity were combined for MVPA. Indices of PSG sleep included timing (sleep midpoint), duration (total sleep time), continuity (sleep efficiency), depth (% slow-wave sleep), and SDB (apnea-hypopnea index [AHI]). Using median splits of sedentary time and MVPA, analyses of covariance examined their relationship with sleep following adjustment for age, sex, race, employment, education, BMI, existing cardiovascular disease, depression history, and mean daily wake time. Binary logistic regression examined the odds of having at least mild-severity SDB (AHI ≥ 5) according to sedentary time, MVPA, and their combination. Adults with above-median sedentary time (i.e., >841.9 min/day) had significantly greater AHI (P = .04) and lower odds of mild SDB (P = .03) compared to adults with low sedentary time; adults with high MVPA (>30.5 min/day) had significantly lower AHI compared to adults with low MVPA (P = .04). When examined in the same model, adults with high sedentary time and low MVPA had significantly higher AHI (P < .01) and higher odds of having mild SDB (P = .03) than all the other groups. No other sleep measures were related to sedentary time, MVPA, or their combination. Sedentary time and MVPA were associated with SDB. Whether reducing sedentary

  8. Sleep-Related Disorders in Children with Attention-Deficit Hyperactivity Disorder: Preliminary Results of a Full Sleep Assessment Study.

    Science.gov (United States)

    Miano, Silvia; Esposito, Maria; Foderaro, Giuseppe; Ramelli, Gian Paolo; Pezzoli, Valdo; Manconi, Mauro

    2016-11-01

    We present the preliminary results of a prospective case-control sleep study in children with a diagnosis of attention-deficit hyperactivity disorder (ADHD). A deep sleep assessment including sleep questionnaires, sleep habits, a video-polysomnographic recording with full high-density electroencephalography (EEG) and cardiorespiratory polygraphy, multiple sleep latency test, and 1-week actigraphic recording were performed to verify whether children with ADHD may be classified into one of the following five phenotypes: (1) hypoarousal state, resembling narcolepsy, which may be considered a "primary" form of ADHD; (2) delayed sleep onset insomnia; (3) sleep-disordered breathing; (4) restless legs syndrome and/or periodic limb movements; and (5) sleep epilepsy and/or EEG interictal epileptiform discharges. Fifteen consecutive outpatients with ADHD were recruited (two female, mean age 10.6 ± 2.2, age range 8-13.7 years) over 6 months. The narcolepsy-like sleep phenotype was observed in three children, the sleep onset insomnia phenotype was observed in one child, mild obstructive sleep apnea was observed in three children, sleep hyperkinesia and/or PLMs were observed in five children, while IEDs and or nocturnal epilepsy were observed in three children. Depending on the sleep phenotype, children received melatonin, iron supplementation, antiepileptic drugs, or stimulants. Our study further highlights the need to design an efficient sleep diagnostic algorithm for children with ADHD, thereby more accurately identifying cases in which a full sleep assessment is indicated. © 2016 John Wiley & Sons Ltd.

  9. Medical image of the week: REM sleep behavior disorder in Parkinson disease

    Directory of Open Access Journals (Sweden)

    Nahapetian RR

    2014-06-01

    Full Text Available No abstract available. Article truncated after first 150 words. A 55 year old female with a past medical history significant for Parkinson disease status-post implantation of bilateral deep brain stimulators, depression, and restless legs syndrome, who initially presented to the sleep clinic on referral by neurology for evaluation of disordered sleep. Medications included carbidopa-levodopa, escitalopram, gabapentin, lorazepam, ambien, and pramipexole. Her subjective sleep complaints included snoring, restless sleep, difficulty in maintaining sleep, sleep related anxiety, dream enactment behavior, nightmares, and sleep talking. She was sent to the sleep laboratory for evaluation of suspected rapid eye movement behavior disorder (RBD. Overnight polysomnogram did not show evidence for sleep disordered breathing. The sleep study was notable for rapid eye movement (REM sleep without atonia, visible arm and leg movements, and audible moaning, speaking, and crying out. These findings corroborated the subjective complaints expressed by the patient and her husband. Her medication regimen was altered. Zolpidem and lorazepam were discontinued and she ...

  10. Evidence-based therapy for sleep disorders in neurodegenerative diseases

    Directory of Open Access Journals (Sweden)

    LIU Ling

    2013-08-01

    Full Text Available Objective To evaluate the effectiveness of the treatments for sleep disorders in neurodegenerative diseases so as to provide the best therapeutic regimens for the evidence-based treatment. Methods Search PubMed, MEDLINE, Cochrane Library, Wanfang Data and China National Knowledge Infrastructure (CNKI databases with "sleep disorder or sleep disturbance", "neurodegenerative diseases", "Parkinson's disease or PD", "Alzheimer's disease or AD", "multiple system atrophy or MSA" as retrieval words. The quality of the articles were evaluated with Jadad Scale. Results A total of 35 articles, including 2 systematic reviews, 5 randomized controlled trials, 13 clinical controlled trials, 13 case series and 2 epidemiological investigation studies were included for evaluation, 13 of which were high grade and 22 were low grade articles. Clinical evidences showed that: 1 advice on sleep hygiene, careful use of dopaminergic drugs and hypnotic sedative agents should be considered for PD. Bright light therapy (BLT may improve circadian rhythm sleep disorders and clonazepam may be effective for rapid eye movement sleep behavior disorder (RBD. However, to date, very few controlled studies are available to make a recommendation for the management of sleep disorders in PD; 2 treatments for sleep disorders in AD include drug therapy (e.g. melatonin, acetylcholinesterase inhibitors, antipsychotic drugs, antidepressants and non-drug therapy (e.g. BLT, behavior therapy, but very limited evidence shows the effectiveness of these treatments; 3 the first line treatment for sleep-related breathing disorder in MSA is nasal continuous positive airway pressure (nCPAP, and clonazepam is effective for RBD in MSA; 4 there is rare evidence related to the treatment of sleep disorders in dementia with Lewy body (DLB and amyotrophic lateral sclerosis (ALS. Conclusion Evidence-based medicine can provide the best clinical evidence on sleep disorders' treatment in neurodegenerative

  11. Unconstrained monitoring of long-term heart and breath rates during sleep

    International Nuclear Information System (INIS)

    Chen, Wenxi; Zhu, Xin; Wei, Daming; Nemoto, Tetsu; Sugitani, Kayo; Kitamura, Kei-ichiro

    2008-01-01

    An unconstrained method for the long-term monitoring of heart and breath rates during sleep is proposed. The system includes a sensor unit and a web-based network module. The sensor unit is set beneath a pillow to pick up the pressure variations from the head induced by inhalation/exhalation movements and heart pulsation during sleep. The measured pressure signal was digitized and transferred to a remote database server via the network module. A wavelet-based algorithm was employed to detect the heart and breath rates, as well as body movement, during sleep. The overall system was utilized for a total six-month trial operation delivered to a female subject. The profiles of the heart and breath rates on a beat-by-beat and daily basis were obtained. Movements during sleep were also estimated. The results show that the daily average percentage of undetectable periods (UPs) during 881.6 sleep hours over a 180 day period was 17.2%. A total of 89.2% of sleep hours had a UP of not more than 25%. The profile of the heart rate revealed a periodic property that corresponded to the female monthly menstrual cycle. Our system shows promise as a long-term unconstrained monitor for heart and breath rates, and for other physiological parameters related to the quality of sleep and the regularity of the menstrual cycle. (note)

  12. Use of thoracic impedance sensors to screen for sleep-disordered breathing in patients with cardiovascular disease

    International Nuclear Information System (INIS)

    Poupard, L; Mathieu, M; Sartène, R; Goldman, M

    2008-01-01

    Screening patients for the possibility of sleep apnoea, one of the most common forms of sleep-disordered breathing, requires measurement of respiration. We propose a simple method to estimate the amplitude modulation of a respiratory tidal volume, using a semi-quantitative measure of respiration based on thoracic impedance (TI). Because respiratory volume changes may be accommodated by varying displacements of the rib cage (RC) and abdomen (AB), the latter produced by outward motion of the diaphragm, it is necessary for any useful measure of respiration to be closely related to both RC and AB displacements. Because the relative contributions of RC and AB displacements to respiratory tidal volume vary in different body positions, the present measurements were recorded from subjects in supine, and right and left lateral decubitus postures. We observed a clear linear relationship between TI and both RC and AB signals in all three body positions. There were no statistically significant differences between observed relationships between TI and AB and between TI and RC, and these relationships were independent of the body position. TI sensors appear to be a useful candidate for a simple method of screening for sleep apnoea, especially in a cardiology clinical setting. Further investigation is warranted for the refinement of algorithms to detect changes in amplitude modulation occurring with apnoeas and to remove artefacts due to gross body movements

  13. Sleep Structure in Children With Attention-Deficit/Hyperactivity Disorder.

    Science.gov (United States)

    Akinci, Gulcin; Oztura, Ibrahim; Hiz, Semra; Akdogan, Ozlem; Karaarslan, Dilay; Ozek, Handan; Akay, Aynur

    2015-10-01

    The authors evaluated basic sleep architecture and non-rapid eye movement (NREM) sleep alterations in drug-naïve attention-deficit/hyperactivity disorder (ADHD) children without psychiatric or other comorbidities. This cross-sectional case-control study included 28 drug-naïve children with ADHD and 15 healthy controls. This subjective studies revealed that children with ADHD had a worse sleep quality and increased daytime sleepiness. Polysomnography data showed that the sleep macrostructure was not significantly different in children with ADHD. Sleep microstructure was altered in ADHD children by means of reduced total cyclic alternating pattern rate and duration of cyclic alternating pattern sequences. This reduction was associated with a selective decrease of A1 index during stage 2 NREM. SpO2 in total sleep was slightly decreased; however, the incidence of sleep disordered breathing showed no significant difference. The authors suggest that cyclic alternating pattern scoring would provide a further insight to obtain a better understanding of the sleep structure in children with ADHD. © The Author(s) 2015.

  14. Pediatric sleep apnea

    Science.gov (United States)

    Sleep apnea - pediatric; Apnea - pediatric sleep apnea syndrome; Sleep-disordered breathing - pediatric ... Untreated pediatric sleep apnea may lead to: High blood pressure Heart or lung problems Slow growth and development

  15. Predicting the presence of sleep-disordered breathing in children with Down syndrome.

    Science.gov (United States)

    Nehme, Joy; LaBerge, Robert; Pothos, Mary; Barrowman, Nick; Hoey, Lynda; Monsour, Andrea; Kukko, Madelaine; Katz, Sherri Lynne

    2017-08-01

    Sleep-disordered breathing (SDB) is highly prevalent in children with Down syndrome. Given the scarcity of resources and the presence of risk factors for SDB in this population, the objective of this study is to identify the clinical predictors of SDB, which would assist prioritization of children with Down syndrome for SDB evaluation. A retrospective cohort study was conducted on children enrolled in the Down syndrome clinic at CHEO who underwent polysomnography in 2004-2014. Total apnea-hypopnea index (AHI) or obstructive AHI (OAHI) > 5 events/hour was considered clinically significant. Associations between SDB and concurrent diagnoses, referral reasons, and sleep symptoms assessed by questionnaire were examined using Pearson's chi-square test or Fisher's exact test as appropriate. Univariate and multivariate logistic regression analyses were used to examine the predictors of SDB. SDB was present in 42.9% of 119 children, with its highest prevalence at age 8 years. Symptoms were not significantly associated with AHI > 5 events/hour or OAHI > 5 events/hour. Gastroesophageal reflux was associated with lower odds of OAHI > 5 events/hour on univariate testing (odds ratio 0.16, 95% CI 0.04-0.72; p = 0.02) and multivariate analysis (odds ratio 0.05, 95% CI 0.0006-0.50; p = 0.002). SDB is highly prevalent at all ages in children with Down syndrome. Symptoms did not predict SDB in this population, although gastroesophageal reflux may mimic SDB, which indicates that clinicians should continue to perform ongoing surveillance for SDB throughout the lifespan of children with Down syndrome. Copyright © 2017 Elsevier B.V. All rights reserved.

  16. Sleep-Disordered Breathing and Excessive Daytime Sleepiness in Patients With Atrial Fibrillation

    Science.gov (United States)

    Albuquerque, Felipe N.; Calvin, Andrew D.; Sert Kuniyoshi, Fatima H.; Konecny, Tomas; Lopez-Jimenez, Francisco; Pressman, Gregg S.; Kara, Thomas; Friedman, Paul; Ammash, Naser; Somers, Virend K.

    2012-01-01

    Background: An important consequence of sleep-disordered breathing (SDB) is excessive daytime sleepiness (EDS). EDS often predicts a favorable response to treatment of SDB, although in the setting of cardiovascular disease, particularly heart failure, SDB and EDS do not reliably correlate. Atrial fibrillation (AF) is another highly prevalent condition strongly associated with SDB. We sought to assess the relationship between EDS and SDB in patients with AF. Methods: We conducted a prospective study of 151 patients referred for direct current cardioversion for AF who also underwent sleep evaluation and nocturnal polysomnography. The Epworth Sleepiness Scale (ESS) was administered prior to polysomnography and considered positive if the score was ≥ 11. The apnea-hypopnea index (AHI) was tested for correlation with the ESS, with a cutoff of ≥ 5 events/h for the diagnosis of SDB. Results: Among the study participants, mean age was 69.1 ± 11.7 years, mean BMI was 34.1 ± 8.4 kg/m2, and 76% were men. The prevalence of SDB in this population was 81.4%, and 35% had EDS. The association between ESS score and AHI was low (R2 = 0.014, P = .64). The sensitivity and specificity of the ESS for the detection of SDB in patients with AF were 32.2% and 54.5%, respectively. Conclusions: Despite a high prevalence of SDB in this population with AF, most patients do not report EDS. Furthermore, EDS does not appear to correlate with severity of SDB or to accurately predict the presence of SDB. Further research is needed to determine whether EDS affects the natural history of AF or modifies the response to SDB treatment. PMID:21903736

  17. CDKL5 deficiency entails sleep apneas in mice.

    Science.gov (United States)

    Lo Martire, Viviana; Alvente, Sara; Bastianini, Stefano; Berteotti, Chiara; Silvani, Alessandro; Valli, Alice; Viggiano, Rocchina; Ciani, Elisabetta; Zoccoli, Giovanna

    2017-08-01

    A recently discovered neurodevelopmental disorder caused by the mutation of the cyclin-dependent kinase-like 5 gene (CDKL5) entails complex autistic-like behaviours similar to Rett syndrome, but its impact upon physiological functions remains largely unexplored. Sleep-disordered breathing is common and potentially life-threatening in patients with Rett syndrome; however, evidence is limited in children with CDKL5 disorder, and is lacking altogether in adults. The aim of this study was to test whether the breathing pattern during sleep differs between adult Cdkl5 knockout (Cdkl5-KO) and wild-type (WT) mice. Using whole-body plethysmography, sleep and breathing were recorded non-invasively for 8 h during the light period. Sleep apneas occurred more frequently in Cdkl5-KO than in WT mice. A receiver operating characteristic (ROC) analysis discriminated Cdkl5-KO significantly from WT mice based on sleep apnea occurrence. These data demonstrate that sleep apneas are a core feature of CDKL5 disorder and a respiratory biomarker of CDKL5 deficiency in mice, and suggest that sleep-disordered breathing should be evaluated routinely in CDKL5 patients. © 2017 European Sleep Research Society.

  18. Prevalence and risk factors of sleep disordered breathing in patients with rheumatic valvular heart disease.

    Science.gov (United States)

    Ding, Ning; Ni, Bu-Qing; Zhang, Xi-Long; Huang, Han-Peng; Su, Mei; Zhang, Shi-Jiang; Wang, Hong

    2013-08-15

    Sleep disordered breathing (SDB) is common in patients with chronic heart failure secondary to non-valvular heart disease; however, the prevalence and characteristics of SDB in patients with rheumatic valvular heart disease (RVHD) are unclear. This study was designed to determine the prevalence, characteristics, and risk factors for SDB in RVHD patients. A cross-sectional study was conducted in 260 RVHD patients. The following data were recorded: types of heart valve lesions, electrocardiographic, echocardiographic, arterial blood gas analysis findings, baseline medication, 6-minute walk test (6MWT) distance, and sleep parameters. Compared to patients with single leftsided valve lesions, patients with left- and rightsided valve lesions had a higher prevalence of SDB (46.2% vs. 31.2%, p = 0.013); the increased prevalence of SDB only involved central sleep apnea (CSA) (31.1% vs. 14.1%, p = 0.001). Patients with obstructive sleep apnea (OSA) or CSA were older and had a shorter 6MWT distance, lower left ventricle ejection fraction and PaO₂, a longer lung-to-finger circulation time, and a higher prevalence of atrial fibrillation (AF) and hypertension (all p < 0.05) as compared with patients without SDB. Multinomial logistic regression analysis showed that PaO2 ≤ 85 mm Hg was the only risk factor for OSA. Male gender, AF, 6MWT distance ≤ 300 m, PaO₂ ≤ 85 mmHg, and PaCO₂ ≤ 40 mm Hg were risk factors for CSA. Patients with RVHD had a high prevalence of SDB (predominantly CSA). RVHD patients with SDB, particularly those who had CSA, manifested more severe symptoms and greater impairment of cardiac function. Assessments of clinical manifestations of cardiac dysfunction may be important for predicting the risk factors for SDB.

  19. Coexistência de transtornos respiratórios do sono e síndrome fibromiálgica Sleep disordered breathing concomitant with fibromyalgia syndrome

    Directory of Open Access Journals (Sweden)

    Dienaro Germanowicz

    2006-08-01

    Full Text Available OBJETIVO: Identificar síndrome fibromiálgica em pacientes com transtornos respiratórios do sono. MÉTODOS: Foram estudados 50 pacientes que compareceram à Clínica do Sono com queixas de roncar no sono, apnéias e sonolência diurna. Confirmou-se o diagnóstico de transtornos respiratórios do sono através de polissonografia. Para se estabelecer o diagnóstico de síndrome fibromiálgica, submeteram-se os pacientes a avaliação de acordo com os critérios estabelecidos pelo American College of Rheumatology. RESULTADOS: Estudaram-se 50 pacientes, 32 do sexo masculino. A média (± desvio-padrão de idade do grupo foi de 50 ± 12 anos. A média do índice de massa corporal do grupo foi de 29,7 ± 5,6 kg/m². A média do índice de apnéias e hipopnéias do grupo foi de 36 ± 29 apnéias e hipopnéias /hora. Nove das 18 mulheres e 2 homens preencheram os critérios estabelecidos pelo American College of Rheumatology para o diagnóstico de síndrome fibromiálgica. CONCLUSÃO: Considerando-se que a prevalência de síndrome fibromiálgica na população geral é de 0,5% para homens e de 3,4% para mulheres, a fração de casos de fibromialgia mais de dez vezes maior nesta amostra reforça a hipótese de associação entre transtornos respiratórios do sono e síndrome fibromiálgica.OBJECTIVE: To identify fibromyalgia syndrome in patients with sleep disordered breathing. METHOD: We studied 50 patients seeking treatment at a sleep disorder clinic for snoring, apnea and excessive daytime sleepiness. Sleep disordered breathing was diagnosed through the use of polysomnography. To diagnose fibromyalgia syndrome, patients were evaluated in accordance with the criteria established by the American College of Rheumatology. RESULTS: Of the 50 patients, 32 were male. The mean (± standard deviation age of the group was 50 ± 12 years. The mean body mass index was 29.7 ± 5.6 kg/m². The mean apnea-hypopnea index was 36 ± 29 attacks of apnea or hypopnea

  20. The association of sleep disordered breathing with left ventricular remodeling in CAD patients: a cross-sectional study.

    Science.gov (United States)

    Alonderis, Audrius; Raskauskiene, Nijole; Gelziniene, Vaidute; Mickuviene, Narseta; Brozaitiene, Julija

    2017-09-18

    There is still insufficient knowledge on the potential effect of mild to moderate sleep-disordered breathing (SDB) that is widely prevalent, often asymptomatic, and largely undiagnosed in patients with stable coronary artery disease (CAD). SDB affects 34% of men and 17% of women aged between 30 and 70. The objective of this study was to evaluate the association between SDB and left ventricular (LV) hypertrophy as well as structural remodeling in stable CAD patients. The study was based on a cross-sectional design. Echocardiography and polysomnography was performed in 772 patients with CAD and with untreated sleep apnea. All study participants underwent testing by Epworth Sleepiness Scale questionnaire. Their mean age, NYHA and left ventricular ejection fraction were, respectively: 57 ± 9 years, 2.1 ± 0.5 and 51 ± 8%, and 76% were men. Sleep apnea (SA) was defined as an apnea-hypopnea-index (AHI) ≥5 events/h, and, non-SA, as an AHI CAD patients with SA. The patients with SA had significantly higher values of both interventricular septal thickness and posterior wall thickness. Multiple logistic regression analysis showed that even mild sleep apnea was an independent predictor for LVH by wall thickness criteria and concentric LVH (OR = 1.5; 95% CI 1.04-2.2 and OR = 1.9; 1.3-2.9 respectively). We concluded that unrecognized sleep apnea was highly prevalent among patients with stable CAD, and the majority of those patients did not report daytime sleepiness. Mild to moderate sleep apnea was associated with increased LV wall thickness, LV mass, and with higher prevalence of concentric LV hypertrophy independently of coexisting obesity, hypertension, diabetes mellitus or advancing age.

  1. Sleep Disorders in Patients with Post-Traumatic Stress Disorder.

    Science.gov (United States)

    El-Solh, Ali A; Riaz, Usman; Roberts, Jasmine

    2018-04-20

    A growing body of evidence supports a bidirectional relationship between post-traumatic stress disorder (PTSD) and sleep disturbances. Fragmented sleep induced by sleep-related breathing disorders, insomnia, and nightmares impacts recovery and treatment outcomes and worsens PTSD symptoms. Despite recent attention, management of these disorders has been unrewarding in the setting of PTSD. This review summarizes the evidence for empirically supported treatments of these sleep ailments as it relates to PTSD including psychotherapeutic and pharmacologic interventions. Recent advances in positive airway pressure technology have made treatment of OSA more acceptable however adherence to CPAP represents a significant challenge. The presence of concomitant insomnia, which engenders psychiatric and medical conditions including depression, suicide, alcohol and substance abuse, can be managed with cognitive behavioral therapy (CBT). Hypnotic agents are considered an alternative therapy but concerns about adverse events and lack of high level evidence supporting their efficacy in PTSD have limited their use to resistant cases or as adjunct to behavioral therapy when the response is less than desirable. Intrusion of nightmares can complicate PTSD treatment and exert serious strain on social, occupational and marital relations. Image rehearsal therapy has shown significant reduction in nightmares intensity and frequency. The success of noradrenergic blocking agents has not been consistent among studies with half reporting treatment failure. An integrated stepped care approach that includes components of both behavioral and pharmacologic interventions customized to patients sleep maladaptive behaviors may offer a solution to delivering accessible, effective, and efficient services for individuals with PTSD. Copyright © 2018. Published by Elsevier Inc.

  2. Comparision of Parent Reported Sleeping Habits and Sleep Problems Between Attention Deficit and Hyperactivity Disorder and Healthy Controls

    Directory of Open Access Journals (Sweden)

    Yusuf Ozturk

    2017-12-01

    Full Text Available Attention Deficit and Hyperactivity Disorder (ADHD children has been shown to affect the quality of sleep. In this study it is aimed to evaluate sleep habits and sleep problems between the cases who are diagnosed with ADHD and healthy controls. The study group consisted of 61 children (8-12 years old with ADHD; the control group (87 children comprised patients of other clinics at hospital. The Kiddie Schedule for Affective Disorders and Schizophrenia for School Aged Children-Present and Lifetime Version (K-SADS-PL and DuPaul ADHD Rating Scale vere used. Children's sleep habits and sleep problems were assessed with the Children's Sleep Habits Questionnaire. ADHD group compared to healthy controls; statistical significant difference was found in bedtime resistance, the sleep onset delay, the sleep duration, the sleep anxiety, the night wakings, the parasomnias and the daytime sleepiness but statistical significant difference wasn’t found the sleep disordered breathing. In our study, problems in the sleep habits evaluated by parents ADHD are more than campared with healty controls likewise literature. However, further studies with larger sample size and objective measures such as actigraphy and polysomnography may allow us to have more knowledge in this area. [JCBPR 2017; 6(3.000: 108-114

  3. Evaluation of sympathetic activity by 123I-metaiodobenzylguanidine myocardial scintigraphy in dilated cardiomyopathy patients with sleep breathing disorder

    International Nuclear Information System (INIS)

    Nanjo, Shuji; Fujimoto, Shinichiro; Yamashiro, Yoshihiro

    2009-01-01

    Because increased sympathetic nervous activity (SNA) in patients with dilated cardiomyopathy (DCM) associated with sleep breathing disorder (SBD) is known to deteriorate the prognosis of cardiac failure, 123 I-metaiodobenzylguanidine (MIBG) myocardial scintigraphy was used as the investigative tool in the present study. The study group comprised 53 patients (47 men, 6 women; mean age 56±3 years) with chronic stable DCM. Patients were divided into SBD(+) or SBD(-) group according to 24-h pulse oximetry results. SBD(+) was defined when the 3% oxygen desaturation index was more than 15/h during sleep. In total, 32 patients were SBD(-) and 21 were SBD(+). In both groups, pulse oximetry were performed during sleep and awakening pulse rate, and measurement of the blood levels of catecholamines and B-type natriuretic peptide was performed. MIBG myocardial scintigraphy and echocardiography were performed at the same time. No significant difference was found between the 2 groups in catecholamine levels or left ventricular ejection fraction. However, MIBG had a significantly increased washout rate and a significantly decreased delayed heart to mediastinum ratio in the SBD(+) group compared with the SBD(-) group. SNA is increased in DCM patients when associated with SBD. MIBG myocardial scintigraphy may be a sensitive method of detecting increased SNA. (author)

  4. [Sleep disorders and impaired sleep as adverse drug reactions of psychotropic drugs: an evaluation of data of summaries of product characteristics].

    Science.gov (United States)

    Gahr, Maximilian; Connemann, Bernhard J; Zeiss, René; Fröhlich, Albrecht

    2018-03-02

     Psychopharmacotherapy is essential in the treatment of many mental disorders. Adverse drug reactions (ADR) have impact on compliance and tolerability. Sleep disorders or impaired sleep may occur as ADRs of psychopharmacotherapy. Sleep disorders are associated with an increased risk for physical and mental illness and may impair cognition, impulse control, emotion regulation and mood. Objective of the following study was the systematic presentation of type and risk of sleep disorders/impairments of sleep of frequently prescribed psychotropic drugs.  Psychotropic agents that are most frequently prescribed in Germany were identified by using the Arzneiverordnungs-Report 2016. Summaries of product characteristics (SmPC) of corresponding original products were analyzed regarding presence and frequency of sleep disorders/impairments of sleep according to the International Classification of Sleep Disorders 3 (ICSD-3).  N = 64 SmPCs were analyzed. In most of the analyzed SmPCs, at least one sleep disorder (50/64; 78 %) was listed. At least one SmPC with a corresponding ADR was found in the categories insomnia (52 %), parasomnias (33 %), and sleep-related movement disorders (20 %); sleep-related breathing disorders (6 %) and central disorders of hypersomnolence (5 %) were rarely listed; circadian rhythm sleep-wake disorder was not found. The SmPCs of the four most frequently prescribed agents (citalopram > venlafaxine > mirtazapine > sertraline) listed insomnia as an ADR. Nearly all analysed hypnotics (except chloral hydrate) were associated with nightmares.  Most of the psychotropic agents frequently prescribed in Germany may induce sleep disorders/impairments of sleep. The four most frequently prescribed agents were antidepressants and all of the corresponding SmPCs listed insomnia as a possible ADR. Sleep disorders should be taken seriously as possible ADRs of psychopharmacotherapy. © Georg Thieme Verlag KG Stuttgart · New York.

  5. Hot Topics in Noninvasive Ventilation: Report of a Working Group at the International Symposium on Sleep-Disordered Breathing in Leuven, Belgium.

    Science.gov (United States)

    Vrijsen, Bart; Chatwin, Michelle; Contal, Oliver; Derom, Eric; Janssens, Jean-Paul; Kampelmacher, Mike J; Muir, Jean-Francois; Pinto, Susana; Rabec, Claudio; Ramsay, Michelle; Randerath, Winfried J; Storre, Jan H; Wijkstra, Peter J; Windisch, Wolfram; Testelmans, Dries

    2015-09-01

    During the last few decades, attention has increasingly focused on noninvasive ventilation (NIV) in the treatment of chronic respiratory failure. The University of Leuven and the University Hospitals Leuven therefore chose this topic for a 2-day working group session during their International Symposium on Sleep-Disordered Breathing. Numerous European experts took part in this session and discussed (1) NIV in amyotrophic lateral sclerosis (when to start NIV, NIV and sleep, secretion management, and what to do when NIV fails), (2) recent insights in NIV and COPD (high-intensity NIV, NIV in addition to exercise training, and NIV during exercise training), (3) monitoring of NIV (monitoring devices, built-in ventilator software, leaks, and asynchronies) and identifying events during NIV; and (4) recent and future developments in NIV (target-volume NIV, electromyography-triggered NIV, and autoregulating algorithms). Copyright © 2015 by Daedalus Enterprises.

  6. Time course of EEG slow-wave activity in pre-school children with sleep disordered breathing: a possible mechanism for daytime deficits?

    Science.gov (United States)

    Biggs, Sarah N; Walter, Lisa M; Nisbet, Lauren C; Jackman, Angela R; Anderson, Vicki; Nixon, Gillian M; Davey, Margot J; Trinder, John; Hoffmann, Robert; Armitage, Roseanne; Horne, Rosemary S C

    2012-09-01

    Daytime deficits in children with sleep disordered breathing (SDB) are theorized to result from hypoxic insult to the developing brain or fragmented sleep. Yet, these do not explain why deficits occur in primary snorers (PS). The time course of slow wave EEG activity (SWA), a proxy of homeostatic regulation and cortical maturation, may provide insight. Clinical and control subjects (N=175: mean age 4.3±0.9 y: 61% male) participated in overnight polysomnography (PSG). Standard sleep scoring and power spectral analyses were conducted on EEG (C4/A1; 0.5-sleep stages and respiratory parameters. Repeated-measures ANCOVA evaluated group differences in the time course of SWA. Four groups were classified: controls (OAHI ≤ 1 event/h; no clinical history); PS (OAHI ≤ 1 event/h; clinical history); mild OSA (OAHI=1-5 events/h); and moderate to severe OSA (MS OSA: OAHI>5 events/h). Group differences were found in the percentage of time spent in NREM Stages 1 and 4 (psleep pressure but impaired restorative sleep function in pre-school children with SDB, providing new insights into the possible mechanism for daytime deficits observed in all severities of SDB. Copyright © 2012 Elsevier B.V. All rights reserved.

  7. Sleep and Metabolism: An Overview

    OpenAIRE

    Sharma, Sunil; Kavuru, Mani

    2010-01-01

    Sleep and its disorders are increasingly becoming important in our sleep deprived society. Sleep is intricately connected to various hormonal and metabolic processes in the body and is important in maintaining metabolic homeostasis. Research shows that sleep deprivation and sleep disorders may have profound metabolic and cardiovascular implications. Sleep deprivation, sleep disordered breathing, and circadian misalignment are believed to cause metabolic dysregulation through myriad pathways i...

  8. Characterising infant inter-breath interval patterns during active and quiet sleep using recurrence plot analysis.

    Science.gov (United States)

    Terrill, Philip I; Wilson, Stephen J; Suresh, Sadasivam; Cooper, David M

    2009-01-01

    Breathing patterns are characteristically different between active and quiet sleep states in infants. It has been previously identified that breathing dynamics are governed by a non-linear controller which implies the need for a nonlinear analytical tool. Further, it has been shown that quantified nonlinear variables are different between adult sleep states. This study aims to determine whether a nonlinear analytical tool known as recurrence plot analysis can characterize breath intervals of active and quiet sleep states in infants. Overnight polysomnograms were obtained from 32 healthy infants. The 6 longest periods each of active and quiet sleep were identified and a software routine extracted inter-breath interval data for recurrence plot analysis. Determinism (DET), laminarity (LAM) and radius (RAD) values were calculated for an embedding dimension of 4, 6, 8 and 16, and fixed recurrence of 0.5, 1, 2, 3.5 and 5%. Recurrence plots exhibited characteristically different patterns for active and quiet sleep. Active sleep periods typically had higher values of RAD, DET and LAM than for quiet sleep, and this trend was invariant to a specific choice of embedding dimension or fixed recurrence. These differences may provide a basis for automated sleep state classification, and the quantitative investigation of pathological breathing patterns.

  9. The influence of sex and gonadal hormones on sleep disorders

    Directory of Open Access Journals (Sweden)

    Orff HJ

    2014-06-01

    Full Text Available Henry J Orff, Charles J Meliska, L Fernando Martinez, Barbara L Parry Department of Psychiatry, University of California, San Diego, CA, USA Abstract: Sleep disorders such as insomnia, sleep-related breathing disorders, circadian rhythm disorders, and sleep-related movement disorders are a significant public health issue, affecting approximately 40 million people in the US each year. Sleep disturbances are observed in both men and women, though prevalence rates often differ between the sexes. In general, research suggests that women more frequently report subjective complaints of insomnia, yet show better sleep than men when evaluated on objective measures of sleep. Men are more likely to be diagnosed with obstructive sleep apnea than women, though rates of obstructive sleep apnea increase after menopause and may be generally underdiagnosed in women. Although circadian rhythm disorders are equally prevalent in men and women, studies find that women typically have earlier bedtimes and exhibit altered temperature and melatonin rhythms relative to men. Lastly, movement disorders appear to be more prevalent in women than men, presumably due to higher rates of anemia and increased risks associated with pregnancy in women. Although gonadal hormones would be expected to play a significant role in the development and/or exacerbation of sleep disturbances, no causal link between these factors has been clearly established. In large part, the impact of hormones on sleep disturbances is significantly confounded by factors such as psychiatric, physical, and lifestyle concerns, which may play an equal or greater role in the development and/or exacerbation of sleep disturbances than do hormonal factors. Current standard of care for persons with sleep disorders includes use of psychological, pharmacologic, and/or medical device supported interventions. Hormonal-based treatments are not typically recommended given the potential for long-term adverse health

  10. Reimbursed drugs in patients with sleep-disordered breathing: A static-charge-sensitive bed study.

    Science.gov (United States)

    Anttalainen, Ulla; Polo, Olli; Vahlberg, Tero; Saaresranta, Tarja

    2010-01-01

    Co-morbidities in men and women with sleep-disordered breathing (SDB) were compared retrospectively to an age-standardized, general Finnish population. The prevalence of diseases was based on the reimbursement refunds of medications. Two hundred thirty-three age- and BMI-matched male-female pairs and 368 consecutive women identified from our sleep recording database were included. Data on medication were gathered from the National Agency for Medicines and Social Insurance Institution database. Men with SDB had three-fold prevalence of reimbursed medication for diabetes and two-fold prevalence of reimbursed medication for chronic arrhythmia. Women with SDB had three-fold prevalence of reimbursed medication for thyroid insufficiency, and postmenopausal women had two-fold prevalence of reimbursed medication for psychosis. BMI and age did not explain prevalence of reimbursed medications for chronic arrhythmia or psychosis. In both genders with SDB, prevalence of reimbursed medications compared to the general population was two-fold for hypertension and seven-fold for asthma and/or chronic obstructive pulmonary disease (COPD). Partial upper airway obstruction was associated with three-fold prevalence of reimbursed medication for asthma and/or COPD in both genders and 60% reduced prevalence of reimbursed medication for hypertension in females matched for age and BMI. Co-morbidity profile differed between genders. Our results emphasize the importance of diagnosis and treatment of co-morbidities and partial upper airway obstruction. Copyright 2009 Elsevier B.V. All rights reserved.

  11. Sleep disordered breathing and daytime sleepiness are associated with poor academic performance in teenagers. A study using the Pediatric Daytime Sleepiness Scale (PDSS).

    Science.gov (United States)

    Perez-Chada, Daniel; Perez-Lloret, Santiago; Videla, Alejandro J; Cardinali, Daniel; Bergna, Miguel A; Fernández-Acquier, Mariano; Larrateguy, Luis; Zabert, Gustavo E; Drake, Christopher

    2007-12-01

    Inadequate sleep and sleep disordered breathing (SDB) can impair learning skills. Questionnaires used to evaluate sleepiness in adults are usually inadequate for adolescents. We conducted a study to evaluate the performance of a Spanish version of the Pediatric Daytime Sleepiness Scale (PDSS) and to assess the impact of sleepiness and SDB on academic performance. A cross-sectional survey of students from 7 schools in 4 cities of Argentina. A questionnaire with a Spanish version of the PDSS was used. Questions on the occurrence of snoring and witnessed apneas were answered by the parents. Mathematics and language grades were used as indicators of academic performance. The sample included 2,884 students (50% males; age: 13.3 +/- 1.5 years) Response rate was 85%; 678 cases were excluded due to missing data. Half the students slept sleep habits. Insufficient hours of sleep were prevalent in this population. The Spanish version of the PDSS was a reliable tool in middle-school-aged children. Reports of snoring or witnessed apneas and daytime sleepiness as measured by PDSS were independent predictors of poor academic performance.

  12. Identifying Predictors of Central Sleep Apnea/Cheyne-Stokes Breathing in Chronic Heart Failure: a Pathophysiological Approach

    Directory of Open Access Journals (Sweden)

    Draganova Aneliya I.

    2016-12-01

    Full Text Available Chronic heart failure (CHF is a major health problem associated with increased mortality, despite modern treatment options. Central sleep apnea (CSA/Cheyne-Stokes breathing (CSB is a common and yet largely under-diagnosed co-morbidity, adding significantly to the poor prognosis in CHF because of a number of acute and chronic effects, including intermittent hypoxia, sympathetic overactivation, disturbed sleep architecture and impaired physical tolerance. It is characterized by repetitive periods of crescendo-decrescendo ventilatory pattern, alternating with central apneas and hypopneas. The pathogenesis of CSA/CSB is based on the concept of loop gain, comprising three major components: controller gain, plant gain and feedback gain. Laboratory polysomnography, being the golden standard for diagnosing sleep-disordered breathing (SDB at present, is a costly and highly specialized procedure unable to meet the vast diagnostic demand. Unlike obstructive sleep apnea, CSA/CSB has a low clinical profile. Therefore, a reliable predictive system is needed for identifying CHF patients who are most likely to suffer from CSA/CSB, optimizing polysomnography use. The candidate predictors should be standardized, easily accessible and low-priced in order to be applied in daily medical routine.

  13. Sleep and Metabolism: An Overview

    Directory of Open Access Journals (Sweden)

    Sunil Sharma

    2010-01-01

    Full Text Available Sleep and its disorders are increasingly becoming important in our sleep deprived society. Sleep is intricately connected to various hormonal and metabolic processes in the body and is important in maintaining metabolic homeostasis. Research shows that sleep deprivation and sleep disorders may have profound metabolic and cardiovascular implications. Sleep deprivation, sleep disordered breathing, and circadian misalignment are believed to cause metabolic dysregulation through myriad pathways involving sympathetic overstimulation, hormonal imbalance, and subclinical inflammation. This paper reviews sleep and metabolism, and how sleep deprivation and sleep disorders may be altering human metabolism.

  14. Declarative and Non-declarative Memory Consolidation in Children with Sleep Disorder.

    Science.gov (United States)

    Csábi, Eszter; Benedek, Pálma; Janacsek, Karolina; Zavecz, Zsófia; Katona, Gábor; Nemeth, Dezso

    2015-01-01

    Healthy sleep is essential in children's cognitive, behavioral, and emotional development. However, remarkably little is known about the influence of sleep disorders on different memory processes in childhood. Such data could give us a deeper insight into the effect of sleep on the developing brain and memory functions and how the relationship between sleep and memory changes from childhood to adulthood. In the present study we examined the effect of sleep disorder on declarative and non-declarative memory consolidation by testing children with sleep-disordered breathing (SDB) which is characterized by disrupted sleep structure. We used a story recall task to measure declarative memory and Alternating Serial Reaction time (ASRT) task to assess non-declarative memory. This task enables us to measure two aspects of non-declarative memory, namely general motor skill learning and sequence-specific learning. There were two sessions: a learning phase and a testing phase, separated by a 12 h offline period with sleep. Our data showed that children with SDB exhibited a generally lower declarative memory performance both in the learning and testing phase; however, both the SDB and control groups exhibited retention of the previously recalled items after the offline period. Here we showed intact non-declarative consolidation in SDB group in both sequence-specific and general motor skill. These findings suggest that sleep disorders in childhood have a differential effect on different memory processes (online vs. offline) and give us insight into how sleep disturbances affects developing brain.

  15. Synchronized imaging and acoustic analysis of the upper airway in patients with sleep-disordered breathing

    International Nuclear Information System (INIS)

    Chang, Yi-Chung; Pham, Van-Truong; Wang, Yung-Hung; Lin, Chen; Lo, Men-Tzung; Huon, Leh-Kiong; Wang, Pa-Chun; Chen, Yunn-Jy; Jiang, Sun-Fen; Shih, Tiffany Ting-Fang; Tran, Thi-Thao; Tsao, Jenho

    2014-01-01

    Progressive narrowing of the upper airway increases airflow resistance and can produce snoring sounds and apnea/hypopnea events associated with sleep-disordered breathing due to airway collapse. Recent studies have shown that acoustic properties during snoring can be altered with anatomic changes at the site of obstruction. To evaluate the instantaneous association between acoustic features of snoring and the anatomic sites of obstruction, a novel method was developed and applied in nine patients to extract the snoring sounds during sleep while performing dynamic magnetic resonance imaging (MRI). The degree of airway narrowing during the snoring events was then quantified by the collapse index (ratio of airway diameter preceding and during the events) and correlated with the synchronized acoustic features. A total of 201 snoring events (102 pure retropalatal and 99 combined retropalatal and retroglossal events) were recorded, and the collapse index as well as the soft tissue vibration time were significantly different between pure retropalatal (collapse index, 24  ±  11%; vibration time, 0.2  ±  0.3 s) and combined (retropalatal and retroglossal) snores (collapse index, 13  ±  7% [P ≤ 0.0001]; vibration time, 1.2  ±  0.7 s [P ≤ 0.0001]). The synchronized dynamic MRI and acoustic recordings successfully characterized the sites of obstruction and established the dynamic relationship between the anatomic site of obstruction and snoring acoustics. (paper)

  16. Sleep-disordered breathing decreases after opioid withdrawal: results of a prospective controlled trial.

    Science.gov (United States)

    Schwarzer, Andreas; Aichinger-Hinterhofer, Marie; Maier, Christoph; Vollert, Jan; Walther, Jörg Werner

    2015-11-01

    An increased cardiovascular event rate in elderly patients under opioid medications was recently reported. One reason for this increase could be the occurrence of nocturnal apnea and hypoxia, as a consequence of sleep-disordered breathing (SDB). Using a controlled study, we prospectively analyzed SDB using polysomnography in a total of 18 patients before and after opioid withdrawal (opioid withdrawal group [OG]) and 14 patients before and after comprehensive pain management (without any strong-acting opioids) who served as the control group (CG). To analyze the differences, unpaired/paired t tests and Mann-Whitney U tests/Wilcoxon rank tests were used. At baseline, the OG presented more nocturnal apneas/hypopneas than the CG with an apnea-hypopnea index (AHI) of 41.4 ± 27.8 vs 21.8 ± 15.9 (P = 0.018). After treatment, the AHI decreased significantly only in the withdrawal group (OG: 16.7 ± 8.9; CG: 20.1 ± 12.9) (P opioid withdrawal and in none of the patients after withdrawal (P opioid intake; these findings may explain the opioid-associated cardiovascular morbidity. Thus, SDB may be a risk at lower opioid doses than hitherto described, and particular caution should be exercised in patients with comorbidities that might make them vulnerable to the consequences of SDB.

  17. Respiratory and sleep disorders in female children with atypical Rett syndrome caused by mutations in the CDKL5 gene.

    Science.gov (United States)

    Hagebeuk, Eveline E O; van den Bossche, Renilde A S; de Weerd, Al W

    2013-05-01

    In female children with drug-resistant seizures and developmental delay from birth, atypical Rett syndrome caused by mutations in the CDKL5 gene should be considered. Several clinical features resemble classic Rett syndrome. Respiratory and sleep abnormalities are frequently present in Rett syndrome, whereas little is known in patients with CDKL5 mutations. In four genetically confirmed female patients with CDKL5 mutations (age range 2-15 y), the presence of breathing and sleep abnormalities was evaluated using the validated Sleep Disturbance Scale for Children and polysomnography (PSG). The Sleep Disturbance Scale for Children indicated disorders of initiating and maintaining sleep, daytime somnolence, and sleep breathing disorders. In one patient, PSG showed central apnoeas during sleep: her total apnoea-hypopnoea index (AHI) was 4.9, of which the central AHI was 3.4/h. When awake, central apnoeas were present in two of the four female children (central AHI 28/h and 41/h respectively), all preceded by hyperventilation. PSG showed low rapid eye movement (REM) sleep (9.7-18.3%), frequent awakenings, and low sleep efficiency (range 59-78%). Episodic hyperventilation followed by central apnoeas was present while awake in two of four patients. This may indicate failure of brainstem respiratory centres. In addition, low REM sleep, frequent arousals (not caused by apnoeas/seizures), and low sleep efficiency were present. Similar to Rett syndrome, in patients with CDKL5 mutations PSG seems warranted to evaluate breathing and sleep disturbances. © The Authors. Developmental Medicine & Child Neurology © 2012 Mac Keith Press.

  18. Declarative and non-declarative memory consolidation in children with sleep disorder

    Directory of Open Access Journals (Sweden)

    Eszter eCsabi

    2016-01-01

    Full Text Available Healthy sleep is essential in children’s cognitive, behavioral, and emotional development. However, remarkably little is known about the influence of sleep disorders on different memory processes in childhood. Such data could give us a deeper insight into the effect of sleep on the developing brain and memory functions and how the relationship between sleep and memory changes from childhood to adulthood. In the present study we examined the effect of sleep disorder on declarative and non-declarative memory consolidation by testing children with sleep-disordered breathing (SDB which is characterized by disrupted sleep structure. We used a story recall task to measure declarative memory and Alternating Serial Reaction Time (ASRT task to assess non-declarative memory. This task enables us to measure two aspects of non-declarative memory, namely general motor skill learning and sequence-specific learning. There were two sessions: a learning phase and a testing phase, separated by a 12-hour offline period with sleep. Our data showed that children with SDB exhibited a generally lower declarative memory performance both in the learning and testing phase; however, both the SDB and control groups exhibited retention of the previously recalled items after the offline period. Here we showed intact non-declarative consolidation in SDB group in both sequence-specific and general motor skill. These findings suggest that sleep disorders in childhood have a differential effect on different memory processes (online vs. offline and give us insight into how sleep disturbances affects developing brain.

  19. Long-term changes in neurocognition and behavior following treatment of sleep disordered breathing in school-aged children.

    Science.gov (United States)

    Biggs, Sarah N; Vlahandonis, Anna; Anderson, Vicki; Bourke, Robert; Nixon, Gillian M; Davey, Margot J; Horne, Rosemary S C

    2014-01-01

    Sleep disordered breathing (SDB) in children is associated with detrimental neurocognitive and behavioral consequences. The long term impact of treatment on these outcomes is unknown. This study examined the long-term effect of treatment of SDB on neurocognition, academic ability, and behavior in a cohort of school-aged children. Four-year longitudinal study. Children originally diagnosed with SDB and healthy non-snoring controls underwent repeat polysomnography and age-standardized neurocognitive and behavioral assessment 4y following initial testing. Melbourne Children's Sleep Centre, Melbourne, Australia. Children 12-16 years of age, originally assessed at 7-12 years, were categorized into Treated (N = 12), Untreated (N = 26), and Control (N = 18) groups. Adenotonsillectomy, Tonsillectomy, Nasal Steroids. Decision to treat was independent of this study. Changes in sleep and respiratory parameters over time were assessed. A decrease in obstructive apnea hypopnea index (OAHI) from Time 1 to Time 2 was seen in 63% and 100% of the Untreated and Treated groups, respectively. The predictive relationship between change in OAHI and standardized neurocognitive, academic, and behavioral scores over time was examined. Improvements in OAHI were predictive of improvements in Performance IQ, but not Verbal IQ or academic measures. Initial group differences in behavioral assessment on the Child Behavior Checklist did not change over time. Children with SDB at baseline continued to exhibit significantly poorer behavior than Controls at follow-up, irrespective of treatment. After four years, improvements in SDB are concomitant with improvements in some areas of neurocognition, but not academic ability or behavior in school-aged children.

  20. Sleep and Eating Disorders.

    Science.gov (United States)

    Allison, Kelly C; Spaeth, Andrea; Hopkins, Christina M

    2016-10-01

    Insomnia is related to an increased risk of eating disorders, while eating disorders are related to more disrupted sleep. Insomnia is also linked to poorer treatment outcomes for eating disorders. However, over the last decade, studies examining sleep and eating disorders have relied on surveys, with no objective measures of sleep for anorexia nervosa or bulimia nervosa, and only actigraphy data for binge eating disorder. Sleep disturbance is better defined for night eating syndrome, where sleep efficiency is reduced and melatonin release is delayed. Studies that include objectively measured sleep and metabolic parameters combined with psychiatric comorbidity data would help identify under what circumstances eating disorders and sleep disturbance produce an additive effect for symptom severity and for whom poor sleep would increase risk for an eating disorder. Cognitive behavior therapy for insomnia may be a helpful addition to treatment of those with both eating disorder and insomnia.

  1. Bed Rest and Hypoxic Exposure Affect Sleep Architecture and Breathing Stability

    Directory of Open Access Journals (Sweden)

    Shawnda A. Morrison

    2017-06-01

    Full Text Available Objective: Despite over 50 years of research on the physiological effects of sustained bed rest, data characterizing its effects on sleep macrostructure and breathing stability in humans are scarce. This study was conducted to determine the effects of continuous exposure to hypoxia and sustained best rest, both individually and combined, on nocturnal sleep and breathing stability.Methods: Eleven participants completed three randomized, counter-balanced, 21-days trials of: (1 normoxic bed rest (NBR, PIO2 = 133.1 ± 0.3, (2 hypoxic ambulatory confinement (HAMB, PIO2 = 90.0 ± 0.4 and (3 hypoxic bed rest (HBR, PIO2 = 90.0 ± 0.4; ~4,000 m equivalent altitude. Full objective polysomnography was performed at baseline, on Night 1 and Night 21 in each condition.Results: In NBR Night 1, more time was spent in light sleep (10 ± 2% compared to baseline (8 ± 2%; p = 0.028; Slow-wave sleep (SWS was reduced from baseline in the hypoxic-only trial by 18% (HAMB Night 21, p = 0.028 and further reduced by 33% (HBR Night 1, p = 0.010, and 36% (HBR Night 21, p = 0.008 when combined with bed rest. The apnea-hypopnea index doubled from Night 1 to Night 21 in HBR (32–62 events·h−1 and HAMB (31–59 events·h−1; p = 0.002. Those who experienced greatest breathing instability from Night 1 to Night 21 (NBR were correlated to unchanged or higher (+1% night SpO2 concentrations (R2 = 0.471, p = 0.020.Conclusion: Bed rest negatively affects sleep macrostructure, increases the apnea-hypopnea index, and worsens breathing stability, each independently exacerbated by continuous exposure to hypoxia.

  2. Bed Rest and Hypoxic Exposure Affect Sleep Architecture and Breathing Stability

    Science.gov (United States)

    Morrison, Shawnda A.; Mirnik, Dani; Korsic, Spela; Eiken, Ola; Mekjavic, Igor B.; Dolenc-Groselj, Leja

    2017-01-01

    Objective: Despite over 50 years of research on the physiological effects of sustained bed rest, data characterizing its effects on sleep macrostructure and breathing stability in humans are scarce. This study was conducted to determine the effects of continuous exposure to hypoxia and sustained best rest, both individually and combined, on nocturnal sleep and breathing stability. Methods: Eleven participants completed three randomized, counter-balanced, 21-days trials of: (1) normoxic bed rest (NBR, PIO2 = 133.1 ± 0.3), (2) hypoxic ambulatory confinement (HAMB, PIO2 = 90.0 ± 0.4) and (3) hypoxic bed rest (HBR, PIO2 = 90.0 ± 0.4; ~4,000 m equivalent altitude). Full objective polysomnography was performed at baseline, on Night 1 and Night 21 in each condition. Results: In NBR Night 1, more time was spent in light sleep (10 ± 2%) compared to baseline (8 ± 2%; p = 0.028); Slow-wave sleep (SWS) was reduced from baseline in the hypoxic-only trial by 18% (HAMB Night 21, p = 0.028) and further reduced by 33% (HBR Night 1, p = 0.010), and 36% (HBR Night 21, p = 0.008) when combined with bed rest. The apnea-hypopnea index doubled from Night 1 to Night 21 in HBR (32–62 events·h−1) and HAMB (31–59 events·h−1; p = 0.002). Those who experienced greatest breathing instability from Night 1 to Night 21 (NBR) were correlated to unchanged or higher (+1%) night SpO2 concentrations (R2 = 0.471, p = 0.020). Conclusion: Bed rest negatively affects sleep macrostructure, increases the apnea-hypopnea index, and worsens breathing stability, each independently exacerbated by continuous exposure to hypoxia. PMID:28676764

  3. A novel NREM and REM parasomnia with sleep breathing disorder associated with antibodies against IgLON5: a case series, pathological features, and characterization of the antigen

    Science.gov (United States)

    Sabater, Lidia; Gaig, Carles; Gelpi, Ellen; Bataller, Luis; Lewerenz, Jan; Torres-Vega, Estefanía; Contreras, Angeles; Giometto, Bruno; Compta, Yaroslau; Embid, Cristina; Vilaseca, Isabel; Iranzo, Alex; Santamaría, Joan; Dalmau, Josep; Graus, Francesc

    2014-01-01

    Summary Background Autoimmunity may be involved in sleep and neurodegenerative disorders. We aimed to describe a neurological syndrome with prominent sleep dysfunction and antibodies to a previously unknown neuronal antigen. Methods In this observational study, clinical and video-polysomnography (V- PSG) investigations identified a novel sleep disorder in three patients referred to the Sleep Unit of Hospital Clinic University of Barcelona for abnormal sleep behaviors and obstructive sleep apnea(OSA). They had antibodies against a neuronal surface antigen also present in five additional patients referred to our laboratory for antibody studies. These five patients had been evaluated with PSG and in two, the study was done or reviewed in our Sleep Unit. Two patients underwent postmortem brain examination. Immunoprecipitation and mass spectrometry were used to characterize the antigen and to develop a diagnostic test. Serum or CSF from 285 patients with neurodegenerative, sleep, or autoimmune disorders served as controls. Findings All eight patients (five women; range: 52–76 years, median 59) had abnormal sleep movements and behaviors and OSA confirmed by PSG. Six patients had a chronic evolution (range 2–12 years, median 5.5); in four the sleep disorder was the initial and most prominent feature, and in two it was preceded by gait instability, and followed by dysarthria, dysphagia, ataxia, or chorea. Two patients had a rapid evolution with disequilibrium, dysarthria, dysphagia, and central hypoventilation, and died two and six months after symptom onset. In 5/5 patients, the V-PSG reviewed in our Unit disclosed OSA, stridor, and abnormal sleep architecture with undifferentiated NREM sleep or poorly structured stage N2 with simple movements and finalistic behaviors, normalization of NREM sleep by the end of the night, and REM sleep behavior disorder. Four/4 patients carried the HLA-DRB1*1001 and HLA-DQB1*0501 alleles. All patients had antibodies (mainly IgG4

  4. Severe obstructive sleep disorders in Prader-Willi syndrome patients in southern Italy.

    Science.gov (United States)

    Canora, Angelo; Franzese, Adriana; Mozzillo, Enza; Fattorusso, Valentina; Bocchino, Marialuisa; Sanduzzi, Alessandro

    2018-01-09

    Sleep-related disordered breathing (SDB) is very common in paediatric patients affected by Prader-Willi Syndrome (PWS). However, data addressing SBD patterns and their management are lacking. The aim of the present study was to analyse SDB features in 14 PWS patients (age range, 8 months-17 years). Polygraphic registration (PG) during a 12-h nocturnal sleep was performed in all patients. Obstructive and central apnoea indices and oxygen saturation (SpO 2 ) were recorded along with demographic and clinical data. Obstructive sleep apnoea (OSA) was diagnosed in 13/14 patients (92.9%); the mean obstructive apnoea-hypopnea index (OAHI) was 7.6 ± 4.2 events/h with a mean central apnoea index (CAI) of 0.7 ± 1.04 events/h. Time spent with SpO 2 Prader-Willi syndrome. What is New: • Severe obstructive sleep apnoea is the most frequent sleep-related disorder in our case series.

