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Sample records for subjective sleepiness scores

  1. Levothyroxine improves subjective sleepiness in a euthyroid patient with narcolepsy without cataplexy.

    Science.gov (United States)

    Sobol, Danielle L; Spector, Andrew R

    2014-11-15

    We discuss the use of levothyroxine for excessive daytime sleepiness (EDS) and prolonged nocturnal sleep time in a euthyroid patient with narcolepsy. After failure of first-line narcolepsy treatments, a 48-year-old female began levothyroxine (25 mcg/day). After 12 weeks of treatment, the patient was evaluated for improvement in total sleep time and subjective daytime sleepiness assessed by Epworth Sleepiness Scale (ESS). At baseline, ESS score was 16 and total sleep time averaged 16 h/day. After 12 weeks, ESS was 13 and reported total sleep time was 13 h/day. Levothyroxine improved EDS and total sleep time in a euthyroid patient with narcolepsy without cataplexy after 12 weeks without side effects. © 2014 American Academy of Sleep Medicine.

  2. Subjective sleepiness and sleep quality in adolescents are related to objective and subjective measures of school performance

    OpenAIRE

    Annemarie eBoschloo; Lydia eKrabbendam; Sanne eDekker; Lee, Nikki C.; Renate ede Groot; Jelle eJolles

    2013-01-01

    This study investigated the relation between sleep and school performance in a large sample of 561 adolescents aged 11-18 years. Three subjective measures of sleep were used: sleepiness, sleep quality and sleep duration. They were compared to three measures of school performance: objective school grades, self-reported school performance, and parent-reported school performance. Sleepiness – ‘I feel sleepy during the first hours at school’ – appeared to predict both school grades and self-repor...

  3. Subjective Sleepiness and Sleep Quality in Adolescents are Related to Objective and Subjective Measures of School Performance

    OpenAIRE

    Boschloo, Annemarie; Krabbendam, Lydia; Dekker, Sanne; Lee, Nikki; De Groot, Renate; Jolles, Jelle

    2013-01-01

    This study investigated the relation between sleep and school performance in a large sample of 561 adolescents aged 11–18 years. Three subjective measures of sleep were used: sleepiness, sleep quality, and sleep duration. They were compared to three measures of school performance: objective school grades, self-reported school performance, and parent-reported school performance. Sleepiness – “I feel sleepy during the first hours at school” – appeared to predict both school grades and self-repo...

  4. Objective and subjective measures of sleepiness, and their associations with on-road driving events in shift workers.

    Science.gov (United States)

    Ftouni, Suzanne; Sletten, Tracey L; Howard, Mark; Anderson, Clare; Lenné, Michael G; Lockley, Steven W; Rajaratnam, Shantha M W

    2013-02-01

    To assess the relationships between sleepiness and the incidence of adverse driving events in nurses commuting to and from night and rotating shifts, 27 rotating and permanent night shift-working nurses were asked to complete daily sleep and duty logs, and wear wrist-activity monitors for 2 weeks (369 driving sessions). During all commutes, ocular measures of drowsiness, including the Johns Drowsiness Scale score, were assessed using the Optalert™ system. Participants self-reported their subjective sleepiness at the beginning and end of each drive, and any events that occurred during the drive. Rotating shift nurses reported higher levels of sleepiness compared with permanent night shift nurses. In both shift-working groups, self-reported sleepiness, drowsiness and drive events were significantly higher during commutes following night shifts compared with commutes before night shifts. Strong associations were found between objective drowsiness and increased odds of driving events during commutes following night shifts. Maximum total blink duration (mean = 7.96 s) during the drive and pre-drive Karolinska Sleepiness Scale (mean = 5.0) were associated with greater incidence of sleep-related events [OR, 5.35 (95% CI, 1.32, 21.60), OR, 1.69 (95% CI, 1.04, 2.73), respectively]. Inattention was strongly associated with a Johns Drowsiness Scale score equal to or above 4.5 [OR, 4.58 (95% CI, 1.26-16.69)]. Hazardous driving events were more likely to occur when drivers had been awake for 16 h or more [OR, 4.50 (95% CI, 1.81, 11.16)]. Under real-world driving conditions, shift-working nurses experience high levels of drowsiness as indicated by ocular measures, which are associated with impaired driving performance following night shift work. © 2012 European Sleep Research Society.

  5. Subjective sleepiness and sleep quality in adolescents are related to objective and subjective measures of school performance

    NARCIS (Netherlands)

    Boschloo, Annemarie; Krabbendam, Lydia; Dekker, Sanne; Lee, Nikki; De Groot, Renate; Jolles, Jelle

    2016-01-01

    This study investigated the relation between sleep and school performance in a large sample of 561 adolescents aged 11–18 years. Three subjective measures of sleep were used: sleepiness, sleep quality, and sleep duration. They were compared to three measures of school performance: objective school

  6. Subjective sleepiness and sleep quality in adolescents are related to objective and subjective measures of school performance

    NARCIS (Netherlands)

    Boschloo, Annemarie; Krabbendam, Lydia; Dekker, Sanne; Lee, Nikki; De Groot, Renate; Jolles, Jelle

    2018-01-01

    This study investigated the relation between sleep and school performance in a large sam- ple of 561 adolescents aged 11–18 years. Three subjective measures of sleep were used: sleepiness, sleep quality, and sleep duration. They were compared to three measures of school performance: objective school

  7. Subjective sleepiness and sleep quality in adolescents are related to objective and subjective measures of school performance

    NARCIS (Netherlands)

    Boschloo, A.; Krabbendam, L.; Dekker, S.; Lee, N.; Groot, R. de; Jolles, J.

    2013-01-01

    This study investigated the relation between sleep and school performance in a large sample of 561 adolescents aged 11-18 years. Three subjective measures of sleep were used: sleepiness, sleep quality, and sleep duration. They were compared to three measures of school performance: objective school

  8. Objective measurement of daytime napping, cognitive dysfunction and subjective sleepiness in Parkinson's disease.

    Directory of Open Access Journals (Sweden)

    Samuel J Bolitho

    Full Text Available INTRODUCTION: Sleep-wake disturbances and concomitant cognitive dysfunction in Parkinson's disease (PD contribute significantly to morbidity in patients and their carers. Subjectively reported daytime sleep disturbance is observed in over half of all patients with PD and has been linked to executive cognitive dysfunction. The current study used daytime actigraphy, a novel objective measure of napping and related this to neuropsychological performance in a sample of PD patients and healthy, age and gender-matched controls. Furthermore this study aimed to identify patients with PD who may benefit from pharmacologic and behavioural intervention to improve these symptoms. METHODS: Eighty-five PD patients and 21 healthy, age-matched controls completed 14 days of wrist actigraphy within two weeks of neuropsychological testing. Objective napping measures were derived from actigraphy using a standardised protocol and subjective daytime sleepiness was recorded by the previously validated Epworth Sleepiness Scale. RESULTS: Patients with PD had a 225% increase in the mean nap time per day (minutes as recorded by actigraphy compared to age matched controls (39.2 ± 35.2 vs. 11.5 ± 11.0 minutes respectively, p < 0.001. Significantly, differences in napping duration between patients, as recorded by actigraphy were not distinguished by their ratings on the subjective measurement of excessive daytime sleepiness. Finally, those patients with excessive daytime napping showed greater cognitive deficits in the domains of attention, semantic verbal fluency and processing speed. CONCLUSION: This study confirms increased levels of napping in PD, a finding that is concordant with subjective reports. However, subjective self-report measures of excessive daytime sleepiness do not robustly identify excessive napping in PD. Fronto-subcortical cognitive dysfunction was observed in those patients who napped excessively. Furthermore, this study suggests that daytime

  9. Objective Measurement of Daytime Napping, Cognitive Dysfunction and Subjective Sleepiness in Parkinson’s Disease

    Science.gov (United States)

    Bolitho, Samuel J.; Naismith, Sharon L.; Salahuddin, Pierre; Terpening, Zoe; Grunstein, Ron R.; Lewis, Simon J. G.

    2013-01-01

    Introduction Sleep-wake disturbances and concomitant cognitive dysfunction in Parkinson’s disease (PD) contribute significantly to morbidity in patients and their carers. Subjectively reported daytime sleep disturbance is observed in over half of all patients with PD and has been linked to executive cognitive dysfunction. The current study used daytime actigraphy, a novel objective measure of napping and related this to neuropsychological performance in a sample of PD patients and healthy, age and gender-matched controls. Furthermore this study aimed to identify patients with PD who may benefit from pharmacologic and behavioural intervention to improve these symptoms. Methods Eighty-five PD patients and 21 healthy, age-matched controls completed 14 days of wrist actigraphy within two weeks of neuropsychological testing. Objective napping measures were derived from actigraphy using a standardised protocol and subjective daytime sleepiness was recorded by the previously validated Epworth Sleepiness Scale. Results Patients with PD had a 225% increase in the mean nap time per day (minutes) as recorded by actigraphy compared to age matched controls (39.2 ± 35.2 vs. 11.5 ± 11.0 minutes respectively, p napping duration between patients, as recorded by actigraphy were not distinguished by their ratings on the subjective measurement of excessive daytime sleepiness. Finally, those patients with excessive daytime napping showed greater cognitive deficits in the domains of attention, semantic verbal fluency and processing speed. Conclusion This study confirms increased levels of napping in PD, a finding that is concordant with subjective reports. However, subjective self-report measures of excessive daytime sleepiness do not robustly identify excessive napping in PD. Fronto-subcortical cognitive dysfunction was observed in those patients who napped excessively. Furthermore, this study suggests that daytime actigraphy, a non-invasive and inexpensive objective measure of

  10. Objective measurement of daytime napping, cognitive dysfunction and subjective sleepiness in Parkinson's disease.

    Science.gov (United States)

    Bolitho, Samuel J; Naismith, Sharon L; Salahuddin, Pierre; Terpening, Zoe; Grunstein, Ron R; Lewis, Simon J G

    2013-01-01

    Sleep-wake disturbances and concomitant cognitive dysfunction in Parkinson's disease (PD) contribute significantly to morbidity in patients and their carers. Subjectively reported daytime sleep disturbance is observed in over half of all patients with PD and has been linked to executive cognitive dysfunction. The current study used daytime actigraphy, a novel objective measure of napping and related this to neuropsychological performance in a sample of PD patients and healthy, age and gender-matched controls. Furthermore this study aimed to identify patients with PD who may benefit from pharmacologic and behavioural intervention to improve these symptoms. Eighty-five PD patients and 21 healthy, age-matched controls completed 14 days of wrist actigraphy within two weeks of neuropsychological testing. Objective napping measures were derived from actigraphy using a standardised protocol and subjective daytime sleepiness was recorded by the previously validated Epworth Sleepiness Scale. Patients with PD had a 225% increase in the mean nap time per day (minutes) as recorded by actigraphy compared to age matched controls (39.2 ± 35.2 vs. 11.5 ± 11.0 minutes respectively, p napping duration between patients, as recorded by actigraphy were not distinguished by their ratings on the subjective measurement of excessive daytime sleepiness. Finally, those patients with excessive daytime napping showed greater cognitive deficits in the domains of attention, semantic verbal fluency and processing speed. This study confirms increased levels of napping in PD, a finding that is concordant with subjective reports. However, subjective self-report measures of excessive daytime sleepiness do not robustly identify excessive napping in PD. Fronto-subcortical cognitive dysfunction was observed in those patients who napped excessively. Furthermore, this study suggests that daytime actigraphy, a non-invasive and inexpensive objective measure of daytime sleep, can identify patients with PD

  11. Subjective sleepiness and sleep quality in adolescents are related to objective and subjective measures of school performance

    Directory of Open Access Journals (Sweden)

    Annemarie eBoschloo

    2013-02-01

    Full Text Available This study investigated the relation between sleep and school performance in a large sample of 561 adolescents aged 11-18 years. Three subjective measures of sleep were used: sleepiness, sleep quality and sleep duration. They were compared to three measures of school performance: objective school grades, self-reported school performance, and parent-reported school performance. Sleepiness – ‘I feel sleepy during the first hours at school’ – appeared to predict both school grades and self-reported school performance. Sleep quality on the other hand – as a measure of (uninterrupted sleep and/or problems falling asleep or waking up – predicted parent-reported school performance. Self- and parent-reported school performance correlated only moderately with school grades. So it turns out that the measures used to measure either sleep or school performance impacts whether or not a relation is found. Further research on sleep and school performance should take this into account. The findings do underscore the notion that sleep in adolescence can be important for learning. They are compatible with the hypothesis that a reduced sleep quality can give rise to sleepiness in the first hours at school which results in lower school performance. This notion could have applied value in counseling adolescents and their parents in changing adolescents’ sleep behavior.

  12. Subjective Sleepiness and Sleep Quality in Adolescents are Related to Objective and Subjective Measures of School Performance.

    Science.gov (United States)

    Boschloo, Annemarie; Krabbendam, Lydia; Dekker, Sanne; Lee, Nikki; de Groot, Renate; Jolles, Jelle

    2013-01-01

    This study investigated the relation between sleep and school performance in a large sample of 561 adolescents aged 11-18 years. Three subjective measures of sleep were used: sleepiness, sleep quality, and sleep duration. They were compared to three measures of school performance: objective school grades, self-reported school performance, and parent-reported school performance. Sleepiness - "I feel sleepy during the first hours at school" - appeared to predict both school grades and self-reported school performance. Sleep quality on the other hand - as a measure of (un)interrupted sleep and/or problems falling asleep or waking up - predicted parent-reported school performance. Self- and parent-reported school performance correlated only moderately with school grades. So it turns out that the measures used to measure either sleep or school performance impacts whether or not a relation is found. Further research on sleep and school performance should take this into account. The findings do underscore the notion that sleep in adolescence can be important for learning. They are compatible with the hypothesis that a reduced sleep quality can give rise to sleepiness in the first hours at school which results in lower school performance. This notion could have applied value in counseling adolescents and their parents in changing adolescents' sleep behavior.

  13. Subjective sleepiness correlates negatively with global alpha (8–12 Hz) and positively with central frontal theta (4–8 Hz) frequencies in the human resting awake electroencephalogram

    NARCIS (Netherlands)

    Strijkstra, Arjen M.; Beersma, Domien G.M.; Drayer, Berdine; Halbesma, Nynke; Daan, Serge

    2003-01-01

    Subjective sleepiness is part of the system controlling the decision to go to sleep in humans. Extended periods of waking lead to increased sleepiness, as well as to changes in cortical electroencephalogram (EEG) during waking. We investigated the association of sleepiness and awake EEG spectra

  14. Subjective sleepiness correlates negatively with global alpha (8-12 Hz) and positively with central frontal theta (4-8 Hz) frequencies in the human resting awake electroencephalogram

    NARCIS (Netherlands)

    Strijkstra, AM; Beersma, DGM; Drayer, B; Halbesma, N; Daan, S

    2003-01-01

    Subjective sleepiness is part of the system controlling the decision to go to sleep in humans. Extended periods of waking lead to increased sleepiness, as well as to changes in cortical electroencephalogram (EEG) during waking. We investigated the association of sleepiness and awake EEG spectra

  15. Resolution of sleepiness and fatigue: a comparison of bupropion and selective serotonin reuptake inhibitors in subjects with major depressive disorder achieving remission at doses approved in the European Union.

    Science.gov (United States)

    Cooper, James A; Tucker, Vivian L; Papakostas, George I

    2014-02-01

    Unlike selective serotonin reuptake inhibitors (SSRIs), bupropion may be classified as a dual noradrenaline and dopamine reuptake inhibitor, a difference with potential implications for the treatment of residual sleepiness and fatigue in major depressive disorder (MDD). Post-hoc analysis of subjects with remitted MDD was performed on data pooled from six double-blind, randomized trials comparing the European Union (EU)-approved dose of ≤300 mg/day bupropion with SSRIs (sertraline, paroxetine or escitalopram) for the resolution of sleepiness and fatigue. Hypersomnia score was defined as the sum of scores of the Hamilton Depression Rating Scale (HDRS) items 22, 23, and 24; fatigue score as HDRS item 13 score; and remission as HDRS-17≤7. Similar proportions of bupropion- and SSRI-treated subjects achieved remission at study endpoint (169/343, 49.3% vs 324/656, 49.4%; last observation carried forward (LOCF), p=0.45). Fewer bupropion-treated remitters had residual symptoms of sleepiness (32/169, 18.9% vs 104/324, 32.1%; pBupropion-treated remitters also showed greater improvement (mean change from baseline) in sleepiness (pBupropion treatment at the EU-approved dose of ≤300 mg/day may offer advantages over SSRIs in the resolution of sleepiness and fatigue in remitted MDD patients.

  16. Subjective sleep quality and daytime sleepiness in late midlife and their association with age-related changes in cognition

    DEFF Research Database (Denmark)

    Waller, Katja Linda; Mortensen, Erik Lykke; Avlund, Kirsten

    2016-01-01

    ) or cognitively impaired (N = 92). METHODS: The Pittsburgh Sleep Quality Index and Epworth Sleepiness Scale measured subjective sleep quality and daytime sleepiness, respectively. Depressive symptoms were determined using Beck's Depression Inventory (BDI-II). A neuropsychological battery was administered....... Our results suggest that sleep quality may be an early marker of cognitive decline in midlife.......UNLABELLED: In an increasingly aged population, sleep disturbances and neurodegenerative disorders have become a major public health concern. Poor sleep quality and cognitive changes are complex health problems in aging populations that are likely to be associated with increased frailty, morbidity...

  17. Circadian phase, dynamics of subjective sleepiness and sensitivity to blue light in young adults complaining of a delayed sleep schedule.

    Science.gov (United States)

    Moderie, Christophe; Van der Maren, Solenne; Dumont, Marie

    2017-06-01

    To assess factors that might contribute to a delayed sleep schedule in young adults with sub-clinical features of delayed sleep phase disorder. Two groups of 14 young adults (eight women) were compared: one group complaining of a delayed sleep schedule and a control group with an earlier bedtime and no complaint. For one week, each subject maintained a target bedtime reflecting their habitual sleep schedule. Subjects were then admitted to the laboratory for the assessment of circadian phase (dim light melatonin onset), subjective sleepiness, and non-visual light sensitivity. All measures were timed relative to each participant's target bedtime. Non-visual light sensitivity was evaluated using subjective sleepiness and salivary melatonin during 1.5-h exposure to blue light, starting one hour after target bedtime. Compared to control subjects, delayed subjects had a later circadian phase and a slower increase of subjective sleepiness in the late evening. There was no group difference in non-visual sensitivity to blue light, but we found a positive correlation between melatonin suppression and circadian phase within the delayed group. Our results suggest that a late circadian phase, a slow build-up of sleep need, and an increased circadian sensitivity to blue light contribute to the complaint of a delayed sleep schedule. These findings provide targets for strategies aiming to decreasing the severity of a sleep delay and the negative consequences on daytime functioning and health. Copyright © 2017 Elsevier B.V. All rights reserved.

  18. Frequent nocturnal awakening in children: prevalence, risk factors, and associations with subjective sleep perception and daytime sleepiness.

    Science.gov (United States)

    Li, Liwen; Ren, Jiwei; Shi, Lei; Jin, Xinming; Yan, Chonghuai; Jiang, Fan; Shen, Xiaoming; Li, Shenghui

    2014-07-30

    Nocturnal awakening is the most frequent insomnia complaint in the general population. In contrast to a growing knowledge based on adults, little is known about its prevalence, correlated factors, and associations with subjective sleep perception and daytime sleepiness in children. This study was designed to assess the prevalence and the correlate factors of frequent nocturnal awakening (FNA) among Chinese school-aged children. Furthermore, the associations of FNA with subjective sleep perception and daytime sleepiness were examined. A random sample of 20,505 children aged 5.00 to 11.92 years old (boys: 49.5% vs. girls: 50.5%) participated in a cross-sectional survey, which was conducted in eight cities of China. Parent-administered questionnaires were used to collect information on children's sleep behaviors, sleep perception, and potential influential factors of FNA from six domains. Univariate and multivariate logistic regression models were performed. The prevalence of FNA was 9.8% (10.0% for boys vs. 8.9% for girls) in our sampled children. The prominent FNA-related factors inclued biological health problems, such as overweight/obesity (OR = 1.70), chronic pain during night (OR = 2.47), and chronic respiratory condition (OR = 1.23), poor psychosocial condition, such as poor mental and emotional functioning (OR = 1.34), poor sleep hygiene, such as frequently doing exciting activities before bedtime (OR = 1.24) and bedtime resistance (OR = 1.42), and parents' history of insomnia (OR = 1.31). FNA was associated with subjective poor sleep quality (OR = 1.24), subjective insufficient sleep (OR = 1.21), and daytime sleepiness (OR = 1.35). FNA was associated with poor sleep and daytime sleepiness. Compared to sleep environment and family susceptibility, chronic health problems, poor psychosocial condition, and poor sleep hygiene had greater impact on FNA, indicating childhood FNA could be partly prevented by health promotion, by psychological intervention, and by

  19. Daytime sleepiness in Parkinson's disease: a reappraisal.

    Directory of Open Access Journals (Sweden)

    Valérie Cochen De Cock

    Full Text Available Excessive daytime sleepiness is a frequent complaint in Parkinson's disease (PD; however the frequency and risk factors for objective sleepiness remain mostly unknown. We investigated both the frequency and determinants of self-reported and objective daytime sleepiness in patients with Parkinson's disease (PD using a wide range of potential predictors.One hundred and thirty four consecutive patients with PD, without selection bias for sleep complaint, underwent a semi-structured clinical interview and a one night polysomnography followed by a multiple sleep latency test (MSLT. Demographic characteristics, medical history, PD course and severity, daytime sleepiness, depressive and insomnia symptoms, treatment intake, pain, restless legs syndrome, REM sleep behaviour disorder, and nighttime sleep measures were collected. Self-reported daytime sleepiness was defined by an Epworth Sleepiness Scale (ESS score above 10. A mean sleep latency on MSLT below 8 minutes defined objective daytime sleepiness.Of 134 patients with PD, 46.3% had subjective and only 13.4% had objective sleepiness with a weak negative correlation between ESS and MSLT latency. A high body mass index (BMI was associated with both ESS and MSLT, a pain complaint with ESS, and a higher apnea/hypopnea index with MSLT. However, no associations were found between both objective and subjective sleepiness, and measures of motor disability, disease onset, medication (type and dose, depression, insomnia, restless legs syndrome, REM sleep behaviour disorder and nighttime sleep evaluation.We found a high frequency of self-reported EDS in PD, a finding which is however not confirmed by the gold standard neurophysiological evaluation. Current treatment options for EDS in PD are very limited; it thus remains to be determined whether decreasing pain and BMI in association with the treatment of sleep apnea syndrome would decrease significantly daytime sleepiness in PD.

  20. Excessive Daytime Sleepiness

    Directory of Open Access Journals (Sweden)

    Yavuz Selvi

    2016-06-01

    Full Text Available Excessive daytime sleepiness is one of the most common sleep-related patient symptoms, with preva-lence in the community estimated to be as high as 18%. Patients with excessive daytime sleepiness may exhibit life threatening road and work accidents, social maladjustment, decreased academic and occupational performance and have poorer health than comparable adults. Thus, excessive daytime sleepiness is a serious condition that requires investigation, diagnosis and treatment primarily. As with most medical condition, evaluation of excessive daytime sleepiness begins a precise history and various objective and subjective tools have been also developed to assess excessive daytime sleepiness. The most common causes of excessive daytime sleepiness are insufficient sleep hygiene, chronic sleep deprivation, medical and psychiatric conditions and sleep disorders, such as obstructive sleep apnea, medications, and narcolepsy. Treatment option should address underlying contributors and promote sleep quantity by ensuring good sleep hygiene. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2016; 8(2: 114-132

  1. Excessive daytime sleepiness and metabolic syndrome in men with obstructive sleep apnea: a large cross-sectional study.

    Science.gov (United States)

    Fu, Yiqun; Xu, Huajun; Xia, Yunyan; Qian, Yingjun; Li, Xinyi; Zou, Jianyin; Wang, Yuyu; Meng, Lili; Tang, Xulan; Zhu, Huaming; Zhou, Huiqun; Su, Kaiming; Yu, Dongzhen; Yi, Hongliang; Guan, Jian; Yin, Shankai

    2017-10-03

    Excessive daytime sleepiness is a common symptom in obstructive sleep apnea (OSA). Previous studies have showed that excessive daytime sleepiness is associated with some individual components of metabolic syndrome. We performed a large cross-sectional study to explore the relationship between excessive daytime sleepiness and metabolic syndrome in male OSA patients. A total of 2241 suspected male OSA patients were consecutively recruited from 2007 to 2013. Subjective daytime sleepiness was assessed using the Epworth sleepiness scale. Anthropometric, metabolic, and polysomnographic parameters were measured. Metabolic score was used to evaluate the severity of metabolic syndrome. Among the male OSA patients, most metabolic parameters varied by excessive daytime sleepiness. In the severe group, male OSA patients with excessive daytime sleepiness were more obese, with higher blood pressure, more severe insulin resistance and dyslipidemia than non-sleepy patients. Patients with metabolic syndrome also had a higher prevalence of excessive daytime sleepiness and scored higher on the Epworth sleepiness scale. Excessive daytime sleepiness was independently associated with an increased risk of metabolic syndrome (odds ratio =1.242, 95% confidence interval: 1.019-1.512). No substantial interaction was observed between excessive daytime sleepiness and OSA/ obesity. Excessive daytime sleepiness was related to metabolic disorders and independently associated with an increased risk of metabolic syndrome in men with OSA. Excessive daytime sleepiness should be taken into consideration for OSA patients, as it may be a simple and useful clinical indicator for evaluating the risk of metabolic syndrome.

  2. Excessive Sleepiness and Longer Nighttime in Bed Increase the Risk of Cognitive Decline in Frail Elderly Subjects: The MAPT-Sleep Study

    Directory of Open Access Journals (Sweden)

    Audrey Gabelle

    2017-09-01

    Full Text Available Objective: To identify self-reported sleep-wake disturbances that increase the risk of cognitive decline over 1-year follow-up in frail participants.Background: Risk factors for cognitive impairment need to be better identified especially at earliest stages of the pathogenesis. Sleep-wake disturbances may be critical factors to consider and were thus being assessed in this at-risk population for cognitive decline.Methods: Frail elderly participants aged ≥70 years were selected from a subsample of the Multi-domain Alzheimer Preventive Trial (MAPT for a sleep assessment (MAPT-sleep study at 18-month follow-up (M18. Sleep-wake disturbances were evaluated using a clinical interview (duration of daytime and nighttime sleep, time in bed, number of naps, and presence of clinically-defined sleep disorders and numerous validated questionnaires [Epworth Sleepiness Scale for excessive daytime sleepiness (EDS, Insomnia Severity Scale and Berlin Questionnaire]. Cognitive decline was defined as a difference between the MMSE and cognitive composite scores at M24 and M36 that was ranked in the lowest decile. Multivariate logistic regression models adjusted for several potential confounding factors were performed.Results: Among the 479 frail participants, 63 developed MMSE-cognitive decline and 50 cognitive composite score decrease between M24 and M36. Subjects with EDS had an increased risk of MMSE decline (OR = 2.46; 95% CI [1.28; 4.71], p = 0.007. A longer time spent in bed during night was associated with cognitive composite score decline (OR = 1.32 [1.03; 1.71], p = 0.03. These associations persisted when controlling for potential confounders. Patients with MMSE score decline and EDS had more naps, clinically-defined REM-sleep Behavior Disorder, fatigue and insomnia symptoms, while patients with cognitive composite score decline with longer time in bed had increased 24-h total sleep time duration but with higher wake time after onset.Conclusions: The risk

  3. Sleepy driving.

    Science.gov (United States)

    Powell, Nelson B; Chau, Jason K M

    2010-05-01

    Sleepiness and drowsiness are neurophysiologic states that may cause attenuation of vigilance and slowing of reaction times, and thus increase the risks of driving. This article reviews selected peer-reviewed publications from the past and present body of knowledge regarding sleepiness and drowsiness while driving and related accidents, injuries, and possible death. Comparative studies of driving drunk and driving sleepy are reviewed because both exhibit similarly dangerous driving behaviors. It is hoped that some of the information from this article could provide new interest in the necessity of education for sleepy drivers.

  4. Scoring Rules for Subjective Probability Distributions

    DEFF Research Database (Denmark)

    Harrison, Glenn W.; Martínez-Correa, Jimmy; Swarthout, J. Todd

    report the true subjective probability of a binary event, even under Subjective Expected Utility. To address this one can “calibrate” inferences about true subjective probabilities from elicited subjective probabilities over binary events, recognizing the incentives that risk averse agents have...

  5. Scoring Rules for Subjective Probability Distributions

    DEFF Research Database (Denmark)

    Harrison, Glenn W.; Martínez-Correa, Jimmy; Swarthout, J. Todd

    2017-01-01

    Subjective beliefs are elicited routinely in economics experiments. However, such elicitation often suffers from two possible disadvantages. First, beliefs are recovered in the form of a summary statistic, usually the mean, of the underlying latent distribution. Second, recovered beliefs are bias...

  6. Objective daytime sleepiness in patients with somnambulism or sleep terrors.

    Science.gov (United States)

    Lopez, Régis; Jaussent, Isabelle; Dauvilliers, Yves

    2014-11-25

    To objectively measure daytime sleepiness and to assess for clinical and polysomnographic determinants of mean sleep latency in adult patients with somnambulism (sleepwalking [SW]) or sleep terrors (ST) compared with controls. Thirty drug-free adult patients with primary SW or ST, and age-, sex-, and body mass index-matched healthy controls underwent a standardized clinical interview, completed questionnaires including the Epworth Sleepiness Scale, and underwent one night of video polysomnography followed by the Multiple Sleep Latency Test (MSLT). Excessive daytime sleepiness defined as Epworth Sleepiness Scale score >10 was reported in 66.7% of patients and 6.7% of controls. The temporal pattern of sleep latencies in individual MSLT trials differed between patients and controls, with progressive increased sleep latency in patients across the trials in contrast to a "U curve" for controls. We did not find between-group differences regarding the mean sleep latency on the 5 MSLT trials, but did observe reduced sleep latencies in patients for the first 2 trials. Despite increased slow-wave sleep disruptions found in patients (i.e, more micro-arousals and hypersynchronous high-voltage delta waves arousals), we did not find polysomnographic characteristic differences when comparing sleepy patients for either subjective or objective daytime sleepiness on the MSLT compared with alert patients. Excessive daytime sleepiness is a common complaint in subjects with SW or ST and shorter sleep latencies in the early morning hours. Despite an increased slow-wave sleep fragmentation found in these patients, we did not identify any association with the level of daytime sleepiness. © 2014 American Academy of Neurology.

  7. Smartphone Restriction and its Effect on Subjective Withdrawal Related Scores

    OpenAIRE

    Aarestad, Sarah Helene; Eide, Tine Almenning

    2017-01-01

    Smartphone overuse is associated with a number of negative consequences for the individual and the environment. In the right end of the distribution of smartphone usage, concepts such as smartphone addiction seem warranted. An area that so far lacks research concerns the effect of smartphone restriction generally and specifically on subjective withdrawal related scores across different degrees of smartphone usage. The present study examined withdrawal related scores on the Smartphone Withdraw...

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

    Science.gov (United States)

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

    2016-09-01

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

  9. Observation and Interview-based Diurnal Sleepiness Inventory for measurement of sleepiness in older adults

    Directory of Open Access Journals (Sweden)

    Pak VM

    2017-09-01

    Full Text Available Victoria M Pak,1,2 S-Hakki Onen,3,4 Nalaka S Gooneratne,4 Bruno Falissard,5 Fannie Onen4–6 1Center for Sleep and Circadian Neurobiology, University of Pennsylvania, Philadelphia, PA, 2Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA; 3CHU Lyon, Hôpital Edouard Herriot, Geriatric Sleep Medicine Center, Lyon, France; 4Division of Geriatric Medicine, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA; 5CHU Bichat Claude Bernard, Gériatrie, APHP, Paris, 6CESP, INSERM 1018 & 1178, Université Paris Sud, Paris, France Introduction: There is no established reference standard for subjective measures of sleepiness in older adults. Methods: This study compares the Observation and Interview-based Diurnal Sleepiness Inventory (ODSI with two existing instruments for measurement of sleepiness and daily functioning, the Epworth Sleepiness Scale (ESS and Functional Outcomes of Sleep Questionnaire (FOSQ. Results: A total of 125 study participants were included in this study and were administered the ODSI, ESS and FOSQ; subjects had a mean age of 70.9 ± 5.27 years, mean Apnea–Hypopnea Index of 31.9 ± 27.9 events/hour and normal cognitive functioning (Mini-Mental State Examination score > 24. The ODSI showed a significant association with the ESS (Spearman’s ρ: 0.67, P < 0.001 and with the FOSQ (Spearman’s ρ: –0.52, P < 0.001. The ODSI 1 item (assessing sleepiness in active situations was borderline significantly correlated with the ESS (β = 0.14; 95% confidence interval [CI], –0.01 to 0.29; P = 0.069. ODSI 2 item (sleepiness in passive situations was correlated with the ESS (β = 1.65; 95% CI, 1.32 to 1.98; P < 0.001. Both ODSI 1 (β = –0.15; 95% CI, –0.24 to –0.07; P < 0.001 and ODSI 2 (β = –0.35; 95% CI, –0.55 to 0.16; P < 0.001 were significantly correlated with the FOSQ. Conclusion: The ODSI is a suitable measure of sleepiness and is appropriate for

  10. Validation of the Arabic version of the Epworth sleepiness scale.

    Science.gov (United States)

    Ahmed, Anwar E; Fatani, Abdulhamid; Al-Harbi, Abdullah; Al-Shimemeri, Abdullah; Ali, Yosra Z; Baharoon, Salim; Al-Jahdali, Hamdan

    2014-12-01

    The Epworth Sleepiness Scale (ESS) is a questionnaire widely used in developed countries to measure daytime sleepiness and diagnose sleep disorders. This study aimed to develop an ESS questionnaire for the Arabic population (ArESS), to determine ArESS internal consistency, and to measure ArESS test-retest reproducibility. It also investigated whether the normal range of ESS scores of healthy people in different cultures are similar. The original ESS questionnaire was translated from English to Arabic and back-translated to English. In both the English and Arabic translations of the survey, ESS consists of eight different situations. The subject was asked to rate the chance of dozing in each situation on a scale of 0-3 with total scores ranging between 0 (normal sleep) and 24 (very sleepy). An Arabic translation of the ESS questionnaire was administered to 90 healthy subjects. Item analysis revealed high internal consistency within ArESS questionnaire (Cronbach's alpha=0.86 in the initial test, and 0.89 in the retest). The test-retest intra-class correlation coefficient (ICC) shows that the test-retest reliability was substantially high: ICC=0.86 (95% confidence interval: 0.789-0.909, p-valueArabic-speaking populations to measure daytime sleepiness. The current study has shown that the average ESS score of healthy Arabian subjects is significantly higher than in Western cultures. Copyright © 2014 Ministry of Health, Saudi Arabia. Published by Elsevier Ltd. All rights reserved.

  11. Reliability of scored patient generated subjective global assessment ...

    African Journals Online (AJOL)

    Objective: Establish the reliability of the scored Patient Generated-Subjective Global Assessment (PG-SGA) in determining nutritional status among Antiretroviral Therapy (ART) naive HIV-infected adults. Methods: A descriptive, cross sectional study among outpatient medical clinics, in The AIDS Support Organization ...

  12. Associations of executive function with sleepiness and sleep duration in adolescents.

    Science.gov (United States)

    Anderson, Basil; Storfer-Isser, Amy; Taylor, H Gerry; Rosen, Carol L; Redline, Susan

    2009-04-01

    Sleep deprivation and sleepiness are associated with poorer school performance, impaired neurobehavioral functioning, and behavioral problems. To determine if adolescents with high levels of sleepiness or short sleep duration have impaired executive functioning. Ours was a cross-sectional analysis of data from 236 healthy adolescents in a community-based cohort study. Sleepiness was measured by using a modified version of the Epworth Sleepiness Scale. Participants underwent 5- to 7-day wrist actigraphy at home before overnight polysomnography. Exposure variables were excessive sleepiness (Epworth Sleepiness Scale > or = 11) and weekday mean sleep duration. The main outcome measures were the global executive composite scale from the Behavior Rating Inventory of Executive Function and the tower test-total achievement score from the Delis-Kaplan Executive Functioning System. Participants (N = 236) were 13.7 +/- 0.8 years of age, and 52.1% were boys. Mean weekday sleep duration was 7.70 +/- 1.03 hours; 11% slept adolescents had poorer executive functioning on the Behavior Rating Inventory of Executive Function global executive composite scale and the Delis-Kaplan Executive Functioning System tower test-total achievement. Analyses adjusted for potential confounders resulted in a modest attenuation of the association with the Behavior Rating Inventory of Executive Function and a larger attenuation for the Delis-Kaplan Executive Functioning System. Caregiver education modified the association between sleepiness and the Behavior Rating Inventory of Executive Function outcomes. Among sleepy adolescents, those with less-educated caregivers had greater impairment on the Behavior Rating Inventory of Executive Function global executive composite scale. Sleep duration was not significantly associated with executive functioning outcomes. Decrements in selected executive function scales are associated with subjective sleepiness, but not sleep duration, in adolescents. The

  13. Associations among daytime sleepiness, depression and suicidal ideation in Korean adolescents.

    Science.gov (United States)

    Yang, Boksun; Choe, Kwisoon; Park, Youngrye; Kang, Youngmi

    2017-06-09

    The aim of this study was to examine the effects of daytime sleepiness on depression and suicidal ideation in adolescent high-school students. A survey of 538 high school students aged 16-17 years attending two academic schools was conducted. The Epworth Sleepiness Scale (ESS), the Beck Depression Inventory and the Scale for Suicide Ideation were used to assess subjects' daytime sleepiness, depression and suicidal ideation. The mean score for daytime sleepiness was 8.52, which indicates a sleep deficit. Significant positive correlations were found between daytime sleepiness and depression, between daytime sleepiness and suicidal ideation and between depression and suicidal ideation. Gender and depression were significant predictors of suicidal ideation, accounting for 48% of the variance in this measure. Depression acts as a mediator of the relationship between daytime sleepiness and suicidal ideation. High school students in Korea generally have insufficient sleep time and feel sleepy during the day; insufficient sleep during adolescence may be associated with depression and suicidal ideation.

  14. Ecological momentary assessment of fatigue, sleepiness, and exhaustion in ESKD.

    Science.gov (United States)

    Abdel-Kader, Khaled; Jhamb, Manisha; Mandich, Lee Anne; Yabes, Jonathan; Keene, Robert M; Beach, Scott; Buysse, Daniel J; Unruh, Mark L

    2014-02-06

    Many patients on maintenance dialysis experience significant sleepiness and fatigue. However, the influence of the hemodialysis (HD) day and circadian rhythms on patients' symptoms have not been well characterized. We sought to use ecological momentary assessment to evaluate day-to-day and diurnal variability of fatigue, sleepiness, exhaustion and related symptoms in thrice-weekly maintenance HD patients. Subjects used a modified cellular phone to access an interactive voice response system that administered the Daytime Insomnia Symptom Scale (DISS). The DISS assessed subjective vitality, mood, and alertness through 19 questions using 7- point Likert scales. Subjects completed the DISS 4 times daily for 7 consecutive days. Factor analysis was conducted and a mean composite score of fatigue-sleepiness-exhaustion was created. Linear mixed regression models (LMM) were used to examine the association of time of day, dialysis day and fatigue, sleepiness, and exhaustion composite scores. The 55 participants completed 1,252 of 1,540 (81%) possible assessments over the 7 day period. Multiple symptoms related to mood (e.g., feeling sad, feeling tense), cognition (e.g., difficulty concentrating), and fatigue (e.g., exhaustion, feeling sleepy) demonstrated significant daily and diurnal variation, with higher overall symptom scores noted on hemodialysis days and later in the day. In factor analysis, 4 factors explained the majority of the observed variance for DISS symptoms. Fatigue, sleepiness, and exhaustion loaded onto the same factor and were highly intercorrelated. In LMM, mean composite fatigue-sleepiness-exhaustion scores were associated with dialysis day (coefficient and 95% confidence interval [CI] 0.21 [0.02 - 0.39]) and time of day (coefficient and 95% CI 0.33 [0.25 - 0.41]. Observed associations were minimally affected by adjustment for demographics and common confounders. Maintenance HD patients experience fatigue-sleepiness-exhaustion symptoms that demonstrate

  15. Validation of the Urdu version of the Epworth Sleepiness Scale.

    Science.gov (United States)

    Surani, Asif Anwar; Ramar, Kannan; Surani, Arif Anwar; Khaliqdina, Jehangir Shehryar; Subramanian, Shyam; Surani, Salim

    2012-09-01

    To translate and validate the Epworth Sleepiness Scale (ESS) for use in Urdu-speaking population. The original Epworth Sleepiness Scale was translated into the Urdu version (ESS-Ur) in three phases - translation and back-translation; committee-based translation; and testing in bilingual individuals. The final was subsequently tested on 89 healthy bilingual subjects between February and April, 2010, to assess the validity of the translation compared to the original version. The subjects were students and employees of Dow University of Health Sciences, Karachi. Both English and Urdu versions of the Epworth Sleepiness Scale were administered to 59 (67%) women and 30 (33%) men. The mean composite Epworth score was 7.53 in English language and 7.7 in the Urdu version (p=0.76). The translated version was found to be highly correlated with the original scale (rho=0.938; pUrdu version as an effective tool for measuring daytime sleepiness in Urdu-speaking population. Future studies assessing the validity of such patients with sleep disorders need to be undertaken.

  16. Association of daytime sleepiness with nigrostriatal dopaminergic degeneration in early Parkinson's disease.

    Science.gov (United States)

    Happe, Svenja; Baier, Paul Christian; Helmschmied, Kathrin; Meller, Johannes; Tatsch, Klaus; Paulus, Walter

    2007-08-01

    Many patients with Parkinson's disease (PD) report daytime sleepiness. Its etiology, however, is still not fully understood. The aim of this study was to examine if the amount of nigrostriatal dopaminergic degeneration is associated with subjective daytime sleepiness in patients with PD. We investigated 21 patients with PD clinically and by means of [(123)I] FP-CIT-SPECT (DaTSCAN(R)). Each patient filled in the Epworth sleepiness scale (ESS), the Parkinson's Disease Sleep Scale (PDSS), and the self-rating depression scale according to Zung (SDS) to assess sleepiness, sleep quality, and depressive symptoms. The mean specific dopamine transporter binding in the 21 PD patients (60.8 +/- 10.4 years, nine females, median Hoehn and Yahr stage 2.0) was decreased. Nine patients were in Hoehn and Yahr stage 1 (58.7 +/- 6.6 years, four females; ESS score 7.4 +/- 4.5; PDSS score 105.1 +/- 30.9), the other 12 patients were in Hoehn and Yahr stage 2 (62.4 +/- 12.6 years, five females; ESS score 6.7 +/- 4.7, PDSS score 97.1 +/- 25.6). Age, gender, ESS, and PDSS scores were not significantly different in both groups. However, ESS scores showed an inverse correlation with mean DAT binding in the striatum (r = -0.627, p = 0.03), the caudate nucleus (r = -0.708, p = 0.01), and the putamen (r = -0.599, p = 0.04) in patients with Hoehn and Yahr stage 2. There was no correlation of the ESS score with age, disease duration, UPDRS motor score, PDSS score, or depression score. Subjective daytime sleepiness seems to be associated with dopaminergic nigrostriatal degeneration in early PD.

  17. Is the Epworth Sleepiness Scale a useful tool for screening excessive daytime sleepiness in commercial drivers?

    Science.gov (United States)

    Baiardi, Simone; La Morgia, Chiara; Sciamanna, Lucia; Gerosa, Alberto; Cirignotta, Fabio; Mondini, Susanna

    2018-01-01

    The significant social and economic impact of excessive daytime sleepiness makes sleep evaluation a primary medical need in commercial drivers. However, the best screening tool is still matter of debate. In our cohort of 221 commercial drivers, only ten (4.5%) had Epworth Sleepiness Scale scores indicative of excessive daytime sleepiness. These findings and the lack of concordance in estimating excessive daytime sleepiness among commercial drivers in previous studies using the same psychometric measure indicate that the Epworth Sleepiness Scale is not a reliable tool. This may be due to the low internal consistency of the scale in non-clinical samples and the possible intentional underscoring of sleepiness due to a perceived threat of driver's license suspension. Moreover, the reliability of the Epworth Sleepiness Scale results may be strongly influenced by the administration setting. The clinical application of inexpensive less time-consuming new tools like performance tests should be considered for the objective evaluation of excessive daytime sleepiness in commercial drivers. Copyright © 2017 Elsevier Ltd. All rights reserved.

  18. Daytime sleepiness in young adults.

    Science.gov (United States)

    Levine, B; Roehrs, T; Zorick, F; Roth, T

    1988-02-01

    The daytime sleepiness of a large sample (n = 129) of healthy, young (age 18-29) adults with no sleep-wake complaints was measured and compared with that of a sample (n = 47) of older (age 30-80) healthy, normal sleeping, subjects. Each spent 8 h in the laboratory on 1 night and received the Multiple Sleep Latency Test (MSLT) the following day. Sleep latency was measured at 1000, 1200, 1400, and 1600 h. Mean sleep latency ranged from 2 to 20 min within each group, but the shape of the distribution of latency between groups was different. The mean latency of young subjects (particularly college students) was shorter than that of the older subjects, with the differences occurring between the sleepiest 80% of each distribution. Among the college students, those with higher nocturnal sleep efficiencies (the previous night) were sleepier the following day than those with lower sleep efficiencies. The relation between nocturnal sleep efficiency and daytime sleepiness suggests that the increased sleepiness of average young adults is due to mild sleep restriction.

  19. Acute versus chronic partial sleep deprivation in middle-aged people: differential effect on performance and sleepiness.

    Science.gov (United States)

    Philip, Pierre; Sagaspe, Patricia; Prague, Mélanie; Tassi, Patricia; Capelli, Aurore; Bioulac, Bernard; Commenges, Daniel; Taillard, Jacques

    2012-07-01

    To evaluate the effects of acute sleep deprivation and chronic sleep restriction on vigilance, performance, and self-perception of sleepiness. Habitual night followed by 1 night of total sleep loss (acute sleep deprivation) or 5 consecutive nights of 4 hr of sleep (chronic sleep restriction) and recovery night. Eighteen healthy middle-aged male participants (age [(± standard deviation] = 49.7 ± 2.6 yr, range 46-55 yr). Multiple sleep latency test trials, Karolinska Sleepiness Scale scores, simple reaction time test (lapses and 10% fastest reaction times), and nocturnal polysomnography data were recorded. Objective and subjective sleepiness increased immediately in response to sleep restriction. Sleep latencies after the second and third nights of sleep restriction reached levels equivalent to those observed after acute sleep deprivation, whereas Karolinska Sleepiness Scale scores did not reach these levels. Lapse occurrence increased after the second day of sleep restriction and reached levels equivalent to those observed after acute sleep deprivation. A statistical model revealed that sleepiness and lapses did not progressively worsen across days of sleep restriction. Ten percent fastest reaction times (i.e., optimal alertness) were not affected by acute or chronic sleep deprivation. Recovery to baseline levels of alertness and performance occurred after 8-hr recovery night. In middle-aged study participants, sleep restriction induced a high increase in sleep propensity but adaptation to chronic sleep restriction occurred beyond day 3 of restriction. This sleepiness attenuation was underestimated by the participants. One recovery night restores daytime sleepiness and cognitive performance deficits induced by acute or chronic sleep deprivation. Philip P; Sagaspe P; Prague M; Tassi P; Capelli A; Bioulac B; Commenges D; Taillard J. Acute versus chronic partial sleep deprivation in middle-aged people: differential effect on performance and sleepiness. SLEEP 2012;35(7):997-1002.

  20. Adolescent daytime sleepiness as a risk factor for adult crime.

    Science.gov (United States)

    Raine, Adrian; Venables, Peter H

    2017-06-01

    While recent cross-sectional research has documented a relationship between sleep problems and antisocial behavior, the longitudinal nature of this relationship is unknown. This study tests both the hypothesis that adolescent daytime sleepiness is associated with later adult criminal offending, and also tests a biopsychosocial mediation model in which social adversity predisposes to sleepiness, which in turn predisposes to attentional impairment, and to adult crime. Schoolboys aged 15 years rated themselves on self-report sleepiness. Age 15 antisocial behavior was assessed by teacher ratings and self-reports, while convictions for crime were assessed at age 29. Attentional capacity at age 15 was assessed by autonomic orienting, with arousal assessed by the electroencephalogram (EEG). Sleepy adolescents were more likely to be antisocial during adolescence, and were 4.5 times more likely to commit crime by age 29. The sleepiness-adult crime relationship withstood control for adolescent antisocial behavior. Self-report sleepiness predicted to adult crime over and above objective measures of daytime sleepiness (EEG theta activity) and age 15 antisocial behavior. Poor daytime attention partly mediated the sleep-crime relationship. Mediation analyses also showed that social adversity predisposed to daytime sleepiness which was associated with reduced attention which in turn predisposed to adult crime. Findings are the first to document a longitudinal association between sleepiness in adolescence and crime in adulthood. The longitudinal nature of this relationship, controlling for age 15 antisocial behavior, is consistent with the hypothesis that adolescent sleepiness predisposes to later antisociality. Findings are also consistent with the notion that the well-established link between social adversity and adult crime is partly explained by sleepiness. Results suggest that a very brief and simple assessment of subjective daytime sleepiness may have prognostic clinical

  1. The SAT® and SAT Subject Tests™: Discrepant Scores and Incremental Validity. Research Report 2012-2

    Science.gov (United States)

    Kobrin, Jennifer L.; Patterson, Brian F.

    2012-01-01

    This study examines student performance on the SAT and SAT Subject Tests in order to identify groups of students who score differently on these two tests, and to determine whether certain demographic groups score higher on one test compared to the other. Discrepancy scores were created to capture individuals' performance differences on the…

  2. An isotonic partial credit model for ordering subjects on the basis of their sum scores

    NARCIS (Netherlands)

    Ligtvoet, R.

    2012-01-01

    In practice, the sum of the item scores is often used as a basis for comparing subjects. For items that have more than two ordered score categories, only the partial credit model (PCM) and special cases of this model imply that the subjects are stochastically ordered on the common latent variable.

  3. Relationships between affect, vigilance, and sleepiness following sleep deprivation.

    Science.gov (United States)

    Franzen, Peter L; Siegle, Greg J; Buysse, Daniel J

    2008-03-01

    This pilot study examined the relationships between the effects of sleep deprivation on subjective and objective measures of sleepiness and affect, and psychomotor vigilance performance. Following an adaptation night in the laboratory, healthy young adults were randomly assigned to either a night of total sleep deprivation (SD group; n = 15) or to a night of normal sleep (non-SD group; n = 14) under controlled laboratory conditions. The following day, subjective reports of mood and sleepiness, objective sleepiness (Multiple Sleep Latency Test and spontaneous oscillations in pupil diameter, PUI), affective reactivity/regulation (pupil dilation responses to emotional pictures), and psychomotor vigilance performance (PVT) were measured. Sleep deprivation had a significant impact on all three domains (affect, sleepiness, and vigilance), with significant group differences for eight of the nine outcome measures. Exploratory factor analyses performed across the entire sample and within the SD group alone revealed that the outcomes clustered on three orthogonal dimensions reflecting the method of measurement: physiological measures of sleepiness and affective reactivity/regulation, subjective measures of sleepiness and mood, and vigilance performance. Sleepiness and affective responses to sleep deprivation were associated (although separately for objective and subjective measures). PVT performance was also independent of the sleepiness and affect outcomes. These findings suggest that objective and subjective measures represent distinct entities that should not be assumed to be equivalent. By including affective outcomes in experimental sleep deprivation research, the impact of sleep loss on affective function and their relationship to other neurobehavioral domains can be assessed.

  4. Differential sleep, sleepiness, and neurophysiology in the insomnia phenotypes of shift work disorder.

    Science.gov (United States)

    Gumenyuk, Valentina; Belcher, Ren; Drake, Christopher L; Roth, Thomas

    2015-01-01

    To characterize and compare insomnia symptoms within two common phenotypes of Shift Work Disorder. Observational laboratory and field study. Hospital sleep center. 34 permanent night workers. Subjects were classified by Epworth Sleepiness Scale and Insomnia Severity Index into 3 subgroups: asymptomatic controls, alert insomniacs (AI), and sleepy insomniacs (SI). Sleep parameters were assessed by sleep diary. Circadian phase was evaluated by dim-light salivary melatonin onset (DLMO). Objective sleepiness was measured using the multiple sleep latency test (MSLT). Brain activity was measured using the N1 event-related potential (ERP). A tandem repeat in PER3 was genotyped from saliva DNA. (1) AI group showed normal MSLT scores but elevated N1 amplitudes indicating cortical hyperarousal. (2) SI group showed pathologically low MSLT scores but normal N1 amplitudes. (3) AI and SI groups were not significantly different from one another in circadian phase, while controls were significantly phase-delayed relative to both SWD groups. (4) AI showed significantly longer sleep latencies and lower sleep efficiency than controls during both nocturnal and diurnal sleep. SI significantly differed from controls in nocturnal sleep parameters, but differences during diurnal sleep periods were smaller and not statistically significant. (5) Genotype × phenotype χ² analysis showed significant differences in the PER3 VNTR: 9 of 10 shift workers reporting sleepiness in a post hoc genetic substudy were found to carry the long tandem repeat on PER3, while 4 of 14 shift workers without excessive sleepiness carried the long allele. Our results suggest that the sleepy insomnia phenotype is comprehensively explained by circadian misalignment, while the alert insomnia phenotype resembles an insomnia disorder precipitated by shift work. © 2014 Associated Professional Sleep Societies, LLC.