  5. Sleep disordered breathing, insomnia, and health related quality of life -- a comparison between age and gender matched elderly with heart failure or without cardiovascular disease.

    Science.gov (United States)

    Johansson, Peter; Arestedt, Kristoffer; Alehagen, Urban; Svanborg, Eva; Dahlström, Ulf; Broström, Anders

    2010-06-01

    The aims of this study are (I) to compare the prevalence of sleep disordered breathing (SDB) and insomnia between elderly with heart failure (HF) and age and gender matched elderly without cardiovascular disease (CVD), and (II) to examine the association between HF, SDB and insomnia, as well as their impact on health related quality of life (Hr-QoL). Three hundred and thirty-one elderly (71-87 years) community-living individuals underwent sleep recordings and echocardiography. Questionnaires assessed insomnia and Hr-QoL. Comparisons were made between age and gender matched individuals with HF (n=36) and without CVD (n=36). The HF group had higher mean apnoea-hypopnoea index (17.6 vs. 6.3, pinsomnia or EDS. SDB, DMS and EDS are more common in elderly with HF. SDB is not an obvious cause for sleep complaints or poor Hr-QoL in elderly. Copyright (c) 2009. Published by Elsevier B.V.

  6. Associations of sleep disturbance with ADHD

    DEFF Research Database (Denmark)

    Hvolby, A.

    2015-01-01

    Attention-deficit/hyperactivity disorder (ADHD) is commonly associated with disordered or disturbed sleep. The relationships of ADHD with sleep problems, psychiatric comorbidities and medications are complex and multidirectional. Evidence from published studies comparing sleep in individuals......, difficulty with morning awakenings, sleep onset difficulties, sleep-disordered breathing, night awakenings and daytime sleepiness in subjective studies. ADHD is also frequently coincident with sleep disorders (obstructive sleep apnea, peripheral limb movement disorder, restless legs syndrome and circadian......-rhythm sleep disorders). Psychostimulant medications are associated with disrupted or disturbed sleep, but also 'paradoxically' calm some patients with ADHD for sleep by alleviating their symptoms. Long-acting formulations may have insufficient duration of action, leading to symptom rebound at bedtime. Current...

  7. Sleep physiology and sleep disorders in childhood

    Directory of Open Access Journals (Sweden)

    El Shakankiry HM

    2011-09-01

    Full Text Available Hanan M El ShakankiryKing Fahd University Hospital, Al Dammam University, Al Khobar, Kingdom of Saudi ArabiaAbstract: Sleep has long been considered as a passive phenomenon, but it is now clear that it is a period of intense brain activity involving higher cortical functions. Overall, sleep affects every aspect of a child's development, particularly higher cognitive functions. Sleep concerns are ranked as the fifth leading concern of parents. Close to one third of all children suffer from sleep disorders, the prevalence of which is increased in certain pediatric populations, such as children with special needs, children with psychiatric or medical diagnoses and children with autism or pervasive developmental disorders. The paper reviews sleep physiology and the impact, classification, and management of sleep disorders in the pediatric age group.Keywords: sleep physiology, sleep disorders, childhood, epilepsy

  8. Pediatric Sleep Disorders: Validation of the Sleep Disorders Inventory for Students

    Science.gov (United States)

    Luginbuehl, Marsha; Bradley-Klug, Kathy L.; Ferron, John; Anderson, W. McDowell; Benbadis, Selim R.

    2008-01-01

    Approximately 20%-25% of the pediatric population will likely develop a sleep disorder sometime during childhood or adolescence. Studies have shown that untreated sleep disorders can negatively affect cognitive abilities, and academic and behavior performance. The Sleep Disorders Inventory for Students (SDIS) is a screening instrument designed to…

  9. Sleep-related movement disorders.

    Science.gov (United States)

    Merlino, Giovanni; Gigli, Gian Luigi

    2012-06-01

    Several movement disorders may occur during nocturnal rest disrupting sleep. A part of these complaints is characterized by relatively simple, non-purposeful and usually stereotyped movements. The last version of the International Classification of Sleep Disorders includes these clinical conditions (i.e. restless legs syndrome, periodic limb movement disorder, sleep-related leg cramps, sleep-related bruxism and sleep-related rhythmic movement disorder) under the category entitled sleep-related movement disorders. Moreover, apparently physiological movements (e.g. alternating leg muscle activation and excessive hypnic fragmentary myoclonus) can show a high frequency and severity impairing sleep quality. Clinical and, in specific cases, neurophysiological assessments are required to detect the presence of nocturnal movement complaints. Patients reporting poor sleep due to these abnormal movements should undergo non-pharmacological or pharmacological treatments.

  10. Sleep apnoea in patients with quadriplegia.

    Science.gov (United States)

    McEvoy, R. D.; Mykytyn, I.; Sajkov, D.; Flavell, H.; Marshall, R.; Antic, R.; Thornton, A. T.

    1995-01-01

    BACKGROUND--This study was undertaken to establish the prevalence of, and the factors contributing towards, sleep disordered breathing in patients with quadriplegia. METHODS--Forty representative quadriplegic patients (time since injury > 6 months, injury level C8 and above, Frankel category A, B, or C; mean (SE) age 35.0 (1.7) years) had home sleep studies in which EEG, EOG, submental EMG, body movement, nasal airflow, respiratory effort, and pulse oximetry (SpO2) were measured. Patients reporting post traumatic amnesia of > 24 hours, drug or alcohol abuse or other major medical illness were excluded from the study. A questionnaire on medications and sleep was administered and supine blood pressure, awake SpO2, spirometric values, height, and neck circumference were measured. RESULTS--A pattern of sustained hypoventilation was not observed in any of the patients. Sleep apnoeas and hypopnoeas were, however, common. Eleven patients (27.5%) had a respiratory disturbance index (RDI, apnoeas plus hypopnoeas per hour of sleep) of > or = 15, with nadir SpO2 ranging from 49% to 95%. Twelve of the 40 (30%) had an apnoea index (AI) of > or = 5 and, of these, nine (75%) had predominantly obstructive apnoeas-that is, > 80% of apnoeas were obstructive or mixed. This represents a prevalence of sleep disordered breathing more than twice that observed in normal populations. For the study population RDI correlated with systolic and diastolic blood pressure and neck circumference. RDI was higher in patients who slept supine compared with those in other postures. Daytime sleepiness was a common complaint in the study population and sleep architecture was considerably disturbed with decreased REM sleep and increased stage 1 non-REM sleep. CONCLUSIONS--Sleep disordered breathing is common in quadriplegic patients and sleep disturbance is significant. The predominant type of apnoea is obstructive. As with non-quadriplegic patients with sleep apnoea, sleep disordered breathing in

  11. Sleep disorders in psychiatry.

    Science.gov (United States)

    Costa e Silva, Jorge Alberto

    2006-10-01

    Sleep is an active state that is critical for our physical, mental, and emotional well-being. Sleep is also important for optimal cognitive functioning, and sleep disruption results in functional impairment. Insomnia is the most common sleep disorder in psychiatry. At any given time, 50% of adults are affected with 1 or more sleep problems such as difficulty in falling or staying asleep, in staying awake, or in adhering to a consistent sleep/wake schedule. Narcolepsy affects as many individuals as does multiple sclerosis or Parkinson disease. Sleep problems are especially prevalent in schizophrenia, depression, and other mental illnesses, and every year, sleep disorders, sleep deprivation, and sleepiness add billions to the national health care bill in industrialized countries. Although psychiatrists often treat patients with insomnia secondary to depression, most patients discuss their insomnia with general care physicians, making it important to provide this group with clear guidelines for the diagnosis and management of insomnia. Once the specific medical, behavioral, or psychiatric causes of the sleep problem have been identified, appropriate treatment can be undertaken. Chronic insomnia has multiple causes arising from medical disorders, psychiatric disorders, primary sleep disorders, circadian rhythm disorders, social or therapeutic use of drugs, or maladaptive behaviors. The emerging concepts of sleep neurophysiology are consistent with the cholinergic-aminergic imbalance hypothesis of mood disorders, which proposes that depression is associated with an increased ratio of central cholinergic to aminergic neurotransmission. The characteristic sleep abnormalities of depression may reflect a relative predominance of cholinergic activity. Antidepressant medications presumably reduce rapid eye movement (REM) sleep either by their anticholinergic properties or by enhancing aminergic neurotransmission. Intense and prolonged dreams often accompany abrupt withdrawal

  12. Measurement of endogenous acetone and isoprene in exhaled breath during sleep

    International Nuclear Information System (INIS)

    King, Julian; Kupferthaler, Alexander; Unterkofler, Karl; Amann, Anton; Frauscher, Birgit; Hackner, Heinz; Högl, Birgit; Teschl, Gerald; Hinterhuber, Hartmann

    2012-01-01

    This explorative study aims at characterizing the breath behavior of two prototypic volatile organic compounds, acetone and isoprene, during normal human sleep and to possibly relate changes in the respective concentration time courses to the underlying sleep architecture. For this purpose, six normal healthy volunteers (two females, four males, age 20–29 years) were monitored over two consecutive nights (the first one being an adaption night) by combining real-time proton-transfer-reaction mass spectrometry measurements from end-tidal exhalation segments with laboratory-based polysomnographic data. Breath acetone concentrations increased overnight in all measurements, with an average relative change by a factor of up to 4 (median 2.5). Nighttime concentration maxima were usually recorded 2–3 h before lights on. For breath isoprene, a nocturnal increase in baseline concentrations of about 74% was observed, with individual changes ranging from 36–110%. Isoprene profiles exhibited pronounced concentration peaks, which were highly specific for leg movements as scored by tibial electromyography. Furthermore, relative to a linear trend, baseline isoprene concentrations decreased during the transition from the NREM to the REM phase of a complete sleep cycle. (paper)

  13. 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.

  14. The role of telemedicine and mobile health in the monitoring of sleep-breathing disorders: improving patient outcomes

    Directory of Open Access Journals (Sweden)

    Villanueva JA

    2017-02-01

    Full Text Available Jair A Villanueva,1,* Monique C Suarez,2,* Onintza Garmendia,2,3 Vera Lugo,2 Concepción Ruiz,2 Josep M Montserrat,2–5 1Unit of Biophysics and Bioengineering, Faculty of Medicine, University of Barcelona, 2Sleep Unit, Respiratory Medicine Department, Hospital Clinic, Barcelona, 3Center for Biomedical Research in Respiratory Diseases (CIBERES, Madrid, 4Faculty of Medicine, University of Barcelona, 5August Pi i Sunyer Biomedical Research Institute (IDIBAPS, Barcelona, Spain *These authors contributed equally to this work Abstract: Although the concepts are broad, telemedicine and mobile health (mHealth can be defined as a methodology to provide health care remotely and improve health services and outcomes using telecommunication tools. The widespread adoption of these technologies and current health care challenges, such as the aging population and increasing costs, has encouraged interest in the development of new strategies involving telemedicine. Overall, there is a lack of evidence rigorously assessing the impact of telemedicine and mHealth. Therefore, proper randomized controlled trials, with cost-effectiveness and impact on quality-of-life analysis, are urgently needed. They should also focus on specific populations and their comorbidities, since customizing telemedicine approaches is paramount to ensure success. Obstructive sleep apnea is a highly prevalent chronic condition and the most common of sleep-breathing disorders, and telemedicine and mHealth could play a pivotal role in the different phases of its management. In the future, using new devices capable of signal acquisition and analysis will refine obstructive sleep apnea diagnosis; even smartphones’ built-in sensors could offer improved comfort and the possibility of home sleep monitoring. Continuous positive airway pressure titration could be performed with wireless devices, whose parameters can be changed remotely from sleep centers. Finally, the follow-up phase could be

  15. Mask Ventilation during Induction of General Anesthesia: Influences of Obstructive Sleep Apnea.

    Science.gov (United States)

    Sato, Shin; Hasegawa, Makoto; Okuyama, Megumi; Okazaki, Junko; Kitamura, Yuji; Sato, Yumi; Ishikawa, Teruhiko; Sato, Yasunori; Isono, Shiroh

    2017-01-01

    Depending on upper airway patency during anesthesia induction, tidal volume achieved by mask ventilation may vary. In 80 adult patients undergoing general anesthesia, the authors tested a hypothesis that tidal volume during mask ventilation is smaller in patients with sleep-disordered breathing priorly defined as apnea hypopnea index greater than 5 per hour. One-hand mask ventilation with a constant ventilator setting (pressure-controlled ventilation) was started 20 s after injection of rocuronium and maintained for 1 min during anesthesia induction. Mask ventilation efficiency was assessed by the breath number needed to initially exceed 5 ml/kg ideal body weight of expiratory tidal volume (primary outcome) and tidal volumes (secondary outcomes) during initial 15 breaths (UMIN000012494). Tidal volume progressively increased by more than 70% in 1 min and did not differ between sleep-disordered breathing (n = 42) and non-sleep-disordered breathing (n = 38) patients. In post hoc subgroup analyses, the primary outcome breath number (mean [95% CI], 5.7 [4.1 to 7.3] vs. 1.7 [0.2 to 3.2] breath; P = 0.001) and mean tidal volume (6.5 [4.6 to 8.3] vs. 9.6 [7.7 to 11.4] ml/kg ideal body weight; P = 0.032) were significantly smaller in 20 sleep-disordered breathing patients with higher apnea hypopnea index (median [25th to 75th percentile]: 21.7 [17.6 to 31] per hour) than in 20 non-sleep disordered breathing subjects with lower apnea hypopnea index (1.0 [0.3 to 1.5] per hour). Obesity and occurrence of expiratory flow limitation during one-hand mask ventilation independently explained the reduction of efficiency of mask ventilation, while the use of two hands effectively normalized inefficient mask ventilation during one-hand mask ventilation. One-hand mask ventilation is difficult in patients with obesity and severe sleep-disordered breathing particularly when expiratory flow limitation occurs during mask ventilation.

  16. 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 <0.01). PRV analysis reflected a significant augmentation of sympathetic activity provoked by intermittent hypoxia in SDB children. A linear classifier was trained with the most discriminating features to identify children with SDB. The classifier was validated with internal and external cross-validation, providing a high negative predictive value (92.6%) and a good balance between sensitivity (88.4%) and specificity (83.6%). Combining SpO2 and PRV analysis improved the classification performance, providing an area under the receiver operating characteristic curve of 88%, beyond the 82% achieved using SpO2 analysis alone. These results demonstrate that the implementation of this algorithm in the Phone Oximeter will provide an improved portable, at-home screening tool, with the capability of monitoring patients

  17. Development of a screening tool for sleep disordered breathing in children using the phone Oximeter™.

    Directory of Open Access Journals (Sweden)

    Ainara Garde

    Full Text Available BACKGROUND: 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. AIM: 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. METHODS: 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. RESULTS: 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 <0.01. PRV analysis reflected a significant augmentation of sympathetic activity provoked by intermittent hypoxia in SDB children. A linear classifier was trained with the most discriminating features to identify children with SDB. The classifier was validated with internal and external cross-validation, providing a high negative predictive value (92.6% and a good balance between sensitivity (88.4% and specificity (83.6%. Combining SpO2 and PRV analysis improved the classification performance, providing an area under the receiver operating characteristic curve of 88%, beyond the 82% achieved using SpO2 analysis alone. CONCLUSIONS: These results demonstrate that the implementation of this algorithm in the Phone Oximeter will provide an improved portable, at

  18. Functional neuroimaging of sleep disorders

    International Nuclear Information System (INIS)

    Qiu Chun; Zhao Jun; Guan Yihui

    2013-01-01

    Sleep disorders may affect the health and normal life of human badly. However, the pathophysiology underlying adult sleep disorders is still unclear. Functional neuroimaging can be used to investigate whether sleep disorders are associated with specific changes in brain structure or regional activity. This paper reviews functional brain imaging findings in major intrinsic sleep disorders (i.e., idiopathic insomnia, narcolepsy, and obstructive sleep apnea) and in abnormal motor behavior during sleep (i.e., periodic limb movement disorder and REM sleep behavior disorder). Metabolic/functional investigations (positron emission tomography, single photon emission computed tomography, functional magnetic resonance imaging) are mainly reviewed, as well as neuroanatomical assessments (voxel-based morphometry, magnetic resonance spectroscopy). Meanwhile, here are some brief introduction of different kinds of sleep disorders. (authors)

  19. Pediatras e os distúrbios respiratórios do sono na criança Pediatricians and sleep-disordered breathing in the child

    Directory of Open Access Journals (Sweden)

    Aracy Pereira Silveira Balbani

    2005-04-01

    Full Text Available OBJETIVOS: pesquisar as opiniões e condutas de pediatras frente aos distúrbios respiratórios do sono (DRS em crianças. MÉTODOS: Foram selecionados aleatoriamente 516 pediatras do Estado de São Paulo. Foi enviado aos pediatras, por correio, um formulário de questões sobre: perfil profissional, seu conhecimento do DRS na criança, opiniões e condutas para diagnóstico e tratamento dessa doença. RESULTADOS: Retornaram preenchidos 112 questionários anônimos (21,7%. O ensino de DRS na infância durante a graduação e a residência médica em Pediatria foi considerado insatisfatório, respectivamente, por 65,2% e 34,8% dos pediatras. Quarenta e nove pediatras (43,8% avaliaram seu conhecimento de DRS na criança como regular, 39 (34,8% como bom e 17 (15,2% como insatisfatório. As questões de anamnese do sono consideradas mais importantes foram: respiração bucal, pausas respiratórias, número de horas de sono, sonolência diurna excessiva e chiado noturno. Os dados clínicos considerados mais importantes para a suspeita de síndrome da apnéia obstrutiva do sono (SAOS foram: pausas respiratórias, hipertrofia da adenóide, respiração bucal, presença de anomalia craniofacial e ronco. As principais condutas citadas para diagnóstico de SAOS na criança foram: radiografia do cavum e avaliação com otorrinolaringologista (25% e oximetria de pulso noturna (14,2%. Somente 11,6% dos pediatras indicaram a polissonografia de noite inteira e 4,5%, a polissonografia breve diurna. As condutas consideradas mais eficazes para tratamento de DRS foram: cirurgias de adenoidectomia e adenotonsilectomia, orientação aos pais, perda de peso e higiene do sono. CONCLUSÕES: Há um descompasso entre as pesquisas sobre DRS na infância e sua abordagem na prática pediátrica.OBJECTIVES: assessment of opinions and practices of pediatricians concerning sleep-disordered breathing (SDB in children. METHODS: randomly 516 pediatricians were selected in the

  20. A systematic review of the literature on disorders of sleep and wakefulness in Parkinson's disease from 2005 to 2015.

    Science.gov (United States)

    Chahine, Lama M; Amara, Amy W; Videnovic, Aleksandar

    2017-10-01

    Sleep disorders are among the most common non-motor manifestations in Parkinson's disease (PD) and have a significant negative impact on quality of life. While sleep disorders in PD share most characteristics with those that occur in the general population, there are several considerations specific to this patient population regarding diagnosis, management, and implications. The available research on these disorders is expanding rapidly, but many questions remain unanswered. We thus conducted a systematic review of the literature published from 2005 to 2015 on the following disorders of sleep and wakefulness in PD: REM sleep behavior disorder, insomnia, nocturia, restless legs syndrome and periodic limb movements, sleep disordered breathing, excessive daytime sleepiness, and circadian rhythm disorders. We discuss the epidemiology, etiology, clinical implications, associated features, evaluation measures, and management of these disorders. The influence on sleep of medications used in the treatment of motor and non-motor symptoms of PD is detailed. Additionally, we suggest areas in need of further research. Copyright © 2016 Elsevier Ltd. All rights reserved.

  1. Sleep Problems as Predictors in Attention-Deficit Hyperactivity Disorder: Causal Mechanisms, Consequences and Treatment.

    Science.gov (United States)

    Um, Yoo Hyun; Hong, Seung-Chul; Jeong, Jong-Hyun

    2017-02-28

    Attention-deficit hyperactivity disorder (ADHD) is notorious for its debilitating consequences and early age of onset. The need for early diagnosis and intervention has frequently been underscored. Previous studies have attempted to clarify the bidirectional relationship between ADHD and sleep problems, proposing a potential role for sleep problems as early predictors of ADHD. Sleep deprivation, sleep-disordered breathing, and circadian rhythm disturbances have been extensively studied, yielding evidence with regard to their induction of ADHD-like symptoms. Genetic-phenotypic differences across individuals regarding the aforementioned sleep problems have been elucidated along with the possible use of these characteristics for early prediction of ADHD. The long-term consequences of sleep problems in individuals with ADHD include obesity, poor academic performance, and disrupted parent-child interactions. Early intervention has been proposed as an approach to preventing these debilitating outcomes of ADHD, with novel treatment approaches ranging from melatonin and light therapy to myofunctional therapy and adjustments of the time point at which school starts.

  2. Peripheral ARtery Atherosclerotic DIsease and SlEep disordered breathing (PARADISE) trial - protocol for an observational cohort study.

    Science.gov (United States)

    Szymański, Filip M; Gałązka, Zbigniew; Płatek, Anna E; Górko, Dariusz; Ostrowski, Tomasz; Adamkiewicz, Karolina; Łęgosz, Paweł; Ryś, Anna; Semczuk-Kaczmarek, Karolina; Celejewski, Krzysztof; Filipiak, Krzysztof J

    2017-01-01

    Peripheral arterial disease (PAD) is in fact a group of disease entities with different symptoms and course but a common underlying cause, i.e. atherosclerosis. Atherosclerosis is known to be aggravated by several cardiovascular risk factors, including obstructive sleep apnoea (OSA). Following paper is a protocol for the Peripheral ARtery Atherosclerotic DIsease and SlEep disordered breathing (PARADISE) trial, which aims to describe the prevalence of OSA in PAD patients scheduled for revascularisation, and to determine the effect of OSA on the procedure outcomes. The PARADISE study is an observational cohort trial. It plans to include 200 consecutive patients hospitalised for revascularisation due to PAD. In every patient an overnight sleep study will be performed to diagnose sleep disorders. Accord¬ing to the results of the test, patients will be divided into two groups: group A - patients with OSA, and group B - patients without OSA (control group). All patients will also be screened for classical and non-classical cardiovascular risk factors. In some of the patients, during surgery, a fragment of atherosclerotic plaque will be collected for further testing. Patients will be followed for one year for adverse events and end-points. Primary end-point of the study will be the failure of revascularisa¬tion defined as recurrence or new onset of the symptoms of ischaemia from the treated region, a need for re-operation or procedure revision, or recurrence of ischaemia signs on the imaging tests. The data obtained will help determine the incidence of OSA in the population of patients with PAD. The au¬thors expect to show that, as with other cardiovascular diseases associated with atherosclerosis, also in patients with PAD the incidence of undiagnosed OSA is high and its presence is associated with elevated cholesterol, inflammatory markers, and higher prevalence of arterial hypertension and poor control of other cardiovascular risk factors. In addition, due to

  3. Fitness, Sleep-Disordered Breathing, Symptoms of Depression, and Cognition in Inactive Overweight Children: Mediation Models.

    Science.gov (United States)

    Stojek, Monika M K; Montoya, Amanda K; Drescher, Christopher F; Newberry, Andrew; Sultan, Zain; Williams, Celestine F; Pollock, Norman K; Davis, Catherine L

    We used mediation models to examine the mechanisms underlying the relationships among physical fitness, sleep-disordered breathing (SDB), symptoms of depression, and cognitive functioning. We conducted a cross-sectional secondary analysis of the cohorts involved in the 2003-2006 project PLAY (a trial of the effects of aerobic exercise on health and cognition) and the 2008-2011 SMART study (a trial of the effects of exercise on cognition). A total of 397 inactive overweight children aged 7-11 received a fitness test, standardized cognitive test (Cognitive Assessment System, yielding Planning, Attention, Simultaneous, Successive, and Full Scale scores), and depression questionnaire. Parents completed a Pediatric Sleep Questionnaire. We used bootstrapped mediation analyses to test whether SDB mediated the relationship between fitness and depression and whether SDB and depression mediated the relationship between fitness and cognition. Fitness was negatively associated with depression ( B = -0.041; 95% CI, -0.06 to -0.02) and SDB ( B = -0.005; 95% CI, -0.01 to -0.001). SDB was positively associated with depression ( B = 0.99; 95% CI, 0.32 to 1.67) after controlling for fitness. The relationship between fitness and depression was mediated by SDB (indirect effect = -0.005; 95% CI, -0.01 to -0.0004). The relationship between fitness and the attention component of cognition was independently mediated by SDB (indirect effect = 0.058; 95% CI, 0.004 to 0.13) and depression (indirect effect = -0.071; 95% CI, -0.01 to -0.17). SDB mediates the relationship between fitness and depression, and SDB and depression separately mediate the relationship between fitness and the attention component of cognition.

  4. Morbidity prior to a diagnosis of sleep-disordered breathing: a controlled national study.

    Science.gov (United States)

    Jennum, Poul; Ibsen, Rikke; Kjellberg, Jakob

    2013-02-01

    Sleep-disordered breathing (SDB) causes burden to the sufferer, the healthcare system, and society. Most studies have focused on cardiovascular diseases (CVDs) after a diagnosis of obstructive sleep apnea (OSA) or obesity hypoventilation syndrome (OHS); however, the overall morbidity prior to an SDB diagnosis has not been evaluated. The aim of this study was to identify morbidity prior to a SDB diagnosis to identify patients at risk for having/developing SDB. Using data from the Danish National Patient Registry (1998-2006), we identified all patients nationwide given a diagnosis of OSA (19,438) or OHS (755) in all hospitals and clinics. For each patient, we randomly selected 4 citizens matched for age, sex, and socioeconomic status from the Danish Civil Registration System Statistics. Patients with OSA or OHS presented with increased morbidity at least 3 years prior to their SDB diagnosis. The most common contacts with the health system (odds ratio [OR]/confidence interval [CI]) for OSA/OHS were due to musculoskeletal system (1.36[1.29-1.42]/1.35[1.05-1.74]); CVD (1.38[1.30-1.46]/1.80[1.38-2.34]); endocrine, nutritional, and metabolic diseases (1.62[1.50-1.76]/4.10[2.90-5.78]); diseases of the nervous system (1.62[1.0-1.76]/3.54[2.56-4.88]); respiratory system (1.84[1.73-1.96]/2.83[2.07-3.89]); skin and subcutaneous tissue (1.18[1.07-1.30]/2.12[1.33-3.38]); gastrointestinal (1.17[1.10-1.24]/NS); infections (1.20[1.08-1.33]/NS); genitourinary system (1.21[1.13-1.30]/NS); and ear, nose, and throat (1.44[1.32-1.56]/NS). Patients with SDB show significant morbidities several years prior to a diagnosis of OSA or OHS. OSA should be considered in all medical specialties as an important comorbidity. In our study, evidence points to particular emphasis for considering this diagnosis in endocrinology and metabolic specialties.

  5. Sleep Disturbances in Mood Disorders.

    Science.gov (United States)

    Rumble, Meredith E; White, Kaitlin Hanley; Benca, Ruth M

    2015-12-01

    The article provides an overview of common and differentiating self-reported and objective sleep disturbances seen in mood-disordered populations. The importance of considering sleep disturbances in the context of mood disorders is emphasized, because a large body of evidence supports the notion that sleep disturbances are a risk factor for onset, exacerbation, and relapse of mood disorders. In addition, potential mechanisms for sleep disturbance in depression, other primary sleep disorders that often occur with mood disorders, effects of antidepressant and mood-stabilizing drugs on sleep, and the adjunctive effect of treating sleep in patients with mood disorders are discussed. Copyright © 2015 Elsevier Inc. All rights reserved.

  6. Objectively measured sleep and β-amyloid burden in older adults: A pilot study

    Directory of Open Access Journals (Sweden)

    Adam P Spira

    2014-08-01

    Full Text Available Background/aims: Although disturbed sleep is associated with cognitive deficits, the association between sleep disturbance and Alzheimer’s disease pathology is unclear. In this pilot study, we examined the extent to which sleep duration, sleep quality, and sleep-disordered breathing are associated with β-amyloid (Aβ deposition in the brains of living humans. Methods: We studied 13 older adults (8 with normal cognition and 5 with mild cognitive impairment. Participants completed neuropsychological testing, polysomnography, and Aβ imaging with [11C]-Pittsburgh compound B. Results: Among participants with mild cognitive impairment, higher apnea–hypopnea index and oxygen desaturation index were associated with greater Aβ deposition, globally and regionally in the precuneus. There were no significant associations between sleep-disordered breathing and Aβ deposition among cognitively normal participants. There were no significant associations between sleep duration or sleep fragmentation and Aβ deposition. Conclusion: These preliminary results suggest that among older adults with mild cognitive impairment, greater sleep-disordered breathing severity is associated with greater Aβ deposition.

  7. eAMI: A Qualitative Quantification of Periodic Breathing Based on Amplitude of Oscillations

    Science.gov (United States)

    Fernandez Tellez, Helio; Pattyn, Nathalie; Mairesse, Olivier; Dolenc-Groselj, Leja; Eiken, Ola; Mekjavic, Igor B.; Migeotte, P. F.; Macdonald-Nethercott, Eoin; Meeusen, Romain; Neyt, Xavier

    2015-01-01

    Study Objectives: Periodic breathing is sleep disordered breathing characterized by instability in the respiratory pattern that exhibits an oscillatory behavior. Periodic breathing is associated with increased mortality, and it is observed in a variety of situations, such as acute hypoxia, chronic heart failure, and damage to respiratory centers. The standard quantification for the diagnosis of sleep related breathing disorders is the apnea-hypopnea index (AHI), which measures the proportion of apneic/hypopneic events during polysomnography. Determining the AHI is labor-intensive and requires the simultaneous recording of airflow and oxygen saturation. In this paper, we propose an automated, simple, and novel methodology for the detection and qualification of periodic breathing: the estimated amplitude modulation index (eAMI). Patients or Participants: Antarctic cohort (3,800 meters): 13 normal individuals. Clinical cohort: 39 different patients suffering from diverse sleep-related pathologies. Measurements and Results: When tested in a population with high levels of periodic breathing (Antarctic cohort), eAMI was closely correlated with AHI (r = 0.95, P Dolenc-Groselj L, Eiken O, Mekjavic IB, Migeotte PF, Macdonald-Nethercott E, Meeusen R, Neyt X. eAMI: a qualitative quantification of periodic breathing based on amplitude of oscillations. SLEEP 2015;38(3):381–389. PMID:25581914

  8. Sleep disturbances in myotonic dystrophy type 2

    OpenAIRE

    Shepard, Paul; Lam, Erek M.; St. Louis, Erik K.; Dominik, Jacob

    2012-01-01

    Sleep disorders in myotonic dystrophy type 1 (DM1) are common and include sleep disordered breathing (SDB), hypersomnia, and fatigue. Little is known regarding the occurrence of sleep disturbance in myotonic dystrophy type 2 (DM2). We hypothesized that DM2 patients may frequently harbor sleep disorders. We reviewed medical records of all genetically confirmed cases of DM2 seen at our sleep center between 1997 and 2010 for demographic, laboratory, overnight oximetry, and polysomnography (PSG) ...

  9. The relationship between sleep disorders and testosterone in men

    Directory of Open Access Journals (Sweden)

    Gary Wittert

    2014-04-01

    Full Text Available Plasma testosterone levels display circadian variation, peaking during sleep, and reaching a nadir in the late afternoon, with a superimposed ultradian rhythm with pulses every 90 min reflecting the underlying rhythm of pulsatile luteinizing hormone (LH secretion. The increase in testosterone is sleep, rather than circadian rhythm, dependent and requires at least 3 h of sleep with a normal architecture. Various disorders of sleep including abnormalities of sleep quality, duration, circadian rhythm disruption, and sleep-disordered breathing may result in a reduction in testosterone levels. The evidence, to support a direct effect of sleep restriction or circadian rhythm disruption on testosterone independent of an effect on sex hormone binding globulin (SHBG, or the presence of comorbid conditions, is equivocal and on balance seems tenuous. Obstructive sleep apnea (OSA appears to have no direct effect on testosterone, after adjusting for age and obesity. However, a possible indirect causal process may exist mediated by the effect of OSA on obesity. Treatment of moderate to severe OSA with continuous positive airway pressure (CPAP does not reliably increase testosterone levels in most studies. In contrast, a reduction in weight does so predictably and linearly in proportion to the amount of weight lost. Apart from a very transient deleterious effect, testosterone treatment does not adversely affect OSA. The data on the effect of sleep quality on testosterone may depend on whether testosterone is given as replacement, in supratherapeutic doses, or in the context abuse. Experimental data suggest that testosterone may modulate individual vulnerability to subjective symptoms of sleep restriction. Low testosterone may affect overall sleep quality which is improved by replacement doses. Large doses of exogenous testosterone and anabolic/androgenic steroid abuse are associated with abnormalities of sleep duration and architecture.

  10. [Pilot study to investigate sleep disorders in the blind and persons with relevant visual impairment].

    Science.gov (United States)

    Dirks, C; Grünewald, D; Young, P; Heidbreder, A

    2018-05-22

    Sleep disorders are associated with serious health problems in blind and visually impaired persons. Loss of light perception may result in a shift of sleep-wake pattern, which may lead to significant impairments in daily life--the so-called non-24-hour sleep-wake disorder. To date, epidemiologic data on non-24 only exist for the USA. This pilot study was conducted to provide first epidemiologic data for the prevalence of non-24 and other sleep disorders among blind and visually impaired persons in Germany. Recruited were 111 blind and visually impaired subjects (36 subjects without light perception; male [m] = 56, 27-85 years, average [Mx] = 59.53, standard deviation [SD] = 14.69) and 111 sighted controls (m = 41, 27-88 years, Mx = 58.32, SD = 14.21), who answered a set of validated questionnaires referring to general health status (SF-36), sleep characteristics (PSQI), and daytime sleepiness (ESS). In addition, a questionnaire to predict non-24-hour sleep-wake disorder, which is not yet validated in German, was provided. The prevalence of 72.2% for the non-24-hour sleep-wake disorder in blind people is in accordance with results from the USA. In contrast, our results indicated non-24 in only 21.3% of the subjects with residual light perception. Furthermore, other sleep disorders like problems falling asleep (100% vs. 79.9%), maintaining sleep (90% vs. 88.1%), sleep-disordered breathing (19.4% vs. 32%), or sleep-related movement disorders (28.1% vs. 32.9%) were also common in the group of blind or visually impaired persons. The non-24-hour sleep-wake disorder is a frequent problem among people with no light perception, associated with problems falling asleep, maintaining sleep, and daytime sleepiness. The perception of light as an external cue for our circadian rhythm plays a key role. However, sleep disruption is not fully explained by non-24, making a detailed sleep history essential.

  11. Sleep Bruxism in Respiratory Medicine Practice.

    Science.gov (United States)

    Mayer, Pierre; Heinzer, Raphael; Lavigne, Gilles

    2016-01-01

    Sleep bruxism (SB) consists of involuntary episodic and repetitive jaw muscle activity characterized by occasional tooth grinding or jaw clenching during sleep. Prevalence decreases from 20% to 14% in childhood to 8% to 3% in adulthood. Although the causes and mechanisms of idiopathic primary SB are unknown, putative candidates include psychologic risk factors (eg, anxiety, stress due to life events, hypervigilance) and sleep physiologic reactivity (eg, sleep arousals with autonomic activity, breathing events). Although certain neurotransmitters (serotonin, dopamine, noradrenalin, histamine) have been proposed to play an indirect role in SB, their exact contribution to rhythmic masticatory muscle activity (RMMA) (the electromyography marker of SB) genesis remains undetermined. No specific gene is associated with SB; familial environmental influence plays a significant role. To date, no single explanation can account for the SB mechanism. Secondary SB with sleep comorbidities that should be clinically assessed are insomnia, periodic limb movements during sleep, sleep-disordered breathing (eg, apnea-hypopnea), gastroesophageal reflux disease, and neurologic disorders (eg, sleep epilepsy, rapid eye movement behavior disorder). SB is currently quantified by scoring RMMA recordings in parallel with brain, respiratory, and heart activity recordings in a sleep laboratory or home setting. RMMA confirmation with audio-video recordings is recommended for better diagnostic accuracy in the presence of neurologic conditions. Management strategies (diagnostic tests, treatment) should be tailored to the patient's phenotype and comorbidities. In the presence of sleep-disordered breathing, a mandibular advancement appliance or CPAP treatment is preferred over single occlusal splint therapy on the upper jaw. Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

  12. Stable Breathing in Patients With Obstructive Sleep Apnea Is Associated With Increased Effort but Not Lowered Metabolic Rate.

    Science.gov (United States)

    de Melo, Camila M; Taranto-Montemurro, Luigi; Butler, James P; White, David P; Loring, Stephen H; Azarbarzin, Ali; Marques, Melania; Berger, Philip J; Wellman, Andrew; Sands, Scott A

    2017-10-01

    In principle, if metabolic rate were to fall during sleep in a patient with obstructive sleep apnea (OSA), ventilatory requirements could be met without increased respiratory effort thereby favoring stable breathing. Indeed, most patients achieve periods of stable flow-limited breathing without respiratory events for periods during the night for reasons that are unclear. Thus, we tested the hypothesis that in patients with OSA, periods of stable breathing occur when metabolic rate (VO2) declines. Twelve OSA patients (apnea-hypopnea index >15 events/h) completed overnight polysomnography including measurements of VO2 (using ventilation and intranasal PO2) and respiratory effort (esophageal pressure). Contrary to our hypothesis, VO2 did not differ between stable and unstable breathing periods in non-REM stage 2 (208 ± 20 vs. 213 ± 18 mL/min), despite elevated respiratory effort during stable breathing (26 ± 2 versus 23 ± 2 cmH2O, p = .03). However, VO2 was lowered during deeper sleep (244 to 179 mL/min from non-REM stages 1 to 3, p = .04) in conjunction with more stable breathing. Further analysis revealed that airflow obstruction curtailed metabolism in both stable and unstable periods, since CPAP increased VO2 by 14% in both cases (p = .02, .03, respectively). Patients whose VO2 fell most during sleep avoided an increase in PCO2 and respiratory effort. OSA patients typically convert from unstable to stable breathing without lowering metabolic rate. During sleep, OSA patients labor with increased respiratory effort but fail to satisfy metabolic demand even in the absence of overt respiratory events. © Sleep Research Society 2017. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

  13. [Electromyography Analysis of Rapid Eye Movement Sleep Behavior Disorder].

    Science.gov (United States)

    Nakano, Natsuko; Kinoshita, Fumiya; Takada, Hiroki; Nakayama, Meiho

    2018-01-01

    Polysomnography (PSG), which records physiological phenomena including brain waves, breathing status, and muscle tonus, is useful for the diagnosis of sleep disorders as a gold standard. However, measurement and analysis are complex for several specific sleep disorders, such as rapid eye movement (REM) sleep behavior disorder (RBD). Usually, brain waves during REM sleep indicate an awakening pattern under relaxed conditions of skeletal and antigravity muscles. However, these muscles are activated during REM sleep when patients suffer from RBD. These activated muscle movements during REM, so-called REM without atonia (RWA) recorded by PSG, may be related to a neurodegenerative disease such as Parkinson's disease. Thus, careful analysis of RWA is significant not only physically, but also clinically. Commonly, manual viewing measurement analysis of RWA is time-consuming. Therefore, quantitative studies on RWA are rarely reported. A software program, developed from Microsoft Office Excel ® , was used to semiautomatically analyze the RWA ratio extracted from PSG to compare with manual viewing measurement analysis. In addition, a quantitative muscle tonus study was carried out to evaluate the effect of medication on RBD patients. Using this new software program, we were able to analyze RWA on the same cases in approximately 15 min as compared with 60 min in the manual viewing measurement analysis. This software program can not only quantify RWA easily but also identify RWA waves for either phasic or tonic bursts. We consider that this software program will support physicians and scientists in their future research on RBD. We are planning to offer this software program for free to physicians and scientists.

  14. Reversible sleep-related stridor during vagus nerve stimulation

    OpenAIRE

    St. Louis, Erik K.; Faber, Kevin

    2010-01-01

    A 23-year-old woman without history of antecedent vocal, respiratory, or sleep disorders received vagus nerve stimulation (VNS) therapy for refractory partial epilepsy and developed sleep-related stridor during the course of parameter titration. Reduction of VNS current during polysomnography completely eliminated stridor. We conclude that VNS may cause sleep-related stridor in rare cases, expanding the spectrum of known sleep-disordered breathing disorders associated with VNS therapy. Parame...

  15. Sleep disorders in children with attention-deficit/hyperactivity disorder

    Directory of Open Access Journals (Sweden)

    Medina Permatawati

    2018-03-01

    Conclusion The proportion of sleep disorder in children with ADHD is relatively high, with the majority having a disorder of initiating and maintaining sleep. Children with combined type ADHD experience a higher amount of sleep disorder than those with either the inattention or hyperactive-impulsive types of ADHD. Children with poor sleep hygiene have significantly more severe sleep disorders.

  16. Artificial neural networks for breathing and snoring episode detection in sleep sounds

    International Nuclear Information System (INIS)

    Emoto, Takahiro; Akutagawa, Masatake; Kinouchi, Yohsuke; Abeyratne, Udantha R; Chen, Yongjian; Kawata, Ikuji

    2012-01-01

    Obstructive sleep apnea (OSA) is a serious disorder characterized by intermittent events of upper airway collapse during sleep. Snoring is the most common nocturnal symptom of OSA. Almost all OSA patients snore, but not all snorers have the disease. Recently, researchers have attempted to develop automated snore analysis technology for the purpose of OSA diagnosis. These technologies commonly require, as the first step, the automated identification of snore/breathing episodes (SBE) in sleep sound recordings. Snore intensity may occupy a wide dynamic range (>95 dB) spanning from the barely audible to loud sounds. Low-intensity SBE sounds are sometimes seen buried within the background noise floor, even in high-fidelity sound recordings made within a sleep laboratory. The complexity of SBE sounds makes it a challenging task to develop automated snore segmentation algorithms, especially in the presence of background noise. In this paper, we propose a fundamentally novel approach based on artificial neural network (ANN) technology to detect SBEs. Working on clinical data, we show that the proposed method can detect SBE at a sensitivity and specificity exceeding 0.892 and 0.874 respectively, even when the signal is completely buried in background noise (SNR <0 dB). We compare the performance of the proposed technology with those of the existing methods (short-term energy, zero-crossing rates) and illustrate that the proposed method vastly outperforms conventional techniques. (paper)

  17. Sleep disorders in children

    OpenAIRE

    Montgomery, Paul; Dunne, Danielle

    2007-01-01

    Sleep disorders may affect 20-30% of young children, and include excessive daytime sleepiness, problems getting to sleep (dysomnias), or undesirable phenomena during sleep (parasomnias), such as sleep terrors, and sleepwalking. Children with physical or learning disabilities are at increased risk of sleep disorders. Other risk factors include the child being the first born, having a difficult temperament or having had colic, and increased maternal responsiveness.

  18. Sleep disorders in children

    OpenAIRE

    Bruni, Oliveiero; Novelli, Luana

    2010-01-01

    Sleep disorders may affect between 20% and 30% of young children, and include problems getting to sleep (dyssomnias) or undesirable phenomena during sleep (parasomnias), such as sleep terrors and sleepwalking. Children with physical or learning disabilities are at increased risk of sleep disorders. Other risk factors include the child being the first born, having a difficult temperament or having had colic, and increased maternal responsiveness.

  19. Attractor structure discriminates sleep states: recurrence plot analysis applied to infant breathing patterns.

    Science.gov (United States)

    Terrill, Philip Ian; Wilson, Stephen James; Suresh, Sadasivam; Cooper, David M; Dakin, Carolyn

    2010-05-01

    Breathing patterns are characteristically different between infant active sleep (AS) and quiet sleep (QS), and statistical quantifications of interbreath interval (IBI) data have previously been used to discriminate between infant sleep states. It has also been identified that breathing patterns are governed by a nonlinear controller. This study aims to investigate whether nonlinear quantifications of infant IBI data are characteristically different between AS and QS, and whether they may be used to discriminate between these infant sleep states. Polysomnograms were obtained from 24 healthy infants at six months of age. Periods of AS and QS were identified, and IBI data extracted. Recurrence quantification analysis (RQA) was applied to each period, and recurrence calculated for a fixed radius in the range of 0-8 in steps of 0.02, and embedding dimensions of 4, 6, 8, and 16. When a threshold classifier was trained, the RQA variable recurrence was able to correctly classify 94.3% of periods in a test dataset. It was concluded that RQA of IBI data is able to accurately discriminate between infant sleep states. This is a promising step toward development of a minimal-channel automatic sleep state classification system.

  20. High risk for obstructive sleep apnea and other sleep disorders among overweight and obese pregnant women.

    Science.gov (United States)

    Rice, Jayne R; Larrabure-Torrealva, Gloria T; Luque Fernandez, Miguel Angel; Grande, Mirtha; Motta, Vicky; Barrios, Yasmin V; Sanchez, Sixto; Gelaye, Bizu; Williams, Michelle A

    2015-09-02

    Obstructive sleep apnea (OSA), a common and serious disorder in which breathing repeatedly stops during sleep, is associated with excess weight and obesity. Little is known about the co-occurrence of OSA among pregnant women from low and middle-income countries. We examined the extent to which maternal pre-pregnancy overweight or obesity status are associated with high risk for OSA, poor sleep quality, and excessive daytime sleepiness in 1032 pregnant women in Lima, Peru. The Berlin questionnaire was used to identify women at high risk for OSA. The Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS) were used to examine sleep quality and excessive daytime sleepiness, respectively. Multinomial logistic regression procedures were employed to estimate odds ratios (aOR) and 95% confidence intervals (CI) adjusted for putative confounding factors. Compared with lean women (overweight women (25-29.9 kg/m(2)) had 3.69-fold higher odds of high risk for OSA (95% CI 1.82-7.50). The corresponding aOR for obese women (≥30 kg/m(2)) was 13.23 (95% CI: 6.25-28.01). Obese women, as compared with their lean counterparts had a 1.61-fold higher odds of poor sleep quality (95% CI: 1.00-2.63). Overweight or obese pregnant women have increased odds of sleep disorders, particularly OSA. OSA screening and risk management may be indicated among pregnant women in low and middle income countries, particularly those undergoing rapid epidemiologic transitions characterized by increased prevalence of excessive adult weight gain.

  1. Immediate postarousal sleep dynamics: an important determinant of sleep stability in obstructive sleep apnea.

    Science.gov (United States)

    Younes, Magdy; Hanly, Patrick J

    2016-04-01

    Arousability from sleep is increasingly recognized as an important determinant of the clinical spectrum of sleep disordered breathing (SDB). Patients with SDB display a wide range of arousability. The reason for these differences is not known. We hypothesized that differences in the speed with which sleep deepens following arousals/awakenings (postarousal sleep dynamics) is a major determinant of these differences in arousability in patients with SDB. We analyzed 40 preexisting clinical polysomnography records from patients with a range of SDB severity (apnea-hypopnea index 5-135/h). Sleep depth was determined every 3 s using the odds ratio product (ORP) method, a continuous index of sleep depth (0 = deep sleep, 2.5 = full wakefulness) that correlates strongly (r = 0.98) with arousability (Younes M, Ostrowski M, Soiferman M, Younes H, Younes M, Raneri J, and Hanly P. Sleep 38: 641-654, 2015). Time course of ORP was determined from end of arousal until the next arousal. All arousals were analyzed (142 ± 65/polysomnogram). ORP increased from 0.58 ± 0.32 during sleep to 1.67 ± 0.35 during arousals. ORP immediately (first 9 s) following arousals/awakenings (ORP-9) ranged from 0.21(very deep sleep) to 1.71 (highly arousable state) in different patients. In patients with high ORP-9, sleep deepened slowly (over minutes) beyond 9 s but only if no arousals/awakenings recurred. ORP-9 correlated strongly with average non-rapid eye movement sleep depth (r = 0.87, P sleep architecture. We conclude that postarousal sleep dynamics are highly variable among patients with sleep-disordered breathing and largely determine average sleep depth and continuity. Copyright © 2016 the American Physiological Society.

  2. Breathing difficulty - lying down

    Science.gov (United States)

    ... other conditions that lead to it) Panic disorder Sleep apnea Snoring Home Care Your health care provider may recommend self-care measures. For example, weight loss may be suggested if you are obese. When to Contact a Medical Professional If you have any unexplained difficulty in breathing ...

  3. Neurobehavioral morbidity associated with disordered breathing during sleep in children: a comprehensive review.

    Science.gov (United States)

    Beebe, Dean W

    2006-09-01

    To comprehensively review research on the association between childhood sleep-disordered breathing (SDB) and neurobehavioral functioning. Qualitative and quantitative literature review. N/A. N/A. N/A. The findings of 61 studies of the relationship between childhood SDB and neurobehavioral functioning were critically evaluated and synthesized. There is strong evidence that childhood SDB is associated with deficits in behavior and emotion regulation, scholastic performance, sustained attention, selective attention, and alertness. There is also evidence that SDB has minimal association with a child's typical mood, expressive language skills, visual perception, and working memory. Findings have been insufficient to draw conclusions about intelligence, memory, and some aspects of executive functioning. Mechanisms by which SDB might result in neurobehavioral morbidity are being explored, but clinical symptoms such as chronic snoring remain the best predictors of morbidity. Short-term SDB treatment outcome studies are encouraging, but the long-term outcomes are not known. Failing to treat SDB appears to leave children at risk for long-term neurobehavioral deficits. Childhood SDB is associated with neurobehavioral morbidity. Applying commonly used guidelines for causal inference, even in the absence of a much-needed randomized clinical trial, there is strong evidence of association, consistent findings, and specificity of effect. There is suggestive evidence that this association fits the expected temporal pattern and that SDB is a biologically plausible cause of neurobehavioral deficits. Clinicians should be alert to the coexistence of SDB symptoms and concerns about a child's academic progress, attention, arousal, or behavior or emotion regulation.

  4. Obesity as an Effect Modifier in Sleep-Disordered Breathing and Postcardiac Surgery Atrial Fibrillation.

    Science.gov (United States)

    Kaw, Roop; El Zarif, Samer; Wang, Lu; Bena, James; Blackstone, Eugene H; Mehra, Reena

    2017-06-01

    Because the interrelationships of objectively ascertained sleep-disordered breathing (SDB), postcardiac surgery atrial fibrillation (PCSAF), and obesity remain unclear, we aimed to further investigate the interrelationships in a clinic-based cohort. Patients with polysomnography and cardiac surgery (coronary artery bypass surgery and/or valvular surgery) within 3 years, from January 2009 to January 2014, were identified, excluding those with preexisting atrial fibrillation. Logistic models were used to determine the association of SDB (apnea hypopnea index [AHI] per 5-unit increase) and secondary predictors (central sleep apnea [CSA] [central apnea index ≥ 5] and oxygen desaturation index [ODI]) with PCSAF. Models were adjusted for age, sex, race, BMI, and hypertension. Statistical interaction and stratification by median BMI was performed. ORs and 95% CIs are presented. There were 190 patients who comprised the analytic sample (mean age, 60.6 ± 11.4 years; 36.1% women; 80% white; BMI, 33.3 ± 7.5 kg/m 2 ; 93.2% had an AHI ≥ 5; 30% had PCSAF). Unlike unadjusted analyses (OR, 1.06; 95% CI, 1.01-1.1), in the adjusted model, increasing AHI was not significantly associated with increased odds of PCSAF (OR, 1.04; 95% CI, 0.98-1.1). Neither CSA nor ODI was associated with PCSAF. A significant interaction with median BMI was noted (P = .015). Effect modification by median BMI was observed; those with a higher BMI > 32 kg/m 2 had 15% increased odds of PCSAF (OR, 1.15; 95% CI, 1.05-1.26; P < .003). SDB was significantly associated with PCSAF in unadjusted analyses, but not after taking into account obesity; those with both SDB and obesity may represent a vulnerable subgroup to target to reduce PCSAF and its associated morbidity. Copyright © 2017 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

  5. Holland Sleep Disorders Questionnaire: a new sleep disorders questionnaire based on the International Classification of Sleep Disorders-2

    NARCIS (Netherlands)

    Kerkhof, G.A.; Geuke, M.E.H.; Brouwer, A.; Rijsman, R.M.; Schimsheimer, R.J.; van Kasteel, V.

    2013-01-01

    The primary objectives of this study were to construct a self-assessment questionnaire for sleep disorders based on the International Classification of Sleep Disorders-2, and to evaluate the questionnaire’s psychometric properties with respect to its total score and the individual scores for each of

  6. Unobtrusive Nocturnal Heartbeat Monitoring by a Ballistocardiographic Sensor in Patients with Sleep Disordered Breathing.

    Science.gov (United States)

    Zink, Matthias Daniel; Brüser, Christoph; Stüben, Björn-Ole; Napp, Andreas; Stöhr, Robert; Leonhardt, Steffen; Marx, Nikolaus; Mischke, Karl; Schulz, Jörg B; Schiefer, Johannes

    2017-10-13

    Sleep disordered breathing (SDB) is known for fluctuating heart rates and an increased risk of developing arrhythmias. The current reference for heartbeat analysis is an electrocardiogram (ECG). As an unobtrusive alternative, we tested a sensor foil for mechanical vibrations to perform a ballistocardiography (BCG) and applied a novel algorithm for beat-to-beat cycle length detection. The aim of this study was to assess the correlation between beat-to-beat cycle length detection by the BCG algorithm and simultaneously recorded ECG. In 21 patients suspected for SDB undergoing polysomnography, we compared ECG to simultaneously recorded BCG data analysed by our algorithm. We analysed 362.040 heartbeats during a total of 93 hours of recording. The baseline beat-to-beat cycle length correlation between BCG and ECG was r s  = 0.77 (n = 362040) with a mean absolute difference of 15 ± 162 ms (mean cycle length: ECG 923 ± 220 ms; BCG 908 ± 203 ms). After filtering artefacts and improving signal quality by our algorithm, the correlation increased to r s  = 0.95 (n = 235367) with a mean absolute difference in cycle length of 4 ± 72 ms (ECG 920 ± 196 ms; BCG 916 ± 194 ms). We conclude that our algorithm, coupled with a BCG sensor foil provides good correlation of beat-to-beat cycle length detection with simultaneously recorded ECG.

  7. Sleep Disorders (PDQ)

    Science.gov (United States)

    ... Types of Cancer Treatment Surgery Radiation Therapy External Beam Radiation Internal Radiation Therapy Side Effects Chemotherapy Immunotherapy ... asleep, sleeping, or waking from sleep, such as walking, talking, or eating. Sleep disorders keep you from ...

  8. Impact of sleep disordered breathing on behaviour among elementary school-aged children: a cross-sectional analysis of a large community-based sample.

    Science.gov (United States)

    Smith, Dale L; Gozal, David; Hunter, Scott J; Philby, Mona F; Kaylegian, Jaeson; Kheirandish-Gozal, Leila

    2016-12-01

    Sleep disordered breathing (SDB) in children has been associated with inattention, impulsivity and hyperactivity, but the associations between SDB severity and the type and severity of behavioural disruption are unclear.1022 children aged 5-7 years old prospectively underwent sleep studies and behavioural assessments through completion of standardised instruments. Participants were subdivided into four categorical groups based on the apnoea-hypopnoea index (AHI; measured per hour of total sleep time (hTST)), i.e. Group 1: nonsnoring and AHI hTST -1 ; Group 2: habitual snoring and AHI hTST -1 ; Group 3: habitual snoring and AHI 1-5 hTST -1 ; and Group 4: habitual snoring and AHI >5 hTST -1 , followed by comparisons of behavioural functioning across the groups.All 10 behavioural variables differed significantly between Group 1 and all other groups. Post hoc comparisons indicated that Group 2 was the most impaired for most behavioural measures. Furthermore, differences between Group 2 and more severe sleep pathology conditions were rarely significant.This large community-based paediatric cohort confirms earlier findings highlighting a significant impact of SDB on behavioural regulation, with the greatest impact being already apparent among habitually snoring children. Thus, a likely low asymptote exists regarding SDB behavioural impact, such that further increases in severity do not measurably increase parent-rated difficulties with behavioural regulation relative to controls. Our findings do support the need for considering early intervention, particularly among those children manifesting a behavioural impact of SDB. Copyright ©ERS 2016.

  9. Seasonal variations in sleep disorders of nurses.

    Science.gov (United States)

    Chang, Yuanmay; Lam, Calvin; Chen, Su-Ru; Sithole, Trevor; Chung, Min-Huey

    2017-04-01

    To investigate the difference between nurses and the general population regarding seasonal variations in sleep disorders during 2004-2008. The effects of season and group interaction on sleep disorders with regard to different comorbidities were also examined. Studies on seasonal variations in sleep disorders were mainly conducted in Norway for the general population. Furthermore, whether different comorbidities cause seasonal variations in sleep disorders in nurses remains unknown. A retrospective study. Data from the Taiwan National Health Insurance Research Database were used in generalised estimating equation Poisson distribution models to investigate the differences in sleep disorders between nurses and the general population diagnosed with sleep disorders (each n = 7643) as well as the interaction effects of sleep disorders between the groups with respect to different seasons. Furthermore, the interaction effects between groups and seasons on sleep disorders in the subgroups of comorbid anxiety disorders and depressive disorders were studied. Both the nurses and the general population had fewer outpatient visits for sleep disorders in winter than in other seasons. The nurses had fewer outpatient visits for sleep disorders than the general population did in each season. The nurses had more outpatient visits for sleep disorders in winter than in summer compared with the general population in the comorbid depressive disorder subgroup but not in the comorbid anxiety disorder subgroup. Nurses and the general population exhibited similar seasonal patterns of sleep disorders, but nurses had fewer outpatient visits for sleep disorders than the general population did in each season. For nurses with comorbid depressive disorders, outpatient visits for sleep disorders were more numerous in winter than in summer, potentially because nurses with comorbid depressive disorders are affected by shorter daylight exposure during winter. Depression and daylight exposure may

  10. Autoimmune encephalitis and sleep disorders

    Directory of Open Access Journals (Sweden)

    Yan HUANG

    2017-10-01

    Full Text Available Research shows that autoimmune encephalitis is associated with sleep disorders. Paraneoplastic neurological syndrome (PNS with Ma2 antibodies can cause sleep disorders, particularly narcolepsy and rapid eye movement sleep behavior disorder (RBD. Limbic encephalitis (LE and Morvan syndrome, associated with voltage - gated potassium channel (VGKC-complex antibodies, which include leucine-rich glioma-inactivated 1 (LGI1 antibody and contactin-associated protein 2 (Caspr2, can result in profound insomnia and other sleep disorders. Central neurogenic hypoventilation are found in patients with anti-N-methyl-D-aspartate (NMDA receptor encephalitis, whereas obstructive sleep apnea (OSA, stridor and parasomnia are prominent features of encephalopathy associated with IgLON5 antibodies. Sleep disorders are cardinal manifestations in patients with autoimmune encephalitis. Immunotherapy possiblely can improve clinical symptoms and prognosis in a positive way. DOI: 10.3969/j.issn.1672-6731.2017.10.004

  11. Sleep Disturbances in Neurodevelopmental Disorders.

    Science.gov (United States)

    Robinson-Shelton, Althea; Malow, Beth A

    2016-01-01

    Sleep disturbances are extremely prevalent in children with neurodevelopmental disorders compared to typically developing children. The diagnostic criteria for many neurodevelopmental disorders include sleep disturbances. Sleep disturbance in this population is often multifactorial and caused by the interplay of genetic, neurobiological and environmental overlap. These disturbances often present either as insomnia or hypersomnia. Different sleep disorders present with these complaints and based on the clinical history and findings from diagnostic tests, an appropriate diagnosis can be made. This review aims to provide an overview of causes, diagnosis, and treatment of sleep disturbances in neurodevelopmental disorders that present primarily with symptoms of hypersomnia and/or insomnia.

  12. Sleep disorders and chronic kidney disease.

    Science.gov (United States)

    Maung, Stephanie C; El Sara, Ammar; Chapman, Cherylle; Cohen, Danielle; Cukor, Daniel

    2016-05-06

    Sleep disorders have a profound and well-documented impact on overall health and quality of life in the general population. In patients with chronic disease, sleep disorders are more prevalent, with an additional morbidity and mortality burden. The complex and dynamic relationship between sleep disorders and chronic kidney disease (CKD) remain relatively little investigated. This article presents an overview of sleep disorders in patients with CKD, with emphasis on relevant pathophysiologic underpinnings and clinical presentations. Evidence-based interventions will be discussed, in the context of individual sleep disorders, namely sleep apnea, insomnia, restless leg syndrome and excessive daytime sleepiness. Limitations of the current knowledge as well as future research directions will be highlighted, with a final discussion of different conceptual frameworks of the relationship between sleep disorders and CKD.

  13. Cell Size Breathing and Possibilities to Introduce Cell Sleep Mode

    DEFF Research Database (Denmark)

    Micallef, Gilbert; Mogensen, Preben; Scheck, Hans-Otto

    2010-01-01

    regular upgrades in the infrastructure. While network equipment is in itself becoming more efficient, these upgrades still increase the overall energy consumption of the networks. This paper investigates the energy saving potential of exploiting cell size breathing by putting low loaded cells into sleep...... mode. The energy consumption and network performance of the resulting network are used to quantify the potential of this feature. The investigation is carried out on a tilt optimized network. Since putting cells into sleep mode results in a non-optimum antenna tilt configuration, this paper also...

  14. Ventilatory response to induced auditory arousals during NREM sleep.

    Science.gov (United States)

    Badr, M S; Morgan, B J; Finn, L; Toiber, F S; Crabtree, D C; Puleo, D S; Skatrud, J B

    1997-09-01

    Sleep state instability is a potential mechanism of central apnea/hypopnea during non-rapid eye movement (NREM) sleep. To investigate this postulate, we induced brief arousals by delivering transient (0.5 second) auditory stimuli during stable NREM sleep in eight normal subjects. Arousal was determined according to American Sleep Disorders Association (ASDA) criteria. A total of 96 trials were conducted; 59 resulted in cortical arousal and 37 did not result in arousal. In trials associated with arousal, minute ventilation (VE) increased from 5.1 +/- 1.24 minutes to 7.5 +/- 2.24 minutes on the first posttone breath (p = 0.001). However, no subsequent hypopnea or apnea occurred as VE decreased gradually to 4.8 +/- 1.5 l/minute (p > 0.05) on the fifth posttone breath. Trials without arousal did not result in hyperpnea on the first breath nor subsequent hypopnea. We conclude that 1) auditory stimulation resulted in transient hyperpnea only if associated with cortical arousal; 2) hypopnea or apnea did not occur following arousal-induced hyperpnea in normal subjects; 3) interaction with fluctuating chemical stimuli or upper airway resistance may be required for arousals to cause sleep-disordered breathing.

  15. Sleep disorders in the elderly

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/000064.htm Sleep disorders in older adults To use the sharing features on this page, please enable JavaScript. Sleep disorders in older adults involve any disrupted sleep ...

  16. Sleep less and bite more: sleep disorders associated with occlusal loads during sleep.

    Science.gov (United States)

    Kato, Takafumi; Yamaguchi, Taihiko; Okura, Kazuo; Abe, Susumu; Lavigne, Gilles J

    2013-04-01

    Occlusal overload during sleep is a significant clinical issue that has negative impacts on the maintenance of teeth and the longevity of dental prostheses. Sleep is usually viewed as an 'out-of-functional' mode for masticatory muscles. However, orodental structures and prostheses are not free from occlusal loads during sleep since masticatory muscles can be activated at a low level within normal sleep continuity. Thus, an increase in masticatory muscle contractions, by whatever the cause, can be associated with a risk of increased occlusal loads during sleep. Among such conditions, sleep bruxism (SB) is a type of sleep-related movement disorders with potential load challenge to the tooth and orofacial structures. Patients with SB usually report frequent tooth grinding noises during sleep and there is a consecutive increase in number and strength of rhythmic masticatory muscle activity (RMMA). Other types of masticatory muscle contractions can be non-specifically activated during sleep, such as brief contractions with tooth tapping, sleep talking, non-rhythmic contractions related to non-specific body movements, etc.; these occur more frequently in sleep disorders. Studies have shown that clinical signs and symptoms of SB can be found in patients with sleep disorders. In addition, sleep becomes compromised with aging process, and a prevalence of most sleep disorders is high in the elderly populations, in which prosthodontic rehabilitations are more required. Therefore, the recognition and understanding of the role of sleep disorders can provide a comprehensive vision for prosthodontic rehabilitations when prosthodontists manage complex orodental cases needing interdisciplinary collaborations between dentistry and sleep medicine. Copyright © 2013 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.

  17. Clinical Practice Guideline for the Treatment of Intrinsic Circadian Rhythm Sleep-Wake Disorders: Advanced Sleep-Wake Phase Disorder (ASWPD), Delayed Sleep-Wake Phase Disorder (DSWPD), Non-24-Hour Sleep-Wake Rhythm Disorder (N24SWD), and Irregular Sleep-Wake Rhythm Disorder (ISWRD). An Update for 2015

    Science.gov (United States)

    Auger, R. Robert; Burgess, Helen J.; Emens, Jonathan S.; Deriy, Ludmila V.; Thomas, Sherene M.; Sharkey, Katherine M.

    2015-01-01

    A systematic literature review and meta-analyses (where appropriate) were performed and the GRADE approach was used to update the previous American Academy of Sleep Medicine Practice Parameters on the treatment of intrinsic circadian rhythm sleep-wake disorders. Available data allowed for positive endorsement (at a second-tier degree of confidence) of strategically timed melatonin (for the treatment of DSWPD, blind adults with N24SWD, and children/ adolescents with ISWRD and comorbid neurological disorders), and light therapy with or without accompanying behavioral interventions (adults with ASWPD, children/adolescents with DSWPD, and elderly with dementia). Recommendations against the use of melatonin and discrete sleep-promoting medications are provided for demented elderly patients, at a second- and first-tier degree of confidence, respectively. No recommendations were provided for remaining treatments/ populations, due to either insufficient or absent data. Areas where further research is needed are discussed. Citation: Auger RR, Burgess HJ, Emens JS, Deriy LV, Thomas SM, Sharkey KM. Clinical practice guideline for the treatment of intrinsic circadian rhythm sleep-wake disorders: advanced sleep-wake phase disorder (ASWPD), delayed sleep-wake phase disorder (DSWPD), non-24-hour sleep-wake rhythm disorder (N24SWD), and irregular sleep-wake rhythm disorder (ISWRD). An update for 2015. J Clin Sleep Med 2015;11(10):1199–1236. PMID:26414986

  18. Lateral facial profile may reveal the risk for sleep disordered breathing in children--the PANIC-study.

    Science.gov (United States)

    Ikävalko, Tiina; Närhi, Matti; Lakka, Timo; Myllykangas, Riitta; Tuomilehto, Henri; Vierola, Anu; Pahkala, Riitta

    2015-01-01

    To evaluate the lateral view photography of the face as a tool for assessing morphological properties (i.e. facial convexity) as a risk factor for sleep disordered breathing (SDB) in children and to test how reliably oral health and non-oral healthcare professionals can visually discern the lateral profile of the face from the photographs. The present study sample consisted of 382 children 6-8 years of age who were participants in the Physical Activity and Nutrition in Children (PANIC) Study. Sleep was assessed by a sleep questionnaire administered by the parents. SDB was defined as apnoeas, frequent or loud snoring or nocturnal mouth breathing observed by the parents. The facial convexity was assessed with three different methods. First, it was clinically evaluated by the reference orthodontist (T.I.). Second, lateral view photographs were taken to visually sub-divide the facial profile into convex, normal or concave. The photos were examined by a reference orthodontist and seven different healthcare professionals who work with children and also by a dental student. The inter- and intra-examiner consistencies were calculated by Kappa statistics. Three soft tissue landmarks of the facial profile, soft tissue Glabella (G`), Subnasale (Sn) and soft tissue Pogonion (Pg`) were digitally identified to analyze convexity of the face and the intra-examiner reproducibility of the reference orthodontist was determined by calculating intra-class correlation coefficients (ICCs). The third way to express the convexity of the face was to calculate the angle of facial convexity (G`-Sn-Pg`) and to group it into quintiles. For analysis the lowest quintile (≤164.2°) was set to represent the most convex facial profile. The prevalence of the SDB in children with the most convex profiles expressed with the lowest quintile of the angle G`-Sn-Pg` (≤164.2°) was almost 2-fold (14.5%) compared to those with normal profile (8.1%) (p = 0.084). The inter-examiner Kappa values between the

  19. Economic implications of sleep disorders.

    Science.gov (United States)

    Skaer, Tracy L; Sclar, David A

    2010-01-01

    Sleep disorders such as insomnia, obstructive sleep apnoea (OSA), excessive daytime sleepiness (EDS) and fatigue, sleep deprivation and restless legs syndrome (RLS) are increasingly seen in clinical practice. Sleep is considered vital for preserving daytime cognitive function and physiological well-being. Sleep insufficiency may have deleterious effects on work-life balance, overall health and safety. The consequential economic burden at both the individual and societal levels is significant. Moreover, sleep disorders are commonly associated with other major medical problems such as chronic pain, cardiovascular disease, mental illness, dementias, gastrointestinal disorders and diabetes mellitus. Thus, in order to properly care for patients presenting with sleep-related morbidity, and to reduce the consequential economic burden, accurate screening efforts and efficacious/cost-effective treatments need to be developed and employed.

  20. Medical comorbidity of sleep disorders.

    Science.gov (United States)

    Dikeos, Dimitris; Georgantopoulos, Georgios

    2011-07-01

    Recently published literature indicates that sleep disorders present with medical comorbidities quite frequently. The coexistence of a sleep disorder with a medical disorder has a substantial impact for both the patient and the health system. Insomnia and hypersomnia are highly comorbid with medical conditions, such as chronic pain and diabetes, as well as with various cardiovascular, respiratory, gastrointestinal, urinary and neurological disorders. Restless legs syndrome and periodic leg movement syndrome have been associated with iron deficiency, kidney disease, diabetes, and neurological, autoimmune, cardiovascular and respiratory disorders. Rapid eye movement behaviour disorder has been described as an early manifestation of serious central nervous system diseases; thus, close neurological monitoring of patients referring with this complaint is indicated. Identification and management of any sleep disorder in medical patients is important for optimizing the course and prognosis. Of equal importance is the search for undetected medical disorder in patients presenting with sleep disorders.

  1. Assessment of Sleep and Breathing in Adults with Prader-Willi Syndrome: A Case Control Series

    Science.gov (United States)

    Yee, Brendon J.; Buchanan, Peter R.; Mahadev, Sri; Banerjee, Dev; Liu, Peter Y.; Phillips, Craig; Loughnan, Georgina; Steinbeck, Kate; Grunstein, Ronald R.

    2007-01-01

    Objectives: Prader-Willi syndrome (PWS) is a genetic disorder (linked to chromosome 15q11-13) characterized by hypotonia and developmental delay, hyperphagia and obesity, hypersomnia and abnormal sleep, and behavioral problems. Such patients may also be at increased risk of obstructive sleep apnea (OSA), although whether this risk is explained by known risk factors has not previously been directly tested. Our aim was to compare sleep and breathing in an older group of patients with Prader-Willi syndrome with a control group—matched on the basis of age, sex, and body mass index (BMI)—in order to determine which specific features are not explained by these known confounders. Methods: Consecutive patients with PWS attending the PWS clinic at Royal Prince Alfred Hospital Sydney, Australia, were recruited. Age-, sex-, and BMI-matched controls were selected from the Sleep Investigation Unit at Royal Prince Alfred Hospital, and polysomnography-derived sleep and other parameters were compared across the groups. Results: Nineteen subjects with PWS (14 males) were included in the study. Eighteen (95 %) had a total respiratory disturbance index (TRDI) of greater than 5 events per hour, with 4 (21%) having severe obstructive sleep apnea (TRDI ≥ 30 events/hour) and 9 (47%) having evidence of obesity hypoventilation syndrome. Patients with PWS, as compared with the control group, had evidence of more nocturnal hypoxemia, with lower oxyhemoglobin saturations and percentages of sleep time at less than 80% oxyhemoglobin saturation (all p values Prader-Willi syndrome: a case control series. J Clin Sleep Med 2007;3(7):713–718. PMID:18198805

  2. Sleep disorders in cerebellar ataxias

    Directory of Open Access Journals (Sweden)

    José L. Pedroso

    2011-04-01

    Full Text Available Cerebellar ataxias comprise a wide range of etiologies leading to central nervous system-related motor and non-motor symptoms. Recently, a large body of evidence has demonstrated a high frequency of non-motor manifestations in cerebellar ataxias, specially in autosomal dominant spinocerebellar ataxias (SCA. Among these non-motor dysfunctions, sleep disorders have been recognized, although still under or even misdiagnosed. In this review, we highlight the main sleep disorders related to cerebellar ataxias focusing on REM sleep behavior disorder (RBD, restless legs syndrome (RLS, periodic limb movement in sleep (PLMS, excessive daytime sleepiness (EDS, insomnia and sleep apnea.

  3. Sleep and sleep disorders in Don Quixote.

    Science.gov (United States)

    Iranzo, Alex; Santamaria, Joan; de Riquer, Martín

    2004-01-01

    In Don Quijote de la Mancha, Miguel de Cervantes presents Don Quixote as an amazing character of the 17th century who suffers from delusions and illusions, believing himself to be a medieval knight errant. Besides this neuropsychiatric condition, Cervantes included masterful descriptions of several sleep disorders such as insomnia, sleep deprivation, disruptive loud snoring and rapid eye movement sleep behaviour disorder. In addition, he described the occurrence of physiological, vivid dreams and habitual, post-prandial sleepiness--the siesta. Cervantes' concept of sleep as a passive state where all cerebral activities are almost absent is in conflict with his description of abnormal behaviours during sleep and vivid, fantastic dreams. His concept of sleep was shared by his contemporary, Shakespeare, and could have been influenced by the reading of the classical Spanish book of psychiatry Examen de Ingenios (1575).

  4. Sleep Behaviors and Sleep Quality in Children with Autism Spectrum Disorders

    Science.gov (United States)

    Souders, Margaret C.; Mason, Thorton B. A.; Valladares, Otto; Bucan, Maja; Levy, Susan E.; Mandell, David S.; Weaver, Terri E.; Pinto-Martin, Jennifer

    2009-01-01

    Study Objectives: (1) Compare sleep behaviors of children with autism spectrum disorders (ASD) with sleep behaviors of typically developing (TD) children using the Children's Sleep Habits Questionnaire (CSHQ); (2) compare sleep quality—defined as mean activity, sleep latency, number of awakenings, sleep efficiency and total sleep time—of the cohort of children with ASD and TD, as measured by 10 nights of actigraphy; and (3) estimate the prevalence of sleep disturbances in the ASD and TD cohorts. Design: Descriptive cross-sectional study. Setting: The Children's Hospital of Philadelphia. Participants: Randomly selected children from the Regional Autism Center. The ASD cohort of 59 children, aged 4 to 10 years, (26 with autism, 21 with pervasive developmental disorder-not otherwise specified [PDD-NOS], and 12 with Asperger disorder) were compared with 40 TD control subjects. Measurements and Results: The CSHQ, sleep diaries, and 10 nights of actigraphy using the Sadeh algorithm of children with ASD and TD control subjects were compared. CSHQ showed 66.1% of parents of children with ASD (62.5% autism, 76.2% PDD-NOS, 58.3% Asperger disorder) and 45% of parents of the control subjects reported that their children had sleep problems. Actigraphic data showed that 66.7% of children with ASD (75% autism, 52.4% PDD-NOS, 75% Asperger disorder) and 45.9% of the control subjects had disturbed sleep. Conclusions: The prevalence estimate of 45% for mild sleep disturbances in the TD cohort highlights pediatric sleep debt as a public health problem of concern. The prevalence estimate of 66% for moderate sleep disturbances in the ASD cohort underscores the significant sleep problems that the families of these children face. The predominant sleep disorders in the ASD cohort were behavioral insomnia sleep-onset type and insomnia due to PDD. Citation: Souders MC; Mason TBA; Valladares O; Bucan M; Levy SE; Mandell DS; Weaver TE; Pinto-Martin D. Sleep behaviors and sleep quality in

  5. High incidence of sleep problems in children with developmental disorders: results of a questionnaire survey in a Japanese elementary school.

    Science.gov (United States)

    Matsuoka, Michiko; Nagamitsu, Shinichiro; Iwasaki, Mizue; Iemura, Akiko; Yamashita, Yushiro; Maeda, Masaharu; Kitani, Shingo; Kakuma, Tatsuyuki; Uchimura, Naohisa; Matsuishi, Toyojiro

    2014-01-01

    The aim of the present school-based questionnaire was to analyze the sleep problems of children with developmental disorders, such as pervasive developmental disorder and attention deficit hyperactivity disorder. The sleep problems of 43 children with developmental disorders were compared with those of 372 healthy children (control group). All children attended one public elementary school in Kurume, Japan; thus, the study avoided the potential bias associated with hospital-based surveys (i.e. a high prevalence of sleep disturbance) and provided a more complete picture of the children's academic performance and family situation compared with a control group under identical conditions. Children's sleep problems were measured with the Japanese version of the Children's Sleep Habits Questionnaire (CSHQ). Children with developmental disorders had significantly higher total CSHQ scores, as well as mean scores on the parasomnias and sleep breathing subscales, than children in the control group. The total CSHQ score, bedtime resistance, sleep onset delay, and daytime sleepiness worsened with increasing age in children with developmental disorders; in contrast, these parameters were unchanged or became better with age in the control group. In children with developmental disorders, there was a significant association between a higher total CSHQ score and lower academic performance, but no such association was found in the control group. For both groups, children's sleep problems affected their parents' quality of sleep. There were no significant differences in physical, lifestyle, and sleep environmental factors, or in sleep/wake patterns, between the two groups. Children with developmental disorders have poor sleep quality, which may affect academic performance. It is important for physicians to be aware of age-related differences in sleep problems in children with developmental disorders. Further studies are needed to identify the association between sleep quality and

  6. National Center on Sleep Disorders Research

    Science.gov (United States)

    ... Resources Register for Updates The National Center on Sleep Disorders Research (NCSDR) Located within the National Heart, Lung, ... 60 percent have a chronic disorder. Each year, sleep disorders, sleep deprivation, and sleepiness add an estimated $15. ...

  7. A non-contact high resolution piezoelectric film based sensor for monitoring breathing during sleep

    Science.gov (United States)

    Johnston, Robert; Nakano, Katsuya; Fujita, Kento; Misaki, Shinya; Fujii, Hiroyuki; Misaki, Yukinori

    2017-07-01

    Currently, research for measuring human breathing during sleep is actively being conducted into using technologies that include piezoelectric, ultrasonic, microwave and infrared rays. But various problems have led to not many practical applications. As such, it was decided to develop a PVDF (PolyVinylidene DiFluoride) based non-contact high resolution sensor for monitoring a subject's breathing as they sleep. Development of the high resolution respiration sensor was possible through the use of PVDF piezoelectric film and the development of a new sensor configuration. Although there was already an existing respiration sensor research resulting product available, is weak signal strength made it very sensitive to noise and difficult to measure respiration accurately. As such, complicated circuits and signal processing were needed. A new high resolution breathing sensor was developed with greater signal strength and with just the use of some simple circuits and signal processing, was able to accurately measure subject breathing. Also due to the greater signal strength, it became possible to measure both heart rate and respiration rate simultaneously.

  8. Sleep in the Military: Promoting Healthy Sleep Among U.S. Servicemembers

    Science.gov (United States)

    2015-01-01

    Punjabi , 2008). Prevalence data on OSA are somewhat inconsistent, depending on how the condition is measured (e.g., with gold-standard, in...indicate a 67.8-percent rate of OSA among those referred for diagnostic sleep testing in sleep center settings ( Punjabi , Welch, and Strohl, 2000). In...February 2012, pp. e99–e103. Aurora, R. Nisha, Ciprian Crainiceanu, Brian Caffo, and Naresh M. Punjabi , “Sleep-Disordered Breathing and Caffeine

  9. Prosthodontic Approach to Treat Obstructive Sleep Apnea ...

    African Journals Online (AJOL)

    Prosthodontic Approach to Treat Obstructive Sleep Apnea. ... Annals of Medical and Health Sciences Research ... disordered breathing represents a continuum, ranging from simple snoring sans sleepiness, upper‑airway resistance syndrome, obstructive sleep apnea (OSA) syndrome, to hypercapnic respiratory failure.

  10. Sleep and anxiety disorders

    OpenAIRE

    Staner, Luc

    2003-01-01

    Sleep disturbances-particularly insomnia - are highly prevalent in anxiety disorders and complaints such as insomnia or nightmares have even been incorporated in some anxiety disorder definitions, such as generalized anxiety disorder and posttraumatic stress disorder. In the first part of this review, the relationship between sleep and anxiety is discussed in terms of adaptive response to stress. Recent studies suggested that the corticotropin-releasing hormone system and the locus ceruleus-a...

  11. Sleep in Autism Spectrum Disorder and Attention Deficit Hyperactivity Disorder.

    Science.gov (United States)

    Singh, Kanwaljit; Zimmerman, Andrew W

    2015-06-01

    Sleep problems are common in autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD). Sleep problems in these disorders may not only worsen daytime behaviors and core symptoms of ASD and ADHD but also contribute to parental stress levels. Therefore, the presence of sleep problems in ASD and ADHD requires prompt attention and management. This article is presented in 2 sections, one each for ASD and ADHD. First, a detailed literature review about the burden and prevalence of different types of sleep disorders is presented, followed by the pathophysiology and etiology of the sleep problems and evaluation and management of sleep disorders in ASD and ADHD. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. [Sleeping habits and sleep disorders during adolescence: relation to school performance].

    Science.gov (United States)

    Salcedo Aguilar, F; Rodríguez Almonacid, F M; Monterde Aznar, M L; García Jiménez, M A; Redondo Martínez, P; Marcos Navarro, A I

    2005-05-15

    To determine the prevalence of sleep disorders in adolescence. To describe sleeping habits of adolescents in relation to sleep disorders and associated factors. To determine the relation between sleep disorders/inappropiate sleeping habits and school performance. Observational, descriptive, cross-sectional study. Secondary school of Cuenca (city in Spain). 1293 school children of first and fourth curses of secondary education. Structured questionnaire with opened and closed questions on sleeping habits during weekdays and at weekends and sleep disorders to be answered by the adolescents anonymously and on their own. Student's school performance with relation with to sleeping habits and sleep disorders were determined. 1155 students out of 1293 (response rate 89.33%) answered the questionnaire, 537 (45.9%) boys and 618 (54.1%) girls, 14 years old on average (between 11-18 years). On weekdays students went to bed at 23.17 h and got up at 7.46 h (average sleeping time =8 hours and 18 minutes). At weekends they went to bed at 1.02 h and got up at 10.42 h (average sleeping time =9 hours and 40 minutes). 45.4% of students said to sleep badly on Sunday night's. On average the number of subjects failed in class is higher with adolescents who complain about sleep (2.28 vs 1.91; P=.04), who are tired at waking up time (2.17 vs 1.97; P=.048) and who have morning sleepiness (2.17 vs 1.75; P=.004). Schools hours cause deficit sleeping time during weekdays which is partly made up for at weekend. At weekends there is an interruption of the adolescent's sleeping habits. School performance of adolescents with sleep disorders is lower.

  13. A novel non-rapid-eye movement and rapid-eye-movement parasomnia with sleep breathing disorder associated with antibodies to IgLON5: a case series, characterisation of the antigen, and post-mortem study.

    Science.gov (United States)

    Sabater, Lidia; Gaig, Carles; Gelpi, Ellen; Bataller, Luis; Lewerenz, Jan; Torres-Vega, Estefanía; Contreras, Angeles; Giometto, Bruno; Compta, Yaroslau; Embid, Cristina; Vilaseca, Isabel; Iranzo, Alex; Santamaría, Joan; Dalmau, Josep; Graus, Francesc

    2014-06-01

    stage N2, simple movements and finalistic behaviours, normalisation of non-REM sleep by the end of the night, and, in the four patients with REM sleep recorded, REM sleep behaviour disorder). Four of four patients had HLA-DRB1*1001 and HLA-DQB1*0501 alleles. All patients had antibodies (mainly IgG4) against IgLON5, a neuronal cell adhesion molecule. Only one of the 298 controls, who had progressive supranuclear palsy, had IgLON5 antibodies. Neuropathology showed neuronal loss and extensive deposits of hyperphosphorylated tau mainly involving the tegmentum of the brainstem and hypothalamus in the two patients studied. IgLON5 antibodies identify a unique non-REM and REM parasomnia with sleep breathing dysfunction and pathological features suggesting a tauopathy. Fondo de Investigaciones Sanitarias, Centros de Investigación Biomédica en Red de enfermedades neurodegenerativas (CIBERNED) and Respiratorias (CIBERES), Ministerio de Economía y Competitividad, Fundació la Marató TV3, and the National Institutes of Health. Copyright © 2014 Elsevier Ltd. All rights reserved.

  14. Shining evolutionary light on human sleep and sleep disorders.

    Science.gov (United States)

    Nunn, Charles L; Samson, David R; Krystal, Andrew D

    2016-01-01

    Sleep is essential to cognitive function and health in humans, yet the ultimate reasons for sleep-i.e. 'why' sleep evolved-remain mysterious. We integrate findings from human sleep studies, the ethnographic record, and the ecology and evolution of mammalian sleep to better understand sleep along the human lineage and in the modern world. Compared to other primates, sleep in great apes has undergone substantial evolutionary change, with all great apes building a sleeping platform or 'nest'. Further evolutionary change characterizes human sleep, with humans having the shortest sleep duration, yet the highest proportion of rapid eye movement sleep among primates. These changes likely reflect that our ancestors experienced fitness benefits from being active for a greater portion of the 24-h cycle than other primates, potentially related to advantages arising from learning, socializing and defending against predators and hostile conspecifics. Perspectives from evolutionary medicine have implications for understanding sleep disorders; we consider these perspectives in the context of insomnia, narcolepsy, seasonal affective disorder, circadian rhythm disorders and sleep apnea. We also identify how human sleep today differs from sleep through most of human evolution, and the implications of these changes for global health and health disparities. More generally, our review highlights the importance of phylogenetic comparisons in understanding human health, including well-known links between sleep, cognitive performance and health in humans. © The Author(s) 2016. Published by Oxford University Press on behalf of the Foundation for Evolution, Medicine, and Public Health.

  15. Obstructive sleep apnoea syndrome in children and anaesthesia

    Directory of Open Access Journals (Sweden)

    A Rudra

    2010-01-01

    Full Text Available Obstructive sleep apnoea syndrome (OSAS is a common medical disorder among adults, which is increasingly being recognized in children too. It is a breathing disorder characterized by upper airway obstruction with or without intermittent complete obstruction that disrupts normal breathing during sleep. Anatomical and neuromuscular disorders are mainly responsible for this disorder. This disorder leads to a state of chronic hypoxemia, which has significant cardiac, pulmonary and central nervous system implications. Diagnosis of OSAS is based on thorough history and clinical examination along with appropriate sleep studies including polysomnography. The mainstay of treatment of paediatric OSAS is adenotonsillectomy. Good anaesthetic practice in Paediatric patients with OSAS revolves around good and ideal airway management. Early detection of airway obstruction, intense monitoring to warn of impending airway problems and appropriate and early intervention of airway compromise are good anaesthetic practices. Coexisting medical problems should be adequately addressed and safe analgesic techniques in the perioperative period go towards improving outcomes in patients with paediatric OSAS.

  16. Dream Content in Patients With Sleep Apnea: A Prospective Sleep Laboratory Study.

    Science.gov (United States)

    Di Pauli, Franziska; Stefani, Ambra; Holzknecht, Evi; Brandauer, Elisabeth; Mitterling, Thomas; Holzinger, Brigitte; Högl, Birgit

    2018-01-15

    Few studies have addressed dreaming in patients with sleep apnea. We hypothesized that respiratory events and subsequent oxygen desaturation act as an important physiological trigger and may thus influence dream content in patients with a sleep-related breathing disorder. Seventy-six patients (28 women, mean age 54 years, range 20-82) who underwent polysomnography because of suspected sleep apnea participated in this study. Dream reports and dream questionnaires were collected immediately after first morning awakening, at 5:30 AM, at the sleep laboratory. Dream content analysis with respect to possible respiratory-related content was performed. Patients were stratified into primary snoring, mild, moderate, and severe sleep apnea groups. In 63 patients sleep apnea was diagnosed (mild n = 31, 49.2%, moderate n = 13, 20.6%, severe n = 19, 30.2%), and 13 subjects in whom a sleep-related breathing disorder was not confirmed were included as a control group with primary snoring. There was no significant difference in respiratory-related dream topics between patients and controls. Also, no influence of respiratory parameters measured during polysomnography on dream content was detectable. We failed to detect a difference in dream content between patients with sleep apnea and controls. Further studies are required to determine whether these results indicate that the incorporation of respiratory events into dreams is absent in patients with sleep apnea or represents a bias due to the collection of dream content in the early morning hours. © 2018 American Academy of Sleep Medicine

  17. Unraveling the Neurobiology of Sleep and Sleep Disorders Using Drosophila.

    Science.gov (United States)

    Chakravarti, L; Moscato, E H; Kayser, M S

    2017-01-01

    Sleep disorders in humans are increasingly appreciated to be not only widespread but also detrimental to multiple facets of physical and mental health. Recent work has begun to shed light on the mechanistic basis of sleep disorders like insomnia, restless legs syndrome, narcolepsy, and a host of others, but a more detailed genetic and molecular understanding of how sleep goes awry is lacking. Over the past 15 years, studies in Drosophila have yielded new insights into basic questions regarding sleep function and regulation. More recently, powerful genetic approaches in the fly have been applied toward studying primary human sleep disorders and other disease states associated with dysregulated sleep. In this review, we discuss the contribution of Drosophila to the landscape of sleep biology, examining not only fundamental advances in sleep neurobiology but also how flies have begun to inform pathological sleep states in humans. © 2017 Elsevier Inc. All rights reserved.

  18. Sleep disorders in children with Tourette syndrome.

    Science.gov (United States)

    Ghosh, Debabrata; Rajan, Prashant V; Das, Deepanjana; Datta, Priya; Rothner, A David; Erenberg, Gerald

    2014-07-01

    The objective of this study was to determine the frequency, nature, and impact of sleep disorders in children and adolescents with Tourette syndrome and to raise awareness about their possible inclusion as a Tourette syndrome comorbidity. Using a prospective questionnaire, we interviewed 123 patients of age ≤21 years with a confirmed diagnosis of Tourette syndrome. Each completed questionnaire was then reviewed in accordance with Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, criteria for categorization to a form of sleep disorder. Of the 123 patients with Tourette syndrome, 75 (61%) had comorbid attention deficit hyperactivity disorder and 48 (39%) had Tourette without attention deficit hyperactivity disorder. The sleep problems observed included problems in the nature of sleep, abnormal behaviors during sleep, and impact of sleep disturbances on quality of life. Within these cohorts, 31 (65%) of the 48 Tourette-only patients and 48 (64%) of the 75 Tourette + attention deficit hyperactivity disorder patients could fit into some form of Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, coded sleep disorders. Of the 48 Tourette + attention deficit hyperactivity disorder patients with sleep disorders, 36 (75%) had insomnia signs, which could be explained by the co-occurrence of attention deficit hyperactivity disorder and high stimulant use. However, 10 (32%) of the 31 Tourette-only patients with sleep disorders had insomnia irrespective of attention deficit hyperactivity disorder or medication use. Sleep problems are common in children with Tourette syndrome irrespective of comorbid attention deficit hyperactivity disorder, justifying their inclusion as a comorbidity of Tourette syndrome. Copyright © 2014 Elsevier Inc. All rights reserved.

  19. Sleep disorders and work performance: findings from the 2008 National Sleep Foundation Sleep in America poll.

    Science.gov (United States)

    Swanson, Leslie M; Arnedt, J Todd; Rosekind, Mark R; Belenky, Gregory; Balkin, Thomas J; Drake, Christopher

    2011-09-01

    Chronic sleep deprivation is common among workers, and has been associated with negative work outcomes, including absenteeism and occupational accidents. The objective of the present study is to characterize reciprocal relationships between sleep and work. Specifically, we examined how sleep impacts work performance and how work affects sleep in individuals not at-risk for a sleep disorder; assessed work performance outcomes for individuals at-risk for sleep disorders, including insomnia, obstructive sleep apnea (OSA) and restless legs syndrome (RLS); and characterized work performance impairments in shift workers (SW) at-risk for shift work sleep disorders relative to SW and day workers. One-thousand Americans who work 30 h per week or more were asked questions about employment, work performance and sleep in the National Sleep Foundation's 2008 Sleep in America telephone poll. Long work hours were associated with shorter sleep times, and shorter sleep times were associated with more work impairments. Thirty-seven percent of respondents were classified as at-risk for any sleep disorder. These individuals had more negative work outcomes as compared with those not at-risk for a sleep disorder. Presenteeism was a significant problem for individuals with insomnia symptoms, OSA and RLS as compared with respondents not at-risk. These results suggest that long work hours may contribute to chronic sleep loss, which may in turn result in work impairment. Risk for sleep disorders substantially increases the likelihood of negative work outcomes, including occupational accidents, absenteeism and presenteeism. © 2010 European Sleep Research Society.

  20. Parkinson's Disease and Sleep/Wake Disturbances

    Directory of Open Access Journals (Sweden)

    Todd J. Swick

    2012-01-01

    Full Text Available Parkinson's disease (PD has traditionally been characterized by its cardinal motor symptoms of bradykinesia, rigidity, resting tremor, and postural instability. However, PD is increasingly being recognized as a multidimensional disease associated with myriad nonmotor symptoms including autonomic dysfunction, mood disorders, cognitive impairment, pain, gastrointestinal disturbance, impaired olfaction, psychosis, and sleep disorders. Sleep disturbances, which include sleep fragmentation, daytime somnolence, sleep-disordered breathing, restless legs syndrome (RLS, nightmares, and rapid eye movement (REM sleep behavior disorder (RBD, are estimated to occur in 60% to 98% of patients with PD. For years nonmotor symptoms received little attention from clinicians and researchers, but now these symptoms are known to be significant predictors of morbidity in determining quality of life, costs of disease, and rates of institutionalization. A discussion of the clinical aspects, pathophysiology, evaluation techniques, and treatment options for the sleep disorders that are encountered with PD is presented.

  1. Children with a history of prematurity presenting with snoring and sleep-disordered breathing: a cross-sectional study.

    Science.gov (United States)

    Manuel, Anura; Witmans, Manisha; El-Hakim, Hamdy

    2013-08-01

    To report on the prevalence of premature (PM) birth in a consecutive series of children treated for snoring and sleep-disordered breathing (S/SDB), the parameters specific to their management and variables predictive of disease severity. A retrospective study was undertaken at a tertiary pediatric hospital. Children with history of PM and presenting with S/SDB were identified from a prospectively kept surgical database. We set out to determine the prevalence of PM among the patients presenting with S/SDB who required airway evaluations and surgery. Pulse oximetry is overnight recordable oxygen saturation and heart rate tracing that provides information about hypoxemia during sleep. This was performed on all children preoperatively. The pulse oximetry findings were used to plan for perioperative monitoring and care. A multivariable analysis was used to identify factors predictive of abnormal pulse oximetry studies. We evaluated the associated diagnoses, surgical procedures required, and response to treatment in these selected children. Fifty-seven out of 1,038 patients were PM (33 males; mean age, 62.09 ± 34.91 months; range, 4-190 months). The mean gestational age was 30.3 ± 4.0 weeks. The prevalence rate of PM among patients treated surgically for SDB is 5.5% (95% CI 5.2-5.8) at our center. Comorbid pulmonary and gastrointestinal disorders were encountered on 23 (40%) and 17 (29.8%) occasions, respectively, and were the most commonly encountered comorbid diagnostic categories. Large airway abnormalities were encountered in 11 (19.3%) children, and the most common were subglottic stenosis (four) and laryngeal paralysis (four). Comorbid respiratory disease was negatively predictive of abnormal pulse oximetry (coefficient -0.35, P<.05). Postoperative respiratory outcomes correlated with abnormal pulse oximetry (coefficient 0.3; P<.05). Our findings suggest children with PM presenting to pediatric otolaryngology require a comprehensive evaluation for S/SDB. A

  2. The role of sleep and sleep disorders in the development, diagnosis, and management of neurocognitive disorders.

    OpenAIRE

    Michelle A Miller

    2015-01-01

    It is becoming increasingly apparent that sleep plays an important role in the maintenance, disease prevention, repair and restoration of both mind and body. The sleep and wake cycles are controlled by the pacemaker activity of the superchiasmic nucleus in the hypothalamus but can be disrupted by diseases of the nervous system causing disordered sleep. A lack of sleep has been associated with an increase in all–cause mortality. Likewise, sleep disturbances and sleep disorders may disrupt neu...

  3. Association of peripheral neuropathy with sleep-related breathing disorders in myotonic dystrophies

    Directory of Open Access Journals (Sweden)

    Banach M

    2017-01-01

    Full Text Available Marta Banach,1,* Jakub Antczak,1,* Rafał Rola21Department of Clinical Neurophysiology, 2First Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland *These authors contributed equally to this workBackground: Myotonic dystrophy (DM type 1 and type 2 are inherited diseases characterized by myotonia and myopathy. Additional symptoms include, among others, peripheral neuropathy and sleep-related breathing disorders (SRBDs. There is growing evidence for a complex association between DM1 and DM2, which was described in patients with diabetes mellitus and in the general population. In this study, we investigated whether there is an association between peripheral neuropathy and SRBDs also in the population of patients with DM.Methods: The study included 16 patients with DM1 (mean age, 37.9±14.1 years; 20–69 years and eight patients with DM2 (mean age, 47.6±14.1 years; 20–65 years, who underwent a sensory and motor nerve conduction study (NCS and diagnostic screening for SRBDs. In both groups, the NCS parameters were correlated with respiratory parameters.Results: In both groups, the amplitude of the ulnar sensory nerve action potential (SNAP correlated with the mean arterial oxygen saturation (SaO2. In addition, in the DM2 group, the median SNAP correlated with the mean SaO2. In the DM1 group, the median SNAP and the distal motor latency (DML of the ulnar nerve correlated with the apnea–hypopnea index, while the oxygen desaturation index correlated with the DML of the tibial nerve and with conduction velocity in the sural nerve.Conclusion: Our results indicate a complex association between neuropathy and SRBDs in DM1 and DM2. Axonal degeneration may contribute to nocturnal hypoxemia and vice versa. Neuropathy may contribute to muscle weakness, which in turn may cause respiratory events.Keywords: myotonic dystrophy, SRBD and neuropathy with AHI, SNAP, CMAP

  4. Obstructive sleep apnea

    Directory of Open Access Journals (Sweden)

    Steven D. Brass

    2011-11-01

    Full Text Available Obstructive sleep apnea (OSA affects millions of Americans and is estimated to be as prevalent as asthma and diabetes. Given the fact that obesity is a major risk factor for OSA, and given the current global rise in obesity, the prevalence of OSA will increase in the future. Individuals with sleep apnea are often unaware of their sleep disorder. It is usually first recognized as a problem by family members who witness the apneic episodes or is suspected by their primary care doctor because of the individual’s risk factors and symptoms. The vast majority remain undiagnosed and untreated, despite the fact that this serious disorder can have significant consequences. Individuals with untreated OSA can stop breathing hundreds of times a night during their sleep. These apneic events can lead to fragmented sleep that is of poor quality, as the brain arouses briefly in order for the body to resume breathing. Untreated, sleep apnea can have dire health consequences and can increase the risk of hypertension, diabetes, heart disease, and heart failure. OSA management has also become important in a number of comorbid neurological conditions, including epilepsy, stroke, multiple sclerosis, and headache. Diagnosis typically involves use of screening questionnaires, physical exam, and an overnight polysomnography or a portable home study. Treatment options include changes in lifestyle, positive airway pressure, surgery, and dental appliances.

  5. Obstructive sleep apnea.

    Science.gov (United States)

    Ho, Matthew L; Brass, Steven D

    2011-11-29

    Obstructive sleep apnea (OSA) affects millions of Americans and is estimated to be as prevalent as asthma and diabetes. Given the fact that obesity is a major risk factor for OSA, and given the current global rise in obesity, the prevalence of OSA will increase in the future. Individuals with sleep apnea are often unaware of their sleep disorder. It is usually first recognized as a problem by family members who witness the apneic episodes or is suspected by their primary care doctor because of the individual's risk factors and symptoms. The vast majority remain undiagnosed and untreated, despite the fact that this serious disorder can have significant consequences. Individuals with untreated OSA can stop breathing hundreds of times a night during their sleep. These apneic events can lead to fragmented sleep that is of poor quality, as the brain arouses briefly in order for the body to resume breathing. Untreated, sleep apnea can have dire health consequences and can increase the risk of hypertension, diabetes, heart disease, and heart failure. OSA management has also become important in a number of comorbid neurological conditions, including epilepsy, stroke, multiple sclerosis, and headache. Diagnosis typically involves use of screening questionnaires, physical exam, and an overnight polysomnography or a portable home study. Treatment options include changes in lifestyle, positive airway pressure, surgery, and dental appliances.

  6. Ultrafast CT in the diagnosis of sleep apnea during awake tidal breathing

    International Nuclear Information System (INIS)

    Galvin, J.R.; Rooholamini, S.A.; Stanford, W.

    1988-01-01

    With sleep there is normally a decrease in neural output to upper airway muscles. If this decrease is superimposed on a structurally abnormal airway, then sleep apnea may result. Ultrafast CT axially images the upper airway in near real time. The authors compared 11 awake patients with sleep apnea with 24 healthy volunteers during quiet tidal breathing. They found that apneic patients have a small oropharyngeal airway (31.3 mm 2 +- 30.2 vs 134.2 mm 2 +- 46.6[P=<.0001]). Apneic patients also have significant collapsibility of the nasopharynx (75% +- 18% vs 27% +- 14% [P=<.0001]). Ultrafast CT gives dynamic anatomic definition of the upper airway and provides a means to eulcidate further the pathogenesis of sleep apnea

  7. Interactions between disordered sleep, post-traumatic stress disorder, and substance use disorders.

    Science.gov (United States)

    Vandrey, Ryan; Babson, Kimberly A; Herrmann, Evan S; Bonn-Miller, Marcel O

    2014-04-01

    Disordered sleep is associated with a number of adverse health consequences and is an integral component of many psychiatric disorders. Rates of substance use disorders (SUDs) are markedly higher among individuals with post-traumatic stress disorder (PTSD), and this relationship may be partly mediated by disturbed sleep. Sleep disturbances (e.g. insomnia, daytime sleepiness, vivid nightmares) are hallmark features of PTSD and there is evidence that individuals with PTSD engage in substance use as a means of coping with these symptoms. However, prolonged substance use can lead to more severe sleep disturbances due to the development of tolerance and withdrawal. Behavioural or pharmacological treatment of disordered sleep is associated with improved daytime symptoms and psychosocial functioning among individuals who have developed PTSD. Initial research also suggests that improving sleep could be similarly beneficial in reducing coping oriented substance use and preventing relapse among those seeking treatment for SUDs. Together, these findings suggest that ameliorating sleep disturbance among at-risk individuals would be a viable target for the prevention and treatment of PTSD and associated SUDs, but prospective research is needed to examine this hypothesis. Enhanced understanding of the interrelation between sleep, PTSD, and SUDs may yield novel prevention and intervention approaches for these costly, prevalent and frequently co-occurring disorders.

  8. Degeneration of rapid eye movement sleep circuitry underlies rapid eye movement sleep behavior disorder.

    Science.gov (United States)

    McKenna, Dillon; Peever, John

    2017-05-01

    During healthy rapid eye movement sleep, skeletal muscles are actively forced into a state of motor paralysis. However, in rapid eye movement sleep behavior disorder-a relatively common neurological disorder-this natural process is lost. A lack of motor paralysis (atonia) in rapid eye movement sleep behavior disorder allows individuals to actively move, which at times can be excessive and violent. At first glance this may sound harmless, but it is not because rapid eye movement sleep behavior disorder patients frequently injure themselves or the person they sleep with. It is hypothesized that the degeneration or dysfunction of the brain stem circuits that control rapid eye movement sleep paralysis is an underlying cause of rapid eye movement sleep behavior disorder. The link between brain stem degeneration and rapid eye movement sleep behavior disorder stems from the fact that rapid eye movement sleep behavior disorder precedes, in the majority (∼80%) of cases, the development of synucleinopathies such as Parkinson's disease, dementia with Lewy bodies, and multiple system atrophy, which are known to initially cause degeneration in the caudal brain stem structures where rapid eye movement sleep circuits are located. Furthermore, basic science and clinical evidence demonstrate that lesions within the rapid eye movement sleep circuits can induce rapid eye movement sleep-specific motor deficits that are virtually identical to those observed in rapid eye movement sleep behavior disorder. This review examines the evidence that rapid eye movement sleep behavior disorder is caused by synucleinopathic neurodegeneration of the core brain stem circuits that control healthy rapid eye movement sleep and concludes that rapid eye movement sleep behavior disorder is not a separate clinical entity from synucleinopathies but, rather, it is the earliest symptom of these disorders. © 2017 International Parkinson and Movement Disorder Society. © 2017 International Parkinson and

  9. [Sleep disorder and lifestyle-related disease].

    Science.gov (United States)

    Shibata, Rei; Murohara, Toyoaki

    2015-06-01

    Sleep disorder is associated with the lifestyle-related diseases including obesity, insulin resistance and atherosclerosis. Adipose tissue functions as an endocrine organ by producing bioactive secretory proteins, also known as adipokines, that can directly act on nearby or remote organs. Recently, the associations between these adipokines and sleep disorders such as obstructive sleep apnea have been reported. In this review, we focus on the relationship between sleep disorder and lifestyle-related diseases.

  10. Prevalence and impact of sleep disorders and sleep habits in the United States.

    Science.gov (United States)

    Ram, Saravanan; Seirawan, Hazem; Kumar, Satish K S; Clark, Glenn T

    2010-02-01

    Epidemiologic studies on sleep disorders in the USA have mostly focused on specific disorders in specific groups of individuals. Most studies on sleep habits and sleep-related difficulties have focused on children and adolescents. The authors describe the prevalence of the three common physician-diagnosed sleep disorders (insomnia, sleep apnea, and restless legs syndrome (RLS)) by age, gender, and race in the US population. In addition, the authors describe the sleep habits and sleep-related difficulties in carrying routine daily activities. The authors also investigate the impact of the sleep disorders on performing routine daily activities. Data from the 2005-2006 National Health and Nutrition Examination Survey for 6,139 individuals over the age of 16 was analyzed for sleep-related parameters. The prevalence was highest for sleep apnea (4.2%), followed by insomnia (1.2%) and RLS (0.4%). Hispanics and Whites reported longer sleep duration than Blacks by 24 to 30 min. The predominant sleep habits were snoring while sleeping (48%), feeling unrested during the day (26.5%), and not getting enough sleep (26%). Difficulty concentrating (25%) or remembering (18%) were the main sleep-related difficulties in our sample. Insomnia, sleep apnea, and RLS had the highest impact on concentration and memory. Our findings suggest that the prevalence of sleep disorders in the USA is much lower than previously reported in the literature suggesting under diagnosis of sleep disorders by primary care physicians.

  11. Questionnaires that screen for multiple sleep disorders.

    Science.gov (United States)

    Klingman, Karen J; Jungquist, Carla R; Perlis, Michael L

    2017-04-01

    The goal of this review was to identify, describe, and evaluate the existing multiple sleep disorders screening questionnaires for their comprehensiveness, brevity, and psychometric quality. A systematic review was conducted using Medline/PubMed, cumulative index to nursing & allied health literature, health and psychosocial instruments and the "grey literature". Search terms were "sleep disorders, screening, questionnaires, and psychometrics". The scope of the search was limited to English language articles for adult age groups from 1989 through 2015. Of the n = 2812 articles identified, most were assessment or treatment guideline reviews, topical reviews, and/or empirical articles. Seven of the articles described multiple sleep disorders screening instruments. Of the identified instruments, two questionnaires (the Holland sleep Disorders questionnaire and sleep-50) were evaluated as comprehensive and one questionnaire (the global sleep assessment questionnaire [GSAQ]) was judged to be both comprehensive and efficient. The GSAQ was found to cover four of the six core intrinsic disorders, sleep insufficiency, and daytime sequela with 11 questions. Accordingly, the GSAQ is the most suitable for application as a general sleep disorders screener. Additional work is required to validate this instrument in the context of primary care. Finally, the future development of multiple sleep disorders screening questionnaires should not only cover all six intrinsic sleep disorders but also acquire some basic demographic information (age, sex, body mass index, presence/absence of bed partner, work status and shift) and some limited data regarding sleep sufficiency and the daytime consequences of sleep disturbance. Copyright © 2016 Elsevier Ltd. All rights reserved.