  5. Counteracting driver sleepiness: effects of napping, caffeine, and placebo.

    Science.gov (United States)

    Horne, J A; Reyner, L A

    1996-05-01

    Sleepy drivers should "take a break," but the efficacy of feasible additional countermeasures that can be used during the break is unknown. We examined a shorter than 15 min nap, 150 mg of caffeine in coffee, and a coffee placebo, each given randomly across test sessions to 10 sleepy subjects during a 30-min rest period between two 1-hr monotonous early afternoon drives in a car simulator. Caffeine and nap significantly reduced driving impairments, subjective sleepiness, and electroencephalographic (EEG) activity indicating drowsiness. Blink rate was unaffected. Sleep during naps varied, whereas caffeine produced more consistent effects. Subjects acknowledged sleepiness when the EEG indicated drowsiness, and driving impairments were preceded by self-knowledge of sleepiness. Taking just a break proved ineffective.

  6. Excessive daytime sleepiness in multiple system atrophy (SLEEMSA study).

    Science.gov (United States)

    Moreno-López, Claudia; Santamaría, Joan; Salamero, Manuel; Del Sorbo, Francesca; Albanese, Alberto; Pellecchia, Maria Teresa; Barone, Paolo; Overeem, Sebastiaan; Bloem, Bastiaan; Aarden, Willemijn; Canesi, Margherita; Antonini, Angelo; Duerr, Susanne; Wenning, Gregor K; Poewe, Werner; Rubino, Alfonso; Meco, Giuseppe; Schneider, Susanne A; Bhatia, Kailash P; Djaldetti, Ruth; Coelho, Miguel; Sampaio, Cristina; Cochen, Valerie; Hellriegel, Helge; Deuschl, Günther; Colosimo, Carlo; Marsili, Luca; Gasser, Thomas; Tolosa, Eduardo

    2011-02-01

    Sleep disorders are common in multiple system atrophy (MSA), but the prevalence of excessive daytime sleepiness (EDS) is not well known. To assess the frequency and associations of EDS in MSA. Survey of EDS in consecutive patients with MSA and comparison with patients with Parkinson disease (PD) and individuals without known neurologic disease. Twelve tertiary referral centers. Eighty-six consecutive patients with MSA; 86 patients with PD matched for age, sex, and Hoehn and Yahr stage; and 86 healthy subject individuals matched for age and sex. Epworth Sleepiness Scale (ESS), modified ESS, Sudden Onset of Sleep Scale, Tandberg Sleepiness Scale, Pittsburgh Sleep Quality Index, disease severity, dopaminergic treatment amount, and presence of restless legs syndrome. Mean (SD) ESS scores were comparable in MSA (7.72 [5.05]) and PD (8.23 [4.62]) but were higher than in healthy subjects (4.52 [2.98]) (P 10) was present in 28% of patients with MSA, 29% of patients with PD, and 2% of healthy subjects (P < .001). In MSA, in contrast to PD, the amount of dopaminergic treatment was not correlated with EDS. Disease severity was weakly correlated with EDS in MSA and PD. Restless legs syndrome occurred in 28% of patients with MSA, 14% of patients with PD, and 7% of healthy subjects (P < .001). Multiple regression analysis (with 95% confidence intervals obtained using nonparametric bootstrapping) showed that sleep-disordered breathing and sleep efficiency predicted EDS in MSA and amount of dopaminergic treatment and presence of restless legs syndrome in PD. More than one-quarter of patients with MSA experience EDS, a frequency similar to that encountered in PD. In these 2 conditions, EDS seems to be associated with different causes.

  7. Fatigued on Venus, sleepy on Mars-gender and racial differences in symptoms of sleep apnea.

    Science.gov (United States)

    Eliasson, Arn H; Kashani, Mariam D; Howard, Robin S; Vernalis, Marina N; Modlin, Randolph E

    2015-03-01

    Clinical guidelines for the care of obstructive sleep apnea (OSA) recommend evaluation of daytime sleepiness but do not specify evaluation of fatigue. We studied how subjects with and without OSA experience fatigue and sleepiness, examining the role of gender and race. Consecutive subjects entering our heart health registry completed validated questionnaires including Berlin Questionnaire for OSA, Fatigue Scale, and Epworth Sleepiness Scale. Data analysis was performed only with Whites and Blacks as there were too few subjects of other races for comparison. Of 384 consecutive subjects, including 218 women (57 %), there were 230 Whites (60 %) and 154 Blacks (40 %), with average age of 55.9 ± 12.8 years. Berlin Questionnaires identified 221 subjects (58 %) as having high likelihood for OSA. Fatigue was much more common in women (75 %) than in men (46 %) with OSA (p < 0.001), while frequency of fatigue was similar in women (30 %) and men (29 %) without OSA (p = 0.86). In multivariate analysis, men with OSA were sleepier than women; Black men with OSA had higher Epworth scores (mean ± SD, 12.8 ± 5.2) compared to White men (10.6 ± 5.3), White women (10.0 ± 4.5), and Black women (10.5 ± 5.2), p = 0.05. These gender differences were not related to the effects of age, body mass index, perceived stress, sleep duration, or thyroid function. Women report fatigue more commonly with OSA than men. Men experience sleepiness more commonly with OSA than women. The findings suggest that evaluation of sleep disorders must include an assessment of fatigue in addition to sleepiness to capture the experience of women.

  8. Sleepiness of occupational drivers.

    Science.gov (United States)

    Philip, Pierre

    2005-01-01

    Drowsiness and sleeping at the wheel are now identified as the reasons behind fatal crashes and highway accidents caused by occupational drivers. For many years, fatigue has been associated to risk of accidents but the causes of this symptom were unclear. Extensive or nocturnal driving was associated to accidents but few reports differentiated fatigue from sleepiness. In the early nineties, epidemiological data started investigating sleepiness and sleep deprivation as cause of accidents. Sleepiness at the wheel, sleep restriction and nocturnal driving have been incriminated in 20% of traffic accidents. Drugs affecting the central nervous system (i.e., narcotic analgesics, antihistamine drugs), nocturnal breathing disorders and narcolepsy have been also associated with an increasing risk of accidents. Treatments improving daytime vigilance (i.e., nasal Continuous Positive Airway Pressure) reduce significantly the risk of traffic accidents for a reasonable economical cost. Sleep disorders among occupational drivers need to be systematically investigated. Chronic daytime sleepiness is still under diagnosed and sleep disorders (i.e. obstructive sleep apnea syndrome) are not enough explored and treated in this exposed population of sedentary males. Drivers education and work schedules integrating notions of sleep hygiene as well as promotion of sleep medicine could significantly improve road safety.

  9. Frequency of Burnout, Sleepiness and Depression in Emergency Medicine Residents with Medical Errors in the Emergency Department

    Directory of Open Access Journals (Sweden)

    Alireza Aala

    2014-07-01

    Full Text Available Aims: Medical error is a great concern of the patients and physicians. It usually occurs due to physicians’ exhaustion, distress and fatigue. In this study, we aimed to evaluate frequency of distress and fatigue among emergency medicine residents reporting a medical error. Materials and Methods: The study population consisted of emergency medicine residents who completed an emailed questionnaire including self-assessment of medical errors, the Epworth Sleepiness Scale (ESS score, the Maslach Burnout Inventory, and PRIME-MD validated depression screening tool.   Results: In this survey, 100 medical errors were reported including diagnostic errors in 53, therapeutic errors in 24 and following errors in 23 subjects. Most errors were reported by males and third year residents. Residents had no signs of depression, but all had some degrees of sleepiness and burnout. There were significant differences between errors subtypes and age, residency year, depression, sleepiness and burnout scores (p<0.0001.   Conclusion: In conclusion, residents committing a medical error usually experience burnout and have some grades of sleepiness that makes them less motivated increasing the probability of medical errors. However, as none of the residents had depression, it could be concluded that depression has no significant role in medical error occurrence and perhaps it is a possible consequence of medical error.    Keywords: Residents; Medical error; Burnout; Sleepiness; Depression

  10. Effects of Shift Work on Cognitive Performance, Sleep Quality, and Sleepiness among Petrochemical Control Room Operators

    OpenAIRE

    Kazemi, Reza; Haidarimoghadam, Rashid; Motamedzadeh, Majid; Golmohammadi, Rostam; Soltanian, Alireza; Zoghipaydar, Mohammad Reza

    2016-01-01

    Background: shift work is associated with both sleepiness and reduced performance. The aim of this study was to examine cognitive performance, sleepiness, and sleep quality among petrochemical control room shift workers. Method: Sixty shift workers participated in this study. Cognitive performance was evaluated using the objective test such as continuous performance test, n-back test, and simple reaction time test; sleepiness scale was measured using the subjective Karolinska Sleepiness Scale...

  11. Predictors of Increased Daytime Sleepiness in Patients with Chronic Obstructive Pulmonary Disease: A Cross-Sectional Study

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    Claudia Enz

    2016-01-01

    Full Text Available Background. Patients with Chronic Obstructive Pulmonary Disease (COPD suffer from increased daytime sleepiness. The aim of this study was to identify potential predictors of subjective daytime sleepiness with special regard to sleep-related breathing disorder and nocturnal activity. Methods. COPD patients were recruited at the University Hospital Basel, Switzerland. COPD risk groups A–D were determined according to spirometry and COPD Assessment Test (CAT. Breathing disorder evaluation was performed with the ApneaLink device. Nocturnal energy expenditure was measured with the SenseWear Mini Armband. Subjective daytime sleepiness was recorded using the Epworth Sleepiness Scale (ESS. Results. Twenty-two patients (36% were in COPD risk group A, 28 patients (45% in risk group B, and 12 patients (19% in risk groups C + D (n=62. Eleven patients (18% had a pathological ESS ≥ 10/24. ESS correlated positively with CAT (r=0.386, p<0.01 and inversely with age (r=-0.347, p<0.01. In multiple linear regression age (β=-0.254, p<0.05, AHI (β=0.287, p<0.05 and CAT score (β=0.380, p<0.01 were independent predictors of ESS, while nocturnal energy expenditure showed no significant association (p=0.619. Conclusion. These findings provide evidence that daytime sleepiness in COPD patients may partly be attributable to nocturnal respiratory disturbances and it seems to mostly affect younger patients with more severe COPD symptoms.

  12. Sleepiness and Cognitive Performance among Younger and Older Adolescents across a 28-Hour Forced Desynchrony Protocol

    Science.gov (United States)

    Wu, Lora J.; Acebo, Christine; Seifer, Ronald; Carskadon, Mary A.

    2015-01-01

    Study Objectives: Quantify the homeostatic and circadian effects on sleepiness and performance of adolescents. Examine age-related changes in homeostatic and circadian regulation of sleepiness and performance by comparing younger and older adolescent groups. Design: Three-week laboratory study including 12 cycles of a 28-h forced desynchrony protocol. Setting: Controlled laboratory environment with individual sleep and performance testing rooms and shared common areas. Participants: Twenty-seven healthy adolescents including 16 females. Ages ranged from 9.6–15.2 years and participants were split into younger (n = 14 ages 9–12) and older (n = 13 ages 13–15) groups based on median age split of 13.0 years. Interventions: N/A Measurements and Results: Testing occurred every 2 h during scheduled wake periods. Measures included sleep latency during repeated nap opportunities and scores from a computerized neurobehavioral assessment battery including a 10-min psychomotor vigilance task, a digit symbol substitution task, and the Karolinska Sleepiness Scale. Significant main effects of circadian and homeostatic factors were observed, as well as several circadian and homeostatic interaction effects. Age group did not have a significant main effect on sleep and performance data. A significant interaction of circadian phase and age group was found for sleep latency, with younger adolescents showing greater circadian modulation than older teens during the circadian night. Conclusions: Adolescents demonstrated a similar pattern of response to forced desynchrony as reported for adults. Sleepiness and performance were affected by homeostatic and circadian factors, and age group did not interact with homoeostatic and circadian factors for subjective sleepiness and most performance metrics. Younger adolescents had a shorter latency to sleep onset than older during the circadian bin spanning 4 to 8 h after the onset of melatonin secretion. Citation: Wu LJ, Acebo C, Seifer R

  13. Sleepiness and performance is disproportionate in patients with non-organic hypersomnia in comparison to patients with narcolepsy and mild to moderate obstructive sleep apnoea.

    Science.gov (United States)

    Kofmel, Nicole C; Schmitt, Wolfgang J; Hess, Christian W; Gugger, Matthias; Mathis, Johannes

    2014-01-01

    Clinical differentiation between organic hypersomnia and non-organic hypersomnia (NOH) is challenging. We aimed to determine the diagnostic value of sleepiness and performance tests in patients with excessive daytime sleepiness (EDS) of organic and non-organic origin. We conducted a retrospective comparison of the multiple sleep latency test (MSLT), pupillography, and the Steer Clear performance test in three patient groups complaining of EDS: 19 patients with NOH, 23 patients with narcolepsy (NAR), and 46 patients with mild to moderate obstructive sleep apnoea syndrome (OSAS). As required by the inclusion criteria, all patients had Epworth Sleepiness Scale (ESS) scores >10. The mean sleep latency in the MSLT indicated mild objective sleepiness in NOH (8.1 ± 4.0 min) and OSAS (7.2 ± 4.1 min), but more severe sleepiness in NAR (2.5 ± 2.0 min). The difference between NAR and the other two groups was significant; the difference between NOH and OSAS was not. In the Steer Clear performance test, NOH patients performed worst (error rate = 10.4%) followed by NAR (8.0%) and OSAS patients (5.9%; p = 0.008). The difference between OSAS and the other two groups was significant, but not between NOH and NAR. The pupillary unrest index was found to be highest in NAR (11.5) followed by NOH (9.2) and OSAS (7.4; n.s.). A high error rate in the Steer Clear performance test along with mild sleepiness in an objective sleepiness test (MSLT) in a patient with subjective sleepiness (ESS) is suggestive of NOH. This disproportionately high error rate in NOH may be caused by factors unrelated to sleep pressure, such as anergia, reduced attention and motivation affecting performance, but not conventional sleepiness measurements.

  14. Increased daytime sleepiness in Parkinson's disease: a questionnaire survey.

    Science.gov (United States)

    Högl, Birgit; Seppi, Klaus; Brandauer, Elisabeth; Glatzl, Susanne; Frauscher, Birgit; Niedermüller, Ulrike; Wenning, Gregor; Poewe, Werner

    2003-03-01

    We evaluated the frequency and severity of excessive daytime sleepiness in an outpatient population with Parkinson's disease in comparison to age-matched controls and examined its relationship with antiparkinsonian drug therapy and sleep history. Increased daytime sleepiness and involuntary sleep episodes have been described in Parkinson's disease, but the etiology is not completely understood. The Epworth Sleepiness Scale (ESS), a validated questionnaire for daytime sleepiness, was prospectively administered to 99 consecutive outpatients with Parkinson's disease and 44 age-matched controls. In addition, a short sleep-screening questionnaire was used. The ESS revealed significantly increased daytime sleepiness in PD patients compared to controls (7.5 +/- 4.6 vs. 5.8 +/- 3.0, P = 0.013). The ESS score was abnormally high (10 or more) in 33 % of PD patients and 11.4% of controls (P = 0.001). ESS was not different between PD patients on levodopa monotherapy and those on levodopa and dopamine agonists, or between patients taking ergoline or non-ergoline dopamine agonists. In PD patients and in controls, sleepiness was significantly associated with reported heavy snoring. Increased daytime sleepiness is more frequent in patients with PD than in elderly controls. Similar to controls, increased daytime sleepiness in PD patients is correlated with heavy snoring. Copyright 2002 Movement Disorder Society

  15. Elevated risk of an intermediate or high SYNTAX score in subjects with impaired fasting glucose.

    Science.gov (United States)

    Yang, Xishan; Liu, Hui; Yang, Fangfang; Dong, Pingshuan; Fa, Xianen; Zhang, Qingyong; Li, Li; Wang, Zhikuan; Zhao, Di

    2015-01-01

    This study was designed to determine the SYNTAX score under different fasting plasma glucose (FPG) states in Chinese patients undergoing coronary angiography, particularly subjects with impaired FPG. Four hundred and forty-six subjects undergoing coronary angiography were enrolled in this study and divided into four groups based on the FPG level or a history of type 2 diabetes mellitus (T2DM): normal FPG, impaired FPG, known and previously unknown T2DM. The angiographic SYNTAX scores were higher in the subjects with known (pimportance of achieving better glycemic control in order to prevent coronary atherosclerosis and improve the cardiovascular prognosis.

  16. Obstetrical complications and Apgar score in subjects at risk of psychosis.

    Science.gov (United States)

    Kotlicka-Antczak, Magdalena; Pawełczyk, Agnieszka; Rabe-Jabłońska, Jolanta; Smigielski, Janusz; Pawełczyk, Tomasz

    2014-01-01

    The objective of the study was to identify associations between a history of obstetrical complications (OCs) and the future development of symptoms indicating risk of psychosis (At Risk Mental State - ARMS). The frequency of OCs was assessed in 66 ARMS subjects, 50 subjects with the first episode of schizophrenia (FES) and 50 healthy controls. Obstetrical data was obtained from medical documentation and evaluated with the Lewis and Murray Scale. Definite OCs, according to the Lewis and Murray Scale, occurred significantly more frequently in the ARMS group compared to the controls (χ(2) = 7.79, p = 0.005; OR = 4.20, 95% CI = 1.46-12.11), as well as in the FES subjects compared to the controls (χ(2) = 8.39, p = 0.004; OR = 4.64, 95% CI = 1.56-13.20). Apgar scores in the first (Apgar 1) and the fifth minute after birth (Apgar 5) were significantly lower in the FES subjects compared to the controls (for Apgar 1 score Z = 4.439, p Apgar 5 score Z = 5.250, p Apgar 5 scores compared to the healthy controls (Z = 3.458, p = 0.0016). The results indicate that OCs and low Apgar 5 score should be considered important factors in identifying subjects at risk of developing psychosis. Copyright © 2013 Elsevier Ltd. All rights reserved.

  17. Factors influencing excessive daytime sleepiness in adolescents

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    Thiago de Souza Vilela

    2016-04-01

    Full Text Available Abstract Objective: Sleep deprivation in adolescents has lately become a health issue that tends to increase with higher stress prevalence, extenuating routines, and new technological devices that impair adolescents' bedtime. Therefore, this study aimed to assess the excessive sleepiness frequency and the factors that might be associated to it in this population. Methods: The cross-sectional study analyzed 531 adolescents aged 10–18 years old from two private schools and one public school. Five questionnaires were applied: the Cleveland Adolescent Sleepiness Questionnaire; the Sleep Disturbance Scale for Children; the Brazilian Economic Classification Criteria; the General Health and Sexual Maturation Questionnaire; and the Physical Activity Questionnaire. The statistical analyses were based on comparisons between schools and sleepiness and non-sleepiness groups, using linear correlation and logistic regression. Results: Sleep deprivation was present in 39% of the adolescents; sleep deficit was higher in private school adolescents (p < 0.001, and there was a positive correlation between age and sleep deficit (p < 0.001; r = 0.337. Logistic regression showed that older age (p = 0.002; PR: 1.21 [CI: 1.07–1.36] and higher score level for sleep hyperhidrosis in the sleep disturbance scale (p = 0.02; PR: 1.16 [CI: 1.02–1.32] were risk factors for worse degree of sleepiness. Conclusions: Sleep deficit appears to be a reality among adolescents; the results suggest a higher prevalence in students from private schools. Sleep deprivation is associated with older age in adolescents and possible presence of sleep disorders, such as sleep hyperhidrosis.

  18. Relation between subjective and objective scores on the active straight leg raising test.

    NARCIS (Netherlands)

    Pool-Goudzwaard, A.L.; Mens, Jan M A; Beekmans, RE; Tijhuis, MT

    2010-01-01

    DESIGN: Cross sectional. OBJECTIVE: To fill a gap in the validation of the active straight leg raising (ASLR) test concerning the relation between a patient's subjective score on the ASLR test and the objective measured force. SUMMARY OF BACKGROUND DATA: The ASLR test is used to classify patients

  19. Subjective Scoring of Divergent Thinking: Examining the Reliability of Unusual Uses, Instances, and Consequences Tasks

    Science.gov (United States)

    Silvia, Paul J.

    2011-01-01

    The present research examined the reliability of three types of divergent thinking tasks (unusual uses, instances, consequences/implications) and two types of subjective scoring (an average across all responses vs. the responses people chose as their top-two responses) within a latent variable framework, using the maximal-reliability "H"…

  20. Assessing Framingham cardiovascular risk scores in subjects with diabetes and their correlation with diabetic retinopathy

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    Deepali R Damkondwar

    2012-01-01

    Full Text Available Aim: To study the Framingham cardiovascular risk assessment scores in subjects with diabetes and their association with diabetic retinopathy in subjects with diabetes. Materials and Methods: In this population-based prospective study, subjects with diabetes were recruited (n=1248; age ≥40 years. The Framingham cardiovascular risk scores were calculated for 1248 subjects with type 2 diabetes. The scores were classified as high risk (>10%, and low risk (<10%. Results: Out of the 1248 subjects, 830 (66.5% patients had a low risk of developing cardiovascular disease (CVD in 10 years and 418 (33.5% had a high risk of developing CVD in 10 years. The risk of developing CVD was more in males than females (56.8% vs. 7% The prevalence of both diabetic retinopathy and sight-threatening retinopathy was more in the high-risk group (21% and 4.5%, respectively. The risk factors for developing diabetic retinopathy were similar in both the groups (low vs. high - duration of diabetes (OR 1.14 vs. 1.08, higher HbA1c (OR 1.24 vs. 1.22, presence of macro- and microalbuminuria (OR 10.17 vs. 6.12 for macro-albuminuria and use of insulin (OR 2.06 vs. 4.38. The additional risk factors in the high-risk group were presence of anemia (OR 2.65 and higher serum high density lipoprotein (HDL cholesterol (OR 1.05. Conclusion: Framingham risk scoring, a global risk assessment tool to predict the 10-year risk of developing CVD, can also predict the occurrence and type of diabetic retinopathy. Those patients with high CVD scores should be followed up more frequently and treated adequately. This also warrants good interaction between the treating physician/cardiologist and the ophthalmologist.

  1. Effect of CPAP Therapy in Improving Daytime Sleepiness in Indian Patients with Moderate and Severe OSA.

    Science.gov (United States)

    Battan, Gulshan; Kumar, Sanjeev; Panwar, Ajay; Atam, Virendra; Kumar, Pradeep; Gangwar, Anil; Roy, Ujjawal

    2016-11-01

    Obstructive Sleep Apnoea (OSA) is a highly prevalent disease and a major public health issue in India. Excessive daytime sleepiness is an almost ubiquitous symptom of OSA. Epworth Sleepiness Scale (ESS) score is a validated objective score to measure the degree of daytime sleepiness. Continuous Positive Airway Pressure (CPAP) therapy has been established as the gold standard treatment modality for OSA patients. A few Indian studies have reported the effectiveness of CPAP therapy in improving ESS scores after 1st month of CPAP use. To observe both, short-term (one month) and long-term (three month) effects of CPAP therapy on ESS scores in moderate to severe OSA patients. The patients complaining of excessive day-time sleepiness, snoring and choking episodes during sleep, consecutively presenting to medicine OPD over a period of 2 years, were subjected to Polysomnography (PSG). Seventy-three patients with apnoea-hypopnea index (AHI) ≥15 were categorised as having moderate to severe forms of OSA (moderate OSA with AHI=15-30 and severe OSA with AHI >30), and were scheduled for an initial trial of CPAP therapy. Forty-seven patients reported good tolerance to CPAP therapy after a trial period of 2 weeks and comprised the final study group. ESS scores in these patients were recorded at the baseline, and after 1st and 3rd month of CPAP therapy, and statistically analysed for significance. Mean ESS score at the baseline among moderate and severe OSA patients were 13.67±2.29 and 16.56 ±1.87, respectively. ESS score in both these subgroups improved significantly to 11.63±3.79, p=0.022, CI (0.3293-4.0106)} and 14.13 ±3.74, p OSA patients improved significantly to 9.84 ±2.97, p = 0.022, CI (0.3293-4.0106) and 12.29 ±3.97, p OSA. Benefits in daytime sleepiness were observed after short-term as well as long-term use of CPAP therapy.

  2. Sleepiness and Cognitive Performance among Younger and Older Adolescents across a 28-Hour Forced Desynchrony Protocol.

    Science.gov (United States)

    Wu, Lora J; Acebo, Christine; Seifer, Ronald; Carskadon, Mary A

    2015-12-01

    Quantify the homeostatic and circadian effects on sleepiness and performance of adolescents. Examine age-related changes in homeostatic and circadian regulation of sleepiness and performance by comparing younger and older adolescent groups. Three-week laboratory study including 12 cycles of a 28-h forced desynchrony protocol. Controlled laboratory environment with individual sleep and performance testing rooms and shared common areas. Twenty-seven healthy adolescents including 16 females. Ages ranged from 9.6-15.2 years and participants were split into younger (n = 14 ages 9-12) and older (n = 13 ages 13-15) groups based on median age split of 13.0 years. N/A. Testing occurred every 2 h during scheduled wake periods. Measures included sleep latency during repeated nap opportunities and scores from a computerized neurobehavioral assessment battery including a 10-min psychomotor vigilance task, a digit symbol substitution task, and the Karolinska Sleepiness Scale. Significant main effects of circadian and homeostatic factors were observed, as well as several circadian and homeostatic interaction effects. Age group did not have a significant main effect on sleep and performance data. A significant interaction of circadian phase and age group was found for sleep latency, with younger adolescents showing greater circadian modulation than older teens during the circadian night. Adolescents demonstrated a similar pattern of response to forced desynchrony as reported for adults. Sleepiness and performance were affected by homeostatic and circadian factors, and age group did not interact with homoeostatic and circadian factors for subjective sleepiness and most performance metrics. Younger adolescents had a shorter latency to sleep onset than older during the circadian bin spanning 4 to 8 h after the onset of melatonin secretion. © 2015 Associated Professional Sleep Societies, LLC.

  3. An on-road study of sleepiness in split shifts among city bus drivers.

    Science.gov (United States)

    Anund, Anna; Fors, Carina; Ihlström, Jonas; Kecklund, Göran

    2017-05-12

    Bus drivers often work irregular hours or split shifts and their work involves high levels of stress. These factors can lead to severe sleepiness and dangerous driving. This study examined how split shift working affects sleepiness and performance during afternoon driving. An experiment was conducted on a real road with a specially equipped regular bus driven by professional bus drivers. The study had a within-subject design and involved 18 professional bus drivers (9 males and 9 females) who drove on two afternoons; one on a day in which they had driven early in the morning (split shift situation) and one on a day when they had been off duty until the test (afternoon shift situation). The hypothesis tested was that split shifts contribute to sleepiness during afternoon, which can increase the safety risks. The overall results supported this hypothesis. In total, five of the 18 drivers reached levels of severe sleepiness (Karolinska Sleepiness Scale ≥8) with an average increase in KSS of 1.94 when driving in the afternoon after working a morning shift compared with being off duty in the morning. This increase corresponded to differences observed between shift workers starting and ending a night shift. The Psychomotor Vigilance Task showed significantly increased response time with split shift working (afternoon: 0.337s; split shift 0.347s), as did the EEG-based Karolinska Drowsiness Score mean/max. Blink duration also increased, although the difference was not significant. One driver fell asleep during the drive. In addition, 12 of the 18 bus drivers reported that in their daily work they have to fight to stay awake while driving at least 2-4 times per month. While there were strong individual differences, the study clearly showed that shift-working bus drivers struggle to stay awake and thus countermeasures are needed in order to guarantee safe driving with split shift schedules. Copyright © 2017. Published by Elsevier Ltd.

  4. Comparison of the ceiling effect in the Lysholm score and the IKDC subjective score for assessing functional outcome after ACL reconstruction.

    Science.gov (United States)

    Ra, Ho Jong; Kim, Hyoung Soo; Choi, Jung Yun; Ha, Jeong Ku; Kim, Ji Yeong; Kim, Jin Goo

    2014-10-01

    To compare the ceiling effect of the Lysholm and IKDC subjective scores for assessing functional outcome after ACL reconstruction and evaluated the correlation with the one-leg hop test. A total of 134 patients who underwent ACL reconstruction between 2007 and 2011 were enrolled in this study. All patients fulfilled the postoperative 6- and 12-month evaluations. The ceiling effect of the Lysholm and IKDC subjective scores was assessed, and the correlations between two scales and one-leg hop test were analysed. For the entire sample, the ceiling effect for the Lysholm score was 14.9% and 30.6% at 6 and 12 months postoperatively. The values for the IKDC subjective score were 5.2% and 17.2%, respectively. In all subjects, the correlation coefficients [95% confidence intervals] between the IKDC subjective score and one-leg hop test at 6 and 12months (r=0.492, [0.34 to 0.62]; r=0.296, [0.12 to 0.46]) were higher than those for the Lysholm score (r=0.355, [0.18 to 0.51]; r=0.241, [0.06 to 0.41]), respectively.(pceiling effect and the correlation with the LSI. However, the concern that the ceiling effect of the Lysholm score was greater than the IKDC subjective score, should be addressed in assessing the patient's functional status postoperatively. III, retrospective comparative study. Copyright © 2014 Elsevier B.V. All rights reserved.

  5. BAHNG score: predictive model for detection of subjects with the oropharynx colonized by uncommon microorganisms.

    Science.gov (United States)

    González-Del Castillo, J; Teja-Marina, J; Candel, F J; Barberán, J; Moreno-Cuervo, A; Chiarella, F; López-González, L; Ramos-Cordero, P; Martín-Sánchez, F J

    2017-11-06

    Pneumonia is most frequently produced by the microaspiration of flora that colonizes the oropharynx. Etiological diagnosis of pneumonia is infrequent in clinical practise and empirical treatment should be prescribed. The aims of the present study were to determine the factors associated with oropharynx colonization by uncommon microorganisms (UM) and to develop a predictive model. A cross-sectional study that included all pa-tients living in one long-term care facilities was developed. Demographic, comorbidities, basal functional status and clinical data were collected. To determinate the oropharyngeal colonization, a single sample of pharynx was obtained for each subject using a cotton swab. A total of 221 subjects were included, mean age 86.27 (SD 8.05) years and 157 (71%) were female. In 32 (14.5%) subjects UM flora was isolated, Gram-negative bacilli in 16 (7.2%) residents, and Staphylococcus aureus in 16 (7.2%). The predictive model included the presence of hypertension, neuromuscular disease, Barthel <90 and use of PEG. The BAHNG score (BArthel, Hypertension, Neuromuscular, Gastrostomy), showed an area under the curve of 0.731 (CI 95% 0.643-0.820; p<0.001). We have classified patients according to this score in low (0-2 points), intermediate (3-5 points) and high risk (≥ 6). The probability of UM colonization in the oropharyngeal based on this classification is 4.1%, 15.8% and 57.1% for low, intermediate and high risk, respectively. The BAHNG score could help in the identifications of elderly patients with high risk of colonization by UM. In case of pneumonia the evaluation of the subject through this score could help in the initial decisions concerning antibiotic treatment.

  6. No Clinically Significant Difference Between Adult and Pediatric IKDC Subjective Knee Evaluation Scores in Adults.

    Science.gov (United States)

    Stegmeier, Nicole; Oak, Sameer R; O'Rourke, Colin; Strnad, Greg; Spindler, Kurt P; Jones, Morgan; Farrow, Lutul D; Andrish, Jack; Saluan, Paul

    Two versions of the International Knee Documentation Committee (IKDC) Subjective Knee Evaluation form currently exist: the original version (1999) and a recently modified pediatric-specific version (2011). Comparison of the pediatric IKDC with the adult version in the adult population may reveal that either version could be used longitudinally. We hypothesize that the scores for the adult IKDC and pediatric IKDC will not be clinically different among adult patients aged 18 to 50 years. Randomized crossover study design. Level 2. The study consisted of 100 participants, aged 18 to 50 years, who presented to orthopaedic outpatient clinics with knee problems. All participants completed both adult and pediatric versions of the IKDC in random order with a 10-minute break in between. We used a paired t test to test for a difference between the scores and a Welch's 2-sample t test to test for equivalence. A least-squares regression model was used to model adult scores as a function of pediatric scores, and vice versa. A paired t test revealed a statistically significant 1.6-point difference between the mean adult and pediatric scores. However, the 95% confidence interval (0.54-2.66) for this difference did not exceed our a priori threshold of 5 points, indicating that this difference was not clinically important. Equivalence testing with an equivalence region of 5 points further supported this finding. The adult and pediatric scores had a linear relationship and were highly correlated with an R2 of 92.6%. There is no clinically relevant difference between the scores of the adult and pediatric IKDC forms in adults, aged 18 to 50 years, with knee conditions. Either form, adult or pediatric, of the IKDC can be used in this population for longitudinal studies. If the pediatric version is administered in adolescence, it can be used for follow-up into adulthood.

  7. A spiritual sleepiness scale: the Friday prayer.

    Science.gov (United States)

    Abouda, Maher; Turki, Senda; Hachicha, Amani; Yangui, Ferdaous; Triki, Miriam; Charfi, Med Ridha

    2016-03-01

    Excessive daytime sleepiness (EDS) affects 5% to 20% of the population and is involved in a large number of traffic accidents. EDS is a major symptom in sleep disorders, especially obstructive sleep apnea syndrome (OSA). The daytime sleepiness is evaluated subjectively using scales and questionnaires based on perception. This study is aimed to build a new questionnaire more suited to our lifestyle and then to compare it to the Epworth sleepiness scales (ESS). We administered to 91 adult's patients (76 men and 15 women) consulting for sleep disturbance the ESS and a single subjective question tendency to drowsiness during the Friday prayer. Patients were listed in four groups according to their response to the question «During the past month, have you ever doze or fall asleep during the sermon of the Friday prayer? » By G1 never dozes, G2 low chance of falling asleep, G3 average chance of dozing, G4 high chance of falling asleep. Only 63 patients (58 men and 5 women) responded to both questionnaires. Group 1 included 14 patients with a ESS of 5.5 +/- 1.8, Group 2 included 18 patients with a ESS of 7.3 +/- 1.9, Group 3 included 18 patients with a ESS of 11.05 +/- 2 and Group 4 included 13 patients with a ESS of 14.69 +/- 2.3. The Rho correlation coefficient was high (0.86) and shows a strong correlation between the Results of the two questionnaires. the answer to the question " During the past month, have you ever doze or fall asleep during the sermon of the Friday prayer? » seems to be an appropriate Sleepiness Scale among Muslim patients.

  8. Observer rated sleepiness and real road driving: an explorative study.

    Directory of Open Access Journals (Sweden)

    Anna Anund

    Full Text Available The aim of the present study was to explore if observer rated sleepiness (ORS is a feasible method for quantification of driver sleepiness in field studies. Two measures of ORS were used: (1 one for behavioural signs based on facial expression, body gestures and body movements labelled B-ORS, and (2 one based on driving performance e.g. if swerving and other indicators of impaired driving occurs, labelled D-ORS. A limited number of observers sitting in the back of an experimental vehicle on a motorway about 2 hours repeatedly 3 times per day (before lunch, after lunch, at night observed 24 participant's sleepiness level with help of the two observer scales. At the same time the participant reported subjective sleepiness (KSS, EOG was recorded (for calculation of blink duration and several driving measure were taken and synchronized with the reporting. Based on mixed model Anova and correlation analysis the result showed that observer ratings of sleepiness based on drivers' impaired performance and behavioural signs are sensitive to extend the general pattern of time awake, circadian phase and time of driving. The detailed analysis of the subjective sleepiness and ORS showed weak correspondence on an individual level. Only 16% of the changes in KSS were predicted by the observer. The correlation between the observer ratings based on performance (D-ORS and behavioural signs (B-ORS are high (r = .588, and the B-ORS shows a moderately strong association (r = .360 with blink duration. Both ORS measures show an association (r>0.45 with KSS, whereas the association with driving performance is weak. The results show that the ORS-method detects the expected general variations in sleepy driving in field studies, however, sudden changes in driver sleepiness on a detailed level as 5 minutes is usually not detected; this holds true both when taking into account driving behaviour or driver behavioural signs.

  9. Daytime sleepiness and sleep quality among Malaysian medical students.

    Science.gov (United States)

    Zailinawati, A H; Teng, C L; Chung, Y C; Teow, T L; Lee, P N; Jagmohni, K S

    2009-06-01

    Poor sleep quality and daytime somnolence is reported to be associated with cardiovascular events, road traffic accident, poor academic performance and psychological distress. Some studies documented that it is prevalent in most populations but its frequency among medical students has not been documented in Malaysia. This is a self-administered questionnaire survey of medical students from International Medical University, Malaysia. Daytime sleepiness of medical students was assessed using Epworth Sleepiness Scale (ESS). Student scoring ESS > 11 was regarded as having excessive daytime sleepiness. Psychological distress was measured using 12-item General Health Questionnaire (GHQ-12). A total of 799 medical students participated in this survey (response rate 69.5%). Daytime sleepiness occurred in 35.5%, psychological distress was present in 41.8% and 16.1% reported bad sleep quality. Daytime sleepiness was significantly more common among the clinical students, those with self-reported bad sleep quality and psychological distress; but unrelated to the number of hours sleep at night. We have documented high prevalence of daytime sleepiness, poor sleep quality and psychological distress. Higher frequency among clinical students and the significant relationship with psychological distress suggest possible link to the stressful clinical training.

  10. 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 <9 h per night on weekdays. The mean PDSS value was 15.74 +/- 5.93. Parental reporting of snoring occurred in 511 subjects (23%); snoring was occasional in 14% and frequent in 9%. Apneas were witnessed in 237 cases (11%), being frequent in 4% and occasional in 7%. Frequent snorers had higher mean PDSS scores than occasional or nonsnorers (18 +/- 5, 15.7 +/- 6 and 15.5 +/- 6, respectively; P < 0.001). Reported snoring or apneas and the PDSS were significant univariate predictors of failure and remained significant in multivariate logistic regression analysis after adjusting for age, sex, body mass index, specific school attended, and 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.

  11. Quantitative Electroencephalography and Behavioural Correlates of Daytime Sleepiness in Chronic Stroke

    Directory of Open Access Journals (Sweden)

    Katherine Herron

    2014-01-01

    Full Text Available Sleepiness is common after stroke, but in contrast to its importance for rehabilitation, existing studies focus primarily on the acute state and often use subjective sleepiness measures only. We used quantitative electroencephalography (qEEG to extract physiological sleepiness, as well as subjective reports, in response to motor-cognitive demand in stroke patients and controls. We hypothesised that (a slowing of the EEG is chronically sustained after stroke; (b increased power in lower frequencies and increased sleepiness are associated; and (c sleepiness is modulated by motor-cognitive demand. QEEGs were recorded in 32 chronic stroke patients and 20 controls using a Karolinska Drowsiness Test protocol administered before and after a motor priming task. Subjective sleepiness was measured using the Karolinska Sleepiness Scale. The findings showed that power density was significantly increased in delta and theta frequency bands over both hemispheres in patients which were not associated with subjective sleepiness ratings. This effect was not observed in controls. The motor priming task induced differential hemispheric effects with greater increase in low-frequency bands and presumably compensatory increases in higher frequency bands. The results indicate sustained slowing in the qEEG in chronic stroke, but in contrast to healthy controls, these changes are not related to perceived sleepiness.

  12. Freezing of Gait Detection in Parkinson's Disease: A Subject-Independent Detector Using Anomaly Scores.

    Science.gov (United States)

    Pham, Thuy T; Moore, Steven T; Lewis, Simon John Geoffrey; Nguyen, Diep N; Dutkiewicz, Eryk; Fuglevand, Andrew J; McEwan, Alistair L; Leong, Philip H W

    Freezing of gait (FoG) is common in Parkinsonian gait and strongly relates to falls. Current clinical FoG assessments are patients' self-report diaries and experts' manual video analysis. Both are subjective and yield moderate reliability. Existing detection algorithms have been predominantly designed in subject-dependent settings. In this paper, we aim to develop an automated FoG detector for subject independent. After extracting highly relevant features, we apply anomaly detection techniques to detect FoG events. Specifically, feature selection is performed using correlation and clusterability metrics. From a list of 244 feature candidates, 36 candidates were selected using saliency and robustness criteria. We develop an anomaly score detector with adaptive thresholding to identify FoG events. Then, using accuracy metrics, we reduce the feature list to seven candidates. Our novel multichannel freezing index was the most selective across all window sizes, achieving sensitivity (specificity) of (). On the other hand, freezing index from the vertical axis was the best choice for a single input, achieving sensitivity (specificity) of () for ankle and () for back sensors. Our subject-independent method is not only significantly more accurate than those previously reported, but also uses a much smaller window (e.g., versus ) and/or lower tolerance (e.g., versus ).Freezing of gait (FoG) is common in Parkinsonian gait and strongly relates to falls. Current clinical FoG assessments are patients' self-report diaries and experts' manual video analysis. Both are subjective and yield moderate reliability. Existing detection algorithms have been predominantly designed in subject-dependent settings. In this paper, we aim to develop an automated FoG detector for subject independent. After extracting highly relevant features, we apply anomaly detection techniques to detect FoG events. Specifically, feature selection is performed using correlation and clusterability metrics. From

  13. Effects of a moderate evening alcohol dose. I: sleepiness.

    Science.gov (United States)

    Rupp, Tracy L; Acebo, Christine; Van Reen, Eliza; Carskadon, Mary A

    2007-08-01

    Few studies examining alcohol's effects consider prior sleep/wake history and circadian timing. We examined introspective and physiological sleepiness on nights with and without moderate alcohol consumption in well-rested young adults at a known circadian phase. Twenty-nine adults (males=9), ages 21 to 25 years (M=22.6, SD=1.2), spent 1 week on an at-home stabilized sleep schedule (8.5 or 9 hours), followed by 3 in-lab nights: adaptation, placebo, and alcohol. Alcohol (vodka; 0.54 g/kg for men; 0.49 g/kg for women) or placebo beverage was consumed over 30 minutes ending 1 hour before stabilized bedtime. In addition to baseline, 3 sleep latency tests (SLTs) occurred after alcohol/placebo ingestion (15, 16.5, and 18 hours after waking). Stanford Sleepiness Scales (SSS) and Visual Analog Scales (VAS) of sleepiness were completed before each SLT and approximately every 30 minutes. The Biphasic Alcohol Effects Scale (BAES) was administered a total of 4 times (baseline, 5, 60, and 90 minutes postalcohol/placebo). Subjects' circadian phase was determined from melatonin levels in saliva samples taken at approximately 30-minute intervals. All sleepiness and sedation measures increased with time awake. Only SSS and BAES sedation measures showed higher levels of sleepiness and sedation after alcohol compared with placebo. The mean circadian phase was the same for assessments at both conditions. Alcohol did not increase physiological sleepiness compared with placebo nor was residual sedation evident under these conditions. We conclude that the effects on sleepiness of a moderate dose of alcohol are masked when sleep-wake homeostatic and circadian timing influences promote high levels of sleepiness.

  14. Individual and average responses of sleep quality and daytime sleepiness after four weeks of strength training in adolescents

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    Maria Julia Lyra

    2018-01-01

    Full Text Available Abstract Aims: To analyze the average and individual responses of sleep quality and daytime sleepiness in adolescents after four weeks of strength training. Methods: 19 adolescents with sleep problems recruited in the Federal Institute of Pernambuco, were subject to anthropometric evaluations as well as those for body composition assessment, a 1 repetition maximum test, the sleep parameters (Pittsburgh Sleep Quality Index-PSQI and Epworth Sleepiness Scale-ESS and were submitted to four weeks of strength-training, performed alternately by segment, two sessions per week, according to recommendations for this population. Results: A decrease in the average PSQI score was observed (10.3±3.3 vs 8.8±4.0; p=0.006, but not in ESS (p>0.05, after intervention. The individual analyses demonstrated that ~63% of adolescents experienced reductions ≥ 3 points in the PSQI and ~58% of them experienced reductions ≥ 3 points in the measure of daytime sleepiness. The prevalence of poor sleep quality and daytime sleepiness reduced from 84.2% to 68.4% and from 52.6% to 31.6%, respectively. The comparisons of high and low responders to exercise training show that adolescents who reduced ≥3 points in the score of a least one sleep parameter presented lower weight, fat mass, and fat percentage (p<0.05. Conclusion: A short-term strength-training program is able to improve global sleep quality, but not daytime sleepiness in adolescents. Furthermore, the changes after training are highly heterogeneous. Further studies are required to better understand the effects of strength training on sleep parameters of adolescents.

  15. Continuing to drive while sleepy: the influence of sleepiness countermeasures, motivation for driving sleepy, and risk perception.

    Science.gov (United States)

    Watling, Christopher N; Armstrong, Kerry A; Obst, Patricia L; Smith, Simon S

    2014-12-01

    Driver sleepiness is a major contributor to road crashes. The current study sought to examine the association between perceptions of effectiveness of six sleepiness countermeasures and their relationship with self-reports of continuing to drive while sleepy among 309 drivers after controlling for the influence of age, sex, motivation for driving sleepy, and risk perception of sleepy driving. The results demonstrate that the variables of age, sex, motivation, and risk perception were significantly associated with self-reports of continuing to drive while sleepy and only one countermeasure was associated with self-reports of continuing to drive while sleepy. Further, it was found that age differences in self-reports of continuing to drive while sleepy was mediated by participants' motivation and risk perception. These findings highlight modifiable factors that could be focused on with interventions that seek to modify drivers' attitudes and behaviours of driving while sleepy. Copyright © 2014 Elsevier Ltd. All rights reserved.

  16. Daytime Sleepiness Increases With Age in Early Adolescence: A Sleep Restriction Dose-Response Study.

    Science.gov (United States)

    Campbell, Ian G; Burright, Christopher S; Kraus, Amanda M; Grimm, Kevin J; Feinberg, Irwin

    2017-05-01

    Daytime sleepiness increases across adolescence. This increase is commonly attributed to insufficient sleep durations resulting from increasingly limited time in bed. We tested the effects of 3 sleep schedules on daytime sleepiness and whether these effects changed with age in early adolescence. In 77 children ranging in age from 9.9 to 14 years, objective (multiple sleep latency test [MSLT]) and subjective (Karolinska sleepiness scale [KSS]) sleepiness was measured following 4 consecutive nights of either 7, 8.5, or 10 hours in bed. All participants completed all 3 sleep schedules. The order in which they completed the schedules was not randomized but was accounted for in all statistical analyses. Time in bed restriction decreased sleep duration and increased objective and subjective daytime sleepiness. Although the sleep durations did not change with age, the likelihood of falling asleep during the MSLT increased with age. Nevertheless, sleep restriction produced a greater increase in MSLT-measured sleepiness in younger participants. Subjective sleepiness measured with the KSS increased with shorter sleep duration, but this effect did not change with age. Increasing objective daytime sleepiness in early adolescence cannot simply be attributed to reduced sleep due to restricted sleep schedules. We propose that some of the increased daytime sleepiness of adolescents is a consequence of adolescent brain reorganization driven by synaptic pruning which decreases the intensity of waking brain activity.

  17. A simple scoring model for advanced colorectal neoplasm in asymptomatic subjects aged 40-49 years.

    Science.gov (United States)

    Park, Yoo Mi; Kim, Hee Sun; Park, Jae Jun; Baik, Su Jung; Youn, Young Hoon; Kim, Jie-Hyun; Park, Hyojin

    2017-01-09

    Limited data are available for advanced colorectal neoplasm in asymptomatic individuals aged 40-49 years. We aimed to identify risk factors and develop a simple prediction model for advanced colorectal neoplasm in these persons. Clinical data were collected on 2781 asymptomatic subjects aged 40-49 years who underwent colonoscopy for routine health examination. Subjects were randomly allocated to a development or validation set. Logistic regression analysis was used to determine predictors of advanced colorectal neoplasm. The prevalence of overall and advanced colorectal neoplasm was 20.2 and 2.5% respectively. Older age (45-49 years), male sex, positive serology of Helicobacter pylori, and high triglyceride and low high-density lipoprotein (HDL) levels were independently associated with an increased risk of advanced colorectal neoplasm. BMI (body mass index) was not significant in multivariable analysis. We developed a simple scoring model for advanced colorectal neoplasm (range 0-9). A cutoff of ≥4 defined 43% of subjects as high risk for advanced colorectal neoplasm (sensitivity, 79%; specificity, 58%; area under the receiver operating curve = 0.72) in the validation datasets. Older age (45-49 years), male sex, positive serology of H. pylori, high triglyceride level, and low HDL level were identified as independent risk factors for advanced colorectal neoplasm.

  18. Efficacy of Modafinil in 10 Taiwanese Patients With Narcolepsy: Findings Using the Multiple Sleep Latency Test and Epworth Sleepiness Scale

    Directory of Open Access Journals (Sweden)

    Shih-Bin Yeh

    2010-08-01

    Full Text Available This is the first report describing the efficacy of modafinil therapy for narcolepsy in patients in Taiwan. The purpose of this study was to compare the objective Multiple Sleep Latency Test (MSLT and the subjective Epworth Sleepiness Scale (ESS for evaluating the efficacy of modafinil in treating excessive daytime sleepiness in patients with narcolepsy in Taiwan. Ten consecutive patients with narcolepsy-with-cataplexy who were treated with 200 mg/day modafinil for more than 6 months at our sleep center between January 2003 and December 2007 were included in this study. This comparative study was prompted by the requirement of the Bureau of National Health Insurance in Taiwan that modafinil users need to be followed up with MSLTs every 6–12 months. The mean age at onset of narcolepsy onset in these 10 patients was 11.8 ± 3.3 years, and eight (80% were male. We compared the differences in MSLT and ESS between baseline and follow-up at 6–12 months after starting modafinil therapy using paired t tests. ESS scores (p < 0.001 were considerably more sensitive than MSLT scores (p < 0.05 in documenting efficacy of modafinil and that the improvements in MSLT scores were minimal and remained in the pathologically sleepy range. These findings suggest that the ESS is a more sensitive and clinically meaningful tool to evaluate the efficacy of modafinil in narcolepsy.

  19. [Influence of hearing aids on monosyllabic test score and subjective everyday hearing].

    Science.gov (United States)

    Thümmler, R; Liebscher, T; Hoppe, U

    2016-08-01

    Pure tone and speech audiometry are essential methods for examining the indication for hearing aids, as well as for hearing aid evaluation. Additionally, the subjective benefit of hearing aids has to be evaluated with appropriate questionnaires. The aim of the present study was to investigate the correlation between speech audiometry data and the results of a simple and user-friendly questionnaire, as well as to provide normative data for subjective benefit. Data from 136 hearing aid users with bilateral sensorineural hearing loss were analyzed retrospectively. Pure tone thresholds and Freiburg monosyllabic speech perception in the binaural situation were measured at 65 dB in quiet and in noise (signal-to-noise ratio, SNR = +5 dB), with and without hearing aids. Additionally, subjective hearing in everyday life was recorded using the 12-item Oldenburg Inventory. Improvement of speech perception with hearing aids for the Freiburg monosyllabic test in quiet was 32.0 percentage points on average; in noise, there was an average improvement of 16.4 percentage points. There was a strong correlation between the results of pure tone and speech audiometry. With hearing aids, patients scored their everyday hearing using the Oldenburg Inventory on average 1.4 scale points better than without hearing aids. Results of the Oldenburg Inventory correlate with both pure tone and speech audiometry. Hearing aid evaluation should include both speech audiometry and systematic measurement of the subjective benefit using a suitable questionnaire. In combination, the Freiburg monosyllabic test and the Oldenburg Inventory allow for quick and comprehensive evaluation.

  20. Temporal stability of the Launay-Slade Hallucination Scale for high- and low-scoring normal subjects

    NARCIS (Netherlands)

    Aleman, André; Nieuwenstein, Mark R.; Böcker, Koen B.E.; de Haan, Edward H.F.

    1999-01-01

    It has been documented that many normal people report hallucinatory experiences. The Launay-Slade Hallucination Scale is widely used to investigate differences between subjects who score high or low in hallucinatory predisposition. In this study we addressed the question of whether scores remain

  1. In-car countermeasures open window and music revisited on the real road: popular but hardly effective against driver sleepiness.

    Science.gov (United States)

    Schwarz, Johanna F A; Ingre, Michael; Fors, Carina; Anund, Anna; Kecklund, Göran; Taillard, Jacques; Philip, Pierre; Åkerstedt, Torbjörn

    2012-10-01

    This study investigated the effects of two very commonly used countermeasures against driver sleepiness, opening the window and listening to music, on subjective and physiological sleepiness measures during real road driving. In total, 24 individuals participated in the study. Sixteen participants received intermittent 10-min intervals of: (i) open window (2 cm opened); and (ii) listening to music, during both day and night driving on an open motorway. Both subjective sleepiness and physiological sleepiness (blink duration) was estimated to be significantly reduced when subjects listened to music, but the effect was only minor compared with the pronounced effects of night driving and driving duration. Open window had no attenuating effect on either sleepiness measure. No significant long-term effects beyond the actual countermeasure application intervals occurred, as shown by comparison to the control group (n = 8). Thus, despite their popularity, opening the window and listening to music cannot be recommended as sole countermeasures against driver sleepiness. © 2012 European Sleep Research Society.