  12. Mobile Phone Interventions for Sleep Disorders and Sleep Quality: Systematic Review.

    Science.gov (United States)

    Shin, Jong Cheol; Kim, Julia; Grigsby-Toussaint, Diana

    2017-09-07

    Although mobile health technologies have been developed for interventions to improve sleep disorders and sleep quality, evidence of their effectiveness remains limited. A systematic literature review was performed to determine the effectiveness of mobile technology interventions for improving sleep disorders and sleep quality. Four electronic databases (EBSCOhost, PubMed/Medline, Scopus, and Web of Science) were searched for articles on mobile technology and sleep interventions published between January 1983 and December 2016. Studies were eligible for inclusion if they met the following criteria: (1) written in English, (2) adequate details on study design, (3) focus on sleep intervention research, (4) sleep index measurement outcome provided, and (5) publication in peer-reviewed journals. An initial sample of 2679 English-language papers were retrieved from five electronic databases. After screening and review, 16 eligible studies were evaluated to examine the impact of mobile phone interventions on sleep disorders and sleep quality. These included one case study, three pre-post studies, and 12 randomized controlled trials. The studies were categorized as (1) conventional mobile phone support and (2) utilizing mobile phone apps. Based on the results of sleep outcome measurements, 88% (14/16) studies showed that mobile phone interventions have the capability to attenuate sleep disorders and to enhance sleep quality, regardless of intervention type. In addition, mobile phone intervention methods (either alternatively or as an auxiliary) provide better sleep solutions in comparison with other recognized treatments (eg, cognitive behavioral therapy for insomnia). We found evidence to support the use of mobile phone interventions to address sleep disorders and to improve sleep quality. Our findings suggest that mobile phone technologies can be effective for future sleep intervention research. ©Jong Cheol Shin, Julia Kim, Diana Grigsby-Toussaint. Originally published

  13. [Treatments of sleep disorders in dementia patients].

    Science.gov (United States)

    Furuta, Nobuo

    2014-02-01

    In elderly, biological changes cause circadian rhythm disturbance, and sleep disorders are often observed. The risk of sleep disorders is higher in dementia patients, sleep disorders are causes of care burden increase. In treatments of sleep disorders in dementia patients, it is important to evaluate correctly about sleep disorders and to check BPSD which merges to insomnia. In clinical, nonpharmacological therapies, such as an improvement of a lifestyle and cause removal of insomnia, are first choices. In medication, when other psychological symptoms and BPSDs merge, use of an easy sleeping drug is avoided, and medication of antidepressants or atypical antipsychotics is considered, but these medications use requires cautions about insurance adaptation and side effects.

  14. Occupational exposure to organic solvents and sleep-disordered breathing.

    Science.gov (United States)

    Ulfberg, J; Carter, N; Talbäck, M; Edling, C

    1997-01-01

    To investigate whether people with occupational exposure to organic solvents have a higher prevalence of obstructive sleep apnea syndrome (OSAS) than the general population and to examine the relationship between snoring and exposure to organic solvents. Consecutive patients, aged 30-64 years, referred during a 3-year period to the sleep laboratory at Avesta Hospital, Sweden, because of suspected OSAS made up the patient groups. Following admission, patients underwent a simplified sleep apnea investigation and were divided into two groups, OSAS (n = 320) and snorers (n = 443). A random sample of 296 men and 289 women aged 30-64 years obtained from a register of all country residents maintained by the county tax authority served as referents (controls). Both patients and referents responded to two questionnaires, including questions about occupation, exposure to organic solvents, and other chemical and physical agents. Men with OSAS or snoring and women with snoring had more often been occupationally exposed to organic solvents than the referents, showing an almost twofold increase in risk for those exposed during whole workdays. For men, the risk of OSAS or snoring increased with increasing exposure. The result indicates that occupational exposure to organic solvents might cause sleep apnea. A new observation is that even snoring could be caused by exposure to organic solvents. It is important to elucidate whether exposure to organic solvents is a cause of OSAS, because such a finding may have important implications for prevention and treatment of sleep disturbances.

  15. Sleep, eating disorder symptoms, and daytime functioning

    Directory of Open Access Journals (Sweden)

    Tromp MD

    2016-01-01

    Full Text Available Marilou DP Tromp,1 Anouk AMT Donners,1 Johan Garssen,1,2 Joris C Verster1,31Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, the Netherlands; 2Nutricia Research, Utrecht, the Netherlands; 3Center for Human Psychopharmacology, Swinburne University, Melbourne, VIC, AustraliaObjective: To investigate the relationship between eating disorders, body mass index (BMI, sleep disorders, and daytime functioning.Design: Survey.Setting: The Netherlands.Participants: N=574 Dutch young adults (18–35 years old.Measurements: Participants completed a survey on eating and sleep habits including the Eating Disorder Screen for Primary care (ESP and SLEEP-50 questionnaire subscales for sleep apnea, insomnia, circadian rhythm disorder (CRD, and daytime functioning. SLEEP-50 outcomes of participants who screened negative (≤2 and positive (>2 on the ESP were compared. In addition, SLEEP-50 scores of groups of participants with different ESP scores (0–4 and different BMI groups (ie, underweight, healthy weight, overweight, and obese were compared using nonparametric statistics.Results: Almost 12% (n=67 of participants screened positive for having an eating disorder. Relative to participants without eating disorders, participants who screened positive for eating disorders reported significantly higher scores on sleep apnea (3.7 versus 2.9, P=0.012, insomnia (7.7 versus 5.5, P<0.0001, CRD (2.9 versus 2.3, P=0.011, and impairment of daytime functioning (8.8 versus 5.8, P=0.0001. ESP scores were associated with insomnia (r=0.117, P=0.005, sleep apnea (r=0.118, P=0.004, sleep quality (r=−0.104, P=0.012, and daytime functioning (r=0.225, P<0.0001, but not with CRD (r=0.066, P=0.112. BMI correlated significantly with ESP scores (r=0.172, P<0.0001 and scores on sleep apnea (r=0.171, P<0.0001. When controlling for BMI, the partial correlation between ESP and sleep apnea remained significant (r=0.10, P=0.015.Conclusion

  16. Characterization of sleep breathing pattern in patients with type 2 diabetes: sweet sleep study.

    Directory of Open Access Journals (Sweden)

    Albert Lecube

    Full Text Available Although sleep apnea-hypopnea syndrome (SAHS is highly prevalent in patients with type 2 diabetes (T2D, it is unknown whether or not subjects with and without T2D share the same sleep breathing pattern.A cross-sectional study in patients with SAHS according to the presence (n = 132 or not (n = 264 of T2D. Both groups were matched by age, gender, BMI, and waist and neck circumferences. A subgroup of 125 subjects was also matched by AHI. The exclusion criteria included chronic respiratory disease, alcohol abuse, use of sedatives, and heart failure. A higher apnea hypopnea index (AHI was observed in T2D patients [32.2 (10.2-114.0 vs. 25.6 (10.2-123.4 events/hours; p = 0.002. When sleep events were evaluated separately, patients with T2D showed a significant increase in apnea events [8.4 (0.1-87.7 vs. 6.3 (0.0-105.6 e/h; p = 0.044, as well as a two-fold increase in the percentage of time spent with oxygen saturation <90% [15.7 (0.0-97.0 vs. 7.9 (0.0-95.6 %; <0.001], higher rates of oxygen desaturation events, and also higher daily sleepiness [7.0 (0.0-21.0 vs. 5.0 (0.0-21.0; p = 0.006] than subjects without T2D. Significant positive correlations between fasting plasma glucose and AHI, the apnea events, and CT90 were observed. Finally, multiple linear regression analyses showed that T2D was independently associated with AHI (R2 = 0.217, the apnea index (R2 = 0.194, CT90 (R2 = 0.222, and desaturation events.T2D patients present a different pattern of sleep breathing than subject without diabetes. The most important differences are the severity of hypoxemia and the number of apneas whereas the incidence of hypopnea episodes is similar.

  17. The Association of Lesion Location and Sleep Related Breathing Disorder in Patients with Acute Ischemic Stroke.

    Science.gov (United States)

    Fisse, Anna Lena; Kemmling, André; Teuber, Anja; Wersching, Heike; Young, Peter; Dittrich, Ralf; Ritter, Martin; Dziewas, Rainer; Minnerup, Jens

    2017-01-01

    Sleep related breathing disorders (SRBD) are common in patients with ischemic stroke and are associated with poor outcome. SRBD after stroke were assumed to be a direct consequence of injury of specific central nervous system structures. However, whether specific locations of ischemic infarcts cause SRBD is yet unknown. We therefore investigated the association of ischemic lesion location with SRBD. Patients with acute ischemic stroke treated on our stroke unit were included in a prospective observational study. All patients underwent magnetic resonance imaging (MRI) and polygraphy in the acute phase after stroke. SRBD was defined by an apnea-hypopnea index (AHI) ≥10. MRI were evaluated using standardized maps to depict voxel-wise probability distribution of infarction for patients with and without SRBD. Groups were compared using logistic regression analysis. Of 142 patients included, 86 (59%) had a SRBD. Age, body mass index and prevalence of arterial hypertension were significantly higher in patients with SRBD. There was no statistically significant association between any lesion location and SRBD. We found no association of lesion location and SRBD in stroke patients, whereas established risk factors for SRBD, known from general population, were significantly associated with SRBD. Given the high prevalence of SRBD in stroke patients, these findings suggest that cerebral ischemia facilitates the occurrence of SRBD in patients with pre-existing risk factors rather than causing it by damaging specific central nervous system structures. Our findings can be used to identify stroke patients who might benefit from polygraphy screening.

  18. Obstructive sleep apnoea (OSA) - a silent killer in anaesthesia ...

    African Journals Online (AJOL)

    Sleep-disordered breathing (SDB) encompasses a wide range of disorders that afflict both adults and children. These disorders are often unrecognised preoperatively and the pathophysiological consequences may impact severely on the patient in the peri-operative period.

  19. Obstructive sleep apnoea syndrome in children

    Directory of Open Access Journals (Sweden)

    Anna Włodarska

    2016-09-01

    Full Text Available Sleep-related breathing disorders in children are a clinical problem which is more and more often diagnosed by doctors nowadays. They can be the basis for diagnosing obstructive sleep apnoea syndrome that causes a number of complications: lowering the quality of life, behavioural problems, complications involving cardiovascular system. The incidence of obstructive sleep apnoea syndrome in the paediatric population is estimated to be at the level of 2%. The symptoms of obstructive sleep apnoea syndrome can be divided into daytime and night ones. Night symptoms in children include: snoring, apnoea, breathing with open mouth (both during the day and at night, dry tongue and mouth during sleep, agitated sleep in unnatural positions. Among daytime symptoms of obstructive sleep apnoea syndrome there are: irritability, aggressiveness, hyperactivity, attention deficit disorder, delayed development and growth pattern (mainly failure to thrive, learning problems, morning headaches. Parents often do not connect the night and daytime symptoms with the possible development of obstructive sleep apnoea syndrome in their children. The main predisposing factor of obstructive sleep apnoea syndrome in children is adenotonsillar hypertrophy. Effective and in most cases preferred treatment for the management of obstructive sleep apnoea syndrome in children is adenotonsillectomy. Polysomnography and polygraphy are diagnostic tools helpful in the study of sleep-related disorders. The objective of this study was to systematise the knowledge on the epidemiology, aetiology, clinical image and prevention of obstructive sleep apnoea syndrome in children.

  20. Exploring sleep disorders in patients with chronic kidney disease

    Directory of Open Access Journals (Sweden)

    Nigam G

    2018-01-01

    Full Text Available Gaurav Nigam,1 Macario Camacho,2 Edward T Chang,2 Muhammad Riaz3 1Division of Sleep Medicine, Clay County Hospital, Flora, IL, 2Division of Otolaryngology, Sleep Surgery and Sleep Medicine, Tripler Army Medical Center, Honolulu, HI, 3Division of Sleep Medicine, Astria Health Center, Grandview, WA, USA Abstract: Kidney disorders have been associated with a variety of sleep-related disorders. Therefore, researchers are placing greater emphasis on finding the role of chronic kidney disease (CKD in the development of obstructive sleep apnea and restless legs syndrome. Unfortunately, the presence of other sleep-related disorders with CKDs and non-CKDs has not been investigated with the same clinical rigor. Recent studies have revealed that myriad of sleep disorders are associated with CKDs. Furthermore, there are a few non-CKD-related disorders that are associated with sleep disorders. In this narrative review, we provide a balanced view of the spectrum of sleep disorders (as identified in International Classification of Sleep disorders-3 related to different types of renal disorders prominently including but not exclusively limited to CKD. Keywords: kidney disease, sleep disorders, obstructive sleep apnea, parasomnias, restless legs syndrome, chronic kidney disease, insomnia

  1. Sleep disorders in Parkinson's disease

    Directory of Open Access Journals (Sweden)

    Marina Romanovna Nodel'

    2011-01-01

    PD-cognition (SCOPA-Cog, and the PD quality of life scale (PDQ-39 were used. Results. Sleep fragmentation and early morning awakenings are the most common sleep disorders in PD. Pramipexole therapy resulted in a significant improvement in sleep quality, a reduction in the frequency of falling asleep and nocturnal awakenings. The improved characteristics of sleep were favored by a therapy-induced decrease in the severity of motor (hypokinesis, rigidity, tremor, nocturnal and morning dystonia and nonmotor (restless legs syndrome/acathisia, sensory disorders, nocturia PD manifestations.

  2. [Sleep disturbances in children with autistic spectrum disorders].

    Science.gov (United States)

    Kelmanson, I A

    2015-01-01

    An association between sleep disorders and autistic spectrum disorders in children is considered. Characteristic variants of sleep disorders, including resistance to going to bed, frequent night awakenings, parasomnias, changes in sleep structure, primarily, the decrease in the percentage of rapid eye movement sleep, are presented. Attention is focused on the possibility of the direct relationship between sleep disturbance and the pathogenesis of autistic spectrum disorders. A role of pathological alterations in the production of neuromediators and morphological changes in the brain structures characteristic of autistic spectrum disorders in the genesis of sleep disorders in children is discussed. Possible non-pharmacological and pharmacological approaches are suggested.

  3. Genetic variants associated with sleep disorders

    OpenAIRE

    Kripke, Daniel F.; Kline, Lawrence E.; Nievergelt, Caroline M.; Murray, Sarah S.; Shadan, Farhad F.; Dawson, Arthur; Poceta, J. Steven; Cronin, John; Jamil, Shazia M.; Tranah, Gregory J.; Loving, Richard T.; Grizas, Alexandra P.; Hahn, Elizabeth K.

    2015-01-01

    © 2014 The Authors. Objective: The diagnostic boundaries of sleep disorders are under considerable debate. The main sleep disorders are partly heritable therefore, defining heritable pathophysiologic mechanisms could delineate diagnoses and suggest treatment. We collected clinical data and DNA from consenting patients scheduled to undergo clinical polysomnograms, to expand our understanding of the polymorphisms associated with the phenotypes of particular sleep disorders. Methods: Patients at...

  4. Sleep-disordered breathing in patients with cystic fibrosis *

    Science.gov (United States)

    Veronezi, Jefferson; Carvalho, Ana Paula; Ricachinewsky, Claudio; Hoffmann, Anneliese; Kobayashi, Danielle Yuka; Piltcher, Otavio Bejzman; Silva, Fernando Antonio Abreu e; Martinez, Denis

    2015-01-01

    Abstract Objective: To test the hypothesis that disease severity in patients with cystic fibrosis (CF) is correlated with an increased risk of sleep apnea. Methods: A total of 34 CF patients underwent clinical and functional evaluation, as well as portable polysomnography, spirometry, and determination of IL-1β levels. Results: Mean apnea-hypopnea index (AHI), SpO2 on room air, and Epworth Sleepiness Scale score were 4.8 ± 2.6, 95.9 ± 1.9%, and 7.6 ± 3.8 points, respectively. Of the 34 patients, 19 were well-nourished, 6 were at nutritional risk, and 9 were malnourished. In the multivariate model to predict the AHI, the following variables remained significant: nutritional status (β = −0.386; p = 0.014); SpO2 (β = −0.453; p = 0.005), and the Epworth Sleepiness Scale score (β = 0.429; p = 0.006). The model explained 51% of the variation in the AHI. Conclusions: The major determinants of sleep apnea were nutritional status, SpO2, and daytime sleepiness. This knowledge not only provides an opportunity to define the clinical risk of having sleep apnea but also creates an avenue for the treatment and prevention of the disease. PMID:26398755

  5. SLEEP DISORDERS IN MENTALLY RETARDED CHILDREN

    Directory of Open Access Journals (Sweden)

    I. A. Kelmanson

    2014-01-01

    Full Text Available The paper presents the study of the association between sleep disturbances and mental retardation in children. Attention is paid to the instant connection between sleep neurophysiology and intellectual progress, as well as between sleep disorders and the pathogenesis of mental retardation in children. The data on characteristic forms of sleep disturbances, including bed-time resistance, frequent night awakenings, parasomnias, abnormal sleep structure, and notably reduced REM-sleep proportion are provided. The potential role of abnormal melatonin production in the origins of sleep disturbances in children with mental retardation is discussed. Certain approaches to pharmacological and non-pharmacological corrections of sleep disorders are outlined.

  6. The role of sleep in bipolar disorder

    Directory of Open Access Journals (Sweden)

    Gold AK

    2016-06-01

    Full Text Available Alexandra K Gold,1 Louisa G Sylvia,1,2 1Department of Psychiatry, Massachusetts General Hospital, 2Harvard Medical School, Boston, MA, USA Abstract: Bipolar disorder is a serious mental illness characterized by alternating periods of elevated and depressed mood. Sleep disturbances in bipolar disorder are present during all stages of the condition and exert a negative impact on overall course, quality of life, and treatment outcomes. We examine the partnership between circadian system (process C functioning and sleep–wake homeostasis (process S on optimal sleep functioning and explore the role of disruptions in both systems on sleep disturbances in bipolar disorder. A convergence of evidence suggests that sleep problems in bipolar disorder result from dysregulation across both process C and process S systems. Biomarkers of depressive episodes include heightened fragmentation of rapid eye movement (REM sleep, reduced REM latency, increased REM density, and a greater percentage of awakenings, while biomarkers of manic episodes include reduced REM latency, greater percentage of stage I sleep, increased REM density, discontinuous sleep patterns, shortened total sleep time, and a greater time awake in bed. These findings highlight the importance of targeting novel treatments for sleep disturbance in bipolar disorder. Keywords: bipolar disorder, circadian rhythms, sleep–wake homeostasis

  7. Sleep-wake disturbances after traumatic brain injury.

    Science.gov (United States)

    Ouellet, Marie-Christine; Beaulieu-Bonneau, Simon; Morin, Charles M

    2015-07-01

    Sleep-wake disturbances are extremely common after a traumatic brain injury (TBI). The most common disturbances are insomnia (difficulties falling or staying asleep), increased sleep need, and excessive daytime sleepiness that can be due to the TBI or other sleep disorders associated with TBI, such as sleep-related breathing disorder or post-traumatic hypersomnia. Sleep-wake disturbances can have a major effect on functional outcomes and on the recovery process after TBI. These negative effects can exacerbate other common sequelae of TBI-such as fatigue, pain, cognitive impairments, and psychological disorders (eg, depression and anxiety). Sleep-wake disturbances associated with TBI warrant treatment. Although evidence specific to patients with TBI is still scarce, cognitive-behavioural therapy and medication could prove helpful to alleviate sleep-wake disturbances in patients with a TBI. Copyright © 2015 Elsevier Ltd. All rights reserved.

  8. Chronic obstructive pulmonary disease and sleep related disorders.

    Science.gov (United States)

    Tsai, Sheila C

    2017-03-01

    Sleep related disorders are common and under-recognized in the chronic obstructive pulmonary disease (COPD) population. COPD symptoms can disrupt sleep. Similarly, sleep disorders can affect COPD. This review highlights the common sleep disorders seen in COPD patients, their impact, and potential management. Treatment of sleep disorders may improve quality of life in COPD patients. Optimizing inhaler therapy improves sleep quality. Increased inflammatory markers are noted in patients with the overlap syndrome of COPD and obstructive sleep apnea versus COPD alone. There are potential benefits of noninvasive positive pressure ventilation therapy for overlap syndrome patients with hypercapnia. Nocturnal supplemental oxygen may be beneficial in certain COPD subtypes. Nonbenzodiazepine hypnotic therapy for insomnia has shown benefit without associated respiratory failure or worsening respiratory symptoms. Melatonin may provide mild hypnotic and antioxidant benefits. This article discusses the impact of sleep disorders on COPD patients and the potential benefits of managing sleep disorders on respiratory disease control and quality of life.

  9. Atypical sexual behavior during sleep.

    Science.gov (United States)

    Guilleminault, Christian; Moscovitch, Adam; Yuen, Kin; Poyares, Dalva

    2002-01-01

    This article reports a case series of atypical sexual behavior during sleep, which is often harmful to patients or bed partners. Eleven subjects underwent clinical evaluation of complaints of sleep-related atypical sexual behavior. Complaints included violent masturbation, sexual assaults, and continuous (and loud) sexual vocalizations during sleep. One case was a medical-legal case. Sleep logs, clinical evaluations, sleep questionnaires, structured psychiatric interviews, polysomnography, actigraphy, home electroencephalographic monitoring during sleep, and clinical electroencephalographic monitoring while awake and asleep were used to determine clinical diagnoses. Atypical sexual behaviors during sleep were associated with feelings of guilt, shame, and depression. Because of these feelings, patients and bed partners often tolerated the abnormal behavior for long periods of time without seeking medical attention. The following pathologic sleep disorders were demonstrated on polysomnography: partial complex seizures, sleep-disordered breathing, stage 3 to 4 non-rapid eye movement (REM) sleep parasomnias, and REM sleep behavior disorder. These findings were concurrent with morning amnesia. The atypical behaviors were related to different syndromes despite the similarity of complaints from bed partners. In most cases the disturbing and often harmful symptoms were controlled when counseling was instituted and sleep disorders were treated. In some cases treatment of seizures or psychiatric disorders was also needed. Clonazepam with simultaneous psychotherapy was the most common successful treatment combination. The addition of antidepressant or antiepileptic medications was required in specific cases.

  10. Wireless nanosensor system for diagnosis of sleep disorders

    Science.gov (United States)

    Ramasamy, Mouli; Varadan, Vijay K.

    2016-04-01

    A good night's sleep plays a vital role in physical and mental wellbeing by performing the recuperative function for the brain and the body. Notwithstanding the fact that, good sleep is an essential part of a person's life, an increasing number of people are experiencing sleep disorders and loss of sleep. According to the research by the National Institutes of Health (NIH), 50 to 70 million Americans suffer from sleep disorders and sleep deprivation. Although sleep disorder is a highly prevalent condition like diabetes or asthma, 80 to 90 percent of the cases remain undiagnosed. The short-term effects of sleep disorder are morning headaches, excessive daytime sleepiness, shot-term memory loss and depression, but the cumulative long-term effects result in severe health consequences like heart attacks and strokes. In addition, people suffering from sleep disorders are 7.5 times more likely to have a higher body mass index and 2.5 times more likely to have diabetes. Further, undiagnosed and untreated sleep disorders have a significant direct and indirect economic impact. The costs associated with untreated sleep disorders are far higher than the costs for adequate treatment. According to the survey, approximately 16 billion of dollars are spent on medical expenses associated with repeated doctor visits, prescriptions and medications.

  11. Circadian Rhythm Sleep Disorders

    Directory of Open Access Journals (Sweden)

    Erhan Akinci

    2016-06-01

    Full Text Available The circadian rhythm sleep disorders define the clinical conditions where sleep and ndash;wake rhythm is disrupted despite optimum environmental and social conditions. They occur as a result of the changes in endogenous circadian hours or non-compatibility of environmental factors or social life with endogenous circadian rhythm. The sleep and ndash;wake rhythm is disrupted continuously or in repeating phases depending on lack of balance between internal and external cycles. This condition leads to functional impairments which cause insomnia, excessive sleepiness or both in people. Application of detailed sleep anamnesis and sleep diary with actigraphy record, if possible, will be sufficient for diagnosis. The treatment aims to align endogenous circadian rhythm with environmental conditions. The purpose of this article is to review pathology, clinical characteristics, diagnosis and treatment of circadian rhythm disorder. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2016; 8(2: 178-189

  12. Systematic review of sleep disorders in cancer patients: can the prevalence of sleep disorders be ascertained?

    International Nuclear Information System (INIS)

    Otte, Julie L; Carpenter, Janet S; Manchanda, Shalini; Rand, Kevin L; Skaar, Todd C; Weaver, Michael; Chernyak, Yelena; Zhong, Xin; Igega, Christele; Landis, Carol

    2015-01-01

    Although sleep is vital to all human functioning and poor sleep is a known problem in cancer, it is unclear whether the overall prevalence of the various types of sleep disorders in cancer is known. The purpose of this systematic literature review was to evaluate if the prevalence of sleep disorders could be ascertained from the current body of literature regarding sleep in cancer. This was a critical and systematic review of peer-reviewed, English-language, original articles published from 1980 through 15 October 2013, identified using electronic search engines, a set of key words, and prespecified inclusion and exclusion criteria. Information from 254 full-text, English-language articles was abstracted onto a paper checklist by one reviewer, with a second reviewer randomly verifying 50% (k = 99%). All abstracted data were entered into an electronic database, verified for accuracy, and analyzed using descriptive statistics and frequencies in SPSS (v.20) (North Castle, NY). Studies of sleep and cancer focus on specific types of symptoms of poor sleep, and there are no published prevalence studies that focus on underlying sleep disorders. Challenging the current paradigm of the way sleep is studied in cancer could produce better clinical screening tools for use in oncology clinics leading to better triaging of patients with sleep complaints to sleep specialists, and overall improvement in sleep quality

  13. Non-invasive ventilation in the treatment of sleep-related breathing disorders: A review and update

    Directory of Open Access Journals (Sweden)

    A. Nicolini

    2014-11-01

    Full Text Available Non-invasive mechanical ventilation (NIV was originally used in patients with acute respiratory compromises or exacerbations of chronic respiratory diseases as an alternative to intubation. Over the last thirty years NIV has been used during the night in patients with stable chronic lung diseases such as obstructive sleep apnea, the overlap syndrome (COPD and obstructive sleep apnea, neuromuscular disorders, obesity-hypoventilation syndrome and in other conditions such as sleep disorders associated with congestive heart failure.In this review we discuss the different types of NIV, the specific conditions in which they can be used as well as the indications, recommendations, and evidence supporting the efficacy of NIV. Resumo: A ventilação mecânica não invasiva (VNI foi originalmente usada em doentes com insuficiência respiratória aguda ou em exacerbações de doença respiratória crónica, como uma alternativa à intubação. Nos últimos trinta anos, a VNI tem sido usada durante a noite, em doentes com doenças pulmonares crónicas estáveis, como a apneia obstrutiva do sono, a síndrome de sobreposição (DPOC - doença pulmonar obstrutiva crónica - e apneia obstrutiva do sono, disfunções neuromusculares, síndrome de hipoventilação e obesidade, e em outras doenças como os distúrbios do sono associados a insuficiência cardíaca congestiva.Nesta análise discutimos os diferentes tipos de VNI, as condições específicas em que cada um deles pode ser usado, assim como as indicações, recomendações e a evidência que comprova a eficácia da VNI. Keywords: Sleep-related respiratory disorders, Non-invasive ventilation, Continuous positive airway pressure, Bi-level positive airway pressure, Palavras-chave: Distúrbios respiratórios do sono, Ventilação não invasiva, Pressão positiva contínua das vias aéreas, Pressão positiva em dois níveis nas vias aéreas

  14. Exploring sleep disorders in patients with chronic kidney disease.

    Science.gov (United States)

    Nigam, Gaurav; Camacho, Macario; Chang, Edward T; Riaz, Muhammad

    2018-01-01

    Kidney disorders have been associated with a variety of sleep-related disorders. Therefore, researchers are placing greater emphasis on finding the role of chronic kidney disease (CKD) in the development of obstructive sleep apnea and restless legs syndrome. Unfortunately, the presence of other sleep-related disorders with CKDs and non-CKDs has not been investigated with the same clinical rigor. Recent studies have revealed that myriad of sleep disorders are associated with CKDs. Furthermore, there are a few non-CKD-related disorders that are associated with sleep disorders. In this narrative review, we provide a balanced view of the spectrum of sleep disorders (as identified in International Classification of Sleep disorders-3) related to different types of renal disorders prominently including but not exclusively limited to CKD.

  15. Sleep, immunity and inflammation in gastrointestinal disorders

    OpenAIRE

    Ali, Tauseef; Choe, James; Awab, Ahmed; Wagener, Theodore L; Orr, William C

    2013-01-01

    Sleep disorders have become a global issue, and discovering their causes and consequences are the focus of many research endeavors. An estimated 70 million Americans suffer from some form of sleep disorder. Certain sleep disorders have been shown to cause neurocognitive impairment such as decreased cognitive ability, slower response times and performance detriments. Recent research suggests that individuals with sleep abnormalities are also at greater risk of serious adverse health, economic ...

  16. SLEEP APNEA IN ENDOCRINE DISORDERS

    Directory of Open Access Journals (Sweden)

    I. V. Misnikova

    2016-01-01

    Full Text Available In the recent years, an association between sleep apnea and a  number of endocrine diseases has been established. The secretion of many hormones after falling asleep is considerably changed, compared to the period of wakefulness. In patients with endocrine disorders, abnormal hormonal secretion and its pathological consequences may contribute to sleep apnea. Sleep fragmentation and intermittent hypoxia arising in sleep apnea result in a decrease in insulin sensitivity, which contributes to the development of type 2 diabetes mellitus. The prevalence of sleep apnea increases in acromegaly, which may affect the risk of cardio-pulmonary complications. There is an association between sleep apnea and testosterone treatment in men, as well as in postmenopausal women. Sleep apnea in hypothyroidism is most frequently related to the development of hypothyroidism per se and can therefore be reversed with thyroid hormone replacement therapy. Timely detection and treatment of sleep apnea in patients with endocrine disorders can improve their survival prognosis and quality of life.

  17. Respiratory difficulties and breathing disorders in achondroplasia.

    Science.gov (United States)

    Afsharpaiman, S; Saburi, A; Waters, Karen A

    2013-12-01

    Respiratory difficulties and breathing disorders in achondroplasia are thought to underlie the increased risk for sudden infant death and neuropsychological deficits seen in this condition. This review evaluates literature regarding respiratory dysfunctions and their sequelae in patients with achondroplasia. The limited number of prospective studies of respiratory disease in achondroplasia means that observational studies and case series provide a large proportion of the data regarding the spectrum of respiratory diseases in achondroplasia and their treatments. Amongst clinical respiratory problems described, snoring is the commonest observed abnormality, but the reported incidence of obstructive sleep apnoea (OSA) shows wide variance (10% to 75%). Reported treatments of OSA include adenotonsillectomy, the use of CPAP, and surgical improvement of the airway, including mid-face advancement. Otolaryngologic manifestations are also common. Respiratory failure due to small thoracic volumes is reported, but uncommon. Mortality rate at all ages was 2.27 (CI: 1.7-3.0) with age-specific mortality increased at all ages. Sudden death was most common in infants and children. Cardiovascular events are the main cause of mortality in adults. Despite earlier recognition and treatment of respiratory complications of achondroplasia, increased mortality rates and other complications remain high. Future and ongoing evaluation of the prevalence and impact of respiratory disorders, particularly OSA, in achondroplasia is recommended. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.

  18. Parkinsonian syndromes presenting with circadian rhythm sleep disorder- advanced sleep-phase type.

    Science.gov (United States)

    Shukla, Garima; Kaul, Bhavna; Gupta, Anupama; Goyal, Vinay; Behari, Madhuri

    2015-01-01

    Circadian rhythm sleep disorder-advanced sleep-phase type is a relatively uncommon disorder, mostly seen among the elderly population. Impaired circadian rhythms have been reported in neurodegenerative conditions; however, there are no reports of any circadian rhythm sleep disorder among patients with Parkinsonian syndromes. We report two patients who presented with this circadian rhythm disorder, and were then diagnosed with a Parkinsonian syndrome. The cases. A 65-year-old retired man presented with history of abrupt change in sleep schedules, sleeping around 6.30-7 p.m. and waking up around 3-4 a.m. for the last 2 months. On detailed examination, the patient was observed to have symmetrical bradykinesia and cogwheel rigidity of limbs. A diagnosis of multiple system atrophy was made, supported by MRI findings and evidence of autonomic dysfunction. Symptoms of change in sleep-wake cycles resolved over the next 1 year, while the patient was treated with dopaminergic therapy. A 47-year-old man, who was being evaluated for presurgical investigation for refractory temporal lobe epilepsy, presented with complaints suggestive of dysarthria, bradykinesia of limbs and frequent falls for 5 months. Simultaneously, he began to sleep around 7 p.m. and wake up at about 2-3 a.m. Examination revealed severe axial rigidity, restricted vertical gaze and bradykinesia of limbs. A diagnosis of progressive supranuclear palsy was made. This is the first report of Parkinson's plus syndromes presenting with a circadian rhythm sleep disorder-advanced sleep-phase type. More prospective assessment for circadian sleep disorders may introduce useful insights into similar associations. Copyright 2015, NMJI.

  19. Sleep, immunity and inflammation in gastrointestinal disorders.

    Science.gov (United States)

    Ali, Tauseef; Choe, James; Awab, Ahmed; Wagener, Theodore L; Orr, William C

    2013-12-28

    Sleep disorders have become a global issue, and discovering their causes and consequences are the focus of many research endeavors. An estimated 70 million Americans suffer from some form of sleep disorder. Certain sleep disorders have been shown to cause neurocognitive impairment such as decreased cognitive ability, slower response times and performance detriments. Recent research suggests that individuals with sleep abnormalities are also at greater risk of serious adverse health, economic consequences, and most importantly increased all-cause mortality. Several research studies support the associations among sleep, immune function and inflammation. Here, we review the current research linking sleep, immune function, and gastrointestinal diseases and discuss the interdependent relationship between sleep and these gastrointestinal disorders. Different physiologic processes including immune system and inflammatory cytokines help regulate the sleep. The inflammatory cytokines such as tumor necrosis factor, interleukin-1 (IL-1), and IL-6 have been shown to be a significant contributor of sleep disturbances. On the other hand, sleep disturbances such as sleep deprivation have been shown to up regulate these inflammatory cytokines. Alterations in these cytokine levels have been demonstrated in certain gastrointestinal diseases such as inflammatory bowel disease, gastro-esophageal reflux, liver disorders and colorectal cancer. In turn, abnormal sleep brought on by these diseases is shown to contribute to the severity of these same gastrointestinal diseases. Knowledge of these relationships will allow gastroenterologists a great opportunity to enhance the care of their patients.

  20. A Medical Cloud-Based Platform for Respiration Rate Measurement and Hierarchical Classification of Breath Disorders

    Directory of Open Access Journals (Sweden)

    Atena Roshan Fekr

    2014-06-01

    Full Text Available The measurement of human respiratory signals is crucial in cyberbiological systems. A disordered breathing pattern can be the first symptom of different physiological, mechanical, or psychological dysfunctions. Therefore, a real-time monitoring of the respiration patterns, as well as respiration rate is a critical need in medical applications. There are several methods for respiration rate measurement. However, despite their accuracy, these methods are expensive and could not be integrated in a body sensor network. In this work, we present a real-time cloud-based platform for both monitoring the respiration rate and breath pattern classification, remotely. The proposed system is designed particularly for patients with breathing problems (e.g., respiratory complications after surgery or sleep disorders. Our system includes calibrated accelerometer sensor, Bluetooth Low Energy (BLE and cloud-computing model. We also suggest a procedure to improve the accuracy of respiration rate for patients at rest positions. The overall error in the respiration rate calculation is obtained 0.53% considering SPR-BTA spirometer as the reference. Five types of respiration disorders, Bradapnea, Tachypnea, Cheyn-stokes, Kaussmal, and Biot’s breathing are classified based on hierarchical Support Vector Machine (SVM with seven different features. We have evaluated the performance of the proposed classification while it is individualized to every subject (case 1 as well as considering all subjects (case 2. Since the selection of kernel function is a key factor to decide SVM’s performance, in this paper three different kernel functions are evaluated. The experiments are conducted with 11 subjects and the average accuracy of 94.52% for case 1 and the accuracy of 81.29% for case 2 are achieved based on Radial Basis Function (RBF. Finally, a performance evaluation has been done for normal and impaired subjects considering sensitivity, specificity and G-mean parameters

  1. Genotyping Sleep Disorders Patients

    OpenAIRE

    Kripke, Daniel F.; Shadan, Farhad F.; Dawson, Arthur; Cronin, John W.; Jamil, Shazia M.; Grizas, Alexandra P.; Koziol, James A.; Kline, Lawrence E.

    2010-01-01

    Objective The genetic susceptibility factors underlying sleep disorders might help us predict prognoses and responses to treatment. Several candidate polymorphisms for sleep disorders have been proposed, but there has as yet inadequate replication or validation that the candidates may be useful in the clinical setting. Methods To assess the validity of several candidate associations, we obtained saliva deoxyribonucleic acid (DNA) samples and clinical information from 360 consenting research p...

  2. Children's sleep disturbance scale in differentiating neurological disorders.

    Science.gov (United States)

    Cohen, Rony; Halevy, Ayelet; Shuper, Avinoam

    2013-12-01

    We use the Sleep Disturbance Scale for Children (SDSC) routinely as a tool for evaluating children's sleep quality in our pediatric neurology clinic. We analyzed at its ability to detect sleep disturbances distinctive to selected neurological disorders. One-hundred and eighty-six children (age range 2-18 years) who were evaluated by the SDSC questionnaire were divided into three groups according to their principal diagnosis: epilepsy, attention deficit hyperactivity disorder, or others. Their responses were analyzed. The average frequency of abnormal total sleep score was 26.9%. The most frequent sleep disorders were excessive somnolence (25.3%), initiating and maintaining sleep (24.7%), and arousal/nightmares (23.1%). There were no significant group differences for total scores or sleep disorder-specific scores; although a sleep-wake transition disorder was more frequent among children with epilepsy (31%). A literature search revealed that the frequency of abnormal total scores in several neurological disorders (e.g., epilepsy, cerebral palsy) ranges between 20% and 30%. The mechanism underlying sleep disturbances in many neurological disorders may be unrelated to that of the primary disease but rather originate from nonspecific or environmental factors (e.g., familial/social customs and habits, temperament, psychological parameters). Although the SDSC is noninformative for studying the effect of a specific neurological disorder on sleep, we still recommend its implementation for screening for sleep disturbances in children with neurological abnormalities. Copyright © 2013 Elsevier Inc. All rights reserved.

  3. FMWC Radar for Breath Detection

    DEFF Research Database (Denmark)

    Suhr, Lau Frejstrup; Tafur Monroy, Idelfonso; Vegas Olmos, Juan José

    We report on the experimental demonstration of an FMCW radar operating in the 25.7 - 26.6 GHz range with a repetition rate of 500 sweeps per second. The radar is able to track the breathing rate of an adult human from a distance of 1 meter. The experiments have utilized a 50 second recording window...... to accurately track the breathing rate. The radar utilizes a saw tooth modulation format and a low latency receiver. A breath tracking radar is useful both in medical scenarios, diagnosing disorders such as sleep apnea, and for home use where the user can monitor its health. Breathing is a central part of every...... radar chip which, through the use of a simple modulation scheme, is able to measure the breathing rate of an adult human from a distance. A high frequency output makes sure that the radar cannot penetrate solid obstacles which is a wanted feature in private homes where people therefore cannot measure...

  4. A Surgical Treatment of Obstructive Sleep Apnoea (OSA)

    African Journals Online (AJOL)

    Snoring is now seen as one end of sleep-related breathing disorder resulting ultimately in obstructive sleep apnea. Uvulopalatopharyngoplasty (UPPP) is the first surgical procedure specifically designed to alleviate the abnormalities, although the use of laser appears to be the new trend. We present a case of Obstructive ...

  5. Critérios diagnósticos e tratamento dos distúrbios respiratórios do sono: RERA Diagnostic criteria and treatment for sleep-disordered breathing: RERA

    Directory of Open Access Journals (Sweden)

    Luciana de Oliveira Palombini

    2010-06-01

    Full Text Available Na polissonografia, RERA é definido como um parâmetro respiratório que indica um despertar associado a um evento respiratório e um aumento do esforço respiratório. Inicialmente, RERA foi descrito com o uso da manometria esofágica utilizada para avaliação do esforço respiratório. Esse maior esforço respiratório ocorre como resposta a um aumento da resistência da via aérea superior, aspecto presente na fisiopatologia dos distúrbios respiratórios do sono, entre esses, SAOS e SRVAS. Posteriormente, o uso de cânula de pressão nasal foi relatado como uma maneira confiável e mais sensível que o termistor para a identificação de eventos de redução do fluxo aéreo e também como um substituto da manometria esofágica para a identificação de períodos de aumento da resistência na via aérea superior. Consequentemente, a American Academy of Sleep Medicine recomenda o uso de um dos métodos para a identificação de RERA, que é definido por um padrão de achatamento da curva inspiratória, característico da limitação ao fluxo aéreo. Embora RERA seja identificado e avaliado na pratica médica, sua padronização ainda é necessária. Portanto, recomenda-se que os laudos de polissonografia indiquem quais eventos respiratórios anormais foram considerados na avaliação do grau de gravidade do distúrbio respiratório.In polysomnography, RERA is defined as a respiratory parameter that indicates an arousal associated with a respiratory event and an increase in respiratory effort. Initially, RERA was described by means of esophageal manometry for the evaluation of respiratory effort. This greater respiratory effort occurs as a response to an increase in upper airway resistance, which is a factor present in the pathophysiology of sleep-disordered breathing, such as obstructive sleep apnea syndrome and upper airway resistance syndrome. Later, the use of a nasal pressure cannula was reported to be a reliable means of identifying

  6. Sleep-dependent memory consolidation in patients with sleep disorders.

    Science.gov (United States)

    Cipolli, Carlo; Mazzetti, Michela; Plazzi, Giuseppe

    2013-04-01

    Sleep can improve the off-line memory consolidation of new items of declarative and non-declarative information in healthy subjects, whereas acute sleep loss, as well as sleep restriction and fragmentation, impair consolidation. This suggests that, by modifying the amount and/or architecture of sleep, chronic sleep disorders may also lead to a lower gain in off-line consolidation, which in turn may be responsible for the varying levels of impaired performance at memory tasks usually observed in sleep-disordered patients. The experimental studies conducted to date have shown specific impairments of sleep-dependent consolidation overall for verbal and visual declarative information in patients with primary insomnia, for verbal declarative information in patients with obstructive sleep apnoeas, and for visual procedural skills in patients with narcolepsy-cataplexy. These findings corroborate the hypothesis that impaired consolidation is a consequence of the chronically altered organization of sleep. Moreover, they raise several novel questions as to: a) the reversibility of consolidation impairment in the case of effective treatment, b) the possible negative influence of altered prior sleep also on the encoding of new information, and c) the relationships between altered sleep and memory impairment in patients with other (medical, psychiatric or neurological) diseases associated with quantitative and/or qualitative changes of sleep architecture. Copyright © 2012 Elsevier Ltd. All rights reserved.

  7. Sleep Disorders (PDQ®)—Health Professional Version

    Science.gov (United States)

    Sleep disorders (e.g., insomnias, sleep apnea, hypersomnias, parasomnias, and problems with circadian rhythm) are common in people with cancer. Get detailed information about the causes and management of the major sleep disorders in this summary for clinicians.

  8. Instrumentation for the analysis of respiratory system disorders during sleep: Design and application

    Science.gov (United States)

    de Melo, Pedro Lopes; de Andrade Lemes, Lucas Neves

    2002-11-01

    Sleep breathing disorders are estimated to be present in 2%-4% of middle-aged adults. Serious adverse consequences, such as systemic arterial hypertension, myocardial infraction, and cerebrovascular disease, can be related to these conditions. Intellectual deficits associated with attention, memory, and problem-solving have also been associated with a poor quality of sleep. The main causes of these disorders are obstructions resulting from repetitive narrowing and closure of the pharyngeal airway, which have been monitored by indirect measurements of temperature, displacement, and other highly invasive procedures. The measurement of mechanical impedance of the respiratory system by the forced oscillation technique (FOT) has recently been suggested to quantify the respiratory obstruction during sleep. It is claimed that the noninvasive and dynamic characteristics of this technique would allow a noninvasive and accurate analysis of these events. In spite of this high scientific and clinical potential, there is no detailed description of a complete instrumentation system to implement this promising technique in sleep studies. In this context, the purpose of this study was twofold: (1) describe the development of a new computer-based system for identification of the mechanical impedance of the respiratory system during sleep by the FOT and (2) evaluate the performance of this device in the description of respiratory events in conditions including no, mild, serious disease, and therapeutic procedures. These evaluations confirmed the desirable features achieved in laboratory tests and the high scientific and clinical potential of this system.

  9. Evaluating Sleep Disorders amongst Children with Attention Deficit/ Hyperactivity Disorder (ADHD)

    OpenAIRE

    Khalil Esmaeilpour; Leila Mehdizadeh Fanid; Azam Hosein nejad

    2017-01-01

    Background: The attention deficit/ hyperactivity disorder (ADHD) is one of the most compromising mental disorders of childhood and adolescence. Subsequently, different studies in recent years were conducted on the relationship between sleep disturbances and ADHD in children. About 30% of children and 60% to 80% of adults with ADHD develop sleep disorders, which may result in cognitive and behavioral changes in the patients. The current study aimed at comparing sleep disorders in children with...

  10. Who are Sleeping in Sleep Laboratory? A Retrospective Study

    Directory of Open Access Journals (Sweden)

    Mine Ayşe Altun Emirza

    2012-03-01

    Full Text Available OBJECTIVE: Aim of this study is to compare the results of gold standard in diagnosing sleep disorders polysomnography (PSG with the physician’s preliminary diagnosis and complaints of patients in our data of sleep laboratory. METHODS: 656 patients who made PSG were included in the study. All of the patients age, gender, comorbid chronic disease, complaints, preliminary diagnosis and PSG diagnosis were evaluated retrospectively. RESULTS: In our study, the average age of patients was 56 and 43% women 57% were male. Complaints of patients were snoring, fatigue, stopped breath during sleep, insomnia, headache, daytime sleepiness, restless legs and abnormal behaviors during sleep. According to preliminary diagnoses and PSG diagnoses; Obstructive Sleep Apnea Syndrome (OSAS, narcolepsy, REM behavior disorder (RBD reduced (p 0.05. Sleep disorders in patients was accompanied by chronic diseases, hypertension (34.3%, diabetes (12.8%, Chronic Obstructive Pulmonary Disease (COPD (1.2%, epilepsy (1.8%, Parkinson's disease (3.5%, dementia (3.2%, depression (18.4%, cardiovascular disease (13.3% and cerebrovascular disease (4.9%. 9%. CONCLUSION: We are offering a good clinical history and physical examination with the correct interpretation of PSG for the differential diagnosis can be made true, accurate diagnoses and appropriate treatment modalities in our patients

  11. Circadian Rhythms, Sleep, and Disorders of Aging.

    Science.gov (United States)

    Mattis, Joanna; Sehgal, Amita

    2016-04-01

    Sleep-wake cycles are known to be disrupted in people with neurodegenerative disorders. These findings are now supported by data from animal models for some of these disorders, raising the question of whether the disrupted sleep/circadian regulation contributes to the loss of neural function. As circadian rhythms and sleep consolidation also break down with normal aging, changes in these may be part of what makes aging a risk factor for disorders like Alzheimer's disease (AD). Mechanisms underlying the connection between circadian/sleep dysregulation and neurodegeneration remain unclear, but several recent studies provide interesting possibilities. While mechanistic analysis is under way, it is worth considering treatment of circadian/sleep disruption as a means to alleviate symptoms of neurodegenerative disorders. Copyright © 2016 Elsevier Ltd. All rights reserved.

  12. Management of sleep disorders in neurodevelopmental disorders and genetic syndromes.

    Science.gov (United States)

    Heussler, Helen S

    2016-03-01

    Sleep disorders in individuals with developmental difficulties continue to be a significant challenge for families, carers, and therapists with a major impact on individuals and carers alike. This review is designed to update the reader on recent developments in this area. A systematic search identified a variety of studies illustrating advances in the regulation of circadian rhythm and sleep disturbance in neurodevelopmental disorders. Specific advances are likely to lead in some disorders to targeted therapies. There is strong evidence that behavioural and sleep hygiene measures should be first line therapy; however, studies are still limited in this area. Nonpharmacological measures such as exercise, sensory interventions, and behavioural are reported. Behavioural regulation and sleep hygiene demonstrate the best evidence for improved sleep parameters in individuals with neurodisability. Although the mainstay of management of children with sleep problems and neurodevelopmental disability is similar to that of typically developing children, there is emerging evidence of behavioural strategies being successful in large-scale trials and the promise of more targeted therapies for more specific resistant disorders.

  13. Association between sleep disorders, obesity, and exercise: a review

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    Hargens TA

    2013-03-01

    Full Text Available Trent A Hargens,1 Anthony S Kaleth,2 Elizabeth S Edwards,1 Katrina L Butner31Department of Kinesiology, James Madison University, Harrisonburg, VA, USA; 2Department of Kinesiology, Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA; 3Laboratory for Health and Exercise Science, Department of Human Nutrition, Food and Exercise, Virginia Tech, Blacksburg, VA, USAAbstract: Decreased sleep duration and quality is associated with an increase in body weight and adiposity. Insomnia, obstructive sleep apnea, and restless legs syndrome are three of the most prevalent types of sleep disorder that lead to an increased risk for numerous chronic health conditions. Various studies have examined the impact of these sleep disorders on obesity, and are an important link in understanding the relationship between sleep disorders and chronic disease. Physical activity and exercise are important prognostic tools in obesity and chronic disease, and numerous studies have explored the relationship between obesity, sleep disorders, and exercise. As such, this review will examine the relationship between sleep disorders and obesity. In addition, how sleep disorders may impact the exercise response and how exercise may impact patient outcomes with regard to sleep disorders will also be reviewed.Keywords: obesity, sleep disorders, obstructive sleep apnea, insomnia

  14. Sleep apnea diagnosis varies with the hypopnea criteria applied

    DEFF Research Database (Denmark)

    Ponsaing, Laura B; Iversen, Helle K; Jennum, Poul

    2016-01-01

    PURPOSE: We aimed to evaluate the three hypopnea criteria, A and B from 2007 and the revised from 2012, proposed by the American Academy of Sleep Medicine (AASM) for scoring sleep-related breathing disorders (SRBDs) in patients with acute stroke or transient ischemic attack (TIA). METHODS...

  15. Suicidality in sleep disorders: prevalence, impact, and management strategies

    Directory of Open Access Journals (Sweden)

    Drapeau CW

    2017-09-01

    Full Text Available Christopher W Drapeau, Michael R Nadorff Department of Psychology, Mississippi State University, Mississippi State, MS, USA Abstract: Sleep disturbances are associated with suicide-related thoughts and behaviors, and the incidence of sleep concerns and suicide has increased recently in the US. Most published research exploring the sleep–suicidality relation is focused on select sleep disorders, with few reviews offering a comprehensive overview of the sleep–suicidality literature. This narrative review broadly investigates the growing research literature on sleep disorders and suicidality, noting the prevalence of suicide ideation and nonfatal and fatal suicide attempts, the impact of several sleep disorders on suicide risk, and potential sleep-disorder management strategies for mitigating suicide risk. Aside from insomnia symptoms and nightmares, there exist opportunities to learn more about suicide risk across many sleep conditions, including whether sleep disorders are associated with suicide risk independently of other psychiatric conditions or symptoms. Generally, there is a lack of randomized controlled trials examining the modification of suicide risk via evidence-based sleep interventions for individuals with sleep disorders. Keywords: sleep, suicide, suicidality, insomnia, nightmares, treatment

  16. Pediatric Obstructive Sleep Apnea and the critical role of oral-facial growth: evidences

    Directory of Open Access Journals (Sweden)

    Christian eGuilleminault

    2013-01-01

    Full Text Available Aims: Review of evidence in support of an oral-facial growth impairment in the development of pediatric sleep apnea in non-obese childrenMethod: Review of experimental data from infant monkeys with experimentally induced nasal resistance. Review of early historical data in the orthodontic literature indicating the abnormal oral-facial development associated with mouth breathing and nasal resistance. Review of the progressive demonstration of sleep disordered breathing in children who underwent incomplete treatment of OSA with adenotonsillectomy, and demonstration of abnormal oral-facial anatomy that must often to be treated in order for the resolution of OSA. Review of long term recurrence data on OSA and indication of oral-facial myofunctional dysfunction in association with the recurrence of OSA. Results: Presentation of prospective data on premature infants and sleep-disordered-breathing (SDB-treated children, supporting the concept of oral-facial hypotonia. Presentation of evidence supporting hypotonia as a primary element in the development of oral-facial anatomic abnormalities leading to abnormal breathing during sleep. Continuous interaction between oral facial muscle tone, maxillary-mandibular growth and development of SDB. Role of myofunctional re-education with orthodontics and elimination of upper airway soft tissue in the treatment of non-obese SDB children. Conclusion: Pediatric OSA in non-obese children is a disorder of oral facial growth.

  17. Armodafinil in the treatment of sleep/wake disorders

    Directory of Open Access Journals (Sweden)

    Jonathan RL Schwartz

    2010-07-01

    Full Text Available Jonathan RL Schwartz1,Thomas Roth2, Chris Drake21INTEGRIS Sleep Disorders Center and University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA; 2Sleep Disorders and Research Center, Henry Ford Hospital, Detroit, MI, USAAbstract: Excessive sleepiness (ES is a major but underestimated public health concern associated with significant impairments in alertness/wakefulness and significant morbidity. The term ES has been used in the sleep medicine literature for years, but due to its nonspecific symptoms (ie tiredness or fatigue, it frequently goes unrecognized or is misdiagnosed in primary care. In some cases ES arises due to poor sleep habits or self-imposed sleep deprivation; however, ES is also a key component of a number of sleep/wake disorders and multiple medical and psychiatric disorders. Identification and treatment of ES is critical to improve the quality of life and well-being of patients and for the safety of the wider community. The inability of patients to recognize the nature, extent, and symptomatic profile of sleep/wake disorders requires vigilance on the part of healthcare professionals. Interventions to address ES and its associated impairments, treatment of the underlying sleep/wake disorder, and follow-up are a priority given the potential for serious consequences if left untreated. Wakefulness-promoting agents are available that treat ES associated with sleep/wake disorders. This review examines current approaches for managing this debilitating and potentially life-threatening condition, focusing on the place of armodafinil as a wakefulness-promoting agent.Keywords: excessive sleepiness, wakefulness, armodafinil, obstructive sleep apnea, narcolepsy, shift-work disorder

  18. Evaluating Sleep Disorders amongst Children with Attention Deficit/ Hyperactivity Disorder (ADHD

    Directory of Open Access Journals (Sweden)

    Khalil Esmaeilpour

    2017-10-01

    Full Text Available Background: The attention deficit/ hyperactivity disorder (ADHD is one of the most compromising mental disorders of childhood and adolescence. Subsequently, different studies in recent years were conducted on the relationship between sleep disturbances and ADHD in children. About 30% of children and 60% to 80% of adults with ADHD develop sleep disorders, which may result in cognitive and behavioral changes in the patients. The current study aimed at comparing sleep disorders in children with ADHD and their normal peers in Tabriz, Iran. Materials and Methods: The current case-control study was conducted on the target population of children within the age range of 6 to 12 years, which included 50 children with ADHD receiving medication, 55 children with ADHD symptoms without receiving any medication, and 71 normal children, all of which screened from the school students of Tabriz using the child symptom inventory-4 (CSI-4 and selected by the multi-stage cluster sampling method. The children's sleep habits questionnaire (CSHQ was completed by their mothers and data were analyzed using the multivariate analysis of variance (MANOVA. Results: According to the results of the current study, a significant number of children with ADHD showed sleep disorder that can accounts for some degree of their behavioral dysregulation. There was a significant difference among the study groups regarding the subscales of sleep resistance and sleep duration, daytime sleep, parasomnia,  and sleep apnea (p 0.05. Conclusion: Since children with ADHD usually have more sleep problems, considering the sleep quality in such children is of great importance; in the treatment of such children their sleep problems should be considered particularly.

  19. Assessing the severity of sleep apnea syndrome based on ballistocardiogram.

    Directory of Open Access Journals (Sweden)

    Zhu Wang

    Full Text Available Sleep Apnea Syndrome (SAS is a common sleep-related breathing disorder, which affects about 4-7% males and 2-4% females all around the world. Different approaches have been adopted to diagnose SAS and measure its severity, including the gold standard Polysomnography (PSG in sleep study field as well as several alternative techniques such as single-channel ECG, pulse oximeter and so on. However, many shortcomings still limit their generalization in home environment. In this study, we aim to propose an efficient approach to automatically assess the severity of sleep apnea syndrome based on the ballistocardiogram (BCG signal, which is non-intrusive and suitable for in home environment.We develop an unobtrusive sleep monitoring system to capture the BCG signals, based on which we put forward a three-stage sleep apnea syndrome severity assessment framework, i.e., data preprocessing, sleep-related breathing events (SBEs detection, and sleep apnea syndrome severity evaluation. First, in the data preprocessing stage, to overcome the limits of BCG signals (e.g., low precision and reliability, we utilize wavelet decomposition to obtain the outline information of heartbeats, and apply a RR correction algorithm to handle missing or spurious RR intervals. Afterwards, in the event detection stage, we propose an automatic sleep-related breathing event detection algorithm named Physio_ICSS based on the iterative cumulative sums of squares (i.e., the ICSS algorithm, which is originally used to detect structural breakpoints in a time series. In particular, to efficiently detect sleep-related breathing events in the obtained time series of RR intervals, the proposed algorithm not only explores the practical factors of sleep-related breathing events (e.g., the limit of lasting duration and possible occurrence sleep stages but also overcomes the event segmentation issue (e.g., equal-length segmentation method might divide one sleep-related breathing event into

  20. Pre-Sleep Arousal and Sleep Problems of Anxiety-Disordered Youth

    Science.gov (United States)

    Alfano, Candice A.; Pina, Armando A.; Zerr, Argero A.; Villalta, Ian K.

    2010-01-01

    The current study examined sleep problems and pre-sleep arousal among 52 anxious children and adolescents, aged 7-14 years, in relation to age, sex, ethnicity, and primary anxiety disorder. Assessment included structured diagnostic interviews and parent and child completed measures of sleep problems and pre-sleep arousal. Overall, 85% of parents…

  1. Sleep quality and functional gastrointestinal disorders. A psychological issue.

    Science.gov (United States)

    Bouchoucha, Michel; Mary, Florence; Bon, Cyriaque; Bejou, Bakhtiar; Airinei, Gheorghe; Benamouzig, Robert

    2018-02-01

    Sleep disorders are often associated with functional gastrointestinal disorders (FGIDs). This study aims to evaluate the association of sleep disorders with specific FGIDs and to assess the related importance of psychological disorders. We included 1009 consecutive patients with FGIDs (70.9% females). The patients completed a Rome III questionnaire and after a psychological evaluation on anxiety and depression they were classified according to their sleep disorders using a 7-point grading scale: Groups 1-3, drowsiness (severe, moderate, mild); Group 4, no change; Groups 5-7, insomnia (mild, moderate, severe). Multinomial logistic regression using sleep group as a dependent variable with no sleep change as reference and body mass index, FGIDs, anxiety and depression as independent variables were used for statistical analysis. Altogether 667 (66.1%) patients reported changes in sleep disorders, of whom 487 (48.3%) had decreased sleep and 180 (17.8%) had increased sleep while 342 (33.9%) reported no change. Depression was lower in patients with no change in sleep pattern and increased with the severity of their sleep disorder (P proctalgia fugax. Sleep disorders are associated with FGIDs, especially in the presence of depressive symptoms. © 2018 Chinese Medical Association Shanghai Branch, Chinese Society of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.

  2. Instruments to study sleep disorders in climacteric women

    Directory of Open Access Journals (Sweden)

    Álvaro Monterrosa-Castro

    2016-07-01

    Full Text Available To identify the scales to assess sleep disorders applied to women with climacteric stage. Bibliographical research without intervention, the available information in scientific databases. Performed in PubMed, ScienceDirect, Scopus, Ebscohos OvidSP and Health Library. The words used in this article: insomnia, adjustment sleep disorder, questionnaires, studies and menopause. Publications of all types were included. Seven scales were identified: Insomnia Severity Index, Athens Insomnia Scale, Pittsburgh Quality of sleep Index, Epworth Sleepiness Scale, Jenkins Sleep Scale, Basic Nordic Sleep Questionnaire and The St Mary's Hospital Sleep Questionnaire. There are validated scales in multiple languages and considered appropriate for studying sleep disorders.

  3. Qualidade de vida em crianças com distúrbios respiratórios do sono Quality of life in children with sleep-disordered breathing

    Directory of Open Access Journals (Sweden)

    Amaury de Machado Gomes

    2012-10-01

    Full Text Available Crianças podem apresentar distúrbios respiratórios do sono (DRS com repercussões na qualidade de vida. OBJETIVO: Avaliar a qualidade de vida de crianças com DRS, comparar crianças com Síndrome da Apneia Obstrutiva do Sono (SAOS e Ronco Primário (RP e identificar quais os domínios do OSA-18 estão mais comprometidos. MÉTODOS: Estudo de coorte histórica com corte transversal em crianças com história de ronco e hiperplasia adenotonsilar. Para avaliar qualidade de vida foi aplicado o questionário OSA-18 aos cuidadores e realizado polissonografia para diagnóstico. RESULTADOS: Participaram 59 crianças com média de idade de 6,7 ± 2,26 anos. O escore médio do OSA-18 foi 77,9 ± 13,22 e os domínios mais afetados foram: "preocupação dos responsáveis" (21,8 ± 4,25, "perturbação do sono" (18,8 ± 5,19, "sofrimento físico" (17,3 ± 5,0. O impacto foi pequeno em seis crianças (10,2%, moderado em 33 (55,9% e grande em 20 (33,9%. RP foi encontrado em 44 crianças (74,6%, SAOS em 15 (25,6%. SAOS tem escore maior no domínio "sofrimento físico" que RP (p = 0,04. CONCLUSÃO: Distúrbios respiratórios do sono na infância causam comprometimento na qualidade de vida e os domínios mais comprometidos do OSA-18 foram: "preocupação dos responsáveis", "perturbação do sono" e "sofrimento físico". SAOS tem o domínio "sofrimento físico" mais afetado que roncadores primários.Children may present sleep-disordered breathing (SDB and suffer with adverse effects upon their quality of life. OBJECTIVE: This study assessed the quality of life of children with SDB, compared subjects with obstructive sleep apnea syndrome (OSAS and primary snoring (PS, and identified which areas in the OSA-18 questionnaire are more affected. METHODS: This is a historical cohort cross-sectional study carried out on a consecutive sample of children with history of snoring and adenotonsillar hyperplasia. The subject's quality of life was assessed based on the

  4. [Sleep disorders and epilepsy].

    Science.gov (United States)

    Aoki, Ryo; Ito, Hiroshi

    2014-05-01

    It has been reported that patients with epilepsy often have insomnia and/or daytime sleepiness; the symptomatologic features differ in seizure types. Not only the administration of anti-epileptics, but also inappropriate sleep hygiene cause daytime sleepiness. In subjective assessment of sleepiness, we need to pay attention if it can correctly assess or not. The prevalence of obstructive sleep apnea in patients with epilepsy is approximately 10-30%. Sleep apnea deteriorates the seizure control because of worsen sleep condition by sleep apnea, especially in elderly patients. Some researchers report that continuous positive airway pressure was effective for seizure control. Patients with epilepsy occasionally have REM sleep behavior disorder as comorbidity. Examination using polysomnography is required for differential diagnosis.

  5. CIRCADIAN SLEEP DISORDERS IN SCHOOLCHILDREN OF COUNTRYSIDE SIBERIA

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    K. A. Gazenkampf

    2017-01-01

    Full Text Available Background. Sleep is an important part of a healthy lifestyle, affecting all aspects of human life. Formation of the sleep–wake regime is associated with other physiological processes in the human body. Sleep disorders can lead to the development of various physical and psychological disorders. In schoolchildren and students sleep disorders can lead to memory loss, increase in anxiety and fatigue. Taken together, these factors can lead to lower performance. A variety of internal and external factors can lead to disruption of sleep: stress, much physical and emotional strain, artificial light in the streets, excessive activity of a person during the night (night work, homework etc.. Schoolchildren, living in rural areas, also suffer from sleep disorders. Most of the schoolchildren of countryside are not satisfied with the quality of nocturnal sleep, sleep at least 8 hours a day and notice daytime sleepiness.Objective: to estimate derangements of circadian rhythms of a sleep at schoolchildren of the senior classes, living in countryside.Materials and methods. 67 questionnaires of schoolchildren of the 10th grades of schools of the Abansky District of the Krasnoyarsk Region were analyzed. To estimate the daytime sleepiness, duration and quality of sleep there were used the Child Sleep Questionnaire and the Epworth Sleepiness Scale.Results. A derangements of nocturnal sleep were registered in 52 % of schoolchildren of the 10th grades.Conclusion. Identified sleep disorders in schoolchildren can cause serious damage to their health and cause the development of a serious disorders in the future. 

  6. [Sleep apnea and heart failure: pathophysiology, diagnosis and therapy].

    Science.gov (United States)

    Monda, Cinzia; Scala, Oriana; Paolillo, Stefania; Savarese, Gianluigi; Cecere, Milena; D'Amore, Carmen; Parente, Antonio; Musella, Francesca; Mosca, Susanna; Filardi, Pasquale Perrone

    2010-11-01

    Sleep apnea, defined as a pathologic pause in breathing during sleep >10 s, promotes the progression of chronic heart failure and may be a predictor of poor prognosis. It causes, in fact, several mechanical, hemodynamic, chemical and inflammatory changes that negatively compromise cardiovascular homeostasis of heart failure patients. Sleep apnea is recognized as sleep apnea syndrome when specific symptoms, such as sleepiness and headache during the daytime and snoring, are present and is diagnosed with an overnight test called polysomnography. There are two different forms of sleep apnea, central and obstructive. Breathing is interrupted by the loss of respiratory drive and the lack of respiratory effort in the central form, which affects about 40-60% of heart failure patients. In obstructive sleep apnea, breathing stops when throat muscles relax, despite respiratory effort. This form affects about 3% of the general population, while it is present in at least 30% of heart failure patients. The diagnosis of sleep disorders in heart failure becomes very important to help patients adopting lifestyle changes and starting specific therapies to improve quality of life and retard the progression of chronic heart failure.

  7. Association among depressive disorder, adjustment disorder, sleep disturbance, and suicidal ideation in Taiwanese adolescent.

    Science.gov (United States)

    Chung, Ming-Shun; Chiu, Hsien-Jane; Sun, Wen-Jung; Lin, Chieh-Nan; Kuo, Chien-Cheng; Huang, Wei-Che; Chen, Ying-Sheue; Cheng, Hui-Ping; Chou, Pesus

    2014-09-01

    The aim of this study is to investigate the association among depressive disorder, adjustment disorder, sleep disturbance, and suicidal ideation in Taiwanese adolescent. We recruited 607 students (grades 5-9) to fill out the investigation of basic data and sleep disturbance. Psychiatrists then used the Mini International Neuropsychiatric Interview-Kid to interview these students to assess their suicidal ideation and psychiatric diagnosis. Multiple logistic regression with forward conditionals was used to find the risk factors for multivariate analysis. Female, age, depressive disorder, adjustment disorder, and poor sleep all contributed to adolescent suicidal ideation in univariate analysis. However, poor sleep became non-significant under the control of depressive disorder and adjustment disorder. We found that both depressive disorder and adjustment disorder play important roles in sleep and adolescent suicidal ideation. After controlling both depressive disorder and adjustment disorder, sleep disturbance was no longer a risk of adolescent suicidal ideation. We also confirm the indirect influence of sleep on suicidal ideation in adolescent. © 2013 Wiley Publishing Asia Pty Ltd.

  8. Rapid eye movement sleep behavior disorder

    DEFF Research Database (Denmark)

    Schenck, C H; Montplaisir, J Y; Frauscher, B

    2013-01-01

    We aimed to provide a consensus statement by the International Rapid Eye Movement Sleep Behavior Disorder Study Group (IRBD-SG) on devising controlled active treatment studies in rapid eye movement sleep behavior disorder (RBD) and devising studies of neuroprotection against Parkinson disease (PD...

  9. Epilepsy and Sleep Disorders: a Clinical Review | Sunmonu ...

    African Journals Online (AJOL)

    Patients with epilepsy (PWE) are at risk of developing sleep disorders and there is a complex inter-relationship between sleep disorders and epilepsy. Sleep disorders could be misdiagnosed as epilepsy and also worsen epilepsy. We searched Medline and Pubmed between 1962-2012, using the following search terms ...

  10. [Sleep disorders among physicians on shift work].

    Science.gov (United States)

    Schlafer, O; Wenzel, V; Högl, B

    2014-11-01

    Sleep disorders in physicians who perform shift work can result in increased risks of health problems that negatively impact performance and patient safety. Even those who cope well with shift work are likely to suffer from sleep disorders. The aim of this manuscript is to discuss possible causes, contributing factors and consequences of sleep disorders in physicians and to identify measures that can improve adaptation to shift work and treatment strategies for shift work-associated sleep disorders. The risk factors that influence the development of sleep disorders in physicians are numerous and include genetic factors (15 % of the population), age (> 50 years), undiagnosed sleep apnea,, alcohol abuse as well as multiple stress factors inherent in clinical duties (including shift work), research, teaching and family obligations. Several studies have reported an increased risk for medical errors in sleep-deprived physicians. Shift workers have an increased risk for psychiatric and cardiovascular diseases and shift work may also be a contributing factor to cancer. A relationship has been reported not only with sleep deprivation and changes in food intake but also with diabetes mellitus, obesity, hypertension and coronary heart disease. Nicotine and alcohol consumption are more frequent among shift workers. Increased sickness and accident rates among physicians when commuting (especially after night shifts) have a socioeconomic impact. In order to reduce fatigue and to improve performance, short naps during shiftwork or naps plus caffeine, have been proposed as coping strategies; however, napping during adverse circadian phases is less effective, if not impossible when unable to fall asleep. Bright and blue light supports alertness during a night shift. After shiftwork, direct sunlight exposure to the retina can be avoided by using dark sunglasses or glasses with orange lenses for commuting home. The home environment for daytime sleeping after a night shift should be

  11. Does night-shift work induce apnea events in obstructive sleep apnea patients?

    Science.gov (United States)

    Laudencka, A; Klawe, J J; Tafil-Klawe, M; Złomańczuk, P

    2007-11-01

    The aim of the present study was to determine the direct effect of night-work on the occurrence of obstructive apneas during sleep after a night shift in fast-rotating shift workers with sleep-related breathing disorders. Eight obstructive sleep apnea patients were examined with the use of a polysomnograph during sleep under two conditions: after day-shift work and after night-shift work. Both sleep studies were conducted within 2 to 3 weeks of each other. In four of the 8 subjects, during sleep after a night-shift, an increase in apnea/hypopnea index was found. Night work significantly increased several breathing variables: total duration of obstructive apneas during REM sleep, mean duration of obstructive apneas during arousal, and apnea index during arousal. We conclude that in a subpopulation of sleep apnea patients, acute sleep deprivation may worsen obstructive sleep apnea index.

  12. [Sleep disorders in epilepsy].

    Science.gov (United States)

    Kotova, O V; Akarachkova, E S

    2014-01-01

    The review of the literature on sleep disorders in epilepsy over the last two decades is presented. Paroxysmal phenomena of epileptic origin, nonepileptic paroxysms, antiepileptic drugs, polypragmasia and comorbid depression may affect sleep in epilepsy.Shortening of sleep time may cause seizures, hallucinations and depression because sleep plays an important role in the regulation of excitatory and inhibitory processes in the brain both in healthy people and in patients with epilepsy. According to the literature data, drugs (short treatment courses of hypnotics) or nonpharmacological methods should be used for treatment insomnia inpatients with epilepsy.

  13. Comparing sleep disorders in urban and suburban adolescents

    Directory of Open Access Journals (Sweden)

    Nur'aini Nur'aini

    2014-10-01

    Full Text Available Background Sleep disturbances commonly occur in adolescents. Socioeconomic levels, lifestyle, and urban or suburban environments influence the sleep patterns of adolescents. The modernization process in urban environments is marked by the development of information technology media, and the lack of parental monitoring potentially influencing adolescent sleep disturbances. Sleep disturbances may affect children's physical growth, as well as their emotional, cognitive, and social development. Objective To assess for sleep disorders in urban and suburban adolescents, and to determine the factors that influence the prevalence of sleep disturbances. Methods A cross-sectional study was conducted on 12 to 15-year-old junior high school students in urban (n=350 and suburban (n=350 environments in the city of Medan, North Sumatera. The study was undertaken from May to June 2010 using the Sleep Disorders Scale for Children (SDSC, a set of questionnaires. The SDSC was filled out by parents based on what they remembered about their children's sleep patterns in the prior 6 months. Results In the urban group, there were 133 (38.0% subjects with sleep disturbances, 182 (52.0% were borderline, and 35 (10.0% were normal. In the suburban group, there were 132 (37.7% subjects with sleep disturbances, 180 (51.4% were borderline, and 38 (10.9% were normal. The most influential factors for sleep disturbances in urban and suburban youth were environmental noise (P=0.001 and consuming beverages that contain caffeine (P=0.001. There were three types of sleep disorders that significantly found more in urban adolescents: disorders of initiating and maintaining sleep, disorders of excessive somnolence, and sleep hyperhidrosis. Conclusion The prevalence of sleep disturbances do not differ between urban and suburban adolescents. Howevet; there are significant differences in the types of sleep disorders experienced. The most influential factors on sleep disturbance in both

  14. Circadian Rhythm Sleep-Wake Disorders.

    Science.gov (United States)

    Abbott, Sabra M; Reid, Kathryn J; Zee, Phyllis C

    2015-12-01

    The circadian system regulates the timing and expression of nearly all biological processes, most notably, the sleep-wake cycle, and disruption of this system can result in adverse effects on both physical and mental health. The circadian rhythm sleep-wake disorders (CRSWDs) consist of 5 disorders that are due primarily to pathology of the circadian clock or to a misalignment of the timing of the endogenous circadian rhythm with the environment. This article outlines the nature of these disorders, the association of many of these disorders with psychiatric illness, and available treatment options. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. Sleep disorders in pediatric chronic kidney disease patients.

    Science.gov (United States)

    Stabouli, Stella; Papadimitriou, Eleni; Printza, Nikoleta; Dotis, John; Papachristou, Fotios

    2016-08-01

    The prevalence of sleep disorders during childhood has been estimated to range from 25 to 43 %. The aim of this review is to determine the prevalence of sleep disorders and possible associations with chronic kidney disease (CKD)-related factors and health-related quality of life (HRQOL) in children with CKD. An electronic systematic literature search for sleep disorders in children with CKD in Pubmed, Embase and the Cochrane Library Databases identified seven relevant articles for review, all of which reported an increased prevalence of sleep disorders in children with CKD. Five studies included children with CKD undergoing dialysis, and two studies included only non-dialysis patients. In all studies the presence of sleep disturbances was assessed by questionnaires; only one study compared the results of a validated questionnaire with laboratory-based polysomnography. The prevalence of any sleep disorder ranged from 77 to 85 % in dialysis patients, to 32-50 % in transplanted patients and 40-50 % in non-dialysis patients. The most commonly studied disorder was restless legs syndrome, which presented at a prevalence of 10-35 %. Three studies showed significant associations between presence of sleep disorders and HRQOL. We found consistent evidence of an increased prevalence of sleep disturbances in children with CKD, and these seemed to play a critical role in HRQOL.

  16. Sleep, chronotype, and sleep hygiene in children with attention-deficit/hyperactivity disorder, autism spectrum disorder, and controls

    NARCIS (Netherlands)

    Van, der Heijden K.B.; Stoffelsen, R.J.; Popma, A.; Swaab, J.T.

    2018-01-01

    Sleep problems are highly prevalent in ADHD and autism spectrum disorder (ASD). Better insight in the etiology is of clinical importance since intervention and prevention strategies of sleep problems are directed at underlying mechanisms. We evaluated the association of sleep problems and sleep

  17. Exercise during Short-Term and Long-Term Continuous Exposure to Hypoxia Exacerbates Sleep-Related Periodic Breathing

    Science.gov (United States)

    Tellez, Helio Fernandez; Morrison, Shawnda A.; Neyt, Xavier; Mairesse, Olivier; Piacentini, Maria Francesca; Macdonald-Nethercott, Eoin; Pangerc, Andrej; Dolenc-Groselj, Leja; Eiken, Ola; Pattyn, Nathalie; Mekjavic, Igor B.; Meeusen, Romain

    2016-01-01

    Study Objectives: Exposure to hypoxia elevates chemosensitivity, which can lead to periodic breathing. Exercise impacts gas exchange, altering chemosensitivity; however, interactions between sleep, exercise and chronic hypoxic exposure have not been examined. This study investigated whether exercise exacerbates sleep-related periodic breathing in hypoxia. Methods: Two experimental phases. Short-Term Phase: a laboratory controlled, group-design study in which 16 active, healthy men (age: 25 ± 3 y, height: 1.79 ± 0.06 m, mass: 74 ± 8 kg) were confined to a normobaric hypoxic environment (FIO2 = 0.139 ± 0.003, 4,000 m) for 10 days, after random assignment to a sedentary (control, CON) or cycle-exercise group (EX). Long-Term Phase: conducted at the Concordia Antarctic Research Station (3,800 m equivalent at the Equator) where 14 men (age: 36 ± 9 y, height: 1.77 ± 0.09 m, mass: 75 ± 10 kg) lived for 12–14 months, continuously confined. Participants were stratified post hoc based on self-reported physical activity levels. We quantified apnea-hypopnea index (AHI) and physical activity variables. Results: Short-Term Phase: mean AHI scores were significantly elevated in the EX group compared to CON (Night1 = CON: 39 ± 51, EX: 91 ± 59; Night10 = CON: 32 ± 32, EX: 92 ± 48; P = 0.046). Long-Term Phase: AHI was correlated to mean exercise time (R2 = 0.4857; P = 0.008) and the coefficient of variation in night oxyhemoglobin saturation (SpO2; R2 = 0.3062; P = 0.049). Conclusions: Data indicate that exercise (physical activity) per se affects night SpO2 concentrations and AHI after a minimum of two bouts of moderate-intensity hypoxic exercise, while habitual physical activity in hypobaric hypoxic confinement affects breathing during sleep, up to 13+ months' duration Citation: Tellez HF, Morrison SA, Neyt X, Mairesse O, Piacentini MF, Macdonald-Nethercott E, Pangerc A, Dolenc-Groselj L, Eiken O, Pattyn N, Mekjavic IB, Meeusen R. Exercise during short-term and long

  18. Sleep Paralysis and Hallucinosis

    Directory of Open Access Journals (Sweden)

    Gregory Stores

    1998-01-01

    Full Text Available Background: Sleep paralysis is one of the many conditions of which visual hallucinations can be a part but has received relatively little attention. It can be associated with other dramatic symptoms of a psychotic nature likely to cause diagnostic uncertainty. Methods and results: These points are illustrated by the case of a young man with a severe bipolar affective disorder who independently developed terrifying visual, auditory and somatic hallucinatory episodes at sleep onset, associated with a sense of evil influence and presence. The episodes were not obviously related to his psychiatric disorder. Past diagnoses included nightmares and night terrors. Review provided no convincing evidence of various other sleep disorders nor physical conditions in which hallucinatory experiences can occur. A diagnosis of predormital isolated sleep paralysis was made and appropriate treatment recommended. Conclusions: Sleep paralysis, common in the general population, can be associated with dramatic auxiliary symptoms suggestive of a psychotic state. Less common forms are either part of the narcolepsy syndrome or (rarely they are familial in type. Interestingly, sleep paralysis (especially breathing difficulty features prominently in the folklore of various countries.

  19. Tonsillectomy and adenoidectomy in children with sleep-related breathing disorders: consensus statement of a UK multidisciplinary working party.

    Science.gov (United States)

    Robb, P J; Bew, S; Kubba, H; Murphy, N; Primhak, R; Rollin, A-M; Tremlett, M

    2009-07-01

    During 2008, ENT-UK received a number of professional enquiries from colleagues about the management of children with upper airway obstruction and uncomplicated obstructive sleep apnoea (OSA). These children with sleep-related breathing disorders (SRBDs) are usually referred to paediatricians and ENT surgeons. In some district general hospitals, (DGHs) where paediatric intensive care (PICU) facilities to ventilate children were not available, paediatrician and anaesthetist colleagues were expressing concern about children with a clinical diagnosis of OSA having routine tonsillectomy, with or without adenoidectomy. As BAPO President, I was asked by the ENT-UK President, Professor Richard Ramsden, to investigate the issues and rapidly develop a working consensus statement to support safe but local treatment of these children. The Royal Colleges of Anaesthetists and Paediatrics and Child Health and the Association of Paediatric Anaesthetists nominated expert members from both secondary and tertiary care to contribute and develop a consensus statement based on the limited evidence base available. Our terms of reference were to produce a statement that was brief, with a limited number of references, to inform decision-making at the present time. With patient safety as the first priority, the working party wished to support practice that facilitated referral to a tertiary centre of those children who could be expected, on clinical assessment alone, potentially to require PICU facilities. In contrast, the majority of children who could be safely managed in a secondary care setting should be managed closer to home in a DGH. BAPO, ENT-UK, APA, RCS-CSF and RCoA have endorsed the consensus statement; the RCPCH has no mechanism for endorsing consensus statements, but the RCPCH Clinical Effectiveness Committee reviewed the statement, concluding it was a 'concise, accurate and helpful document'. The consensus statement is an interim working tool, based on level-five evidence. It

  20. Comorbid sleep disorders and suicide risk among children and adolescents with bipolar disorder.

    Science.gov (United States)

    Stanley, Ian H; Hom, Melanie A; Luby, Joan L; Joshi, Paramjit T; Wagner, Karen D; Emslie, Graham J; Walkup, John T; Axelson, David A; Joiner, Thomas E

    2017-12-01

    Children and adolescents with bipolar disorder are at increased risk for suicide. Sleep disturbances are common among youth with bipolar disorder and are also independently implicated in suicide risk; thus, comorbid sleep disorders may amplify suicide risk in this clinical population. This study examined the effects of comorbid sleep disorders on suicide risk among youth with bipolar disorder. We conducted secondary analyses of baseline data from the Treatment of Early Age Mania (TEAM) study, a randomized controlled trial of individuals aged 6-15 years (mean ± SD = 10.2 ± 2.7 years) with DSM-IV bipolar I disorder (N = 379). Sleep disorders (i.e., nightmare, sleep terror, and sleepwalking disorders) and suicide risk were assessed via the WASH-U-KSADS and the CDRS-R, respectively. We constructed uncontrolled logistic regression models as well as models controlling for trauma history, a generalized anxiety disorder (GAD) diagnosis, and depression symptoms. Participants with a current comorbid nightmare disorder versus those without were nearly twice as likely to screen positive for suicide risk in an uncontrolled model and models controlling for trauma history, a GAD diagnosis, and depression symptoms. Neither a current comorbid sleep terror disorder nor a sleepwalking disorder was significantly associated with suicide risk. This pattern of findings remained consistent for both current and lifetime sleep disorder diagnoses. Youth with bipolar I disorder and a comorbid nightmare disorder appear to be at heightened suicide risk. Implications for assessment and treatment are discussed. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. [Sleep disorders in Parkinson's disease: insomnia and sleep fragmentation, daytime hypersomnia, alterations to the circadian rhythm and sleep apnea syndrome].

    Science.gov (United States)

    Mondragón-Rezola, E; Arratíbel-Echarren, I; Ruiz-Martínez, J; Martí-Massó, J F

    2010-02-08

    Sleep disorders in Parkinson's disease are present in 60-98% of patients and reduce their quality of life. To review the pathophysiology, diagnostic approach and management of the different sleep disorders. We describe the pathophysiology associated with neurodegeneration, due to symptoms (motor and nonmotor) and drug therapies. This article reviews insomnia, excessive daytime sleepiness, circadian sleep disorders and sleep apnea. Subjective or objective sleepiness assessment should routinely be performed by physicians looking after Parkinson's disease patients. Management is difficult and should be targeted to the specific sleep disorder and its likely cause.

  2. Characteristics of Obstructive Sleep Apnea Across the Spectrum of Glucose Tolerance in Obese Adolescents

    Directory of Open Access Journals (Sweden)

    Tamara S. Hannon

    2018-06-01

    Full Text Available BackgroundIt is not known if dysglycemia and sleep-disordered breathing are linked in adolescents, as in adults.ObjectiveTo perform a pilot study evaluating measures of sleep-disordered breathing across the spectrum of glucose tolerance in obese adolescents. We hypothesized that dysglycemia would be associated with sleep-disordered breathing.Participants/methodsThis was a prospective, cross-sectional clinical pilot study that included 57 adolescents [body mass index (BMI 38.9 ± 8.4 kg/m2] aged 12–18 years (14.5 ± 1.6 with normal glucose tolerance (NGT, or dysglycemia [impaired glucose tolerance (IGT or type 2 diabetes (T2D].MeasuresAnthropometrics, overnight polysomnogram, and oral glucose tolerance tests were performed. Participant characteristics and outcome measures were compared by glucose tolerance status. Correlational analyses were conducted to assess the associations between variables of interest.ResultsParticipants with dysglycemia (n = 21 were not different from those with NGT (n = 36 for BMI, waist circumference, body fat, or sleep characteristics. Nocturnal oxygen desaturation was associated with higher BMI (r = −0.334, p = 0.012. The apnea–hypopnea index (AHI was not associated with physical and metabolic parameters. Although participants with dysglycemia tended to have higher AHIs (median 3.2, 2.2, and 1.6 events/h for T2D, IGT, and NGT, respectively, there was not a linear relationship between measures of glycemia and AHI.ConclusionFurther study with a larger proportion of youth with prediabetes and T2D is necessary to determine whether evaluation for sleep-disordered breathing is uniformly warranted.

  3. 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

    2016-01-01

    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, 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” softwares. 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, i.e., 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 one condition; however, no two 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 one single variable. PMID:27416139

  4. REM sleep behavior disorder and other sleep disturbances in Disney animated films.

    Science.gov (United States)

    Iranzo, Alex; Schenck, Carlos H; Fonte, Jorge

    2007-08-01

    During a viewing of Disney's animated film Cinderella (1950), one author (AI) noticed a dog having nightmares with dream-enactment that strongly resembled RBD. This prompted a study in which all Disney classic full-length animated films and shorts were analyzed for other examples of RBD. Three additional dogs were found with presumed RBD in the classic films Lady and the Tramp (1955) and The Fox and the Hound (1981), and in the short Pluto's Judgment Day (1935). These dogs were elderly males who would pant, whine, snuffle, howl, laugh, paddle, kick, and propel themselves while dreaming that they were chasing someone or running away. In Lady and the Tramp the dog was also losing both his sense of smell and his memory, two associated features of human RBD. These four films were released before RBD was first formally described in humans and dogs. In addition, systematic viewing of the Disney films identified a broad range of sleep disorders, including nightmares, sleepwalking, sleep related seizures, disruptive snoring, excessive daytime sleepiness, insomnia and circadian rhythm sleep disorder. These sleep disorders were inserted as comic elements. The inclusion of a broad range of accurately depicted sleep disorders in these films indicates that the Disney screenwriters were astute observers of sleep and its disorders.

  5. Clinical identification of the simple sleep-related movement disorders.

    Science.gov (United States)

    Walters, Arthur S

    2007-04-01

    Simple sleep-related movement disorders must be distinguished from daytime movement disorders that persist during sleep, sleep-related epilepsy, and parasomnias, which are generally characterized by activity that appears to be simultaneously complex, goal-directed, and purposeful but is outside the conscious awareness of the patient and, therefore, inappropriate. Once it is determined that the patient has a simple sleep-related movement disorder, the part of the body affected by the movement and the age of the patient give clues as to which sleep-related movement disorder is present. In some cases, all-night polysomnography with accompanying video may be necessary to make the diagnosis. Hypnic jerks (ie, sleep starts), bruxism, rhythmic movement disorder (ie, head banging/body rocking), and nocturnal leg cramps are discussed in addition to less well-appreciated disorders such as benign sleep myoclonus of infancy, excessive fragmentary myoclonus, and hypnagogic foot tremor/alternating leg muscle activation.

  6. Sleep disorder risk factors among student athletes.

    Science.gov (United States)

    Monma, Takafumi; Ando, Akira; Asanuma, Tohru; Yoshitake, Yutaka; Yoshida, Goichiro; Miyazawa, Taiki; Ebine, Naoyuki; Takeda, Satoko; Omi, Naomi; Satoh, Makoto; Tokuyama, Kumpei; Takeda, Fumi

    2018-04-01

    To clarify sleep disorder risk factors among student athletes, this study examined the relationship between lifestyle habits, competition activities, psychological distress, and sleep disorders. Student athletes (N = 906; male: 70.1%; average age: 19.1 ± 0.8 years) in five university sports departments from four Japanese regions were targeted for analysis. Survey items were attributes (age, gender, and body mass index), sleep disorders (recorded through the Pittsburgh Sleep Quality Index), lifestyle habits (bedtime, wake-up time, smoking, drinking alcohol, meals, part-time jobs, and use of electronics after lights out), competition activities (activity contents and competition stressors), and psychological distress (recorded through the K6 scale). The relation between lifestyle habits, competition activities, psychological distress, and sleep disorders was explored using logistic regression analysis. Results of multivariate logistic regression analysis with attributes as adjustment variables showed that "bedtime," "wake-up time," "psychological distress," "part-time jobs," "smartphone/cellphone use after lights out," "morning practices," and "motivation loss stressors," were risk factors that were independently related to sleep disorders. Sleep disorders among student athletes are related to lifestyle habits such as late bedtime, early wake-up time, late night part-time jobs, and use of smartphones/cellphones after lights out; psychological distress; and competition activities such as morning practices and motivation loss stressors related to competition. Therefore, this study suggests the importance of improving these lifestyle habits, mental health, and competition activities. Copyright © 2017 Elsevier B.V. All rights reserved.

  7. 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).

  8. Sleep disorders and an increased risk of Parkinson's disease in individuals with non-apnea sleep disorders: a population-based cohort study.

    Science.gov (United States)

    Hsiao, Yi-Han; Chen, Yung-Tai; Tseng, Ching-Ming; Wu, Li-An; Perng, Diahn-Warng; Chen, Yuh-Min; Chen, Tzeng-Ji; Chang, Shi-Chuan; Chou, Kun-Ta

    2017-10-01

    Sleep disorders are common non-motor symptoms in patients with Parkinson's disease. Our study aims to explore the relationship between non-apnea sleep disorders and future Parkinson's disease. This is a cohort study using a nationwide database. The participants were recruited from the Taiwan National Health Insurance Research Database between 2000 and 2003. A total of 91 273 adult patients who had non-apnea sleep disorders without pre-existing Parkinson's disease were enrolled. An age-, gender-, income-, urbanization- and Charlson comorbidity index score-matched control cohort consisting of 91 273 participants was selected for comparison. The two cohorts were followed for the occurrence of Parkinson's disease, death or until the end of 2010, whichever came first. The Kaplan-Meier analyses revealed patients with non-apnea sleep disorders tended to develop Parkinson's disease (log-rank test, P sleep disorders was an independent risk factor for the development of Parkinson's disease [crude hazard ratio: 1.63, 95% confidence interval (CI): 1.54-1.73, P sleep disorders, especially chronic insomnia, are associated with a higher risk for future Parkinson's disease. © 2017 European Sleep Research Society.

  9. Gastrointestinal physiology and digestive disorders in sleep.

    Science.gov (United States)

    Kanaly, Travis; Shaheen, Nicholas J; Vaughn, Bradley V

    2009-11-01

    The dynamic interplay of the digestive system and sleep is an excellent example of brain-body interaction. New advances in measuring techniques provide an opportunity to evaluate physiology that is dependent upon the sleep/wake state or circadian rhythm and potentially differentiate between normal and pathological conditions. Sleep-related changes in gastrointestinal physiology create vulnerabilities to digestive issues such as reflux, whereas disorders such as duodenal ulcers raise the importance of circadian variations in digestive system function. Advances in the area of normal sleep physiology have furthered our understanding of the underlying cause of irritable bowel syndrome, and the mechanisms by which sleep disruption may aggravate inflammatory bowel disease. Additionally, important early work has shown that the treatment of digestive disorders such as reflux can improve sleep quality just as the improvement in sleep may aid in the treatment of digestive disorders. For the clinician, these forward steps in our knowledge mark the start of an era in which understanding the effects of the sleep/wake state and circadian rhythms on gastrointestinal physiology promise to yield novel diagnostic and therapeutic opportunities.

  10. Sleep Disorders, Epilepsy, and Autism

    Science.gov (United States)

    Malow, Beth A.

    2004-01-01

    The purpose of this review article is to describe the clinical data linking autism with sleep and epilepsy and to discuss the impact of treating sleep disorders in children with autism either with or without coexisting epileptic seizures. Studies are presented to support the view that sleep is abnormal in individuals with autistic spectrum…

  11. The relationship between partial upper-airway obstruction and inter-breath transition period during sleep.

    Science.gov (United States)

    Mann, Dwayne L; Edwards, Bradley A; Joosten, Simon A; Hamilton, Garun S; Landry, Shane; Sands, Scott A; Wilson, Stephen J; Terrill, Philip I

    2017-10-01

    Short pauses or "transition-periods" at the end of expiration and prior to subsequent inspiration are commonly observed during sleep in humans. However, the role of transition periods in regulating ventilation during physiological challenges such as partial airway obstruction (PAO) has not been investigated. Twenty-nine obstructive sleep apnea patients and eight controls underwent overnight polysomnography with an epiglottic catheter. Sustained-PAO segments (increased epiglottic pressure over ≥5 breaths without increased peak inspiratory flow) and unobstructed reference segments were manually scored during apnea-free non-REM sleep. Nasal pressure data was computationally segmented into inspiratory (T I , shortest period achieving 95% inspiratory volume), expiratory (T E , shortest period achieving 95% expiratory volume), and inter-breath transition period (T Trans , period between T E and subsequent T I ). Compared with reference segments, sustained-PAO segments had a mean relative reduction in T Trans (-24.7±17.6%, P<0.001), elevated T I (11.8±10.5%, P<0.001), and a small reduction in T E (-3.9±8.0, P≤0.05). Compensatory increases in inspiratory period during PAO are primarily explained by reduced transition period and not by reduced expiratory period. Copyright © 2017 Elsevier B.V. All rights reserved.

  12. Sleep and obsessive-compulsive disorder (OCD).

    Science.gov (United States)

    Paterson, Jessica L; Reynolds, Amy C; Ferguson, Sally A; Dawson, Drew

    2013-12-01

    Obsessive-compulsive disorder (OCD) is a chronic mental illness that can have a debilitating effect on daily functioning. A body of research reveals altered sleep behaviour in OCD sufferers; however, findings are inconsistent and there is no consensus on the nature of this relationship. Understanding sleep disturbance in OCD is of critical importance given the known negative consequences of disturbed sleep for mood and emotional wellbeing. A systematic literature search was conducted of five databases for studies assessing sleep in adults diagnosed with OCD. Fourteen studies met inclusion criteria and qualitative data analysis methods were used to identify common themes. There was some evidence of reduced total sleep time and sleep efficiency in OCD patients. Many of the sleep disturbances noted were characteristic of depression. However, some OCD sufferers displayed delayed sleep onset and offset and an increased prevalence of delayed sleep phase disorder (DSPD). Severe OCD symptoms were consistently associated with greater sleep disturbance. While the sleep of OCD patients has not been a major focus to date, the existing literature suggests that addressing sleep disturbance in OCD patients may ensure a holistic approach to treatment, enhance treatment efficacy, mitigate relapse and protect against the onset of co-morbid psychiatric illnesses. Crown Copyright © 2012. Published by Elsevier Ltd. All rights reserved.

  13. Behavioral symptoms and sleep problems in children with anxiety disorder.

    Science.gov (United States)

    Iwadare, Yoshitaka; Kamei, Yuichi; Usami, Masahide; Ushijima, Hirokage; Tanaka, Tetsuya; Watanabe, Kyota; Kodaira, Masaki; Saito, Kazuhiko

    2015-08-01

    Sleep disorders are frequently associated with childhood behavioral problems and mental illnesses such as anxiety disorder. To identify promising behavioral targets for pediatric anxiety disorder therapy, we investigated the associations between specific sleep and behavioral problems. We conducted retrospective reviews of 105 patients aged 4-12 years who met the DSM-IV criteria for primary diagnosis of generalized anxiety disorder (n = 33), separation anxiety disorder (n = 23), social phobia (n = 21), or obsessive compulsive disorder (n = 28). Sleep problems were evaluated using the Children's Sleep Habits Questionnaire (CSHQ) and behavioral problems by the Spence Children's Anxiety Scale, Oppositional Defiant Behavior Inventory (ODBI), and Depression Self-Rating Scale for Children. Depressive behavior was weakly correlated with CSHQ subscores for sleep onset delay and night waking but not with total sleep disturbance. Anxiety was correlated with bedtime resistance, night waking, and total sleep disturbance score. Oppositional defiance was correlated with bedtime resistance, daytime sleepiness, sleep onset delay, and most strongly with total sleep disturbance. On multiple regression analysis ODBI score had the strongest positive association with total sleep disturbance and the strongest negative association with total sleep duration. Sleep problems in children with anxiety disorders are closely related to anxiety and oppositional defiant symptoms. © 2015 Japan Pediatric Society.

  14. Prevalence and pattern of sleep disorder among children with ...

    African Journals Online (AJOL)

    Background: Sleep disorders significantly affect the quality of live and may impair cognitive development. Sleep disorders are reported to be common in children with neurological diseases. However no report has evaluated the prevalence of sleep disorders among children chronic neurological diseases in Nigeria.

  15. Sleep in children with cancer: case review of 70 children evaluated in a comprehensive pediatric sleep center.

    Science.gov (United States)

    Rosen, Gerald; Brand, Sarah R

    2011-07-01

    The goal of this study was to characterize the sleep problems of children with cancer who were referred for a comprehensive sleep evaluation. A retrospective case series review was conducted of all children with cancer referred to the pediatric sleep clinic from 1994 to 2009 for evaluation of a sleep problem. Seventy children were seen and evaluated during this interval; all had a complete sleep history taken, and further objective sleep evaluations were performed as part of their evaluation only when clinically indicated. An overnight polysomnogram was performed in 53 children. In 36 children with a history of excessive daytime sleepiness (EDS), a multiple sleep latency study was performed the following day. Seven children had a 3-4-week actigraphic study. Children with neoplasms of central nervous system (CNS) involving the hypothalamus, thalamus, and brainstem were the most commonly referred children and had the most frequent and severe sleep problems. Excessive daytime sleepiness was the most common sleep problem, seen in 60% of children with cancer and in 80% of children with CNS neoplasms involving the hypothalamus, thalamus, and brainstem. Sleep disordered breathing (SDB) was present in 40% of the entire group of children with cancer and 46% of children with neoplasms involving the hypothalamus, thalamus, and brainstem. Children with CNS neoplasms often had more than one sleep problem, most commonly EDS and SDB. In these children, correction of the SDB often did not eliminate the EDS. In children with leukemia, insomnia was the most common sleep problem identified, present in 39%. The causes of the sleep problems were varied and included neurologic injury caused by the neoplasm and/or the CNS-directed treatments; seizures, adenotonsillar hypertrophy, medication side effects, obesity, pain, anxiety, and drug abuse. Some of the sleep problems were present before the diagnosis of cancer, though most developed after treatment was begun. A wide range of

  16. Sleep Disorders: Insomnia.

    Science.gov (United States)

    Burman, Deepa

    2017-09-01

    Insomnia is the most common type of sleep disorder in the family medicine population. It is defined as a persistent difficulty initiating or maintaining sleep, or a report of nonrestorative sleep, accompanied by related daytime impairment. Insomnia is a significant public health problem because of its high prevalence and management challenges. There is increasing evidence of a strong association between insomnia and various medical and psychiatric comorbidities. Diagnosis of insomnia and treatment planning rely on a thorough sleep history to address contributing and precipitating factors as well as maladaptive behaviors resulting in poor sleep. Using a sleep diary or sleep log is more accurate than patient recall to determine sleep patterns. A sleep study is not routinely indicated for evaluation of insomnia. Cognitive behavioral therapy for insomnia (CBT-I) is the mainstay of treatment and is a safe and effective approach. The key challenge of CBT-I is the lack of clinicians to implement it. The newer generation nonbenzodiazepines (eg, zolpidem, zaleplon) are used as first-line pharmacotherapy for chronic insomnia. Newer drugs active on targets other than the gamma-aminobutyric acid receptor are now available, but clear treatment guidelines are needed. Written permission from the American Academy of Family Physicians is required for reproduction of this material in whole or in part in any form or medium.

  17. Spontaneous sleep-like brain state alternations and breathing characteristics in urethane anesthetized mice.

    Directory of Open Access Journals (Sweden)

    Silvia Pagliardini

    Full Text Available Brain state alternations resembling those of sleep spontaneously occur in rats under urethane anesthesia and they are closely linked with sleep-like respiratory changes. Although rats are a common model for both sleep and respiratory physiology, we sought to determine if similar brain state and respiratory changes occur in mice under urethane. We made local field potential recordings from the hippocampus and measured respiratory activity by means of EMG recordings in intercostal, genioglossus, and abdominal muscles. Similar to results in adult rats, urethane anesthetized mice displayed quasi-periodic spontaneous forebrain state alternations between deactivated patterns resembling slow wave sleep (SWS and activated patterns resembling rapid eye movement (REM sleep. These alternations were associated with an increase in breathing rate, respiratory variability, a depression of inspiratory related activity in genioglossus muscle and an increase in expiratory-related abdominal muscle activity when comparing deactivated (SWS-like to activated (REM-like states. These results demonstrate that urethane anesthesia consistently induces sleep-like brain state alternations and correlated changes in respiratory activity across different rodent species. They open up the powerful possibility of utilizing transgenic mouse technology for the advancement and translation of knowledge regarding sleep cycle alternations and their impact on respiration.

  18. Impact of coexisting irritable bowel syndrome and non-erosive reflux disease on postprandial abdominal fullness and sleep disorders in functional dyspepsia.

    Science.gov (United States)

    Futagami, Seiji; Yamawaki, Hiroshi; Shimpuku, Mayumi; Izumi, Nikki; Wakabayashi, Taiga; Kodaka, Yasuhiro; Nagoya, Hiroyuki; Shindo, Tomotaka; Kawagoe, Tetsuro; Sakamoto, Choitsu

    2013-01-01

    The association between clinical symptoms and sleep disorders in functional dyspepsia (FD)-overlap syndrome has not been studied in detail. The subjects were 139 patients with FD, 14 with irritable bowel syndrome (IBS), 12 with nonerosive reflux disease (NERD), and 41 healthy volunteers. Gastric motility was evaluated with the (13)C-acetate breath test. We used Rome III criteria to evaluate upper abdominal symptoms, and Self-Rating Questionnaire for Depression (SRQ-D) scores to determine depression status. Sleep disorders were evaluated with Pittsburgh Sleep Quality Index (PSQI) scores. There were no significant differences in age, body-mass index, alcohol intake, and smoking rate between patients with FD alone and those with FD-overlap syndrome. The postprandial abdominal fullness score in patients with FD-NERD-IBS was significantly greater than that in patients with FD-NERD overlap syndrome (pSleep Quality Index score in subjects with FD-NERD-IBS overlap syndrome was significantly greater than that in subjects with FD alone. Symptom scores, such as those for postprandial abdominal fullness, heartburn, and the feeling of hunger, in patients with FD-overlap syndromes are significantly greater than those in patients with FD alone. Further studies are necessary to clarify whether various symptoms are related to sleep disorders in patients with FD-NERD-IBS overlap syndrome.

  19. REM Sleep Behavior Disorder in Parkinson's Disease and Other Synucleinopathies.

    Science.gov (United States)

    St Louis, Erik K; Boeve, Angelica R; Boeve, Bradley F

    2017-05-01

    Rapid eye movement sleep behavior disorder is characterized by dream enactment and complex motor behaviors during rapid eye movement sleep and rapid eye movement sleep atonia loss (rapid eye movement sleep without atonia) during polysomnography. Rapid eye movement sleep behavior disorder may be idiopathic or symptomatic and in both settings is highly associated with synucleinopathy neurodegeneration, especially Parkinson's disease, dementia with Lewy bodies, multiple system atrophy, and pure autonomic failure. Rapid eye movement sleep behavior disorder frequently manifests years to decades prior to overt motor, cognitive, or autonomic impairments as the presenting manifestation of synucleinopathy, along with other subtler prodromal "soft" signs of hyposmia, constipation, and orthostatic hypotension. Between 35% and 91.9% of patients initially diagnosed with idiopathic rapid eye movement sleep behavior disorder at a sleep center later develop a defined neurodegenerative disease. Less is known about the long-term prognosis of community-dwelling younger patients, especially women, and rapid eye movement sleep behavior disorder associated with antidepressant medications. Patients with rapid eye movement sleep behavior disorder are frequently prone to sleep-related injuries and should be treated to prevent injury with either melatonin 3-12 mg or clonazepam 0.5-2.0 mg to limit injury potential. Further evidence-based studies about rapid eye movement sleep behavior disorder are greatly needed, both to enable accurate prognostic prediction of end synucleinopathy phenotypes for individual patients and to support the application of symptomatic and neuroprotective therapies. Rapid eye movement sleep behavior disorder as a prodromal synucleinopathy represents a defined time point at which neuroprotective therapies could potentially be applied for the prevention of Parkinson's disease, dementia with Lewy bodies, multiple system atrophy, and pure autonomic failure. © 2017

  20. Circadian Rhythm Sleep-Wake Disorders in Older Adults.

    Science.gov (United States)

    Kim, Jee Hyun; Duffy, Jeanne F

    2018-03-01

    The timing, duration, and consolidation of sleep result from the interaction of the circadian timing system with a sleep-wake homeostatic process. When aligned and functioning optimally, this allows wakefulness throughout the day and a long consolidated sleep episode at night. Mismatch between the desired timing of sleep and the ability to fall and remain asleep is a hallmark of the circadian rhythm sleep-wake disorders. This article discusses changes in circadian regulation of sleep with aging; how age influences the prevalence, diagnosis, and treatment of circadian rhythm sleep-wake disorders; and how neurologic diseases in older patients affect circadian rhythms and sleep. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. [Treatment of sleep disorders in children with a psychiatric diagnosis].

    Science.gov (United States)

    Godbout, Roger

    2015-01-01

    Health sciences suffer from insomnia: experts too often concentrate their efforts on the wake state. Fortunately enough, some of them have taken the road towards the "Dark Third of Life": sleep. This article gives an historical account of the development of the first Canadian sleep disorders laboratory and clinic specifically and selectively designed for children and adolescents with a psychiatric diagnosis. It then stresses the importance of sleep in children bearing a psychiatric diagnosis and summarizes therapeutic strategies. Data-on-file and selective review of literature. An innovative scheme matching sleep psychologists and psychiatrists with expertise in neurodevelopmental disorders led to the creation of a sleep research laboratory on mental health disorders. The initial research projects on the sleep and dreams of patients with schizophrenia and persons with autism are summarized. The Sleep Disorders Clinic for Children and Adolescents was then created at the Hôpital Rivière-des-Prairies, leading to much needed activities focused on youth. Indeed, sleep disorders show a high prevalence in children with a psychiatric diagnosis and the literature shows that these children have an increased sensitivity for diurnal effects of poor sleep. The main sleep-relevant issues at stake are reviewed, including the high frequency of sleep disorders in pedopsychiatric patients. Clinical challenges are described and the operating mode of the Sleep Disorders Clinic is illustrated. Sleep disorders and their effects on daytime functioning need to be assessed in children with a psychiatric diagnosis in order to generate a full clinical picture. Appropriate tools and know-how are readily available in order to achieve this goal.