  2. Nutritional Assessment Score: A new tool derived from Subjective Global Assessment for hospitalized adults.

    Science.gov (United States)

    da Silva Fink, Jaqueline; de Mello, Elza Daniel; Beghetto, Mariur Gomes; Luft, Vivian Cristine; de Jezus Castro, Stela Maris; de Mello, Paula Daniel

    2017-02-24

    There is no method to be used as a reference standard for nutritional assessment. This study aims to develop and verify the performance of a new tool, based on the Item Response Theory (IRT), from the Subjective Global Assessment (SGA) questionnaire, in hospitalized adult patients. Retrospective cohort study, composed by secondary database, formed by patients included from October 2005 to June 2006. The new tool presented was developed through the usage of cumulative models from the IRT. Out of 1503 evaluated patients, 2/3 were randomly selected to the development sample of the new tool and 1/3 to the performance verification sample. After item adjustments, the "Nutritional Assessment Score" (NAS) was proposed, with reduced number of questions, and, in comparison to SGA, less polytomic items. NAS demonstrates association to variables that are clinically relevant (hospital mortality, long hospital stay, serum albumin and body mass index) and has shown itself to be more precise to patients with the worst degrees of nutritional status. Results point to the validation of the NAS in detecting, accurately, the nutritional status of hospitalized patients. Copyright © 2017 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

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

    Science.gov (United States)

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

    2014-08-01

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

  4. Sleep quality, daytime sleepiness and health-related quality-of-life in maintenance haemodialysis patients.

    Science.gov (United States)

    Shen, Quanquan; Huang, Xiaohong; Luo, Zhaofen; Xu, Xiujun; Zhao, Xiang; He, Qiang

    2016-06-01

    To assess the relationship between sleep quality, daytime sleepiness and health-related quality-of-life (HRQoL) in Chinese patients undergoing maintenance haemodialysis (MHD). This cross-sectional study enrolled patients undergoing MHD. Self-reported sleep quality (Pittsburgh Sleep Quality Index [PSQI]), daytime sleepiness (Epworth Sleepiness Scale [ESS]) and HRQoL (36-item Short Form [SF-36]) were recorded for all patients. Sixty eight patients (mean ± SD age = 61.75 ± 16.56 years; 43 male/25 female) who regularly received MHD were included. The prevalence of poor sleepers was 69.1% (47/68) and daytime sleepiness was 11.8% (eight of 68). Poor sleepers had a significantly lower Physical Component Scale (PCS) score, Mental Component Scale (MCS) score and total SF-36 score than good sleepers. The PSQI score correlated inversely with both the PCS and MCS scores and correlated positively with age. Independent variables associated with total SF-36 score were duration of MHD, ESS score and PSQI score. Poor sleep quality is a common and severe issue for MHD patients in east China. Both sleep quality and daytime sleepiness were associated with lower HRQoL scores. © The Author(s) 2016.

  5. Team-based learning on a third-year pediatric clerkship improves NBME subject exam blood disorder scores

    Directory of Open Access Journals (Sweden)

    Kris Saudek

    2015-10-01

    Full Text Available Purpose: At our institution, speculation amongst medical students and faculty exists as to whether team-based learning (TBL can improve scores on high-stakes examinations over traditional didactic lectures. Faculty with experience using TBL developed and piloted a required TBL blood disorders (BD module for third-year medical students on their pediatric clerkship. The purpose of this study is to analyze the BD scores from the NBME subject exams before and after the introduction of the module. Methods: We analyzed institutional and national item difficulties for BD items from the NBME pediatrics content area item analysis reports from 2011 to 2014 before (pre and after (post the pilot (October 2012. Total scores of 590 NBME subject examination students from examinee performance profiles were analyzed pre/post. t-Tests and Cohen's d effect sizes were used to analyze item difficulties for institutional versus national scores and pre/post comparisons of item difficulties and total scores. Results: BD scores for our institution were 0.65 (±0.19 compared to 0.62 (±0.15 nationally (P=0.346; Cohen's d=0.15. The average of post-consecutive BD scores for our students was 0.70(±0.21 compared to examinees nationally [0.64 (±0.15] with a significant mean difference (P=0.031; Cohen's d=0.43. The difference in our institutions pre [0.65 (±0.19] and post [0.70 (±0.21] BD scores trended higher (P=0.391; Cohen's d=0.27. Institutional BD scores were higher than national BD scores for both pre and post, with an effect size that tripled from pre to post scores. Institutional BD scores increased after the use of the TBL module, while overall exam scores remained steadily above national norms. Conclusions: Institutional BD scores were higher than national BD scores for both pre and post, with an effect size that tripled from pre to post scores. Institutional BD scores increased after the use of the TBL module, while overall exam scores remained steadily above

  6. Adolescent Sleepiness: Causes and Consequences.

    Science.gov (United States)

    Hansen, Shana L; Capener, Dale; Daly, Christopher

    2017-09-01

    Insufficient sleep duration and poor sleep quality are common among adolescents. The multidimensional causes of insufficient sleep duration and poor sleep quality include biological, health-related, environmental, and lifestyle factors. The most common direct consequence of insufficient and/or poor sleep quality is excessive daytime sleepiness, which may contribute to poor academic performance, behavioral health problems, substance use, and drowsy driving. Evaluation of sleepiness includes a detailed sleep history and sleep diary, with polysomnography only required for the assessment of specific sleep disorders. Management involves encouraging healthy sleep practices such as having consistent bed and wake times, limiting caffeine and electronics at night before bed, and eliminating napping, in addition to treating any existing sleep or medical disorders. [Pediatr Ann. 2017;46(9):e340-e344.]. Copyright 2017, SLACK Incorporated.

  7. Sleep and Sleepiness in Children with Nocturnal Enuresis

    Science.gov (United States)

    Cohen-Zrubavel, Vered; Kushnir, Baruch; Kushnir, Jonathan; Sadeh, Avi

    2011-01-01

    Study Objectives: To assess if sleep patterns and sleepiness are compromised in children with nocturnal enuresis (NE), in comparison with normal control subjects, and to evaluate the role of enuresis-related events during sleep. Design: Assessment of natural sleep patterns at home in a sample of children referred to enuresis clinics and controls. Setting: Children's homes. Participants: Thirty-two children (19 boys and 13 girls aged 5.1 to 9.1 years) who suffer from primary NE and 94 healthy control subjects (49 boys and 45 girls aged 5 to 8.58 years). Interventions: N/A. Measurements and Results: Sleep measures were derived from 3 to 5 nights of actigraphy and daily logs. Additional information on events related to enuresis and daytime sleepiness was collected using daily reports. Children with NE slept significantly worse than did the control subjects. Their compromised sleep patterns were reflected in a higher number of actigraphic nighttime awakenings, the reduced percentages of motionless sleep, the higher number of reported nighttime awakening, and the increased sleep latency. Children with NE also reported higher levels of sleepiness in the morning and in the evening. Conclusions: Compared with the sleep of control subjects, the natural sleep of children with NE is significantly more fragmented, and the children with NE experience higher levels of daytime sleepiness. This phenomenology is associated with bedwetting episodes and attempts to keep the child dry during the night. These findings may suggest that children with NE suffer from sleep fragmentation, which may explain their higher arousal threshold. These findings have clinical implications for enuresis management. Citation: Cohen-Zrubavel V; Kushnir B; Kushnir J; Sadeh A. Sleep and sleepiness in children with nocturnal enuresis. SLEEP 2011;34(2):191-194. PMID:21286252

  8. Effect of Continuous Positive Airway Pressure Treatment on Health-Related Quality of Life and Sleepiness in High Cardiovascular Risk Individuals With Sleep Apnea: Best Apnea Interventions for Research (BestAIR) Trial.

    Science.gov (United States)

    Zhao, Ying Y; Wang, Rui; Gleason, Kevin J; Lewis, Eldrin F; Quan, Stuart F; Toth, Claudia M; Morrical, Michael; Rueschman, Michael; Weng, Jia; Ware, James H; Mittleman, Murray A; Redline, Susan

    2017-04-01

    The long-term effect of continuous positive airway pressure (CPAP) on health-related quality of life (HRQOL) in patients with high cardiovascular disease risk and obstructive sleep apnea (OSA) without severe sleepiness is uncertain. We aimed to determine the effect of CPAP treatment on HRQOL in individuals with moderate or severe OSA and cardiovascular disease (CVD) or multiple CVD risk factors without severe sleepiness. In this randomized, controlled, parallel group study, 169 participants were assigned to treatment with CPAP or the control group (conservative medical therapy [CMT] or CMT with sham CPAP). Analyses were based on an intention-to-treat approach. Linear mixed effect models were fitted to compare the changes in the Medical Outcomes Study Short Form-36 (SF-36) and in subjective sleepiness (Epworth Sleepiness Scale [ESS]) between groups from baseline to the average of 6- and 12-month measurements. CPAP improved several domains of HRQOL including bodily pain (treatment effect 9.7 [95% confidence interval, CI 3.9 to 15.4]; p = .001), vitality (5.7 [95% CI 1.5 to 9.9]; p = .008), general health (8.2 [95% CI 3.7 to 12.7]; p < .001), physical functioning (5.5 [95% CI 1.1 to 10.0]; p = .016), and the physical health summary score (3.3 [95% CI 1.4 to 5.3]; p = .001). CPAP also resulted in less daytime sleepiness (mean change in ESS -1.0 point [95% CI -2.0 to -0.0]; p = .040). In patients with moderate-severe OSA at high risk of cardiovascular events and without severe sleepiness, CPAP improved daytime sleepiness and multiple domains of HRQOL over 6 to 12 months of follow-up, with the largest improvement observed for bodily pain.

  9. Effects of naps at work on the sleepiness of 12-hour night shift nursing personnel

    OpenAIRE

    Borges, Flávio Notarnicola da Silva; Fischer, Frida Marina; Rotenberg,Lúcia; SOARES, Nilson Silva; FONSECA, Mauro Breviglieri; SMOLENSKY, Michael Hale; Sackett-Lundeen, Linda; Haus, Erhard; Moreno, Claudia Roberta de Castro

    2009-01-01

    Background and objective: The purpose of the present study was to evaluate the effects of a nap at work on the sleepiness of 12-hour, night-shift (registered and assistant) nursing personnel.Methods: Twelve nurses filled out daily logs, the Karolinska Sleepiness Scale (KS), and wore wrist actigraphs for two periods of four continuous days.Results: Mean nap duration during the night shifts was 138.3 (SD+39.8) minutes. The mean sleepiness level assessed by the KS score was lower, 3.3 (SD±1.6), ...

  10. Sleepiness and sleep-disordered breathing during pregnancy.

    Science.gov (United States)

    Sarberg, Maria; Bladh, Marie; Josefsson, Ann; Svanborg, Eva

    2016-12-01

    This study aimed to examine if there is a difference in the prevalence of obstructive sleep apnea (OSA) and sleepiness between pregnant and non-pregnant women. It also aimed to evaluate if obstetric outcomes were associated to sleep-disordered breathing among the pregnant women. One hundred pregnant women (gestational weeks 24-34) and 80 age- and body mass index-matched non-pregnant women underwent whole-night respiratory recordings (airflow, snoring, respiratory movements, body position, pulse oximetry). The women also answered a questionnaire including the Epworth sleepiness scale. Eighty-nine percent of the pregnant women had normal body mass index (BMI). Objectively, recorded snoring was more common among the pregnant women (median 9 % of total estimated sleep time) than among the controls (4 % of total sleep time, p = 0.005). Three of the pregnant women had OSA (apnea/hypopnea index (AHI) >5), but in two cases, this was mainly due to central hypopneas. None had AHI >10. Two controls were diagnosed as OSA. Respiratory parameters including snoring showed no impact on obstetric outcomes. Total Epworth sleepiness scale (ESS) score was higher among pregnant women than among controls (median 9 vs 7, p sleep apnea among pregnant women. One reason for this could be that the majority of the women in this study were non-obese. Neither OSA nor snoring was likely an explanation for the increased daytime sleepiness seen in the pregnant women.

  11. Visual analogue scale foot and ankle: validity and reliability of Thai version of the new outcome score in subjective form.

    Science.gov (United States)

    Angthong, Chayanin; Chernchujit, Bancha; Suntharapa, Thongchai; Harnroongroj, Thossart

    2011-08-01

    Nowadays, measuring score in the form of subjective questionnaires is the important tool for clinical evaluation of the foot and ankle-related problems. VisualAnalogue Scale-Foot and Ankle (VAS-FA) is the newly developed subjective questionnaire, which has sufficiency of validity and reliability from a previous study Translate the original English version of VAS-FA into the Thai version and evaluate the validity and reliability of Thai VAS-FA in patients with foot and ankle-related problems. According to the forward-backward translation protocol, original VAS-FA was translated into the Thai version. Thai VAS-FA and validated Thai Short Form-36 (SF-36) questionnaires were distributed to 42 Thai patients to complete. For validation, Thai VAS-FA scores were correlated with SF-36 scores. For reliability, the test-retest reliability and internal consistency were analyzed. Thai VAS-FA score demonstrated the sufficient correlations with physical functioning (PF), role physical (RP), bodily pain (BP) domains, and total score of SF-36 (statistically significant with p 0.5 values). The result of reliability revealed highly intra-class correlation coefficient as 0.995 from test-retest study. The internal consistency was excellent with Cronbach alpha: 0.995. The original VAS-FA score is a well-validated, subjective, visual-analogue-scale based outcome score. The Thai version of VAS-FA form maintained the validity and reliability of the original version. This newly translated-validated score can be distributed for the evaluation of the functions, symptoms, and limitation of activities in Thai patients with foot and ankle problems.

  12. An Assessment of Daytime Sleepiness among Students of the Gulhane Military Faculty of Medicine using the Epworth Sleepiness Scale

    Directory of Open Access Journals (Sweden)

    Soykan sahin

    2014-02-01

    Full Text Available AIM: Sleep is in an active state which is of vital importance for the regeneration of our mental and physical health and which takes up about one third of our lifespan. Sleep disorders are particularly important for specific groups of professionals like health workers. This research aimed to establish the frequency of sleepiness in Gulhane Military Faculty of Medicine students, their sleep disorders and factors that may affect their sleep patterns. It also set out to identify the particular features that may give rise to these conditions and the precautions which may be taken to prevent them. METHOD: The research aimed to encompass all the students in the Gulhane Military Faculty of Medicine. Actual participation was 69% (412/597. The research was cross-sectional with data collected by means of a questionnaire. The Epworth Sleepiness Scale (ESS score was the dependent variable of the research. The sociodemographic particularities of the students, the physical conditions of their sleep area, their habits and health problems were the independent variables. RESULTS: 84.3% of participants stated that they felt the need to sleep during the day. 56.8% of the students revealed that they felt excessively sleepy during the day, whilst 42.8% did not feel excessively sleeply. A significant statistical link has been established in the ESS score between feeling extremely sleepy every day and and #8220;not going to bed at the usual time every day and #8221;, and #8220;not feeling rested upon waking up and #8221;, and #8220;feeling excessively sleepy during the day and #8221; and and #8220;experiencing sleepiness in class because of the classroom environment and #8221; (p<0.05. CONCLUSIONS: Of the students who participated in the survey, 34.5% did experience sleepiness, and this was about 4-6% above the expected level in normal circumstances. The percentage of those Gulhane Military Faculty of Medicine students who had not had enough sleep and those who stated

  13. Amino acid positions subject to multiple coevolutionary constraints can be robustly identified by their eigenvector network centrality scores.

    Science.gov (United States)

    Parente, Daniel J; Ray, J Christian J; Swint-Kruse, Liskin

    2015-12-01

    As proteins evolve, amino acid positions key to protein structure or function are subject to mutational constraints. These positions can be detected by analyzing sequence families for amino acid conservation or for coevolution between pairs of positions. Coevolutionary scores are usually rank-ordered and thresholded to reveal the top pairwise scores, but they also can be treated as weighted networks. Here, we used network analyses to bypass a major complication of coevolution studies: For a given sequence alignment, alternative algorithms usually identify different, top pairwise scores. We reconciled results from five commonly-used, mathematically divergent algorithms (ELSC, McBASC, OMES, SCA, and ZNMI), using the LacI/GalR and 1,6-bisphosphate aldolase protein families as models. Calculations used unthresholded coevolution scores from which column-specific properties such as sequence entropy and random noise were subtracted; "central" positions were identified by calculating various network centrality scores. When compared among algorithms, network centrality methods, particularly eigenvector centrality, showed markedly better agreement than comparisons of the top pairwise scores. Positions with large centrality scores occurred at key structural locations and/or were functionally sensitive to mutations. Further, the top central positions often differed from those with top pairwise coevolution scores: instead of a few strong scores, central positions often had multiple, moderate scores. We conclude that eigenvector centrality calculations reveal a robust evolutionary pattern of constraints-detectable by divergent algorithms--that occur at key protein locations. Finally, we discuss the fact that multiple patterns coexist in evolutionary data that, together, give rise to emergent protein functions. © 2015 Wiley Periodicals, Inc.

  14. Amino acid positions subject to multiple co-evolutionary constraints can be robustly identified by their eigenvector network centrality scores

    Science.gov (United States)

    Parente, Daniel J.; Ray, J. Christian J.; Swint-Kruse, Liskin

    2015-01-01

    As proteins evolve, amino acid positions key to protein structure or function are subject to mutational constraints. These positions can be detected by analyzing sequence families for amino acid conservation or for co-evolution between pairs of positions. Co-evolutionary scores are usually rank-ordered and thresholded to reveal the top pairwise scores, but they also can be treated as weighted networks. Here, we used network analyses to bypass a major complication of co-evolution studies: For a given sequence alignment, alternative algorithms usually identify different, top pairwise scores. We reconciled results from five commonly-used, mathematically divergent algorithms (ELSC, McBASC, OMES, SCA, and ZNMI), using the LacI/GalR and 1,6-bisphosphate aldolase protein families as models. Calculations used unthresholded co-evolution scores from which column-specific properties such as sequence entropy and random noise were subtracted; “central” positions were identified by calculating various network centrality scores. When compared among algorithms, network centrality methods, particularly eigenvector centrality, showed markedly better agreement than comparisons of the top pairwise scores. Positions with large centrality scores occurred at key structural locations and/or were functionally sensitive to mutations. Further, the top central positions often differed from those with top pairwise co-evolution scores: Instead of a few strong scores, central positions often had multiple, moderate scores. We conclude that eigenvector centrality calculations reveal a robust evolutionary pattern of constraints – detectable by divergent algorithms – that occur at key protein locations. Finally, we discuss the fact that multiple patterns co-exist in evolutionary data that, together, give rise to emergent protein functions. PMID:26503808

  15. Temporal profile of prolonged, night‐time driving performance: breaks from driving temporarily reduce time‐on‐task fatigue but not sleepiness

    National Research Council Canada - National Science Library

    PHIPPS‐NELSON, JO; REDMAN, JENNIFER R; RAJARATNAM, SHANTHA M. W

    2011-01-01

    .... We examined the temporal profile of changes in driving performance, electroencephalogram (EEG) activity and subjective measures of sleepiness and fatigue during prolonged nocturnal driving in a car simulator...

  16. Epworth Sleepiness Scale- a novel tool to assess somnolence syndrome in patients receiving radiotherapy to the brain

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    Ritika Rajkumar Harjani

    2015-03-01

    Full Text Available Purpose: Radiation to brain causes early, early-delayed, and delayed side effects. There is paucity of literature regarding early-delayed effects like somnolence syndrome. Existing studies use general symptom assessment and visual analog scales. Epworth Sleepiness Scale (ESS is a time tested tool to assess daytime sleepiness in various conditions. In this study, the ESS has been used to determine the occurrence of somnolence in patients receiving cranial radiotherapy for primary and metastatic brain tumors. Thus the ESS has been used in a novel setting in our study. The ESS is a simple to administer questionnaire and may be useful in grading the severity of somnolence. To our knowledge, this is the second study to determine post radiation somnolence using ESS. Methods: This prospective study was conducted in 23 patients with primary and metastatic brain tumor. Patient demographics and tumor type and grade was noted. Those with Karnofsky Performance Scale (KPS less than 70 and with pre-existing sleep disorders were excluded. Radiotherapy regimen included palliative whole brain radiation for brain metastases and conformal adjuvant radiotherapy for primary brain tumors as per standard guidelines. All subjects included were administered ESS at baseline and weekly thereafter during and for 6 weeks after radiation. Results: All 23 patients (median age 50 years completed the planned questionnaires until 6 weeks post radiation. Twenty (87% patients had primary brain tumors whereas three (13% patients had metastatic lesions in brain. Of the 23 patients, 14 patients (60.86% had abnormal or increased daytime sleepiness; of which 3 had ESS scores greater than 16. Conclusion: Somnolence was noted in 60.86% of the patients, which is in accordance with existing literature. Epworth sleepiness scale is an effective tool to detect and quantify somnolence, However, it does not consider other symptoms of somnolence syndrome and hence should be combined with visual

  17. The sleepy teenager - diagnostic challenges.

    Science.gov (United States)

    Landtblom, Anne-Marie; Engström, Maria

    2014-01-01

    The sleepy teenager puts the doctor in a, often tricky, situation where it must be decided if we deal with normal physiology or if we should suspect pathological conditions. What medical investigations are proper to consider? What differential diagnoses should be considered in the first place? And what tools do we actually have? The symptoms and problems that usually are presented at the clinical visit can be both of medical and psychosocial character - and actually they are often a mixture of both. Subsequently, the challenge to investigate the sleepy teenager often includes the examination of a complex behavioral pattern. It is important to train and develop diagnostic skills and to realize that the physiological or pathological conditions that can cause the symptoms may have different explanations. Research in sleep disorders has shown different pathological mechanisms congruent with the variations in the clinical picture. There are probably also different patterns of involved neuronal circuits although common pathways may exist. The whole picture remains to be drawn in this interesting and challenging area.

  18. Person-directed, non-pharmacological interventions for sleepiness at work and sleep disturbances caused by shift work.

    Science.gov (United States)

    Slanger, Tracy E; Gross, J Valérie; Pinger, Andreas; Morfeld, Peter; Bellinger, Miriam; Duhme, Anna-Lena; Reichardt Ortega, Rosalinde Amancay; Costa, Giovanni; Driscoll, Tim R; Foster, Russell G; Fritschi, Lin; Sallinen, Mikael; Liira, Juha; Erren, Thomas C

    2016-08-23

    , revealed a mean reduction 0.83 score points of sleepiness (measured via the Stanford Sleepiness Scale (SSS) (95% confidence interval (CI) -1.3 to -0.36, very low quality evidence). Another trial did not find a significant difference in overall sleepiness on another sleepiness scale (16 participants, low quality evidence).Bright light during the night plus sunglasses at dawn did not significantly influence sleepiness compared to normal light (1 study, 17 participants, assessment via reaction time, very low quality evidence).Bright light during the day shift did not significantly reduce sleepiness during the day compared to normal light (1 trial, 61 participants, subjective assessment, low quality evidence) or compared to normal light plus placebo capsule (1 trial, 12 participants, assessment via reaction time, very low quality evidence). Napping during the night shiftA meta-analysis on a single nap opportunity and the effect on the mean reaction time as a surrogate for sleepiness, resulted in a 11.87 ms reduction (95% CI 31.94 to -8.2, very low quality evidence). Two other studies also reported statistically non-significant decreases in reaction time (1 study seven participants; 1 study 49 participants, very low quality evidence).A two-nap opportunity resulted in a statistically non-significant increase of sleepiness (subjective assessment) in one study (mean difference (MD) 2.32, 95% CI -24.74 to 29.38, 1 study, 15 participants, low quality evidence). Other interventionsPhysical exercise and sleep education interventions showed promise, but sufficient data to draw conclusions are lacking. Given the methodological diversity of the included studies, in terms of interventions, settings, and assessment tools, their limited reporting and the very low to low quality of the evidence they present, it is not possible to determine whether shift workers' sleepiness can be reduced or if their sleep length or quality can be improved with these interventions.We need better and

  19. Daytime Sleepiness: Associations with Alcohol Use and Sleep Duration in Americans

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    Subhajit Chakravorty

    2014-01-01

    Full Text Available The aim of the current analysis was to investigate the relationship of daytime sleepiness with alcohol consumption and sleep duration using a population sample of adult Americans. Data was analyzed from adult respondents of the National Health and Nutritional Examination Survey (NHANES 2007-2008 (N=2919 using self-reported variables for sleepiness, sleep duration, and alcohol consumption (quantity and frequency of alcohol use. A heavy drinking episode was defined as the consumption of ≥5 standard alcoholic beverages in a day. Logistic regression models adjusted for sociodemographic variables and insomnia covariates were used to evaluate the relationship between daytime sleepiness and an interaction of alcohol consumption variables with sleep duration. The results showed that daytime sleepiness was reported by 15.07% of the subjects. In univariate analyses adjusted for covariates, an increased probability of daytime sleepiness was predicted by decreased log drinks per day [OR = 0.74 (95% CI, 0.58–0.95], a decreased log drinking frequency [0.90 (95% CI, 0.83–0.98], and lower sleep duration [OR = 0.75 (95% CI, 0.67–0.84]. An interaction between decreased sleep duration and an increased log heavy drinking frequency predicted increased daytime sleepiness (P=0.004. Thus, the effect of sleep duration should be considered when evaluating the relationship between daytime sleepiness and heavy drinking.

  20. Daytime Sleepiness in Men During Early Fatherhood: Implications for Work Safety.

    Science.gov (United States)

    Mellor, Gary; Van Vorst, Stephen

    2015-11-01

    This study measured the daytime sleepiness (DS) and work safety of fathers during the first 12 weeks of their babies' lives (i.e., early fatherhood). A questionnaire was developed using the Epworth Sleepiness Scale (ESS), the Safety Behaviour at Work Scale, a self-reported sleep history, and a work-related incident history. Of the 221 participants, the vast majority reported they experienced less than 6 hours of interrupted sleep per night during the 12 weeks of the study, and an increasing frequency and severity of DS. The study also revealed an inverse correlation between ESS and Safety Behaviour at Work scores; fathers were 14% more likely to report a near-miss accident at work at 12 weeks. This study posits that antenatal classes and assessment of fathers' sleepiness at work by occupational health practitioners could assist fathers in reducing daytime sleepiness and mitigating the risk of workplace incidents. © 2015 The Author(s).

  1. Framingham coronary heart disease risk score can be predicted from structural brain images in elderly subjects.

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    Jane Maryam Rondina

    2014-12-01

    Full Text Available Recent literature has presented evidence that cardiovascular risk factors (CVRF play an important role on cognitive performance in elderly individuals, both those who are asymptomatic and those who suffer from symptoms of neurodegenerative disorders. Findings from studies applying neuroimaging methods have increasingly reinforced such notion. Studies addressing the impact of CVRF on brain anatomy changes have gained increasing importance, as recent papers have reported gray matter loss predominantly in regions traditionally affected in Alzheimer’s disease (AD and vascular dementia in the presence of a high degree of cardiovascular risk. In the present paper, we explore the association between CVRF and brain changes using pattern recognition techniques applied to structural MRI and the Framingham score (a composite measure of cardiovascular risk largely used in epidemiological studies in a sample of healthy elderly individuals. We aim to answer the following questions: Is it possible to decode (i.e., to learn information regarding cardiovascular risk from structural brain images enabling individual predictions? Among clinical measures comprising the Framingham score, are there particular risk factors that stand as more predictable from patterns of brain changes? Our main findings are threefold: i we verified that structural changes in spatially distributed patterns in the brain enable statistically significant prediction of Framingham scores. This result is still significant when controlling for the presence of the APOE 4 allele (an important genetic risk factor for both AD and cardiovascular disease. ii When considering each risk factor singly, we found different levels of correlation between real and predicted factors; however, single factors were not significantly predictable from brain images when considering APOE4 allele presence as covariate. iii We found important gender differences, and the possible causes of that finding are discussed.

  2. Daytime Sleepiness, Performance, Mood, Nocturnal Sleep: The Effect of Benzodiazepine and Caffeine on Their Relationship

    Science.gov (United States)

    1989-03-01

    experimenter.Lpaced tasks and no change on subject-paced tasks. Possible causes for this effect are not clear. Carskadon et al. (28) found 18 that performance on a...there appears to be more than one type of daytime sleepiness. Broughton differentiated sleepiness with respect to cause , i.e., sleep loss vs path- 0ology...conclusions would be inappropriate. Thus, as it is necessary to have corroborative data before narcolepsy can be diagnosed from the appearance of MSLT

  3. A score including ADAM17 substrates correlates to recurring cardiovascular event in subjects with atherosclerosis.

    Science.gov (United States)

    Rizza, Stefano; Copetti, Massimiliano; Cardellini, Marina; Menghini, Rossella; Pecchioli, Chiara; Luzi, Alessio; Di Cola, Giovanni; Porzio, Ottavia; Ippoliti, Arnaldo; Romeo, Franco; Pellegrini, Fabio; Federici, Massimo

    2015-04-01

    Atherosclerosis disease is a leading cause for mortality and morbidity. The narrowing/rupture of a vulnerable atherosclerotic plaque is accountable for acute cardiovascular events. However, despite of an intensive research, a reliable clinical method which may disclose a vulnerable patient is still unavailable. We tested the association of ADAM17 (A Disintegrin and Metallo Protease Domain 17) circulating substrates (sICAM-1, sVCAM-1, sIL6R and sTNFR1) with a second major cardiovascular events [MACEs] (cardiovascular death, peripheral artery surgeries, non-fatal myocardial infarction and non-fatal stroke) in 298 patients belonging to the Vascular Diabetes (AVD) study. To evaluate ADAM17 activity we create ADAM17 score through a RECPAM model. Finally we tested the discrimination ability and the reclassification of clinical models. At follow-up (mean 47 months, range 1-118 months), 55 MACEs occurred (14 nonfatal MI, 14 nonfatal strokes, 17 peripheral artery procedures and 10 cardiovascular deaths) (incidence = 7.8% person-years). An increased risk for incident events was observed among the high ADAM17 score individuals both in univariable (HR 19.20, 95% CI 15.82-63.36, p atherosclerosis. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  4. Impact of overnight traffic noise on sleep quality, sleepiness, and vigilant attention in long-haul truck drivers: Results of a pilot study.

    Science.gov (United States)

    Popp, Roland Fj; Maier, Stefanie; Rothe, Siegfried; Zulley, Jürgen; Crönlein, Tatjana; Wetter, Thomas C; Rupprecht, Rainer; Hajak, Göran

    2015-01-01

    This study aimed to evaluate the impact of traffic noise along the motorway on sleep quality, sleepiness, and vigilant attention in long-haul truck drivers. This was a randomized, crossover, within-subject controlled study. Healthy long-haul truck drivers spent 6 consecutive nights in a real truck berth with full sleep laboratory equipment. During 3 nights, subjects were exposed to replayed traffic noise alongside motorways, whereas the other 3 nights were without traffic noise. Polysomnography was recorded during the nights and numerous sleepiness tests and vigilance examinations were performed during the following standardized working day. Outcome measures were compared between noisy and silent nights using the paired Wilcoxon test. Ten healthy long-haul truck drivers with a mean age of 36.3 ± 7.3 years completed the study as planned. On noisy nights, subjects had greater latencies to the rapid eye movement (REM) phase (90 ± 32 min vs 69 ± 16 min, P = 0.074) and higher percentages of sleep stage 1 (13.7 ± 5.5% vs 11.2 ± 4.4%; P = 0.059). Subjects also rated their sleep quality as having been better during nights without noise (28.1 ± 3.7 vs 30.3 ± 6.2, P = 0.092). The impact of these differences on daytime sleepiness and vigilance was rather low; however, mean Karolinska Sleepiness Scale (KSS) scores measured during the course of the following day were higher on six out of eight occasions after noisy nights. The effects of overnight traffic noise on sleep quality are detectable but unlikely to have any major impact on the vigilant attention and driving performance of long haul-truck drivers with low nocturnal noise sensitivity. This might not be true for subgroups prone to sleeping disorders.

  5. Circadian melatonin rhythm and excessive daytime sleepiness in Parkinson disease.

    Science.gov (United States)

    Videnovic, Aleksandar; Noble, Charleston; Reid, Kathryn J; Peng, Jie; Turek, Fred W; Marconi, Angelica; Rademaker, Alfred W; Simuni, Tanya; Zadikoff, Cindy; Zee, Phyllis C

    2014-04-01

    Diurnal fluctuations of motor and nonmotor symptoms and a high prevalence of sleep-wake disturbances in Parkinson disease (PD) suggest a role of the circadian system in the modulation of these symptoms. However, surprisingly little is known regarding circadian function in PD and whether circadian dysfunction is involved in the development of sleep-wake disturbances in PD. To determine the relationship between the timing and amplitude of the 24-hour melatonin rhythm, a marker of endogenous circadian rhythmicity, with self-reported sleep quality, the severity of daytime sleepiness, and disease metrics. A cross-sectional study from January 1, 2009, through December 31, 2012, of 20 patients with PD receiving stable dopaminergic therapy and 15 age-matched control participants. Both groups underwent blood sampling for the measurement of serum melatonin levels at 30-minute intervals for 24 hours under modified constant routine conditions at the Parkinson's Disease and Movement Disorders Center of Northwestern University. Twenty-four hour monitoring of serum melatonin secretion. Clinical and demographic data, self-reported measures of sleep quality (Pittsburgh Sleep Quality Index) and daytime sleepiness (Epworth Sleepiness Scale), and circadian markers of the melatonin rhythm, including the amplitude, area under the curve (AUC), and phase of the 24-hour rhythm. Patients with PD had blunted circadian rhythms of melatonin secretion compared with controls; the amplitude of the melatonin rhythm and the 24-hour AUC for circulating melatonin levels were significantly lower in PD patients (P Parkinson's Disease Rating Scale scores, levodopa equivalent dose, and global Pittsburgh Sleep Quality Index score in the PD group were not significantly related to measures of the melatonin circadian rhythm. Circadian dysfunction may underlie excessive sleepiness in PD. The nature of this association needs to be explored further in longitudinal studies. Approaches aimed to strengthen

  6. The sleepy teenager - diagnostic challenges

    Directory of Open Access Journals (Sweden)

    Anne-Marie eLandtblom

    2014-08-01

    Full Text Available The sleepy teenager is a diagnostic challenge because the problems may be physiological or pathological, with behavioural, social and pychological expressions. It is of great importance that health staff that encounter young people with sleep disturbance have good knowledge about the diseases that must be excluded. Narcolepsy, periodic hypersomnia like Kleine Levin syndrome, delayed sleep phase syndrome and obstructive sleep apnoea syndrome, depression and substance use as well as fatigue from chronic disease like multiple sclerosis should be investigated. Clinical assessment, neurophysiological and laboratory investigations constitute important support in these investigations. Functional methods, for example fMRI, are being developed. The role of computer gaming and use of social media in the night is discussed in relation to these diseases. Cognitive dysfunction may develop with several of the conditions. There is need for increased awareness of how to investigate sleep disturbance in children and young people.

  7. [Diagnostic accuracy of Epworth sleepiness scale in the acute phase of myocardial infarction].

    Science.gov (United States)

    Ben Ahmed, H; Boussaid, H; Hamdi, I; Longo, S; Baccar, H; Boujnah, M R

    2014-06-01

    Obstructive sleep apnea syndrome (OSAS) is underdiagnosed in cardiologist daily practice, especially in patients with acute coronary syndrome. Its diagnosis is based on a polysomnography study. The Epworth Sleepiness Scale (ESS) stands as a simple and rapid means to select patients for the sleep investigation. The aim of this study was to determine the diagnostic accuracy of the ESS for screening OSAS in patients with ST elevation myocardial infarction. We conducted a prospective study of 120 consecutive patients admitted for acute myocardial infarction, from April 2011 to March 2012. Daytime sleepiness was evaluated using the ESS, when patients were in the intensive care unit. All patients have undergone an overnight sleep study using a portable diagnostic device, in the 15 days following the acute coronary syndrome. The diagnostic of OSA was considered as apnea-hypopnea index (AHI) of ≥5 events/hour, severe OSA was defined as AHI of ≥30. The study included 120 patients comprising 102 men and 18 women. The mean age was 58 ± 12 years. Smoking was the major cardiovascular risk factor with 72% of all patients; prevalence of diabetes was 40% and hypertension was found in 44% of the population. The prevalence of OSA was 79%. Severe OSA was diagnosed in 16% of all patients and mean AHI was 15.76 ± 14.93. Mean ESS was 2.2 ± 1.84 in the global population while it was 5.2 ± 1.2 in patients with severe OSAS. Multivariate analysis showed that ESS score ≥ 4 was an independent predictive factor for severe OSA (OR=28; 95% IC: 8-101; P<0.001). The prevalence of OSA in patients with acute myocardial infarction was very high. ESS score ≥ 4 was an independent predictive factor for severe OSA. Despite its subjective feature, the ESS seems to be an interesting score for screening patients to undergo polysomnography. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  8. Weight Symmetry and Latency Scores for Unexpected Surface Perturbations in Subjects With Traumatic and Vascular Unilateral Transtibial Amputation.

    Science.gov (United States)

    Molina-Rueda, Francisco; Molero-Sánchez, Alberto; Alguacil-Diego, Isabel M; Carratalá-Tejada, María; Cuesta-Gómez, Alicia; Miangolarra-Page, Juan Carlos

    2016-03-01

    Subjects with lower limb amputation develop new motor control strategies to preserve balance when they experience unexpected perturbations. Most studies performed thus far have not aimed to discuss the possible differences in postural control between subjects with vascular unilateral transtibial amputation (UTA) and subjects with traumatic UTA. To analyze the automatic postural reaction in response to unexpected surface perturbations in a sample of subjects with traumatic and vascular UTA and to compare these observations with those for a group of healthy subjects. University department. Observational study. A total of 9 men with traumatic UTA, 7 men with vascular UTA, and 10 control subjects without amputation. Computerized dynamic posturography Smart EquiTest System version 8.0 was used to measure automatic postural responses in both groups. The motor control test was used to assess the participants' automatic postural responses to unexpected surface perturbations. Latency scores showed that subjects with traumatic UTA coped with faster latencies under their sound limb than did the subjects with vascular UTA in medium backward and forward perturbations (medium-backward: P = .004; medium-forward: P = .037). In addition, the subjects with traumatic UTA also managed faster responses to medium-backward (P = .017 versus right control limb; P = .046 versus left control limb) and large-backward (P = .021 versus right control limb) and medium-forward (P = .012 versus right control limb; P = .043 versus left control limb) perturbations in their sound limb in contrast to control subjects. Weight symmetry showed that the subjects with traumatic UTA bore significantly more weight through their sound limb compared with the control subjects during medium and large backward translations (P = .028 and P = .045, respectively). The subjects with traumatic UTA had a greater reliance on their sound limb, and they had faster latencies and more weight in the sound limb upon

  9. Nocturnal hypoxemia biomarker predicts sleepiness in patients with severe obstructive sleep apnea.

    Science.gov (United States)

    Uysal, Askin; Liendo, Cesar; McCarty, David E; Kim, Paul Y; Paxson, Chad; Chesson, Andrew L; Marino, Andrew A

    2014-03-01

    This study aims to assess the association between excessive daytime sleepiness (EDS) and variables extracted from the pulse-oximetry signal obtained during overnight polysomnography. A cross-sectional design was used to study the relation between four hypoxemia variables and EDS as determined by Epworth Sleepiness Scale scores (ESSS) in 200 consecutive patients, newly diagnosed with obstructive sleep apnea (OSA), as defined by an apnea-hypopnea index (AHI)≥ 15. Hypoxemia measurements were compared between sleepy (ESSS ≥ 10) and nonsleepy (ESSShypoxemia variable (and for AHI) such that there were 35 (165) patients in each of the corresponding higher (lower) subcohorts. The hypoxemia variables were combined into a biomarker, and its accuracy for predicting sleepiness in individual patients was evaluated. We planned to interpret prediction accuracy above 80 % as evidence that hypoxemia predicted EDS. Hypoxemia was unassociated with sleepiness in OSA patients with AHI in the range of 15 to 50. In patients with AHI>50, the hypoxemia biomarker (but not individual hypoxemia variables) predicted sleepiness with 82 % accuracy. Nocturnal hypoxemia as determined by a polyvariable biomarker reliably predicted EDS in patients with severe OSA (AHI>50), indicating that oxygen fluctuation had a direct role in the development of EDS in patients with severe OSA.

  10. Sleep, sleepiness and motor vehicle accidents: a national survey.

    Science.gov (United States)

    Gander, Philippa H; Marshall, Nathaniel S; Harris, Ricci B; Reid, Papaarangi

    2005-02-01

    To assess the role of sleep-related factors, ethnicity and socioeconomic deprivation in self-reported motor vehicle accidents while driving, after controlling for gender, age and driving exposure. Mail survey to a random electoral roll sample of 10,000 people aged 30-60 years, stratified by age decades and ethnicity (71% response rate). The analytical sample included 5,534 current drivers (21.6% Maori men, 21.2% Maori women, 30% non-Maori men, 27.2% non-Maori women). Multiple logistic regression analyses revealed the following independent risk factors for accident involvement while driving (last three years): being younger; higher average weekly driving hours; never/rarely getting enough sleep (OR=1.26, 95% CI 1.06-1.49); reporting any chance of dozing in a car while stopped in traffic (Epworth Sleepiness Scale question 8, OR=1.52, 95% CI 1.15-2.02); and among women, being non-Maori. Total Epworth score was not significantly related to reported accident involvement. Chronic sleep restriction, and any likelihood of dozing off at the wheel of a motor vehicle, were significant independent predictors of self-reported involvement in all types of motor vehicle accidents, not only those identified as fatigue-related. The Epworth Sleepiness Scale alone is not a reliable clinical tool for identifying individuals at higher risk of crashes. Factors relating to chronic sleepiness were as important as established demographic risk factors for self-reported motor vehicle accident involvement among 30-60 year-old drivers. The findings reinforce the need for multi-faceted campaigns to reduce sleepy driving.

  11. Specific sleepiness symptoms are indicators of performance impairment during sleep deprivation.

    Science.gov (United States)

    Howard, Mark E; Jackson, Melinda L; Berlowitz, David; O'Donoghue, Fergal; Swann, Philip; Westlake, Justine; Wilkinson, Vanessa; Pierce, Rob J

    2014-01-01

    Drivers are not always aware that they are becoming impaired as a result of sleepiness. Using specific symptoms of sleepiness might assist with recognition of drowsiness related impairment and help drivers judge whether they are safe to drive a vehicle, however this has not been evaluated. In this study, 20 healthy volunteer professional drivers completed two randomized sessions in the laboratory - one under 24h of acute sleep deprivation, and one with alcohol. The Psychomotor Vigilance Task (PVT) and a 30min simulated driving task (AusEdTM) were performed every 3-4h in the sleep deprivation session, and at a BAC of 0.00% and 0.05% in the alcohol session, while electroencephalography (EEG) and eye movements were recorded. After each test session, drivers completed the Karolinska Sleepiness Scale (KSS) and the Sleepiness Symptoms Questionnaire (SSQ), which includes eight specific sleepiness and driving performance symptoms. A second baseline session was completed on a separate day by the professional drivers and in an additional 20 non-professional drivers for test-retest reliability. There was moderate test-retest agreement on the SSQ (r=0.59). Significant correlations were identified between individual sleepiness symptoms and the KSS score (r values 0.50-0.74, pdriving performance were most accurate at detecting severely impaired driving performance (AUC on ROC curve of 0.86-0.91 for detecting change in lateral lane position greater than the change at a BAC of 0.05%). Individual sleepiness symptoms are related to impairment during acute sleep deprivation and might be able to assist drivers in recognizing their own sleepiness and ability to drive safely. Copyright © 2013. Published by Elsevier Ltd.

  12. Eveningness Chronotype, Daytime Sleepiness, Caffeine Consumption, and Use of Other Stimulants Among Peruvian University Students.

    Science.gov (United States)

    Whittier, Anjalene; Sanchez, Sixto; Castañeda, Benjamín; Sanchez, Elena; Gelaye, Bizu; Yanez, David; Williams, Michelle A

    2014-03-01

    Objectives: The aims of this study were to evaluate patterns of circadian preferences and daytime sleepiness, and to examine the extent to which the consumption of stimulant beverages is associated with daytime sleepiness and evening chronotype among Peruvian college-age students. Methods: A total of 2,581 undergraduate students completed a self-administered comprehensive questionnaire that gathered information about sleep habits, sociodemographic and lifestyle characteristics, and the use of caffeinated beverages. The Morningness-Eveningness Questionnaire (MEQ) and Epworth Sleepiness Scale (ESS) were used to assess chronotype and daytime sleepiness. We used multivariable linear and logistic regression procedures to estimate odds ratios (OR) and 95% confidence intervals (95% CI) for the associations of sleep disorders with sociodemographic and behavioral factors. Results: The prevalence of daytime sleepiness was 35% [95% CI 32.7-36.4] and eveningness chronotype was 10% [95% CI 8.8-11.1%]. Age, sex, cigarette smoking, and alcohol consumption were significantly associated with an evening chronotype. After adjusting for age, sex, smoking, body mass index, and physical activity, students who reported consumption of any stimulant beverages had 1.25 increased odds of excessive daytime sleepiness (OR=1.25 [95% CI 1.03-1.53]) compared with students who did not consume stimulant beverages. Consumption of any stimulant beverages was not statistically significantly associated with being an evening chronotype (OR=1.30 [95% CI 0.86-1.96]). Conclusions: Excessive daytime sleepiness and eveningness chronotype are common among Peruvian college students. MEQ scores were associated with age, sex, smoking, and alcohol consumption. Regular stimulant beverage consumption tended to be positively associated with excessive daytime sleepiness.

  13. Genetic Association and Risk Scores in a Chronic Obstructive Pulmonary Disease Meta-analysis of 16,707 Subjects.

    Science.gov (United States)

    Busch, Robert; Hobbs, Brian D; Zhou, Jin; Castaldi, Peter J; McGeachie, Michael J; Hardin, Megan E; Hawrylkiewicz, Iwona; Sliwinski, Pawel; Yim, Jae-Joon; Kim, Woo Jin; Kim, Deog K; Agusti, Alvar; Make, Barry J; Crapo, James D; Calverley, Peter M; Donner, Claudio F; Lomas, David A; Wouters, Emiel F; Vestbo, Jørgen; Tal-Singer, Ruth; Bakke, Per; Gulsvik, Amund; Litonjua, Augusto A; Sparrow, David; Paré, Peter D; Levy, Robert D; Rennard, Stephen I; Beaty, Terri H; Hokanson, John; Silverman, Edwin K; Cho, Michael H

    2017-07-01

    The heritability of chronic obstructive pulmonary disease (COPD) cannot be fully explained by recognized genetic risk factors identified as achieving genome-wide significance. In addition, the combined contribution of genetic variation to COPD risk has not been fully explored. We sought to determine: (1) whether studies of variants from previous studies of COPD or lung function in a larger sample could identify additional associated variants, particularly for severe COPD; and (2) the impact of genetic risk scores on COPD. We genotyped 3,346 single-nucleotide polymorphisms (SNPs) in 2,588 cases (1,803 severe COPD) and 1,782 control subjects from four cohorts, and performed association testing with COPD, combining these results with existing genotyping data from 6,633 cases (3,497 severe COPD) and 5,704 control subjects. In addition, we developed genetic risk scores from SNPs associated with lung function and COPD and tested their discriminatory power for COPD-related measures. We identified significant associations between SNPs near PPIC (P = 1.28 × 10-8) and PPP4R4/SERPINA1 (P = 1.01 × 10-8) and severe COPD; the latter association may be driven by recognized variants in SERPINA1. Genetic risk scores based on SNPs previously associated with COPD and lung function had a modest ability to discriminate COPD (area under the curve, ∼0.6), and accounted for a mean 0.9-1.9% lower forced expiratory volume in 1 second percent predicted for each additional risk allele. In a large genetic association analysis, we identified associations with severe COPD near PPIC and SERPINA1. A risk score based on combining genetic variants had modest, but significant, effects on risk of COPD and lung function.

  14. Short Daytime Naps Briefly Attenuate Objectively Measured Sleepiness Under Chronic Sleep Restriction.

    Science.gov (United States)

    Saletin, Jared M; Hilditch, Cassie J; Dement, William C; Carskadon, Mary A

    2017-09-01

    Napping is a useful countermeasure to the negative effects of acute sleep loss on alertness. The efficacy of naps to recover from chronic sleep loss is less well understood. Following 2 baseline nights (10 hours' time-in-bed), participants were restricted to 7 nights of 5-hour sleep opportunity. Ten adults participated in the No-Nap condition, and a further 9 were assigned to a Nap condition with a daily 45-minute nap opportunity at 1300 h. Sleepiness was assessed using the multiple sleep latency test and a visual analogue scale at 2-hour intervals. Both objective and subjective indexes of sleepiness were normalized within subject as a difference from those at baseline prior to sleep restriction. Mixed-effects models examined how the daytime nap opportunity altered sleepiness across the day and across the protocol. Short daytime naps attenuated sleepiness due to chronic sleep restriction for up to 6-8 hours after the nap. Benefits of the nap did not extend late into evening. Subjective sleepiness demonstrated a similar short-lived benefit that emerged later in the day when objective sleepiness already returned to pre-nap levels. Neither measure showed a benefit of the nap the following morning after the subsequent restriction night. These data indicate a short daytime nap may attenuate sleepiness in chronic sleep restriction, yet subjective and objective benefits emerge at different time scales. Because neither measure showed a benefit the next day, the current study underscores the need for careful consideration before naps are used as routine countermeasures to chronic sleep loss.

  15. Reliability of scored patient generated subjective global assessment for nutritional status among HIV infected adults in TASO, Kampala.

    Science.gov (United States)

    Mokori, A; Kabehenda, M K; Nabiryo, C; Wamuyu, M G

    2011-08-01

    Establish the reliability of the scored Patient Generated-Subjective Global Assessment (PG-SGA) in determining nutritional status among Antiretroviral Therapy (ART) naive HIV-infected adults. A descriptive, cross sectional study among outpatient medical clinics, in The AIDS Support Organization (TASO), Mulago Centre, Kampala, Uganda. The study group (n=217) consisted of male (n=60) and female (n=157) HIV patients (18-67 years). Purposive sampling was used. Anthropometry (weight, height, BMI), nutritional history (body weight, dietary intake, gastrointestinal symptoms, functional capacity and infections), and clinical status were assessed. Sensitivity and specificity of PG-SGA were determined using Receiver Operating Characteristic (ROC) curve. Data collection was done from April-May 2008. Only 12% of the subjects were underweight and over half (58.2%) had normal weight. The PG-SGA had low sensitivity (69.2%) and specificity (57.1%) at categorizing the risk for malnutrition indicated by BMInutritional status in this population.

  16. Short-term reproducibility and variability of the pupillographic sleepiness test.

    Science.gov (United States)

    Wilhelm, Barbara; Bittner, Evelyn; Hofmann, Anna; Koerner, Andreas; Peters, Tobias; Lüdtke, Holger; Wilhelm, Helmut

    2015-01-01

    The pupillographic sleepiness test (PST) measures the amplitude of the fluctuations of pupil size in the dark, which reflects the level of central nervous system activation and thus alertness. The aim of this study was to assess the short-term reproducibility and variability of the results obtained with the PST in normal healthy subjects. The PST was measured at 9.00, 11:00, and 13:00 h on three consecutive days in 13 young adults. Subjective sleepiness was assessed with the Stanford Sleepiness Scale (SSS) and with a Visual Analogue Scale (VAS). The intra-class correlation (ICC), a measure of reproducibility and the intra- and inter-individual variability, was calculated. ANOVA analysis of the data revealed no significant differences in the PST measurements for testing day. Time of day and subject did however significantly affect the results with an ICC 73.1%. For the SSS and VAS, the ICC was 38.8% and 45.9%, respectively. The intra- and inter-individual variability in PST results did not differ considerably between time and days. We conclude that recordings of the PST have a good reproducibility and low intra- and inter-individual variability compared to subjective scales of sleepiness or the Multiple Sleep Latency Test. The PST is thus a viable method to measure daytime sleepiness objectively. © 2015 Wiley Periodicals, Inc.

  17. The Impact of Relative Poverty on Norwegian Adolescents’ Subjective Health: A Causal Analysis with Propensity Score Matching

    Directory of Open Access Journals (Sweden)

    Jon Ivar Elstad

    2012-12-01

    Full Text Available Studies have revealed that relative poverty is associated with ill health, but the interpretations of this correlation vary. This article asks whether relative poverty among Norwegian adolescents is causally related to poor subjective health, i.e., self-reported somatic and mental symptoms. Data consist of interview responses from a sample of adolescents (N = 510 and their parents, combined with register data on the family’s economic situation. Relatively poor adolescents had significantly worse subjective health than non-poor adolescents. Relatively poor adolescents also experienced many other social disadvantages, such as parental unemployment and parental ill health. Comparisons between the relatively poor and the non-poor adolescents, using propensity score matching, indicated a negative impact of relative poverty on the subjective health among those adolescents who lived in families with relatively few economic resources. The results suggest that there is a causal component in the association between relative poverty and the symptom burden of disadvantaged adolescents. Relative poverty is only one of many determinants of adolescents’ subjective health, but its role should be acknowledged when policies for promoting adolescent health are designed.

  18. Sleepiness, sleep, and use of sleepiness countermeasures in shift-working long-haul truck drivers.

    Science.gov (United States)

    Pylkkönen, M; Sihvola, M; Hyvärinen, H K; Puttonen, S; Hublin, C; Sallinen, M

    2015-07-01

    Driver sleepiness is a prevalent phenomenon among professional drivers working unconventional and irregular hours. For compromising occupational and traffic safety, sleepiness has become one of the major conundrums of road transportation. To further elucidate the phenomenon, an on-road study canvassing the under-explored relationship between working hours and sleepiness, sleep, and use of sleepiness countermeasures during and outside statutory rest breaks was conducted. Testing the association between the outcomes and working hours, generalized estimating equations models were fitted on a data collected from 54 long-haul truck drivers (mean 38.1 ± 10.5 years, one female) volunteering in the 2-week study. Unobtrusive data-collection methods applied under naturalistic working and shift conditions included the Karolinska Sleepiness Scale (KSS) measuring sleepiness, a combination of actigraphy and sleep-log measuring sleep, and self-report questionnaire items incorporated into the sleep-log measuring the use of sleepiness countermeasures during and outside statutory rest breaks. Drivers' working hours were categorized into first and consecutive night, morning and day/evening shifts based on shift timing. The results reveal severe sleepiness (KSS≥7) was most prevalent on the first night (37.8%) and least on the morning (10.0%) shifts. Drivers slept reasonably well prior to duty hours, with main sleep being longest prior to the first night (total sleep time 7:21) and shortest prior to the morning (total sleep time 5:43) shifts. The proportion of shifts whereby drivers reported using at least one sleepiness countermeasure outside statutory rest breaks was approximately 22% units greater for the night than the non-night shifts. Compared to the day/evening shifts, the odds of severe sleepiness were greater only on the first night shifts (OR 6.4-9.1 with 95% confidence intervals, depending on the statistical model), the odds of insufficient daily sleep were higher

  19. Sleep complaints and daytime sleepiness among pharmaceutical students in Tripoli

    Directory of Open Access Journals (Sweden)

    Yousef A. Taher

    2012-10-01

    Full Text Available Background: The effect of sleep difficulties has achieved a great deal of attention recently, with university students considered as a homogenized population, particularly affected by sleep habits. Aim: The objective of this study was to investigate whether Libyan college students experience sleep disturbance during their academic programmes. Methods: A cross-sectional survey was conducted in the college of Pharmacy, Tripoli University, during February 2010. A total of 201 students, including 179 females (89.05% and 22 males (10.95%, were recruited from different academic levels. Data were collected using a structured questionnaire and included a number of life-style variables. Epworth Sleepiness Scale (ESS was used for the assessment of daytime sleepiness. Results: This study showed that the total sleep time (TST on a weeknight was 6.40 h and 67 students reported napping during daytime. The TST plus naps totalled 7.39 h. Out of eight possible dozing situations, we found that the mean score for ESS was 8.78. In addition, 79 students showed an ESS score of >10. Furthermore, our results showed that the majority of students (>92% reported poor sleep satisfaction with quality and duration of sleep hours. Thinking about difficulty of study but not increasing education programs or tea/coffee consumption is associated with sleep difficulties reported. Moreover, 77.6% of students reported an irregular sleep–wake schedule. Conclusion: These findings indicate that students experienced excessive daytime sleepiness. The TST of pharmaceutical students in Libya, as in other developing countries, is less than those reported by Western students. Students experienced various environmental demands during their college years and, their quality of sleep was negatively affected.

  20. Independent or Integrated? The Impact on Subject Examination Scores of Changing a Neuropsychiatry Clerkship to Independent Clerkships in Psychiatry and Neurology.

    Science.gov (United States)

    Anderson, Heather S; Gabrielli, William F; Paolo, Anthony; Walling, Anne

    2017-08-01

    This study was undertaken to assess any impact on National Board of Medical Examiners (NBME) neurology and psychiatry subject examination scores of changing from an integrated neuropsychiatry clerkship to independent neurology and psychiatry clerkships. NBME psychiatry and neurology subject examinations scores were compared for all 625 students completing the required neuropsychiatry clerkship in academic years 2005-2006 through 2008-2009 with all 650 students completing the independent neurology and psychiatry clerkships in academic years 2009-2010 through 2012-2013. Statistical adjustments were made to ensure comparability across groups and over time. A significant improvement in subject examination scores was associated with the independent clerkships. The independent clerkship model was associated with a modest improvement in NBME subject examination scores. This finding may be attributable to many causes or combination of causes other than curricular design. Curricular planners need to pay attention to the potential impact of course integration on specialty-specific NBME subject examination performance.

  1. Job demands and resting and napping opportunities for nurses during night shifts: impact on sleepiness and self-evaluated quality of healthcare.

    Science.gov (United States)

    Barthe, Béatrice; Tirilly, Ghislaine; Gentil, Catherine; Toupin, Cathy

    2016-01-01

    The aim of this field study is to describe night shift resting and napping strategies and to examine their beneficial effects on sleepiness and quality of work. The study was carried out with 16 nurses working in an intensive care unit. Data collected during 20 night shifts were related to job demands (systematic observations), to the duration and timing of rests and naps taken by nurses (systematic observations, sleep diaries), to sleepiness (Karolinska Sleepiness Scale), and to quality of work scores (visual analog scale). The results showed that the number of rests and naps depended on the job demands. Resting and napping lowered the levels of sleepiness at the end of the shift. There was no direct relationship between sleepiness and the quality of work score. Discussions about the choice of indicators for the quality of work are necessary. Suggestions for implementing regulations for prescribed napping during night shifts are presented.

  2. Sleep Disturbances and Symptoms of Depression and Daytime Sleepiness in Pregnant Women.

    Science.gov (United States)

    Tsai, Shao-Yu; Lin, Jou-Wei; Wu, Wei-Wen; Lee, Chien-Nan; Lee, Pei-Lin

    2016-06-01

    Sleep disturbance, depression, and daytime sleepiness are among the most prevalent symptoms reported by women during pregnancy. However, available data on the association between sleep disturbances and symptoms of depression and daytime sleepiness in pregnant women are sparse and methodological limitations have been acknowledged. The purpose of the study was to examine objective and self-reported sleep disturbances and symptoms of depression and daytime sleepiness in a group of healthy pregnant women. A total of 274 third-trimester pregnant women wore a wrist actigraph continuously for 7 days to assess objective sleep quality and quantity. Self-reported sleep quality was assessed by the Pittsburgh Sleep Quality Index (PSQI), with self-reported poor sleep quality defined as a PSQI score more than 5. The Center for Epidemiologic Studies-Depression Scale (CES-D) and Epworth Sleepiness Scale were used to evaluate symptoms of depression and daytime sleepiness, respectively. Sixty-four (23.4%) women were at risk for clinical depression and 69 (25.2%) had daytime sleepiness. Risk of clinically meaningful depressive symptomatology was significantly increased in women with objective total nighttime sleep less than 6 hours (OR 2.53 [95% CI 1.26-5.08]) and self-reported poor sleep quality (OR 3.31 [95% CI 1.74-6.30]), even after multiple adjustment. Neither objective nor self-reported sleep disturbances increased daytime sleepiness in this group of pregnant women. Both objective nighttime sleep less than 6 hours and self-reported poor sleep quality in healthy third-trimester pregnant women is associated with significant risks for clinical depression. Improving sleep would likely be associated with a reduction in depression symptom severity and an attenuation of the prevalence of depression in pregnant women. © 2016 Wiley Periodicals, Inc.

  3. Association of Musculoskeletal Joint Pain With Obstructive Sleep Apnea, Daytime Sleepiness, and Poor Sleep Quality in Men.

    Science.gov (United States)

    Li, Joule J; Appleton, Sarah L; Gill, Tiffany K; Vakulin, Andrew; Wittert, Gary A; Antic, Nick A; Taylor, Anne W; Adams, Robert J; Hill, Catherine L

    2017-05-01

    To investigate the association of musculoskeletal pain with objectively determined obstructive sleep apnea (OSA) and subjective sleep measures in a population-based sample. Participants were community-dwelling men (n = 360) age ≥35 years from the Men Androgen Inflammation Lifestyle Environment and Stress (MAILES) study. Shoulder, back, hip, knee, hand, and foot pain were assessed by computer-assisted telephone interview or self-completed questionnaire. OSA was determined with full in-home unattended polysomnography (Embletta X100) scored by 2007 American Academy of Sleep Medicine alternative criteria. The Epworth Sleepiness Scale assessed daytime sleepiness and the Pittsburgh Sleep Quality Index assessed sleep quality. OSA was not associated with the presence of any joint pain (adjusted odds ratio [OR] 1.03 [95% confidence interval (95% CI) 0.61-1.76]). There was no association between OSA and pain in any specific joint (shoulder, back, hip, knee, hand, or foot), nor was the number of joints in pain associated with OSA. There was, similarly, no association between pain variables and excessive daytime sleepiness, except for hand pain (OR 3.10 [95% CI 1.50-6.39]). However, pain was associated with poor sleep quality: any pain (OR 2.19 [95% CI 1.25-3.82]), shoulder pain (OR 2.16 [95% CI 1.25-3.75]), back pain (OR 2.24 [95% CI 1.41-3.55]), and foot pain (OR 2.47 [95% CI 1.43-4.26]). The number of painful joints was also associated with poor sleep quality (5-6 joints versus no joints OR 7.34 [95% CI 2.30-23.42]). No association between OSA and pain or between daytime sleepiness and pain was found. Consistent with previous reports, poor sleep quality was associated with musculoskeletal pain in this population sample. The etiologic differences between OSA-related sleep disruption and poor subjective sleep quality require further investigation. © 2016, American College of Rheumatology.

  4. 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.

  5. Sleep-related eye symptoms and their potential for identifying driver sleepiness.

    Science.gov (United States)

    Filtness, Ashleigh J; Anund, Anna; Fors, Carina; Ahlström, Christer; Akerstedt, Torbjørn; Kecklund, Göran

    2014-10-01

    The majority of individuals appear to have insight into their own sleepiness, but there is some evidence that this does not hold true for all, for example treated patients with obstructive sleep apnoea. Identification of sleep-related symptoms may help drivers determine their sleepiness, eye symptoms in particular show promise. Sixteen participants completed four motorway drives on two separate occasions. Drives were completed during daytime and night-time in both a driving simulator and on the real road. Ten eye symptoms were rated at the end of each drive, and compared with driving performance and subjective and objective sleep metrics recorded during driving. 'Eye strain', 'difficulty focusing', 'heavy eyelids' and 'difficulty keeping the eyes open' were identified as the four key sleep-related eye symptoms. Drives resulting in these eye symptoms were more likely to have high subjective sleepiness and more line crossings than drives where similar eye discomfort was not reported. Furthermore, drivers having unintentional line crossings were likely to have 'heavy eyelids' and 'difficulty keeping the eyes open'. Results suggest that drivers struggling to identify sleepiness could be assisted with the advice 'stop driving if you feel sleepy and/or have heavy eyelids or difficulty keeping your eyes open'. © 2014 European Sleep Research Society.

  6. Effects of Shift Work on Cognitive Performance, Sleep Quality, and Sleepiness among Petrochemical Control Room Operators.

    Science.gov (United States)

    Kazemi, Reza; Haidarimoghadam, Rashid; Motamedzadeh, Majid; Golmohamadi, Rostam; Soltanian, Alireza; Zoghipaydar, Mohamad Reza

    2016-02-03

    Shift work is associated with both sleepiness and reduced performance. The aim of this study was to examine cognitive performance, sleepiness, and sleep quality among petrochemical control room shift workers. Sixty shift workers participated in this study. Cognitive performance was evaluated using a number of objective tests, including continuous performance test, n-back test, and simple reaction time test; sleepiness was measured using the subjective Karolinska Sleepiness Scale (KSS); and sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) questionnaire. ANCOVA, t-test, and repeated-measures ANOVA were applied for statistical analyses, and the significance level was set at p cognitive performance, except for omission error, significantly decreased at the end of both day and night shifts (p sleep quality on both day and night shifts, and there were significant differences between the day and night shifts in terms of subjective sleep quality and quantity (p sleep, induced cognitive performance decline at the end of both day and night shifts, and increased sleepiness in night shift. It, thus, seems necessary to take ergonomic measures such as planning for more appropriate shift work and reducing working hours.

  7. Association between Framingham risk score and subclinical atherosclerosis among elderly with both type 2 diabetes mellitus and healthy subjects

    Science.gov (United States)

    Amer, Moatassem S; Khater, Mohamed S; Omar, Omar H; Mabrouk, Randa A; Mostafa, Shimaa A

    2014-01-01

    Framingham risk score (FRS) is a widely used tool to identify asymptomatic individuals who are at risk to cardiovascular disease. We aimed to investigate the association between subclinical atherosclerosis and FRS among elderly with both type 2 diabetes mellitus and healthy participants. Methods: As case-control study was done on 58 men and women, who had type 2 diabetes mellitus, and in 59 age and gender matched control participants. They were selected from a geriatric outpatient clinic at Ain Shams University Hospital, Cairo, Egypt. The carotid intima-media thickness (cIMT), clinical variables, plasma lipid profile, high-sensitivity C-reactive protein (hs-CRP) were measured for each participants. Results: Diabetic patients had higher FRS, body mass index (BMI), fasting glucose, total cholesterol level, and LDL levels than control subjects. Mean cIMT values were higher in diabetic than healthy subjects. After multivariate regression analysis, FRS was independently associated with carotid IMT in type 2 diabetes patients after adjustment for other risk factors. However triglycerides and BMI were independently associated with cIMT among the control group. Conclusion: FRS is likely to be more informative about the atherosclerotic state in diabetics but not in the healthy elderly. PMID:24551481

  8. Increased automatic spreading activation in healthy subjects with elevated scores in a scale assessing schizophrenic language disturbances.

    Science.gov (United States)

    Moritz, S; Andresen, B; Domin, F; Martin, T; Probsthein, E; Kretschmer, G; Krausz, M; Naber, D; Spitzer, M

    1999-01-01

    Previous studies on semantic priming have suggested that schizophrenic patients with language disturbances demonstrate enhanced semantic and indirect semantic priming effects relative to controls. However, the interpretation of semantic priming studies in schizophrenic patients is obscured by methological problems and several artefacts (such as length of illness). We, therefore, used a psychometric high-risk approach to test whether healthy subjects reporting language disturbances resembling those of schizophrenics (as measured by the Frankfurt Complaint Questionnaire subscale 'language') display increased priming effects. In addition, the Schizotypal Personality Questionnaire was used to cover symptoms of schizotypal personality. Enhanced priming was expected to occur under conditions favouring automatic processes. One hundred and sixty healthy subjects performed a lexical decision semantic priming task containing two different stimulus onset asynchronicities (200 ms and 700 ms) with two experimental conditions (semantic priming and indirect semantic priming) each. Analyses of variance revealed that the Frankfurt Complaint Questionnaire-' language' high scorers significantly differed from low scorers in three of the four priming conditions indicating increased automatic spreading activation. No significant results were obtained for the Schizotypal Personality Questionnaire total and subscales scores. In line with Maher and Spitzer it is suggested that increased automatic spreading activation underlies schizophrenia-typical language disturbances which in our study cannot be attributed to confounding variables such as different reaction time baselines, medication or length of illness. Finally, results confirm that the psychometric high-risk approach is an important tool for investigating issues relevant to schizophrenia.

  9. The viability of an ecologically valid chronic sleep restriction and circadian timing protocol: An examination of sample attrition, compliance, and effectiveness at impacting sleepiness and mood.

    Science.gov (United States)

    Dickinson, David L; Drummond, Sean P A; McElroy, Todd

    2017-01-01

    Chronic sleep restriction (SR) increases sleepiness, negatively impacts mood, and impairs a variety of cognitive performance measures. The vast majority of work establishing these effects are tightly controlled in-lab experimental studies. Examining commonly-experienced levels of SR in naturalistic settings is more difficult and generally involves observational methods, rather than active manipulations of sleep. The same is true for analyzing behavioral and cognitive outcomes at circadian unfavorable times. The current study tested the ability of an at-home protocol to manipulate sleep schedules (i.e., impose SR), as well as create a mismatch between a subject's circadian preference and time of testing. Viability of the protocol was assessed via completion, compliance with the SR, and success at manipulating sleepiness and mood. An online survey was completed by 3630 individuals to assess initial eligibility, 256 agreed via email response to participate in the 3-week study, 221 showed for the initial in-person session, and 184 completed the protocol (175 with complete data). The protocol consisted of 1 week at-home SR (5-6 hours in bed/night), 1 week wash-out, and 1 week well-rested (WR: 8-9 hours in bed/night). Sleep was monitored with actigraphy, diary, and call-ins. Risk management strategies were implemented for subject safety. At the end of each experimental week, subjects reported sleepiness and mood ratings. Protocol completion was 83%, with lower depression scores, higher anxiety scores, and morning session assignment predicting completion. Compliance with the sleep schedule was also very good. Subjects spent approximately 2 hours less time in bed/night and obtained an average of 1.5 hours less nightly sleep during SR, relative to WR, with 82% of subjects obtaining at least 60 minutes less average nightly sleep. Sleepiness and mood were impacted as expected by SR. These findings show the viability of studying experimental chronic sleep restriction outside

  10. The viability of an ecologically valid chronic sleep restriction and circadian timing protocol: An examination of sample attrition, compliance, and effectiveness at impacting sleepiness and mood.

    Directory of Open Access Journals (Sweden)

    David L Dickinson

    Full Text Available Chronic sleep restriction (SR increases sleepiness, negatively impacts mood, and impairs a variety of cognitive performance measures. The vast majority of work establishing these effects are tightly controlled in-lab experimental studies. Examining commonly-experienced levels of SR in naturalistic settings is more difficult and generally involves observational methods, rather than active manipulations of sleep. The same is true for analyzing behavioral and cognitive outcomes at circadian unfavorable times. The current study tested the ability of an at-home protocol to manipulate sleep schedules (i.e., impose SR, as well as create a mismatch between a subject's circadian preference and time of testing. Viability of the protocol was assessed via completion, compliance with the SR, and success at manipulating sleepiness and mood. An online survey was completed by 3630 individuals to assess initial eligibility, 256 agreed via email response to participate in the 3-week study, 221 showed for the initial in-person session, and 184 completed the protocol (175 with complete data. The protocol consisted of 1 week at-home SR (5-6 hours in bed/night, 1 week wash-out, and 1 week well-rested (WR: 8-9 hours in bed/night. Sleep was monitored with actigraphy, diary, and call-ins. Risk management strategies were implemented for subject safety. At the end of each experimental week, subjects reported sleepiness and mood ratings. Protocol completion was 83%, with lower depression scores, higher anxiety scores, and morning session assignment predicting completion. Compliance with the sleep schedule was also very good. Subjects spent approximately 2 hours less time in bed/night and obtained an average of 1.5 hours less nightly sleep during SR, relative to WR, with 82% of subjects obtaining at least 60 minutes less average nightly sleep. Sleepiness and mood were impacted as expected by SR. These findings show the viability of studying experimental chronic sleep

  11. Clinical Implications of Daytime Sleepiness for the Academic Performance of Middle School Age Adolescents with ADHD

    Science.gov (United States)

    Langberg, Joshua M.; Dvorsky, Melissa R.; Marshall, Stephen; Evans, Steven W.

    2013-01-01

    This study investigated the relative impact of total time slept per night and daytime sleepiness on the academic functioning of 100 middle school age youth (Mage = 11.9) with Attention-Deficit/Hyperactivity Disorder (ADHD). The primary goal of the study was to determine if total time slept per night and/or daytime sleepiness, as measured by youth self-report on the Pediatric Daytime Sleepiness Scale (PDSS), predicted academic functioning above and beyond symptoms of ADHD and relevant covariates, such as intelligence, achievement scores, and parent education level. Self-reported daytime sleepiness but not self-reported total time slept per night was significantly associated with all academic outcomes. When examined in a hierarchical regression model, self-reported daytime sleepiness significantly predicted parent-rated homework problems and academic impairment and teacher-rated academic competence above and beyond symptoms of ADHD and relevant covariates but did not predict GPA or teacher-rated academic impairment. The implications of these findings for better understanding the association between ADHD and sleep and the functional implications of this relationship are discussed. PMID:23509927

  12. Nintendo® Wii Fit based sleepiness tester detects impairment of postural steadiness due to 24 h of wakefulness.

    Science.gov (United States)

    Tietäväinen, Aino; Gates, Fred K; Meriläinen, Antti; Mandel, Jeff E; Hæggström, Edward

    2013-12-01

    A field-usable sleepiness tester could reduce sleepiness related accidents. 15 subjects' postural steadiness was measured with a Nintendo(®) Wii Fit balance board every hour for 24 h. Body sway was quantified with complexity index, CI, and the correlation between CI and alertness predicted by a three-process model of sleepiness was calculated. The CI group average was 8.9 ± 1.3 for alert and 7.9 ± 1.4 for sleep deprived subjects (p < 0.001, ρ = 0.94). The Wii Fit board detects the impairment of postural steadiness. This may allow large scale sleepiness testing outside the laboratory setting. Copyright © 2013 IPEM. All rights reserved.

  13. The relationship between weight change and daytime sleepiness: the Sleep Heart Health Study.

    Science.gov (United States)

    Ng, Winda L; Orellana, Liliana; Shaw, Jonathan E; Wong, Evelyn; Peeters, Anna

    2017-08-01

    Through a causal framework, we aim to assess the association between weight change and daytime sleepiness, and the role of obstructive sleep apnoea (OSA) in this relationship. From the Sleep Heart Health Study, we selected individuals who were: (1) 40-64 years old, with (2) body mass index (BMI) ≥18.5 kg/m2, (3) no history of stroke, treatment for OSA, and tracheostomy at baseline. We used multiple linear regression to assess the relationship between five-year weight change and daytime sleepiness (assessed through Epworth Sleepiness Scale (ESS)) at five years, adjusting for daytime sleepiness, demographics, diabetes, subjective sleep duration, sleep disturbance, smoking status, weight, and use of antidepressants and benzodiazepines at baseline, in those with complete data (N = 1468). We further assessed the potential mediating role of OSA in this relationship. At baseline, the study participants were on average 55 years old, 46% males, with mean BMI 28 kg/m2; and 25% had ESS>10. ESS at five years worsened by 0.36 units (95% confidence interval (CI) 0.12-0.61, p = 0.004) with every 10-kg weight gain. When stratified by sex, this relationship was only found in women (0.55, 95% CI 0.25-0.86, p weight change and daytime sleepiness was mediated by severity of OSA at five years. Weight gain has a detrimental effect on daytime sleepiness, mostly through pathways other than OSA. This study provides further evidence and understanding of the relationship between obesity and excessive daytime sleepiness. Copyright © 2017 Elsevier B.V. All rights reserved.

  14. Subjectivity

    Directory of Open Access Journals (Sweden)

    Jesús Vega Encabo

    2015-11-01

    Full Text Available In this paper, I claim that subjectivity is a way of being that is constituted through a set of practices in which the self is subject to the dangers of fictionalizing and plotting her life and self-image. I examine some ways of becoming subject through narratives and through theatrical performance before others. Through these practices, a real and active subjectivity is revealed, capable of self-knowledge and self-transformation. 

  15. Daytime sleepiness and associated factors in Japanese school children.

    Science.gov (United States)

    Gaina, Alexandru; Sekine, Michikazu; Hamanishi, Shimako; Chen, Xiaoli; Wang, Hongbing; Yamagami, Takashi; Kagamimori, Sadanobu

    2007-11-01

    To examine daytime sleepiness and sleepiness interrelationship with sleep-wake patterns, eating habits, physical activity, and TV/video game time. A cross-sectional survey with 9,261 school children (mean age of 12.8 years) from 93 junior high schools in Toyama prefecture, Japan. The main outcome measures were daytime sleepiness during schooldays and sleepiness interrelationship with sleep-wake patterns, eating habits, physical activity, and visual media use. A total of 2,328 children (25.2%) reported sleepiness almost always and 4,401 (47.6%) sleepiness often. Regarding sex difference, a higher proportion of girls reported sleepiness in comparison to boys (79% vs 66%, P media use time. Sleep insufficiency represents a main cause for daytime sleepiness in Japanese junior high school children. Proper sleep habits, high physical activity level, and limited TV viewing time should be promoted among school children.

  16. Clinical and polysomnographic characteristics of excessive daytime sleepiness in children.

    Science.gov (United States)

    Lee, Jiwon; Na, Geonyoub; Joo, Eun Yeon; Lee, Munhyang; Lee, Jeehun

    2017-08-18

    This study aimed to delineate the clinical and polysomnography (PSG) characteristics of sleep disorders in children with excessive daytime sleepiness (EDS). Between February 2002 and June 2015, 622 pediatric patients with EDS were evaluated with overnight PSG and the Multiple Sleep Latency Test at the Samsung Medical Center. The medical records; questionnaire responses about depression, sleepiness, sleep habits; and sleep study data of 133 patients without obstructive sleep apnea (OSA) were reviewed retrospectively. The patients (63 girls, 70 boys) slept for an average of 7 h 30 min and 8 h 44 min on weekdays and weekends, respectively. The mean Epworth Sleepiness Scale score was 11.01 ± 4.09 and did not differ significantly among sleep disorders. Among the 102 patients who completed the depression questionnaire, 53 showed depressive feelings, which were moderate or severe in 39, with no significant differences among specific sleep disorders. Thirty-four patients exhibited normal PSG results. Seventeen of them were concluded as not having any sleep disorders, and the others as having delayed sleep phase disorder (DSPD). Narcolepsy (n = 78) was the most common disorder, followed by DSPD (n = 17) and idiopathic hypersomnia (n = 12). Pediatric patients with EDS had various sleep disorders and some did not have any sleep disorder despite EDS. More than half the patients with EDS showed depressive feelings affecting their daily lives. For pediatric patients with EDS, a systematic diagnostic approach including questionnaires for sleep habits and emotion and PSG is essential for accurate diagnosis and treatment.

  17. Inter-examiner reproducibility of Ocular Response Analyzer using the waveform score quality index in healthy subjects.

    Science.gov (United States)

    Mandalos, Achilleas; Anastasopoulos, Eleftherios; Makris, Leonidas; Dervenis, Nikolaos; Kilintzis, Vasilis; Topouzis, Fotis

    2013-02-01

    To evaluate the inter-examiner reproducibility of Ocular Response Analyzer (ORA) parameters in healthy subjects using the waveform score (WS) for quality control of acquisition. Fifteen healthy subjects had their intraocular pressure (IOP) measured with ORA by 2 masked examiners. An acquisition protocol that aimed at obtaining 4 reliable measurements in each eye with WS≥6 and with as few repeated measurements as possible was employed, whereas a maximum of 8 measurements per eye was allowed. Additional good quality criteria included symmetrical force-in and force-out applanation signal peaks on the ORA waveform and few or no distortions of the applanation signal curve. Only the right eyes were included in the analysis. Examiners were trained but not experienced. The inter-examiner reproducibility of ORA parameters was assessed using the intraclass correlation coefficient (ICC). Mean values of the best 4 measurements were considered in analysis. ICC including the best 4 measurements per eye was high for all ORA parameters. Specifically, ICC for Goldmann-correlated IOP was 0.961, for corneal-compensated IOP was 0.962, for corneal resistance factor was 0.987, and for corneal hysteresis was 0.988. Similar reproducibility was found when only the 3 best measurements per eye were included in the analysis. The protocol for IOP measurement with ORA using the WS ≥6 as quality index achieved high inter-examiner reproducibility for all ORA parameters. High reproducibility was obtained even by inexperienced examiners when considering the mean of the best 3 measurements per eye.

  18. Relationship between the Finnish Diabetes Risk Score (FINDRISC), vitamin D levels, and insulin resistance in obese subjects.

    Science.gov (United States)

    Lima-Martínez, Marcos M; Arrau, Carlos; Jerez, Saimar; Paoli, Mariela; González-Rivas, Juan P; Nieto-Martínez, Ramfis; Iacobellis, Gianluca

    2017-02-01

    To assess the relationship between 25-hydroxyvitamin D [25(OH)D] blood concentrations in subjects with obesity and type 2 diabetes mellitus (T2D) risk according to the Finnish Diabetes Risk Score (FINDRISC) modified for Latin America (LA-FINDRISC). This study was conducted in Ciudad Bolívar, Venezuela. Eighty two women and 20 men (53 obese and 49 nonobese), with an average age of 42.6±12.30 years were enrolled. Weight, height, body mass index (BMI), waist circumference (WC), fasting glucose, basal insulin, plasma lipids, Homeostasis Model Assessment-Insulin Resistance (HOMA-IR), and 25(OH)D levels were measured. FINDRISC with WC cutoff points modified for Latin America was applied. No difference in 25(OH)D levels between obese and nonobese subjects was found. When anthropometric, clinical, and biochemical variables according to the 25(OH)D status were compared, the only difference detected was higher LA-FINDRISC in the insufficient/low 25(OH)D group compared to normal 25(OH)D levels group (12.75±6.62; vs 10.15±5.21; p=0.031). LA-FINDRISC was negatively correlated with plasma 25(OH)D levels (r=-0.302; p=0.002) and positively correlated with the HOMA-IR index (r=0.637; p=0.0001). The LA-FINDRISC significantly correlated with both 25(OH)D levels and insulin resistance markers in this group of patients. Copyright © 2016 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.

  19. Multilevel Intervention Mapping with sleepiness in focus

    NARCIS (Netherlands)

    Hof, T.; Wilschut, E.S.

    2011-01-01

    This report provides an overview of methods to prevent drowsy driving of drivers (Wilschut et al., 2009). Several preventive approaches were discussed such as the use of questionnaires, campaigns and fatigue management plans. A search for law enforcement instruments to prevent sleepiness at the

  20. Excessive daytime sleepiness, nocturnal sleep duration and ...

    African Journals Online (AJOL)

    Background and objectives. Short nocturnal sleep duration resulting in sleep debt may be a cause of excessive daytime sleepiness (EDS). Severity of depression (psychopathology) has been found to be directly related to EDS. There is an association between sleep duration and mental health, so there may therefore be an ...

  1. Sleepiness and alertness in American industries

    Energy Technology Data Exchange (ETDEWEB)

    Coleman, R.M.; Dillingham, J.; Dement, W.C.

    1989-01-01

    Recent evidence that industrial accidents may be caused in part by shiftworkers' lack of alertness has caused growing concern at the US Nuclear Regulatory Commission and within the scientific community. The purpose of the study reported in this paper was threefold: (1) Is sleepiness on the job specific to utility plants (2) Are performance and safety problems caused by sleepiness specific to utility plants (3) Are specific shift schedules associated with a higher prevalence of sleepiness Findings indicate sleepiness on the job among shiftworkers is a widespread problem, not limited to the nuclear power industry. The most common solution in American industry is to overstaff each shift and discipline sleeping employees. Results show this is not effective. A more proactive solution is recommended including some of the following: (1) Provide employees education to assist adjustment to shiftwork. (2) Design and implement shift schedules that are more compatible with human physiological capabilities. (3) Allow officially sanctioned napping on shift as is done in Japan. (4) Divide 6-, 8-, or 12-h shifts into smaller blocks of 2 to 3 h of primary duty. (5) make the environment where employees work more conductive to alertness. (6) Develop a firehouse type of schedule where some employees sleep throughout the night, but are awakened if operational problems arise. (7) Provide incentives to employees to adjust their life style to the night shift and reward them with time off.

  2. The viability of an ecologically valid chronic sleep restriction and circadian timing protocol: An examination of sample attrition, compliance, and effectiveness at impacting sleepiness and mood

    Science.gov (United States)

    Drummond, Sean P. A.; McElroy, Todd

    2017-01-01

    Chronic sleep restriction (SR) increases sleepiness, negatively impacts mood, and impairs a variety of cognitive performance measures. The vast majority of work establishing these effects are tightly controlled in-lab experimental studies. Examining commonly-experienced levels of SR in naturalistic settings is more difficult and generally involves observational methods, rather than active manipulations of sleep. The same is true for analyzing behavioral and cognitive outcomes at circadian unfavorable times. The current study tested the ability of an at-home protocol to manipulate sleep schedules (i.e., impose SR), as well as create a mismatch between a subject’s circadian preference and time of testing. Viability of the protocol was assessed via completion, compliance with the SR, and success at manipulating sleepiness and mood. An online survey was completed by 3630 individuals to assess initial eligibility, 256 agreed via email response to participate in the 3-week study, 221 showed for the initial in-person session, and 184 completed the protocol (175 with complete data). The protocol consisted of 1 week at-home SR (5-6 hours in bed/night), 1 week wash-out, and 1 week well-rested (WR: 8-9 hours in bed/night). Sleep was monitored with actigraphy, diary, and call-ins. Risk management strategies were implemented for subject safety. At the end of each experimental week, subjects reported sleepiness and mood ratings. Protocol completion was 83%, with lower depression scores, higher anxiety scores, and morning session assignment predicting completion. Compliance with the sleep schedule was also very good. Subjects spent approximately 2 hours less time in bed/night and obtained an average of 1.5 hours less nightly sleep during SR, relative to WR, with 82% of subjects obtaining at least 60 minutes less average nightly sleep. Sleepiness and mood were impacted as expected by SR. These findings show the viability of studying experimental chronic sleep restriction outside

  3. Adaptation of the Oral Aesthetic Subjective Impact Score (OASIS) questionnaire for perception of oral aesthetics in Brazil.

    Science.gov (United States)

    Pimenta, Wladimir Vinicius; Traebert, Jefferson

    2010-01-01

    The aim of the present study was to assess the cross-cultural adaptation and reliability and validity of the Oral Aesthetic Subjective Impact Score (OASIS) for the perception of oral aesthetics in Brazilian adolescents. The cross-cultural adaptation was developed in agreement with internationally recommended methodology. The psychometric properties were assessed by application of the Brazilian version of the OASIS in 304 adolescents aged 13 to 19 years who were enrolled at two public schools and one private school in Tubarão, Brazil. The internal consistency of the instrument was measured using Cronbach's alpha. The reliability was estimated through stability and homogeneity, using the Intraclass Correlation Coefficient and the Bland-Altman agreement. Validity was determined by comparing the OASIS-Brazil with the aesthetic component of the instrument Oral Impact on Daily Performance (OIDP) using the Spearman Rank Correlation Coefficient. The internal consistency obtained was 0.52. Inter-observer and intra-observer correlations were strong, 0.87 and 0.83, respectively. The correlation with the aesthetic part of OIDP was 0.44. The results showed that the process of cross-cultural adaptation was successful and the adapted instrument showed good psychometric properties.

  4. Same Noses, Different Nasalance Scores: Data from Normal Subjects and Cleft Palate Speakers for Three Systems for Nasalance Analysis

    Science.gov (United States)

    Bressmann, Tim; Klaiman, Paula; Fischbach, Simone

    2006-01-01

    Nasalance scores from the Nasometer, the NasalView and the OroNasal System were compared. The data was collected from 50 normal participants and 19 hypernasal patients with cleft palate. The Nasometer had the lowest nasalance scores for the non-nasal Zoo Passage and that the OroNasal System had the lowest nasalance scores for the Nasal Sentences.…

  5. Automated Scoring of Short-Answer Open-Ended GRE® Subject Test Items. ETS GRE® Board Research Report No. 04-02. ETS RR-08-20

    Science.gov (United States)

    Attali, Yigal; Powers, Don; Freedman, Marshall; Harrison, Marissa; Obetz, Susan

    2008-01-01

    This report describes the development, administration, and scoring of open-ended variants of GRE® Subject Test items in biology and psychology. These questions were administered in a Web-based experiment to registered examinees of the respective Subject Tests. The questions required a short answer of 1-3 sentences, and responses were automatically…

  6. Cytochrome P450 2D6 genotype affects the pharmacokinetics of controlled-release paroxetine in healthy Chinese subjects: comparison of traditional phenotype and activity score systems.

    Science.gov (United States)

    Chen, Rui; Wang, Haotian; Shi, Jun; Shen, Kai; Hu, Pei

    2015-07-01

    This study evaluated the effects of cytochrome P450 (CYP) 2D6 polymorphisms on the pharmacokinetics of controlled-release paroxetine in healthy Chinese subjects and used paroxetine as a tool drug to compare the performance of traditional phenotype and activity score systems. Pharmacokinetic data were evaluated in 24 subjects who received a single oral dose of 25 mg controlled-release paroxetine. Plasma paroxetine concentrations were measured by LC-MS/MS. CYP2D6 genotypes were tested by PCR and direct DNA sequencing. Subjects were classified by two systems of phenotype prediction. In the traditional phenotype system, subjects were classified as extensive metabolizers or intermediate metabolizers; in the activity score system, subjects were divided into four activity groups. Analysis of variance testing was applied to estimate the effects of CYP2D6 polymorphisms on the pharmacokinetics of paroxetine. With the traditional phenotype system, significant differences were observed in the following pharmacokinetic parameters of paroxetine: t 1/2, C max, AUC0-t, AUC0-inf, Vz/F, and CL/F (all P paroxetine was about 3.5-fold higher in the intermediate metabolizer group than in the extensive metabolizer group. With the activity score system, significant differences were observed in the t 1/2, C max, AUC0-t, AUC0-inf, Vz/F, and CL/F among the four different activity score groups (all P paroxetine decreased by around one half as the activity score increased by 0.5. The pharmacokinetics of controlled-release paroxetine after a single administration was affected by CYP2D6 polymorphisms. Both the traditional phenotype and the activity score systems performed well and distinguished subjects with different drug exposures. The activity score system provided a more detailed classification for the subjects.

  7. Orexin/hypocretin levels in the cerebrospinal fluid and characteristics of patients with myotonic dystrophy type 1 with excessive daytime sleepiness

    Directory of Open Access Journals (Sweden)

    Omori Y

    2018-02-01

    Full Text Available Yuki Omori,1 Takashi Kanbayashi,1,2 Aya Imanishi,1 Ko Tsutsui,1 Yohei Sagawa,1 Yuka S Kikuchi,1 Masahiro Takeshima,1 Kazuhisa Yoshizawa,1 Sachiko Uemura,3 Tetsuo Shimizu1,2 1Department of Neuropsychiatry, Akita University Graduate School of Medicine, Akita, Japan; 2International Institute for Integrative Sleep Medicine (WPI-IIIS, University of Tsukuba, Tsukuba, Japan; 3Department of Physical Therapy, Akita University Graduate School of Health Sciences, Akita, Japan Purpose: Myotonic dystrophy type 1 (DM1 is often characterized by excessive daytime sleepiness (EDS and sleep-onset rapid eye movement periods caused by muscleblind-like protein 2. The EDS tends to persist even after treatment of sleep apnea. We measured the cerebrospinal fluid (CSF orexin levels in DM1 patients with EDS and compared the clinical characteristics with narcolepsy type 1 and idiopathic hypersomnia (IHS patients.Patients and methods: We measured the CSF orexin levels in 17 DM1 patients with EDS and evaluated subjective sleepiness using the Epworth Sleepiness Scale (ESS, objective sleepiness using mean sleep latency (MSL, and sleep apnea using apnea-hypopnea index (AHI. We compared the ESS scores and MSL between decreased (≤200 pg/mL and normal (>200 pg/mL CSF orexin group in DM1 patients. Furthermore, we compared the CSF orexin levels, ESS scores, MSL, and AHI among patients with DM1, narcolepsy type 1 (n=46, and IHS (n=30.Results: Seven DM1 patients showed decreased CSF orexin levels. There were significant differences in the ESS scores and MSL between decreased and normal CSF orexin groups in DM1 patients. The ESS scores showed no significant difference among patients with DM1, narcolepsy type 1, and IHS. The MSL in DM1 and IHS patients were significantly higher than narcolepsy type 1 patients (p=0.01, p<0.001. The AHI in DM1 patients was significantly higher than narcolepsy type 1 patients (p=0.042 and was insignificantly different from IHS patients. The CSF orexin

  8. Cognitive Performance, Sleepiness, and Mood in Partially Sleep Deprived Adolescents: The Need for Sleep Study

    Science.gov (United States)

    Lo, June C.; Ong, Ju Lynn; Leong, Ruth L.F.; Gooley, Joshua J.; Chee, Michael W.L.

    2016-01-01

    Study Objectives: To investigate the effects of sleep restriction (7 nights of 5 h time in bed [TIB]) on cognitive performance, subjective sleepiness, and mood in adolescents. Methods: A parallel-group design was adopted in the Need for Sleep Study. Fifty-six healthy adolescents (25 males, age = 15–19 y) who studied in top high schools and were not habitual short sleepers were randomly assigned to Sleep Restriction (SR) or Control groups. Participants underwent a 2-w protocol consisting of 3 baseline nights (TIB = 9 h), 7 nights of sleep opportunity manipulation (TIB = 5 h for the SR and 9 h for the control groups), and 3 nights of recovery sleep (TIB = 9 h) at a boarding school. A cognitive test battery was administered three times each day. Results: During the manipulation period, the SR group demonstrated incremental deterioration in sustained attention, working memory and executive function, increase in subjective sleepiness, and decrease in positive mood. Subjective sleepiness and sustained attention did not return to baseline levels even after 2 recovery nights. In contrast, the control group maintained baseline levels of cognitive performance, subjective sleepiness, and mood throughout the study. Incremental improvement in speed of processing, as a result of repeated testing and learning, was observed in the control group but was attenuated in the sleep-restricted participants, who, despite two recovery sleep episodes, continued to perform worse than the control participants. Conclusions: A week of partial sleep deprivation impairs a wide range of cognitive functions, subjective alertness, and mood even in high-performing high school adolescents. Some measures do not recover fully even after 2 nights of recovery sleep. Commentary: A commentary on this article appears in this issue on page 497. Citation: Lo JC, Ong JL, Leong RL, Gooley JJ, Chee MW. Cognitive performance, sleepiness, and mood in partially sleep deprived adolescents: the need for sleep study

  9. Obstructive Sleep Apnea With Objective Daytime Sleepiness Is Associated With Hypertension.

    Science.gov (United States)

    Ren, Rong; Li, Yun; Zhang, Jihui; Zhou, Junying; Sun, Yuanfeng; Tan, Lu; Li, Taomei; Wing, Yun-Kwok; Tang, Xiangdong

    2016-11-01

    Subjective daytime sleepiness is considered a significant risk factor of hypertension in patients with obstructive sleep apnea (OSA). In this study, our goal was to examine the joint effect on hypertension of OSA and objective daytime sleepiness measured by the multiple sleep latency test (MSLT). A total of 1338 Chinese patients with OSA and 484 primary snorers were included in the study. All subjects underwent 1 night polysomnography followed by MSLT. The MSLT values were classified into 3 categories: >8 minutes, 5 to 8 minutes, and Hypertension was defined based either on direct blood pressure measures or on diagnosis by a physician. After controlling for confounders, OSA combined with MSLT of 5 to 8 minutes increased the odds of hypertension by 95% (odds ratio, 1.95; 95% confidence interval, 1.10-3.46), whereas OSA combined with MSLT hypertension by 111% (odds ratio, 2.11; 95% confidence interval, 1.22-3.31) compared with primary snorers with MSLT >8 minutes. In stratified analyses, the association of hypertension with MSLT in OSA patients was seen among both sexes, younger ages, both obese and nonobese patients, and patients with and without subjective excessive daytime sleepiness. We conclude that objective daytime sleepiness is associated with hypertension in patients with OSA. © 2016 American Heart Association, Inc.

  10. Prevalence of poor sleep quality, sleepiness and obstructive sleep apnoea risk factors in athletes.

    Science.gov (United States)

    Swinbourne, Richard; Gill, Nicholas; Vaile, Joanna; Smart, Daniel

    2016-10-01

    Despite the perceived importance of sleep for athletes, little is known regarding athlete sleep quality, their prevalence of daytime sleepiness or risk factors for obstructive sleep apnoea (OSA) such as snoring and witnessed apnoeic episodes. The purpose of the present study was to characterise normative sleep quality among highly trained team sport athletes. 175 elite or highly trained rugby sevens, rugby union and cricket athletes completed the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Score (ESS) and Quality of Life questionnaires and an OSA risk factor screen. On average, athletes reported 7.9 ± 1.3 h of sleep per night. The average PSQI score was 5.9 ± 2.6, and 50% of athletes were found to be poor sleepers (PSQI > 5). Daytime sleepiness was prevalent throughout the population (average global score of 8.5) and clinically significant (ESS score of ≥10) in 28% of athletes. OSA may be an important clinical consideration within athletic populations, as a considerable number of athletes (38%) defined themselves as snorers and 8% reported having a witnessed apnoeic episode. The relationship between self-rated sleep quality and actual PSQI score was strong (Pearson correlation of 0.4 ± 0.1, 90% confidence limits). These findings suggest that this cohort of team sport athletes suffer a preponderance of poor sleep quality, with associated high levels of daytime sleepiness. Athletes should receive education about how to improve sleep wake schedules, extend total sleep time and improve sleep quality.

  11. The impact of short night-time naps on performance, sleepiness and mood during a simulated night shift.

    Science.gov (United States)

    Centofanti, Stephanie A; Hilditch, Cassie J; Dorrian, Jillian; Banks, Siobhan

    2016-01-01

    Short naps on night shift are recommended in some industries. There is a paucity of evidence to verify the sustained recovery benefits of short naps in the last few hours of the night shift. Therefore, the current study aimed to investigate the sustained recovery benefits of 30 and 10-min nap opportunities during a simulated night shift. Thirty-one healthy participants (18F, 21-35 y) completed a 3-day, between-groups laboratory study with one baseline night (22:00-07:00 h time in bed), followed by one night awake (time awake from 07:00 h on day two through 10:00 h day three) with random allocation to: a 10-min nap opportunity ending at 04:00 h, a 30-min nap opportunity ending at 04:00 h or no nap (control). A neurobehavioral test bout was administered approximately every 2 h during wake periods. There were no significant differences between nap conditions for post-nap psychomotor vigilance performance after controlling for pre-nap scores (p > 0.05). The 30-min nap significantly improved subjective sleepiness compared to the 10-min nap and no-nap control (p nap significantly worsened negative mood compared to the 30-min nap and no-nap control (p power naps" can help to alleviate performance decrements, a 30-min nap opportunity at approximately 04:00 h was found to improve subjective, but not objective sleepiness. A 10-min nap may lead to increased negative mood in the hours following the nap due to a "short nap aversion" effect.

  12. Oral Appliance Therapy in Patients With Daytime Sleepiness and Snoring or Mild to Moderate Sleep Apnea: A Randomized Clinical Trial.

    Science.gov (United States)

    Marklund, Marie; Carlberg, Bo; Forsgren, Lars; Olsson, Tommy; Stenlund, Hans; Franklin, Karl A

    2015-08-01

    Oral appliances that move the mandible forward during sleep are suggested as treatment for mild to moderate obstructive sleep apnea. To test whether an adjustable, custom-made oral appliance improves daytime sleepiness and quality of life in patients with daytime sleepiness and snoring or mild to moderate obstructive sleep apnea. Ninety-six patients with daytime sleepiness and an apnea-hypopnea index (AHI) lower than 30 were included in a randomized, placebo-controlled, parallel trial in Umeå, Sweden, from May 2007 through August 2011. Four months' intervention with an oral appliance or a placebo device. Daytime sleepiness was measured with the Epworth Sleepiness Scale, the Karolinska Sleepiness Scale, and the Oxford Sleep Resistance (OSLER) test. Quality of life was assessed with the Short-Form 36-Item Health Survey (SF-36) and the Functional Outcomes of Sleep Questionnaire (FOSQ). Secondary outcomes included the apnea-hypopnea index, headaches, symptoms of restless legs, and insomnia. Oral appliance therapy was not associated with improvements in daytime sleepiness from baseline to 4-month follow-up when compared with the placebo device; Epworth score >10: 53% at baseline to 24% at follow-up for the oral appliance group vs 54% at baseline to 40% at follow-up for the placebo device group, P = .11; median (IQR) for Karolinska score ≥7/wk: 10 (8 to 14) at baseline to 7 (4 to 9) at follow-up for the oral appliance group vs 12 (6 to 15) at baseline to 8 (5 to 12) at follow-up for the placebo device group, P = .11; mean between-group difference in OSLER test, -2.4 min (95% CI, -6.3 to 1.4). The mean between-group difference for the total FOSQ score was insignificant (-1.2 [95% CI, -2.5 to 0.1]). No domain of the SF-36 differed significantly between the groups. The AHI was below 5 in 49% of patients using the active appliance and in 11% using placebo, with an odds ratio of 7.8 (95% CI, 2.6-23.5) and a number needed to treat of 3. Snoring (P oral appliance

  13. Causes and consequences of sleepiness among college students

    OpenAIRE

    Hershner SD; Chervin RD

    2014-01-01

    Shelley D Hershner, Ronald D ChervinDepartment of Neurology, University of Michigan, Ann Arbor, MI, USAAbstract: Daytime sleepiness, sleep deprivation, and irregular sleep schedules are highly prevalent among college students, as 50% report daytime sleepiness and 70% attain insufficient sleep. The consequences of sleep deprivation and daytime sleepiness are especially problematic to college students and can result in lower grade point averages, increased risk of academic failure, compromised ...

  14. Cross-cultural adaptation of the Dutch version of the scored patient-generated subjective global assessment

    NARCIS (Netherlands)

    Dr. C.P. van der Schans; Martine J. Sealy; Ulrike Hass; Jan L. Roodenburg; Dr Harriët Jager-Wittenaar

    2014-01-01

    Posterpresentatie gehouden tijdens en in het kader van Clinical Nutrition Week 2014. Background: Nutritional assessment is considered to be an important element in the nutrition care process of cancer patients, since nutritional status is positively associated with health outcome. The Scored

  15. [Validation of the Arabic Version of the Epworth Sleepiness Scale: Multicentre study].

    Science.gov (United States)

    Riachy, M; Juvelikian, G; Sleilaty, G; Bazarbachi, T; Khayat, G; Mouradides, C

    2012-05-01

    The Epworth Sleepiness Scale (ESS) is a self-completion questionnaire developed in the English language and used for the evaluation of sleepiness. The objective of this study was to develop an Arabic version of ESS (AESS) and to investigate its reliability and the validity. The AESS was created according to the recommendations of the ISPOR Task Force for Translation and Cultural Adaptation with bilingual individuals. It was applied to 91 patients referred to three sleep Lebanese centers for suspicion of sleep-related breathing diseases, and to 166 controls in good health. AESS scores of 60 patients were compared to 60 matched controls according to their age, sex and body mass index. Reproducibility was tested in 30 controls. The treatment response was tested among 15 patients after one month of CPAP treatment. Principal component analysis showed convergence towards only one latent factor. The AESS had a good internal consistency (Cronbach's alpha 0.76, intraclass correlation coefficient of 0.85 (IC95%: 0.76-0.92), Spearman 0.97, P<0.001). An increase in the severity of sleep apnea was accompanied by an increase in the score on the AESS (P<0.001). AESS scores improved significantly after CPAP. The AESS, a reliable and valid instrument for the evaluation of daytime sleepiness, is a valuable tool for clinical practice and multicenter research. Copyright © 2012 SPLF. Published by Elsevier Masson SAS. All rights reserved.

  16. Nutritional status assessed by scored patient-generated subjective global assessment associated with length of hospital stay in adult patients receiving an appendectomy

    Directory of Open Access Journals (Sweden)

    Tzu-Hao Huang

    2014-04-01

    Full Text Available Background: Malnutrition has been associated with poor health outcomes in hospitalized patients. This study assessed the validity of the scored patient-generated subjective global assessment (PG-SGA in adult patients who had undergone an open appendectomy, and examined the association of this assessment tool with length of hospital stay. Methods: Nutritional status was determined by using the scored PG-SGA in adult patients (n = 86 who had undergone an open appendectomy within 24 hours of admission. Variables were compared between well-nourished and malnourished participants. Regression analysis was used to identify potential predictors for length of hospital stay. Receiver operator characteristic (ROC analysis was used to examine the validity of the PG-SGA score to predict the nutritional status. Results: On admission, 17% of the study subjects were malnourished and associated with a significantly older age (53.0 vs. 39.5, greater PG-SGA score (8 vs. 2, higher comorbidity (67% vs. 27%, and longer length of hospital stay (6.9 d vs. 4.1 d. The PG-SGA score and comorbidity were the determined risk factors for length of hospital stay after performing multiple regression analysis. Furthermore, the PG-SGA score had a significantly positive correlation with length of hospital stay (Spearman's rho = 0.378, p < 0.001. The area under the ROC curve indicating the PG-SGA score, compared with nutritional status, is 0.9751. Conclusions: The scored PG-SGA in adults receiving an appendectomy is significantly associated with length of hospital stay, and is an effective tool for assessing the nutritional status of patients with cancer and chronic illness, as well as of patients with acute surgical abdomen.

  17. Pupillographic Sleepiness Test and Polysomnography in Nondemented Patients with Ischemic White Matter Lesions

    Directory of Open Access Journals (Sweden)

    Ralf Landwehr

    2015-01-01

    Full Text Available Background. Patients with ischemic white matter lesions (WML frequently report nonrestorative sleep or daytime sleepiness. However, subjective estimations of sleep and sleepiness can differ considerably from objective measures. The pupillographic sleepiness test (PST could identify patients with sleep disorders requiring polysomnography (PSG and further treatment. Methods. We performed a PST and a PSG of 35 nondemented patients with WML, who reported nonrestorative sleep or daytime sleepiness, and assessed the diagnostic value of the pupillary unrest index (PUI. Sleep parameters were compared to normative data. Results. The mean PUI of WML patients was normal (5.89 mm/min and comparable to PUIs of patients with other neurological disorders. All 9 of the 35 WML patients (25.7% who had a PUI above normal also had clinically relevant sleep disorders (5: sleep apnea, 7: periodic leg movements, and 4: insomnia. Six patients with a normal PUI had mild to moderate primary insomnia. Conclusion. PST and PSG parameters were physiological in most patients with WML. Age-related changes and affective and neuropsychological disorders might account for their sleep-related complaints. An elevated PUI in patients with WML seems to indicate comorbid sleep disorders that require further diagnostic evaluation and treatment (sleep apnea, insomnia with periodic leg movements, but not primary insomnia.