  2. Oral-appliance therapy obstructive sleep apnea-hypopnea syndrome : a clinical study on therapeutic outcome

    NARCIS (Netherlands)

    Hoekema, Aarnoud

    2007-01-01

    The obstructive sleep apnea-hypopnea syndrome (OSAHS) is a common sleep-related breathing disorder characterized by disruptive snoring and repetitive upper airway obstructions. Its neurobehavioral consequences include excessive sleepiness, an increased risk of accidents, and an impaired quality of

  3. Sleep-related disorders in chronic obstructive pulmonary disease.

    LENUS (Irish Health Repository)

    Crinion, Sophie J

    2014-02-01

    Sleep may have several negative consequences in patients with chronic obstructive pulmonary disease (COPD). Sleep is typically fragmented with diminished slow wave and rapid-eye-movement sleep, which likely represents an important contributing factor to daytime symptoms such as fatigue and lethargy. Furthermore, normal physiological adaptations during sleep, which result in mild hypoventilation in normal subjects, are more pronounced in COPD, which can result in clinically important nocturnal oxygen desaturation. The co-existence of obstructive sleep apnea and COPD is also common, principally because of the high prevalence of each disorder, and there is little convincing evidence that one disorder predisposes to the other. Nonetheless, this co-existence, termed the overlap syndrome, typically results in more pronounced nocturnal oxygen desaturation and there is a high prevalence of pulmonary hypertension in such patients. Management of sleep disorders in patients with COPD should address both sleep quality and disordered gas exchange. Non-invasive pressure support is beneficial in selected cases, particularly during acute exacerbations associated with respiratory failure, and is particularly helpful in patients with the overlap syndrome. There is limited evidence of benefit from pressure support in the chronic setting in COPD patients without obstructive sleep apnea.

  4. Rapid eye movement sleep behavior disorder and rapid eye movement sleep without atonia in narcolepsy

    DEFF Research Database (Denmark)

    Dauvilliers, Yves; Jennum, Poul; Plazzi, Giuseppe

    2013-01-01

    Narcolepsy is a rare disabling hypersomnia disorder that may include cataplexy, sleep paralysis, hypnagogic hallucinations, and sleep-onset rapid eye movement (REM) periods, but also disrupted nighttime sleep by nocturnal awakenings, and REM sleep behavior disorder (RBD). RBD is characterized...... by dream-enacting behavior and impaired motor inhibition during REM sleep (REM sleep without atonia, RSWA). RBD is commonly associated with neurodegenerative disorders including Parkinsonisms, but is also reported in narcolepsy in up to 60% of patients. RBD in patients with narcolepsy is, however...... with narcolepsy often present dissociated sleep features including RSWA, increased density of phasic chin EMG and frequent shift from REM to NREM sleep, with or without associated clinical RBD. Most patients with narcolepsy with cataplexy lack the hypocretin neurons in the lateral hypothalamus. Tonic and phasic...

  5. Sleep, eating disorder symptoms, and daytime functioning

    NARCIS (Netherlands)

    Tromp, Marilou Dp; Donners, Anouk Amt; Garssen, Johan; Verster, Joris C

    OBJECTIVE: To investigate the relationship between eating disorders, body mass index (BMI), sleep disorders, and daytime functioning. DESIGN: Survey. SETTING: The Netherlands. PARTICIPANTS: N=574 Dutch young adults (18-35 years old). MEASUREMENTS: Participants completed a survey on eating and sleep

  6. Sleep and inflammatory markers in different psychiatric disorders.

    Science.gov (United States)

    Krysta, Krzysztof; Krzystanek, Marek; Bratek, Agnieszka; Krupka-Matuszczyk, Irena

    2017-02-01

    Many psychiatric disorders, like schizophrenia, affective disorders, addictions and different forms of dementia are associated with sleep disturbances. In the etiology and course of those diseases inflammatory processes are regarded to be an increasingly important factor. They are also a frequently discussed element of the pathology of sleep. In this literature review reports on correlations between poor sleep and inflammatory responses in various psychiatric conditions are discussed. The link between schizophrenia, affective disorders and inflammatory cytokines is a complex phenomenon, which has been already confirmed in a number of studies. However, the presence of sleep deficits in those conditions, being a common symptom of depression and psychoses, can be an additional factor having a considerable impact on the immunological processes in mental illnesses. In the analyzed data, a number of studies are presented describing the role of inflammatory markers in sleep disturbances and psychopathological symptoms of affective, psychotic, neurogenerative and other disorders. Also attention is drawn to possible implications for their treatment. Efforts to use, e.g., anti-inflammatory agents in psychiatry in the context of their impact on sleep are reported. The aspect of inflammatory markers in the role of sleep deprivation as the treatment method in major depressive disorder is also discussed. A general conclusion is drawn that the improvement of sleep quality plays a crucial role in the care for psychiatric patients.

  7. The Role of Sleep in Childhood Psychiatric Disorders

    Science.gov (United States)

    Alfano, Candice A.; Gamble, Amanda L.

    2009-01-01

    Although sleep problems often comprise core features of psychiatric disorders, inadequate attention has been paid to the complex, reciprocal relationships involved in the early regulation of sleep, emotion, and behavior. In this paper, we review the pediatric literature examining sleep in children with primary psychiatric disorders as well as…

  8. Sleep Disorders in Childhood Neurogenetic Disorders

    Directory of Open Access Journals (Sweden)

    Laura Beth Mann Dosier

    2017-09-01

    Full Text Available Genetic advances in the past three decades have transformed our understanding and treatment of many human diseases including neurogenetic disorders. Most neurogenetic disorders can be classified as “rare disease,” but collectively neurogenetic disorders are not rare and are commonly encountered in general pediatric practice. The authors decided to select eight relatively well-known neurogenetic disorders including Down syndrome, Angelman syndrome, Prader–Willi syndrome, Smith–Magenis syndrome, congenital central hypoventilation syndrome, achondroplasia, mucopolysaccharidoses, and Duchenne muscular dystrophy. Each disorder is presented in the following format: overview, clinical characteristics, developmental aspects, associated sleep disorders, management and research/future directions.

  9. Investigating the Efficacy of Sleep Hygiene Education on Improving Sleep Disorders in Shahid Sadoughi Hospital Nurses

    Directory of Open Access Journals (Sweden)

    A Hazeri

    2015-07-01

    Methods:This is an analytical study with Field Trail method and pre- and post-style. Data were collected using a questionnaire consisting of demographic information, ESS, SMII, and ISI. In the first phase of the study, questionnaires were distributed among 207 nurses out of whom 100 nurses were diagnosed with sleep disorder. Eventually after the training period, the data from 66 questionnaires were analysed, using SPSS20 software with Paired T-test and ANOVA. Results:The first part of the findings showed that 48.3 percent of the nurses have sleep disorder. Findings also indicated that factors such as age, gender, marital status, work experience, number of children, type of shift work and job satisfaction did not have significant statistical impact on sleep disorder. The second part measured improvement of sleep disorders related to sleep hygiene education for nurses. Results revealed a better condition of sleep disorder among the participants after their education around sleep hygiene. Although there wasstatistically no significant relationship between pre- and post-training sleep disorder scores, given the small p-value it can be said that a marginal meaningful relationship does exist.

  10. Ictal SPECT in patients with rapid eye movement sleep behaviour disorder.

    Science.gov (United States)

    Mayer, Geert; Bitterlich, Marion; Kuwert, Torsten; Ritt, Philipp; Stefan, Hermann

    2015-05-01

    Rapid eye movement sleep behaviour disorder is a rapid eye movement parasomnia clinically characterized by acting out dreams due to disinhibition of muscle tone in rapid eye movement sleep. Up to 80-90% of the patients with rapid eye movement sleep behaviour disorder develop neurodegenerative disorders within 10-15 years after symptom onset. The disorder is reported in 45-60% of all narcoleptic patients. Whether rapid eye movement sleep behaviour disorder is also a predictor for neurodegeneration in narcolepsy is not known. Although the pathophysiology causing the disinhibition of muscle tone in rapid eye movement sleep behaviour disorder has been studied extensively in animals, little is known about the mechanisms in humans. Most of the human data are from imaging or post-mortem studies. Recent studies show altered functional connectivity between substantia nigra and striatum in patients with rapid eye movement sleep behaviour disorder. We were interested to study which regions are activated in rapid eye movement sleep behaviour disorder during actual episodes by performing ictal single photon emission tomography. We studied one patient with idiopathic rapid eye movement sleep behaviour disorder, one with Parkinson's disease and rapid eye movement sleep behaviour disorder, and two patients with narcolepsy and rapid eye movement sleep behaviour disorder. All patients underwent extended video polysomnography. The tracer was injected after at least 10 s of consecutive rapid eye movement sleep and 10 s of disinhibited muscle tone accompanied by movements registered by an experienced sleep technician. Ictal single photon emission tomography displayed the same activation in the bilateral premotor areas, the interhemispheric cleft, the periaqueductal area, the dorsal and ventral pons and the anterior lobe of the cerebellum in all patients. Our study shows that in patients with Parkinson's disease and rapid eye movement sleep behaviour disorder-in contrast to wakefulness

  11. A cross-sectional study of breath acetone based on diabetic metabolic disorders.

    Science.gov (United States)

    Li, Wenwen; Liu, Yong; Lu, Xiaoyong; Huang, Yanping; Liu, Yu; Cheng, Shouquan; Duan, Yixiang

    2015-02-26

    Breath acetone is a known biomarker for diabetes mellitus in breath analysis. In this work, a cross-sectional study of breath acetone based on clinical metabolic disorders of type 2 diabetes mellitus (T2DM) was carried out. Breath acetone concentrations of 113 T2DM patients and 56 apparently healthy individuals were measured at a single time point. Concentrations varied from 0.22 to 9.41 ppmv (mean 1.75 ppmv) for T2DM, which were significantly higher than those for normal controls (ranged from 0.32 to 1.96 ppmv, mean 0.72 ppmv, p = 0.008). Observations in our work revealed that breath acetone concentrations elevated to different degrees, along with the abnormality of blood glucose, glycated hemoglobin (HbA1c), triglyceride and cholesterol. Breath acetone showed obviously positive correlations with blood ketone and urine ketone. Possible metabolic relations between breath acetone and diabetic disorders were also discussed. This work aimed at giving an overall assessment of breath acetone from the perspective of clinical parameters for type 2 diabetes.

  12. Sleep education in pediatric residency programs: a cross-cultural look.

    Science.gov (United States)

    Mindell, Jodi A; Bartle, Alex; Ahn, Youngmin; Ramamurthy, Mahesh Babu; Huong, Huynh Thi Duy; Kohyama, Jun; Li, Albert M; Ruangdaraganon, Nichara; Sekartini, Rini; Teng, Arthur; Goh, Daniel Y T

    2013-04-03

    The objective of this study was to assess the prevalence of education about sleep and sleep disorders in pediatric residency programs and to identify barriers to providing such education. Surveys were completed by directors of 152 pediatric residency programs across 10 countries (Hong Kong, India, Indonesia, Japan, Singapore, South Korea, Thailand, United States-Canada, and Vietnam). Overall, the average amount of time spent on sleep education is 4.4 hours (median = 2.0 hours), with 23% responding that their pediatric residency program provides no sleep education. Almost all programs (94.8%) offer less than 10 hours of instruction. The predominant topics covered include sleep-related development, as well as normal sleep, sleep-related breathing disorders, parasomnias, and behavioral insomnia of childhood. These results indicate that there is still a need for more efforts to include sleep-related education in all pediatric residency programs, as well as coverage of the breadth of sleep-related topics. Such education would be consistent with the increased recognition of the importance of sleep and under-diagnosis of sleep disorders in children and adolescents.

  13. Complex sleep apnea syndrome

    Directory of Open Access Journals (Sweden)

    Wang J

    2013-07-01

    Full Text Available Juan Wang,1,* Yan Wang,1,* Jing Feng,1,2 Bao-yuan Chen,1 Jie Cao1 1Respiratory Department of Tianjin Medical University General Hospital, Tianjin, People's Republic of China; 2Division of Pulmonary and Critical Care Medicine, Duke University Medical Center, Durham, NC, USA *The first two authors contributed equally to this work Abstract: Complex sleep apnea syndrome (CompSAS is a distinct form of sleep-disordered breathing characterized as central sleep apnea (CSA, and presents in obstructive sleep apnea (OSA patients during initial treatment with a continuous positive airway pressure (CPAP device. The mechanisms of why CompSAS occurs are not well understood, though we have a high loop gain theory that may help to explain it. It is still controversial regarding the prevalence and the clinical significance of CompSAS. Patients with CompSAS have clinical features similar to OSA, but they do exhibit breathing patterns like CSA. In most CompSAS cases, CSA events during initial CPAP titration are transient and they may disappear after continued CPAP use for 4–8 weeks or even longer. However, the poor initial experience of CompSAS patients with CPAP may not be avoided, and nonadherence with continued therapy may often result. Treatment options like adaptive servo-ventilation are available now that may rapidly resolve the disorder and relieve the symptoms of this disease with the potential of increasing early adherence to therapy. But these approaches are associated with more expensive and complicated devices. In this review, the definition, potential plausible mechanisms, clinical characteristics, and treatment approaches of CompSAS will be summarized. Keywords: complex sleep apnea syndrome, obstructive sleep apnea, central sleep apnea, apnea threshold, continuous positive airway pressure, adaptive servo-ventilation

  14. Assessment of Elderlies Sleep Disorders and Different Confronts Methods Among Them

    Directory of Open Access Journals (Sweden)

    Monir Nobahar

    2007-07-01

    Full Text Available Objectives: Sleep is one of the essential needs for human and every disorder in during of sleep causes psychological problem and decreased person>s ability. Although sleep disorders occur in every of ages. Elderly person usually has very problem for satisfied sleep. The aim of this study was to estimate prevalence of sleep disorders and confront methods of those in elderly persons in Semnan city. Methods & Materials: This is a descriptive analytical research. 200 elderly residents of Semnan were selected through rundomical sampling. Sleep disorders was assessment with questioner and interviewer that include of sleep disorders (Dissomnia, Parasomnia and confront methods (Behavioral, Cognitive, sleep hygiene and drug therapy. Results: Data indicated that prevalence of dissomnia was 67% and prevalence of insomnia was 61% that the most problem were in all stage of sleep (early, intermittent and end. Prevalence of Parasomnia was 29% that more of those (14% had night terror. In the part of confront methods of sleep disorders, 57% used of behavioral therapy. The most of that (25% were concentration of the limb before the sleep and 95.5% of them comprehension of cognitive methods. The most of that (26% were comprehension of effect of age on sleep. 100% of them orientation of sleep hygiene and the most of that (39% were orientation with 4 choose of sleep hygiene. 20% of them used of drug therapy. Conclusion: Finding above indicate that high prevalence of sleep disorders in elderly in Semnan, need supervised and widespread program for promoting awareness among population about sleep disorders and confront methods of those.

  15. [Sleep bruxism in children and adolescents].

    Science.gov (United States)

    Firmani, Mónica; Reyes, Milton; Becerra, Nilda; Flores, Guillermo; Weitzman, Mariana; Espinosa, Paula

    2015-01-01

    Bruxism is a rhythmic masticatory muscle activity, characterized by teeth grinding and clenching. This is a phenomenon mainly regulated by the central nervous system and peripherally influenced. It has two circadian manifestations, during sleep (sleep bruxism) and awake states (awake bruxism). Bruxism is much more than just tooth wearing. It is currently linked to orofacial pain; headaches; sleep disorders; sleep breathing disorders, such as apnea and hypopnea sleep syndrome; behavior disorders, or those associated with the use of medications. It is also influenced by psycho-social and behavior factors, which means that oromandibular parafunctional activities, temporomandibular disorders, malocclusion, high levels of anxiety and stress, among others, may precipitate the occurrence of bruxism. Nowadays, its etiology is multifactorial. The dentist and the pediatrician are responsible for its early detection, diagnosis, management, and prevention of its possible consequences on the patients. The aim of this review is to update the concepts of this disease and to make health professionals aware of its early detection and its timely management. Copyright © 2015 Sociedad Chilena de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

  16. Dyssomnias, parasomnias, and sleep disorders associated with medical and psychiatric diseases.

    Science.gov (United States)

    Barthlen, G M; Stacy, C

    1994-03-01

    Sleep disorders can be intrinsic, as are insomnia or narcolepsy, or can be accounted for by external factors, such as noise, altitude, drug or alcohol abuse, or shift work. The arousal disorders, common in children, are usually benign and disappear by puberty. Sleep-wake transition disorders such as sleep starts are benign as well, and may occur at any age. The parasomnias comprise different entities such as nightmares, REM-sleep behavior disorder, sleep enuresis, and bruxism. Diagnosis and treatment often require a multidisciplinary approach. Virtually every psychiatric, neurologic, or medical disease, when of sufficient severity, leaves its specific fingerprint on sleep; some disorders, such as peptic ulcer disease, gastroesophageal reflux, or epilepsy, tend to be exacerbated during sleep. Fortunately, most sleep disorders are amenable to therapy, which can include counseling, sleep hygiene, withholding of an offending agent, behavioral therapy, light therapy, or cautious drug therapy.

  17. Long-term effect of adaptive servo ventilation on patients with chronic heart failure and sleep-disordered breathing: Meta analysis

    Directory of Open Access Journals (Sweden)

    Yu-xing FEI

    2017-02-01

    Full Text Available Objective To evaluate the long-tem effect of adaptive servo ventilation (ASV on patients with chronic heart failure (CHF and sleep-disordered breathing (SDB. Methods The controlled clinical articles were searched included in PubMed, Cochrane, EMBASE and CBM, CJFD, WangFang Database from Jan. 1970 to Dec. 2015. Included standard: left ventricular ejection fraction (LVEF ≤55%, apnea hypopnea index (AHI ≥15/h, follow up period over 4 weeks. After quality assessment (modified Jadad score and data extraction by two independent reviewers, mete analysis was performed with RevMan 5.3 software. Results Thirteen studies were recruited including 442 cases being followed over 4 weeks [ASV group 233 cases and control group 216 cases (corssover design 7]. Compared to control group, LVEF increased [weighted mean difference (WMD=3.72, 95%CI: 1.80-5.64, P<0.01] and AHI decreased significantly (WMD=–18.63, 95%CI: –26.19-–11.08, the distance walked in 6 minutes increased (WMD=28.72, 95%CI: 2.26-55.18, P=0.03 and plasma N terminal brain natriuretic peptide precursor (NT-pro BNP decreased significantly (WMD=–744.03, 95%CI: –1262.45-–225.62, P<0.05 in ASV group. Conclusion Over 4 weeks ASV may improve LVEF and AHI, increase 6-min walking distance and decrease NT-pro BNP in patients with CHF and SDB. DOI: 10.11855/j.issn.0577-7402.2016.12.12

  18. Sleep disorders — a doctor's nightmare

    African Journals Online (AJOL)

    Repro

    chronic pain and gastro- oesophageal reflux which are ... Extrinsic sleep disorders (includes medication/drug-related causes, poor sleep hygiene .... avoid functional impairment and the possible ... flow and chest and abdominal movement.

  19. Sleep Quality Improvement During Cognitive Behavioral Therapy for Anxiety Disorders.

    Science.gov (United States)

    Ramsawh, Holly J; Bomyea, Jessica; Stein, Murray B; Cissell, Shadha H; Lang, Ariel J

    2016-01-01

    Despite the ubiquity of sleep complaints among individuals with anxiety disorders, few prior studies have examined whether sleep quality improves during anxiety treatment. The current study examined pre- to posttreatment sleep quality improvement during cognitive behavioral therapy (CBT) for panic disorder (PD; n = 26) or generalized anxiety disorder (GAD; n = 24). Among sleep quality indices, only global sleep quality and sleep latency improved significantly (but modestly) during CBT. Sleep quality improvement was greater for treatment responders, but did not vary by diagnosis. Additionally, poor baseline sleep quality was independently associated with worse anxiety treatment outcome, as measured by higher intolerance of uncertainty. Additional intervention targeting sleep prior to or during CBT for anxiety may be beneficial for poor sleepers.

  20. Sibutramine versus continuous positive airway pressure in obese obstructive sleep apnoea patients.

    Science.gov (United States)

    Ferland, A; Poirier, P; Sériès, F

    2009-09-01

    The aim of the present study was to compare the efficacy of 1 yr of sibutramine-induced weight loss versus continuous positive airway pressure (CPAP) treatment on sleep-disordered breathing, cardiac autonomic function and systemic blood pressure in obese patients with obstructive sleep apnoea. Subjects with a body mass index of > or =30 kg.m(-2) without previous treatment for obstructive sleep apnoea underwent either sibutramine (n = 22) or CPAP (n = 18) treatment for 1 yr. Sibutramine induced a 5.4+/-1.4 kg decrease in body weight compared to the CPAP group, in which no changes in anthropometric variables were observed. The CPAP treatment improved all sleep and respiratory variables, whereas sibutramine-induced weight loss improved only nocturnal arterial oxygen saturation profile. Only CPAP treatment improved night-time systolic and diastolic blood pressure and 24-h and daytime ambulatory diastolic blood pressure. Sibutramine-induced weight loss had no impact on indices of heart rate variability, whereas CPAP treatment increased daytime time domain indices. CPAP treatment for 1 yr had beneficial impacts on nocturnal breathing disturbances, and improved nocturnal oxygenation, night-time systolic and diastolic blood pressure, and daytime cardiac parasympathetic modulation. Sibutramine did not improve sleep-disordered breathing, systemic blood pressure or heart rate variability. There were no adverse effects, such as increment in blood pressure or arrhythmias, associated with this treatment regimen.

  1. Antimony and sleep-related disorders: NHANES 2005-2008.

    Science.gov (United States)

    Scinicariello, Franco; Buser, Melanie C; Feroe, Aliya G; Attanasio, Roberta

    2017-07-01

    Antimony is used as a flame-retardant in textiles and plastics, in semiconductors, pewter, and as pigments in paints, lacquers, glass and pottery. Subacute or chronic antimony poisoning has been reported to cause sleeplessness. The prevalence of short sleep duration (sleep apnea (OSA) affects 12-28 million US adults. Insufficient sleep and OSA have been linked to the development of several chronic conditions including diabetes, cardiovascular disease, obesity and depression, conditions that pose serious public health threats. To investigate whether there is an association between antimony exposure and sleep-related disorders in the US adult population using the National Health and Nutrition Examination Survey (NHANES) 2005-2008. We performed multivariate logistic regression to analyze the association of urinary antimony with several sleep disorders, including insufficient sleep and OSA, in adult (ages 20 years and older) participants of NHANES 2005-2008 (n=2654). We found that participants with higher urinary antimony levels had higher odds to experience insufficient sleep (≤6h/night) (OR 1.73; 95%CI; 1.04, 2.91) as well as higher odds to have increased sleep onset latency (>30min/night). Furthermore, we found that higher urinary antimony levels in participants were associated with OSA (OR 1.57; 95%CI; 1.05, 2.34), sleep problems, and day-time sleepiness. In this study, we found that urinary antimony was associated with higher odds to have insufficient sleep and OSA. Because of the public health implications of sleep disorders, further studies, especially a prospective cohort study, are warranted to evaluate the association between antimony exposure and sleep-related disorders. Copyright © 2017. Published by Elsevier Inc.

  2. Sleep and its disorders in translational medicine.

    Science.gov (United States)

    Paterson, Louise M; Nutt, David J; Wilson, Sue J

    2011-09-01

    The study of sleep is a useful approach to studying the brain in psychiatric disorders and in investigating the effects of psychotropic drugs. Sleep physiology lends itself well to pharmacological and physiological manipulation, as it has the advantage of a functional output, the electroencephalograph, which is common to all mammals, and can be measured in freely moving (or naturally sleeping) animals under controlled laboratory conditions or in a naturalistic home environment. The complexity of sleep architecture varies between species but all share features which are comparable. In addition, sleep architecture is sensitive to changes in brain neurotransmitters such as serotonin, so cross-species sleep measurement can be combined with pharmacological manipulation to investigate the receptor mechanisms controlling sleep-wake regulation and sleep architecture in response to known and novel agents. Translational approaches such as these have improved our understanding of sleep circuitry and facilitated the development of new treatments for sleep disorders, particularly insomnia. This review provides examples of how research findings within the sleep field have been translated between animal models, healthy volunteers and patient populations with particular focus on the serotonergic system.

  3. The tongue and its control by sleep state-dependent modulators.

    Science.gov (United States)

    Horner, R L

    2011-12-01

    The neural networks controlling vital functions such as breathing are embedded in the brain, the neural and chemical environment of which changes with state, i.e., wakefulness, non-rapid eye movement (non-REM) sleep and REM sleep, and with commonly administered drugs such as anaesthetics, sedatives and ethanol. One particular output from the state-dependent chemical brain is the focus of attention in this paper; the motor output to the muscles of the tongue, specifically the actions of state-dependent modulators acting at the hypoglossal motor pool. Determining the mechanisms underlying the modulation of the hypoglossal motor output during sleep is relevant to understanding the spectrum of increased upper airway resistance, airflow limitation, hypoventilation and airway obstructions that occur during natural and drug-influenced sleep in humans. Understanding the mechanisms underlying upper airway dysfunction in sleep-disordered breathing is also important given the large and growing prevalence of obstructive sleep apnea syndrome which constitutes a major public health problem with serious clinical, social and economic consequences.

  4. Genetic variants associated with sleep disorders.

    Science.gov (United States)

    Kripke, Daniel F; Kline, Lawrence E; Nievergelt, Caroline M; Murray, Sarah S; Shadan, Farhad F; Dawson, Arthur; Poceta, J Steven; Cronin, John; Jamil, Shazia M; Tranah, Gregory J; Loving, Richard T; Grizas, Alexandra P; Hahn, Elizabeth K

    2015-02-01

    The diagnostic boundaries of sleep disorders are under considerable debate. The main sleep disorders are partly heritable; therefore, defining heritable pathophysiologic mechanisms could delineate diagnoses and suggest treatment. We collected clinical data and DNA from consenting patients scheduled to undergo clinical polysomnograms, to expand our understanding of the polymorphisms associated with the phenotypes of particular sleep disorders. Patients at least 21 years of age were recruited to contribute research questionnaires, and to provide access to their medical records, saliva for deoxyribonucleic acid (DNA), and polysomnographic data. From these complex data, 38 partly overlapping phenotypes were derived indicating complaints, subjective and objective sleep timing, and polysomnographic disturbances. A custom chip was used to genotype 768 single-nucleotide polymorphisms (SNPs). Additional assays derived ancestry-informative markers (eg, 751 participants of European ancestry). Linear regressions controlling for age, gender, and ancestry were used to assess the associations of each phenotype with each of the SNPs, highlighting those with Bonferroni-corrected significance. In peroxisome proliferator-activated receptor gamma, coactivator 1 beta (PPARGC1B), rs6888451 was associated with several markers of obstructive sleep apnea. In aryl hydrocarbon receptor nuclear translocator-like (ARNTL), rs10766071 was associated with decreased polysomnographic sleep duration. The association of rs3923809 in BTBD9 with periodic limb movements in sleep was confirmed. SNPs in casein kinase 1 delta (CSNK1D rs11552085), cryptochrome 1 (CRY1 rs4964515), and retinoic acid receptor-related orphan receptor A (RORA rs11071547) were less persuasively associated with sleep latency and time of falling asleep. SNPs associated with several sleep phenotypes were suggested, but due to risks of false discovery, independent replications are needed before the importance of these associations

  5. Sleep and REM sleep behaviour disorder in Parkinson's disease with impulse control disorder.

    Science.gov (United States)

    Fantini, Maria Livia; Figorilli, Michela; Arnulf, Isabelle; Zibetti, Maurizio; Pereira, Bruno; Beudin, Patricia; Puligheddu, Monica; Cormier-Dequaire, Florence; Lacomblez, Lucette; Benchetrit, Eve; Corvol, Jean Christophe; Cicolin, Alessandro; Lopiano, Leonardo; Marques, Ana; Durif, Franck

    2018-03-01

    Because the association between rapid eye movement sleep behaviour disorder (RBD) and impulse control disorders (ICDs) in Parkinson's disease (PD) has been debated, we assessed the sleep characteristics and the frequency of RBD using video-polysomnography (v-PSG) in patients with PD with versus without ICDs. Eighty non-demented patients with PD consecutively identified during routine evaluation at three movement disorders centres were enrolled in a case-control study. Forty patients (22 men; mean age: 62.6±9.7 years, Hoehn & Yahr: 2.1±0.6) with one or more current ICDs were age-matched and sex-matched with 40 patients with no history of ICDs (22 men, mean age: 64.9±7.8 years, Hoehn & Yahr: 2.2±0.6). They underwent a detailed sleep interview followed by a full-night in-lab v-PSG. Sleep was scored blindly to ICDs condition and RBD diagnosis included a clinical complaint of enacted dreams and/or documented behaviour during rapid eye movement (REM) sleep, with the presence of quantified REM sleep without atonia (RSWA). Patients with ICDs had a higher arousal index and higher RSWA than those without ICDs (51.9%±28.2%vs 32.2±27.1%, p=0.004). In addition, RBD was more frequent in the ICD group (85%vs53%, p=0.0001). RBD was still associated with ICDs in a multivariate regression analysis including age of onset, PD duration and severity, treatment duration, levodopa-equivalent and dopamine agonist-equivalent daily doses and antidepressant use (OR: 4.9 (95% CI 1.3 to 18.5), p=0.02). This large, controlled series of patients with PD with ICDs assessed by v-PSG confirms the association between ICDs and RBD. Increased surveillance of symptoms of ICDs should be recommended in patients with PD with RBD. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  6. Is there a common motor dysregulation in sleepwalking and REM sleep behaviour disorder?

    Science.gov (United States)

    Haridi, Mehdi; Weyn Banningh, Sebastian; Clé, Marion; Leu-Semenescu, Smaranda; Vidailhet, Marie; Arnulf, Isabelle

    2017-10-01

    This study sought to determine if there is any overlap between the two major non-rapid eye movement and rapid eye movement parasomnias, i.e. sleepwalking/sleep terrors and rapid eye movement sleep behaviour disorder. We assessed adult patients with sleepwalking/sleep terrors using rapid eye movement sleep behaviour disorder screening questionnaires and determined if they had enhanced muscle tone during rapid eye movement sleep. Conversely, we assessed rapid eye movement sleep behaviour disorder patients using the Paris Arousal Disorders Severity Scale and determined if they had more N3 awakenings. The 251 participants included 64 patients with rapid eye movement sleep behaviour disorder (29 with idiopathic rapid eye movement sleep behaviour disorder and 35 with rapid eye movement sleep behaviour disorder associated with Parkinson's disease), 62 patients with sleepwalking/sleep terrors, 66 old healthy controls (age-matched with the rapid eye movement sleep behaviour disorder group) and 59 young healthy controls (age-matched with the sleepwalking/sleep terrors group). They completed the rapid eye movement sleep behaviour disorder screening questionnaire, rapid eye movement sleep behaviour disorder single question and Paris Arousal Disorders Severity Scale. In addition, all the participants underwent a video-polysomnography. The sleepwalking/sleep terrors patients scored positive on rapid eye movement sleep behaviour disorder scales and had a higher percentage of 'any' phasic rapid eye movement sleep without atonia when compared with controls; however, these patients did not have higher tonic rapid eye movement sleep without atonia or complex behaviours during rapid eye movement sleep. Patients with rapid eye movement sleep behaviour disorder had moderately elevated scores on the Paris Arousal Disorders Severity Scale but did not exhibit more N3 arousals (suggestive of non-rapid eye movement parasomnia) than the control group. These results indicate that dream

  7. Hypnosis in the Management of Sleep Disorders.

    Science.gov (United States)

    Becker, Philip M

    2015-03-01

    Hypnosis has been used to manage insomnia and disorders of arousal. The alteration in the state of consciousness produced during hypnotic trance is more similar to relaxed reverie than sleep. Hypnosis typically occurs in a state of repose and the accomplished subject may have no recollection of the experience during a trance, 2 commonalities with sleep. Because hypnosis allows for relaxation, increased suggestibility, posthypnotic suggestion, imagery rehearsal, access to preconscious cognitions and emotions, and cognitive restructuring, disorders of sleep such as the insomnias, parasomnias, and related mood or anxiety disorders can be amenable to this therapeutic intervention. Copyright © 2015 Elsevier Inc. All rights reserved.

  8. Sleep disorder among medical students: relationship to their academic performance.

    Science.gov (United States)

    Abdulghani, Hamza M; Alrowais, Norah A; Bin-Saad, Norah S; Al-Subaie, Nourah M; Haji, Alhan M A; Alhaqwi, Ali I

    2012-01-01

    Medical students are exposed to a significant level of pressure due to academic demands. Their sleep pattern is characterized by insufficient sleep duration, delayed sleep onset, and occurrence of napping episodes during the day. To examine the prevalence of sleep disorder among medical students and investigate any relationship between sleep disorder and academic performance. This is a cross-sectional self-administered questionnaire-based study. The participants were medical students of the first, second, and third academic years. The Epworth Sleepiness Scale (ESS) was also included to identify sleep disorder and grade point average was recorded for academic performance. There were 491 responses with a response rate of 55%. The ESS score demonstrated that 36.6% of participants were considered to have abnormal sleep habits, with a statistically significant increase in female students (p = 0.000). Sleeping between 6-10 h per day was associated with normal ESS scores (p = 0.019) as well as the academic grades ≥ 3.75. Abnormal ESS scores were associated with lower academic achievement (p = 0.002). A high prevalence of sleep disorder was found in this group of students, specifically female students. Analysis of the relationship between sleep disorder and academic performance indicates a significant relationship between abnormal ESS scores, total sleeping hours, and academic performance.

  9. No objectively measured sleep disturbances in children with attention-deficit/hyperactivity disorder.

    Science.gov (United States)

    Bergwerff, Catharina E; Luman, Marjolein; Oosterlaan, Jaap

    2016-10-01

    The main goal of this study was to gain more insight into sleep disturbances in children with attention-deficit/hyperactivity disorder, using objective measures of sleep quality and quantity. The evidence for sleep problems in children with attention-deficit/hyperactivity disorder thus far is inconsistent, which might be explained by confounding influences of comorbid internalizing and externalizing problems and low socio-economic status. We therefore investigated the mediating and moderating role of these factors in the association between attention-deficit/hyperactivity disorder and sleep problems. To control for the effects of stimulant medication use, all participants were tested free of medication. Sixty-three children with attention-deficit/hyperactivity disorder and 61 typically developing children, aged 6-13 years, participated. Sleep was monitored for one to three school nights using actigraphy. Parent and teacher questionnaires assessed symptoms of attention-deficit/hyperactivity disorder, internalizing behaviour, oppositional defiant disorder and conduct disorder. Results showed no differences between the attention-deficit/hyperactivity disorder and typically developing group in any sleep parameter. Within the attention-deficit/hyperactivity disorder group, severity of attention-deficit/hyperactivity disorder symptoms was not related to sleep quality or quantity. Moderation analyses in the attention-deficit/hyperactivity disorder group showed an interaction effect between attention-deficit/hyperactivity disorder symptoms and internalizing and externalizing behaviour on total sleep time, time in bed and average sleep bout duration. The results of our study suggest that having attention-deficit/hyperactivity disorder is not a risk factor for sleep problems. Internalizing and externalizing behaviour moderate the association between attention-deficit/hyperactivity disorder and sleep, indicating a complex interplay between psychiatric symptoms and sleep.

  10. Autism and sleep disorders

    OpenAIRE

    Devnani, Preeti A.; Hegde, Anaita U.

    2015-01-01

    “Autism Spectrum Disorders” (ASDs) are neurodevelopment disorders and are characterized by persistent impairments in reciprocal social interaction and communication. Sleep problems in ASD, are a prominent feature that have an impact on social interaction, day to day life, academic achievement, and have been correlated with increased maternal stress and parental sleep disruption. Polysomnography studies of ASD children showed most of their abnormalities related to rapid eye movement (REM) slee...

  11. Leptin: A biomarker for sleep disorders?

    OpenAIRE

    Pan, Weihong; Kastin, Abba J.

    2013-01-01

    Leptin, a pleiotropic protein hormone produced mainly by fat cells, regulates metabolic activity and many other physiological functions. The intrinsic circadian rhythm of blood leptin is modulated by gender, development, feeding, fasting, sleep, obesity, and endocrine disorders. Hyperleptinemia is implicated in leptin resistance. To determine the specificity and sensitivity of leptin concentrations in sleep disorders, we summarize here the alterations of leptin in four conditions in animal an...

  12. Rhinitis and sleep disorders: The trigeminocardiac reflex link?

    Science.gov (United States)

    Bindu, Barkha; Singh, Gyaninder Pal; Chowdhury, Tumul; Schaller, Bernhard

    2017-06-01

    Rhinitis, allergic or non-allergic, is an inflammatory condition of the nose. It is associated with a wide range of sleep disorders that are generally attributed to nasal congestion and presence of inflammatory mediators like cytokines and interleukins. However, the pathophysiological mechanisms behind these sleep disorders remain unclear. On the other hand, the trigeminocardiac reflex (TCR) has recently been linked to various sleep disorders like obstructive sleep apnea, sleep bruxism and rapid eye movement (REM) sleep apnea. TCR can be incited by stimulation of the trigeminal nerve or the area innervated by its branches including the nasal mucosa. Trigeminal nasal afferents can be activated on exposure to noxious stimuli (mechanical or chemical) like ammonia vapors, carbon-dioxide, nicotine, hypertonic saline, air-puffs and smoke. In rhinitis, there is associated neuronal hyper-responsiveness of sensory nasal afferents due to inflammation (which can be suppressed by steroids). This may further lead to increased occurrence of TCR in rhinitis. Moreover, there is involvement of autonomic nervous system both in rhinitis and TCR. In TCR, parasympathetic over activity and sympathetic inhibition leads to sudden onset bradycardia, hypotension, apnea and gastric motility. Also, the autonomic imbalance reportedly plays a significant role in the pathophysiology of rhinitis. Thus, considering these facts we hypothesize that the TCR could be the link between rhinitis and sleep disorders and we believe that further research in this direction may yield significant development in our understanding of sleep disorders in rhinitis. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. Sleep-related problems in common medical conditions.

    Science.gov (United States)

    Parish, James M

    2009-02-01

    Common medical problems are often associated with abnormalities of sleep. Patients with chronic medical disorders often have fewer hours of sleep and less restorative sleep compared to healthy individuals, and this poor sleep may worsen the subjective symptoms of the disorder. Individuals with lung disease often have disturbed sleep related to oxygen desaturations, coughing, or dyspnea. Both obstructive lung disease and restrictive lung diseases are associated with poor quality sleep. Awakenings from sleep are common in untreated or undertreated asthma, and cause sleep disruption. Gastroesophageal reflux is a major cause of disrupted sleep due to awakenings from heartburn, dyspepsia, acid brash, coughing, or choking. Patients with chronic renal disease commonly have sleep complaints often due to insomnia, insufficient sleep, sleep apnea, or restless legs syndrome. Complaints related to sleep are very common in patients with fibromyalgia and other causes of chronic pain. Sleep disruption increases the sensation of pain and decreases quality of life. Patients with infectious diseases, including acute viral illnesses, HIV-related disease, and Lyme disease, may have significant problems with insomnia and hypersomnolence. Women with menopause have from insomnia, sleep-disordered breathing, restless legs syndrome, or fibromyalgia. Patients with cancer or receiving cancer therapy are often bothered by insomnia or other sleep disturbances that affect quality of life and daytime energy. The objective of this article is to review frequently encountered medical conditions and examine their impact on sleep, and to review frequent sleep-related problems associated with these common medical conditions.

  14. Sleep Disorders and Their Management in Children With Ehlers-Danlos Syndrome Referred to Sleep Clinics.

    Science.gov (United States)

    Domany, Keren Armoni; Hantragool, Sumalee; Smith, David F; Xu, Yuanfang; Hossain, Monir; Simakajornboon, Narong

    2018-04-15

    The nature of sleep disorders in children with Ehlers-Danlos syndrome (EDS) is unknown. We aimed to describe the type, the management, and the short-term outcome of sleep disorders in children with EDS referred to sleep clinics. This is a retrospective review of medical records and polysomnography tests of children with EDS younger than 18 years who were referred to the sleep clinic. Demographic information and medical history were collected, and polysomnography tests were reviewed. Questionnaires completed during previous clinic visits, including the Pediatrics Sleep Questionnaire (PSQ), Epworth Sleepiness Scale (ESS), and Pediatric Quality of Life Inventory (PedsQL), were also evaluated. Sixty-five patients with EDS-hypermobility type were included. The mean age was 13.15 ± 3.9 years. There were 68% of patients who were female, and 91% of patients were Caucasian. The mean follow-up period was 1.14 ± 1.55 years. Common sleep diagnoses included insomnia (n = 14, 22%), obstructive sleep apnea (OSA) (n = 17, 26%), periodic limb movement disorder (PLMD) (n = 11, 17%), and hypersomnia (n = 10, 15%). In addition, 65% required pharmacologic treatment and 29% were referred to behavioral sleep medicine. For OSA, two patients required continuous positive airway pressure. A significant improvement was observed in the PSQ, ESS, and PedsQL scores during follow-up visits after treatment (n = 34; P = .0004, 0.03, and 0.01, respectively). There is a high prevalence of sleep disorders, including OSA, insomnia, PLMD, and hypersomnia in children with EDS referred to sleep clinics. Specific management can improve quality of life and questionnaire scores of this patient population. Our study emphasizes the importance of screening for sleep disorders in children with EDS. © 2018 American Academy of Sleep Medicine.

  15. Primary nocturnal enuresis as a risk factor for sleep disorders: an observational questionnaire-based multicenter study

    Directory of Open Access Journals (Sweden)

    Esposito M

    2013-03-01

    Full Text Available Maria Esposito,1 Beatrice Gallai,2 Lucia Parisi,3 Michele Roccella,3 Rosa Marotta,4 Serena Marianna Lavano,4 Giovanni Mazzotta,5 Marco Carotenuto11Center for Childhood Headache, Clinic of Child and Adolescent Neuropsychiatry, Department of Mental Health, Physical and Preventive Medicine, Second University of Naples, Naples, Italy; 2Unit of Child and Adolescent Neuropsychiatry, University of Perugia, Perugia, Italy; 3Child Neuropsychiatry, Department of Psychology, University of Palermo, Palermo, Italy; 4Department of Psychiatry, “Magna Graecia” University of Catanzaro, Catanzaro, Italy; 5Unit of Child and Adolescent Neuropsychiatry, AUSL Umbria 2, Terni, ItalyIntroduction: Primary nocturnal enuresis (PNE is a common problem in developmental age with an estimated overall prevalence ranging from 1.6% to 15%, and possible persistence during adolescence. There is a growing interest in the sleep habits of children affected by PNE, which is derived from the contradictory data present in clinical literature. The aim of the present study was to evaluate the presence of sleep disturbances in a population of children affected by PNE, and to identify whether PNE could be considered as a risk factor for sleep disturbances among children.Materials and methods: A total of 190 PNE children (97 males, 93 females aged 7–15 years, (mean 9.64 ± 1.35 years, and 766 typically developing children matched for age (P = 0.131 and gender (P = 0.963 were enrolled. To evaluate the presence of sleep habits and disturbances, all of the subjects’ mothers filled out the Sleep Disturbances Scale for Children (SDSC, a questionnaire consisting of six subscales: Disorders in Initiating and Maintaining Sleep (DIMS, Sleep Breathing Disorders (SBD, Disorders of Arousal (DA, Sleep–Wake Transition Disorders (SWTD, Disorders of Excessive Somnolence (DOES, and Nocturnal Hyperhidrosis (SHY. The results were divided into “pathological” and “normal” scores using a cut

  16. Late postoperative nocturnal episodic hypoxaemia and associated sleep pattern

    DEFF Research Database (Denmark)

    Rosenberg, J; Wildschiødtz, G; Pedersen, M H

    1994-01-01

    significantly after surgery (P REM) sleep decreased significantly on the first night after operation (P REM sleep (rebound) on the second, third or both nights after operation compared with the preoperative night. Slow wave sleep...... was depressed significantly on the first two nights after operation (P REM sleep-associated hypoxaemic episodes for individual patients increased about three-fold on the second and third nights after operation compared with the night before operation (P sleep...... pattern is disturbed severely with early depression of REM and slow wave sleep and with rebound of REM sleep on the second and third nights. Postoperative rebound of REM sleep may contribute to the development of sleep disordered breathing and nocturnal episodic hypoxaemia....

  17. Sleep disturbances in myotonic dystrophy type 2.

    Science.gov (United States)

    Shepard, Paul; Lam, Erek M; St Louis, Erik K; Dominik, Jacob

    2012-01-01

    Sleep disorders in myotonic dystrophy type 1 (DM1) are common and include sleep-disordered breathing, hypersomnia, and fatigue. Little is known regarding the occurrence of sleep disturbance in myotonic dystrophy type 2 (DM2). We hypothesized that DM2 patients may frequently harbor sleep disorders. We reviewed medical records of all genetically confirmed cases of DM2 seen at our sleep center between 1997 and 2010 for demographic, laboratory, overnight oximetry, and polysomnography (PSG) data. Eight patients (5 women, 3 men) with DM2 were identified. Excessive daytime sleepiness was seen in 6 patients (75%), insomnia in 5 (62.5%), and excessive fatigue in 4 (50%). Obstructive sleep apnea was diagnosed in 3 of 5 patients (60%) studied with PSG. Respiratory muscle weakness was present in all 6 patients (100%) who received pulmonary function testing. Four of 8 (50%) met criteria for diagnosis of restless legs syndrome. The clinical spectrum of DM2 may include a wide range of sleep disturbances. Although respiratory muscle weakness was frequent, sustained sleep-related hypoxia suggestive of hypoventilation was not seen in our patients. Further prospective studies are needed to examine the frequency and scope of sleep disturbances in DM2. Copyright © 2012 S. Karger AG, Basel.

  18. Investigation of acetone, butanol and carbon dioxide as new breath biomarkers for convenient and noninvasive diagnosis of obstructive sleep apnea syndrome.

    Science.gov (United States)

    Bayrakli, Ismail; Öztürk, Önder; Akman, Hatice

    2016-12-01

    The objective of the present study was to investigate whether analysis of carbon dioxide, acetone and/or butanol present in human breath can be used as a simple and noninvasive diagnosis method for obstructive sleep apnea syndrome (OSAS). For this purpose, overnight changes in the concentrations of these breath molecules were measured before and after sleep in 10 patients who underwent polysomnography and were diagnosed with OSAS, and were compared with the levels of these biomarkers determined after sleep in 10 healthy subjects. The concentrations of exhaled carbon dioxide were measured using external cavity laser-based off-axis cavity enhanced absorption spectroscopy, whereas the levels of exhaled acetone and butanol were determined using thermal desorption gas chromatography mass spectrometry. We observed no significant changes in the levels of exhaled acetone and carbon dioxide in OSAS patients after sleep compared with pre-sleep values and compared with those in healthy control subjects. However, for the first time, to our knowledge, analyses of expired air showed an increased concentration of butanol after sleep compared with that before sleep and compared with that in healthy subjects. These results suggest that butanol can be established as a potential biomarker to enable the convenient and noninvasive diagnosis of OSAS in the future. Copyright © 2016 John Wiley & Sons, Ltd.

  19. Adults with Attention Deficit Hyperactivity Disorder Report High Symptom Levels of Troubled Sleep, Restless Legs, and Cataplexy

    Directory of Open Access Journals (Sweden)

    Bjørn Bjorvatn

    2017-09-01

    Full Text Available Objective: To compare the occurrence of a spectrum of different self-reported sleep problems in adults with ADHD and a control group, and to study the impact of current ADHD medication use and clinical ADHD subtype.Method: Cross-sectional study of 268 clinically ascertained adult ADHD patients (DSM-IV criteria and 202 randomly selected controls. Sleep problems were self-reported using validated questions, partly from Global Sleep Assessment Questionnaire.Results: ADHD patients reported more sleep problems than controls: Lifetime occurrence of sleep problems (82.6 vs. 36.5%, hypnotics use (61.4 vs. 20.2%, current sleep duration below 6 h (26.6 vs. 7.6%, and symptoms/signs during the past 4 weeks of excessive daytime sleepiness, cataplexy, loud snoring, breathing pauses during sleep, restless legs, and periodic limb movements in sleep (significant odds ratios ranged from 1.82 to 14.55. Current ADHD medication use was associated with less cataplexy compared with not using medication. Patients with inattentive subtype reported better sleep quality and less restless legs than patients with hyperactive/impulsive subtypes.Conclusions: Adults with ADHD reported a very high occurrence of many different self-reported sleep problems, underlining the importance of screening for sleep disorders. Among the ADHD patients, medication use was not associated with more sleep-related symptoms, but in fact less cataplexy. When comparing ADHD subtypes, the inattentive subtype was associated with less sleep problems.

  20. Breathing disturbances without hypoxia are associated with objective sleepiness in sleep apnea

    DEFF Research Database (Denmark)

    Koch, Henriette; Schneider, Logan Douglas; Finn, Laurel A

    2017-01-01

    analyzed with our automated algorithm, developed to detect breathing disturbances and desaturations. Breathing events were time-locked to desaturations, resulting in 2 indices - desaturating (H-BDI) and non-desaturating (NH-BDI) events - regardless of arousals. Measures of subjective (Epworth Sleepiness...... Scale) and objective (2,981 multiple sleep latency tests from a subset of 865 subjects) sleepiness were analyzed, in addition to clinically relevant clinicodemographic variables. Hypertension was defined as BP ≥140/90 or antihypertensive use. H-BDI, but not NH-BDI, correlated strongly with SDB severity...... indices that included hypoxia (r≥0.89, p≤0.001 with 3% ODI and AHI with 4%-desaturations). A doubling of desaturation-associated events was associated with hypertension prevalence, which was significant for ODI but not H-BDI (3% ODI OR=1.06, 95% CI=1.00-1.12, p...

  1. Orexin: a Missing Link Between Sleep Disorders and Heart Failure?

    Science.gov (United States)

    Pan, Stephen; Cabral, Carolina S; Ashley, Euan A; Perez, Marco V

    2017-04-01

    Sleep disorders represent a significant comorbidity in the heart failure population, and there is mounting evidence that treatment of sleep disorders such as obstructive sleep apnea can significantly improve cardiac function. However, the link between these two disorders is still not entirely clear. Recently, a novel neurohormonal pathway has been elucidated involving signaling molecules now collectively known as the orexins, which have been implicated in regulating autonomic function during sleep/wake cycles. Further evidence has mounted that orexin signaling is deeply perturbed in the setting of sleep disorders, and furthermore that abnormal orexin signaling may be implicated in the pathology of heart failure. The orexin signaling pathway represents an enticing novel target for both the treatment of sleep disorders as well as heart failure, and may represent one facet of the "missing link" between these two prevalent and often comorbid diseases.

  2. Sleep disturbances in patients with major depressive disorder: incongruence between sleep log and actigraphy.

    Science.gov (United States)

    Kung, Pei-Ying; Chou, Kuei-Ru; Lin, Kuan-Chia; Hsu, Hsin-Wei; Chung, Min-Huey

    2015-02-01

    Depression has become a severe global health problem, and sleeping difficulties are typically associated with depression. The purpose of this study was to investigate the relationships among subjective sleep quality, objective sleep quality, and the sleep hygiene practices of hospitalized patients with major depressive disorder. Daily sleep logs and actigraphy were used to obtain subjective and objective sleep data. Thirty patients were recruited from a regional teaching hospital in Taipei and completed the Hamilton Rating Scale for Depression and the Sleep Hygiene Practice Scale. Significant differences were found between subjective and objective sleep data in patients with major depressive disorder (MDD). For patients with more severe depression, subjective measurements obtained using sleep logs, such as total sleep time and sleep efficiency, were significantly lower than those obtained using actigraphy by controlling for demographics. The results regarding the differences between subjective and objective sleep data can be a reference for care providers when comforting depression patients who complain of sleep disturbance. Copyright © 2014 Elsevier Inc. All rights reserved.

  3. Role of sleep quality in the metabolic syndrome

    Directory of Open Access Journals (Sweden)

    Koren D

    2016-08-01

    Full Text Available Dorit Koren,1,2 Magdalena Dumin,1 David Gozal2,3 1Section of Adult and Pediatric Endocrinology, Diabetes, and Metabolism, Department of Medicine, 2Section of Pediatric Sleep Medicine, 3Section of Pulmonology, Department of Pediatrics, Pritzker School of Medicine, Biological Sciences Division, The University of Chicago, Chicago, IL, USA Abstract: Emerging evidence has assigned an important role to sleep as a modulator of metabolic homeostasis. The impact of variations in sleep duration, sleep-disordered breathing, and chronotype to cardiometabolic function encompasses a wide array of perturbations spanning from obesity, insulin resistance, type 2 diabetes, the metabolic syndrome, and cardiovascular disease risk and mortality in both adults and children. Here, we critically and extensively review the published literature on such important issues and provide a comprehensive overview of the most salient pathophysiologic pathways underlying the links between sleep, sleep disorders, and cardiometabolic functioning. Keywords: sleep apnea, circadian clock, insulin resistance, obesity, cardiovascular risk

  4. Sleep In Older Adults: Normative Changes, Sleep Disorders, and Treatment Options

    Science.gov (United States)

    Gooneratne, Nalaka S.; Vitiello, Michael V.

    2014-01-01

    1 Synopsis Sleep disorders are common in older adults: Approximately 5% of older adults meet criteria for clinically significant insomnia disorders and 20% for sleep apnea syndromes. When considering insomnia symptoms, it is important to distinguish age-appropriate changes in sleep from clinically significant insomnia, with the latter distinguished by the presence of significant daytime symptoms such as fatigue. Evaluation with a sleep diary and screening for comorbid conditions, especially mood disorders, is essential. Non-pharmacologic therapies, such as cognitive-behavioral therapy for insomnia, can be highly effective and have sustained benefit. A broad range of pharmacologic therapies are also available but can have unwanted psychomotor effects. If left untreated, insomnia can be associated with increased risk of depression and significant impairments in quality of life. In regards to sleep apnea, a high index of suspicion is crucial for effective diagnosis because symptoms commonly noted in younger patients, such as obesity or loud snoring, may not be present in older patients. Diagnosis and management is fairly similar across age groups, except that a more nuanced approach to weight loss is warranted in older adults. The increasing use of home-based portable polysomnography and auto-titrating positive-airway pressure therapy can reduce barriers to treatment. PMID:25037297

  5. Sleep disorders and Parkinson disease; lessons from genetics.

    Science.gov (United States)

    Gan-Or, Ziv; Alcalay, Roy N; Rouleau, Guy A; Postuma, Ronald B

    2018-01-31

    Parkinson disease is a common, age-related neurodegenerative disorder, projected to afflict millions of individuals in the near future. Understanding its etiology and identifying clinical, genetic or biological markers for Parkinson disease onset and progression is therefore of major importance. Various sleep-related disorders are the most common group of non-motor symptoms in advanced Parkinson disease, but they can also occur during its prodromal phase. However, with the exception of REM sleep behavior disorder, it is unclear whether they are part of the early pathological process of Parkinson disease, or if they develop as Parkinson disease advances because of treatments and neurodegeneration progression. The advancements in genetic studies in the past two decades have generated a wealth of information, and recent genetic studies offer new insight on the association of sleep-related disorders with Parkinson disease. More specifically, comparing genetic data between Parkinson disease and sleep-related disorders can clarify their association, which may assist in determining whether they can serve as clinical markers for Parkinson disease risk or progression. In this review, we discuss the current knowledge on the genetics of sleep-related disorders in Parkinson disease context, and the potential implications on research, diagnosis, counseling and treatment. Copyright © 2018 Elsevier Ltd. All rights reserved.

  6. Recent Advances in the Study of Sleep in the Anxiety Disorders, Obsessive-Compulsive Disorder, and Posttraumatic Stress Disorder.

    Science.gov (United States)

    Boland, Elaine M; Ross, Richard J

    2015-12-01

    Sleep disturbance is frequently associated with generalized anxiety disorder, panic disorder, obsessive-compulsive disorder, and posttraumatic stress disorder. This article reviews recent advances in understanding the mechanisms of the sleep disturbances in these disorders and discusses the implications for developing improved treatments. Published by Elsevier Inc.

  7. Automatic REM sleep detection associated with idiopathic rem sleep Behavior Disorder

    DEFF Research Database (Denmark)

    Kempfner, J; Sørensen, Gertrud Laura; Sorensen, H B D

    2011-01-01

    Rapid eye movement sleep Behavior Disorder (RBD) is a strong early marker of later development of Parkinsonism. Currently there are no objective methods to identify and discriminate abnormal from normal motor activity during REM sleep. Therefore, a REM sleep detection without the use of chin...... electromyography (EMG) is useful. This is addressed by analyzing the classification performance when implementing two automatic REM sleep detectors. The first detector uses the electroencephalography (EEG), electrooculography (EOG) and EMG to detect REM sleep, while the second detector only uses the EEG and EOG....

  8. THE SUFFERING OF PATIENTS WITH RESPIRATORY DISORDERS DURING SLEEP

    Directory of Open Access Journals (Sweden)

    Jacek Lech

    2013-11-01

    Full Text Available Assumption : Respiratory disorders during sleep involving the occurrence of sleep apnoea leading to a reduction in arterial oxygen saturation are classified as: obstructive sleep apnoea, central sleep apnoea and sleep-related hypoventilation with hypoxaemia. A close correlation has been proved between the occurrence of apnoea and obesity. This problem concerns 2–4% of the population, and is more likely to affect men. Aim : Presentation of the problem of respiratory disorders during sleep as a chronic disease causing much suffering. Its symptoms may lead to sleep fragmentation and somatic consequences (such as dysfunction of the cardiovascular system as well as mental consequences (personality changes. Method : An analysis of literature concerning the subject-matter from the perspective of a doctor conducting ventilation therapy of patients with respiratory sleep disorders. Summary : The problem of sleep apnoea is most often diagnosed and treated too late due to the number of symptoms with a simultaneous absence of pathognomonic symptoms. Despite its commonness, recognition of this disease is still insufficient.

  9. Incidence of sleep disorders in patients with Alzheimer disease

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    Einstein Francisco Camargos

    2011-12-01

    Full Text Available Objective: To determine the incidence of sleep disorder at a follow-up examination from 1 to 4 years, in demented patients diagnosed at first visit, besides analyzing associated demographic and comorbidities characteristics. Methods: A total of 122 elderly patients aged 60 years or older and diagnosed with dementia (Alzheimer and other were followed in a reference geriatric center for dementia. The clinical protocols included interviews with patient and caregiver, complete physical examination, laboratory and imaging tests. Criteria for the diagnosis of sleep disorder included complain of insomnia from the patient or caregiver using the Neuropsychiatric Inventory nighttime. Results: The incidence density of sleep disorder among dements was 18.7/100 person/years. The risk of developing sleep disorder within the first and fourth years of follow-up was 9.8% and 50.9%, respectively. Multivariate Cox regression analysis revealed that educational level less than 8 years and report of aggressiveness at baseline were an independent predictor of sleep disorder, increased risk in 3.1 (95%CI: 1.30-9.22 and 2.1 times (95%CI: 1.16-4.17, respectively. Conclusion: The incidence of sleep disorder in demented patients was elevated, and was particularly associated to low educational level and aggressiveness at admission.

  10. INTEGRATED DIAGNOSTICS AND CORRECTION OF SLEEP DISORDERS IN CHILDREN

    Directory of Open Access Journals (Sweden)

    S. A. Nemkova

    2015-01-01

    Full Text Available The article is devoted to the actual problem of modern pediatrics and neurology ― a comprehensive diagnosis and correction of sleep disorders in children. Detail the features of the clinical manifestations of sleep disorders in childhood (insomnia and parasomnia, great attention is paid to sleep apnea syndrome as a risk factor for somatic and psychopathological disorders in children. Highlight the current capabilities of complex instrumental diagnosis of sleep disorders with the use of highly effective methods of polysomnography and pulse oximetry. The actual dimensions as non-drug and drug treatment of sleep disorders in children, taking into account the pathogenetic features of their occurrence. From the standpoint of evidence-based medicine demonstrate efficient methods of herbal medicine, developed on the basis of traditional Chinese recipes, as well as modern nootropics and magnesium preparations. It is shown that sleep disorders in children not only lead to a deterioration of emotional mood, cognitive function, health and school performance, but also are associated with increasing risk of somatic disorders, which determines the need for timely diagnosis and comprehensive differentiated medical and psychological data correction of pathological conditions, taking into account the neurophysiological and biochemical mechanisms of their development, as well as polymorphism of clinical manifestations, in order to increase the effectiveness of treatment and quality of life of patients.  

  11. Sleep Disorder Diagnosis During Pregnancy and Risk of Preterm Birth.

    Science.gov (United States)

    Felder, Jennifer N; Baer, Rebecca J; Rand, Larry; Jelliffe-Pawlowski, Laura L; Prather, Aric A

    2017-09-01

    To test the hypothesis that sleep disorder diagnosis would be associated with increased risk of preterm birth and to examine risk by gestational age, preterm birth type, and specific sleep disorder (insomnia, sleep apnea, movement disorder, and other). In this observational study, participants were from a cohort of nearly 3 million women in California between 2007 and 2012. Inclusion criteria were women with singleton neonates liveborn between 20 and 44 weeks of gestation without chromosomal abnormalities or major structural birth defects linked to a hospital discharge database maintained by the California Office of Statewide Health Planning and Development and without mental illness during pregnancy. Sleep disorder was defined based on International Classification of Diseases, 9th Revision, Clinical Modification diagnostic code (n=2,265). Propensity score matching was used to select a referent population at a one-to-one ratio. Odds of preterm birth were examined by gestational age (less than 34 weeks, 34-36 weeks, and less than 37 weeks of gestation) and type (spontaneous, indicated). Prevalence of preterm birth (before 37 weeks of gestation) was 10.9% in the referent group compared with 14.6% among women with a recorded sleep disorder diagnosis. Compared with the referent group, odds (95% CI, P value, percentage) of preterm birth were 1.3 (1.0-1.7, P=.023, 14.1%) for insomnia and 1.5 (1.2-1.8, P<.001, 15.5%) for sleep apnea. Risk varied by gestational age and preterm birth type. Odds of preterm birth were not significantly increased for sleep-related movement disorders or other sleep disorders. Insomnia and sleep apnea were associated with significantly increased risk of preterm birth. Considering the high prevalence of sleep disorders during pregnancy and availability of evidence-based nonpharmacologic interventions, current findings suggest that screening for severe presentations would be prudent.

  12. Sleep disorders in children with cerebral palsy: An integrative review.

    Science.gov (United States)

    Lélis, Ana Luíza P A; Cardoso, Maria Vera L M; Hall, Wendy A

    2016-12-01

    Sleep disorders are more prevalent in children with cerebral palsy. The review aimed to identify and synthesize information about the nature of sleep disorders and their related factors in children with cerebral palsy. We performed an electronic search by using the search terms sleep/child*, and sleep/cerebral palsy in the following databases: Latin American literature on health sciences, SCOPUS, medical publications, cumulative index to nursing and allied health literature, psycinfo, worldcat, web of science, and the Cochrane library. The selection criteria were studies: available in Portuguese, English or Spanish and published between 2004 and 2014, with results addressing sleep disorders in children (ages 0-18 y) with a diagnosis of cerebral palsy. 36,361 abstracts were identified. Of those, 37 papers were selected, and 25 excluded. Twelve papers were incorporated in the study sample: eight quantitative studies, three reviews, and one case study. Eleven types of sleep disorders were identified, such as difficult morning awakening, insomnia, nightmares, difficulties in initiating and maintaining nighttime sleep (night waking), and sleep anxiety. Twenty-one factors were linked to sleep disorders, which we classified as intrinsic factors associated with common comorbidities accompanying cerebral palsy, and extrinsic aspects, specifically environmental and socio-familial variables, and clinical-surgical and pharmacological interventions. Copyright © 2015 Elsevier Ltd. All rights reserved.

  13. Periodic Limb Movements During Sleep Mimicking REM Sleep Behavior Disorder: A New Form of Periodic Limb Movement Disorder.

    Science.gov (United States)

    Gaig, Carles; Iranzo, Alex; Pujol, Montserrat; Perez, Hernando; Santamaria, Joan

    2017-03-01

    To describe a group of patients referred because of abnormal sleep behaviors that were suggestive of rapid eye movement (REM) sleep behavior disorder (RBD) in whom video-polysomnography ruled out RBD and showed the reported behaviors associated with vigorous periodic limb movements during sleep (PLMS). Clinical history and video-polysomnography review of patients identified during routine visits in a sleep center. Patients were 15 men and 2 women with a median age of 66 (range: 48-77) years. Reported sleep behaviors were kicking (n = 17), punching (n = 16), gesticulating (n = 8), falling out of bed (n = 5), assaulting the bed partner (n = 2), talking (n = 15), and shouting (n = 10). Behaviors resulted in injuries in 3 bed partners and 1 patient. Twelve (70.6%) patients were not aware of displaying abnormal sleep behaviors that were only noticed by their bed partners. Ten (58.8%) patients recalled unpleasant dreams such as being attacked or chased. Video-polysomnography showed (1) frequent and vigorous stereotyped PLMS involving the lower limbs, upper limbs, and trunk (median PLMS index 61.2; median PLMS index in NREM sleep 61.9; during REM sleep only 8 patients had PLMS and their median PLMS index in REM sleep was 39.5); (2) abnormal behaviors (e.g., punching, groaning) during some of the arousals that immediately followed PLMS in NREM sleep; and (3) ruled out RBD and other sleep disorders such as obstructive sleep apnea. Dopaminergic agents were prescribed in 14 out of the 17 patients and resulted in improvement of abnormal sleep behaviors and unpleasant dreams in all of them. After dopaminergic treatment, follow-up video-polysomnography in 7 patients showed a decrease in the median PLMS index from baseline (108.9 vs. 19.2, p = .002) and absence of abnormal behaviors during the arousals. Abnormal sleep behaviors and unpleasant dreams simulating RBD symptomatology may occur in patients with severe PLMS. In these cases, video-polysomnography ruled out RBD and

  14. Sleep disorders in mental diseases and their correction

    Directory of Open Access Journals (Sweden)

    Nina Arkadyevna Tyuvina

    2012-01-01

    Full Text Available The authors analyze the data available in the literature on sleep disorders and their correction in the population and in patients with mental disorders and give their experience in using zolpidem (sanval to treat insomnia in different mental diseases. The clinical features of sleep disorders are characterized in neurotic and affective disorders, schizophrenia, and organic brain injuries. Indications for the use of sanval both alone and in combination with other psychotropic drugs (antidepressants and antipsychotics with a sedative effect for the therapy of sleep disorders within the framework of mental disorders are discussed. Sanval is shown to be highly effective and well tolerated in 100psychiatric in- and outpatients. No dependence on this drug and withdrawal syndrome permit sanval to be used as long-term courses in patients with chronic permanent insomnia and at an old age.

  15. Impaired bed mobility and disordered sleep in Parkinson's disease.

    Science.gov (United States)

    Stack, Emma L; Ashburn, Ann M

    2006-09-01

    The contribution of impaired mobility to disordered sleep in Parkinson's disease (PD) remains uncertain. We evaluated the sleep of 38 people with PD and observed their turning strategies. Most reported difficulty maintaining sleep and difficulty turning. Those who hip-hitched rated themselves more disabled and those who sat up had more severe PD than those who used support. Using multiple strategies was associated with sleep disturbance. As the ability to turn deteriorates, we recommend patients identify the single strategy least disruptive to sleep. Research must address whether improving mobility improves sleep quality. (c) 2006 Movement Disorder Society.

  16. A Review of Sleep Disorder Diagnosis by Electromyogram Signal Analysis.

    Science.gov (United States)

    Shokrollahi, Mehrnaz; Krishnan, Sridhar

    2015-01-01

    Sleep and sleep-related problems play a role in a large number of human disorders and affect every field of medicine. It is estimated that 50 to 70 million Americans suffer from a chronic sleep disorder, which hinders their daily life, affects their health, and confers a significant economic burden to society. The negative public health consequences of sleep disorders are enormous and could have long-term effects, including increased risk of hypertension, diabetes, obesity, heart attack, stroke and in some cases death. Polysomnographic modalities can monitor sleep cycles to identify disrupted sleep patterns, adjust the treatments, increase therapeutic options and enhance the quality of life of recording the electroencephalogram (EEG), electromyogram (EMG) and electrocardiogram (ECG). Although the skills acquired by medical facilitators are quite extensive, it is just as important for them to have access to an assortment of technologies and to further improve their monitoring and treatment capabilities. Computer-aided analysis is one advantageous technique that could provide quantitative indices for sleep disorder screening. Evolving evidence suggests that Parkinson's disease may be associated with rapid eye movement sleep behavior disorder (RBD). With this article, we are reviewing studies that are related to EMG signal analysis for detection of neuromuscular diseases that result from sleep movement disorders. As well, the article describes the recent progress in analysis of EMG signals using temporal analysis, frequency-domain analysis, time-frequency, and sparse representations, followed by the comparison of the recent research.

  17. Sleep and circadian rhythm disturbance in bipolar disorder.

    Science.gov (United States)

    Bradley, A J; Webb-Mitchell, R; Hazu, A; Slater, N; Middleton, B; Gallagher, P; McAllister-Williams, H; Anderson, K N

    2017-07-01

    Subjective reports of insomnia and hypersomnia are common in bipolar disorder (BD). It is unclear to what extent these relate to underlying circadian rhythm disturbance (CRD). In this study we aimed to objectively assess sleep and circadian rhythm in a cohort of patients with BD compared to matched controls. Forty-six patients with BD and 42 controls had comprehensive sleep/circadian rhythm assessment with respiratory sleep studies, prolonged accelerometry over 3 weeks, sleep questionnaires and diaries, melatonin levels, alongside mood, psychosocial functioning and quality of life (QoL) questionnaires. Twenty-three (50%) patients with BD had abnormal sleep, of whom 12 (52%) had CRD and 29% had obstructive sleep apnoea. Patients with abnormal sleep had lower 24-h melatonin secretion compared to controls and patients with normal sleep. Abnormal sleep/CRD in BD was associated with impaired functioning and worse QoL. BD is associated with high rates of abnormal sleep and CRD. The association between these disorders, mood and functioning, and the direction of causality, warrants further investigation.

  18. Dopaminergic Neurogenetics of Sleep Disorders in Reward Deficiency Syndrome (RDS).

    Science.gov (United States)

    Blum, Kenneth; Oscar-Berman, Marlene; Badgaiyan, Rajendra D; Khurshid, Khurshid A; Gold, Mark S

    2014-02-18

    It is well-known that sleep has a vital function especially as it relates to prevention of substance-related disorders as discussed in the DSM-V. We are cognizant that certain dopaminergic gene polymorphisms have been associated with various sleep disorders. The importance of "normal dopamine homeostasis" is tantamount for quality of life especially for the recovering addict. Since it is now know that sleep per se has been linked with metabolic clearance of neurotoxins in the brain, it is parsonomiuos to encourage continued research in sleep science, which should ultimately result in attenuation of sleep deprivation especially associated with substance related disorders.

  19. Associations of sleep bruxism with age, sleep apnea, and daytime problematic behaviors in children.

    Science.gov (United States)

    Tachibana, M; Kato, T; Kato-Nishimura, K; Matsuzawa, S; Mohri, I; Taniike, M

    2016-09-01

    The aims of this study were to investigate the prevalence of sleep bruxism in children in Japan, and its relationships with sleep-related factors and daytime problematic behavior. Guardians of 6023 children aged 2-12 years completed the Japanese Sleep Questionnaire. Multiple regression analysis and structural equation modeling were performed. Sleep bruxism was reported in 21.0% children (n = 1263): the prevalence was highest in the age group of 5-7 years (27.4%). Multiple regression analysis showed that sleep bruxism had significant correlations with age 5-7 years (OR: 1.72; P bruxism had a significant but weak direct effect on daytime problematic behavior, while sleep bruxism significantly correlated with obstructive sleep apnea, which had a higher direct effect on daytime problematic behavior. Sleep bruxism was reported in 21.0% of Japanese children and had independent relationships with age, movements during sleep, and snoring. A comorbidity of sleep-disordered breathing might be related to daytime problematic behavior in children with sleep bruxism. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  20. [How to characterize and treat sleep complaints in bipolar disorders?

    Science.gov (United States)

    Geoffroy, P A; Micoulaud Franchi, J-A; Lopez, R; Poirot, I; Brion, A; Royant-Parola, S; Etain, B

    2017-08-01

    Sleep complaints are very common in bipolar disorders (BD) both during acute phases (manic and depressive episodes) and remission (about 80 % of patients with remitted BD have poor sleep quality). Sleep complaints during remission are of particular importance since they are associated with more mood relapses and worse outcomes. In this context, this review discusses the characterization and treatment of sleep complaints in BD. We examined the international scientific literature in June 2016 and performed a literature search with PubMed electronic database using the following headings: "bipolar disorder" and ("sleep" or "insomnia" or "hypersomnia" or "circadian" or "apnoea" or "apnea" or "restless legs"). Patients with BD suffer from sleep and circadian rhythm abnormalities during major depressive episodes (insomnia or hypersomnia, nightmares, nocturnal and/or early awakenings, non-restorative sleep) and manic episodes (insomnia, decreased need for sleep without fatigue), but also some of these abnormalities may persist during remission. These remission phases are characterized by a reduced quality and quantity of sleep, with a longer sleep duration, increased sleep latency, a lengthening of the wake time after sleep onset (WASO), a decrease of sleep efficiency, and greater variability in sleep/wake rhythms. Patients also present frequent sleep comorbidities: chronic insomnia, sleepiness, sleep phase delay syndrome, obstructive sleep apnea/hypopnea syndrome (OSAHS), and restless legs syndrome (RLS). These disorders are insufficiently diagnosed and treated whereas they are associated with mood relapses, treatment resistance, affect cognitive global functioning, reduce the quality of life, and contribute to weight gain or metabolic syndrome. Sleep and circadian rhythm abnormalities have been also associated with suicidal behaviors. Therefore, a clinical exploration with characterization of these abnormalities and disorders is essential. This exploration should be

  1. Sleep disorders among high school students in New Zealand

    OpenAIRE

    Fernando AT; Samaranayake CB; Blank CJ; Roberts G; Arroll B

    2013-01-01

    INTRODUCTION: Adolescents are known to have high risk factors for sleep disorders, yet the youth rates of sleep disturbances are unknown. AIM: This study aimed to determine the prevalence of sleep disorders among New Zealand high school students. METHODS: The Auckland Sleep Questionnaire (ASQ) was administered to high school students at six schools in the North Island. Schools were chosen to reflect a range of ethnicities and school deciles, which identify the socioeconomic status of househol...

  2. Environmental risk factors for REM sleep behavior disorder

    DEFF Research Database (Denmark)

    Postuma, R B; Montplaisir, J Y; Pelletier, A

    2012-01-01

    Idiopathic REM sleep behavior disorder is a parasomnia characterized by dream enactment and is commonly a prediagnostic sign of parkinsonism and dementia. Since risk factors have not been defined, we initiated a multicenter case-control study to assess environmental and lifestyle risk factors...... for REM sleep behavior disorder....

  3. Rapid eye movement sleep behavior disorder

    DEFF Research Database (Denmark)

    Zoetmulder, Marielle; Jennum, Poul

    2009-01-01

    Rapid eye movement (REM) sleep behaviour disorder (RBD) is characterized by loss of REM sleep and related electromyographic atonia with marked muscular activity and dream enactment behaviour. RBD is seen in 0.5% of the population. It occurs in an idiopathic form and secondarily to medical...

  4. Academic achievement of junior high school students with sleep disorders

    Directory of Open Access Journals (Sweden)

    Fijri Auliyanti

    2015-03-01

    Full Text Available Background Sleep disorders are prevalent in adolescents and may influence their academic achievement. To date, no study has been done in Indonesia on academic achievement in students with sleep disorders and its related factors. Objective To assess for relationships between academic achievement and related factors, including gender, motivation and learning strategies, IQ level, maternal educational level, socioeconomic status, family structure, after-hours education program, presence of TV/computer in the bedroom, sleep duration during school days, as well as bedtime and wakeup time difference in junior high school students with sleep disorders. Methods This cross-sectional study was performed from January to March 2013. Subjects were students from five junior high schools in Jakarta who fulfilled the criteria for sleep disorders based on the Sleep Disturbance Scale for Children questionnaire. Results There were 111 study subjects. The prevalence of sleep disorders was 39.7%, mostly in difficulties initiating and maintaining sleep (70.2%. Below-average academic achievement was seen in 47.6% of subjects. Factors significantly related to below-average academic achievement were after-hours education program (prevalence ratio 5.6; 95%CI 1.36 to 23.18; P = 0.017, average IQ level (prevalence ratio 3.26; 95%CI 1.38 to 7.71; P = 0.007, and male gender (prevalence ratio 2.68; 95%CI 1.06 to 6.78; P = 0.037. Conclusion Among junior high school students with sleep disorders, factors related to below-average academic achievement are afterhours education program (more than 2 types, the average IQ level, and male gender.

  5. Sleep disorders and the dental patient: an overview.

    Science.gov (United States)

    Lavigne, G J; Goulet, J P; Zuconni, M; Morrison, F; Lobbezoo, F

    1999-09-01

    This article is intended to briefly describe common sleep disorders of interest to the dental profession and to render general management guidelines. Topics include sleep-related bruxism, xerostomia, hypersalivation, gastroesophageal reflux, apnea, and the effect of orofacial pain on sleep quality. The term sleep-related is used instead of the term nocturnal because some of the activities described can occur with daytime sleep.

  6. Evidence that non-dreamers do dream: a REM sleep behaviour disorder model.

    Science.gov (United States)

    Herlin, Bastien; Leu-Semenescu, Smaranda; Chaumereuil, Charlotte; Arnulf, Isabelle

    2015-12-01

    To determine whether non-dreamers do not produce dreams or do not recall them, subjects were identified with no dream recall with dreamlike behaviours during rapid eye movement sleep behaviour disorder, which is typically characterised by dream-enacting behaviours congruent with sleep mentation. All consecutive patients with idiopathic rapid eye movement sleep behaviour disorder or rapid eye movement sleep behaviour disorder associated with Parkinson's disease who underwent a video-polysomnography were interviewed regarding the presence or absence of dream recall, retrospectively or upon spontaneous arousals. The patients with no dream recall for at least 10 years, and never-ever recallers were compared with dream recallers with rapid eye movement sleep behaviour disorder regarding their clinical, cognitive and sleep features. Of the 289 patients with rapid eye movement sleep behaviour disorder, eight (2.8%) patients had no dream recall, including four (1.4%) patients who had never ever recalled dreams, and four patients who had no dream recall for 10-56 years. All non-recallers exhibited, daily or almost nightly, several complex, scenic and dreamlike behaviours and speeches, which were also observed during rapid eye movement sleep on video-polysomnography (arguing, fighting and speaking). They did not recall a dream following sudden awakenings from rapid eye movement sleep. These eight non-recallers with rapid eye movement sleep behaviour disorder did not differ in terms of cognition, clinical, treatment or sleep measures from the 17 dreamers with rapid eye movement sleep behaviour disorder matched for age, sex and disease. The scenic dreamlike behaviours reported and observed during rapid eye movement sleep in the rare non-recallers with rapid eye movement sleep behaviour disorder (even in the never-ever recallers) provide strong evidence that non-recallers produce dreams, but do not recall them. Rapid eye movement sleep behaviour disorder provides a new model to

  7. The impact of sleep-disordered breathing on early functional recovery in ischemic stroke

    Directory of Open Access Journals (Sweden)

    G. M. Lutokhin

    2017-01-01

    Full Text Available The rehabilitation potential in ischemic stroke depends both on the localization and size of cerebral infarction and on many other factors ensuring the restoration of neuron function in the ischemic penumbra. Sleep-disordered breathing (SDB appears as intermittent episodes of apnea and hypopnea, which are accompanied by hypoxemia and tissue hypoxia, and may slow early functional recovery in patients.Objective: to evaluate the impact of SDB on early neurological recovery in patients with ischemic stroke and to identify predictors of unfavorable functional outcome.Patients and methods. A total of 56 patients (24 men, 32 women; mean age 62±15 years with ischemic stroke were examined. All the patients underwent brain magnetic resonance imaging. Neurological deficit was assessed using the National Institutes of Health Stroke Scale (NIHSS, modified Rankin Scale (mRS on admission and at 3 weeks. To identify SDB, cardiorespiratory monitoring was performed on 2–5 days after the onset of the disease. The total number of episodes of SDB, apnea, hypopnea, apnea-hypopnea index (AHI, hypoxemia index, and the total time with arterial oxygen saturation < 90% (desaturation time < 90% were recorded. Results and discussion. At baseline, the median NIHSS score was 6 (range 4–10 and the median mRS score was 3 (range 2–5. After 3 weeks, the median NIHSS score was 3 (range 1.5–5 and the median mRS score was 1 (range 0–3. According to the degree of achieved functional independence, the patients were divided into 2 groups: 1 40 functionally independent patients (a mRS score of ≤2; 2 16 patients in need of assistance/care (a mRS score of ≥3. The groups were matched for age, sex, localization of cerebral infarction, degree of cerebral atherosclerosis, and incidence of cardiac pathology. At the same time, at baseline Group 2 had a more severity of neurological deficit (p=0.001 and respiratory disorders (p<0.04 and more frequently large and

  8. Rating Scales for Movement Disorders With Sleep Disturbances: A Narrative Review

    Science.gov (United States)

    Rodríguez-Blázquez, Carmen; Forjaz, Maria João; Kurtis, Monica M.; Balestrino, Roberta; Martinez-Martin, Pablo

    2018-01-01

    Introduction: In recent years, a wide variety of rating scales and questionnaires for movement disorders have been developed and published, making reviews on their contents, and attributes convenient for the potential users. Sleep disorders are frequently present in movement disorders, and some movement disorders are accompanied by specific sleep difficulties. Aim: The aim of this study is to perform a narrative review of the most frequently used rating scales for movement disorders with sleep problems, with special attention to those recommended by the International Parkinson and Movement Disorders Society. Methods: Online databases (PubMed, SCOPUS, Web of Science, Google Scholar), related references from papers and websites and personal files were searched for information on comprehensive or global rating scales which assessed sleep disturbances in the following movement disorders: akathisia, chorea, dystonia, essential tremor, myoclonus, multiple system atrophy, Parkinson's disease, progressive supranuclear palsy, and tics and Tourette syndrome. For each rating scale, its objective and characteristics, as well as a summary of its psychometric properties and recommendations of use are described. Results: From 22 rating scales identified for the selected movement disorders, only 5 included specific questions on sleep problems. Movement Disorders Society-Unified Parkinson's Disease Rating scale (MDS-UPDRS), Non-Motor Symptoms Scale and Questionnaire (NMSS and NMSQuest), Scales for Outcomes in Parkinson's Disease (SCOPA)-Autonomic and Progressive Supranuclear Palsy Rating Scale (PSPRS) were the only rating scales that included items for assessing sleep disturbances. Conclusions: Despite sleep problems are frequent in movement disorders, very few of the rating scales addresses these specific symptoms. This may contribute to an infra diagnosis and mistreatment of the sleep problems in patients with movement disorders.

  9. Sleep disorders associated with primary mitochondrial diseases.

    Science.gov (United States)

    Ramezani, Ryan J; Stacpoole, Peter W

    2014-11-15

    Primary mitochondrial diseases are caused by heritable or spontaneous mutations in nuclear DNA or mitochondrial DNA. Such pathological mutations are relatively common in humans and may lead to neurological and neuromuscular complication that could compromise normal sleep behavior. To gain insight into the potential impact of primary mitochondrial disease and sleep pathology, we reviewed the relevant English language literature in which abnormal sleep was reported in association with a mitochondrial disease. We examined publication reported in Web of Science and PubMed from February 1976 through January 2014, and identified 54 patients with a proven or suspected primary mitochondrial disorder who were evaluated for sleep disturbances. Both nuclear DNA and mitochondrial DNA mutations were associated with abnormal sleep patterns. Most subjects who underwent polysomnography had central sleep apnea, and only 5 patients had obstructive sleep apnea. Twenty-four patients showed decreased ventilatory drive in response to hypoxia and/ or hyperapnea that was not considered due to weakness of the intrinsic muscles of respiration. Sleep pathology may be an underreported complication of primary mitochondrial diseases. The probable underlying mechanism is cellular energy failure causing both central neurological and peripheral neuromuscular degenerative changes that commonly present as central sleep apnea and poor ventilatory response to hyperapnea. Increased recognition of the genetics and clinical manifestations of mitochondrial diseases by sleep researchers and clinicians is important in the evaluation and treatment of all patients with sleep disturbances. Prospective population-based studies are required to determine the true prevalence of mitochondrial energy failure in subjects with sleep disorders, and conversely, of individuals with primary mitochondrial diseases and sleep pathology. © 2014 American Academy of Sleep Medicine.

  10. Effects of sleep disorders on the non-motor symptoms of Parkinson disease.

    Science.gov (United States)

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

    2013-11-15

    To evaluate the impact of sleep disorders on non-motor symptoms in patients with Parkinson disease (PD). This was a cross-sectional study. Patients with PD were evaluated for obstructive sleep apnea (OSA), restless legs syndrome (RLS), periodic limb movement syndrome (PLMS), and REM sleep behavior disorder (RBD). Cognition was assessed with the Montreal Cognitive Assessment and patients completed self-reported questionnaires assessing non-motor symptoms including depressive symptoms, fatigue, sleep complaints, daytime sleepiness, and quality of life. Sleep laboratory. 86 patients with PD (mean age = 67.4 ± 8.8 years; range: 47-89; 29 women). N/A. Having sleep disorders was a predictor of overall non-motor symptoms in PD (R(2) = 0.33, p sleep disorder significantly predicted sleep complaints (ΔR(2) = 0.13, p = 0.006), depressive symptoms (ΔR(2) = 0.01, p = 0.03), fatigue (ΔR(2) = 0.12, p = 0.007), poor quality of life (ΔR(2) = 0.13, p = 0.002), and cognitive decline (ΔR(2) = 0.09, p = 0.036). Additionally, increasing number of sleep disorders (0, 1, or ≥ 2 sleep disorders) was a significant contributor to non-motor symptom impairment (R(2) = 0.28, p sleep disorders predicted more non-motor symptoms including increased sleep complaints, more depressive symptoms, lower quality of life, poorer cognition, and more fatigue. RBD and RLS were factors of overall increased non-motor symptoms, but OSA was not.

  11. Sleep disorders in high school and pre-university students.

    Science.gov (United States)

    Rocha, Célia R S; Rossini, Sueli; Reimão, Rubens

    2010-12-01

    Adolescence is a period in which youngsters have to make choices such as applying for university. The selection process is competitive, and it brings distress and anxiety, risk factors for the appearance of sleep disorders. To verify the occurrence of sleep disorders in third-year high school and pre-university students. This cross-sectional descriptive study comprised a sample of 529 students (M=241, F=288) from three public schools, four private schools and two pre-university courses - a middle-class neighborhood in the city of São Paulo - aged between 16 and 19 years old. We used the Pittsburgh Sleep Quality Index (PSQI) - a standardized questionnaire. The participants (52.9%) took about 30 minutes to fall asleep, with an average of 306.4 minutes asleep, moderate daytime sleepiness (n=243, 45.9%) and indisposition (n=402, 75.9%) to develop the activities. The scores (M and F) were similar regarding problems that affect sleep. The investigated population showed sleep disorders and poor sleep quality.

  12. Sleep Disorders in Chronic Obstructive Pulmonary Disease: Etiology, Impact, and Management

    Science.gov (United States)

    Budhiraja, Rohit; Siddiqi, Tauseef A.; Quan, Stuart F.

    2015-01-01

    Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality and may frequently be complicated by sleep disorders. Insomnia and obstructive sleep apnea are commonly encountered in patients with COPD. Nocturnal hypoxemia is also prevalent in COPD may occur despite adequate awake oxygenation and can be especially severe in rapid eye movement sleep. Additionally, several factors—some of them unique to COPD—can contribute to sleep-related hypoventilation. Recognition of hypoventilation can be vital as supplemental oxygen therapy itself can acutely worsen hypoventilation and lead to disastrous consequences. Finally, accruing data establish an association between restless leg syndrome and COPD— an association that may be driven by hypoxemia and/or hypercapnia. Comorbid sleep disorders portend worse sleep quality, diminished quality of life, and multifarious other adverse consequences. The awareness and knowledge regarding sleep comorbidities in COPD has continued to evolve over past many years. There are still several lacunae, however, in our understanding of the etiologies, impact, and therapies of sleep disorders, specifically in patients with COPD. This review summarizes the latest concepts in prevalence, pathogenesis, diagnosis, and management of diverse sleep disorders in COPD. Citation: Budhiraja R, Siddiqi TA, Quan SF. Sleep disorders in chronic obstructive pulmonary disease: etiology, impact, and management. J Clin Sleep Med 2015;11(3):259–270. PMID:25700872

  13. Sleep habits and disturbances in Malaysian children with epilepsy.

    Science.gov (United States)

    Ong, Lai Choo; Yang, Wai Wai; Wong, Sau Wei; alSiddiq, Feizel; Khu, Yi Soon

    2010-03-01

    To compare sleep habits and disturbances between Malaysian children with epilepsy and their siblings (age range 4-18 years) and to determine the factors associated with greater sleep disturbance. The Sleep Disturbance Scale for Children (SDSC) questionnaire was completed by the primary caregiver for 92 epileptic children (mean age 11.1 years, 50 male, 42 females) and their healthy siblings (mean age 11.1 years, 47 males, 45 females). Details of sleep arrangements and illness severity were obtained. Multiple regression analysis was used to determine factors associated with high Total SDSC scores in epileptic patients. Compared with their siblings, epileptic children had significantly higher total SDSC score (difference between means 8.7, 95% confidence interval (CI) 6.4-11.1) and subscale scores in disorders of initiating and maintaining sleep (3.9, 95% CI 2.8-5.2), sleep-wake transition disorders (2.1, 95% CI 1.3-2.9), sleep-disordered breathing (0.7, 95% CI 0.3-1.1) and disorders of excessive sleepiness (1.5, 95% CI 0.6-2.4). Epileptic children had a higher prevalence of co-sleeping (73.7% vs 31.5%) and on more nights per week (difference between means 3, 95% CI 2.0-3.9) than their siblings. Higher Epilepsy Illness Severity scores were associated with higher total SDSC scores (P= 0.02). Co-sleeping was highly prevalent in children with epilepsy, who also had more sleep disturbances (especially problems with initiating and maintaining sleep and sleep-wake transition disorders) than their siblings. Epilepsy severity contributed to the sleep disturbances. Evaluation of sleep problems should form part of the comprehensive care of children with severe epilepsy.

  14. Sleep Disorders Among Holocaust Survivors: A Review of Selected Publications.

    Science.gov (United States)

    Lurie, Ido

    2017-09-01

    After World War II, traumatic after effects often caused persistent sleep disorders for Holocaust survivors (HSs). This is a review of studies reporting on sleep disturbances and nightmares (as primary or secondary outcomes) among HSs between 1939 and 2015, conducted in various countries and contexts (clinical settings, pension claims, community surveys, sleep laboratories). Most studies revealed various sleep disturbances among HSs. Some studies found those disturbances in the absence of clinical disorders. Both men and women reported similar frequencies of sleep disturbances, although posttraumatic stress disorder and depression were more frequent in women. Sleep laboratory studies provided the single most direct and detailed sources of information. Findings included a) long-standing changes in sleep architecture, for example, decreased rapid eye movement (REM) sleep, and b) contrasting patterns of dreaming and recall among better versus poorly adjusted survivors. These results are of importance to both HSs and their families and for medical and mental health professionals.

  15. Sleep disorders and their clinical significance in children with Down syndrome.

    Science.gov (United States)

    Stores, Gregory; Stores, Rebecca

    2013-02-01

    Our aim was to review basic aspects of sleep disorders in children with Down syndrome in the light of present-day findings of such disorders in children in general, including other groups of children with developmental disabilities. A literature search of adverse developmental effects of sleep disturbance, types of sleep disturbance in children with Down syndrome, their aetiology, including possible contributions of physical and psychiatric comorbidities and medication effects, principles of assessment and diagnosis, and treatment issues, was carried out. Sleep disturbance is particularly common in children with developmental disorders including Down syndrome. Although there are just three basic sleep problems (sleeplessness or insomnia, excessive daytime sleepiness, and parasomnias) there are many possible underlying causes (sleep disorders), the nature of which dictates the particular treatment required. In children with Down syndrome, in addition to the same influences in other children, various comorbid physical and psychiatric conditions are capable of disturbing sleep. Possible adverse medication effects also need to be considered. Screening for sleep disorders and their causes should be routine; positive findings call for detailed diagnosis. Management should acknowledge the likely multifactorial aetiology of the sleep disorders in Down syndrome. Successful treatment can be expected to alleviate significantly the difficulties of both child and family. © The Authors. Developmental Medicine & Child Neurology © 2012 Mac Keith Press.

  16. Sleep disorders among high school students in New Zealand.

    Science.gov (United States)

    Fernando, Antonio T; Samaranayake, Chinthaka B; Blank, Christopher J; Roberts, Gareth; Arroll, Bruce

    2013-12-01

    Adolescents are known to have high risk factors for sleep disorders, yet the youth rates of sleep disturbances are unknown. This study aimed to determine the prevalence of sleep disorders among New Zealand high school students. The Auckland Sleep Questionnaire (ASQ) was administered to high school students at six schools in the North Island. Schools were chosen to reflect a range of ethnicities and school deciles, which identify the socioeconomic status of households in the school catchment area. A total of 1388 students completed the ASQ. The median age was 17 years (range 14-23) and females represented 43.5% (n=604) of the total group. A total of 37.2% of the students surveyed reported having significant sleep symptoms lasting longer than one month. Depression and anxiety were present in 51.7% and 44.8% of students reporting a sleep problem, respectively. A moderate correlation was observed between sleep problems and depression (r=0.34, psleep problems and anxiety (r=0.31, pstudents with sleep symptoms (12.2% and 5.5% respectively). No difference was found in the rate of sleep problems reported by different ethnic groups. A considerable proportion of students surveyed reported significant sleep symptoms. This study has the potential to aid physicians within New Zealand in better appreciating the burden of sleep disorders faced by young people and in effectively assessing and managing different causes of sleep symptoms in this demographic.

  17. Sleep Patterns in Children with Attention-Deficit/Hyperactivity Disorder, Tic Disorder, and Comorbidity

    Science.gov (United States)

    Kirov, Roumen; Kinkelbur, Joerg; Banaschewski, Tobias; Rothenberger, Aribert

    2007-01-01

    Background: In children, attention-deficit/hyperactivity disorder (ADHD), tic disorder (TD), and their coexistence (ADHD + TD comorbidity) are very common and clinically important. Associated sleep patterns and their clinical role are still insufficiently investigated. This study aimed at characterizing these sleep patterns in children with ADHD,…

  18. Hypnotherapy for sleep disorders.

    Science.gov (United States)

    Ng, Beng-Yeong; Lee, Tih Shih

    2008-08-01

    Hypnosis can be defined as a procedure during which changes in sensations, perceptions, thoughts, feelings or behaviour are suggested. Hypnosis can be used to amplify whatever it is about therapy that makes it therapeutic. It permits a wide range of choices regarding where and how to intervene in the patient's problems. In this paper, we set out to examine the rationale of using hypnotherapy to manage various types of sleep disorders, and to explore the techniques, strategies and hypnotic scripts employed by various hypnotherapists. We also examine the research data available on the efficacy of hypnosis in the treatment of sleep disorders. Acute and chronic insomnia often respond to relaxation and hypnotherapy approaches, along with sleep hygiene instructions. Hypnotherapy has also helped with nightmares and sleep terrors. There are several reports of successful use of hypnotherapy for parasomnias, specifically for head and body rocking, bedwetting and sleepwalking. Hypnosis is a specialised technique, not a therapy itself, and should be used as an adjunctive intervention within a complete psychological and medical treatment package. Most of the literature is limited to case reports or studies with such a small sample that at times it is very difficult to interpret the results. There is a major placebo effect, so uncontrolled trials are of limited value. It is hard to perform a randomised, double-blind, controlled trial to evaluate hypnotherapy given that cooperation and rapport between patient and therapist is needed to achieve a receptive trance state.

  19. Exploring Interventions for Sleep Disorders in Adolescent Cannabis Users

    Directory of Open Access Journals (Sweden)

    Tzvi Furer

    2018-02-01

    Full Text Available This review summarizes the available literature on the intersection of adolescent cannabis use and sleep disturbances, along with interventions for adolescent cannabis users who suffer sleep impairments. Adolescents are susceptible to various sleep disorders, which are often exacerbated by the use of substances such as cannabis. The relationship between cannabis and sleep is bidirectional. Interventions to improve sleep impairments among adolescent cannabis users to date have demonstrated limited efficacy, although few studies indicating the benefits of behavioral interventions—such as Cognitive Behavior Therapy for Insomnia or Mindfulness Based Stress Reduction—appear promising in the treatment of sleep disorders, which are present for users of cannabis. Further research is necessary to elucidate the precise mechanisms by which cannabis use coexists with sleep impairments, along with effective interventions for those users who suffer sleep difficulties.

  20. Central sleep apnea

    Science.gov (United States)

    Sleep apnea - central; Obesity - central sleep apnea; Cheyne-Stokes - central sleep apnea; Heart failure - central sleep apnea ... Central sleep apnea results when the brain temporarily stops sending signals to the muscles that control breathing. The condition ...

  1. Sleep disorders among high school students in New Zealand

    Directory of Open Access Journals (Sweden)

    Fernando AT

    2013-12-01

    Full Text Available INTRODUCTION: Adolescents are known to have high risk factors for sleep disorders, yet the youth rates of sleep disturbances are unknown. AIM: This study aimed to determine the prevalence of sleep disorders among New Zealand high school students. METHODS: The Auckland Sleep Questionnaire (ASQ was administered to high school students at six schools in the North Island. Schools were chosen to reflect a range of ethnicities and school deciles, which identify the socioeconomic status of households in the school catchment area. RESULTS: A total of 1388 students completed the ASQ. The median age was 17 years (range 14-23 and females represented 43.5% (n=604 of the total group. A total of 37.2% of the students surveyed reported having significant sleep symptoms lasting longer than one month. Depression and anxiety were present in 51.7% and 44.8% of students reporting a sleep problem, respectively. A moderate correlation was observed between sleep problems and depression (r=0.34, p<0.01, and sleep problems and anxiety (r=0.31, p<0.01. Problem alcohol use and other substance use were more common in students with sleep symptoms (12.2% and 5.5% respectively. No difference was found in the rate of sleep problems reported by different ethnic groups. DISCUSSION: A considerable proportion of students surveyed reported significant sleep symptoms. This study has the potential to aid physicians within New Zealand in better appreciating the burden of sleep disorders faced by young people and in effectively assessing and managing different causes of sleep symptoms in this demographic.

  2. Racial/Ethnic Differences in Sleep Disorders and Reporting of Trouble Sleeping Among Women of Childbearing Age in the United States.

    Science.gov (United States)

    Amyx, Melissa; Xiong, Xu; Xie, Yiqiong; Buekens, Pierre

    2017-02-01

    Objectives Whether racial/ethnic differences in prevalence/reporting of sleep disorders exist in pregnant women/women of child-bearing age is unknown. Study objectives were to estimate prevalence of sleep disorders and to examine racial/ethnic differences in sleep disorders, reporting of sleep issues, and amount of sleep among women of child-bearing age (15-44 years) in the US. Methods Through a secondary analysis of the National Health and Nutrition Examination Survey 2005-2010 (3175 non-pregnant, 432 pregnant women in main analysis), prevalence of sleep disorders, reporting of sleep disorders to a physician/health professional, and amount of sleep were estimated overall, by pregnancy status, and by race/ethnicity stratified by pregnancy status. Racial/ethnic differences in reporting of trouble sleeping by pregnancy status were examined using univariate and multivariate logistic regression. Results Prevalence of diagnosed sleep disorders among women of childbearing age was 4.9 % [3.9 % pregnant; 5.1 % non-pregnant (p sleep (7-8 h) than non-Hispanic white (white) women (p sleeping were significantly higher for white compared to black (aOR 0.47 [95 % CI 0.36, 0.61]) or Mexican-American women (aOR 0.29 [95 % CI 0.21, 0.41]); non-pregnant minority women were also significantly less likely to report trouble sleeping than white women when controlling for amount of sleep. Among pregnant women, these same trends were found. Discussion Compared to white women, minority women, despite reporting less adequate sleep, are less likely to report trouble sleeping, providing evidence of an important health disparity.

  3. Sleep disorders in chronic obstructive pulmonary disease: etiology, impact, and management.

    Science.gov (United States)

    Budhiraja, Rohit; Siddiqi, Tauseef A; Quan, Stuart F

    2015-03-15

    Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality and may frequently be complicated by sleep disorders. Insomnia and obstructive sleep apnea are commonly encountered in patients with COPD. Nocturnal hypoxemia is also prevalent in COPD may occur despite adequate awake oxygenation and can be especially severe in rapid eye movement sleep. Additionally, several factors--some of them unique to COPD--can contribute to sleep-related hypoventilation. Recognition of hypoventilation can be vital as supplemental oxygen therapy itself can acutely worsen hypoventilation and lead to disastrous consequences. Finally, accruing data establish an association between restless leg syndrome and COPD--an association that may be driven by hypoxemia and/or hypercapnia. Comorbid sleep disorders portend worse sleep quality, diminished quality of life, and multifarious other adverse consequences. The awareness and knowledge regarding sleep comorbidities in COPD has continued to evolve over past many years. There are still several lacunae, however, in our understanding of the etiologies, impact, and therapies of sleep disorders, specifically in patients with COPD. This review summarizes the latest concepts in prevalence, pathogenesis, diagnosis, and management of diverse sleep disorders in COPD. © 2015 American Academy of Sleep Medicine.

  4. The National Veteran Sleep Disorder Study: Descriptive Epidemiology and Secular Trends, 2000-2010.

    Science.gov (United States)

    Alexander, Melannie; Ray, Meredith A; Hébert, James R; Youngstedt, Shawn D; Zhang, Hongmei; Steck, Susan E; Bogan, Richard K; Burch, James B

    2016-07-01

    A large proportion of individuals affected by sleep disorders are untreated and susceptible to accidents, injuries, long-term sequelae (e.g., risk of cardiovascular disease, cancer, psychiatric disorders), and increased mortality risk. Few studies have examined the scope and magnitude of sleep disorder diagnoses in the United States (US) or factors influencing them. Veterans are particularly vulnerable to factors that elicit or exacerbate sleep disorders. This serial cross-sectional study characterized secular trends in diagnosed sleep disorders among veterans seeking care in US Veterans Health Administration facilities over an eleven-year span (FY2000-2010, n = 9,786,778). Electronic medical records from the national Veterans Administration Informatics and Computing Infrastructure database were accessed. Cases were defined using diagnostic codes specified by the American Academy of Sleep Medicine. Age-adjusted annual prevalence was summarized by sex, race, combat exposure, body mass index, and comorbid diagnoses (cardiovascular disease, cancer, mental disorders). Sleep apnea (47%) and insomnia (26%) were the most common diagnoses among patients with any sleep disorder. There was a six-fold relative increase in total sleep disorder prevalence over the study period. Posttraumatic stress disorder, which tripled over the same time period, was associated with the highest prevalence of sleep disorders (16%) among the comorbid conditions evaluated. The results indicate a growing need for integration of sleep disorder management with patient care and health care planning among US veterans. A commentary on this article appears in this issue on page 1331. © 2016 Associated Professional Sleep Societies, LLC.

  5. Relaxation Therapy on Fetal Outcomes in Complicated Pregnancies Suffering Sleep Disorders: A Randomized Clinical Trial

    Directory of Open Access Journals (Sweden)

    azar nematollahi

    2016-10-01

    Full Text Available Background: Sleep disorders like snoring, mouth breathing, and insomnia are frequent in pregnancy and studies have shown that poor sleep is linked to obstetric complications. Muscle relaxation technique is an effective method used for improving sleep quality. The purpose of this study was to determine the effect of muscle relaxation technique on fetal outcomes in complicated pregnancies with sleep disorders. Methods: This study was performed as a clinical trial on 160 pregnant women who suffered from preeclampsia and gestational diabetes. The participants filled the Pittsburgh Sleep Quality Index (PSQI in order to measure the quality and patterns of their sleep. The participants with the total score of 5 or more were included in the present study. Intervention group were asked to use muscle relaxation technique twice a week at home for 8 weeks alongside the routine care. Study variables included sleep quality, Apgar scores, birth weight, levels of Interleukin- 6 (IL- 6, as well as umbilical cord PH and PO2. Results: The mean score of PSQI before the intervention was 9.28±4.16 and 9.18±3.06 in the intervention and control groups without a significant difference (P=0.6, respectively. However, PSQI global score of the experimental group was smaller than the control group at the end of the study (P<0.001. Also, birth weight (P=0.04, Apgar score (P=0.01, and umbilical cord blood po2 (P=0.03 and PH (P=0.01 were higher, and IL-6 (P=0.04 was smaller in the experimental group compared to the control group. Conclusion: The results of this study showed that muscle relaxation, as a simple, inexpensive and safe method, can improve the fetal outcomes such as birth weight, Apgar score, cord blood po2, and cord blood PH, and also it leads to lower IL-6 in complicated pregnancies.

  6. PALLIATIVE CARE ELDERLY PATIENTS WITH SLEEPING DISORDERS ARE POORLY TREATED

    OpenAIRE

    Bellido-Estevez, Inmaculada

    2015-01-01

    Background: Sleep disorders are frequent in patients with advanced cancer receiving palliative-care, especially in elderly patients (1). Sleep disorders during palliative-care may be related with anxiety, opioids related central-sleep apnoea or corticoids therapy between others (2). Our aim was to quantify the effectiveness of hypnotic medication in the sleep quality in advanced cancer receiving palliative-care elderly patients. Material and methods: A descriptive cross-sectional study was...

  7. Validation of a Hindi version of the Epworth Sleepiness Scale (ESS) at AIIMS, New Delhi in sleep-disordered breathing.

    Science.gov (United States)

    Kanabar, K; Sharma, S K; Sreenivas, V; Biswas, A; Soneja, M

    2016-12-01

    The Epworth Sleepiness Scale (ESS) is one of the most widely used questionnaire for the assessment of excessive daytime sleepiness (EDS) in sleep-disordered breathing (SDB). This study was conducted to assess the validity of ESS in the Hindi language. The Hindi version was developed by translation and back translation by independent translators. The English and Hindi versions were administered to 115 bilingual subjects who presented with symptoms of SDB, of whom 98 underwent a polysomnography at a tertiary care hospital in North India. The questionnaire had a high level of internal consistency as measured by Cronbach's alpha (α = 0.84). There was no significant difference between the mean ESS scores of Hindi and English versions (11.65 ± 5.47 vs 11.70 ± 5.49, respectively; p = 0.80). The Hindi version of ESS showed a strong correlation with the English version (Spearman's correlation ρ = 0.98 and weighted kappa = 0.94). Each of the 8 individual questions of Hindi ESS demonstrated a good agreement with the corresponding English version. The Hindi ESS score was significantly higher in subjects with OSA compared to those without OSA (12.67 ± 5.29 vs 7.76 ± 5.44, respectively; p = 0.002). However, there was no difference in ESS score between mild and moderate OSA or between moderate and severe OSA. The Hindi version of the ESS showed a good internal consistency and a strong correlation with the English version and can be used in the Hindi-speaking population.

  8. Parent-Reported Behavioral and Psychiatric Problems Mediate the Relationship between Sleep-Disordered Breathing and Cognitive Deficits in School-Aged Children

    Directory of Open Access Journals (Sweden)

    Dale L. Smith

    2017-08-01

    Full Text Available BackgroundNumerous studies over the past several decades have illustrated that children who suffer from sleep-disordered breathing (SDB are at greater risk for cognitive, behavioral, and psychiatric problems. Although behavioral problems have been proposed as a potential mediator between SDB and cognitive functioning, these relationships have not been critically examined.MethodsThis analysis is based on a community-based cohort of 1,115 children who underwent overnight polysomnography, and cognitive and behavioral phenotyping. Structural model of the relationships between SDB, behavior, and cognition, and two recently developed mediation approaches based on propensity score weighting and resampling were used to assess the mediational role of parent-reported behavior and psychiatric problems in the relationship between SDB and cognitive functioning. Multiple models utilizing two different SDB definitions further explored direct effects of SDB on cognition as well as indirect effects through behavioral pathology. All models were adjusted for age, sex, race, BMI z-score, and asthma status.ResultsIndirect effects of SDB through behavior problems were significant in all mediation models, while direct effects of SDB on cognition were not. The findings were consistent across different mediation procedures and remained essentially unaltered when different criteria for SDB, behavior, and cognition were used.ConclusionPotential effects of SDB on cognitive functioning appear to occur through behavioral problems that are detectable in this pediatric population. Thus, early attentional or behavioral pathology may be implicated in the cognitive functioning deficits associated with SDB, and may present an early morbidity-related susceptibility biomarker.

  9. College Students with ADHD at Greater Risk for Sleep Disorders

    Science.gov (United States)

    Gaultney, Jane F.

    2014-01-01

    The pediatric literature indicates that children with ADHD are at greater risk for sleep problems, daytime sleepiness, and some sleep disorders than children with no diagnosed disability. It has not been determined whether this pattern holds true among emerging adults, and whether comorbid sleep disorders with ADHD predict GPA. The present study…

  10. Sleep disorders and depressive feelings: a global survey with the Beck depression scale.

    Science.gov (United States)

    Vandeputte, Melissa; de Weerd, Al

    2003-07-01

    Patients with (chronic) sleep disorders are prone to depression. Until now studies on the prevalence of depression in the various sleep disorders focused mainly on obstructive sleep apnea patients and narcolepsy. Studies in other common sleep disorders are scarce. The aim of our study was to estimate the prevalence of depressive feelings in the various sleep disorders diagnosed in a Center for Sleep and Wake Disorders. We included 917 consecutive patients (age between 14 and 84 years, median age: 49, 396 male and 521 female), seen in our center for sleep and wake disorders during 2001 and first half of 2002. The diagnosis was based on the history taken at the outpatient-clinic and two consecutive 24-h polysomnographic recordings at home (APSG). The final decisions on the diagnosis were made according to the ASDA international classification of sleep disorders. The severity of depressive feelings was based on the Beck depression scale. Overall, the prevalence of depressive feelings was high. There were no significant differences in age and gender. In psychophysiological insomnia, inadequate sleep- and wake hygiene, sleep state misperception and periodic limb movement disorder/restless legs syndrome some form of depression occurred in more than half of the patients. Moderate to severe depression was found in 3.5% of the patients. The study suggests that the use of a depression scale in the daily routine of diagnosing and treating sleep disorders should be encouraged in order to optimise diagnosis and therapy in these patients.