  18. Obesity-related sleepiness and fatigue: the role of the stress system and cytokines.

    Science.gov (United States)

    Vgontzas, Alexandros N; Bixler, Edward O; Chrousos, George P

    2006-11-01

    Obesity has epidemic proportions in Western societies and, because of its significant association with morbidity and mortality, is a major public health issue. Excessive daytime sleepiness (EDS) and fatigue (tiredness without increased sleep propensity)--which have been associated with obesity--have a significant impact on individual well-being and public safety. In this article, we review data that challenge the belief that sleep apnea and sleep disruption per se are the primary determinants of obesity-related daytime sleepiness and fatigue. Specifically, it appears that obesity per se is associated with objective and subjective daytime sleepiness compared to normal-weight controls regardless of sleep apnea and sleep loss. Indeed, obese patients without sleep apnea are sleepier compared to nonobese controls whereas within the morbidly obese, those who have high sleep efficiency at night are sleepier than those who have low sleep efficiency. In addition, in recent studies based on large random samples of the general population, the primary determinants of subjective EDS were depression and metabolic disturbances, that is, obesity/diabetes, and not sleep apnea or objective sleep disruption. Furthermore, sleepiness and fatigue are very prevalent in conditions associated with insulin resistance, for instance, the polycystic ovary syndrome (PCOS), independently of sleep apnea or obesity, or in conditions of insufficient physical activity. On the basis of these data, we propose that obesity-related objective daytime sleepiness and fatigue are associated primarily with metabolic and psychological factors and less with sleep apnea and sleep disruption per se. Furthermore, we suggest that objective sleepiness is primarily related to metabolic factors, whereas fatigue appears to be related to psychological distress. Finally, based on data from studies in normal controls and patients with sleep disorders, we propose that the interaction of the hypothalamic

  19. Self-Regulation and Sleep Duration, Sleepiness, and Chronotype in Adolescents.

    Science.gov (United States)

    Owens, Judith A; Dearth-Wesley, Tracy; Lewin, Daniel; Gioia, Gerard; Whitaker, Robert C

    2016-12-01

    To determine whether shorter school-night sleep duration, greater daytime sleepiness, and greater eveningness chronotype were associated with lower self-regulation among adolescents. An online survey of 7th- to 12th-grade students in 19 schools in Fairfax County, Virginia Public Schools was conducted in 2015. Self-regulation was measured with the Behavior Rating Inventory of Executive Function, 2nd edition, Screening Self-Report Form. Sleep measures included school night-sleep duration (hours between usual bedtime and wake time), daytime sleepiness (Sleepiness Scale in the Sleep Habits Survey, tertiles), and chronotype (Morningness-Eveningness Scale for Children, continuous score and tertiles). Sociodemographic factors and mental health conditions were analyzed as potential confounders. Among 2017 students surveyed, the mean age was 15.0 years (range, 12.1-18.9 years), and 21.7% slept sleep duration (P = .80). Compared with those in the lowest tertile of daytime sleepiness, those in the highest tertile had lower (0.59 SD units; 95% confidence interval, 0.48-0.71) self-regulation, as did those in the eveningness tertile of chronotype compared with those in the morningness tertile (0.35 SD units lower; 95% confidence interval, 0.24-0.46). Among adolescents, greater daytime sleepiness and greater eveningness chronotype were independently associated with lower self-regulation, but shorter sleep duration was not. Aspects of sleep other than school-night sleep duration appear to be more strongly associated with self-regulation. Copyright © 2016 by the American Academy of Pediatrics.

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

    Science.gov (United States)

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

    2009-12-15

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

  1. Scored Patient-Generated Subjective Global Assessment, albumin and transferrin for nutritional assessment of gastrostomy fed head or neck cancer patients.

    Science.gov (United States)

    Correira Pereira, Marta Alexandra; Santos, Carla Adriana; Almeida Brito, José; Fonseca, Jorge

    2014-02-01

    Gastrostomy fed head or neck cancer patients frequently have impaired speech capacities. Enteral feeding teams frequently depend on laboratorial or anthropometrical parameters for nutritional assessment. In these patients, this study aimed to evaluate: (1) the practicability of Scored - Patient-Generated Subjective Global Assessment (PG-SGA); (2) their nutritional status using the Scored-PG-SGA; (3) association of serum albumin and transferrin values to the nutritional status rating using PG-SGA. On adult outpatients with head or neck cancer under prolonged (> 1 month) gastrostomy feeding, Scored-PGSGA, albumin and transferrin were evaluated during the same appointment. Scored-PG-SGA was easily feasible in 42 patients, even in patients with speech difficulties. Twenty-five patients were moderately/severely undernourished (PG-SGA/B+C). Scored-PG-SGA rated 41 patients as ≥ 2, thus needing nutritional/ pharmacologic intervention. Albumin was low in 13 patients. Transferrin was low in 19 patients. Average albumin and transferrin in moderately/severely undernourished patients (PG-SGA/B+C) was significantly lower than in well-nourished (PG-SGA/A). There was association between Scored- PG-SGA rating, albumin and transferrin. In PEG fed head or neck cancer patients, PGSGA was practicable and useful, even in patients with impaired speaking skills. Most patients displayed moderate/severe malnutrition (PG-SGA/B+C). Scored-PG-SGA rated 41 patients as needing for nutritional/pharmacological intervention. Scored-PG-SGA should be systematically included in the evaluation of these patients. In these patients, albumin and transferrin levels showed relation with Scored-PG-SGA and should be considered as nutritional biomarkers. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  2. Malnutrition in Geriatric Rehabilitation: Prevalence, Patient Outcomes, and Criterion Validity of the Scored Patient-Generated Subjective Global Assessment and the Mini Nutritional Assessment.

    Science.gov (United States)

    Marshall, Skye; Young, Adrienne; Bauer, Judith; Isenring, Elizabeth

    2016-05-01

    Accurate identification and management of malnutrition is essential so that patient outcomes can be improved and resources used efficaciously. In malnourished older adults admitted to rehabilitation: 1) report the prevalence, health and aged care use, and mortality of malnourished older adults; 2) determine and compare the criterion (concurrent and predictive) validity of the Scored Patient-Generated Subjective Global Assessment (PG-SGA) and the Mini Nutritional Assessment (MNA) in diagnosing malnutrition; and 3) identify the Scored PG-SGA score cut-off value associated with malnutrition. Observational, prospective cohort. Participants were 57 older adults (65 years and older; mean±standard deviation age=79.1±7.3 years) from two rural rehabilitation units in New South Wales, Australia. Scored PG-SGA; MNA; and the International Statistical Classification of Diseases and Health Related Problems, 10th revision, Australian Modification (ICD-10-AM) classification of malnutrition were compared to establish concurrent validity and report malnutrition prevalence. Length of stay, discharge location, rehospitalization, admission to a residential aged care facility, and mortality were measured to report health-related outcomes and to establish predictive validity. Malnutrition prevalence varied according to assessment tool (ICD-10-AM: 46%; Scored PG-SGA: 53%; MNA: 28%). Using the ICD-10-AM as the reference standard, the Scored PG-SGA ratings (sensitivity 100%, specificity 87%) and score (sensitivity 92%, specificity 84%, ROC AUC [receiver operating characteristics area under the curve]=0.910±0.038) showed strong concurrent validity, and the MNA had moderate concurrent validity (sensitivity 58%, specificity 97%, receiver operating characteristics area under the curve=0.854±0.052). The Scored PG-SGA rating, Scored PG-SGA score, and MNA showed good predictive validity. Malnutrition can increase the risk of longer rehospitalization length of stay, admission to a residential

  3. Assessment of sleepiness, fatigue, and depression among Gulf Cooperation Council commercial airline pilots.

    Science.gov (United States)

    Aljurf, Tareq M; Olaish, Awad H; BaHammam, Ahmed S

    2017-09-07

    No studies have assessed the prevalence of fatigue, depression, sleepiness, and the risk of obstructive sleep apnea (OSA) among commercial airlines pilots in the Gulf Cooperation Council (GCC). This was a quantitative cross-sectional study conducted among pilots who were on active duty and had flown during the past 6 months for one of three commercial airline companies. We included participants with age between 20 and 65 years. Data were collected using a predesigned electronic questionnaire composed of questions related to demographic information in addition to the Fatigue Severity Scale (FSS), the Berlin Questionnaire, the Epworth Sleepiness Scale (ESS), and the Hospital Anxiety and Depression Scale (HADS). The study included 328 pilots with a mean age ± standard deviation of 41.4 ± 9.7 years. Overall, 224 (68.3%) pilots had an FSS score ≥ 36 indicating severe fatigue and 221 (67.4%) reported making mistakes in the cockpit because of fatigue. One hundred and twelve (34.1%) pilots had an ESS score ≥ 10 indicating excessive daytime sleepiness and 148 (45.1%) reported falling asleep at the controls at least once without previously agreeing with their colleagues. One hundred and thirteen (34.5%) pilots had an abnormal HADS depression score (≥ 8), and 96 (29.3%) pilots were at high risk for OSA requiring further assessment. Fatigue, sleepiness, risk of OSA, and depression are prevalent among GCC commercial airline pilots. Regular assessment by aviation authorities is needed to detect and treat these medical problems.

  4. Driver sleepiness on YouTube: A content analysis.

    Science.gov (United States)

    Hawkins, A N; Filtness, A J

    2017-02-01

    Driver sleepiness is a major contributor to severe crashes and fatalities on our roads. Many people continue to drive despite being aware of feeling tired. Prevention relies heavily on education campaigns as it is difficult to police driver sleepiness. The video sharing social media site YouTube is extremely popular, particularly with at risk driver demographics. Content and popularity of uploaded videos can provide insight into the quality of publicly accessible driver sleepiness information. The purpose of this research was to answer two questions; firstly, how prevalent are driver sleepiness videos on YouTube? And secondly, what are the general characteristics of driver sleepiness videos in terms of (a) outlook on driver sleepiness, (b) tone, (c) countermeasures to driver sleepiness, and, (d) driver demographics. Using a keywords search, 442 relevant videos were found from a five year period (2nd December 2009-2nd December 2014). Tone, outlook, and countermeasure use were thematically coded. Driver demographic and video popularity data also were recorded. The majority of videos portrayed driver sleepiness as dangerous. However, videos that had an outlook towards driver sleepiness being amusing were viewed more often and had more mean per video comments and likes. Humorous videos regardless of outlook, were most popular. Most information regarding countermeasures to deal with driver sleepiness was accurate. Worryingly, 39.8% of videos with countermeasure information contained some kind of ineffective countermeasure. The use of humour to convey messages about the dangers of driver sleepiness may be a useful approach in educational interventions. Copyright © 2015 Elsevier Ltd. All rights reserved.

  5. Cognitive Performance, Sleepiness, and Mood in Partially Sleep Deprived Adolescents: The Need for Sleep Study.

    Science.gov (United States)

    Lo, June C; Ong, Ju Lynn; Leong, Ruth L F; Gooley, Joshua J; Chee, Michael W L

    2016-03-01

    To investigate the effects of sleep restriction (7 nights of 5 h time in bed [TIB]) on cognitive performance, subjective sleepiness, and mood in adolescents. A parallel-group design was adopted in the Need for Sleep Study. Fifty-six healthy adolescents (25 males, age = 15-19 y) who studied in top high schools and were not habitual short sleepers were randomly assigned to Sleep Restriction (SR) or Control groups. Participants underwent a 2-w protocol consisting of 3 baseline nights (TIB = 9 h), 7 nights of sleep opportunity manipulation (TIB = 5 h for the SR and 9 h for the control groups), and 3 nights of recovery sleep (TIB = 9 h) at a boarding school. A cognitive test battery was administered three times each day. During the manipulation period, the SR group demonstrated incremental deterioration in sustained attention, working memory and executive function, increase in subjective sleepiness, and decrease in positive mood. Subjective sleepiness and sustained attention did not return to baseline levels even after 2 recovery nights. In contrast, the control group maintained baseline levels of cognitive performance, subjective sleepiness, and mood throughout the study. Incremental improvement in speed of processing, as a result of repeated testing and learning, was observed in the control group but was attenuated in the sleep-restricted participants, who, despite two recovery sleep episodes, continued to perform worse than the control participants. A week of partial sleep deprivation impairs a wide range of cognitive functions, subjective alertness, and mood even in high-performing high school adolescents. Some measures do not recover fully even after 2 nights of recovery sleep. A commentary on this article appears in this issue on page 497. © 2016 Associated Professional Sleep Societies, LLC.

  6. The Sleepy Teenager – Diagnostic Challenges

    Science.gov (United States)

    Landtblom, Anne-Marie; Engström, Maria

    2014-01-01

    The sleepy teenager puts the doctor in a, often tricky, situation where it must be decided if we deal with normal physiology or if we should suspect pathological conditions. What medical investigations are proper to consider? What differential diagnoses should be considered in the first place? And what tools do we actually have? The symptoms and problems that usually are presented at the clinical visit can be both of medical and psychosocial character – and actually they are often a mixture of both. Subsequently, the challenge to investigate the sleepy teenager often includes the examination of a complex behavioral pattern. It is important to train and develop diagnostic skills and to realize that the physiological or pathological conditions that can cause the symptoms may have different explanations. Research in sleep disorders has shown different pathological mechanisms congruent with the variations in the clinical picture. There are probably also different patterns of involved neuronal circuits although common pathways may exist. The whole picture remains to be drawn in this interesting and challenging area. PMID:25136329

  7. Acute modafinil exposure reduces daytime sleepiness in abstinent methamphetamine-dependent volunteers

    Science.gov (United States)

    Mahoney, James J.; Jackson, Brian J.; Kalechstein, Ari D.; De La Garza, Richard; Chang, Lee C.; Newton, Thomas F.

    2012-01-01

    The purpose of this study was to evaluate the effects of acute, oral modafinil (200 mg) exposure on daytime sleepiness in methamphetamine (Meth)-dependent individuals. Eighteen Meth-dependent subjects were enrolled in a 7-d inpatient study and were administered placebo or modafinil on day 6 and the counter-condition on day 7 (randomized) of the protocol. Subjects completed several subjective daily assessments (such as the Epworth Sleepiness Scale, Pittsburgh Sleep Quality Index, Beck Depression Inventory and visual analogue scale) throughout the protocol as well as objective assessments on days 5–7, when the Multiple Sleep Latency Test was performed. The results of the current study suggest that short-term abstinence from Meth is associated with increased daytime sleepiness and that a single dose of 200 mg modafinil reduces daytime somnolence in this population. In addition, a positive correlation was found between subjective reporting of the likelihood of taking a nap and craving and desire for Meth, as well as the likelihood of using Meth and whether Meth would make the participant feel better. The results of this study should be considered when investigating candidate medications for Meth-dependence, especially in those individuals who attribute their Meth use to overcoming deficits resulting from sleep abnormalities. PMID:22214752

  8. Dutch Patient-Generated Subjective Global Assessment (PG-SGA): training improves scores for comprehensibility and difficulty

    NARCIS (Netherlands)

    Faith Ottery; Jan Roodenburg; Anne van der Braak; Dr. C.P. van der Schans; Martine J. Sealy; Danique Haven; Harriët Jager-Wittenaar

    2015-01-01

    Rationale: The Patient-Generated Subjective Global Assessment (PG-SGA) is a validated instrument to assess and monitor malnutrition, which consists of both patient-reported and professional-reported items. A professional should be able to correctly interpret all items. Untrained professionals may

  9. Clinical implications of daytime sleepiness for the academic performance of middle school-aged adolescents with attention deficit hyperactivity disorder.

    Science.gov (United States)

    Langberg, Joshua M; Dvorsky, Melissa R; Marshall, Stephen; Evans, Steven W

    2013-10-01

    This study investigated the relative impact of total time slept per night and daytime sleepiness on the academic functioning of 100 middle school-aged youth (mean age = 11.9) with attention deficit hyperactivity disorder (ADHD). The primary goal of the study was to determine if total time slept per night and/or daytime sleepiness, as measured by youth self-report on the Pediatric Daytime Sleepiness Scale (PDSS), predicted academic functioning above and beyond symptoms of ADHD and relevant covariates, such as intelligence, achievement scores and parent education level. Self-reported daytime sleepiness but not self-reported total time slept per night was associated significantly with all academic outcomes. When examined in a hierarchical regression model, self-reported daytime sleepiness significantly predicted parent-rated homework problems and academic impairment and teacher-rated academic competence above and beyond symptoms of ADHD and relevant covariates, but did not predict grade point average or teacher-rated academic impairment. The implications of these findings for understanding more clearly the association between ADHD and sleep and the functional implications of this relationship are discussed. © 2013 European Sleep Research Society.

  10. Sleep and daytime sleepiness in methylphenidate medicated and ...

    African Journals Online (AJOL)

    Objective: Excessive daytime sleepiness due to any cause can result in various symptoms similar to those used for the diagnosis of attention deficit/hyperactivity disorder (ADHD). A common treatment for children diagnosed with ADHD is methylphenidate which is also used to treat excessive daytime sleepiness. This paper ...

  11. Sleep and daytime sleepiness in methylphenidate medicated and ...

    African Journals Online (AJOL)

    Sleep and daytime sleepiness in methylphenidate medicated and un-medicated children with attention-deficit/hyperactivity disorder (ADHD) ... with ADHD taking methylphenidate, there was a significant increase in sleepiness a few hours after taking the medication, which may then have a significant impact on their learning.

  12. Daytime Sleepiness among Medical Students in University of Benin ...

    African Journals Online (AJOL)

    Background: Day time sleepiness remains an unexplored area of research in Nigeria despite its far reaching implication on cognitive function and productivity. This study was carried out to evaluate the prevalence of day time sleepiness among medical students in a Nigerian University. Methods: A questionnaire based ...

  13. The prevalence of excessive daytime sleepiness among academic physicians and its impact on the quality of life and occupational performance

    Directory of Open Access Journals (Sweden)

    Aclan Ozder

    2015-08-01

    Full Text Available Objectives: Sleep disorders can affect health and occupational performance of physicians as well as outcomes in patients. The purpose of this study was to assess the prevalence of excessive daytime sleepiness (EDS measured by the Epworth Sleepiness Scale (ESS among academic physicians at a tertiary academic medical center in an urban area in the northwest region of Turkey, and to establish a relationship between the self-perceived sleepiness and the quality of life using the EuroQol-5 dimensions (EQ-5D. Material and Methods: A questionnaire prepared by the researchers after scanning the literature on the subject was e-mailed to the academic physicians of a tertiary academic medical center in Istanbul. The ESS and the EQ-5D were also included in the survey. The e-mail database of the institution directory was used to compile a list of active academic physicians who practiced clinical medicine. Paired and independent t tests were used for the data analysis at a significance level of p 10 (p < 0.001. In the case of the EQ-5D index and visual analogue scale of the EQ-5D questionnaire (EQ-5D VAS, the status of sleepiness of academic physicians was associated with a poorer quality of life (p < 0.001. Conclusions: More than a 1/4 of the academic physicians suffered from sleepiness. There was an association between the poor quality of life and daytime sleepiness. There was also a positive relationship between habitual napping and being sleepy during the day.

  14. Examination of daytime sleepiness and cognitive performance testing in patients with primary insomnia.

    Directory of Open Access Journals (Sweden)

    Hong Liu

    Full Text Available While individuals with insomnia consistently complain of cognitive impairment, previous studies on the effect of insomnia on objective measures of cognitive function have obtained ambiguous results. The relationship between daytime sleepiness and cognitive manifestations in insomnia patients is not clear.Thirty-six primary insomnia patients (PIPs and 26 good sleep controls (GSCs with age and gender matched manner were included in the study. Participants underwent an overnight polysomnography followed by a multiple sleep latency test (MSLT and an examination of the attention network test (ANT. ANT reflected three attentional networks including alerting, orienting and executive control. According to whether accompanied with excessive daytime sleepiness (EDS, the insomnia group were subdivided into PIPs with EDS (n = 12, score on MSLT<10 min and PIPs without EDS (n = 24, score on MSLT≥10 min.PIPs only performed worse on executive control function than GSCs in ANT. PIPs with EDS had longer overall reaction time (RT related to PIPs without EDS. Further analyses with Pearson correlation analysis showed a significant negative correlation between the overall RT and MSLT latency in insomniacs (r = -0.444, p<0.01, whereas no such correlation was found in controls.Results suggest that PIPs do show executive control function deficits compared with GSCs. Daytime sleepiness in terms of MSLT latency was associated with poor cognitive manifestations in patients with insomnia.

  15. [SLEEP QUALITY, EXCESSIVE DAYTIME SLEEPINESS AND INSOMNIA IN CHILEAN PARALYMPIC ATHLETES].

    Science.gov (United States)

    Durán Agüero, Samuel; Arroyo Jofre, Patricio; Varas Standen, Camila; Herrera-Valenzuela, Tomas; Moya Cantillana, Cristobal; Pereira Robledo, Rodolfo; Valdés-Badilla, Pablo

    2015-12-01

    the sleep takes part in diverse biological and physiological functions, associating his restriction, with minor performance in the sport, nevertheless the quantity and quality of sleep is not known in paralympic athletes. to determine the sleep quality, insomnia and excessive daytime sleepiness in Chilean paralympic athletes. descriptive transverse Study, the sample included 33 paralympic athletes (24.2% women), those who were practicing swimming, tennis of table, football 5, powerlifting and tennis chair. The studied variables measured up across two surveys of dream: the Questionnaire of Insomnia and the Pittsburgh Sleep Quality Index. the paralympic athletes sleep were 6.9 } 1.4 hours, 27.7% presents daytime sleepiness, 69.6 % insomnia (Survey of insomnia =7), whereas 78.7 % exhibits a bad sleep quality. The age showed a positive correlation with latency to the sleep (r=0.417 *), the insomnia with latency to the sleep (r=0.462 **), the Pittsburg score was correlated negatively by the sleep duration (r =-0.323) and latency to the sleep is correlated positively by the Pittsburgh score (r=0.603 **). the chilean paralympic athletes, present a low sleep quality, insomnia and excessive daytime sleepiness, situation that might influence negatively the sports performance. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  16. Development of new diabetes risk scores on the basis of the current definition of diabetes in Japanese subjects [Rapid Communication].

    Science.gov (United States)

    Miyakoshi, Takahiro; Oka, Rie; Nakasone, Yasuto; Sato, Yuka; Yamauchi, Keishi; Hashikura, Rie; Takayama, Masayuki; Hirayama, Yudai; Hirabayashi, Kazuko; Koike, Hideo; Aizawa, Toru

    2016-09-30

    To develop diabetes risk score (RS) based on the current definition of diabetes, we retrospectively analyzed consecutive 4,159 health examinees who were non-diabetic at baseline. Diabetes, diagnosed by fasting plasma glucose (FPG) ≥7.0 mmol/L, 2hPG ≥11.1 mmol/L and/or HbA1c ≥6.5% (48 mmol/mol), developed in 279 of them during the mean period of 4.9 years. A full RS (RS Full ), a RS without 2hPG (RS -2hPG ) and a non-invasive RS (RS NI ) were created on the basis of multivariate Cox proportional model by weighted grading based on hazard ratio in half the persons assigned. The RSs were verified in the remaining half of the participants. Positive family history (FH), male sex, smoking and higher age, systolic blood pressure (SBP), FPG, 2hPG and HbA1c were independent predictors for RS Full . For RS -2hPG , 7 independent predictors, exclusive of 2hPG and smoking but inclusive of elevated triglycerides (TG) comparing to RS Full , were selected. FH, male sex, and higher age, SBP and HbA1c were independent predictors in RS NI . In the validation cohort, C-statistic (95%CI) of RS Full , RS -2hPG and RS NI were 0.80 (0.76-0.84), 0.75 (0.70-0.78) and 0.68 (0.63-0.72), respectively, which were significantly different from each other (P <0.01). Absolute percentage difference between predicted probability and observed diabetes were 1.9%, 0.7% and 0.9%, by the three scores, respectively, and not significantly different from each other. In conclusion, diabetes defined by the current criteria was predicted by the new diabetes risk scores with reasonable accuracy. Nonetheless, RS Full with a postchallenge glucose value performed superior to RS -2hPG and RS NI .

  17. Daytime sleepiness in elderly Parkinson’s disease patients and treatment with the psychostimulant modafinil: A preliminary study

    Directory of Open Access Journals (Sweden)

    Johan Lökk

    2010-03-01

    Full Text Available Johan LökkInstitution of Neurobiology, Caring Sciences, and Society, Karolinska Institute, Stockholm, SwedenBackground: Patients with Parkinson’s disease (PD or Parkinsonian syndromes often report excessive daytime sleepiness (EDS. The aim of this study was to evaluate the effects of the psychostimulant modafinil on elderly, institutionalized, severely impaired PD patients with EDS.Method: A three-week open study on ten institutionalized PD patients scoring >10 points on the Epworth Sleepiness Scale (ESS with modafinil eventually on 100 mg twice a day. Patients were assessed at the start, week 1, and week 3 with ESS, Clinical Global Impression (CGI scale severity of PD and appetite.Results: Reduction of ESS score and PD severity over time were found as well as a significant increase in appetite and reduction in CGI score.Conclusion: Modafinil 100 mg twice a day was safe and modestly effective for the treatment of EDS in elderly, institutionalized PD patients. Sustaining wakefulness throughout all stages of PD is crucial for participating in life, maintaining social life, and improving quality of life.Keywords: Parkinson’s disease, daytime sleepiness, Epworth sleepiness scale, psychostimulant

  18. Determinants of sleepiness at work among railway control workers.

    Science.gov (United States)

    Cotrim, Teresa; Carvalhais, José; Neto, Catarina; Teles, Júlia; Noriega, Paulo; Rebelo, Francisco

    2017-01-01

    In the last two decades the control of the Portuguese railway network has become much more centralized in three centres, there integrating the functions of route flow management, electrical control and signalling. This study aimed to investigate the influence of work and individual determinants in sleepiness among railway control workers, namely socio-demographic factors, work ability, psychosocial factors, shiftwork characteristics, fatigue perception, and sleep. Sleepiness by shift was associated with quality of sleep, job satisfaction, fatigue perception, quantitative demands, and age. The results indicate a high prevalence of sleepiness during the night shift and show the relevance of the quality of sleep as a predictor in the three models of sleepiness for morning, afternoon and night shifts. This study, done at the major Portuguese railway control centre, alerted managers to the importance of schedule planning as well as sleepiness prevention plans and makes these results a reference for future research. Copyright © 2016 Elsevier Ltd. All rights reserved.

  19. Preferred 11 different job rotation types in automotive company and their effects on productivity, quality and musculoskeletal disorders: comparison between subjective and actual scores by workers' age.

    Science.gov (United States)

    Jeon, In Sik; Jeong, Byung Yong; Jeong, Ji Hyun

    2016-10-01

    This study investigates workers' favoured rotation types by their age and compares means between subjective and actual scores on productivity, quality and musculoskeletal disorders (MSDs). The subjects of research were 422 assembly line units in Hyundai Motor Company. The survey of 422 units focused on the workers' preference for 11 different rotation types and subjective scores for each type's perceived benefits, both by the workers' age. Then, actual scores on production-related indices were traced over a five-year period. The results suggest that different rotation types lead to different results in productivity, product quality and MSDs. Workers tend to perceive job rotation as a helpful method to enhance satisfaction, productivity and product quality more so than the actual production data suggests. Job rotation was especially effective in preventing MSDs for workers aged under 45, while its effects were not clear for the workers aged 45 years or older. Practitioner's Summary: This research presents appropriate rotation type for different age groups. Taking workers' age into account, administrators can use the paper's outcomes to select and implement the suitable rotation type to attain specific goals such as enhancing productivity, improving product quality or reducing MSDs.

  20. Effects of acute 3,4-methylenedioxymethamphetamine on sleep and daytime sleepiness in MDMA users: a preliminary study.

    Science.gov (United States)

    Randall, Surilla; Johanson, Chris-Ellyn; Tancer, Manuel; Roehrs, Timothy

    2009-11-01

    3,4-Methylenedioxymethamphetamine (MDMA) affects monoamine neurotransmitters that play a critical role in sleep and daytime alertness. However, the acute effects of MDMA on sleep and daytime sleepiness have not been studied under placebo-controlled conditions. This study was designed to establish the effects of acute MDMA or placebo administration and sleep restriction on sleep and daytime sleepiness. Participants with a history of MDMA use were studied on 3 sessions of 3 nights (baseline, treatment, and recovery) and 2 days (following night 2 and 3) per session. On treatment nights (night 2), participants received placebo or 2 mg/kg of MDMA or underwent a restricted bed schedule with placebo. Sleep restriction was a positive control to compare sleep loss and consequent sleepiness associated with MDMA use. The scheduled sleep period was 8 hours long on nonrestricted nights, and standard sleep recordings and daytime sleepiness tests were conducted. Age-matched controls received 1 night and day of standard sleep and daytime sleepiness testing. Sleep laboratory. Seven recreational MDMA-users and 13 matched control subjects. Acute MDMA shortened sleep primarily by increasing sleep latency, and it reduced stage 3/4 sleep and suppressed rapid eye movement (REM) sleep. The MDMA-reduced sleep time was not associated with increased daytime sleepiness the following day, as was seen in the sleep-restriction condition. Compared with control subjects, the MDMA users on the first night in the laboratory had shorter total sleep times and less stage 3/4 sleep. Average daily sleep latency on daytime sleepiness tests the day after nighttime placebo administration was increased in MDMA users compared with the control subjects, and MDMA users had an elevated number of sleep-onset REM periods on these tests, compared with control subjects. Acute MDMA administration disrupts sleep and REM sleep, specifically, without producing daytime sleepiness such as sleep restriction does. Compared

  1. Sleep and sleepiness of pilots operating long-range airplane emergency medical missions.

    Science.gov (United States)

    Amann, Ulrike; Holmes, Alex; Caldwell, John; Hilditch, Cassie

    2014-09-01

    Airplane emergency medical services (AEMS) operators use fixed-wing airplanes to undertake rapid response, round-the-clock medical transport missions. This paper explores the structure of long-range, multileg AEMS missions and the sleep and sleepiness of the pilots who work them. During nine long-range AEMS missions, pilots kept a sleep and sleepiness logbook and wore a wrist activity monitor to evaluate the timing of sleep/wake. Missions had a mean duration of 20 h 00 min ± 2 h 39 min, involved two to four flight legs, and were crewed by three or four pilots who rotated between operating and sleeping in curtained-off bunks. The pilots obtained a mean of 15 h 26 min ± 4 h 51 min and 7 h 54 min ± 1 h 33 min of sleep in the 48 h and 24 h prior to checking in for duty, respectively. During missions, a mean of 3 h 33 min ± 1 h 46 min of sleep was taken, usually across two in-flight sleep periods. Karolinska Sleepiness Scores (KSS) at top of climb and top of descent were typically less than 5 ('neither alert nor sleepy'). A small number of individual higher KSS scores were recorded on the longest missions and on flights between 02:00 and 06:00. These findings suggest that despite the long duration, timing, and multileg nature of AEMS missions, it is possible via careful design and management to operate these missions with appropriate levels of pilot alertness.

  2. Sonolência excessiva Excessive daytime sleepiness

    Directory of Open Access Journals (Sweden)

    Lia Rita Azeredo Bittencourt

    2005-05-01

    Full Text Available A sonolência é uma função biológica, definida como uma probabilidade aumentada para dormir. Já a sonolência excessiva (SE, ou hipersonia, refere-se a uma propensão aumentada ao sono com uma compulsão subjetiva para dormir, tirar cochilos involuntários e ataques de sono, quando o sono é inapropriado. As principais causas de sonolência excessiva são a privação crônica de sono (sono insuficiente, a Síndrome da Apnéia e Hipopnéia Obstrutiva do Sono (SAHOS, a narcolepsia, a Síndrome das Pernas Inquietas/Movimentos Periódicos de Membros (SPI/MPM, Distúrbios do Ritmo Circadiano, uso de drogas e medicações e a hipersonia idiopática. As principais conseqüências são prejuízo no desempenho nos estudos, no trabalho, nas relações familiares e sociais, alterações neuropsicológicas e cognitivas e risco aumentado de acidentes. O tratamento da sonolência excessiva deve estar voltado para as causas específicas. Na privação voluntária do sono, aumentar o tempo de sono e higiene do sono, o uso do CPAP (Continuous Positive Airway Pressure na Síndrome da Apnéia e Hipopnéia Obstrutiva do Sono, exercícios e agentes dopaminérgicos na Síndrome das Pernas Inquietas/Movimentos Periódicos de Membros, fototerapia e melatonina nos Distúrbios do Ritmo Circadiano, retiradas de drogas que causam sonolência excessiva e uso de estimulantes da vigília.Sleepiness is a physiological function, and can be defined as increased propension to fall asleep. However, excessive sleepiness (ES or hypersomnia refer to an abnormal increase in the probability to fall asleep, to take involuntary naps, or to have sleep atacks, when sleep is not desired. The main causes of excessive sleepiness is chronic sleep deprivation, sleep apnea syndrome, narcolepsy, movement disorders during sleep, circadian sleep disorders, use of drugs and medications, or idiopathic hypersomnia. Social, familial, work, and cognitive impairment are among the consequences of

  3. Cortical and Subcortical Grey and White Matter Atrophy in Myotonic Dystrophies Type 1 and 2 Is Associated with Cognitive Impairment, Depression and Daytime Sleepiness.

    Directory of Open Access Journals (Sweden)

    Christiane Schneider-Gold

    Full Text Available Central nervous system involvement is one important clinical aspect of myotonic dystrophy type 1 and 2 (DM1 and DM2. We assessed CNS involvement DM1 and DM2 by 3T MRI and correlated clinical and neuocognitive symptoms with brain volumetry and voxel-based morphometry (VBM.12 patients with juvenile or classical DM1 and 16 adult DM2 patients underwent 3T MRI, a thorough neurological and neuropsychological examination and scoring of depression and daytime sleepiness. Volumes of brain, ventricles, cerebellum, brainstem, cervical cord, lesion load and VBM results of the patient groups were compared to 33 matched healthy subjects.Clinical symptoms were depression (more pronounced in DM2, excessive daytime sleepiness (more pronounced in DM1, reduced attention and flexibility of thinking, and deficits of short-term memory and visuo-spatial abilities in both patient groups. Both groups showed ventricular enlargement and supratentorial GM and WM atrophy, with prevalence for more GM atrophy and involvement of the motor system in DM1 and more WM reduction and affection of limbic structures in DM2. White matter was reduced in DM1 in the splenium of the corpus callosum and in left-hemispheric WM adjacent to the pre- and post-central gyrus. In DM2, the bilateral cingulate gyrus and subgyral medio-frontal and primary somato-sensory WM was affected. Significant structural-functional correlations of morphological MRI findings (global volumetry and VBM with clinical findings were found for reduced flexibility of thinking and atrophy of the left secondary visual cortex in DM1 and of distinct subcortical brain structures in DM2. In DM2, depression was associated with brainstem atrophy, Daytime sleepiness correlated with volume decrease in the middle cerebellar peduncles, pons/midbrain and the right medio-frontal cortex.GM and WM atrophy was significant in DM1 and DM2. Specific functional-structural associations related morphological changes to cognitive impairment

  4. The relationship of sleepiness and blood pressure to respiratory variables in obstructive sleep apnea.

    Science.gov (United States)

    Mendelson, W B

    1995-10-01

    As a follow-up to a previous assessment of complications of sleep-disturbed breathing in 265 patients, we have reevaluated measures of sleepiness and hypertension in patients with obstructive sleep apnea (OSA) (n = 518), central sleep apnea (n = 50), and subclinical sleep-disordered breathing (SDB) (n = 107). Both subjective and objective (multiple sleep latency test [MSLT]) measures indicated that OSA patients were sleepier than those with subclinical SDB. The OSA patients weighed significantly more than the patients with central sleep apnea or subclinical SDB. They had a higher proportion of men, described more habitual sleepiness, and had a higher likelihood of feeling unrefreshed in the morning compared with the group with subclinical SDB. Among the OSA patients, there was a significant correlation between subjective and objective assessment of sleepiness, but this relationship was quantitatively very small. A forward stepwise regression analysis revealed that weight, and to a lesser degree waking time after sleep onset, could account for 65.5% of the variance in subjective sleepiness. Seventy-five percent of the variance of the mean sleep latency in the MSLT could be accounted for by the mean minimum arterial oxygen saturation in non-REM sleep and the nocturnal sleep latency. Diastolic BP was significantly higher in OSA patients compared with the patients with central sleep apnea and subclinical SDB. When covarying for weight, age, and gender, this effect lost significance. Among OSA patients taken by themselves, 98.3% of the variance in diastolic blood pressure could be accounted for by the mean minimum arterial oxygen saturation in non-REM sleep, with very small additional contributions of apnea/hypopnea index, weight, and age. In summary, among patients across a spectrum of SDB, differences in diastolic BP were primarily associated with weight, age, and gender. Among OSA patients, perhaps because of a more limited variance in weight, diastolic BP was

  5. 2 years outcome of thread lifting with absorbable barbed pdo threads: Innovative score for objective and subjective assessment.

    Science.gov (United States)

    Ali, Yasser Helmy

    2017-09-01

    Thread lifting rejuvenation procedures are re-evolved again, after developing of absorbable threads, with very popular spread among plastic surgeons and dermatologists but with little articles have been written in literature about absorbable threads. Objective to evaluate two years' outcome of absorbable barbed thread lifting used for facial rejuvenation. Prospective comparative study both objectively and subjectively and follow up assessment for 24 months. Thread lifting for face rejuvenation has significant long-lasting considerable skin lifting from 3-10 mm and high degree of patients' satisfaction with less incidence rate of complications about 4.8%. Augmented results are obtained when thread lifting is combined with other lifting and rejuvenation modalities. Significant facial rejuvenations are got by thread lifting and highly augmented results are observed when they are combined with Botox, fillers and/or platelet rich plasma (PRP) rejuvenations.

  6. Weak relationships between suppression of melatonin and suppression of sleepiness/fatigue in response to light exposure

    NARCIS (Netherlands)

    Ruger, M; Gordijn, MCM; Beersma, DGM; De Vries, B; Daan, S

    In this paper we examine the relationship between melatonin suppression and reduction of sleepiness through light by comparing three different data sets. In total 36 subjects participated in three studies and received 4 h of bright light either from midnight till 4:00 hours (experiments A and B) or

  7. Diagnostic performance of a CT-based scoring system for diagnosis of anastomotic leakage after esophagectomy: comparison with subjective CT assessment

    Energy Technology Data Exchange (ETDEWEB)

    Goense, Lucas; Rossum, Peter S.N. van [University Medical Center Utrecht, Department of Surgery, Utrecht (Netherlands); University Medical Center Utrecht, Department of Radiation Oncology, Utrecht (Netherlands); Stassen, Pauline M.C.; Ruurda, Jelle P.; Hillegersberg, Richard van [University Medical Center Utrecht, Department of Surgery, Utrecht (Netherlands); Wessels, Frank J.; Leeuwen, Maarten S. van [University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands)

    2017-10-15

    To develop a CT-based prediction score for anastomotic leakage after esophagectomy and compare it to subjective CT interpretation. Consecutive patients who underwent a CT scan for a clinical suspicion of anastomotic leakage after esophagectomy with cervical anastomosis between 2003 and 2014 were analyzed. The CT scans were systematically re-evaluated by two radiologists for the presence of specific CT findings and presence of an anastomotic leak. Also, the original CT interpretations were acquired. These results were compared to patients with and without a clinical confirmed leak. Out of 122 patients that underwent CT for a clinical suspicion of anastomotic leakage; 54 had a confirmed leak. In multivariable analysis, anastomotic leakage was associated with mediastinal fluid (OR = 3.4), esophagogastric wall discontinuity (OR = 4.9), mediastinal air (OR = 6.6), and a fistula (OR = 7.2). Based on these criteria, a prediction score was developed resulting in an area-under-the-curve (AUC) of 0.86, sensitivity of 80%, and specificity of 84%. The original interpretation and the systematic subjective CT assessment by two radiologists resulted in AUCs of 0.68 and 0.75 with sensitivities of 52% and 69%, and specificities of 84% and 82%, respectively. This CT-based score may provide improved diagnostic performance for diagnosis of anastomotic leakage after esophagectomy. (orig.)

  8. Excessive Daytime Sleepiness in Stroke Survivors: An Integrative Review.

    Science.gov (United States)

    Ding, Qinglan; Whittemore, Robin; Redeker, Nancy

    2016-07-01

    Excessive daytime sleepiness (EDS) is a prevalent symptom among stroke survivors. This symptom is an independent risk factor for stroke and may reduce stroke survivors' quality of life, cognitive functioning, and daytime functional performance. The lack of a universally accepted definition of EDS makes it difficult to measure EDS and synthesize research. The purpose of this integrative review is to describe poststroke EDS, ascertain conceptual and operational definitions of EDS, identify factors that contribute to EDS in stroke survivors, and explore outcomes associated with EDS in stroke survivors. We searched the following databases: PubMed and MEDLINE (OvidSP 1946-April; Week 2, 2015), Embase (OvidSP 1974-March; Week 1, 2015), and PsycINFO (OvidSP 1967-April; Week 2, 2015). Our search yielded 340 articles, 27 of which met inclusion criteria. The literature reveals EDS to be a multidimensional construct that is operationalized with both subjective and objective measures. Choosing measures that can quantify both the objective and subjective components is useful for gaining a comprehensive understanding of EDS. The antecedents of EDS are stroke, sleep-disordered breathing, reversed Robin Hood syndrome, and depression. The outcomes associated with EDS in stroke patients are serious and negative. Via synthesis of this research, we propose a possible framework for poststroke EDS, which may be of use in clinical practice and in research to identify valid quantifying methods for EDS as well as to prevent harmful outcomes in stroke survivors. © The Author(s) 2016.

  9. Evaluation of Physiological Indices to Indicate Sleepy or Relaxed States Using Illuminance Stimulation

    Science.gov (United States)

    Shibagaki, Yumi; Ogawa, Kozue; Hagiwara, Hiroshi

    The purpose of the present study was to clarify the ability of physiological indices to reflect the degree of sleepiness or relaxation of an individual due to stress, fatigue and other factors. Several studies have investigated the use of high-frequency (HF) components (0.15-0.40Hz) in heart rate variability to evaluate parasympathetic nervous activity. However, it has been difficult to assess the differences between states of sleepiness and relaxation using this method. In the present study, in order to evaluate the indices, two experimental illuminance conditions, 100 and 1,500 lx, reflecting differing states of arousal, were used during a cognitive judgment test lasting for 30 minutes. During the cognitive judgment test, electroencephalograms (EEG), electrocardiograms (ECG), physiological state and reaction time were measured, and results indicated that the two illuminance conditions could be differentiated from the recorded physiological data. More specifically, in the 1,500-lx condition, arousal level, activity level and test performance increased, and the level of HF components decreased. Opposite tendencies were observed in the 100-lx condition. Two indices of Lorenz plots (LP) at ECG RR intervals, center (C of LP) and ellipse area (S of LP), were subsequently determined from the physiological data. Subjects were then divided according to these LP indices based on their exhibited physiological responses, and we evaluated the effectiveness of the indices in differentiating between states of sleepiness and relaxation by comparing arousal level, psychological state, and reaction time. Results indicated that the C of LP and S of LP are possible indices for evaluating sleepiness or relaxation and suggest that these two indices may also be able to evaluate the relationship between physiological changes and other, subjective feelings.

  10. The Epworth Sleepiness Scale in Portuguese adults: from classical measurement theory to Rasch model analysis.

    Science.gov (United States)

    Sargento, Paulo; Perea, Victoria; Ladera, Valentina; Lopes, Paulo; Oliveira, Jorge

    2015-05-01

    The Epworth Sleepiness Scale (ESS) is a largely wide used scale for sleepiness assessment. Measurement properties are studied in a sample of Portuguese adults, using different statistical procedures. The sample consisted of 222 Portuguese adults (97 men and 125 women) with a mean age of 42 years old (SD = 12.5), 46 of which had obstructive sleep apnea (OSA) confirmed by polysomnography. The participants were assessed with the ESS, which was tested through a quantitative analysis based on the classical measurement theory (CMT) or the Rasch model (RM) conventions. A principal component factor analysis was performed according to the CMT, revealing a single factor explaining 39.92% of the total variance of the scale. Internal consistency measured by Cronbach's α coefficient was of .77. The mean of inter-item correlation was of .31 (.05  .47), whereas the item-total correlations were considered good (.46  .73). The ESS total score for OSA patients was significantly higher than healthy participants (p measure for assessing sleepiness in Portuguese adults.

  11. Sleep duration and its association with sleepiness and depression in "ronin-sei" preparatory school students.

    Science.gov (United States)

    Matsushita, Masateru; Koyama, Asuka; Ushijima, Hirokage; Mikami, Akira; Katsumata, Yotaro; Kikuchi, Yoko; Ichimi, Naoko; Jono, Tadashi; Fujise, Noboru; Ikeda, Manabu

    2014-06-01

    The Japanese word "ronin-sei" refers to a student who has failed their university entrance examination and is preparing to re-take the examination in the following year. We aimed to determine how sleep duration is associated with daytime sleepiness or depression in ronin-sei because impaired daytime performance is known to result from sleep deprivation. The participants in this cross-sectional study were 1075 ronin-sei and 285 university students. Sleepiness and depressive symptoms were assessed using the Epworth Sleepiness Scale (ESS) and the Center for Epidemiologic Studies Depression Scale (CES-D), respectively. Ronin-sei had significantly shorter sleep duration and earlier bed- and rise-times than university students. There was no significant difference in CES-D between the groups; however, the ESS score of university students was significantly higher than that of ronin-sei. Ronin-sei who slept for 5 to Sleep deprivation appears to be common among ronin-sei. Furthermore, a U-shaped relationship was found between sleep duration and depressive symptoms, revealing that ronin-sei who had too little or too much sleep were more likely to exhibit an increase in depressive symptoms. Copyright © 2014 Elsevier B.V. All rights reserved.

  12. Irregular sleep habits of parents are associated with increased sleep problems and daytime sleepiness of children.

    Science.gov (United States)

    Komada, Yoko; Adachi, Naomi; Matsuura, Noriko; Mizuno, Koh; Hirose, Kazuhiro; Aritomi, Ryoji; Shirakawa, Shuichiro

    2009-10-01

    Longitudinal studies in Japan indicate that nocturnal sleep onset has become later and sleep duration has been progressively shortened. This study aimed to investigate the relationship between sleep patterns and sleep problems among children, and to determine the association between parents and their children's sleep habits. Questionnaires about sleep problems and life habits were administered to families living in Tokyo metropolitan areas of Japan. We analyzed the data of pre-school-age (1-5 years old; n = 319, including 175 girls) and elementary school-age children (6-11 years; n = 217, including 116 girls) as well as their parents (402 mothers: 37.0 +/- 4.9 years, 402 fathers: 39.0 +/- 5.9 years). Subjects were categorized as morning (evening) type when they answered their lifestyle habit as "definitely or moderately morning (evening) type". Sleep was categorized into regular, irregular, and intermediate from the sleeping-waking regularity scores. The frequency of daytime dozing is significantly high in children with evening-irregular sleep. Moreover, mothers of children (aged 1-5 and 6-11 years) with evening-irregular sleep have significantly more irregular sleep habits than those of children with morning-regular sleep. Likewise, fathers of children (aged 1-5 years) with evening-irregular sleep have significantly more irregular sleep habits. Thus, irregular late bedtime of parents is associated with sleep problems, daytime sleepiness, and irregular dietary habits of children. Mothers' sleep habits have a stronger influence on their children's sleep than fathers'. Our study indicates the importance of promoting sleep hygiene that encourages healthy sleep for all family members.

  13. Self-reported sleep, sleepiness, and repeated alcohol withdrawals: a randomized, double blind, controlled comparison of lorazepam vs gabapentin.

    Science.gov (United States)

    Malcolm, Robert; Myrick, L Hugh; Veatch, Lynn M; Boyle, Elizabeth; Randall, Patrick K

    2007-02-15

    Insomnia is a central symptom of alcohol withdrawal and increases relapse potential. The primary objective of this study was to compare the efficacy of gabapentin to lorazepam in alleviating sleep disturbances and daytime sleepiness during an episode of alcohol withdrawal. The secondary objective of this study was to determine if drug treatment efficacy differed by the patient history of previous treatments for alcohol withdrawal. Outpatients in treatment for alcohol withdrawal received a 4-day fixed-dose taper of gabapentin or lorazepam in a double-blind, randomized, controlled trial with an 8-day follow-up. Daily across a 5 day outpatient treatment and Days 7 and 12 post-treatment, patients self-reported daytime sleepiness using the Epworth Sleepiness Scale. Self-reports of depression (Beck Depression Inventory) were completed at Days 1, 5, 7 and 12. Staff assessed daily alcohol withdrawal using the Clinical Institute Withdrawal Assessment for Alcohol. From these instruments, self-reported sleep and sleepiness were extracted and assessed in the context of limited (0-1) or multiple (2 or more) previously treated alcohol withdrawal episodes. Patients with limited previous withdrawals reported similar treatment effects on self-reports of sleep and sleepiness for gabapentin and lorazepam. In contrast, patients with multiple previous alcohol withdrawals receiving gabapentin reported reduced sleep disturbances and sleepiness in comparison to those receiving lorazepam. During treatment for alcohol withdrawal, gabapentin as compared to standard therapy with lorazepam, was superior on multiple sleep measures, in patients who had previous withdrawals. Lorazepam subjects experienced rebound symptoms. Early drinking was related to persisting insomnia with both drugs.

  14. Toxoplasma-infected subjects report an Obsessive-Compulsive Disorder diagnosis more often and score higher in Obsessive-Compulsive Inventory.

    Science.gov (United States)

    Flegr, J; Horáček, J

    2017-02-01

    Latent toxoplasmosis, the life-long presence of dormant stages of Toxoplasma in immunoprivileged organs and of anamnestic IgG antibodies in blood, affects about 30% of humans. Infected subjects have an increased incidence of various disorders, including schizophrenia. Several studies, as well as the character of toxoplasmosis-associated disturbance of neurotransmitters, suggest that toxoplasmosis could also play an etiological role in Obsessive-Compulsive Disorder (OCD). The aim of the present cross-sectional study performed on a population of 7471 volunteers was to confirm the association between toxoplasmosis and OCD, and toxoplasmosis and psychological symptoms of OCD estimated by the standard Obsessive-Compulsive Inventory-Revised (OCI-R). Incidence of OCD was 2.18% (n=39) in men and 2.28% (n=83) in women. Subjects with toxoplasmosis had about a 2.5 times higher odds of OCD and about a 2.7 times higher odds of learning disabilities. The incidence of 18 other neuropsychiatric disorders did not differ between Toxoplasma-infected and Toxoplasma-free subjects. The infected subjects, even the OCD-free subjects, scored higher on the OCI-R. Examined subjects provided the information about their toxoplasmosis and OCD statuses themselves, which could result in underrating the strength of observed associations. The results confirmed earlier reports of the association between toxoplasmosis and OCD. They also support recent claims that latent toxoplasmosis is in fact a serious disease with many impacts on quality of life of patients. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  15. Measuring driver impairments: sleepiness, distraction, and workload.

    Science.gov (United States)

    Ahlstrom, Christer; Kircher, Katja; Fors, Carina; Dukic, Tania; Patten, Christopher; Anund, Anna

    2012-03-01

    Snow was falling heavily when Sarah was driving on a slippery road to her cousin's country cottage. It was dark outside, and the visibility was poor. She had planned to arrive before sunset, but the rental service had made a mistake, and it took hours before she got her rental car at the airport. It was past midnight now, and after a long day of traveling, Sarah was starting to get sleepy. Fortunately, there were only 15 km to go, but her eyelids were starting to feel heavy. To stay awake, she put her favorite CD on, turned up the volume, and started to sing along. This seemed to help a little-good-only 10 km to go. This was when Sarah's phone started ringing, and she awkwardly tried to find the mute button for the car stereo while answering the phone. As she looked up again, she barely caught a glimpse of the red brake lights of the car in front of her as she smashed into it.

  16. A Methodology of Analysis for Monitoring Treatment Progression with 19-Channel Z-Score Neurofeedback (19ZNF) in a Single-Subject Design.

    Science.gov (United States)

    Krigbaum, Genomary; Wigton, Nancy L

    2015-09-01

    19-Channel Z-Score Neurofeedback (19ZNF) is a modality using 19-electrodes with real-time normative database z-scores, suggesting effective clinical outcomes in fewer sessions than traditional neurofeedback. Thus, monitoring treatment progression and clinical outcome is necessary. The area of focus in this study was a methodology of quantitative analysis for monitoring treatment progression and clinical outcome with 19ZNF. This methodology is noted as the Sites-of-Interest, which included repeated measures analyses of variance (rANOVA) and t-tests for z-scores; it was conducted on 10 cases in a single subject design. To avoid selection bias, the 10 sample cases were randomly selected from a pool of 17 cases that met the inclusion criteria. Available client outcome measures (including self-report) are briefly discussed. The results showed 90% of the pre-post comparisons moved in the targeted direction (z = 0) and of those, 96% (80% Bonferroni corrected) of the t-tests and 96% (91% Bonferroni corrected) of the rANOVAs were statistically significant; thus indicating a progression towards the mean in 15 or fewer 19ZNF sessions. All cases showed and reported improvement in all outcome measures (including quantitative electroencephalography assessment) at case termination.