  11. Attenuated heart rate response in REM sleep behavior disorder and Parkinson's disease

    DEFF Research Database (Denmark)

    Sorensen, Gertrud Laura; Kempfner, Jacob; Zoetmulder, Marielle

    2012-01-01

    The objective of this study was to determine whether patients with Parkinson's disease with and without rapid‐eye‐movement sleep behavior disorder and patients with idiopathic rapid‐eye‐movement sleep behavior disorder have an attenuated heart rate response to arousals or to leg movements during...... sleep compared with healthy controls. Fourteen and 16 Parkinson's patients with and without rapid‐eye‐movement sleep behavior disorder, respectively, 11 idiopathic rapid‐eye‐movement sleep behavior disorder patients, and 17 control subjects underwent 1 night of polysomnography. The heart rate response...... associated with arousal or leg movement from all sleep stages was analyzed from 10 heartbeats before the onset of the sleep event to 15 heartbeats following onset of the sleep event. The heart rate reponse to arousals was significantly lower in both parkinsonian groups compared with the control group...

  12. Sleep disorders in high school and pre-university students

    Directory of Open Access Journals (Sweden)

    Célia R.S. Rocha

    2010-12-01

    Full Text Available Adolescence is a period in which youngsters have to make choices such as applying for university. The selection process is competitive, and it brings distress and anxiety, risk factors for the appearance of sleep disorders. OBJECTIVE: To verify the occurrence of sleep disorders in third-year high school and pre-university students. METHOD: This cross-sectional descriptive study comprised a sample of 529 students (M=241, F=288 from three public schools, four private schools and two pre-university courses - a middle-class neighborhood in the city of São Paulo - aged between 16 and 19 years old. We used the Pittsburgh Sleep Quality Index (PSQI - a standardized questionnaire. RESULTS: The participants (52.9% took about 30 minutes to fall asleep, with an average of 306.4 minutes asleep, moderate daytime sleepiness (n=243, 45.9% and indisposition (n=402, 75.9% to develop the activities. The scores (M and F were similar regarding problems that affect sleep. CONCLUSION: The investigated population showed sleep disorders and poor sleep quality.

  13. Leptin and Leptin Resistance in the Pathogenesis of Obstructive Sleep Apnea: A Possible Link to Oxidative Stress and Cardiovascular Complications

    Directory of Open Access Journals (Sweden)

    Slava Berger

    2018-01-01

    Full Text Available Obesity-related sleep breathing disorders such as obstructive sleep apnea (OSA and obesity hypoventilation syndrome (OHS cause intermittent hypoxia (IH during sleep, a powerful trigger of oxidative stress. Obesity also leads to dramatic increases in circulating levels of leptin, a hormone produced in adipose tissue. Leptin acts in the hypothalamus to suppress food intake and increase metabolic rate. However, obese individuals are resistant to metabolic effects of leptin. Leptin also activates the sympathetic nervous system without any evidence of resistance, possibly because these effects occur peripherally without a need to penetrate the blood-brain barrier. IH is a potent stimulator of leptin expression and release from adipose tissue. Hyperleptinemia and leptin resistance may upregulate generation of reactive oxygen species, increasing oxidative stress and promoting inflammation. The current review summarizes recent data on a possible link between leptin and oxidative stress in the pathogenesis of sleep breathing disorders.

  14. Aripiprazole-induced sleep-related eating disorder: a case report.

    Science.gov (United States)

    Kobayashi, Nobuyuki; Takano, Masahiro

    2018-04-05

    Sleep-related eating disorder is characterized by parasomnia with recurrent episodes of nocturnal eating or drinking during the main sleep period. Several drugs, including atypical antipsychotics, induce sleep-related eating disorder. However, aripiprazole has not previously been associated with sleep-related eating disorder. A 41-year-old Japanese man visited our clinic complaining of depression. The patient was treated with sertraline, which was titrated up to 100 mg for 4 weeks. A sleep inducer and an anxiolytic were coadministered. His depressive mood slightly improved, but it continued for an additional 4 months. Subsequently, aripiprazole (3 mg) was added as an adjunctive therapy. After 3 weeks, the patient's mother found that the patient woke up and ate food at night. The next morning, the patient was amnesic for this event, felt full, and wondered why the bags of food were empty. This episode lasted for 2 days. The patient gained 5 kg during these 3 weeks. After the aripiprazole dose was reduced to 1.5 mg, the patient's nocturnal eating episodes rapidly and completely disappeared. To the best of our knowledge, this is first report of sleep-related eating disorder induced by aripiprazole, and it indicates that this disorder should be considered a possible side effect of aripiprazole. Although aripiprazole is used mainly in patients with schizophrenia, its recently documented use as an adjunctive therapy in patients with depression might induce hitherto unknown side effects.

  15. Morbidities in rapid eye movement sleep behavior disorder

    DEFF Research Database (Denmark)

    Jennum, Poul; Mayer, Geert; Ju, Yo-El

    2013-01-01

    Idiopathic rapid eye movement (REM) sleep behavior disorder (iRBD, RBD without any obvious comorbid major neurological disease), is strongly associated with numerous comorbid conditions. The most prominent is that with neurodegenerative disorders, especially synuclein-mediated disorders, above all...... function, neuropsychiatric manifestations and sleep complaints. Furthermore, patients with PD and RBD may have worse prognosis in terms of impaired cognitive function and overall morbidity/mortality; in dementia, the presence of RBD is strongly associated with clinical hallmarks and pathological findings...

  16. Objective measures of sleep and dim light melatonin onset in adolescents and young adults with delayed sleep phase disorder compared to healthy controls.

    Science.gov (United States)

    Saxvig, Ingvild W; Wilhelmsen-Langeland, Ane; Pallesen, Ståle; Vedaa, Oystein; Nordhus, Inger H; Sørensen, Eli; Bjorvatn, Bjørn

    2013-08-01

    Delayed sleep phase disorder is characterized by a delay in the timing of the major sleep period relative to conventional norms. The sleep period itself has traditionally been described as normal. Nevertheless, it is possible that sleep regulatory mechanism disturbances associated with the disorder may affect sleep duration and/or architecture. Polysomnographic data that may shed light on the issue are scarce. Hence, the aim of this study was to examine polysomnographic measures of sleep in adolescents and young adults with delayed sleep phase disorder, and to compare findings to that of healthy controls. A second aim was to estimate dim light melatonin onset as a marker of circadian rhythm and to investigate the phase angle relationship (time interval) between dim light melatonin onset and the sleep period. Data from 54 adolescents and young adults were analysed, 35 diagnosed with delayed sleep phase disorder and 19 healthy controls. Results show delayed timing of sleep in participants with delayed sleep phase disorder, but once sleep was initiated no group differences in sleep parameters were observed. Dim light melatonin onset was delayed in participants with delayed sleep phase disorder, but no difference in phase angle was observed between the groups. In conclusion, both sleep and dim light melatonin onset were delayed in participants with delayed sleep phase disorder. The sleep period appeared to occur at the same circadian phase in both groups, and once sleep was initiated no differences in sleep parameters were observed. © 2013 European Sleep Research Society.

  17. Automatic REM Sleep Detection Associated with Idiopathic REM Sleep Behavior Disorder

    DEFF Research Database (Denmark)

    Kempfner, Jacob; Sørensen, Gertrud Laura; Sørensen, Helge Bjarup Dissing

    2011-01-01

    Rapid eye movement sleep Behavior Disorder (RBD) is a strong early marker of later development of Parkinsonism. Currently there are no objective methods to identify and discriminate abnormal from normal motor activity during REM sleep. Therefore, a REM sleep detection without the use of chin...... electromyography (EMG) is useful. This is addressed by analyzing the classification performance when implementing two automatic REM sleep detectors. The first detector uses the electroencephalography (EEG), electrooculography (EOG) and EMG to detect REM sleep, while the second detector only uses the EEG and EOG......, an automatic computerized REM detection algorithm has been implemented, using wavelet packet combined with artificial neural network. Results: When using the EEG, EOG and EMG modalities, it was possible to correctly classify REM sleep with an average Area Under Curve (AUC) equal to 0:900:03 for normal subjects...

  18. Pharmacological treatment of sleep disorders and its relationship with neuroplasticity.

    Science.gov (United States)

    Abad, Vivien C; Guilleminault, Christian

    2015-01-01

    Sleep and wakefulness are regulated by complex brain circuits located in the brain stem, thalamus, subthalamus, hypothalamus, basal forebrain, and cerebral cortex. Wakefulness and NREM and REM sleep are modulated by the interactions between neurotransmitters that promote arousal and neurotransmitters that promote sleep. Various lines of evidence suggest that sleep disorders may negatively affect neuronal plasticity and cognitive function. Pharmacological treatments may alleviate these effects but may also have adverse side effects by themselves. This chapter discusses the relationship between sleep disorders, pharmacological treatments, and brain plasticity, including the treatment of insomnia, hypersomnias such as narcolepsy, restless legs syndrome (RLS), obstructive sleep apnea (OSA), and parasomnias.

  19. Sleep in Children and Adolescents with Obsessive-Compulsive Disorder.

    Science.gov (United States)

    Reynolds, Katharine C; Gradisar, Michael; Alfano, Candice A

    2015-06-01

    Sleep problems are not a core feature of obsessive-compulsive disorder (OCD), but emerging empirical data indicate some form of sleep disruption to be highly common. Available research in both adult and child patients is limited in several important ways, including the use of subjective reports (particularly in children), high rates of comorbid depression, and concurrent use of psychotropic medication. The presence of sleep disruption in OCD patients may compound severity and impairment of the disorder. More research is needed to fully understand the nature and consequences of sleep-wake disruption in children with OCD. Copyright © 2015 Elsevier Inc. All rights reserved.

  20. In-vivo staging of pathology in REM sleep behaviour disorder

    DEFF Research Database (Denmark)

    Knudsen, Karoline; Fedorova, Tatyana D.; Hansen, Allan K.

    2018-01-01

    originating in the locus coeruleus, and 18F-dihydroxyphenylalanine (DOPA) PET to assess nigrostriatal dopamine storage capacity. For each imaging modality, we compared patients with idiopathic REM sleep behaviour disorder with previously published reference data of controls without neurological disorders...... or cognitive impairment and with symptomatic patients with Parkinson's disease. We assessed imaging data using one-way ANOVA corrected for multiple comparisons. Findings: Between June 3, 2016, and Dec 19, 2017, we recruited 22 consecutive patients with idiopathic REM sleep behaviour disorder to the study...... REM sleep behaviour disorder (pequal to that in diagnosed Parkinson's disease. These patients also showed noradrenergic...

  1. Pediatric obstructive sleep apnea and the critical role of oral-facial growth: evidences.

    Science.gov (United States)

    Huang, Yu-Shu; Guilleminault, Christian

    2012-01-01

    Review of evidence in support of an oral-facial growth impairment in the development of pediatric sleep apnea in non-obese children. Review of experimental data from infant monkeys with experimentally induced nasal resistance. Review of early historical data in the orthodontic literature indicating the abnormal oral-facial development associated with mouth breathing and nasal resistance. Review of the progressive demonstration of sleep-disordered-breathing (SDB) in children who underwent incomplete treatment of OSA with adenotonsillectomy, and demonstration of abnormal oral-facial anatomy that must often be treated in order for the resolution of OSA. Review of data of long-term recurrence of OSA and indication of oral-facial myofunctional dysfunction in association with the recurrence of OSA. Presentation of prospective data on premature infants and SDB-treated children, supporting the concept of oral-facial hypotonia. Presentation of evidence supporting hypotonia as a primary element in the development of oral-facial anatomic abnormalities leading to abnormal breathing during sleep. Continuous interaction between oral-facial muscle tone, maxillary-mandibular growth and development of SDB. Role of myofunctional reeducation with orthodontics and elimination of upper airway soft tissue in the treatment of non-obese SDB children. Pediatric OSA in non-obese children is a disorder of oral-facial growth.

  2. Transcranial magnetic stimulation and sleep disorders: pathophysiologic insights.

    Science.gov (United States)

    Nardone, Raffaele; Höller, Yvonne; Brigo, Francesco; Tezzon, Frediano; Golaszewski, Stefan; Trinka, Eugen

    2013-11-01

    The neural mechanisms underlying the development of the most common intrinsic sleep disorders are not completely known. Therefore, there is a great need for noninvasive tools which can be used to better understand the pathophysiology of these diseases. Transcranial magnetic stimulation (TMS) offers a method to noninvasively investigate the functional integrity of the motor cortex and its corticospinal projections in neurologic and psychiatric diseases. To date, TMS studies have revealed cortical and corticospinal dysfunction in several sleep disorders, with cortical hyperexcitability being a characteristic feature in some disorders (i.e., the restless legs syndrome) and cortical hypoexcitability being a well-established finding in others (i.e., obstructive sleep apnea syndrome narcolepsy). Several research groups also have applied TMS to evaluate the effects of pharmacologic agents, such as dopaminergic agent or wake-promoting substances. Our review will focus on the mechanisms underlying the generation of abnormal TMS measures in the different types of sleep disorders, the contribution of TMS in enhancing the understanding of their pathophysiology, and the potential diagnostic utility of TMS techniques. We also briefly discussed the possible future implications for improving therapeutic approaches. Copyright © 2013 Elsevier B.V. All rights reserved.

  3. Organization and logistics of drug-induced sleep endoscopy in a training hospital.

    Science.gov (United States)

    Benoist, L B L; de Vries, N

    2015-09-01

    Drug-induced sleep endoscopy (DISE) is a rapidly growing method to evaluate airway collapse in patients receiving non-CPAP therapies for sleep-disordered breathing (SDB). The growing number of DISEs has consequences for the organization of clinical protocols. In this paper we present our recent experiences with DISE, performed by an ENT resident, with sedation given by a nurse anesthetist, in an outpatient endoscopy setting, while the staff member/sleep surgeon discusses the findings and the recommended treatment proposal on the same day.

  4. Knowledge of physicians about sleep disorders in Osogbo, South ...

    African Journals Online (AJOL)

    Background: Sleep disorders are common and global problem that affects a larger proportion of the population. The condition is significantly under diagnosed and most cases are left untreated. Objective: The presents study aims to study the knowledge of physicians about sleep disorders in suburban town in south-west ...

  5. Child temperament, parenting discipline style, and daytime behavior in childhood sleep disorders.

    Science.gov (United States)

    Owens-Stively, J; Frank, N; Smith, A; Hagino, O; Spirito, A; Arrigan, M; Alario, A J

    1997-10-01

    Fifty-two children without significant sleep disturbance seen at a primary care clinic for well-child care were compared on measures of temperament, parenting style, daytime behavior, and overall sleep disturbance to three diagnostic subgroups identified in a pediatric sleep clinic: children with obstructive sleep apnea (n = 33), parasomnias (night terrors, sleepwalking, etc.) (n = 16), and behavioral sleep disorders (limit-setting disorder, etc.) (n = 31). The mean age of the entire sample was 5.7 years. Temperamental emotionality in the behavioral sleep disorders group was associated with a higher level of sleep disturbance (p parenting laxness was associated with sleep disturbance in the general pediatric population (p parenting styles and daytime disruptive behaviors were more likely to be associated with the milder sleep disturbances found in children in a primary care setting.

  6. Association of sleep impairments and gastrointestinal disorders in the context of the visceral theory of sleep.

    Science.gov (United States)

    Pigarev, Ivan N; Pigareva, Marina L

    2017-01-01

    It was noticed long ago that sleep disorders or interruptions to the normal sleep pattern were associated with various gastrointestinal disorders. We review the studies which established the causal link between these disorders and sleep impairment. However, the mechanism of interactions between the quality of sleep and gastrointestinal pathophysiology remained unclear. Recently, the visceral theory of sleep was formulated. This theory proposes that the same brain structures, and particularly the same cortical sensory areas, which in wakefulness are involved in processing of the exteroceptive information, switch during sleep to the processing of information coming from various visceral systems. We review the studies which demonstrated that neurons of the various cortical areas (occipital, parietal, frontal) during sleep began to fire in response to activation coming from the stomach and small intestine. These data demonstrate that, during sleep, the computational power of the central nervous system, including all cortical areas, is engaged in restoration of visceral systems. Thus, the general mechanism of the interaction between quality of sleep and health became clear.

  7. The Importance of Sleep: Attentional Problems in School-Aged Children With Down Syndrome and Williams Syndrome.

    Science.gov (United States)

    Ashworth, Anna; Hill, Catherine M; Karmiloff-Smith, Annette; Dimitriou, Dagmara

    2015-01-01

    In typically developing (TD) children, sleep problems have been associated with day-time attentional difficulties. Children with developmental disabilities often suffer with sleep and attention problems, yet their relationship is poorly understood. The present study investigated this association in school-aged children with Down syndrome (DS) and Williams syndrome (WS). Actigraphy and pulse oximetry assessed sleep and sleep-disordered breathing respectively, and attention was tested using a novel visual Continuous Performance Task (CPT).Attentional deficits were evident in both disorder groups. In the TD group, higher scores on the CPT were related to better sleep quality, higher oxyhemoglobin saturation (SpO2), and fewer desaturation events. Sleep quality, duration, and SpO2 variables were not related to CPT performance for children with DS and WS.

  8. Recommendations for the management of patients with obstructive sleep apnoea and hypertension

    DEFF Research Database (Denmark)

    Parati, Gianfranco; Lombardi, Carolina; Hedner, Jan

    2013-01-01

    Respiratory Society and the European Society of Hypertension. In particular, these recommendations are aimed at reminding cardiovascular experts to consider the occurrence of sleep-related breathing disorders in patients with high blood pressure. They are also aimed at reminding respiration experts...

  9. Declarative and Non-declarative Memory Consolidation in Children with Sleep Disorder

    OpenAIRE

    Cs?bi, Eszter; Benedek, P?lma; Janacsek, Karolina; Zavecz, Zs?fia; Katona, G?bor; Nemeth, Dezso

    2016-01-01

    Healthy sleep is essential in children’s cognitive, behavioral, and emotional development. However, remarkably little is known about the influence of sleep disorders on different memory processes in childhood. Such data could give us a deeper insight into the effect of sleep on the developing brain and memory functions and how the relationship between sleep and memory changes from childhood to adulthood. In the present study we examined the effect of sleep disorder on declarative and non-decl...

  10. Active reward processing during human sleep: insights from sleep-related eating disorder

    Directory of Open Access Journals (Sweden)

    Lampros ePerogamvros

    2012-11-01

    Full Text Available In this paper, we present two carefully documented cases of patients with sleep-related eating disorder (SRED, a parasomnia which is characterized by involuntary compulsive eating during the night and whose pathophysiology is not known. Using video-polysomnography and psychometric examination, we found that both patients present elevated novelty seeking and increased reward sensitivity on reward-related questionnaires. In light of new evidence on the mesolimbic dopaminergic implication in compulsive eating disorders, our findings suggest a role of an active reward system during sleep in the manifestation of SRED.

  11. A systematic review of the incidence and prevalence of sleep disorders and seizure disorders in multiple sclerosis

    DEFF Research Database (Denmark)

    Marrie, Ruth Ann; Reider, Nadia; Cohen, Jeffrey

    2015-01-01

    was 3.09% (95% CI: 2.01-4.16%). For sleep disorders we evaluated 18 studies; none were population-based. The prevalence ranged from 0-1.6% for narcolepsy, 14.4-57.5% for restless legs syndrome, 2.22-3.2% for REM behavior disorder, and 7.14-58.1% for obstructive sleep apnea. CONCLUSION: This review......BACKGROUND: Several studies have suggested that comorbid neurologic disorders are more common than expected in multiple sclerosis (MS). OBJECTIVE: To estimate the incidence and prevalence of comorbid seizure disorders and sleep disorders in persons with MS and to evaluate the quality of studies...... suggests that seizure disorders and sleep disorders are common in MS, but highlights gaps in the epidemiological knowledge of these conditions in MS worldwide. Other than central-western Europe and North America, most regions are understudied....

  12. Diagnostic REM sleep muscle activity thresholds in patients with idiopathic REM sleep behavior disorder with and without obstructive sleep apnea.

    Science.gov (United States)

    McCarter, Stuart J; St Louis, Erik K; Sandness, David J; Duwell, Ethan J; Timm, Paul C; Boeve, Bradley F; Silber, Michael H

    2017-05-01

    We aimed to determine whether visual and automated rapid eye movement (REM) sleep without atonia (RSWA) methods could accurately diagnose patients with idiopathic REM sleep behavior disorder (iRBD) and comorbid obstructive sleep apnea (OSA). In iRBD patients (n = 15) and matched controls (n = 30) with and without OSA, we visually analyzed RSWA phasic burst durations, phasic, tonic, and "any" muscle activity by 3-s mini-epochs, phasic activity by 30-s (AASM rules) epochs, and automated REM atonia index (RAI). Group RSWA metrics were analyzed with regression models. Receiver operating characteristic (ROC) curves were used to determine the best diagnostic cutoff thresholds for REM sleep behavior disorder (RBD). Both split-night and full-night polysomnographic studies were analyzed. All mean RSWA phasic burst durations and muscle activities were higher in iRBD patients than in controls (p sleep behavior disorder (PD-RBD), consistent with a common mechanism and presumed underlying etiology of synucleinopathy in both groups. Copyright © 2016 Elsevier B.V. All rights reserved.

  13. Alcohol Dependence and Its Relationship With Insomnia and Other Sleep Disorders.

    Science.gov (United States)

    Chakravorty, Subhajit; Chaudhary, Ninad S; Brower, Kirk J

    2016-11-01

    Sleep-related complaints are widely prevalent in those with alcohol dependence (AD). AD is associated not only with insomnia, but also with multiple sleep-related disorders as a growing body of literature has demonstrated. This article will review the various aspects of insomnia associated with AD. In addition, the association of AD with other sleep-related disorders will be briefly reviewed. The association of AD with insomnia is bidirectional in nature. The etiopathogenesis of insomnia has demonstrated multiple associations and is an active focus of research. Treatment with cognitive behavioral therapy for insomnia is showing promise as an optimal intervention. In addition, AD may be associated with circadian abnormalities, short sleep duration, obstructive sleep apnea, and sleep-related movement disorder. The burgeoning knowledge on insomnia associated with moderate-to-severe alcohol use disorder has expanded our understanding of its underlying neurobiology, clinical features, and treatment options. Copyright © 2016 by the Research Society on Alcoholism.

  14. Hubungan Phantom Vibration Syndrome Terhadap Sleep Disorder dan Kondisi Stress

    Directory of Open Access Journals (Sweden)

    Ajeng Yeni Setianingrum

    2017-10-01

    Full Text Available Phantom vibration syndrome is a condition where a person would feel the sensation of vibration of a cell phone as if there were incoming notification but the fact is not. This research investigated the relationship between phantom vibration syndromes, sleep disorder and stress condition. Questionnaires were distributed to 120 participants with age range 18 to 23 years old. Data of participants showed that all of participants using a smart mobile phone and 24% of them have more than one cell phone. Time usage of cell phone is at least 1 hour. 23% of participants using a cell phone for social media activity, followed by 21% related to entertainment (music, video and games. The results showed a positive relationship between phantom vibration syndrome, sleep disorder and stress condition. Insomnia contributed a greater influence on stress condition. However, the phantom vibration syndrome is more directly affecting the sleep apnea compared to insomnia and stress condition. Therefore, the phantom vibration syndrome more affects stress condition indirectly, through sleep disorder (sleep apnea and insomnia. Consequently, phantom vibration syndrome has a strong relationship with stress condition at the time of the phantom vibration syndrome can cause sleep disorder.

  15. An under-diagnosed geriatric syndrome: sleep disorders among older adults.

    Science.gov (United States)

    Tufan, Asli; Ilhan, Birkan; Bahat, Gulistan; Karan, Mehmet Akif

    2017-06-01

    Sleep disorders are commonly under-diagnosed in the geriatric population. We aimed to determine the prevalence of sleep problems among older adults admitted to the geriatrics out-patient clinic. Two hundred and three patients (136 female) older than 75 years of age were included in the study. Patients underwent comprehensive geriatric assessment, including identification of sleep problems using the Sleep Disturbance Scale, Rapid eye movement (REM) sleep behavior disorder (RBD) Single-Question Screen questionnaire (RBD1Q) and The Johns Hopkins Restless Leg Syndrome Severity Scale. Demographic and clinical data including age, sex, medications, comorbid diseases, body mass index and functional scores was noted. The mean age of the patients was 80.92±4.3 years. 35.5% of the patients had findings of REM-SBD and 32.5% of the patients had restless legs syndrome. Ninety-seven percent of the patients answered 'yes' to at least one of the sleep disturbance scale questions. There was no significant difference between male and female groups. We observed that sleep disorders were common among older adults. For this reason, the course and quality of sleep should be examined in all patients as a routine part of comprehensive geriatric assessment.

  16. Delayed sleep phase disorder: clinical perspective with a focus on light therapy

    Directory of Open Access Journals (Sweden)

    Figueiro MG

    2016-04-01

    Full Text Available Mariana G Figueiro Lighting Research Center, Rensselaer Polytechnic Institute, Troy, NY, USAAbstract: Delayed sleep phase disorder (DSPD is common among adolescents and further increases their susceptibility to chronic sleep restriction and associated detrimental outcomes, including increased risk of depression, drug and alcohol use, behavioral problems, and poor scholastic performance. DSPD is characterized by sleep onset that occurs significantly later than desired bedtimes and societal norms. Individuals with DSPD exhibit long sleep latencies when attempting to sleep at conventional bedtimes. Circadian sleep disorders such as DSPD can occur when there is misalignment between sleep timing and societal norms. This review discusses studies using light therapy to advance the timing of sleep in adolescents and college students, in particular on those suffering from DSPD. A discussion on how to increase effectiveness of light therapy in the field will also be provided.Keywords: circadian, melatonin, light, sleep, sleep phase disorder, adolescents

  17. Progress in studies of the reciprocal interaction between sleep disorders and Alzheimer's disease

    Directory of Open Access Journals (Sweden)

    LIU Zhen-yu

    2013-06-01

    Full Text Available Alzheimer's disease (AD is a common neurodegenerative disease in the elderly, and is the most common cause of dementia. Epidemiological studies have discovered that, 44% of patients with AD are associated with sleep disorders and (or circadian rhythm disorders. Now there are growing evidences indicating that interstitial fluid amyloid-β protein (A β levels exhibit circadian rhythm fluctuation, and sleep disorders will accelerate the process of Aβ deposition, which may act as a risk factor of AD, suggesting the possible reciprocal interaction between sleep disorders and AD. The mechanism is not yet completely clear. Sleep disorders may be related with the impairments of both sleep-wake regulating system, circadian rhythm regulating system and the change of zeitgeber in AD. Sleep disorders would affect neuronal activity, neurotransmitter secretion, and as a stressor affecting A β processing and metabolism, thus accelerate the pathological process of AD. This paper reviewed the progress in the studies of reciprocal interaction between sleep disorders and Alzheimer's disease and the possible mechanisms.

  18. Sleep disorders and the prevalence of asymptomatic nocturnal acid and non-acid reflux.

    Science.gov (United States)

    Herdman, Christine; Marzio, Dina Halegoua-De; Shah, Paurush; Denuna-Rivera, Susie; Doghramji, Karl; Cohen, Sidney; Dimarino, Anthony J

    2013-01-01

    Nocturnal acid reflux is associated with symptomatic and asymptomatic sleep arousals, leading to fragmented sleep. The frequency and influence of acid reflux in patients with various forms of insomnia has not been reported. The aim of this study was to quantify nocturnal acid and nonacid reflux in patients with primary sleep disorders as previously diagnosed by polysomnography. THIRTY ONE SUBJECTS WERE STUDIED: (A) 9 subjects with a polysomnographically diagnosed sleep disorder (1 with restless legs syndrome, 4 with narcolepsy, 4 with periodic limb movement disorder); (B) 12 subjects with primary insomnia (PI) and unrevealing polysomnography; and (C) 10 controls without disturbed sleep. All subjects underwent a physical examination and 24 h transnasal pH and impedance monitoring to detect acid and non-acid reflux. The 21 subjects with fragmented sleep due to a primary sleep disorder had significantly more recumbent acid exposure (>1.2% of time) as compared with control subjects (33% versus 0%). When fragmented sleep subjects were divided into two groups, 17% of PI subjects and 55% of subjects with a diagnosed sleep disorder had significant recumbent acid exposure (P=0.009). Likewise, the median recumbent nonacid events were increased in the sleep disordered group (P=0.011). This study indicates that patients with primary sleep disorders have prominent nocturnal acid reflux without symptoms of daytime acid reflux. Acid reflux is most prominent in patients with polysomnographic findings of disturbed sleep as compared to patients with PI; while non acid reflux is increased minimally in these patients.

  19. Association between Serum Uric Acid Levels and Sleep Variables: Results from the National Health and Nutrition Survey 2005–2008

    Directory of Open Access Journals (Sweden)

    R. Constance Wiener

    2012-01-01

    Full Text Available Sleep disordered breathing as well as high serum uric acid levels are independent risk factors for cardiovascular disease. However, studies evaluating the relationship between sleep-disordered breathing and hyperuricemia are limited. We examined the 2005–2008 National Health and Nutrition Examination survey's sleep variables and high serum uric acid among 6491 participants aged ≥20 years. The sleep variables included sleep duration, snoring, snorting, and daytime sleepiness. The main outcome was high serum uric acid level, defined as levels of serum uric acid >6.8 mg/dL in males and >6.0 mg/dL in females. We found that snoring more than 5 nights per week, daytime sleepiness, and an additive composite score of sleep variables were associated with high serum uric acid in the age- , sex-adjusted model and in a multivariable model adjusting for demographic and lifestyle/behavioral risk factors. The association was attenuated with the addition of variables related to clinical outcomes such as depression, diabetes, hypertension, and high-cholesterol levels. Our results indicate a positive relationship between sleep variables, including the presence of snoring, snorting, and daytime sleepiness, and high serum uric acid levels.

  20. Sleep disturbances in Parkinsonism.

    Science.gov (United States)

    Askenasy, J J M

    2003-02-01

    according to the progression of the degenerative process of the disease will diminishe aggravation. The following types of sleep-arousal disturbances have to be considered in PD patients: - Sleep Disturbances, Light Fragmented Sleep (LFS), Abnormal Motor Activity During Sleep (AMADS), REM Behavior Disorders (RBD), Sleep Related Breathing Disorders (SRBD), Sleep Related Hallucinations (SRH), Sleep Related Psychotic Behavior (SRPB). - Arousal Disturbances, Sleep Attacks (SA), Excessive Daytime Sleepiness (EDS), Each syndrome has to receive a score according to its severity. III. The specific therapy consists in: LFS: Benzodiazepines & Nondiazepines. AMADS: Clonazepam, Opioid, Apomorphine infusion; RBD: Clonazepam and dopaminergic agonists; SRBD: CPAP, UPPP, nasal interventions, losing weight; SRH: Clozapine, Risperidone; SRPD: Nortriptyline, Clozapine, Olanzepine; SA-adjustment; EDS-arousing drugs. Each therapeutic approach must be tailored to the individual PD patient.

  1. Therapeutic Effects of Melatonin Receptor Agonists on Sleep and Comorbid Disorders

    Directory of Open Access Journals (Sweden)

    Moshe Laudon

    2014-09-01

    Full Text Available Several melatonin receptors agonists (ramelteon, prolonged-release melatonin, agomelatine and tasimelteon have recently become available for the treatment of insomnia, depression and circadian rhythms sleep-wake disorders. The efficacy and safety profiles of these compounds in the treatment of the indicated disorders are reviewed. Accumulating evidence indicates that sleep-wake disorders and co-existing medical conditions are mutually exacerbating. This understanding has now been incorporated into the new Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5. Therefore, when evaluating the risk/benefit ratio of sleep drugs, it is pertinent to also evaluate their effects on wake and comorbid condition. Beneficial effects of melatonin receptor agonists on comorbid neurological, psychiatric, cardiovascular and metabolic symptomatology beyond sleep regulation are also described. The review underlines the beneficial value of enhancing physiological sleep in comorbid conditions.

  2. Sleep Apnea (For Parents)

    Science.gov (United States)

    ... Safe Videos for Educators Search English Español Obstructive Sleep Apnea KidsHealth / For Parents / Obstructive Sleep Apnea What's ... How Is Sleep Apnea Treated? Print What Is Sleep Apnea? Brief pauses in breathing during sleep are ...

  3. Children's Sleep Comic: development of a new diagnostic tool for children with sleep disorders.

    Science.gov (United States)

    Schwerdtle, Barbara; Kanis, Julia; Kahl, Lena; Kübler, Andrea; Schlarb, Angelika A

    2012-01-01

    A solid diagnosis of sleep disorders in children should include both self-ratings and parent ratings. However, there are few standardized self-assessment instruments to meet this need. The Children's Sleep Comic is an adapted version of the unpublished German questionnaire "Freiburger Kinderschlafcomic" and provides pictures for items and responses. Because the drawings were outdated and allowed only for qualitative analysis, we revised the comic, tested its applicability in a target sample, and suggest a procedure for quantitative analysis. All items were updated and pictures were newly drawn. We used a sample of 201 children aged 5-10 years to test the applicability of the Children's Sleep Comic in young children and to run a preliminary analysis. The Children's Sleep Comic comprises 37 items covering relevant aspects of sleep disorders in children. Application took on average 30 minutes. The procedure was well accepted by the children, as reflected by the absence of any dropouts. First comparisons with established questionnaires indicated moderate correlations. The Children's Sleep Comic is appropriate for screening sleep behavior and sleep problems in children. The interactive procedure can foster a good relationship between the investigator and the child, and thus establish the basis for successful intervention if necessary.

  4. Characteristics of rapid eye movement sleep behavior disorder in narcolepsy

    DEFF Research Database (Denmark)

    Jennum, Poul Jørgen; Frandsen, Rune Asger Vestergaard; Knudsen, Stine

    2013-01-01

    Rapid eye movement (REM) sleep behavior disorder (RBD) is characterized by dream-enacting behavior and impaired motor inhibition during REM sleep (REM sleep without atonia, RSWA). RBD is commonly associated with Parkinsonian disorders, but is also reported in narcolepsy. Most patients...... of hypocretin deficiency. Thus, hypocretin deficiency is linked to the two major disturbances of REM sleep motor regulation in narcolepsy: RBD and cataplexy. Moreover, it is likely that hypocretin deficiency independently predicts periodic limb movements in REM and NREM sleep, probably via involvement...... of the dopaminergic system. This supports the hypothesis that an impaired hypocretin system causes general instability of motor regulation during wakefulness, REM and NREM sleep in human narcolepsy. We propose that hypocretin neurons are centrally involved in motor tone control during wakefulness and sleep in humans...

  5. Combination of STOP-Bang Score with Mallampati Score fails to improve specificity in the prediction of sleep-disordered breathing.

    Science.gov (United States)

    Dette, Frank G; Graf, Juergen; Cassel, Werner; Lloyd-Jones, Carla; Boehm, Stefan; Zoremba, Martin; Schramm, Patrick; Pestel, Gunther; Thal, Serge C

    2016-06-01

    Sleep-disordered breathing (SDB) is closely associated with perioperative complications. STOP-Bang score was validated for preoperative screening of SDB. However, STOP-Bang Score lacks adequately high specificity. We aimed to improve it by combining it with the Mallampati Score. The study included 347 patients, in which we assessed both STOP-Bang and Mallampati scores. Overnight oxygen saturation was measured to calculate ODI4%. We calculated the sensitivity and specificity for AHI and ODI4% of both scores separately and in combination. We found that STOP-Bang Score ≥3 was present in 71%, ODI≥5/h (AHI ≥5/h) in 42.6% (39.3%) and ODI≥15/h (AHI ≥15/h) in 13.5% (17.8%). For ODI4%≥5/h (AHI ≥5/h) we observed in men a response rate for sensitivity and specificity of STOP-Bang of 94.5% and 17.1% (90.9% and 12.5%) and in women 66% and 51% (57.8% and 46.9%). For ODI4%≥15/h (AHI≥15/h) it was 92% and 12% (84.6% and 10.3%) and 93% and 49% (75% and 49.2%). For ODI4%≥5 (AHI≥5) sensitivity and specificity of Mallampati score were in men 38.4% and 78.6% (27.3% and 68.2%) and in women 25% and 82.7% (21.9% and 81.3%), for ODI≥15 (AHI ≥15/h) 38.5% and 71.8% (26.9% and 69.2%) and 33.3% and 81.4% (17.9% and 79.6%). In combination, for ODI4%≥15/h, we found sensitivity in men to be 92.3% and in women 93.3%, specificity 10.3% and 41.4%. STOP-Bang Score combined with Mallampati Score fails to increase specificity. Low specificity should be considered when using both scores for preoperative screening of SDB.

  6. Seasonal trends in sleep-disordered breathing: evidence from Internet search engine query data.

    Science.gov (United States)

    Ingram, David G; Matthews, Camilla K; Plante, David T

    2015-03-01

    The primary aim of the current study was to test the hypothesis that there is a seasonal component to snoring and obstructive sleep apnea (OSA) through the use of Google search engine query data. Internet search engine query data were retrieved from Google Trends from January 2006 to December 2012. Monthly normalized search volume was obtained over that 7-year period in the USA and Australia for the following search terms: "snoring" and "sleep apnea". Seasonal effects were investigated by fitting cosinor regression models. In addition, the search terms "snoring children" and "sleep apnea children" were evaluated to examine seasonal effects in pediatric populations. Statistically significant seasonal effects were found using cosinor analysis in both USA and Australia for "snoring" (p search term in Australia (p = 0.13). Seasonal patterns for "snoring children" and "sleep apnea children" were observed in the USA (p = 0.002 and p search volume to examine these search terms in Australia. All searches peaked in the winter or early spring in both countries, with the magnitude of seasonal effect ranging from 5 to 50 %. Our findings indicate that there are significant seasonal trends for both snoring and sleep apnea internet search engine queries, with a peak in the winter and early spring. Further research is indicated to determine the mechanisms underlying these findings, whether they have clinical impact, and if they are associated with other comorbid medical conditions that have similar patterns of seasonal exacerbation.

  7. Sleep, anxiety and psychiatric symptoms in children with Tourette syndrome and tic disorders.

    Science.gov (United States)

    Modafferi, Sergio; Stornelli, Maddalena; Chiarotti, Flavia; Cardona, Francesco; Bruni, Oliviero

    2016-09-01

    The current study evaluated the relationship between tic, sleep disorders and specific psychiatric symptoms (anxiety, depression, obsessive compulsive symptoms). Assessment of 36 consecutive children and adolescents with tic disorders included: the Yale Global Tic Severity Scale (YGTSS) to assess the severity of tic symptoms; the Self-administered scale for children and adolescents (SAFA) to evaluate the psychopathological profile; a specific sleep questionnaire consisting of 45 items to assess the presence of sleep disorders. An age and sex-matched control group was used for comparisons. Sleep was significantly more disturbed in patients with tic disorders than in controls. Difficulties in initiating sleep and increased motor activity during sleep were the most frequent sleep disturbances found in our sample. Patients showed also symptoms of anxiety (SAFA A), depressed mood (SAFA D) and doubt-indecision (SAFA O). Additionally, difficulties in initiating sleep resulted associated with other SAFA subscales relative to obsessive-compulsive symptoms and depression symptoms. Furthermore, anxiety symptoms (SAFA A) resulted associated with increased motor activity during sleep. Findings confirm literature studies reporting high frequency of sleep problems, anxiety and other psychopathological symptoms in patients with tic disorders, and support the hypothesis that intrusive thoughts and other emotional disturbances might disrupt the sleep onset of these patients. These results suggest the importance of a thorough assessment of sleep and psychiatric disturbances in patients with tic disorders. Copyright © 2016 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

  8. 抽动症儿童的睡眠特征研究%Study on sleeping features in children with tic disorder

    Institute of Scientific and Technical Information of China (English)

    晏翠芳; 徐桂凤; 苏海浩; 蔡丽君; 郭梦杰; 麦坚凝; 王波

    2016-01-01

    目的 研究抽动症儿童睡眠习惯及特征,全面了解抽动症儿童的各种表现,为制定全面干预对策提供相关依据.方法 采用儿童睡眠习惯问卷(the Children's Sleep Habits Questionnaire,CSHQ)中文修订版对59名抽动症儿童进行睡眠调查并与有61名正常儿童的对照组进行比较,分析其睡眠特征.结果 抽动症儿童在睡眠阻抗、入睡时间、睡眠焦虑、异态睡眠、夜醒及白天嗜睡各层面的得分明显高于对照组儿童(P<0.05);两组儿童在睡眠呼吸障碍及睡眠时长层面得分比较差异无统计学意义(P>0.05).结论 相比于正常儿童,抽动症儿童更多的出现各种睡眠问题,需要在寻找病因及治疗干预时给予相应关注.%Objective To study the sleeping features of children with tic disorder,searching for the medical comprehensive intervention plan based on study evidence.Methods 59 children with tic disorder and 61 healthy children (control group) were enrolled.The sleeping situation of those children was investigated by Children's Sleep Habits Questionnaire (CSHQ) under the help of their parents.Then the results were analyzed.Results The scores of bedtime resistance,sleep onset delay,sleep anxiety,parasomnia,night awakening and daytime sleepiness of children with tic disorder were obviously higher than those of control group (P<0.05),there were no statistically significant differences in the scores of sleep-disordered breathing and sleep duration between two groups (P>0.05).Conclusion Compared with normal children,children with tic disorder show more sleep problems,which are needed to take more special therapy when managing those children.

  9. Sleep Apnea and Hypoventilation in Patients with Down Syndrome: Analysis of 144 Polysomnogram Studies

    Directory of Open Access Journals (Sweden)

    Zheng Fan

    2017-06-01

    Full Text Available Patients with Down syndrome (DS are at risk for both obstructive sleep apnea (OSA and central sleep apnea (CSA; however, it is unclear how these components evolve as patients age and whether patients are also at risk for hypoventilation. A retrospective review of 144 diagnostic polysomnograms (PSG in a tertiary care facility over 10 years was conducted. Descriptive data and exploratory correlation analyses were performed. Sleep disordered breathing was common (seen in 78% of patients with an average apnea-hypopnea index (AHI = 10. The relative amount of obstructive apnea was positively correlated with age and body mass index (BMI. The relative amount of central sleep apnea was associated with younger age in the very youngest group (0–3 years. Hypoventilation was common occurring in more than 22% of patients and there was a positive correlation between the maximum CO2 and BMI. Sleep disordered breathing, including hypoventilation, was common in patients with DS. The obstructive component increased significantly with age and BMI, while the central component occurred most in the very young age group. Due to the high risk of hypoventilation, which has not been previously highlighted, it may be helpful to consider therapies to target both apnea and hypoventilation in this population.

  10. Hormonal status and the orexin system in obese patients with obstructive sleep apnea syndrome

    Directory of Open Access Journals (Sweden)

    Natalya Viktorovna Strueva

    2015-05-01

    Full Text Available The aim of research was to estimate the influence of hormone metabolism and sleep apnea on patients with obesity. 76 patients (37 males and 39 females with obesity were included in this study. After night polysomnography all patients were divided in two groups comparableby age, sex ratio and BMI. The first group consisted of 41 patients with obstructive sleep apnea syndrome (OSAS, the second (controls – 35 patients without breath disorders during sleep. OSAS is accompanied by the increase in urinary cortisol during the night, high levels ofbasal insulin, disturbances of hepatic production of IGF-1, dysfunction of the pituitary-gonadal axis. Our results show that sleep-related breathing disorders render markedly and negatively affect on hormonal parameters of patients with obesity. As a reliable difference of basalsecretion of orexin A in obese patients with and without OSAS was not revealed (42,0 [14; 99,5] vs. 18,0 [14,5; 124,5] pg/ml; р=0,9, we were not able to show the existence that the existence of OSAS is followed by any special changes of activity of the orexin system.

  11. Sleep stages identification in patients with sleep disorder using k-means clustering

    Science.gov (United States)

    Fadhlullah, M. U.; Resahya, A.; Nugraha, D. F.; Yulita, I. N.

    2018-05-01

    Data mining is a computational intelligence discipline where a large dataset processed using a certain method to look for patterns within the large dataset. This pattern then used for real time application or to develop some certain knowledge. This is a valuable tool to solve a complex problem, discover new knowledge, data analysis and decision making. To be able to get the pattern that lies inside the large dataset, clustering method is used to get the pattern. Clustering is basically grouping data that looks similar so a certain pattern can be seen in the large data set. Clustering itself has several algorithms to group the data into the corresponding cluster. This research used data from patients who suffer sleep disorders and aims to help people in the medical world to reduce the time required to classify the sleep stages from a patient who suffers from sleep disorders. This study used K-Means algorithm and silhouette evaluation to find out that 3 clusters are the optimal cluster for this dataset which means can be divided to 3 sleep stages.

  12. Sleep, chronotype, and sleep hygiene in children with attention-deficit/hyperactivity disorder, autism spectrum disorder, and controls.

    Science.gov (United States)

    van der Heijden, K B; Stoffelsen, R J; Popma, A; Swaab, H

    2018-01-01

    Sleep problems are highly prevalent in ADHD and autism spectrum disorder (ASD). Better insight in the etiology is of clinical importance since intervention and prevention strategies of sleep problems are directed at underlying mechanisms. We evaluated the association of sleep problems and sleep patterns with sleep hygiene (behavioral/environmental practices that influence sleep quality, e.g. caffeine use), access to electronic media, chronotype, and anxiety/depression in children aged 6-12 years with ADHD, ASD, or typical development (TD) using parental questionnaires. ANOVA and linear regression analyses were adjusted for age and sex. Children with ADHD and ASD showed more sleep problems (63.6 and 64.7%, vs 25.1% in TD) and shorter sleep duration than controls, while differences between ADHD and ASD were not significant. Sleep hygiene was worse in ADHD and ASD compared to TD, however, the association of worse sleep hygiene with more sleep problems was only significant in ASD and TD. There was a significant association of access to electronic media with sleep problems only in typically developing controls. Chronotype did not differ significantly between groups, but evening types were associated with sleep problems in ADHD and TD. Associations of greater anxiety/depression with more sleep problems were shown in ADHD and TD; however, anxiety/depression did not moderate the effects of chronotype and sleep hygiene. We conclude that sleep problems are highly prevalent in ADHD and ASD, but are differentially related to chronotype and sleep hygiene. In ASD, sleep problems are related to inadequate sleep hygiene and in ADHD to evening chronotype, while in TD both factors are important. Clinical implications are discussed.

  13. 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...

  14. Sleep and the Cardiovascular System in Children.

    Science.gov (United States)

    Paul, Grace R; Pinto, Swaroop

    2017-06-01

    Subspecialty pediatric practice provides comprehensive medical care for a range of ages, from premature infants to children, and often includes adults with complex medical and surgical issues that warrant multidisciplinary care. Normal physiologic variations involving different body systems occur during sleep and these vary with age, stage of sleep, and underlying health conditions. This article is a concise review of the cardiovascular (CV) physiology and pathophysiology in children, sleep-disordered breathing (SDB) contributing to CV morbidity, congenital and acquired CV pathology resulting in SDB, and the relationship between SDB and CV morbidity in different clinical syndromes and systemic diseases in the expanded pediatric population. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. Rapid eye movement sleep behaviour disorder in patients with narcolepsy is associated with hypocretin-1 deficiency

    DEFF Research Database (Denmark)

    Knudsen, Stine; Gammeltoft, Steen; Jennum, Poul J

    2010-01-01

    Rapid eye movement sleep behaviour disorder is characterized by dream-enacting behaviour and impaired motor inhibition during rapid eye movement sleep. Rapid eye movement sleep behaviour disorder is commonly associated with neurodegenerative disorders, but also reported in narcolepsy with cataplexy....... Most narcolepsy with cataplexy patients lack the sleep-wake, and rapid eye movement sleep, motor-regulating hypocretin neurons in the lateral hypothalamus. In contrast, rapid eye movement sleep behaviour disorder and hypocretin deficiency are rare in narcolepsy without cataplexy. We hypothesized...... that rapid eye movement sleep behaviour disorder coexists with cataplexy in narcolepsy due to hypocretin deficiency. In our study, rapid eye movement sleep behaviour disorder was diagnosed by the International Classification of Sleep Disorders (2nd edition) criteria in 63 narcolepsy patients with or without...

  16. Children’s Sleep Comic: development of a new diagnostic tool for children with sleep disorders

    Directory of Open Access Journals (Sweden)

    Schwerdtle B

    2012-08-01

    Full Text Available Barbara Schwerdtle,1 Julia Kanis,1 Lena Kahl,1 Andrea Kübler,1,2 Angelika A Schlarb3,41Institute of Psychology, Department of Psychology I, University of Würzburg, Würzburg, 2Institute of Medical Psychology and Behavioral Neurobiology, 3Faculty of Science, Clinical and Developmental Psychology, University of Tübingen, Tübingen, 4Department of Clinical Psychology and Psychotherapy, University of Koblenz-Landau, Landau, GermanyBackground: A solid diagnosis of sleep disorders in children should include both self-ratings and parent ratings. However, there are few standardized self-assessment instruments to meet this need. The Children’s Sleep Comic is an adapted version of the unpublished German questionnaire “Freiburger Kinderschlafcomic” and provides pictures for items and responses. Because the drawings were outdated and allowed only for qualitative analysis, we revised the comic, tested its applicability in a target sample, and suggest a procedure for quantitative analysis.Methods: All items were updated and pictures were newly drawn. We used a sample of 201 children aged 5–10 years to test the applicability of the Children’s Sleep Comic in young children and to run a preliminary analysis.Results: The Children’s Sleep Comic comprises 37 items covering relevant aspects of sleep disorders in children. Application took on average 30 minutes. The procedure was well accepted by the children, as reflected by the absence of any dropouts. First comparisons with established questionnaires indicated moderate correlations.Conclusion: The Children’s Sleep Comic is appropriate for screening sleep behavior and sleep problems in children. The interactive procedure can foster a good relationship between the investigator and the child, and thus establish the basis for successful intervention if necessary.Keywords: children, sleep, sleep disorders, diagnostic, assessment, self-rating

  17. Rapid eye movement sleep behavior disorder as an outlier detection problem

    DEFF Research Database (Denmark)

    Kempfner, Jacob; Sørensen, Gertrud Laura; Nikolic, M.

    2014-01-01

    OBJECTIVE: Idiopathic rapid eye movement (REM) sleep behavior disorder is a strong early marker of Parkinson's disease and is characterized by REM sleep without atonia and/or dream enactment. Because these measures are subject to individual interpretation, there is consequently need...... for quantitative methods to establish objective criteria. This study proposes a semiautomatic algorithm for the early detection of Parkinson's disease. This is achieved by distinguishing between normal REM sleep and REM sleep without atonia by considering muscle activity as an outlier detection problem. METHODS......: Sixteen healthy control subjects, 16 subjects with idiopathic REM sleep behavior disorder, and 16 subjects with periodic limb movement disorder were enrolled. Different combinations of five surface electromyographic channels, including the EOG, were tested. A muscle activity score was automatically...

  18. Mechanisms of breathing instability in patients with obstructive sleep apnea.

    Science.gov (United States)

    Younes, Magdy; Ostrowski, Michele; Atkar, Raj; Laprairie, John; Siemens, Andrea; Hanly, Patrick

    2007-12-01

    The response to chemical stimuli (chemical responsiveness) and the increases in respiratory drive required for arousal (arousal threshold) and for opening the airway without arousal (effective recruitment threshold) are important determinants of ventilatory instability and, hence, severity of obstructive apnea. We measured these variables in 21 obstructive apnea patients (apnea-hypopnea index 91 +/- 24 h(-1)) while on continuous-positive-airway pressure. During sleep, pressure was intermittently reduced (dial down) to induce severe hypopneas. Dial downs were done on room air and following approximately 30 s of breathing hypercapneic and/or hypoxic mixtures, which induced a range of ventilatory stimulation before dial down. Ventilation just before dial down and flow during dial down were measured. Chemical responsiveness, estimated as the percent increase in ventilation during the 5(th) breath following administration of 6% CO(2) combined with approximately 4% desaturation, was large (187 +/- 117%). Arousal threshold, estimated as the percent increase in ventilation associated with a 50% probability of arousal, ranged from 40% to >268% and was chemical drive. Effective recruitment threshold, estimated as percent increase in pre-dial-down ventilation associated with a significant increase in dial-down flow, ranged from zero to >174% and was chemical drive, but instability results because of a low arousal threshold and a brisk increase in drive following brief reduction in alveolar ventilation.

  19. Sleep disturbances and binge eating disorder symptoms during and after pregnancy.

    Science.gov (United States)

    Ulman, T Frances; Von Holle, Ann; Torgersen, Leila; Stoltenberg, Camilla; Reichborn-Kjennerud, Ted; Bulik, Cynthia M

    2012-10-01

    We compared sleep problems during pregnancy and sleep dissatisfaction 18 months after pregnancy in pregnant women with binge eating disorder (BED) symptoms and pregnant women without an eating disorder. Norwegian Mother and Child Cohort Study (MoBa). Data were gathered from 72,435 women. A total of 1,495 (2.1%) women reported having BED symptoms both before and during pregnancy; 921 (1.3%) reported pre-pregnancy BED symptoms that remitted during pregnancy; 1,235 (1.7%) reported incident BED symptoms during pregnancy; and 68,784 (95.0%) reported no eating disorder symptoms before or during pregnancy (referent). Questionnaires were collected at 3 time points, with a median completion time of 17.1 weeks gestation, 30.1 weeks gestation, and 18.7 months after childbirth. We collected information on demographics, eating disorder status before and during pregnancy, sleep problems during the first 18 weeks of pregnancy, hours of sleep during the third trimester, and sleep satisfaction 18 months after childbirth. All BED symptom groups were significantly more likely to report sleep problems during the first 18 weeks of pregnancy than the referent (adjusted odds ratio [OR] = 1.26-1.42, false discovery rate [FDR] P sleep than the referent (adjusted OR = 1.49, FDR P sleep 18 months after childbirth (adjusted ORs = 1.28-1.47, FDR P sleeping problems during pregnancy and dissatisfaction with sleep 18 months after childbirth. Health care professionals should inquire about BED during pregnancy as it may be associated with sleep disturbances, in addition to the hallmark eating concerns.

  20. Parental rating of sleep in children with attention deficit/hyperactivity disorder

    DEFF Research Database (Denmark)

    Hvolby, Allan; Jørgensen, Jan; Bilenberg, Niels

    2009-01-01

    OBJECTIVE: Sleep problems have often been associated with attention deficit/hyperactivity disorder (ADHD). Parents of those with ADHD and children with ADHD report sleep difficulties more frequently than healthy children and their parents. The primary objective of this paper is to describe sleep...... regarding numbers of awakenings per night and total sleep time per night. Comorbid oppositional defiant disorder appeared not to have an added effect on problematic behaviour around bedtime. CONCLUSION: Parents of children with ADHD report that their children do not sleep properly more often than other...