  17. Excessive sleepiness is predictive of cognitive decline in the elderly.

    Science.gov (United States)

    Jaussent, Isabelle; Bouyer, Jean; Ancelin, Marie-Laure; Berr, Claudine; Foubert-Samier, Alexandra; Ritchie, Karen; Ohayon, Maurice M; Besset, Alain; Dauvilliers, Yves

    2012-09-01

    To examine the association of sleep complaints reported at baseline (insomnia complaints and excessive daytime sleepiness (EDS)) and medication, with cognitive decline in community-dwelling elderly. An 8-yr longitudinal study. The French Three-City Study. There were 4,894 patients without dementia recruited from 3 French cities and having a Mini-Mental Status Examination (MMSE) score ≥ 24 points at baseline. Questionnaires were used to evaluate insomnia complaints (poor sleep quality (SQ), difficulty in initiating sleep (DIS), difficulty in maintaining sleep (DMS), early morning awakening (EMA)), EDS, and sleep medication at baseline. Cognitive decline was defined as a 4-point reduction in MMSE score during follow-up at 2, 4, and 8 yr. Logistic regression models were adjusted for sociodemographic, behavioral, physical, and mental health variables, and apolipoprotein E genotype. EDS independently increased the risk of cognitive decline (odds ratio (OR) = 1.26, 95% confidence interval (CI) = 1.02-1.56), especially for those patients who also developed dementia during the follow-up period (OR = 1.39, 95% CI = 1.00-1.97). The number of insomnia complaints and DMS were negatively associated with MMSE cognitive decline (OR = 0.77, 95% CI = 0.60-0.98 for 3-4 complaints, OR = 0.81, 95% CI = 0.68-0.96, respectively). The 3 other components of insomnia (SQ, DIS, EMA) were not significantly associated with MMSE cognitive decline. Our results suggest that EDS may be associated independently with the risk of cognitive decline in the elderly population. Such results could have important public health implications because EDS may be an early marker and potentially reversible risk factor of cognitive decline and onset of dementia.

  18. Excessive Daytime Sleepiness and Epilepsy: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Andre S. Giorelli

    2013-01-01

    Full Text Available Background. Sleep complaints are common in patients with epilepsy (PWE. Excessive daytime sleepiness (EDS is one of the most reported complaints and its impact is still a matter of debate. Objective. Evaluate the relationship between EDS and epilepsy, with emphasis on prevalence, assessment, and causes. Methods. A systematic review on PubMed database in the last 10 years (2002 to 2012. The search returned 53 articles and 34 were considered relevant. After citation analysis, 3 more articles were included. Results. Most studies were cross-sectional and questionnaire based. 14 papers addressed EDS as the primary endpoint. 14 adult and 3 children studies used subjective and objective analysis as methodology. The number of studies increased throughout the decade, with 21 in the last 5 years. Adult studies represent almost three times the number of children studies. EDS prevalence in PWE varies from 10 to 47.5%. Prevalence was higher in developing countries. Conclusion. EDS seems to be related more frequently to undiagnosed sleep disorders than to epilepsy-related factors, and although it affects the quality of life of PWE, it can be improved by treating comorbid primary sleep disorders.

  19. Excessive daytime sleepiness and epilepsy: a systematic review.

    Science.gov (United States)

    Giorelli, Andre S; Passos, Pâmela; Carnaval, Thiago; Gomes, Marleide da Mota

    2013-01-01

    Background. Sleep complaints are common in patients with epilepsy (PWE). Excessive daytime sleepiness (EDS) is one of the most reported complaints and its impact is still a matter of debate. Objective. Evaluate the relationship between EDS and epilepsy, with emphasis on prevalence, assessment, and causes. Methods. A systematic review on PubMed database in the last 10 years (2002 to 2012). The search returned 53 articles and 34 were considered relevant. After citation analysis, 3 more articles were included. Results. Most studies were cross-sectional and questionnaire based. 14 papers addressed EDS as the primary endpoint. 14 adult and 3 children studies used subjective and objective analysis as methodology. The number of studies increased throughout the decade, with 21 in the last 5 years. Adult studies represent almost three times the number of children studies. EDS prevalence in PWE varies from 10 to 47.5%. Prevalence was higher in developing countries. Conclusion. EDS seems to be related more frequently to undiagnosed sleep disorders than to epilepsy-related factors, and although it affects the quality of life of PWE, it can be improved by treating comorbid primary sleep disorders.

  20. Residual sleepiness after N2O sedation: a randomized control trial [ISRCTN88442975

    Directory of Open Access Journals (Sweden)

    Lichtor J Lance

    2004-05-01

    Full Text Available Abstract Background Nitrous oxide (N2O provides sedation for procedures that result in constant low-intensity pain. How long do individuals remain sleepy after receiving N2O? We hypothesized that drug effects would be apparent for an hour or more. Methods This was a randomized, double blind controlled study. On three separate occasions, volunteers (N = 12 received 100% oxygen or 20% or 40% N2O for 30 min. Dependent measures included the multiple sleep latency test (MSLT, a Drug Effects/Liking questionnaire, visual analogue scales, and five psychomotor tests. Repeated measures analysis of variance was performed with drug and time as factors. Results During inhalation, drug effects were apparent based on the questionnaire, visual analogue scales, and psychomotor tests. Three hours after inhaling 100% oxygen or 20% N2O, subjects were sleepier than if they breathed 40% N2O. No other drug effects were apparent 1 hour after inhalation ceased. Patients did not demonstrate increased sleepiness after N2O inhalation. Conclusion We found no evidence for increased sleepiness greater than 1 hour after N2O inhalation. Our study suggests that long-term effects of N2O are not significant.

  1. Snoring, sleep quality, and sleepiness across attention-deficit/hyperactivity disorder subtypes.

    Science.gov (United States)

    LeBourgeois, Monique K; Avis, Kristin; Mixon, Michele; Olmi, Joe; Harsh, John

    2004-05-01

    To characterize the relationship between pediatric attention-deficit/hyperactivity disorder (ADHD) subtypes, chronic snoring, and indexes of sleep quality and daytime sleepiness. A cross-sectional design with planned comparisons of ADHD (all subtypes) versus general community controls; ADHD Predominantly Inattentive Type (ADHD-I) versus a group with both ADHD Predominantly Hyperactive/Impulsive Type (ADHD-HI) and ADHD Combined Type (ADHD-C); and ADHD-HI versus ADHD-C. Subjects recruited from a pediatric clinic, a university psycholgy clinic, and the general community. Caretakers of 74 children (45 with ADHD, 29 community controls; 53 boys, 21 girls; mean age, 9.6 years; age range, 6 to 16 years). Thirty-two (71.1%) of the children with ADHD were taking stimulant medication and 7 (15.5%) were taking hypnotic medication. N/A. Caretakers completed the Pediatric Sleep Questionnaire (PSQ) and the Children's Sleep-Wake Scale (CSWS). Only the ADHD-HI diagnosis was associated with an increased likelihood of chronic snoring. Sleep quality was poorer among children with ADHD than controls; however, there were no differences in sleep quality across ADHD subtypes. Sleepiness was greater in children with ADHD, especially the ADHD-I Type. Chronic snoring may be a correlated feature in only a subgroup of the ADHD population, possibly those more likely to be diagnosed with ADHD-HI. Although children with ADHD have poorer sleep quality and greater daytime sleepiness, these 2 features of ADHD are not closely related.

  2. Daytime sleepiness associated with poor sustained attention in middle and late adulthood.

    Science.gov (United States)

    Yun, Chang-Ho; Kim, Hyun; Lee, Seung Ku; Suh, Sooyeon; Lee, Seung Hoon; Park, Seong-Ho; Thomas, Robert J; Au, Rhoda; Shin, Chol

    2015-01-01

    We aimed to determine the association between psychomotor vigilance task (PVT) performance and sleep-related factors including sleep duration, daytime sleepiness, poor sleep quality, insomnia, and habitual snoring in a population-based sample. This was a cross-sectional analysis from the ongoing prospective cohort study, the Korean Genome and Epidemiology Study. We measured PVT performance and documented demographics, sleep-related factors, life style, and medical conditions in community dwelling adults (N = 2499; mean age 57.1 ± 7.3; male 1259). Associations between PVT parameters and sleep-related factors were tested, adjusting for age, gender, smoking, alcohol use, education, body mass index, hypertension, diabetes, depression, and the interval between mid-sleep time and PVT test. High Epworth Sleepiness Scale (ESS, ≥8) was associated with slower mean reciprocal response speed (mean RRT) (3.69 ± 0.02 vs. 3.77 ± 0.01, p sleep and PVT test were also associated with poor performance. Sleep duration, habitual snoring, insomnia, or poor sleep quality (the Pittsburgh Sleep Quality Index score > 5) was not related to PVT parameters. At the population level, our results revealed important modifiers of PVT performance, which included subjective reports of daytime sleepiness. Copyright © 2014 Elsevier B.V. All rights reserved.

  3. Consequences of Split Shift Work in Indian Traffic Police Personnel: Daytime Sleepiness, Stressors and Psychological Distress

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    Rakesh Kumar Soni

    2016-12-01

    Full Text Available The present study was aimed to measure the daily routine preference, daytime sleepiness, and psychological distress experiences, because of split shift system job in a sample in traffic police personnel of Raipur city, India. To measure such parameters we used the Morningness-Eveningness Questionnaire, Epworth Sleepiness Scale (ESS, Operational Police Stress Questionnaire (OPSQ, General Health Questionnaire and the Distress. To evaluate differences between age, body mass index, period of service length and drug / alcohol use for all the subjects (traffic police personnel the t-test and chi-square test were used. Total Hundred male traffic police personnel participated and out of which most of them were found to belong in the evening active category. This study also indicates increased prevalence of excessive daytime sleepiness and (EDS high level of psychological distress as measured by the GHQ-12 among few police workers. Moreover, a number of participants reported significant distress levels, when measured with distress thermometer. In nutshell, the study sample suggests adaptive coping strategies of traffic police personnel working in split shift system profession can be attributed to their evening (E-type circadian preferences.

  4. Which diagnostic findings in disorders with excessive daytime sleepiness are really helpful? A retrospective study.

    Science.gov (United States)

    Kretzschmar, Ute; Werth, Esther; Sturzenegger, Christian; Khatami, Ramin; Bassetti, Claudio L; Baumann, Christian R

    2016-06-01

    Due to extensive clinical and electrophysiological overlaps, the correct diagnosis of disorders with excessive daytime sleepiness is often challenging. The aim of this study was to provide diagnostic measures that help discriminating such disorders, and to identify parameters, which don't. In this single-center study, we retrospectively identified consecutive treatment-naïve patients who suffered from excessive daytime sleepiness, and analyzed clinical and electrophysiological measures in those patients in whom a doubtless final diagnosis could be made. Of 588 patients, 287 reported subjective excessive daytime sleepiness. Obstructive sleep apnea is the only disorder that could be identified by polysomnography alone. The diagnosis of insufficient sleep syndrome relies on actigraphy as patients underestimate their sleep need and the disorder shares several clinical and electrophysiological properties with both narcolepsy type 1 and idiopathic hypersomnia. Sleep stage sequencing on MSLT appears helpful to discriminate between insufficient sleep syndrome and narcolepsy. Sleep inertia is a strong indicator for idiopathic hypersomnia. There are no distinctive electrophysiological findings for the diagnosis of restless legs syndrome. Altogether, EDS disorders are common in neurological sleep laboratories, but usually cannot be diagnosed based on PSG and MSLT findings alone. The diagnostic value of actigraphy recordings can hardly be overestimated. © 2016 European Sleep Research Society.

  5. Sleep patterns and school performance of Korean adolescents assessed using a Korean version of the pediatric daytime sleepiness scale

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    Seon kyeong Rhie

    2011-01-01

    Full Text Available Purpose: Korean adolescents have severe nighttime sleep deprivation and daytime sleepiness because of their competitive educational environment. However, daytime sleep patterns and sleepiness have never been studied using age-specific methods, such as the pediatric daytime sleepiness scale (PDSS. We surveyed the daytime sleepiness of Korean adolescents using a Korean translation of the PDSS. Methods: We distributed the 27-item questionnaire, including the PDSS and questions related to sleep pattern, sleep satisfaction, and emotional state, to 3,370 students in grades 5-12. Results: The amount of nighttime sleep decreased significantly with increasing age. During weekday nights, 5- 6th graders slept for 7.95¡?#?.05; h, 7-9th graders for 7.57¡?#?.05; h, and 10-12th graders for 5.78¡?#?.13; h. However, the total amounts of combined daytime and nighttime sleep during weekdays were somewhat greater, 8.15¡?#?.12; h for 5- 6th graders, 8.17¡?#?.20; h for 7-9th graders, and 6.87¡?#?.40; h for 10-12th graders. PDSS scores increased with age, 11.89¡?#?.56; for 5- 6th graders, 16.57¡?#?.57; for 7-9th graders, and 17.71¡?#?.24; for 10-12th graders. Higher PDSS scores were positively correlated with poor school performance and emotional instability. Conclusion: Korean teenagers sleep to an unusual extent during the day because of nighttime sleep deprivation. This negatively affects school performance and emotional stability. A Korean translation of the PDSS was effective in evaluating the severity of daytime sleepiness and assessing the emotional state and school performance of Korean teenagers.

  6. Sleep patterns and school performance of Korean adolescents assessed using a Korean version of the pediatric daytime sleepiness scale.

    Science.gov (United States)

    Rhie, Seonkyeong; Lee, Sihyoung; Chae, Kyu Young

    2011-01-01

    Korean adolescents have severe nighttime sleep deprivation and daytime sleepiness because of their competitive educational environment. However, daytime sleep patterns and sleepiness have never been studied using age-specific methods, such as the pediatric daytime sleepiness scale (PDSS). We surveyed the daytime sleepiness of Korean adolescents using a Korean translation of the PDSS. We distributed the 27-item questionnaire, including the PDSS and questions related to sleep pattern, sleep satisfaction, and emotional state, to 3,370 students in grades 5-12. The amount of nighttime sleep decreased significantly with increasing age. During weekday nights, 5-6(th) graders slept for 7.95±1.05 h, 7-9(th) graders for 7.57±1.05 h, and 10-12(th) graders for 5.78±1.13 h. However, the total amounts of combined daytime and nighttime sleep during weekdays were somewhat greater, 8.15±1.12 h for 5-6(th) graders, 8.17±1.20 h for 7-9(th) graders, and 6.87±1.40 h for 10-12(th) graders. PDSS scores increased with age, 11.89±5.56 for 5-6(th) graders, 16.57±5.57 for 7-9(th) graders, and 17.71±5.24 for 10-12(th) graders. Higher PDSS scores were positively correlated with poor school performance and emotional instability. Korean teenagers sleep to an unusual extent during the day because of nighttime sleep deprivation. This negatively affects school performance and emotional stability. A Korean translation of the PDSS was effective in evaluating the severity of daytime sleepiness and assessing the emotional state and school performance of Korean teenagers.

  7. A case-control field study on the relationships among type 2 diabetes, sleepiness and habitual caffeine intake.

    Science.gov (United States)

    Urry, Emily; Jetter, Alexander; Holst, Sebastian C; Berger, Wolfgang; Spinas, Giatgen A; Langhans, Wolfgang; Landolt, Hans-Peter

    2017-02-01

    The purpose of this study was to examine the possible links between type 2 diabetes, daytime sleepiness, sleep quality and caffeine consumption. In this case-control field study, comparing type 2 diabetic ( n=134) and non-type 2 diabetic ( n=230) participants, subjects completed detailed and validated questionnaires to assess demographic status, health, daytime sleepiness, sleep quality and timing, diurnal preference, mistimed circadian rhythms and habitual caffeine intake. All participants gave saliva under standardised conditions for CYP1A2 genotyping and quantification of caffeine concentration. Hierarchical linear regression analyses examined whether type 2 diabetes status was associated with caffeine consumption. Type 2 diabetic participants reported greater daytime sleepiness ( p=0.001), a higher prevalence of sleep apnoea ( p=0.005) and napping ( p=0.008), and greater habitual caffeine intake ( pconsumption of an extra cup of coffee each day. This finding was confirmed by higher saliva caffeine concentration at bedtime ( p=0.01). Multiple regression analyses revealed that type 2 diabetes status was associated with higher self-reported caffeine consumption ( pcaffeine ( pcaffeine intake. Subjective sleep and circadian estimates were similar between case and control groups. Type 2 diabetic patients may self-medicate with caffeine to alleviate daytime sleepiness. High caffeine intake reflects a lifestyle factor that may be considered when promoting type 2 diabetes management.

  8. Does more sleep matter? Differential effects of NREM- and REM-dominant sleep on sleepiness and vigilance.

    Science.gov (United States)

    Neu, D; Mairesse, O; Newell, J; Verbanck, P; Peigneux, P; Deliens, G

    2015-05-01

    We investigated effects of NREM and REM predominant sleep periods on sleepiness and psychomotor performances measured with visual analog scales and the psychomotor vigilance task, respectively. After one week of stable sleep-wake rhythms, 18 healthy sleepers slept 3hours of early sleep and 3hours of late sleep, under polysomnographic control, spaced by two hours of sustained wakefulness between sleep periods in a within subjects split-night, sleep interruption protocol. Power spectra analysis was applied for sleep EEG recordings and sleep phase-relative power proportions were computed for six different frequency bands (delta, theta, alpha, sigma, beta and gamma). Both sleep periods presented with similar sleep duration and efficiency. As expected, phasic NREM and REM predominances were obtained for early and late sleep conditions, respectively. Albeit revealing additive effects of total sleep duration, our results showed a systematic discrepancy between psychomotor performances and sleepiness levels. In addition, sleepiness remained stable throughout sustained wakefulness during both conditions, whereas psychomotor performances even decreased after the second sleep period. Disregarding exchanges for frequency bands in NREM or stability in REM, correlations between outcome measures and EEG power proportions further evidenced directional divergence with respect to sleepiness and psychomotor performances, respectively. Showing that the functional correlation pattern changed with respect to early and late sleep condition, the relationships between EEG power and subjective or behavioral outcomes might however essentially be related to total sleep duration rather than to the phasic predominance of REM or NREM sleep. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  9. Entorhinal cortex volume measured with 3T MRI is positively correlated with the Wechsler Memory Scale-Revised logical/verbal memory score for healthy subjects.

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    Goto, Masami; Abe, Osamu; Miyati, Tosiaki; Yoshikawa, Takeharu; Hayashi, Naoto; Takao, Hidemasa; Inano, Sachiko; Kabasawa, Hiroyuki; Mori, Harushi; Kunimatsu, Akira; Aoki, Shigeki; Ino, Kenji; Iida, Kyouhito; Yano, Keiichi; Ohtomo, Kuni

    2011-08-01

    Previous studies revealed a correlation between local brain volume and cognitive function. The aim of the present study was to investigate the correlation between local gray matter volume and the Wechsler Memory Scale-Revised (WMS-R) logical/verbal memory (WMS-R-verbal) score in healthy adults using a 3 Tesla magnetic resonance scanner and voxel-based morphometry (VBM). T1-weighted magnetic resonance images were obtained in 1,169 healthy adults. The T1-weighted images in native space were bias-corrected, spatially normalized, and segmented into gray matter, white matter, and cerebrospinal fluid images with Statistical Parametric Mapping 5. To investigate regionally the specific effects of the WMS-R-verbal score on the gray matter images, simple regression analysis was performed by VBM treating age, total intracranial volume, and gender as confounding covariates. A P value of less than 0.05 corrected with false discovery rate in voxel difference was considered to be statistically significant. Our study showed a significant positive correlation between the WMS-R-verbal score and the bilateral entorhinal cortex volume. In the right entorhinal, T value is 4.75, and the size of the clusters is 155 voxels. In the left entorhinal, T value is 4.08, and the size of the clusters is 23 voxels. A significant negative correlation was not found. To our knowledge, this is the first VBM study showing that entorhinal cortex volume is positively correlated with the WMS-R-verbal score for healthy subjects. Therefore, in our structural neuroimaging study, we add evidence to the hypothesis that the entorhinal cortex is involved in verbal memory processing.

  10. Entorhinal cortex volume measured with 3T MRI is positively correlated with the Wechsler memory scale-revised logical/verbal memory score for healthy subjects

    Energy Technology Data Exchange (ETDEWEB)

    Goto, Masami [University of Tokyo Hospital, Department of Radiological Technology, Graduate School of Medicine, Tokyo (Japan); Kanazawa University, Tsunomatyou, Graduate School of Medical Science, Kanazawa (Japan); Abe, Osamu; Takao, Hidemasa; Inano, Sachiko; Mori, Harushi; Kunimatsu, Akira; Ohtomo, Kuni [University of Tokyo Hospital, Department of Radiology, Tokyo (Japan); Miyati, Tosiaki [Kanazawa University, Tsunomatyou, Graduate School of Medical Science, Kanazawa (Japan); Yoshikawa, Takeharu; Hayashi, Naoto [University of Tokyo Hospital, Department of Computational Diagnostic Radiology and Preventive Medicine, Tokyo (Japan); Kabasawa, Hiroyuki [GE Healthcare, Japan Applied Science Laboratory, Hino (Japan); Aoki, Shigeki [Juntendo University, Department of Radiology, Tokyo (Japan); Ino, Kenji; Iida, Kyouhito; Yano, Keiichi [University of Tokyo Hospital, Department of Radiological Technology, Graduate School of Medicine, Tokyo (Japan)

    2011-08-15

    Previous studies revealed a correlation between local brain volume and cognitive function. The aim of the present study was to investigate the correlation between local gray matter volume and the Wechsler Memory Scale-Revised (WMS-R) logical/verbal memory (WMS-R-verbal) score in healthy adults using a 3 Tesla magnetic resonance scanner and voxel-based morphometry (VBM). T1-weighted magnetic resonance images were obtained in 1,169 healthy adults. The T1-weighted images in native space were bias-corrected, spatially normalized, and segmented into gray matter, white matter, and cerebrospinal fluid images with Statistical Parametric Mapping 5. To investigate regionally the specific effects of the WMS-R-verbal score on the gray matter images, simple regression analysis was performed by VBM treating age, total intracranial volume, and gender as confounding covariates. A P value of less than 0.05 corrected with false discovery rate in voxel difference was considered to be statistically significant. Our study showed a significant positive correlation between the WMS-R-verbal score and the bilateral entorhinal cortex volume. In the right entorhinal, T value is 4.75, and the size of the clusters is 155 voxels. In the left entorhinal, T value is 4.08, and the size of the clusters is 23 voxels. A significant negative correlation was not found. To our knowledge, this is the first VBM study showing that entorhinal cortex volume is positively correlated with the WMS-R-verbal score for healthy subjects. Therefore, in our structural neuroimaging study, we add evidence to the hypothesis that the entorhinal cortex is involved in verbal memory processing. (orig.)

  11. Validation of a modified Hindi version of the Epworth Sleepiness Scale among a North Indian population.

    Science.gov (United States)

    Bajpai, Geetika; Shukla, Garima; Pandey, Ravindra M; Gupta, Anupama; Afsar, Mohammed; Goyal, Vinay; Srivastava, Achal; Behari, Madhuri

    2016-01-01

    Since a majority of population in India does not drive automobiles, one item on the Epworth Sleepiness Scale (ESS) requires modification and validation. In addition, data collected by us indicated that a majority of rural and urban Indians regularly spend time in prayer/spiritual activity. The main purpose of this study was to develop a cross-cultural adaptation of the ESS for a North Indian population, in Hindi language (ESS-I). The study also provides evidence of reliability and validity of the modified version. The subjects included were normal volunteers aged 18-75 years (Group 1) (n = 70), compared with patients with complaints of excessive daytime sleepiness, who had undergone polysomnography (Group 2) (n = 22) and patients who had undergone multiple sleep latency test (Group 3) (n = 10). The study was carried out in four phases: Translation and retranslation of the original scale with modification of item 8 (mainly addition of option of question on "while offering prayers or in spiritual activity"); reliability (test-retest) (n = 30); internal consistency (using Cronbach's alpha index) (n = 102); and sensitivity to change (n = 8). Group 1 showed spiritual activity as a significantly more commonly practiced activity than driving. The Cronbach's alpha for the modified version was 0.892 (excellent), and this was not improved by removing the modified item. The alpha value for Group 1 versus Groups 2 and 3 was 0.667 and 0.892, respectively. The scale was reliable over time (test-retest), and it was sensitive to sleepiness change in patients with obstructive sleep apnea during treatment. The ESS-I, is comparable to the original scale. It is reliable, valid, and change-sensitive. It is proposed that the modified version can be very useful for detecting sleepiness among Indian population, especially those who do not drive their own vehicles.

  12. Timed Light Therapy for Sleep and Daytime Sleepiness Associated With Parkinson Disease: A Randomized Clinical Trial.

    Science.gov (United States)

    Videnovic, Aleksandar; Klerman, Elizabeth B; Wang, Wei; Marconi, Angelica; Kuhta, Teresa; Zee, Phyllis C

    2017-04-01

    Impaired sleep and alertness are some of the most common nonmotor manifestations of Parkinson disease (PD) and currently have only limited treatment options. Light therapy (LT), a widely available treatment modality in sleep medicine, has not been systematically studied in the PD population. To determine the safety and efficacy of LT on excessive daytime sleepiness (EDS) associated with PD. This randomized, placebo-controlled, clinical intervention study was set in PD centers at Northwestern University and Rush University. Participants were 31 patients with PD receiving stable dopaminergic therapy with coexistent EDS, as assessed by an Epworth Sleepiness Scale score of 12 or greater, and without cognitive impairment or primary sleep disorder. Participants were randomized 1:1 to receive bright LT or dim-red LT (controlled condition) twice daily in 1-hour intervals for 14 days. This trial was conducted between March 1, 2007, and October 31, 2012. Data analysis of the intention-to-treat population was conducted from November 1, 2012, through April 30, 2016. The primary outcome measure was the change in the Epworth Sleepiness Scale score comparing the bright LT with the dim-red LT. Secondary outcome measures included the Pittsburgh Sleep Quality Index score, the Parkinson's Disease Sleep Scale score, the visual analog scale score for daytime sleepiness, and sleep log-derived and actigraphy-derived metrics. Among the 31 patients (13 males and 18 females; mean [SD] disease duration, 5.9 [3.6] years), bright LT resulted in significant improvements in EDS, as assessed by the Epworth Sleepiness Scale score (mean [SD], 15.81 [3.10] at baseline vs 11.19 [3.31] after the intervention). Both bright LT and dim-red LT were associated with improvements in sleep quality as captured by mean (SD) scores on the Pittsburg Sleep Quality Index (7.88 [4.11] at baseline vs 6.25 [4.27] after bright LT, and 8.87 [2.83] at baseline vs 7.33 [3.52] after dim-red LT) and the Parkinson's Disease

  13. A survey study of the association between mobile phone use and daytime sleepiness in California high school students.

    Science.gov (United States)

    Nathan, Nila; Zeitzer, Jamie

    2013-09-12

    Mobile phone use is near ubiquitous in teenagers. Paralleling the rise in mobile phone use is an equally rapid decline in the amount of time teenagers are spending asleep at night. Prior research indicates that there might be a relationship between daytime sleepiness and nocturnal mobile phone use in teenagers in a variety of countries. As such, the aim of this study was to see if there was an association between mobile phone use, especially at night, and sleepiness in a group of U.S. teenagers. A questionnaire containing an Epworth Sleepiness Scale (ESS) modified for use in teens and questions about qualitative and quantitative use of the mobile phone was completed by students attending Mountain View High School in Mountain View, California (n = 211). Multivariate regression analysis indicated that ESS score was significantly associated with being female, feeling a need to be accessible by mobile phone all of the time, and a past attempt to reduce mobile phone use. The number of daily texts or phone calls was not directly associated with ESS. Those individuals who felt they needed to be accessible and those who had attempted to reduce mobile phone use were also ones who stayed up later to use the mobile phone and were awakened more often at night by the mobile phone. The relationship between daytime sleepiness and mobile phone use was not directly related to the volume of texting but may be related to the temporal pattern of mobile phone use.

  14. Microcurrent stimulation at shenmen acupoint facilitates EEG associated with sleepiness and positive mood: a randomized controlled electrophysiological study.

    Science.gov (United States)

    Cheung, Mei-Chun; Chan, Agnes S; Yip, Joanne

    2015-01-01

    To examine the electrophysiological effects of microcurrent stimulation at the Shenmen acupoint, 40 healthy normal subjects were randomly assigned to a placebo group (sham stimulation) and an experimental group (bilateral electrocutaneous stimulation at the Shenmen). The following two electroencephalographic indicators were used to measure brain activity. (1) Arousal level was measured with reference to log-transformed absolute alpha power and power source and analyzed using low-resolution electromagnetic tomography and (2) frontal alpha asymmetry was used as an indicator of mood. After real stimulation for 10 minutes, absolute alpha power was globally reduced in the experimental group, particularly in the anterior and centrotemporal regions of the brain. This indicates a decline in the brain activity associated with arousal. Moreover, the reduction was more prominent in the left frontal region, as compared to the right frontal region, resulting in significant increase from negative to positive frontal alpha asymmetry scores and reflecting an increase in the brain activity associated with enhanced mood. However, the placebo group exhibited no significant changes in two indicators after sham stimulation. This study provides initial electrophysiological evidence of changes in brain activity associated with reduced arousal (and thus greater sleepiness) and enhanced mood after microcurrent stimulation at the Shenmen acupoint.

  15. Microcurrent Stimulation at Shenmen Acupoint Facilitates EEG Associated with Sleepiness and Positive Mood: A Randomized Controlled Electrophysiological Study

    Directory of Open Access Journals (Sweden)

    Mei-chun Cheung

    2015-01-01

    Full Text Available To examine the electrophysiological effects of microcurrent stimulation at the Shenmen acupoint, 40 healthy normal subjects were randomly assigned to a placebo group (sham stimulation and an experimental group (bilateral electrocutaneous stimulation at the Shenmen. The following two electroencephalographic indicators were used to measure brain activity. (1 Arousal level was measured with reference to log-transformed absolute alpha power and power source and analyzed using low-resolution electromagnetic tomography and (2 frontal alpha asymmetry was used as an indicator of mood. After real stimulation for 10 minutes, absolute alpha power was globally reduced in the experimental group, particularly in the anterior and centrotemporal regions of the brain. This indicates a decline in the brain activity associated with arousal. Moreover, the reduction was more prominent in the left frontal region, as compared to the right frontal region, resulting in significant increase from negative to positive frontal alpha asymmetry scores and reflecting an increase in the brain activity associated with enhanced mood. However, the placebo group exhibited no significant changes in two indicators after sham stimulation. This study provides initial electrophysiological evidence of changes in brain activity associated with reduced arousal (and thus greater sleepiness and enhanced mood after microcurrent stimulation at the Shenmen acupoint.

  16. Use of an abridged scored Patient-Generated Subjective Global Assessment (abPG-SGA) as a nutritional screening tool for cancer patients in an outpatient setting.

    Science.gov (United States)

    Gabrielson, Denise K; Scaffidi, Donna; Leung, Elizabeth; Stoyanoff, Linda; Robinson, Jennifer; Nisenbaum, Rosane; Brezden-Masley, Christine; Darling, Pauline B

    2013-01-01

    The scored Patient-Generated Subjective Global Assessment tool (PG-SGA), regarded as the most appropriate means of identifying malnutrition in cancer patients, is often challenging to implement in a busy outpatient setting. We assessed the validity of an abridged version of the PG-SGA (abPG-SGA), which forgoes the physical examination, and compared its usefulness in discerning malnutrition to the full PG-SGA and Malnutrition Screening Tool (MST). The nutritional status of 90 oncology outpatients receiving chemotherapy was assessed according to SGA global rating, PG-SGA, and MST. Receiver operating characteristic (ROC) curves were generated to estimate the sensitivity and specificity of various cut-off scores for malnutrition. Thirty-six percent of patients were malnourished (SGA). The abPG-SGA yielded 94% sensitivity and 78% specificity and area under the curve (AUC) = 0.956, which was slightly lower than PG-SGA (97% sensitivity, 86% specificity, AUC = 0.967) and higher than MST (81% sensitivity, 72% specificity, AUC = 0.823). Patient reported symptoms included loss of appetite (30%), altered taste (31%), fatigue (30%), and decreased ability to perform activities of daily living (53%). In conclusion, the abPG-SGA is a practical, informative and valid tool for detecting malnutrition in the outpatient oncology setting.

  17. Impact of clinical, psychological, and social factors on decreased Tinetti test score in community-living elderly subjects: a prospective study with two-year follow-up.

    Science.gov (United States)

    Manckoundia, Patrick; Thomas, Frédérique; Buatois, Séverine; Guize, Louis; Jégo, Bertrand; Aquino, Jean-Pierre; Benetos, Athanase

    2008-06-01

    Balance and gait are essential to maintain physical autonomy, particularly in elderly people. Thus the detection of risk factors of balance and gait impairment appears necessary in order to prevent falls and dependency. The objective of this study was to analyze the impact of demographic, social, clinical, psychological, and biological parameters on the decline in balance and gait assessed by the Tinetti test (TT) after a two-year follow-up. This prospective study was conducted among community-living, young elderly volunteers in the centre "Investigations Preventives et Cliniques" and "Observatoire De l'Age" (Paris, France). Three hundred and forty-four participants aged 63.5 on average were enrolled and performed the TT twice, once at inclusion and again two years later. After the two-year follow-up, two groups were constituted according to whether or not there was a decrease in the TT score: the "TT no-deterioration" group comprised subjects with a decrease of less than two points and the "TT deterioration" group comprised those with a decrease of two points or more. Selected demographic, social, clinical, psychological, and biological parameters for the two groups were then compared. Statistical analysis showed that female sex, advanced age, high body mass index, osteoarticular pain, and a high level of anxiety all have a negative impact on TT score. Knowledge of predictive factors of the onset or worsening of balance and gait disorders could allow clinicians to detect young elderly people who should benefit from a specific prevention program.

  18. Epworth's sleepiness scale in outpatients with different values of arterial blood pressure

    Directory of Open Access Journals (Sweden)

    Miguel Gus

    2002-01-01

    Full Text Available OBJECTIVE: To compare sleepiness scores of the Epworth scale in patients with different levels of arterial pressure when undergoing outpatient monitoring within the context of clinical evaluation. METHODS: A total of 157 patients selected for outpatient monitoring of arterial pressure during hypertension evaluation were divided into 3 groups: group 1 - normotensive; group 2 - hypertensive; group 3 - resistant hypertensive. For analysis, values > or = 11 were considered as associated with respiratory disturbances during sleep. RESULTS: Seventeen (10.8% patients in group 1, 112 (71.3% in group 2, and 28 (17.8% in group 3, which was composed of aged, more severely hypertensive individuals, were analyzed. Groups were similar relative to sex and body mass index, but different in relation to systolic and diastolic pressure levels and age. Despite an absolute difference, no statistically significant difference occurred between Epworth scores and in the proportion of patients with values > or = 11 (5.9% vs. 18.8% vs. 212.4%; P=0.37. Despite the positive association between degree of sleepiness measured with the scale and the severity of the hypertension, no statistical significance occurred following control by age (p=0.18. CONCLUSION: A positive correlation exists between degree of sleepiness and hypertension severity. The absence of a statistical significance shown in the present study could be due to a beta type of error. Instruments that render this complaint into an objective finding could help in the pursuit of an investigation of respiratory disturbances during sleep in more severely hypertensive patients, and should therefore be studied better.

  19. Effects of Sleep Hygiene Education on Subjective Sleep Quality and Academic Performance

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    Erkan Sahin

    2014-12-01

    Full Text Available Aim: Sleep problems are common in students with one third of university students reporting insufficient sleep. It is known that sleep quality and daytime sleepiness cause decrasing academic performans. For this reason we aimed to investigate the effects of a sleep hygiene education on sleep quality and academic performance of first year medical students. Material and Method: Self-reported sleep data and academic performance of 131 first grade medical students were collected. To all students enrolled Pittsburg Sleep Quality Scale in the assessment of sleep quality and Epworth Sleepiness Scale for assessment of daytime sleepiness in the evaluation.The students were divided into two subgroups and the intervention group received a 30 minute structured sleep hygiene education. Global academic performance was assessed by grade point average at the end of the year. Results: Mean Pittsburgh sleep quality index score of the students was 7.9±3.5 and 106 (82.8% of then had a score %u22655.After intervention, .the worse the initial sleep quality, the more improvement by the sleep hygiene education on sleep quality and academic performance. Discussion: An education on sleep hygiene might improve subjective sleep quality and academic performance of medical students.

  20. Association of daytime sleepiness with obstructive sleep apnoea and comorbidities varies by sleepiness definition in a population cohort of men.

    Science.gov (United States)

    Adams, Robert J; Appleton, Sarah L; Vakulin, Andrew; Lang, Carol; Martin, Sean A; Taylor, Anne W; McEvoy, R Doug; Antic, Nick A; Catcheside, Peter G; Wittert, Gary A

    2016-10-01

    To determine correlates of excessive daytime sleepiness (EDS) identified with the Epworth Sleepiness Scale (ESS) and a more broad definition, while accounting for obstructive sleep apnoea (OSA) in community dwelling men. Participants of the Men Androgens Inflammation Lifestyle Environment and Stress (MAILES) Study (n = 837, ≥ 40 years) without a prior OSA diagnosis, underwent in-home full unattended polysomnography (PSG, Embletta X100), completed the ESS, STOP questionnaire and Pittsburgh Sleep Quality Index in 2010-2011. In 2007-2010, questionnaires and biomedical assessment (in South Australian public hospital-based clinics) identified medical conditions. An alternate EDS definition (EDSAlt ) consisted of ≥ 2 of 3 problems (feeling sleepy sitting quietly; feeling tired/fatigued/sleepy; trouble staying awake). EDSAlt (30.4%, n = 253), but not ESS ≥ 11 (EDSESS , 12.6%, n = 104), increased significantly across OSA severity and body mass index categories. In adjusted analyses, EDSESS was significantly associated with depression: odds ratio (OR), 95%CI: 2.2 (1.3-3.8) and nocturia: 2.0 (1.3-3.2). EDSAlt was associated with depression, financial stress, relationship, work-life balance problems and associations with nocturia and diabetes were borderline. After excluding men with EDSESS , EDSAlt was associated with oxygen desaturation index (3%) ≥ 16 and the highest arousal index quartile but not with comorbidities. Sleepiness not necessarily leading to dozing, but not ESS ≥ 11, was related to sleep disordered breathing. Clinicians should be alert to (1) differing perspectives of sleepiness for investigation and treatment of OSA, and (2) the presence of depression and nocturia in men presenting with significant Epworth sleepiness regardless of the presence of OSA. © 2016 Asian Pacific Society of Respirology.

  1. Sleep disorders, sleepiness and traffic safety: a public health menace

    Directory of Open Access Journals (Sweden)

    S.R. Pandi-Perumal

    2006-07-01

    Full Text Available Sleep disorders are not uncommon and have been widely reported throughout the world. They have a profound impact on industrialized 24-h societies. Consequences of these problems include impaired social and recreational activities, increased human errors, loss of productivity, and elevated risk of accidents. Conditions such as acute and chronic insomnia, sleep loss, excessive sleepiness, shift-work, jet lag, narcolepsy, and sleep apnea warrant public health attention, since residual sleepiness during the day may affect performance of daily activities such as driving a car. Benzodiazepine hypnotics and zopiclone promote sleep, both having residual effects the following day including sleepiness and reduced alertness. In contrast, the non-benzodiazepine hypnotics zolpidem and zaleplon have no significant next-day residual effects when taken as recommended. Research on the effects of wakefulness-promoting drugs on driving ability is limited. Countermeasures for excessive daytime sleepiness have a limited effect. There is a need for a social awareness program to educate the public about the potential consequences of various sleep disorders such as narcolepsy, sleep apnea, shift-work-related sleep loss, and excessive daytime sleepiness in order to reduce the number of sleep-related traffic accidents.

  2. Causes and consequences of sleepiness among college students

    Science.gov (United States)

    Hershner, Shelley D; Chervin, Ronald D

    2014-01-01

    Daytime sleepiness, sleep deprivation, and irregular sleep schedules are highly prevalent among college students, as 50% report daytime sleepiness and 70% attain insufficient sleep. The consequences of sleep deprivation and daytime sleepiness are especially problematic to college students and can result in lower grade point averages, increased risk of academic failure, compromised learning, impaired mood, and increased risk of motor vehicle accidents. This article reviews the current prevalence of sleepiness and sleep deprivation among college students, contributing factors for sleep deprivation, and the role of sleep in learning and memory. The impact of sleep and sleep disorders on academics, grade point average, driving, and mood will be examined. Most importantly, effective and viable interventions to decrease sleepiness and sleep deprivation through sleep education classes, online programs, encouragement of naps, and adjustment of class time will be reviewed. This paper highlights that addressing sleep issues, which are not often considered as a risk factor for depression and academic failure, should be encouraged. Promotion of university and college policies and class schedules that encourage healthy and adequate sleep could have a significant impact on the sleep, learning, and health of college students. Future research to investigate effective and feasible interventions, which disseminate both sleep knowledge and encouragement of healthy sleep habits to college students in a time and cost effective manner, is a priority. PMID:25018659

  3. Causes and consequences of sleepiness among college students

    Directory of Open Access Journals (Sweden)

    Hershner SD

    2014-06-01

    Full Text Available Shelley D Hershner, Ronald D ChervinDepartment of Neurology, University of Michigan, Ann Arbor, MI, USAAbstract: Daytime sleepiness, sleep deprivation, and irregular sleep schedules are highly prevalent among college students, as 50% report daytime sleepiness and 70% attain insufficient sleep. The consequences of sleep deprivation and daytime sleepiness are especially problematic to college students and can result in lower grade point averages, increased risk of academic failure, compromised learning, impaired mood, and increased risk of motor vehicle accidents. This article reviews the current prevalence of sleepiness and sleep deprivation among college students, contributing factors for sleep deprivation, and the role of sleep in learning and memory. The impact of sleep and sleep disorders on academics, grade point average, driving, and mood will be examined. Most importantly, effective and viable interventions to decrease sleepiness and sleep deprivation through sleep education classes, online programs, encouragement of naps, and adjustment of class time will be reviewed. This paper highlights that addressing sleep issues, which are not often considered as a risk factor for depression and academic failure, should be encouraged. Promotion of university and college policies and class schedules that encourage healthy and adequate sleep could have a significant impact on the sleep, learning, and health of college students. Future research to investigate effective and feasible interventions, which disseminate both sleep knowledge and encouragement of healthy sleep habits to college students in a time and cost effective manner, is a priority.Keywords: grade point average, GPA, sleep deprivation, academic performance, adolescence, sleep education programs

  4. Causes and consequences of sleepiness among college students.

    Science.gov (United States)

    Hershner, Shelley D; Chervin, Ronald D

    2014-01-01

    Daytime sleepiness, sleep deprivation, and irregular sleep schedules are highly prevalent among college students, as 50% report daytime sleepiness and 70% attain insufficient sleep. The consequences of sleep deprivation and daytime sleepiness are especially problematic to college students and can result in lower grade point averages, increased risk of academic failure, compromised learning, impaired mood, and increased risk of motor vehicle accidents. This article reviews the current prevalence of sleepiness and sleep deprivation among college students, contributing factors for sleep deprivation, and the role of sleep in learning and memory. The impact of sleep and sleep disorders on academics, grade point average, driving, and mood will be examined. Most importantly, effective and viable interventions to decrease sleepiness and sleep deprivation through sleep education classes, online programs, encouragement of naps, and adjustment of class time will be reviewed. This paper highlights that addressing sleep issues, which are not often considered as a risk factor for depression and academic failure, should be encouraged. Promotion of university and college policies and class schedules that encourage healthy and adequate sleep could have a significant impact on the sleep, learning, and health of college students. Future research to investigate effective and feasible interventions, which disseminate both sleep knowledge and encouragement of healthy sleep habits to college students in a time and cost effective manner, is a priority.

  5. Effect of intraarticular inoculation of mesenchymal stem cells in dogs with hip osteoarthritis by means of objective force platform gait analysis: concordance with numeric subjective scoring scales.

    Science.gov (United States)

    Vilar, Jose M; Cuervo, Belen; Rubio, Monica; Sopena, Joaquín; Domínguez, Juan M; Santana, Angelo; Carrillo, Jose M

    2016-10-07

    Subjective pain assessment scales have been widely used for assessing lameness in response to pain, but the accuracy of these scales has been questioned. To assess scale accuracy, 10 lame, presa Canario dogs with osteoarthritis (OA) associated with bilateral hip dysplasia were first treated with mesenchymal stem cells. Then, potential lameness improvement was analyzed using two pain scales (Bioarth and visual analog scale). These data were compared with similar data collected using a force platform with the same animals during a period of 6 months after treatment. The F test for intraclass correlation showed that concordance in pain/lameness scores between the 2 measuring methodologies was not significant (P value ≥ 0.9213; 95 % confidence interval, -0.56, 0.11). Although subjective pain assessment showed improvement after 6 months, force platform data demonstrated those same animals had returned to the initial lameness state. Use of pain assessment scales to measure lameness associated with OA did not have great accuracy and concordance when compared with quantitative force platform gait analysis.

  6. The Role of Family Orientations in Shaping the Effect of Fertility on Subjective Well-being: A Propensity Score Matching Approach.

    Science.gov (United States)

    Balbo, Nicoletta; Arpino, Bruno

    2016-08-01

    This article investigates whether and how having a child impacts an individual's subjective well-being, while taking into account heterogeneity in family attitudes. People with different family orientations have different values, gender attitudes, preferences toward career and family, and expectations about how childbearing can affect their subjective well-being. These differences impact fertility decisions and the effect of parenthood on an individual's life satisfaction. We define three groups of people based on their family orientations: Traditional, Mixed, and Modern. Applying propensity score matching on longitudinal data (British Household Panel Survey), we create groups of individuals with very similar socioeconomic characteristics and family orientations before childbearing. We then compare those who have one child with those who are childless, and those who have two children with those who have only one child. We show that parents are significantly more satisfied than nonparents, and this effect is stronger among men than among women. For men, we do not find significant differences across family orientations groups in the effect of the birth of the first child on life satisfaction. Among women, only Traditional mothers seem to be more satisfied than their childless counterparts. Women who have a second child are never more satisfied than those who have only one child, regardless of their family orientations. Traditional and Mixed men experience a gain in life satisfaction when they have a second child, but this effect is not found for Modern men.

  7. Correlation between podoplanin expression and extracapsular spread in squamous cell carcinoma of the oral cavity using subjective immunoreactivity scores and semiquantitative image analysis.

    Science.gov (United States)

    Mermod, Maxime; Bongiovanni, Massimo; Petrova, Tatiana V; Dubikovskaya, Elena A; Simon, Christian; Tolstonog, Genrich; Monnier, Yan

    2017-01-01

    The correlation between podoplanin expression and extracapsular spread in head and neck squamous cell carcinoma (HNSCC) has never been reported. The purpose of this study was to assess the predictive value of podoplanin expression for this parameter. Subjective immunoreactivity scores and semiquantitative image analysis of podoplanin expression were performed in 67 patients with primary oral squamous cell carcinoma and in their corresponding lymph nodes. Neck classification showed 34 cases (51%) of pN0 and 33 cases (49%) of pN+. Correlation between the levels of podoplanin expression and the histopathological data was established. In lymph nodes, a high level of podoplanin expression correlated with the presence of extracapsular spread by multivariate analysis (p = .03). A strong correlation between subjective and semiquantitative image analysis was observed (r = 0.77; p < .001). A high level of podoplanin expression in lymph node metastases of oral squamous cell carcinoma is independently associated with extracapsular spread. © 2016 Wiley Periodicals, Head Neck 39: 98-108, 2017. © 2016 Wiley Periodicals, Inc.

  8. Sonolência e acidentes automobilísticos Sleepiness and motor vehicle accidents

    Directory of Open Access Journals (Sweden)

    SIMONE FAGONDES CANANI

    2001-03-01

    Full Text Available Objetivo: Este artigo tem por finalidade apresentar uma sucinta revisão sobre as repercussões da sonolência excessiva no desempenho dos motoristas no trânsito, enfatizando a necessidade da maior valorização do tema abordado. Métodos: Revisão bibliográfica da literatura nacional e internacional, abrangendo artigos originais e publicações oficiais da American Thoracic Society e da American Sleep Apnea Association. Resultados: As evidências de que a sonolência é um fator que pode contribuir de forma decisiva para a ocorrência de acidentes automobilísticos são crescentes. As dificuldades com relação à caracterização da sonolência precedendo o acidente são discutidas no texto. Muitas são as causas de sonolência excessiva; felizmente, sua maioria é passível de identificação e manejo adequado. Conclusões: É importante que haja maior entendimento do problema em nosso meio, para que possam ocorrer modificações na abordagem do paciente com sonolência excessiva e também discussões acerca das leis de trânsito vigentes e das obrigações legais do médico com relação a este problema.Objective: The purpose of this article is to present a brief review of the effects of excessive sleepiness on driving performance, and to emphasize the importance of the subject. Methods: Bibliographic review of national and international literature, including original articles and official publications from the American Thoracic Society and the American Sleep Apnea Association. Results: There is growing evidence that excessive sleepiness may be an important factor related to the occurrence of motor vehicle accidents. Difficulties regarding the identification of sleepiness as a preceding factor related to motor vehicle crashes are discussed on the text. There are many causes for excessive sleepiness. Fortunately most of them are easy to recognize and have specific treatment. Conclusions: A better understanding of the problem is fundamental

  9. Association of Mild Obstructive Sleep Apnea With Cognitive Performance, Excessive Daytime Sleepiness, and Quality of Life in the General Population: The Korean Genome and Epidemiology Study (KoGES).

    Science.gov (United States)

    Kim, Hyun; Thomas, Robert J; Yun, Chang-Ho; Au, Rhoda; Lee, Seung Ku; Lee, Sunghee; Shin, Chol

    2017-05-01

    Research points to impaired cognitive performance in sleep clinic patients with obstructive sleep apnea (OSA). However, inconsistent findings from various epidemiologic studies make this relationship less generalizable. The current study investigated the association between OSA and functional outcome measures, such as cognition, daytime sleepiness, and quality of life, in a Korean general population sample. A total of 1492 participants from the Korean Genome and Epidemiology Study (KoGES) were included in the analyses. The presence of OSA measured by overnight polysomnography (PSG) was defined by apnea-hypopnea index (AHI) >5. Cognitive performance was determined with scores from a comprehensive neuropsychological battery. Excessive daytime sleepiness and quality of life were additionally measured through subjective reports. After adjusting for various demographic and medical characteristics, OSA was independently associated with lower performance in the Digit Symbol Test (52.73 ± 17.08 vs. 58.72 ± 18.03, OSA vs. not, p = .02). Hypoxia measures were not related to cognitive performance. OSA was associated with higher odds of displaying excessive daytime sleepiness (odds ratio = 1.72, 95% CI: 1.05-2.80), but there was no significant relationship between OSA and quality of life. Cognition was unexpectedly unaffected overall. However, OSA was associated with impairment in a multidomain test that taps skills generally associated with frontal lobe function. The results suggest that research on protective and adaptive brain mechanisms to OSA stress can provide unique insights into the brain-sleep interface. As the study runs longitudinally, it will enable future studies on the impact of OSA on cognitive decline.

  10. Assessment of Divergent Thinking by means of the Subjective Top-Scoring Method: Effects of the Number of Top-Ideas and Time-on-Task on Reliability and Validity

    Science.gov (United States)

    Benedek, Mathias; Mühlmann, Caterina; Jauk, Emanuel; Neubauer, Aljoscha C.

    2014-01-01

    Divergent thinking tasks are commonly used as indicators of creative potential, but traditional scoring methods of ideational originality face persistent problems such as low reliability and lack of convergent and discriminant validity. Silvia et al. (2008) have proposed a subjective top-2 scoring method, where participants are asked to select their two most creative ideas, which then are evaluated for creativity. This method was found to avoid problems with discriminant validity, and to outperform other scoring methods in terms of convergent validity. These findings motivate a more general, systematic analysis of the subjective top-scoring method. Therefore, this study examined how reliability and validity of the originality and fluency scores depend on the number of top-ideas and on time-on-task. The findings confirm that subjective top-scoring avoids the confounding of originality with fluency. The originality score showed good internal consistency, and evidence of reliability was found to increase as a function of the number of top-ideas and of time-on-task. Convergent validity evidence, however, was highest for a time-on-task of about 2 to 3 minutes and when using a medium number of about three top-ideas. Reasons for these findings are discussed together possible limitations of this study and future directions. The article also presents some general recommendations for the assessment of divergent thinking with the subjective top-scoring method. PMID:24790683

  11. Objective measurement of sleepiness in summer vacation long-distance drivers.

    Science.gov (United States)

    Philip, P; Ghorayeb, I; Leger, D; Menny, J C; Bioulac, B; Dabadie, P; Guilleminault, C

    1997-05-01

    The study investigated whether sleepiness at the wheel is a problem in non-commercial drivers going on summer vacation. All drivers, who stopped at a rest area on a large European freeway while one of the interviewers was available, were systematically approached and asked to respond to a questionnaire. All subjects who had driven at least 400 km (240 miles), whose age was between 20 and 46 years of age, and who agreed to participate were asked to undergo a longer investigation that included a short sleep/wake diary describing overall sleep habits during the year, a sleep/wake log covering the days just prior to departure, an analog visual scale indicating sleepiness at time of interview, and a polygraphically monitored two nap sleep test (TNST). A control group was recruited that consisted of subjects of the same age range, normal sleep habits, and normal nocturnal sleep time before administration of the TNST. One hundred and four drivers (2 women) participated between 08:00 and 20:00 h. The total group was subdivided into 6 subgroups based upon the time of day of their investigation (08:00-10:00 h, 10:01-12:00 h, etc.). The control group included 50 men with 50-55% of control subjects, relative to the total number of index-cases, in each subgroup. Eighty-eight percent (n = 92) of studied drivers had experienced acute sleep deprivation within one day prior to departure due to the planned long driving. The TNST demonstrated that, overall, drivers had a significantly shorter sleep latency in nap 1 and nap 2 than controls, had a significantly longer sleep duration in nap 1 and nap 2, and there was a significant correlation between the sleep debt prior to departure and the sleep stage reached during the TNST. It is concluded that the TNST is a test which allows the objective study of sleepiness in drivers without the burden of the multiple sleep latency test. Many drivers are excessively sleepy when making long summer vacation journeys.

  12. The prevalence of excessive daytime sleepiness among academic physicians and its impact on the quality of life and occupational performance.

    Science.gov (United States)

    Ozder, Aclan; Eker, Hasan Huseyin

    2015-01-01

    Sleep disorders can affect health and occupational performance of physicians as well as outcomes in patients. The purpose of this study was to assess the prevalence of excessive daytime sleepiness (EDS) measured by the Epworth Sleepiness Scale (ESS) among academic physicians at a tertiary academic medical center in an urban area in the northwest region of Turkey, and to establish a relationship between the self-perceived sleepiness and the quality of life using the EuroQol-5 dimensions (EQ-5D). A questionnaire prepared by the researchers after scanning the literature on the subject was e-mailed to the academic physicians of a tertiary academic medical center in Istanbul. The ESS and the EQ-5D were also included in the survey. The e-mail database of the institution directory was used to compile a list of active academic physicians who practiced clinical medicine. Paired and independent t tests were used for the data analysis at a significance level of p rate. There were 84 (33.3%) female and 168 (66.7%) male academic physicians participating in the study. One hundred and eight out of 252 (42.8%) academic physicians were taking night calls (p sleep and 84 (33.3%) reported napping daily (p 10) (p quality of life (p poor quality of life and daytime sleepiness. There was also a positive relationship between habitual napping and being sleepy during the day. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

  13. Prevalence of sleepiness while driving four-wheel motor vehicles in Fiji: a population-based survey (TRIP 9).

    Science.gov (United States)

    Herman, Josephine; Ameratunga, Shanthi N; Wainiqolo, Iris; Kafoa, Berlin; Robinson, Elizabeth; McCaig, Eddie; Jackson, Rod

    2013-08-01

    Sleepiness has been shown to be a risk factor for road crashes in high-income countries, but has received little attention in low- and middle-income countries. We examined the prevalence of sleepiness and sleep-related disorders among drivers of four-wheel motor vehicles in Fiji. Using a two-stage cluster sampling roadside survey conducted over 12 months, we recruited a representative sample of people driving four-wheel motor vehicles on the island of Viti Levu, Fiji. A structured interviewer-administered questionnaire sought self-report information on driver characteristics including sleep-related measures. The 752 motor vehicle drivers recruited (84% response rate) were aged 17-75 years, with most driving in Viti Levu undertaken by male subjects (93%), and those identifying with Indian (70%) and Fijian (22%) ethnic groups. Drivers who reported that they were not fully alert accounted for 17% of driving, while a further 1% of driving was undertaken by those who reported having difficulty staying awake or feeling sleepy. A quarter of the driving time among 15-24-year-olds included driving while sleepy or not fully alert, with a similar proportion driving while chronically sleep deprived (ie, with less than five nights of adequate sleep in the previous week=27%). Driving while acutely or chronically sleep deprived was generally more common among Fijians compared with Indians. Driving while not fully alert is relatively common in Fiji. Sleepiness while driving may be an important contributor to road traffic injuries in this and other low- and middle-income countries.

  14. Category fluency test: effects of age, gender and education on total scores, clustering and switching in Brazilian Portuguese-speaking subjects

    Directory of Open Access Journals (Sweden)

    Brucki S.M.D.

    2004-01-01

    Full Text Available Verbal fluency tests are used as a measure of executive functions and language, and can also be used to evaluate semantic memory. We analyzed the influence of education, gender and age on scores in a verbal fluency test using the animal category, and on number of categories, clustering and switching. We examined 257 healthy participants (152 females and 105 males with a mean age of 49.42 years (SD = 15.75 and having a mean educational level of 5.58 (SD = 4.25 years. We asked them to name as many animals as they could. Analysis of variance was performed to determine the effect of demographic variables. No significant effect of gender was observed for any of the measures. However, age seemed to influence the number of category changes, as expected for a sensitive frontal measure, after being controlled for the effect of education. Educational level had a statistically significant effect on all measures, except for clustering. Subject performance (mean number of animals named according to schooling was: illiterates, 12.1; 1 to 4 years, 12.3; 5 to 8 years, 14.0; 9 to 11 years, 16.7, and more than 11 years, 17.8. We observed a decrease in performance in these five educational groups over time (more items recalled during the first 15 s, followed by a progressive reduction until the fourth interval. We conclude that education had the greatest effect on the category fluency test in this Brazilian sample. Therefore, we must take care in evaluating performance in lower educational subjects.

  15. Psychometric Properties of Turkish Version of Pediatric Daytime Sleepiness Scale (PDSS-T

    Directory of Open Access Journals (Sweden)

    Murat Bektas, PhD, RN

    2016-03-01

    Conclusions: The study's results showed that PDSS-T is a valid and reliable instrument for detecting Turkish-speaking children's and adolescents' daytime sleepiness. PDSS-T is convenient for professionals to prevent and manage daytime sleepiness.

  16. Effects of Shift Work on Cognitive Performance, Sleep Quality, and Sleepiness among Petrochemical Control Room Operators

    National Research Council Canada - National Science Library

    Kazemi, Reza; Haidarimoghadam, Rashid; Motamedzadeh, Majid; Golmohamadi, Rostam; Soltanian, Alireza; Zoghipaydar, Mohamad Reza

    2016-01-01

    Shift work is associated with both sleepiness and reduced performance. The aim of this study was to examine cognitive performance, sleepiness, and sleep quality among petrochemical control room shift workers...

  17. Home exercise improves the quality of sleep and daytime sleepiness of elderlies: a randomized controlled trial.

    Science.gov (United States)

    Brandão, Glauber Sá; Gomes, Glaucia Sá Brandão Freitas; Brandão, Glaudson Sá; Callou Sampaio, Antônia A; Donner, Claudio F; Oliveira, Luis V F; Camelier, Aquiles Assunção

    2018-01-01

    Aging causes physiological changes which affect the quality of sleep. Supervised physical exercise is an important therapeutic resource to improve the sleep of the elderlies, however there is a low adherence to those type of programs, so it is necessary to implement an exercise program which is feasible and effective. The study aimed to test the hypothesis that a semi-supervised home exercise program, improves sleep quality and daytime sleepiness of elderlies of the community who present poor sleep quality. This was a randomized controlled trial study, conducted from May to September 2017, in Northeastern Brazil, with elderlies of the community aging 60 years old or older, sedentary, with lower scores or equal to 5 at the Pittsburgh Sleep Quality Index (PSQI) and without cognitive decline. From one hundred ninety-one potential participants twenty-eight refused to participate, therefore, one hundred thirty-one (mean age 68 ± 7 years), and 88% female, were randomly assigned to an intervention group - IG (home exercise and sleep hygiene, n = 65) and a control group - CG (sleep hygiene only, n = 66). Sleep assessment tools were used: PSQI, Epworth sleepiness scale (ESS) and clinical questionnaire of Berlin. The level of physical activity has been assessed by means of International Physical Activity Questionnaire adapted for the elderly (IPAQ) and Mini-Mental State Examination for cognitive decline. All participants were assessed before and after the 12-week intervention period and, also, the assessors were blind. The IG showed significant improvement in quality of sleep with a mean reduction of 4.9 ± 2.7 points in the overall PSQI (p exercise is effective in improving the quality of sleep and self-referred daytime sleepiness of sedentary elderlies of the community who presented sleep disorders. Ensaiosclinicos.gov.br process number: RBR-3cqzfy.

  18. Effects of a 12-hour shift on mood states and sleepiness of Neonatal Intensive Care Unit nurses

    Directory of Open Access Journals (Sweden)

    Tadeu Sartini Ferreira

    Full Text Available Abstract OBJECTIVE To assess the effect of a 12-hour shift on mood states and sleepiness at the beginning and end of the shift. METHOD Quantitative, cross-sectional and descriptive study.It was conducted with 70 neonatal intensive care unit nurses. The Brunel Mood Scale (BRUMS, Karolinska Sleepiness Scale (KSS, and a socio-demographic profile questionnaire were administered. RESULTS When the KSS and BRUMS scores were compared at the beginning of the shift associations were found with previous sleep quality (p ≤ 0.01, and quality of life (p ≤ 0.05. Statistical significant effects on BRUMS scores were also associated with previous sleep quality, quality of life, liquid ingestion, healthy diet, marital status, and shift work stress. When the beginning and end of the shift were compared, different KSS scores were seen in the group of all nurses and in the night shift one. Significant vigor and fatigue scores were observed within shift groups. CONCLUSION A good night’s sleep has positive effects on the individual`s mood states both at the beginning and the end of the shift. The self-perception of a good quality of life also positively influenced KSS and BRUMS scores at the beginning and end of the shift. Proper liquid ingestion led to better KSS and BRUMS scores.

  19. [Nutritional status, healthy habits, quality of life and daytime sleepiness in nightlife workers of Córdoba].

    Science.gov (United States)

    Moreno Linares, Vicente; Diéguez Cantueso, Inmaculada; Lara Carmona, Juan José; Molina Recio, Guillermo

    2015-04-01

    This study is aimed to analyze the factors that affect body composition, nutritional status, dietary habits, substance abuse (alcohol and smoking), physical activity, sleepiness disorders and self-rated health status in people working in nightlife in the city of Cordoba. Representative sample of 144 subjects (88 men and 56 women) with a mean age of 26.88 (± 4.7) years was studied. Individuals were analized for their body composition. Besides, a personal interview was used to administrate validated questionnaires to get other important data related to the aim of the study. The male group showed higher body mass index (p<0.05), showing overweight in more than half of the sample, and higher levels of body fat in 42% of subjects. Adherence to the Mediterranean diet was low and up to 48.6% presents a risk alcohol consumption, being higher in the male group. 40% of the subjects suffer from disorders of daytime sleepiness, however they spend a big amount of time in physical activities. The sample shows a high obesity and overweight prevalence and a low adherence to the mediterranean diet. Although they are not sedentary, the sample has unhealthy habits such as drinking alcohol and smoking and at the same time they suffer from sleepiness daytime disorders. In spite of they seems to have a high self-awareness about their own health status, 1 from every 5 individuals recognize that they could improve it. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  20. Body Mass Index, Gender, and Ethnic Variations Alter the Clinical Implications of the Epworth Sleepiness Scale in Patients with Suspected Obstructive Sleep Apnea§

    Science.gov (United States)

    Hesselbacher, Sean; Subramanian, Shyam; Allen, Jerry; Surani, Sara; Surani, Salim

    2012-01-01

    Introduction: The Epworth Sleepiness Scale (ESS) is often used in the evaluation of obstructive sleep apnea (OSA), though questions remain about the influence gender, ethnicity, and body morphometry have in the responses to this questionnaire. The aim of this study was to examine differences in ESS scores between various demographic groups of patients referred for polysomnography, and the relationship of these score to sleep-disordered breathing Methods: Nineteen hundred consecutive patients referred for polysomnographic diagnosis of OSA completed questionnaires, including demographic data and ESS. OSA was determined based on a respiratory disturbance index (RDI) ≥15 by polysomnography. Results: In this high risk population for OSA, the ESS was 10.7 ± 5.6. The highest ESS scores were seen in obese males; non-obese females and non-obese Caucasian males scored the lowest. ESS was weakly correlated with RDI (r = 0.17, P < 0.0001). The sensitivity of ESS for the diagnosis of OSA was 54% and the specificity was 57%. The positive (PPV) and negative (NPV) predictive values were 64% and 47%, respectively. In obese subjects, the sensitivity and specificity were 55% and 53%, compared with 47% and 63% in non-obese subjects. In obese, Hispanic males, the sensitivity, specificity, and PPV were 59%, 54%, and 84%, respectively. In non-obese, Caucasian females, the sensitivity, specificity, and NPV were 43%, 59%, and 72%. Conclusions: The ESS appears to be affected by many factors, including gender, ethnicity, and body morphometry. The ability of the ESS to predict OSA is modest, despite a significant correlation with the severity of OSA. The test characteristics improve significantly when applied to select populations, especially those at risk for OSA. PMID:22670164

  1. A new approach for the assessment of sleepiness and predictivity of obstructive sleep apnea in drivers: A pilot study

    Directory of Open Access Journals (Sweden)

    Vitaliano Nicola Quaranta

    2016-01-01

    Full Text Available Background: Falling asleep behind the wheel is one of the most relevant consequences of obstructive sleep apnea (OSA. We created a new screening questionnaire, named the Driver Sleepiness Score (DSS, aiming to assess sleepiness in drivers with suspected OSA. The primary aim of our study was to evaluate sleepiness in drivers with a suspicion of OSA by the DSS in order to assess its correlation with the apnea-hypopnea index (AHI, oxygen desaturation index (ODI, and total sleep time with oxyhemoglobin saturation below 90% (TST90. We also aimed to assess the diagnostic accuracy of DSS for three different cutoffs of AHI (AHI = 5, AHI = 15, AHI = 30, which allow stratification of the severity of OSA. Materials and Methods: Seventy-three driving patients at risk for OSA participated in the study. DSS and the Epworth Sleepiness Scale (ESS were both administered in operator-dependent modality and in randomized sequence. Results: The DSS showed higher accuracy in screening patients with mild OSA [area under curve (AUC: 0.88 vs 0.74] and moderate OSA (AUC: 0.88 vs 0.79, whereas ESS showed higher accuracy in screening patients with severe OSA (AUC: 0.91 vs 0.78. A DSS score ≥ 7 is the optimal cutoff for distinguishing true positives from false positives for the presence of OSA and for its different severity levels. The administration of both questionnaires increases the accuracy for the detection of all OSA severity levels. Conclusions: If validated, DSS may qualify as a new screening tool specifically for drivers with the suspicion of having OSA, in combination with the ESS.

  2. A new approach for the assessment of sleepiness and predictivity of obstructive sleep apnea in drivers: A pilot study.

    Science.gov (United States)

    Quaranta, Vitaliano Nicola; Dragonieri, Silvano; Carratù, Pierluigi; Falcone, Vito Antonio; Carucci, Elisa; Ranieri, Teresa; Ventura, Valentina; Resta, Onofrio

    2016-01-01

    Falling asleep behind the wheel is one of the most relevant consequences of obstructive sleep apnea (OSA). We created a new screening questionnaire, named the Driver Sleepiness Score (DSS), aiming to assess sleepiness in drivers with suspected OSA. The primary aim of our study was to evaluate sleepiness in drivers with a suspicion of OSA by the DSS in order to assess its correlation with the apnea-hypopnea index (AHI), oxygen desaturation index (ODI), and total sleep time with oxyhemoglobin saturation below 90% (TST90). We also aimed to assess the diagnostic accuracy of DSS for three different cutoffs of AHI (AHI = 5, AHI = 15, AHI = 30), which allow stratification of the severity of OSA. Seventy-three driving patients at risk for OSA participated in the study. DSS and the Epworth Sleepiness Scale (ESS) were both administered in operator-dependent modality and in randomized sequence. The DSS showed higher accuracy in screening patients with mild OSA [area under curve (AUC): 0.88 vs 0.74] and moderate OSA (AUC: 0.88 vs 0.79), whereas ESS showed higher accuracy in screening patients with severe OSA (AUC: 0.91 vs 0.78). A DSS score ≥ 7 is the optimal cutoff for distinguishing true positives from false positives for the presence of OSA and for its different severity levels. The administration of both questionnaires increases the accuracy for the detection of all OSA severity levels. If validated, DSS may qualify as a new screening tool specifically for drivers with the suspicion of having OSA, in combination with the ESS.

  3. Sleep and daytime sleepiness in methylphenidate medicated and ...

    African Journals Online (AJOL)

    daytime sleepiness were reported by the parents of the un-medicated children between the hours of 13:00 and 15:00, compared to the medicated children. ... leg syndrome, sleep-disordered breathing and snoring or sleep apnea, all of which ... associated with significantly greater anxiety, daytime fatigue, nocturnal enuresis ...

  4. Sleepiness in Idiopathic REM Sleep Behavior Disorder and Parkinson Disease.

    Science.gov (United States)

    Arnulf, Isabelle; Neutel, Dulce; Herlin, Bastien; Golmard, Jean-Louis; Leu-Semenescu, Smaranda; Cochen de Cock, Valérie; Vidailhet, Marie

    2015-10-01

    To determine whether patients with idiopathic and symptomatic RBD were sleepier than controls, and if sleepiness in idiopathic RBD predicted earlier conversion to Parkinson disease. The Epworth Sleepiness Scale (ESS) and its determinants were compared at the time of a video-polysomnography for an RBD diagnosis in patients with idiopathic RBD, in patients with Parkinson disease, and in controls. Whether sleepiness at time of RBD diagnosis predicted an earlier conversion to neurodegenerative diseases was retrospectively analyzed in the followed-up patients. The 75 patients with idiopathic RBD were sleepier (ESS: 7.8 ± 4.6) at the time of RBD diagnosis than 74 age- and sex-matched controls (ESS: 5.0 ± 3.6, P sleep measures. Among the 69 patients with idiopathic RBD who were followed up for a median 3 years (1-15 years), 16 (23.2%) developed parkinsonism (n = 6), dementia (n = 6), dementia plus parkinsonism (n = 2), and multiple system atrophy (n = 2). An ESS greater than 8 at time of RBD diagnosis predicted a shorter time to phenoconversion to parkinsonism and dementia, from RBD onset, and from RBD diagnosis (when adjusted for age and time between RBD onset and diagnosis). Sleepiness is associated with idiopathic REM sleep behavior disorder and predicts more rapid conversion to parkinsonism and dementia, suggesting it is an early marker of neuronal loss in brainstem arousal systems. © 2015 Associated Professional Sleep Societies, LLC.

  5. Excessive daytime sleepiness and hepatic encephalopathy: it is worth asking.

    Science.gov (United States)

    De Rui, Michele; Schiff, Sami; Aprile, Daniele; Angeli, Paolo; Bombonato, Giancarlo; Bolognesi, Massimo; Sacerdoti, David; Gatta, Angelo; Merkel, Carlo; Amodio, Piero; Montagnese, Sara

    2013-06-01

    The relationship between hepatic encephalopathy (HE) and the sleep-wake disturbances exhibited by patients with cirrhosis remains debated. The aim of this study was to examine the usefulness of sleep-wake interview within the context of HE assessment. One-hundred-and-six cirrhotic patients were asked three yes/no questions investigating the presence of difficulty falling asleep, night awakenings and daytime sleepiness. All underwent formal HE assessment, quantitative electroencephalography and standardised psychometry. Fifty-eight were monitored for 8 ± 6 months in relation to the occurrence of HE. Patients complaining of daytime sleepiness (n = 75, 71 %) had slower EEGs than those who did not report it (relative alpha power: 37 ± 19 vs. 48 ± 17 %, p history (72 vs. 45 %, p < 0.05). Finally, the absence of excessive daytime sleepiness had a Negative Predictive Value of 92 % (64-100) in relation to the development of HE during the follow-up period. These data support the appropriateness of adding a yes/no question on the presence of excessive daytime sleepiness to routine assessment of patients with cirrhosis, to help identify those who do not need further, formal HE screening.

  6. Sleep, Sleepiness and Medical College Students: A Comparative ...

    African Journals Online (AJOL)

    Travel time of Hostellers was a maximum 40 minutes while day scholars was up to 4 hours/day. Poor sleep quality was reported by 20.7% students and Excessive Day time Sleepiness (ESS) by 24.4% students. More number of MBBS day scholars reported poor sleep quality and ESS than the hostellers. No student reported ...

  7. Evaluation of in-car systems that prevent sleepiness

    NARCIS (Netherlands)

    Wilschut, E.S.; Caljouw, C.J.; Valk, P.J.L.

    2011-01-01

    This report provides an overview of methods to prevent drowsy driving of drivers (Wilschut et al., 2009). Several preventive approaches were discussed such as the use of questionnaires, campaigns and fatigue management plans. A search for law enforcement instruments to prevent sleepiness at the

  8. Excessive daytime sleepiness in multiple system atrophy (SLEEMSA study)

    NARCIS (Netherlands)

    Moreno-Lopez, C.; Santamaria, J.; Salamero, M.; Del Sorbo, F.; Albanese, A.; Pellecchia, M.T.; Barone, P.; Overeem, S.; Bloem, B.R.; Aarden, W.C.C.A.; Canesi, M.; Antonini, A.; Duerr, S.; Wenning, G.K.; Poewe, W.; Rubino, A.; Meco, G.; Schneider, S.A.; Bhatia, K.P.; Djaldetti, R.; Coelho, M.; Sampaio, C.; Cochen, V.; Hellriegel, H.; Deuschl, G.; Colosimo, C.; Marsili, L.; Gasser, T.; Tolosa, E.

    2011-01-01

    BACKGROUND: Sleep disorders are common in multiple system atrophy (MSA), but the prevalence of excessive daytime sleepiness (EDS) is not well known. OBJECTIVE: To assess the frequency and associations of EDS in MSA. DESIGN: Survey of EDS in consecutive patients with MSA and comparison with patients

  9. Risk of obstructive sleep apnea and excessive daytime sleepiness in hospitalized psychiatric patients

    Directory of Open Access Journals (Sweden)

    Talih FR

    2017-04-01

    Full Text Available Farid R Talih,1 Jean J Ajaltouni,1 Hani M Tamim,2 Firas H Kobeissy3 1Department of Psychiatry, 2Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon; 3Department of Biochemistry and Molecular Genetics, Faculty of Medicine, American University of Beirut, Beirut, Lebanon Objectives: This study evaluated the risk of developing obstructive sleep apnea (OSA and excessive daytime sleepiness (EDS in hospitalized psychiatric patients at the American University of Beirut Medical Center (AUB-MC. Factors associated with OSA and EDS occurrence in this sample were also examined. Methods: The Berlin questionnaire and the Epworth sleepiness scale; which respectively evaluate OSA and EDS symptoms, were administered to individuals hospitalized at an acute psychiatric treatment unit at the AUB-MC between the dates of January 2014 and October 2016. Additional data collected included general demographics, psychiatric diagnoses, and questionnaires evaluating depression and anxiety symptoms. Statistical analyses utilizing SPSS were performed to determine the prevalence of OSA and EDS, as well as their respective associations with patient profiles. Results: Our results showed that 39.5% of participants were found to have a high risk of sleep apnea and 9.9% of the participants were found to have abnormal daytime sleepiness. The risk of developing OSA was associated with a higher body mass index (BMI (P=0.02, and depression severity (patient health questionnaire 9 score (P=0.01. Increasing severity of depressive symptoms was associated with a higher risk of sleep apnea (P=0.01. BMI (odds ratio [OR] =5.97, 95% confidence interval [CI] 1.89–18.82 and depression severity (OR =4.04, 95% CI 1.80–9.07 were also found to be predictors of OSA. The psychiatric diagnoses of the participants were not found to have a significant association with the risk of sleep apnea. Conclusion: The risk of OSA is increased among hospitalized

  10. Disrupted sleep without sleep curtailment induces sleepiness and cognitive dysfunction via the tumor necrosis factor-α pathway

    Directory of Open Access Journals (Sweden)

    Ramesh Vijay

    2012-05-01

    Full Text Available Abstract Background Sleepiness and cognitive dysfunction are recognized as prominent consequences of sleep deprivation. Experimentally induced short-term sleep fragmentation, even in the absence of any reductions in total sleep duration, will lead to the emergence of excessive daytime sleepiness and cognitive impairments in humans. Tumor necrosis factor (TNF-α has important regulatory effects on sleep, and seems to play a role in the occurrence of excessive daytime sleepiness in children who have disrupted sleep as a result of obstructive sleep apnea, a condition associated with prominent sleep fragmentation. The aim of this study was to examine role of the TNF-α pathway after long-term sleep fragmentation in mice. Methods The effect of chronic sleep fragmentation during the sleep-predominant period on sleep architecture, sleep latency, cognitive function, behavior, and inflammatory markers was assessed in C57BL/6 J and in mice lacking the TNF-α receptor (double knockout mice. In addition, we also assessed the above parameters in C57BL/6 J mice after injection of a TNF-α neutralizing antibody. Results Mice subjected to chronic sleep fragmentation had preserved sleep duration, sleep state distribution, and cumulative delta frequency power, but also exhibited excessive sleepiness, altered cognitive abilities and mood correlates, reduced cyclic AMP response element-binding protein phosphorylation and transcriptional activity, and increased phosphodiesterase-4 expression, in the absence of AMP kinase-α phosphorylation and ATP changes. Selective increases in cortical expression of TNF-α primarily circumscribed to neurons emerged. Consequently, sleepiness and cognitive dysfunction were absent in TNF-α double receptor knockout mice subjected to sleep fragmentation, and similarly, treatment with a TNF-α neutralizing antibody abrogated sleep fragmentation-induced learning deficits and increases in sleep propensity. Conclusions Taken together

  11. Effects of recovery sleep after one work week of mild sleep restriction on interleukin-6 and cortisol secretion and daytime sleepiness and performance.

    Science.gov (United States)

    Pejovic, Slobodanka; Basta, Maria; Vgontzas, Alexandros N; Kritikou, Ilia; Shaffer, Michele L; Tsaoussoglou, Marina; Stiffler, David; Stefanakis, Zacharias; Bixler, Edward O; Chrousos, George P

    2013-10-01

    One workweek of mild sleep restriction adversely impacts sleepiness, performance, and proinflammatory cytokines. Many individuals try to overcome these adverse effects by extending their sleep on weekends. To assess whether extended recovery sleep reverses the effects of mild sleep restriction on sleepiness/alertness, inflammation, and stress hormones, 30 healthy young men and women (mean age ± SD, 24.7 ± 3.5 yr; mean body mass index ± SD, 23.6 ± 2.4 kg/m(2)) participated in a sleep laboratory experiment of 13 nights [4 baseline nights (8 h/night), followed by 6 sleep restriction nights (6 h/night) and 3 recovery nights (10 h/night)]. Twenty-four-hour profiles of circulating IL-6 and cortisol, objective and subjective daytime sleepiness (Multiple Sleep Latency Test and Stanford Sleepiness Scale), and performance (Psychomotor Vigilance Task) were assessed on days 4 (baseline), 10 (after 1 wk of sleep restriction), and 13 (after 2 nights of recovery sleep). Serial 24-h IL-6 plasma levels increased significantly during sleep restriction and returned to baseline after recovery sleep. Serial 24-h cortisol levels during restriction did not change compared with baseline, but after recovery they were significantly lower. Subjective and objective sleepiness increased significantly after restriction and returned to baseline after recovery. In contrast, performance deteriorated significantly after restriction and did not improve after recovery. Extended recovery sleep over the weekend reverses the impact of one work week of mild sleep restriction on daytime sleepiness, fatigue, and IL-6 levels, reduces cortisol levels, but does not correct performance deficits. The long-term effects of a repeated sleep restriction/sleep recovery weekly cycle in humans remain unknown.

  12. Changes in medical treatment six months after risk stratification with HeartScore and coronary artery calcification scanning of healthy middle-aged subjects

    DEFF Research Database (Denmark)

    Sørensen, Mette Hjortdal; Gerke, Oke; Lambrechtsen, Jess

    2012-01-01

    Objectives: The aim was to examine and compare the impact of HeartScore and coronary artery calcification (CAC) score on subsequent changes in the use of medication. Methods: A total of 1156 healthy men and women, aged 50 or 60, had a baseline medical examination and a coronary artery CT-scan as ...

  13. Comparing Treatment Effect Measurements in Narcolepsy: The Sustained Attention to Response Task, Epworth Sleepiness Scale and Maintenance of Wakefulness Test.

    Science.gov (United States)

    van der Heide, Astrid; van Schie, Mojca K M; Lammers, Gert Jan; Dauvilliers, Yves; Arnulf, Isabelle; Mayer, Geert; Bassetti, Claudio L; Ding, Claire-Li; Lehert, Philippe; van Dijk, J Gert

    2015-07-01

    To validate the Sustained Attention to Response Task (SART) as a treatment effect measure in narcolepsy, and to compare the SART with the Maintenance of Wakefulness Test (MWT) and the Epworth Sleepiness Scale (ESS). Validation of treatment effect measurements within a randomized controlled trial (RCT). Ninety-five patients with narcolepsy with or without cataplexy. The RCT comprised a double-blind, parallel-group, multicenter trial comparing the effects of 8-w treatments with pitolisant (BF2.649), modafinil, or placebo (NCT01067222). MWT, ESS, and SART were administered at baseline and after an 8-w treatment period. The severity of excessive daytime sleepiness and cataplexy was also assessed using the Clinical Global Impression scale (CGI-C). The SART, MWT, and ESS all had good reliability, obtained for the SART and MWT using two to three sessions in 1 day. The ability to distinguish responders from nonresponders, classified using the CGI-C score, was high for all measures, with a high performance for the SART (r = 0.61) and the ESS (r = 0.54). The Sustained Attention to Response Task is a valid and easy-to-administer measure to assess treatment effects in narcolepsy, enhanced by combining it with the Epworth Sleepiness Scale. © 2015 Associated Professional Sleep Societies, LLC.

  14. Associations of Caffeinated Beverage Consumption and Screen Time with Excessive Daytime Sleepiness in Korean High School Students.

    Science.gov (United States)

    Jun, Nuri; Lee, Aeri; Baik, Inkyung

    2017-01-01

    The present study investigated caffeinated beverage consumption and screen time in the association with excessive daytime sleepiness (EDS) and sleep duration. We conducted a cross-sectional study including 249 Korean male high school students. These participants responded to a questionnaire inquiring the information on lifestyle factors, consumption of caffeinated beverages, time spent for screen media, and sleep duration as well as to the Epworth Sleepiness Scale (ESS) questionnaire. EDS was defined as ESS scores of 9 or greater. Students with EDS consumed greater amount of chocolate/cocoa drinks and spent longer time for a TV and a mobile phone than those without EDS (p coffee than others whereas students with long sleep (> 8 hours) consumed greater amount of chocolate/cocoa drinks than others (p < 0.05). Screen time did not differ according to the categories of sleep duration. Although these findings do not support causal relationships, they suggest that screen time is associated with EDS, but not with sleep duration, and that consumption of certain types of caffeinated beverages is associated with EDS and sleep duration. Adolescents may need to reduce screen time and caffeine consumption to improve sleep quality and avoid daytime sleepiness.

  15. Associations between night work and anxiety, depression, insomnia, sleepiness and fatigue in a sample of Norwegian nurses.

    Science.gov (United States)

    Øyane, Nicolas M F; Pallesen, Ståle; Moen, Bente Elisabeth; Akerstedt, Torbjörn; Bjorvatn, Bjørn

    2013-01-01

    Night work has been reported to be associated with various mental disorders and complaints. We investigated relationships between night work and anxiety, depression, insomnia, sleepiness and fatigue among Norwegian nurses. The study design was cross-sectional, based on validated self-assessment questionnaires. A total of 5400 nurses were invited to participate in a health survey through the Norwegian Nurses' Organization, whereof 2059 agreed to participate (response rate 38.1%). Nurses completed a questionnaire containing items on demographic variables (gender, age, years of experience as a nurse, marital status and children living at home), work schedule, anxiety/depression (Hospital Anxiety and Depression Scale), insomnia (Bergen Insomnia Scale), sleepiness (Epworth Sleepiness Scale) and fatigue (Fatigue Questionnaire). They were also asked to report number of night shifts in the last 12 months (NNL). First, the parameters were compared between nurses i) never working nights, ii) currently working nights, and iii) previously working nights, using binary logistic regression analyses. Subsequently, a cumulative approach was used investigating associations between NNL with the continuous scores on the same dependent variables in hierarchical multiple regression analyses. Nurses with current night work were more often categorized with insomnia (OR = 1.48, 95% CI = 1.10-1.99) and chronic fatigue (OR = 1.78, 95% CI = 1.02-3.11) than nurses with no night work experience. Previous night work experience was also associated with insomnia (OR = 1.45, 95% CI = 1.04-2.02). NNL was not associated with any parameters in the regression analyses. Nurses with current or previous night work reported more insomnia than nurses without any night work experience, and current night work was also associated with chronic fatigue. Anxiety, depression and sleepiness were not associated with night work, and no cumulative effect of night shifts during the last 12 months was found on any

  16. Efficacy and safety of adjunctive modafinil treatment on residual excessive daytime sleepiness among nasal continuous positive airway pressure-treated japanese patients with obstructive sleep apnea syndrome: a double-blind placebo-controlled study.

    Science.gov (United States)

    Inoue, Yuichi; Takasaki, Yuji; Yamashiro, Yoshihiro

    2013-08-15

    This double-blind study evaluated the efficacy and safety of modafinil for treating excessive daytime sleepiness in Japanese patients with obstructive sleep apnea syndrome (OSAS). Patients with residual excessive sleepiness (Epworth Sleepiness Scale [ESS] ≥ 11) on optimal nasal continuous positive airway pressure (nCPAP) therapy (apnea-hypopnea index ≤ 10) were randomized to either 200 mg modafinil (n = 52) or placebo (n = 62) once daily for 4 weeks. Outcomes included baseline-week 4 changes in ESS total score, sleep latency on maintenance of wakefulness test (SL-MWT), nocturnal polysomnography, Pittsburgh Sleep Quality Index (PSQI), and safety. All 114 randomized patients completed the study. Mean change in ESS total score (-6.6 vs -2.4, p modafinil than with placebo. ESS total score decreased from > 11 to modafinil-treated patients and 30.6% of placebo-treated patients (p modafinil and placebo groups, respectively (p = 0.146). Once-daily modafinil was effective and well tolerated for managing residual daytime sleepiness in Japanese OSAS patients with residual excessive daytime sleepiness on optimal nCPAP therapy.

  17. [Excessive Daytime Sleepiness, Poor Quality Sleep, and Low Academic Performance in Medical Students].

    Science.gov (United States)

    Machado-Duque, Manuel Enrique; Echeverri Chabur, Jorge Enrique; Machado-Alba, Jorge Enrique

    2015-01-01

    Quality of sleep and excessive daytime sleepiness (EDS) affect cognitive ability and performance of medical students. This study attempts to determine the prevalence of EDS, sleep quality, and assess their association with poor academic performance in this population. A descriptive, observational study was conducted on a random sample of 217 medical students from the Universidad Tecnológica de Pereira, who completed the Pittsburgh Sleep Quality Index (PSQI) questionnaire and the Epworth sleepiness scale. Sociodemographic, clinic and academic variables were also measured. Multivariate analyses for poor academic performance were performed. The included students had a mean age of 21.7±3.3 years, of whom 59.4% were men. Almost half (49.8%) had EDS criteria, and 79.3% were poor sleepers (PSQI ≥ 5), while 43.3% had poor academic performance during the last semester. The bivariate analysis showed that having used tobacco or alcohol until intoxicated, fairly bad subjective sleep quality, sleep efficiency < 65%, and being a poor sleeper were associated with increased risk of low performance. Sleep efficiency < 65% was statistically associated with poor academic performance (P=.024; OR = 4.23; 95% CI, 1.12-15.42) in the multivariate analysis. A poor sleep quality determined by low efficiency was related to poor academic achievement at the end of semester in medical students. Copyright © 2015 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  18. Subjective sleep characteristics associated with anxiety and depression in older adults: a population-based study.

    Science.gov (United States)

    Potvin, Olivier; Lorrain, Dominique; Belleville, Geneviève; Grenier, Sébastien; Préville, Michel

    2014-12-01

    Sleep complaints are often associated with anxiety and depression, but the specific complaints related to each syndrome are poorly characterized, especially in older adults. The objective was to identify subjective sleep characteristics specific to anxiety and depression in this population. A random sample of 2393 individuals aged 65 years or older was used. Anxiety and depression were categorized using DSM-V criteria for phobias, panic disorder, generalized anxiety disorder, unspecified anxiety disorder, major depressive episode, and depressive episode with insufficient symptoms. Subjective sleep characteristics were measured using the Pittsburgh Sleep Quality Index. Logistic regression models predicting anxiety or depression were used to determine the independent sleep characteristics associated with each syndrome adjusting for age, sex, education level, cognitive functioning, anxiolytic/sedative/hypnotic use, antidepressants use, subjective health, chronic diseases, cardiovascular conditions, and anxiety or depression (as appropriate). Nearly all Pittsburgh Sleep Quality Index subscales were significantly associated with anxiety, but these subscales shared variance and only sleep duration in hours, sleep disturbance score, and daytime functioning score were independently related to anxiety. Within these significant subscales, the main specific sleep complaints associated with anxiety were daytime sleepiness and sleep disturbances related to coughing/snoring, feeling cold, and bad dreams. The use of sleeping medication was the only specific sleep characteristic associated with depression. These results suggest that in older adults, symptoms of short sleep duration, daytime sleepiness and sleep disturbances are independently related to anxiety while the use of sleep medication is independently associated to depression. Copyright © 2014 John Wiley & Sons, Ltd.

  19. Effects of long working hours and the night shift on severe sleepiness among workers with 12-hour shift systems for 5 to 7 consecutive days in the automobile factories of Korea.

    Science.gov (United States)

    Son, Mia; Kong, Jeong-Ok; Koh, Sang-Baek; Kim, Jaeyoung; Härmä, Mikko

    2008-12-01

    We investigated the effects of 12-hour shift work for five to seven consecutive days and overtime on the prevalence of severe sleepiness in the automobile industry in Korea. [Correction added after online publication 28 Nov: Opening sentence of the summary has been rephrased for better clarity.] A total of 288 randomly selected male workers from two automobile factories were selected and investigated using questionnaires and sleep-wake diaries in South Korea. The prevalence of severe sleepiness at work [i.e. Karolinska Sleepiness Scale (KSS) score of 7 or higher] was modeled using marginal logistic regression and included theoretical risk factors related to working hours and potential confounding factors related to socio-economic status, work demands, and health behaviors. Factors related to working hours increased the risk for severe sleepiness at the end of the shift in the following order: the night shift [odds ratio (OR): 4.7; 95% confidence interval (CI): 3.6-6.0)], daily overtime (OR: 2.2; 95% CI: 1.7-2.9), weekly overtime (OR: 1.6; 95% CI: 1.0-2.6), and night overtime (OR: 1.6; 95% CI: 0.8-3.0). Long working hours and shift work had a significant interactive effect for severe sleepiness at work. Night shift workers who worked for 12 h or more a day were exposed to a risk of severe sleepiness that was 7.5 times greater than day shift workers who worked less than 11 h. Night shifts and long working hours were the main risk factors for severe sleepiness among automobile factory workers in Korea. Night shifts and long working hours have a high degree of interactive effects resulting in severe sleepiness at work, which highlight the need for immediate measures to address these characteristics among South Korean labor force patterns.

  20. [Narcolepsy in sleepy obese children. Two case reports].

    Science.gov (United States)

    Rives-Lange, C; Karsenty, A; Chantereau, H; Oderda, L; Dubern, B; Lecendreux, M; Tounian, P

    2016-06-01

    Narcolepsy is a disabling disorder, characterized by excessive daytime sleepiness, irresistible sleep attacks, and partial or complete cataplexy. Many cases of obesity and precocious puberty have been reported in narcoleptic children, suggesting that the deficiency of hypocretin in narcolepsy could also be implicated in appetite stimulation. We report the observations of two young girls, who were referred for obesity and who developed narcolepsy accompanied by an abrupt weight gain. In both cases, specific drugs promoted wakefulness and overweight stabilization. Narcolepsy has to be suspected in sleepy obese children and not misdiagnosed as obstructive apnea. A nocturnal polysomnography with multiple sleep latency tests should be performed to confirm the diagnosis and begin specific treatment that is effective for sleep disorders and weight gain. Copyright © 2016. Published by Elsevier SAS.

  1. Excessive daytime sleepiness is associated with an exacerbation of migraine: A population-based study.

    Science.gov (United States)

    Kim, Jiyoung; Cho, Soo-Jin; Kim, Won-Joo; Yang, Kwang Ik; Yun, Chang-Ho; Chu, Min Kyung

    2016-12-01

    Previous studies have shown that migraine and sleep disturbances are closely associated. Excessive daytime sleepiness (EDS) is a common symptom of various types of sleep disturbance. Findings from clinic-based studies suggest that a high percentage of migraineurs experience EDS. However, the prevalence and clinical impact of EDS among migraineurs at the population level have rarely been reported. The objective of this study was to investigate the prevalence and impact of EDS among migraineurs using a population-based sample in Korea. We selected a stratified random sample of Koreans aged 19 to 69 years and evaluated them using a semi-structured interview designed to identify EDS, headache type, and the clinical characteristics of migraine. If the score on the Epworth Sleepiness Scale (ESS) was more than or equal to 11, the participant was classified as having EDS. Of the 2,695 participants that completed the interview, 143 (5.3 %) and 313 (11.6 %) were classified as having migraine and EDS, respectively. The prevalence of EDS was significantly higher in participants with migraine (19.6 %) and non-migraine headache (13.4 %) compared to non-headache controls (9.4 %). Migraineurs with EDS had higher scores on the Visual Analogue Scale (VAS) for headache intensity (6.9 ± 1.8 vs. 6.0 ± 1.9, p = 0.014) and Headache Impact Test-6 (59.8 ± 10.2 vs. 52.5 ± 8.2, p migraine symptoms.

  2. Plasma levels of neuropeptides and metabolic hormones, and sleepiness in obstructive sleep apnea.

    Science.gov (United States)

    Sánchez-de-la-Torre, M; Barceló, A; Piérola, J; Esquinas, C; de la Peña, M; Durán-Cantolla, J; Capote, F; Masa, J F; Marin, J M; Vilá, M; Cao, G; Martinez, M; de Lecea, L; Gozal, D; Montserrat, J M; Barbé, F

    2011-12-01

    Obstructive sleep apnea (OSA) is related to obesity and metabolic disorders. The main clinical symptoms are excessive daytime sleepiness (EDS) and snoring. However, not all patients with OSA manifest EDS. Hypocretin-1, neuropeptide Y, leptin, ghrelin and adiponectin are implicated in both metabolic and sleep regulation, two conditions affected by OSA. We hypothesized that levels of these peptides may be related to EDS in OSA patients. We included 132 patients with EDS, as defined by an Epworth Sleepiness Scale (ESS) score ≥ 13 (mean ± SD, 15.7 ± 2.3) and 132 patients without EDS as defined by an ESS score ≤ 9 (6.5 ± 1.9). All patients had an apnea-hypopnea index (AHI) ≥ 20 h(-1). Both groups were matched for gender (males; 83.3% vs. 85.6%), age (50.15 ± 11.2 yrs vs. 50.7 ± 9.9 yrs), body mass index (BMI) (31.8 ± 5.6 kg m(-2) vs. 32.1 ± 4.8 kg m(-2)), and apnea-hypopnea index (AHI) (45.5 ± 19.1 h(-1) vs. 43 ± 19.2 h(-1)). OSA patients with EDS showed significantly higher plasma hypocretin-1 levels (p sleep time. Our study shows that EDS in patients with OSA is associated with increased circulating hypocretin-1 and decreased circulating ghrelin levels, two peptides involved in the regulation of body weight, energy balance, sympathetic tone and sleep-wake cycle. This relationship is independent of AHI and obesity (two key phenotypic features of OSA). Copyright © 2011 Elsevier Ltd. All rights reserved.

  3. A Clinical-EEG Study of Sleepiness and Psychological Symptoms in Pharmacoresistant Epilepsy Patients Treated with Lacosamide

    Directory of Open Access Journals (Sweden)

    Filippo S. Giorgi

    2013-01-01

    Full Text Available Our aim was to evaluate the EEG and clinical modifications induced by the new antiepileptic drug lacosamide (LCM in patients with epilepsy. We evaluated 10 patients affected by focal pharmacoresistant epilepsy in which LCM (mean 250 mg/day was added to the preexisting antiepileptic therapy, which was left unmodified. Morning waking EEG recording was performed before (t0 and at 6 months (t1 after starting LCM. At t0 and t1, patients were also administered questionnaires evaluating mood, anxiety, sleep, sleepiness, and fatigue (Beck Depression Inventory; State-Trait Anxiety Inventory Y1 and Y2; Pittsburgh Sleep Quality Index; Epworth Sleepiness Scale; Fatigue Severity Scale. We performed a quantitative analysis of EEG interictal abnormalities and background EEG power spectrum analysis. LCM as an add-on did not significantly affect anxiety, depression, sleepiness, sleep quality, and fatigue scales. Similarly, adding LCM to preexisting therapy did not modify significantly patient EEGs in terms of absolute power, relative power, mean frequency, and interictal abnormalities occurrence. In conclusion, in this small cohort of patients, we confirmed that LCM as an add-on does not affect subjective parameters which play a role, among others, in therapy tolerability, and our clinical impression was further supported by evaluation of EEG spectral analysis.

  4. Blue light exposure reduces objective measures of sleepiness during prolonged nighttime performance testing.

    Science.gov (United States)

    Phipps-Nelson, Jo; Redman, Jennifer R; Schlangen, Luc J M; Rajaratnam, Shantha M W

    2009-07-01

    This study examined the effects of nocturnal exposure to dim, narrowband blue light (460 nm, approximately 1 lux, 2 microW/cm2), compared to dim broad spectrum (white) ambient light ( approximately 0.2 lux, 0.5 microW/cm2), on subjective and objective indices of sleepiness during prolonged nighttime performance testing. Participants were also exposed to a red light (640 nm, approximately 1 lux, 0.7 microW/cm2) placebo condition. Outcome measures were driving simulator and psychomotor vigilance task (PVT) performance, subjective sleepiness, salivary melatonin, and electroencephalographic (EEG) activity. The study had a repeated-measures design, with three counterbalanced light conditions and a four-week washout period between each condition. Participants (n = 8) maintained a regular sleep-wake schedule for 14 days prior to the approximately 14 h laboratory study, which consisted of habituation to light conditions followed by neurobehavioral performance testing from 21:00 to 08:30 h under modified constant-routine conditions. A neurobehavioral test battery (2.5 h) was presented four times between 21:00 and 08:30 h, with a 30 min break between each. From 23:30 to 05:30 h, participants were exposed to blue or red light, or remained in ambient conditions. Compared to ambient light exposure, blue light exposure suppressed EEG slow wave delta (1.0-4.5 Hz) and theta (4.5-8 Hz) activity and reduced the incidence of slow eye movements. PVT reaction times were significantly faster in the blue light condition, but driving simulator measures, subjective sleepiness, and salivary melatonin levels were not significantly affected by blue light. Red light exposure, as compared to ambient light exposure, reduced the incidence of slow eye movements. The results demonstrate that low-intensity, blue light exposure can promote alertness, as measured by some of the objective indices used in this study, during prolonged nighttime performance testing. Low intensity, blue light exposure has

  5. WISC-III subtests of similarities, vocabulary and comprehension: objective or subjective scoring? / Subtestes semelhanças, vocabulário e compreensão do WISC-III: pontuação objetiva ou subjetiva?

    Directory of Open Access Journals (Sweden)

    Vera Lucia Marques de Figueiredo

    2010-01-01

    Full Text Available In all psychological tests, scoring should be of concern for examiners because the accuracy of results depends, at some extent, on the quality of the correction. This work aims to examine the correction, by different psychologists, of the scores for the Wechsler Intelligence Scale for Children (WISC-III subtests of Similarities, Vocabulary and Comprehension since these are the subtests where examiner's subjectivity seemingly most influences scoring. Forty two psychologists from different states in Brazil participated in this study. They corrected the answers of six test protocols randomly selected from a standardization sample for the Brazilian context. Taking as reference the total scores, the Vocabulary subtest showed greater variability in score, followed by the Comprehension one. Considering the total number of items tested in each subtest, Similarities had the highest agreement among raters. The results showed that all the three subtests involve subjectivity on behalf of the examiner to score the answers. Continuing in this study, we also aim to determine test reliability based on interrater agreement.

  6. Subjective sleep disturbances and quality of life in chronic tetraplegia.

    Science.gov (United States)

    Spong, J; Graco, M; Brown, D J; Schembri, R; Berlowitz, D J

    2015-08-01

    This is a cross-sectional survey. The objective of this study was to evaluate the subjective sleep disturbances and quality of life in chronic tetraplegia. This study was conducted in a community sample from Victoria, Australia. People with tetraplegia were mailed a survey battery including the following: demographic questions; Karolinska Sleepiness Scale (KSS); Basic Nordic Sleepiness Questionnaire; Functional Outcomes of Sleep Questionnaire (FOSQ); Multivariate Apnoea Prediction Index and Assessment of Quality of Life (AQoL) Questionnaire. Scores were compared with the best available normative data. A total of 163 of 424 (38%) surveys were returned (77% male; 39% sensory and motor complete; mean age±s.d.=46±14 years; mean years since injury=11±8 years). The AQoL health utility score (0.31±0.29) was significantly lower than published population norms. FOSQ total (17.55±2.57) and KSS (3.93±2.27) scores were no different from the best available population data. People with tetraplegia reported worse sleep habits, symptoms and quality than a normal population, as indicated on 17 of 21 questions on the Basic Nordic Sleep Questionnaire. Multivariate analysis found that greater injury severity (coefficient (95% CI)=0.14 (0.10, 0.18)), increasing age (-0.004 (-0.008, -0.001)) and worse sleep symptoms (-0.005 (-0.009, -0.0003)) were all significantly associated with reduced quality of life. People with chronic tetraplegia experience more subjective sleep problems and worse quality of life than their able-bodied counterparts. Quality of life is related to injury severity, age and sleep symptoms. Treating the sleep disorders experienced by people living with tetraplegia has the potential to improve their health and well-being.

  7. The Effect of Music on the Test Scores of the Students in Limits and Derivatives Subject in the Mathematics Exams Done with Music

    Science.gov (United States)

    Kesan, Cenk; Ozkalkan, Zuhal; Iric, Hamdullah; Kaya, Deniz

    2012-01-01

    In the exams based on limits and derivatives, in this study, it was tried to determine that if there was any difference in students' test scores according to the type of music listened to and environment without music. For this purpose, the achievement test including limits and derivatives and whose reliability coefficient of Cronbach Alpha is…

  8. Daytime sleepiness in obesity: mechanisms beyond obstructive sleep apnea--a review.

    Science.gov (United States)

    Panossian, Lori A; Veasey, Sigrid C

    2012-05-01

    Increasing numbers of overweight children and adults are presenting to sleep medicine clinics for evaluation and treatment of sleepiness. Sleepiness negatively affects quality of life, mental health, productivity, and safety. Thus, it is essential to comprehensively address all potential causes of sleepiness. While many obese individuals presenting with hypersomnolence will be diagnosed with obstructive sleep apnea and their sleepiness will improve with effective therapy for sleep apnea, a significant proportion of patients will continue to have hypersomnolence. Clinical studies demonstrate that obesity without sleep apnea is also associated with a higher prevalence of hypersomnolence and that bariatric surgery can markedly improve hypersomnolence before resolution of obstructive sleep apnea. High fat diet in both humans and animals is associated with hypersomnolence. This review critically examines the relationships between sleepiness, feeding, obesity, and sleep apnea and then discusses the hormonal, metabolic, and inflammatory mechanisms potentially contributing to hypersomnolence in obesity, independent of sleep apnea and other established causes of excessive daytime sleepiness.

  9. [Risk assessment for sleep apnea syndrome and excessive daytime sleepiness in patients with chronic obstructive pulmonary disease].

    Science.gov (United States)

    Maricić, Lana; Visević, Roberta; Vceva, Andrijana; Vcev, Aleksandar; Labor, Slavica

    2013-06-01

    The objective of this study was to examine the risk of sleep apnea syndrome in patients with chronic obstructive pulmonary disease (COPD) and to determine correlation with the associated cardiovascular comorbidity in these patients. Chronic and occasional sleep disturbances represent a problem for millions of people worldwide. COPD is a multisystem disease and the leading cause of mortality and morbidity in the world. It is estimated that it will be the third cause of death in the world by 2020. Poor quality of sleep in patients with COPD occurs as a result of reduced oxygen saturation, hypercapnia, and the use of auxiliary respiratory muscles. The study included 47 patients with COPD, examined at the Department of Pulmonology, Clinical Department of Internal Medicine, Osijek University Hospital Center in 2011. The respondents answered questions from the Croatian version of the Snoring, Tired, Observed, Pressure (STOP) questionnaire, which examines the risk of sleep apnea syndrome, and the Epworth Sleepiness Scale, which examines excessive daytime sleepiness. The respondents also provided data related to the current smoking status, bronchodilation therapy they apply at home, the associated cardiovascular comorbidity related to coronary heart disease (previous myocardial infarction, angina pectoris), cerebrovascular incident, diabetes, asthma, gastroesophageal reflux disease (GERD) and anxiety-depressive disorder. According to the STOP questionnaire, the risk of sleep apnea syndrome was recorded in 35 (74.5%) respondents. Patients at risk had a higher frequency of comorbidities such as hypertension, diabetes mellitus type 2 and GERD. Excessive daytime sleepiness was recorded in 14.9% of patients with COPD and the mean daytime sleepiness scored 4.76 points. In patients at a high risk according to the STOP questionnaire, the mean daytime sleepiness was 6.24 points versus 3.72 points in the group at a low risk. Snoring was present in 23 (49%), excessive tiredness in 27

  10. Sleep Duration and Sleep Quality following Acute Mild Traumatic Brain Injury: A Propensity Score Analysis

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    Ting-Yun Huang

    2015-01-01

    Full Text Available Introduction. Mild traumatic brain injury (mTBI has been widely studied and the effects of injury can be long term or even lifelong. This research aims to characterize the sleep problems of patients following acute mTBI. Methods. A total of 171 patients with mTBI within one month and 145 non-mTBI controls were recruited in this study. The questionnaire, Pittsburgh Sleep Quality Index (PSQI, was used to evaluate seven aspects of sleep problems. A propensity score method was used to generate a quasirandomized design to account for the background information, including gender, age, Beck’s Anxiety Index, Beck’s Depression Index, and Epworth Sleepiness Scale. The effect was evaluated via cumulative logit regression including propensity scores as a covariate. Results. Before adjustment, about 60% mTBI patients and over three quarters of control subjects had mild sleep disturbance while one third mTBI patients had moderate sleep disturbance. After adjusting by the propensity scores, the scores of sleep quality and duration were significant between mTBI and control groups. Conclusion. Our study supports that sleep problem is common in mTBI group. After adjusting the confounders by propensity score, sleep duration and subjective sleep quality are the most frequently reported problems in mTBI patients within one month after the injury.

  11. Ocular indicators of sleepiness: implications for drowsy driving prevention in shift workers

    OpenAIRE

    Ftouni, Suzanne

    2017-01-01

    In Australia, approximately 20% of motor vehicle collisions result from fatigue or sleepiness-related driving, making it one of the most common causes of preventable motor vehicle crashes (MVC). The shift working population is found to be overrepresented in sleepiness-related vehicle crashes due to the effect of circadian misalignment and sleep loss, resulting in excessive sleepiness and neurobehavioural performance decline during waking hours. It is therefore essential that effective counter...

  12. Daytime Sleepiness, Circadian Preference, Caffeine Consumption and Use of Other Stimulants among Thai College Students

    OpenAIRE

    Tran, Jason; Lertmaharit, Somrat; Lohsoonthorn, Vitool; Pensuksan, Wipawan C.; Rattananupong, Thanapoom; Tadesse, Mahlet G.; GELAYE, Bizu; Williams, Michelle A

    2014-01-01

    We conducted this study to evaluate the prevalence of daytime sleepiness and evening chronotype, and to assess the extent to which both are associated with the use of caffeinated stimulants among 3,000 Thai college students. Demographic and behavioral characteristics were collected using a self-administered questionnaire. The Epworth Sleepiness Scale and the Horne and Ostberg Morningness-Eveningness Questionnaire were used to evaluate prevalence of daytime sleepiness and circadian preference....

  13. Excessive daytime sleepiness and body composition: a population-based study of adults.

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    Amie C Hayley

    Full Text Available BACKGROUND: Excessive daytime sleepiness (EDS is often associated with increased adiposity, particularly when assessed in the context of samples of sleep-disordered patients; however, it is unclear if this relationship is sustained among non-clinical, population-based cohorts. This study aimed to investigate the relationship between EDS and a number of body composition markers among a population-based sample of men and women. METHODS: This study assessed 1066 women aged 21-94 yr (median = 51 yr, IQR 35-66, and 911 men aged 24-92 yr (median = 60 yr, IQR 46-73 who participated in the Geelong Osteoporosis Study (GOS between the years 2001 and 2008. Total body fat mass was determined from whole body dual-energy X-ray absorptiometry scans, and anthropometric parameters (weight, height, and waist circumference were measured. Lifestyle and health information was collected via self-report. Sleepiness was assessed using the Epworth Sleepiness Scale (ESS. Scores of ≥ 10 were considered indicative of EDS. RESULTS: Women: After adjusting for age, alcohol intake, antidepressant medication use and physical activity, EDS was associated with greater waist circumference and body mass index (BMI. EDS was also associated with 1.5-1.6-fold increased odds of being overweight or obese. Men: After adjusting for age, alcohol use, physical activity and smoking status, EDS was associated with greater BMI. These findings were not explained by the use of sedative or antidepressant medication. EDS was also associated with 1.5-fold increased likelihood of being obese, independent of these factors. No differences in lean mass, %body fat, or %lean mass were detected between those with and without EDS for men or women. CONCLUSIONS: These data suggest that EDS is associated with several anthropometric adiposity profiles, independent of associated lifestyle and health factors. Among women, symptoms of EDS are pervasive at both overweight and obese BMI classifications

  14. Sleep and sleepiness of fishermen on rotating schedules.

    Science.gov (United States)

    Gander, Philippa; van den Berg, Margo; Signal, Leigh

    2008-04-01

    Seafaring is a hazardous occupation with high death and injury rates, but the role of seafarer fatigue in these events is generally not well documented. The International Maritime Organization has identified seafarer fatigue as an important health and safety issue. Most research to date has focused on more regularly scheduled types of operations (e.g., merchant vessels, ferries), but there is relatively little information on commercial fishing, which often involves high day-to-day and seasonal variability in work patterns and workload. The present study was designed to monitor the sleep and sleepiness of commercial fishermen at home and during extended periods at sea during the peak of the hoki fishing season, with a view to developing better fatigue management strategies for this workforce. Sleep (wrist actigraphy and sleep diaries) and sleepiness (Karolinska Sleepiness Scale [KSS] before and after each sleep period) of 20 deckhands were monitored for 4-13 days at home and for 5-9 days at sea while working a nominal 12 h on/6 h off schedule. On the 12 h on/6 hoff schedule, there was still a clear preference for sleep at night. Comparing the last three days at home and the first three days at sea showed that fishermen were more likely to have split sleep at sea (Wilcoxon signed ranks p or= 7 on 24% of days at sea vs. 9% of days at home (Wilcoxon signed ranks p fishing season increases the risk of performance impairment due to greater cumulative sleep loss than would be expected on typical three-day trips. Key fatigue management strategies in this environment include that fishermen report to work as well rested as possible. Once at sea, the day-to-day variability in activities due to uncontrollable factors, such as fishing success, repairing gear, and weather conditions, mean that contingency planning is required for managing situations where the entire crew have experienced long periods of intensive work with minimum recovery opportunities.

  15. Excessive Daytime Sleepiness Predicts Neurodegeneration in Idiopathic REM Sleep Behavior Disorder.

    Science.gov (United States)

    Zhou, Junying; Zhang, Jihui; Lam, Siu Ping; Chan, Joey Wy; Mok, Vincent; Chan, Anne; Li, Shirley Xin; Liu, Yaping; Tang, Xiangdong; Yung, Wing Ho; Wing, Yun Kwok

    2017-05-01

    To determine the association of excessive daytime sleepiness (EDS) with the conversion of neurodegenerative diseases in patients with idiopathic REM sleep behavior disorder (iRBD). A total of 179 patients with iRBD (79.1% males, mean age = 66.3 ± 9.8 years) were consecutively recruited. Forty-five patients with Epworth Sleepiness Scale score ≥14 were defined as having EDS. Demographic, clinical, and polysomnographic data were compared between iRBD patients with and without EDS. The risk of developing neurodegenerative diseases was examined using Cox proportional hazards model. After a mean follow-up of 5.8 years (SD = 4.3 years), 50 (27.9%) patients developed neurodegenerative diseases. There was a significantly higher proportion of conversion in patients with EDS compared to those without EDS (42.2 % vs. 23.1%, p = .01). EDS significantly predicted an increased risk of developing neurodegenerative diseases (adjusted hazard ratios [HR] = 2.56, 95% confidence interval [CI] 1.37 to 4.77) after adjusting for age, sex, body mass index, current depression, obstructive sleep apnea, and periodic limb movements during sleep. Further analyses demonstrated that EDS predicted the conversion of Parkinson's disease (PD) (adjusted HR = 3.55, 95% CI 1.59 to 7.89) but not dementia (adjusted HR = 1.48, 95% CI 0.44 to 4.97). EDS is associated with an increased risk of developing neurodegenerative diseases, especially PD, in patients with iRBD. Our findings suggest that EDS is a potential clinical biomarker of α-synucleinopathies in iRBD.

  16. A pictorial Sleepiness and Sleep Apnoea Scale to recognize individuals with high risk for obstructive sleep apnea syndrome.

    Science.gov (United States)

    Edelmann, Cathrin; Ghiassi, Ramesh; Vogt, Deborah R; Partridge, Martyn R; Khatami, Ramin; Leuppi, Jörg D; Miedinger, David

    2017-01-01

    The aim of this study was to evaluate the validity of a new pictorial form of a screening test for obstructive sleep apnea syndrome (OSAS) - the pictorial Sleepiness and Sleep Apnoea Scale (pSSAS). Validation was performed in a sample of patients admitted to sleep clinics in the UK and Switzerland. All study participants were investigated with objective sleep tests such as full-night-attended polysomnography or polygraphy. The pSSAS was validated by taking into account the individual result of the sleep study, sleep-related questionnaires and objective parameters such as body mass index (BMI) or neck circumference. Different scoring schemes of the pSSAS were evaluated, and an internal validation was undertaken. The full data set consisted of 431 individuals (234 patients from the UK, 197 patients from Switzerland). The pSSAS showed good predictive performance for OSAS with an area under the curve between 0.77 and 0.81 depending on which scoring scheme was used. The subscores of the pSSAS had a moderate-to-strong correlation with widely used screening questionnaires for OSAS or excessive daytime sleepiness as well as with BMI and neck circumference. The pSSAS can be used to select patients with a high probability of having OSAS. Due to its simple pictorial design with short questions, it might be suitable for screening in populations with low health literacy and in non-native English or German speakers.

  17. A systematic review of the sleep, sleepiness, and performance implications of limited wake shift work schedules.

    Science.gov (United States)

    Short, Michelle A; Agostini, Alexandra; Lushington, Kurt; Dorrian, Jillian

    2015-09-01

    The aim of this review was to identify which limited wake shift work schedules (LWSW) best promote sleep, alertness, and performance. LWSW are fixed work/rest cycles where the time-at-work does is ≤8 hours and there is >1 rest period per day, on average, for ≥2 consecutive days. These schedules are commonly used in safety-critical industries such as transport and maritime industries. Literature was sourced using PubMed, Embase, PsycInfo, Scopus, and Google Scholar databases. We identified 20 independent studies (plus a further 2 overlapping studies), including 5 laboratory and 17 field-based studies focused on maritime watch keepers, ship bridge officers, and long-haul train drivers. The measurement of outcome measures was varied, incorporating subjective and objective measures of sleep: sleep diaries (N=5), actigraphy (N=4), and polysomnography, (N=3); sleepiness: Karolinska Sleepiness Scale (N=5), visual analog scale (VAS) alertness (N=2) and author-derived measures (N=2); and performance: Psychomotor Vigilance Test (PVT) (N=5), Reaction Time or Vigilance tasks (N=4), Vector and Letter Cancellation Test (N=1), and subjective performance (N=2). Of the three primary rosters examined (6 hours-on/6 hours-off, 8 hours-on/8 hours-off and 4 hours-on/8 hours-off), the 4 hours-on/8 hours-off roster was associated with better sleep and lower levels of sleepiness. Individuals working 4 hours-on/8 hours-off rosters averaged 1 hour more sleep per night than those working 6 hours-on/6 hours-off and 1.3 hours more sleep than those working 8 hours-on/8 hours-off (Pschedules were associated with better sleep and lower sleepines in the case of (i) shorter time-at-work, (ii) more frequent rest breaks, (iii) shifts that start and end at the same clock time every 24 hours, and (iv) work shifts commencing in the daytime (as opposed to night). The findings for performance remain incomplete due to the small number of studies containing a performance measure and the heterogeneity of

  18. Sleep patterns and sleepiness of working college students.

    Science.gov (United States)

    Teixeira, Liliane; Lowden, Arne; da Luz, Andrea Aparecida; Turte, Samantha Lemos; Valente, Daniel; Matsumura, Roberto Jun; de Paula, Leticia Pickersgill; Takara, Meire Yuri; Nagai-Manelli, Roberta; Fischer, Frida Marina

    2012-01-01

    The double journey (work and study) may result or aggravate health problems, including sleep disturbances, as observed in previous studies with high school students. The aim of this study is to analyze the sleep-wake cycle and perceived sleepiness of working college students during weekdays. Twenty-three healthy college male students, 21-24 years old, working during the day and attending classes in the evening, participated in this study. During five consecutive days, the students filled out daily activities logs and wore actigraphs. Mean sleeping time was lower than 6 hours per night. No significant differences were observed in the sleep-wake cycle during the weekdays. The observed lack of changes in the sleepwake cycle of these college students might occur as participants were not on a free schedule, but exposed to social constraints, as was the regular attendance to evening college and day work activities. Sleepiness worsened over the evening school hours. Those results show the burden carried by College students who perform double activities - work and study.

  19. Subtestes semelhanças, vocabulário e compreensão do WISC-III: pontuação objetiva ou subjetiva? WISC-III subtests of similarities, vocabulary and comprehension: objective or subjective scoring?

    Directory of Open Access Journals (Sweden)

    Vera Lucia Marques de Figueiredo

    2010-01-01

    Full Text Available Este trabalho visou analisar a pontuação dos subtestes Semelhanças, Vocabulário e Compreensão do WISC-III, tendo em vista que podem envolver maior subjetividade do avaliador. Participaram do estudo 42 psicólogos de diferentes Estados do Brasil, os quais corrigiram as respostas de 6 protocolos do teste selecionados aleatoriamente da amostra de padronização ao contexto brasileiro. Tomando-se como referência os escores totais, o subteste Vocabulário apresentou maior variabilidade nas pontuações, seguido por Compreensão. Considerando-se o total de itens analisados em cada subteste, Semelhanças apresentou a maior concordância entre os avaliadores. Entretanto, os resultados evidenciaram que os três subtestes envolvem a subjetividade do avaliador na pontuação das respostas.In all psychological tests, scoring should be of concern for examiners because the accuracy of results depends, at some extent, on the quality of the correction. This work aims to examine the correction, by different psychologists, of the scores for the Wechsler Intelligence Scale for Children (WISC-III subtests of Similarities, Vocabulary and Comprehension since these are the subtests where examiner's subjectivity seemingly most influences scoring. Forty two psychologists from different states in Brazil participated in this study. They corrected the answers of six test protocols randomly selected from a standardization sample for the Brazilian context. Taking as reference the total scores, the Vocabulary subtest showed greater variability in score, followed by the Comprehension one. Considering the total number of items tested in each subtest, Similarities had the highest agreement among raters. The results showed that all the three subtests involve subjectivity on behalf of the examiner to score the answers. Continuing in this study, we also aim to determine test reliability based on interrater agreement.

  20. Tai chi and self-rated quality of sleep and daytime sleepiness in older adults: a randomized controlled trial.

    Science.gov (United States)

    Li, Fuzhong; Fisher, K John; Harmer, Peter; Irbe, Dainis; Tearse, Robert G; Weimer, Cheryl

    2004-06-01

    To determine the effectiveness of tai chi on self-rated sleep quality and daytime sleepiness in older adults reporting moderate sleep complaints. Randomized, controlled trial with allocation to tai chi or exercise control. General community. One hundred eighteen women and men aged 60 to 92. Participants were randomized into tai chi or low-impact exercise and participated in a 60-minute session, three times per week, for 24 consecutive weeks. Primary outcome measures were the seven subscales of the Pittsburgh Sleep Quality Index (PSQI), PSQI global score, and Epworth Sleepiness Scale (ESS). Secondary outcome measures were physical performance (single leg stand, timed chair rise, 50-foot speed walk) and 12-item short form (SF-12) physical and mental summary scores. Tai chi participants reported significant improvements in five of the PSQI subscale scores (sleep quality, sleep-onset latency, sleep duration, sleep efficiency, sleep disturbances) (Psleep-onset latency of about 18 minutes less per night (95% confidence interval (CI)=-28.64 to -7.12) and sleep duration of about 48 minutes more per night (95% CI=14.71-82.41) than low-impact exercise participants. Tai chi participants also showed better scores in secondary outcome measures than low-impact exercise participants. Both groups reported improvements in SF-12 mental summary scores. Older adults with moderate sleep complaints can improve self-rated sleep quality through a 6-month, low- to moderate-intensity tai chi program. Tai chi appears to be effective as a nonpharmacological approach to sleep enhancement for sleep-disturbed elderly individuals.

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

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    Sarah Damanti

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

  2. Modafinil improves daytime sleepiness in patients with mild to moderate obstructive sleep apnoea not using standard treatments: a randomised placebo-controlled crossover trial.

    Science.gov (United States)

    Chapman, Julia L; Kempler, Liora; Chang, Catherina L; Williams, Shaun C; Sivam, Sheila; Wong, Keith K H; Yee, Brendon J; Grunstein, Ronald R; Marshall, Nathaniel S

    2014-03-01

    Patients with mild to moderate obstructive sleep apnoea (OSA) commonly suffer excessive daytime sleepiness. Continuous positive airway pressure (CPAP) has limited effectiveness in reducing sleepiness in milder OSA. Modafinil is a wake-promoting drug licensed to treat residual sleepiness in CPAP-treated OSA. We hypothesised that modafinil may effectively treat sleepiness in untreated mild to moderate OSA. Untreated sleepy men with mild to moderate OSA (age 18-70, apnoea-hypopnoea index (AHI) 5-30/h, Epworth Sleepiness Scale (ESS) ≥10) were randomised to receive 200 mg modafinil or matching placebo daily for 2 weeks before crossing over to the alternative treatment after a minimum 2-week washout. Mixed model analysis of variance was used to compare the changes on modafinil to placebo while classifying all randomised patients as random factors. 32 patients were randomised (mean (SD) AHI 13 (6.4)/h, age 47 (10.7) years, ESS 13.6 (3.3), body mass index 28.2 (3.6) kg/m(2)), 29 of whom (91%) completed the trial. The primary outcome (ESS) improved more on modafinil than placebo (3.6 points, 95% CI 1.3 to 5.8, p=0.003) and the secondary outcome (40-min driving simulator performance) also improved more on modafinil than placebo (steering deviation 4.7 cm, 95% CI 0.8 to 8.5, p=0.018). Psychomotor Vigilance Task reciprocal reaction time improved significantly over placebo (0.15 (1/ms), 95% CI 0.03 to 0.27, p=0.016). Improvements on the Functional Outcomes of Sleep Questionnaire were not significant (5.3 points over placebo, 95% CI -1 to 11.6, p=0.093). Modafinil significantly improved subjective sleepiness in patients with untreated mild to moderate OSA. The size of this effect is clinically relevant at 3-4 ESS points of improvement compared with only 1-2 points in CPAP clinical trials. Driving simulator performance and reaction time also improved on modafinil. ACTRN#12608000128392.

  3. Impact of Sleepiness and Sleep Deficiency on Public Health—Utility of Biomarkers

    OpenAIRE

    Czeisler, Charles A.

    2011-01-01

    Sleep disorders and sleep deficiency are important causes of adverse health effects and increased mortality in the United States and worldwide. Sleep deficiency can also result in myriad adverse behavioral consequences, including profound sleepiness, cognitive slowing, automatic behavior, attentional failures and performance degradation, errors, and accidents. It is important to recognize that sleepiness and sleep deficiency are not synonymous.

  4. Eveningness Chronotype, Daytime Sleepiness, Caffeine Consumption, and Use of Other Stimulants Among Peruvian University Students

    OpenAIRE

    Whittier, Anjalene; Sanchez, Sixto; Castañeda, Benjamín; Sanchez, Elena; GELAYE, Bizu; Yanez, David; Williams, Michelle A

    2014-01-01

    Objectives: The aims of this study were to evaluate patterns of circadian preferences and daytime sleepiness, and to examine the extent to which the consumption of stimulant beverages is associated with daytime sleepiness and evening chronotype among Peruvian college-age students.

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

    Directory of Open Access Journals (Sweden)

    Esther Yuet Ying Lau

    2013-01-01

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

  6. Fatigue in Parkinson's disease is not related to excessive sleepiness or quality of sleep

    NARCIS (Netherlands)

    Havlikova, Eva; van Dijk, Jitse P.; Rosenberger, Jaroslav; Nagyova, Iveta; Middel, Berrie; Dubayova, Tatiana; Gdovinova, Zuzana; Groothoff, Johan W.

    2008-01-01

    Objectives: Many patients with Parkinson's disease (PD) suffer from non-motor symptoms like sleep disturbances, excessive daytime sleepiness and fatigue. The aim of our research was to explore whether fatigue is related to sleepiness and sleep problems, depression and functional status, controlled

  7. Translation and validation of the Pediatric Daytime Sleepiness Scale (PDSS) into Brazilian Portuguese.

    Science.gov (United States)

    Felden, Érico P G; Carniel, Joana D; Andrade, Rubian D; Pelegrini, Andreia; Anacleto, Tâmile S; Louzada, Fernando M

    2016-01-01

    The aim of this study was to translate and validate the Pediatric Daytime Sleepiness Scale (PDSS) into Brazilian Portuguese. The translation/validation process was carried out through translation, back translation, technical review, assessment of verbal comprehension/clarity of the scale by experts and a focus group, test-retest, and application of the tool. The reproducibility analysis was performed by applying the PDSS in test-retest; internal consistency was verified by applying the scale in 90 children and adolescents. The mean score of the sum of PDSS questions was 15.6 (SD=5.0) points. The PDSS showed appropriate indicators of content validation and clarity for the Brazilian Portuguese version. The internal consistency analysis showed a Cronbach's alpha of 0.784. The PDSS showed adequate reproducibility. The PDSS scores showed a significant and negative correlation with time spent in bed (r=-0.214; p=0.023). The Brazilian Portuguese version of the PDSS shows satisfactory indicators of validity and can be applied in clinical practice and scientific research. Copyright © 2015 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  8. Sleep length and quality, sleepiness and urinary melatonin among healthy Danish nurses with shift work during work and leisure time

    DEFF Research Database (Denmark)

    Garde, Anne Helene; Hansen, Åse Marie; Hansen, Johnni

    2009-01-01

    Sleep problems are common effects of shift work. The aim of the present study was to evaluate how different types of shift affect sleep and sleepiness, and to relate sleepiness to urinary 6-sulfatoxymelatonin....

  9. Driving simulators in the clinical assessment of fitness to drive in sleepy individuals: A systematic review.

    Science.gov (United States)

    Schreier, David R; Banks, Christina; Mathis, Johannes

    2017-05-04

    Road traffic injuries are projected to be the leading cause of death for those aged between 15 and 29 years by the year 2030, and sleepiness is estimated to be the underlying cause in up to 15-20% of all motor vehicle accidents. Sleepiness at the wheel is most often caused by socially induced sleep deprivation or poor sleep hygiene in otherwise healthy individuals, medical disorders, or the intake of drugs. Validated methods for objectifying sleepiness are urgently sought, particularly in the context of driving. Based on the assumption that the identification and treatment of sleepiness, and its causes, may prevent motor vehicle accidents, driving simulators are a seemingly promising diagnostic tool. Despite the rising use of these in research, the reliability of their conclusions in healthy sleepy individuals and patients is still unclear. This systematic review aims to evaluate the practical value of driving simulators in a clinical environment when judging fitness to drive in sleepy individuals. From the 1674 records screened, 12 studies in sleepy individuals containing both simulated and real driving data were included. In general, simulated driving did not reliably predict real-life motor vehicle accidents, and especially not on an individual level, despite the moderate relationship between simulated and real-road test driving performance. The severity of sleepiness is most likely not the critical factor leading to motor vehicle accidents, but rather the perception of sleepiness. The self-perception of sleepiness related impairment, and risky behaviour while at the wheel should also be considered as key influencing factors. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. Excessive daytime sleepiness in patients with depressive disorder Sonolência diurna excessiva em pacientes com transtorno depressivo

    Directory of Open Access Journals (Sweden)

    Sarah Laxhmi Chellappa

    2006-06-01

    Full Text Available OBJECTIVE: To evaluate excessive daytime sleepiness in patients with depressive disorder and to examine its association with the severity of depression and suicidal ideation. METHOD: Seventy patients were interviewed and assessed by the Epworth Sleepiness Scale (ESS, the Beck Depression Inventory (BDI and the Beck Scale for Suicidal Ideation (SSI. Descriptive analysis, Pearson correlations and Student's t-test were used for data analyses. RESULTS: Most of the patients (57.1% obtained high scores on the ESS. Correlation was positive and strongly significant between ESS scores and BDI scores, as well as between ESS scores and SSI scores. Patients with high ESS scores obtained higher mean BDI and SSI scores in comparison to patients with lower ESS scores. Significant differences (p 10 and lower (OBJETIVO: Avaliar a incidência de sonolência diurna excessiva em pacientes com transtorno depressivo e examinar sua associação com a gravidade do quadro depressivo e ideação suicida. MÉTODO: Setenta pacientes foram entrevistados e avaliados através da Escala de Sonolência de Epworth (ESE, da Escala de Depressão de Beck BD e da Escala de Ideação Suicida de Beck (EIS. Análises descritivas, análise de correlação de Pearson e teste-t de Student foram utilizados para a análise dos dados. RESULTADOS: A maioria dos paciente (57,1% apresentaram altas pontuações na ESE. Houve correlações positivas e fortes entre scores da ESE e BD e entre scores da ESE e EIS. Pacientes com altas pontuações na ESE obtiveram escores na BD e na EIS mais elevados do que os pacientes com baixos escores de ESE. Houve diferenças significativas (p 10 na ESE, em relação às pontuações totais das ESE, EDB e EIS. CONCLUSÕES: A sonolência diurna excessiva foi freqüente nos pacientes e significativamente associada a maior gravidade da depressão e ideação suicida. Desta maneira, é necessária uma cuidadosa investigação da sonolência diurna excessiva em

  11. An Efficient Sleepy Algorithm for Particle-Based Fluids

    Directory of Open Access Journals (Sweden)

    Xiao Nie

    2014-01-01

    Full Text Available We present a novel Smoothed Particle Hydrodynamics (SPH based algorithm for efficiently simulating compressible and weakly compressible particle fluids. Prior particle-based methods simulate all fluid particles; however, in many cases some particles appearing to be at rest can be safely ignored without notably affecting the fluid flow behavior. To identify these particles, a novel sleepy strategy is introduced. By utilizing this strategy, only a portion of the fluid particles requires computational resources; thus an obvious performance gain can be achieved. In addition, in order to resolve unphysical clumping issue due to tensile instability in SPH based methods, a new artificial repulsive force is provided. We demonstrate that our approach can be easily integrated with existing SPH based methods to improve the efficiency without sacrificing visual quality.

  12. Children's Sleep, Sleepiness, and Performance on Cognitive Tasks.

    Science.gov (United States)

    Buckhalt, Joseph A

    2011-01-01

    While causal connections between sleep deprivation and attention, learning, and memory have been well established in adults, much less research has been done with children. Relations between the amount and quality of sleep and daytime sleepiness have been found for a number of cognitive and academic tasks in several groups of children. These relations have been found for children who have sleep disorders, for children with disorders involving cognitive impairment, and for typically developing children with no known disorders. The research is reviewed here with a focus on the types of cognitive and academic tasks that have been related to insufficient sleep. A series of studies is described that relates sleep parameters to the Woodcock-Johnson® III Tests of Cognitive Abilities and other, similar measures. Implications for educators and psychologists who work with children are discussed.

  13. Nocturnal frontal lobe epilepsy presenting as excessive daytime sleepiness

    Directory of Open Access Journals (Sweden)

    Jocelyn Y Cheng

    2013-01-01

    Full Text Available Excessive daytime sleepiness (EDS is common in the general population. Etiologies include insufficient sleep and primary sleep disorders. Due to its high prevalence, physicians often overlook EDS as a significant problem. However, EDS may also be the presenting symptom of seizures, in particular Nocturnal Frontal Lobe Epilepsy (NFLE. Due to the clinical similarity between the nocturnal behaviors of NFLE and parasomnias, and poor patient-related history, NFLE remains a challenging diagnosis. We report the case of a patient with NFLE who presented with a primary complaint of EDS, and discuss the differential diagnosis and evaluation of patients with EDS associated with nocturnal behaviors. In the context of a patient presenting with EDS and stereotyped nocturnal events, clinical suspicion should be high for NFLE.

  14. Gender differences in excessive daytime sleepiness among Japanese workers.

    Science.gov (United States)

    Doi, Yuriko; Minowa, Masumi

    2003-02-01

    Excessive daytime sleepiness (EDS) is serious concern in the workplace with respect to errors, accidents, absenteeism, reduced productivity and impaired personal or professional life. Previous community studies found a female preponderance of EDS, however, there is little research on EDS and gender in occupational settings. We examined the gender differences in prevalence and risk factors of EDS among employees working at a telecommunications company in the Tokyo metropolitan area. Our outcome measure of EDS was the Epworth Sleepiness Scale (ESS). A self-administered questionnaire on health and sleep including ESS was distributed to 5,571 workers between December 1999 and January 2000, and 5,072 responses were returned (91.0%). A total of 4,722 full-time, non-manual and non-shift employees aged 20-59 were used for analysis (3,909 men and 813 women). Chi-squared tests and multiple logistic regression analyses were applied for examining the gender differences in the prevalence and risk factors of EDS. The prevalence rates of EDS were 13.3% for women and 7.2% for men (Pgenders, and being married worked as a protective factor against EDS for men alone. It is obvious that a ban on overtime work and a provision of mental health hygiene are the general strategies for reducing EDS at worksites. In the case of women, we suggest the formation of effective strategies for improving women's status at home and in the workplace must also be a solution for the prevention of EDS (e.g. promoting gender equality in the division of labor at home and strengthening family care policies for working women).

  15. Optimal treatment of obstructive sleep apnea and excessive sleepiness.

    Science.gov (United States)

    Rosenberg, Russell; Doghramji, Paul

    2009-03-01

    Collapsibility of the upper airway in obstructive sleep apnea (OSA) causes repeated arousals from sleep, decreased oxygen saturation of the blood, and excessive sleepiness (ES). Patients with OSA are at increased risk of cardiovascular and cerebrovascular disease, and experience occupational and vehicular accidents more frequently than the general population. Furthermore, the life expectancy of patients with untreated OSA is significantly reduced. A MEDLINE search of articles published between 2003 and 2008 was conducted using the search terms: obstructive sleep apnea [ti/ab] AND treatment; obstructive sleep apnoea [ti/ab] AND treatment; and excessive sleepiness [ti/ab] AND treatment. Searches were limited to articles in English; clinical trials; meta-analyses; practice guidelines; randomized, controlled trials; and reviews. Continuous positive airway pressure (CPAP) is the reference-standard treatment for patients with OSA. CPAP addresses the symptoms of OSA and reduces the risk of heart disease and depression associated with this sleep disorder. However, the efficacy of CPAP is contingent on patient adherence, and >or=4 hours of therapy per night are required for patients with OSA to experience significant clinical benefits. However, reports of nonadherence to CPAP therapy range from 29% to 83%. Other therapies are available for patients who refuse or cannot adhere to CPAP treatment, including dental devices and surgery, but these treatments are generally considered to be less efficacious. A significant number of patients continue to experience residual ES despite CPAP treatment. Pharmacologic therapies, eg, modafinil and armodafinil, may be of use in patients with OSA to improve tolerance with CPAP or to address residual ES. There are a variety of treatments available for patients with OSA. Successful treatment involves encouraging patient compliance with CPAP or oral appliances. Primary-care physicians play a crucial role in recognizing this disorder and

  16. The self-morningness/eveningness (Self-ME): An extremely concise and totally subjective assessment of diurnal preference.

    Science.gov (United States)

    Turco, M; Corrias, M; Chiaromanni, F; Bano, M; Salamanca, M; Caccin, L; Merkel, C; Amodio, P; Romualdi, C; De Pittà, C; Costa, R; Montagnese, S

    2015-01-01

    The assessment of diurnal preference, or the preferred timing of sleep and activity, is generally based on comprehensive questionnaires such as the Horne-Östberg (HÖ). The aim of the present study was to assess the reliability of a subject's self-classification as extremely morning (Self-MM), more morning than evening (Self-M), more evening than morning (Self-E) or extremely evening (Self-EE) type, based on the last question of the HÖ (Self-ME). A convenience sample of 461 subjects [23.8 ± 4.7 years; 322 females] completed a full sleep-wake assessment, including diurnal preference (HÖ), night sleep quality (Pittsburgh Sleep Quality Index, PSQI), daytime sleepiness (Karolinska Sleepiness Scale, KSS), and habitual sleep-wake timing (12 d sleep diaries; n = 296). Significant differences in HÖ total score were observed between Self-ME classes, with each class being significantly different from neighboring classes (p classes. Such differences were maintained when sleep-wake habits were analysed separately on work and free days, and also in a smaller group of 67 subjects who completed the Self-ME as a stand-alone rather than as part of the original questionnaire. Significant differences were observed in the time-course of subjective sleepiness by Self-ME class in both the large and the small group, with Self-MM and Self-M subjects being significantly more alert in the morning and sleepier in the evening hours compared with their Self-E and Self-EE counterparts. Finally, significant differences were observed in night sleep quality between Self-ME classes, with Self-EE/Self-E subjects sleeping worse than their Self-MM/Self-M counterparts, and averaging just over the abnormality PSQI threshold of 5. In conclusion, young, healthy adults can define their diurnal preference based on a single question (Self-ME) in a way that reflects their sleep-wake timing, their sleepiness levels over the daytime hours, and their night sleep quality. Validation of the Self

  17. Relationship Between Sleep Quality, Obstructive Sleep Apnea and Sleepiness During Day With Related Factors in Professional Drivers

    Directory of Open Access Journals (Sweden)

    Samira Joorabbaf Motlagh

    2018-01-01

    Full Text Available One of the important reasons for accidents is sleepiness.With this description, the sleep disorders are associated with health and mortality, and not only affect the person but also the family and the whole society. Aim of this study was assessing of relationship between Sleep Quality, Obstructive sleep Apnea and Sleepiness during day with related factors in professional drivers. This was a cross-sectional study measuring correlation between sleep quality questionnaire (Pittsburgh Sleep Quality Index or PSQI, Epworth Sleepiness Scale (ESS and Stop Bang questionnaire (STOP BANG.the appropriate sample size to achieve a 95% confidence level was 943 people. The study population was chosen among qualified drivers using a convenience sampling method that took place over 12 months duration. Exclusion criterion consisted of the presence of a physical or mental disability. Data analyzed by software SPSS, version 15. In this study, all drivers were men with mean of age 36±9/5 year (minimum 22 year and maximum 72 year, 799 (84.7% were married, 535 (56.7% had high school education. Also, 96.4 % of drivers had undesirable sleep quality, 25.8% obstructive sleep apnea and 6.8% abnormal sleepiness during day. Multiple linear regression test showed, Score of STOP-Bang was correlated with smoking (OR (β=0/2, P=0.006 and history of hurt disease (OR (β=0.95, P=0.003, shift work (OR (β=0.19, P=0.006 more probability. Moreover, PSQI was statistically significant with shift work (OR (β=0.44, P=0.02, smoking (OR (β=0.98, P=0.001, history of pulmonary disease (OR (β=3.58, P=0.009 more probability , and ESS was statistically significant with smoking (OR (β=0.64, P=0.007 and history of pulmonary disease(OR (β=2.82, P=0.006, shift work (OR (β=0.59, P=0.008 more probability. In our study, according to the results, it should be planning to reduce the driving time in day and night and also it are recommended short breaks during driving. It is suggested the more

  18. Relationship Between Sleep Quality, Obstructive Sleep Apnea and Sleepiness During Day With Related Factors in Professional Drivers.

    Science.gov (United States)

    Joorabbaf Motlagh, Samira; Shabany, Maryam; Sadeghniiat Haghighi, Khosro; Nikbakht Nasrabadi, Alireza; Emami Razavi, Seyed Hassan

    2017-11-01

    One of the important reasons for accidents is sleepiness.With this description, the sleep disorders are associated with health and mortality, and not only affect the person but also the family and the whole society. Aim of this study was assessing of relationship between Sleep Quality, Obstructive sleep Apnea and Sleepiness during day with related factors in professional drivers. This was a cross-sectional study measuring correlation between sleep quality questionnaire (Pittsburgh Sleep Quality Index or PSQI), Epworth Sleepiness Scale (ESS) and Stop Bang questionnaire (STOP BANG).the appropriate sample size to achieve a 95% confidence level was 943 people. The study population was chosen among qualified drivers using a convenience sampling method that took place over 12 months duration. Exclusion criterion consisted of the presence of a physical or mental disability. Data analyzed by software SPSS, version 15. In this study, all drivers were men with mean of age 36±9/5 year (minimum 22 year and maximum 72 year), 799 (84.7%) were married, 535 (56.7%) had high school education. Also, 96.4 % of drivers had undesirable sleep quality, 25.8% obstructive sleep apnea and 6.8% abnormal sleepiness during day. Multiple linear regression test showed, Score of STOP-Bang was correlated with smoking (OR (β)=0/2, P=0.006) and history of hurt disease (OR (β)=0.95, P=0.003), shift work (OR (β)=0.19, P=0.006) more probability. Moreover, PSQI was statistically significant with shift work (OR (β)=0.44, P=0.02), smoking (OR (β)=0.98, P=0.001), history of pulmonary disease (OR (β)=3.58, P=0.009) more probability , and ESS was statistically significant with smoking (OR (β)=0.64, P=0.007) and history of pulmonary disease(OR (β)=2.82, P=0.006), shift work (OR (β)=0.59, P=0.008) more probability. In our study, according to the results, it should be planning to reduce the driving time in day and night and also it are recommended short breaks during driving. It is suggested the more

  19. An experimental study of adolescent sleep restriction during a simulated school week: changes in phase, sleep staging, performance and sleepiness.

    Science.gov (United States)

    Agostini, Alex; Carskadon, Mary A; Dorrian, Jillian; Coussens, Scott; Short, Michelle A

    2017-04-01

    This laboratory study investigated the impact of restricted sleep during a simulated school week on circadian phase, sleep stages and daytime functioning. Changes were examined across and within days and during a simulated weekend recovery. Participants were 12 healthy secondary school students (six male) aged 15-17 years [mean = 16.1 years, standard deviation (SD) = 0.9]. After 2 nights with 10 h (21:30-07:30 hours), time in bed was restricted to 5 h for 5 nights (02:30-07:30 hours), then returned to 10 h time in bed for 2 nights (21:30-07:30 hours). Saliva was collected in dim light on the first and last sleep restriction nights to measure melatonin onset phase. Sleep was recorded polysomnographically, and the Psychomotor Vigilance Task (PVT) and Karolinska Sleepiness Scale were undertaken 3-hourly while awake. Average phase delay measured by melatonin was 3 h (SD = 50 min). Compared to baseline, sleep during the restriction period contained a smaller percentage of Stages 1 and 2 and rapid eye movement (REM) and a greater percentage of Stage 4. PVT lapses increased significantly during sleep restriction and did not return to baseline levels during recovery. Subjective sleepiness showed a similar pattern during restriction, but returned to baseline levels during recovery. Results suggest that sustained attention in adolescents is affected negatively by sleep restriction, particularly in the early morning, and that a weekend of recovery sleep is insufficient to restore performance. The discrepancy between sleepiness ratings and performance may indicate a lack of perception of this residual impairment. © 2016 European Sleep Research Society.

  20. Fatigue and excessive daytime sleepiness in idiopathic Parkinson's disease differently correlate with motor symptoms, depression and dopaminergic treatment.

    Science.gov (United States)

    Valko, P O; Waldvogel, D; Weller, M; Bassetti, C L; Held, U; Baumann, C R

    2010-12-01

    A comprehensive study of both fatigue and excessive daytime sleepiness (EDS) in association with Parkinson's disease (PD)-related symptoms and treatment has not been performed yet. To assess the frequency and severity of fatigue and EDS in patients with idiopathic PD and to study their relation to motor and non-motor symptoms and dopaminergic treatment. We prospectively assessed Fatigue Severity Scale (FSS) scores, Epworth Sleepiness Scale (ESS) scores, Beck Depression Inventory (BDI) scores, severity (Unified PD Rating Scale, UPDRS, part III; Hoehn & Yahr staging) and duration of the disease, and the current dopaminergic treatment in 88 consecutive patients with idiopathic PD. Fatigue was found in 52 (59%), EDS in 42 (48%), and both complaints in 31 (35%) patients. Fatigued patients had higher UPDRS III scores (23.5 ± 11.1 vs. 18.6 ± 7.6, P = 0.03), higher Hoehn & Yahr staging (2.4 ± 0.9 vs. 2.1 ± 0.7, P = 0.03), and higher BDI scores (13.4 ± 7.1 vs. 9.1 ± 5.8, P = 0.004) than non-fatigued patients. In contrast, UPDRS III, Hoehn & Yahr, and BDI scores did not differ between patients with or without EDS. However, the type of dopaminergic treatment (levodopa monotherapy versus combination of levodopa/dopamine agonists) was associated with significant differences in ESS (8.5 ± 5.2 vs. 10.8 ± 4.3, P = 0.04), but not FSS scores (4.1 ± 1.5 vs. 4.3 ± 1.5, P = 0.55). Disease duration correlated with ESS scores (r = 0.32, P = 0.003), but not with FSS scores (r = -0.02, P = 0.82). In PD, there is a significant overlap of fatigue and EDS, but the two symptoms are differently correlated with the severity of motor symptoms, disease duration, depression, and dopaminergic treatment. © 2010 The Author(s). European Journal of Neurology © 2010 EFNS.

  1. Sleep habits, sleepiness and accidents among truck drivers Hábitos de sono, sonolência e acidentes em caminhoneiros

    Directory of Open Access Journals (Sweden)

    José Carlos Souza

    2005-12-01

    Full Text Available OBJECTIVE: To evaluate the quality of sleep, shift work, alcohol and psychostimulant drug use, and the prevalence of accidents among truck drivers. METHOD: Data were collected using a demographic questionnaire, the Epworth Sleepiness Scale (ESS and the Pittsburgh sleep quality index (PSQI. Statistical analysis was conducted using the Student t, chi-square, Pearson and Fisher tests. RESULTS: 43.2% of the drivers drove over 16 h a day, and 2.9% worked shifts. Mean number of sleep hours/day was 5.97±1.47; 23.8% slept 5; 23 subjects snored more than three times a week (11.1%. Mean ESS was 6.56±4.2; 21.7% had a score >10. In the preceding five years, 27 drivers (13.1% were involved in accidents, 5 of which resulted in injuries and 3 in deaths. CONCLUSION: Results showed a high prevalence of sleep disorders, use of alcohol and psychostimulant drugs, and accidents.OBETIVO: Avaliar a qualidade do sono, trabalho em turnos, consumo de álcool e psicoestimulantes, e a prevalência de acidentes, entre caminhoneiros. MÉTDO: Foram aplicados questionários demográficos, a Escala de Epworth e o Índice de Pittsburgh. A análise estatística foi feita com os testes t de Student, qui-quadrado, Pearson e Fisher. RESULTADOS: 43,2% dirigiam mais que 16 h/dia; 2,9% faziam trabalho por turnos. A média de horas de sono foi 5,97 +/- 1,47. 23,8% dormiam menos de 5 horas. 50,9% faziam uso de bebida alcoólica; usavam cafeína 95,6% e anfetaminas 11,1%. A média do PSQI foi 4,95 +/- 2,56; 35,4% tinham o PSQI maior que 5; 23 sujeitos ressonavam mais que 3 vezes por semana (11,1%. A ESE teve uma média de 6,56 +/- 4,2; 21.7% um escore superior a 10. Nos últimos cinco anos 27 motoristas (13,1% estiveram envolvidos em acidentes, 5 com feridos e 3 com mortos. CONCLUSÃO: Foi alta a prevalência de distúrbios do sono, uso de álcool e estimulantes, e de acidentes.

  2. Sustainable Reduction of Sleepiness through Salutogenic Self-Care Procedure in Lunch Breaks: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Sebastian Schnieder

    2013-01-01

    Full Text Available The aim of the study was to elucidate the immediate, intermediate, and anticipatory sleepiness reducing effects of a salutogenic self-care procedure called progressive muscle relaxation (PMR, during lunch breaks. The second exploratory aim deals with determining the onset and long-term time course of sleepiness changes. In order to evaluate the intraday range and interday change of the proposed relaxation effects, 14 call center agents were assigned to either a daily 20-minute self-administered PMR or a small talk (ST group during a period of seven months. Participants’ levels of sleepiness were analyzed in a controlled trial using anticipatory, postlunchtime, and afternoon changes of sleepiness as indicated by continuously determined objective reaction time measures (16,464 measurements and self-reports administered five times per day, once per month (490 measurements. Results indicate that, in comparison to ST, the PMR break (a induces immediate, intermediate, and anticipatory reductions in sleepiness; (b these significant effects remarkably show up after one month, and sleepiness continues to decrease for at least another five months. Although further research is required referring to the specific responsible mediating variables, our results suggest that relaxation based lunch breaks are both accepted by employees and provide a sustainable impact on sleepiness.

  3. Daytime Sleepiness in Obesity: Mechanisms Beyond Obstructive Sleep Apnea—A Review

    Science.gov (United States)

    Panossian, Lori A.; Veasey, Sigrid C.

    2012-01-01

    Increasing numbers of overweight children and adults are presenting to sleep medicine clinics for evaluation and treatment of sleepiness. Sleepiness negatively affects quality of life, mental health, productivity, and safety. Thus, it is essential to comprehensively address all potential causes of sleepiness. While many obese individuals presenting with hypersomnolence will be diagnosed with obstructive sleep apnea and their sleepiness will improve with effective therapy for sleep apnea, a significant proportion of patients will continue to have hypersomnolence. Clinical studies demonstrate that obesity without sleep apnea is also associated with a higher prevalence of hypersomnolence and that bariatric surgery can markedly improve hypersomnolence before resolution of obstructive sleep apnea. High fat diet in both humans and animals is associated with hypersomnolence. This review critically examines the relationships between sleepiness, feeding, obesity, and sleep apnea and then discusses the hormonal, metabolic, and inflammatory mechanisms potentially contributing to hypersomnolence in obesity, independent of sleep apnea and other established causes of excessive daytime sleepiness. Citation: Panossian LA; Veasey SC. Daytime sleepiness in obesity: mechanisms beyond obstructive sleep apnea—a review. SLEEP 2012;35(5):605-615. PMID:22547886

  4. Effects of a selective educational system on fatigue, sleep problems, daytime sleepiness, and depression among senior high school adolescents in Taiwan.

    Science.gov (United States)

    Chen, Tien-Yu; Chou, Yu-Ching; Tzeng, Nian-Sheng; Chang, Hsin-An; Kuo, Shin-Chang; Pan, Pei-Yin; Yeh, Yi-Wei; Yeh, Chin-Bin; Mao, Wei-Chung

    2015-01-01

    The aim of the study reported here was to clarify the effects of academic pressure on fatigue, sleep problems, daytime sleepiness, and depression among senior high school adolescents in Taiwan. This cross-sectional study enrolled 757 senior high school adolescents who were classified into four groups: Grade 1 (n=261), Grade 2 (n=228), Grade 3T (n=199; Grade 3 students who had another college entrance test to take), and Grade 3S (n=69; Grade 3 students who had succeeded in their college application). Fatigue, sleep quality, daytime sleepiness, and depression were assessed using the Chinese version of the Multidimensional Fatigue Symptom Inventory - Short Form, Pittsburgh Sleep Quality Index-Taiwan Form, the Chinese version of the Epworth Sleepiness Scale, and the Chinese version of the Beck Depression Inventory(®)-II (BDI-II), respectively. Physical, emotional, and mental fatigue scores were all higher in higher-grade groups. The Grade 3T (test) students had the worst fatigue severity, and the Grade 3S (success) students had the least fatigue severity. More than half of the students (60.9%) went to bed after 12 am, and they had on average 6.0 hours of sleep per night. More than 30% of the students in Grade 2 (37.3%) and Grades 3T/S (30.2%/30.4%) possibly had daily sleepiness problems. The students in Grade 3T had the worst BDI-II score (13.27±9.24), and the Grade 3S students had a much lower BDI-II score (7.91±6.13). Relatively high proportions of fatigue, sleep problems, daytime sleepiness, and depression among senior high school adolescents were found in our study. The severities of fatigue, sleep problems, and depression were significantly diminished in the group under less academic stress (Grade 3S). Our findings may increase the understanding of the mental health of senior high school students under academic pressure in Taiwan. Further large sample size and population-based study should be done for better understanding about this topic.

  5. Risk Factors for Cardiovascular Disease, Metabolic Syndrome and Sleepiness in Truck Drivers

    Directory of Open Access Journals (Sweden)

    Antonio de Padua Mansur

    2015-01-01

    Full Text Available AbstractBackground:Truck driver sleepiness is a primary cause of vehicle accidents. Several causes are associated with sleepiness in truck drivers. Obesity and metabolic syndrome (MetS are associated with sleep disorders and with primary risk factors for cardiovascular diseases (CVD. We analyzed the relationship between these conditions and prevalence of sleepiness in truck drivers.Methods:We analyzed the major risk factors for CVD, anthropometric data and sleep disorders in 2228 male truck drivers from 148 road stops made by the Federal Highway Police from 2006 to 2011. Alcohol consumption, illicit drugs and overtime working hours were also analyzed. Sleepiness was assessed using the Epworth Sleepiness Scale.Results:Mean age was 43.1 ± 10.8 years. From 2006 to 2011, an increase in neck (p = 0.011 and abdominal circumference (p < 0.001, total cholesterol (p < 0.001, triglyceride plasma levels (p = 0.014, and sleepiness was observed (p < 0.001. In addition, a reduction in hypertension (39.6% to 25.9%, p < 0.001, alcohol consumption (32% to 23%, p = 0.033 and overtime hours (52.2% to 42.8%, p < 0.001 was found. Linear regression analysis showed that sleepiness correlated closely with body mass index (β = 0.19, Raj2 = 0.659, p = 0.031, abdominal circumference (β = 0.24, Raj2 = 0.826, p = 0.021, hypertension (β = -0.62, Raj2 = 0.901, p = 0.002, and triglycerides (β = 0.34, Raj2 = 0.936, p = 0.022. Linear multiple regression indicated that hypertension (p = 0.008 and abdominal circumference (p = 0.025 are independent variables for sleepiness.Conclusions:Increased prevalence of sleepiness was associated with major components of the MetS.

  6. Head-to-toe whole-body MRI in psoriatic arthritis, axial spondyloarthritis and healthy subjects: first steps towards global inflammation and damage scores of peripheral and axial joints.

    Science.gov (United States)

    Poggenborg, René Panduro; Pedersen, Susanne Juhl; Eshed, Iris; Sørensen, Inge Juul; Møller, Jakob M; Madsen, Ole Rintek; Thomsen, Henrik S; Østergaard, Mikkel

    2015-06-01

    By whole-body MRI (WBMRI), we aimed to examine the frequency and distribution of inflammatory and structural lesions in PsA patients, SpA patients and healthy subjects (HSs), to introduce global WBMRI inflammation/damage scores, and to assess WBMRI's reproducibility and correlation with conventional MRI (convMRI). WBMRI (3.0-T) of patients with peripheral PsA (n = 18) or axial SpA (n = 18) and of HS (n = 12) was examined for proportion of evaluable features (readability) and the presence and pattern of lesions in axial and peripheral joints. Furthermore, global WBMRI scores of inflammation and structural damage were constructed, and WBMRI findings were compared with clinical measures and convMRI (SpA/HS: spine and SI joints; PsA/HS: hand). The readability (92-100%) and reproducibility (intrareader intraclass correlation coefficient: 0.62-1.0) were high in spine/SI joint, but lower in the distal peripheral joints. Wrists, shoulders, knees, ankles and MTP joints were most commonly involved, with frequency of synovitis > bone marrow oedema (BMO) > erosion. WBMRI global BMO scores of peripheral and axial joints were higher in PsA {median 7 [interquartile range (IQR) 3-15]} and SpA [8 (IQR 2-14)] than in HSs [2.5 (IQR 1-4.5)], both P joint scores were ρ = 0.20-0.78. WBMRI allows simultaneous assessment of peripheral and axial joints in PsA and SpA, and the distribution of inflammatory and structural lesions and global scores can be determined. The study strongly encourages further development and longitudinal testing of WBMRI techniques and assessment methods in PsA and SpA. © The Author 2014. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  7. Evening chronotype and sleepiness predict impairment in executive abilities and academic performance of adolescents.

    Science.gov (United States)

    Cohen-Zion, Mairav; Shiloh, Elisheva

    2017-11-07

    The study aim was to better understand sleep and sleep-related factors affecting everyday executive capacities and academic performance among healthy adolescents. A cross-sectional survey on sleep, phase preference, academic performance and executive functions of high-school students was conducted. Female gender, grade status, sleepiness and evening chronotype accounted for approximately 25-30% of the variance in daily executive ability. Sleep duration was a weak predictor of executive skills. Lower school grades were associated with increased sleepiness, evening preference and poorer executive skills. These findings support the need for health education on ways to attenuate sleepiness and delayed phase in this population.

  8. Sleep patterns and sleepiness among young students: A longitudinal study before and after admission as trainees and apprentices.

    Science.gov (United States)

    Fischer, Frida Marina; Wey, Daniela; Valente, Daniel; Luz, Andréa Aparecida da; Pinheiro, Fernando; Fonseca, Barbara Cristina; Silva-Costa, Aline; Moreno, Claudia Roberta; Menna-Barreto, Luiz; Teixeira, Liliane Reis

    2015-05-01

    In developing countries, youngsters start to work during the high school years. Several studies have shown the difficulties associated with double shift, i.e. to work and study concomitantly, and its negative health consequences. Work and study time, as social synchronizers, have significant effects on the sleep-wake cycle (SWC). The purpose of this study was to evaluate sleep patterns and sleepiness in young students before and after entering the workforce as apprentices or trainees. Participants were 40 adolescents (26 males), 15-18 years old (mean = 15.8 years old) engaged in a first-job program at a non-governmental organization (NGO) while attending evening high school in the outskirts of the city of São Paulo, Brazil. The participants wore actigraphs (Ambulatory Monitoring, Inc.) and registered subjective sleepiness on KSS (Karolinska Sleepiness Scale) along 7 consecutive days, before and after admission to the job. Descriptive analyses were performed, and the variables were tested by means of the t-test and repeated measures ANOVA taking factors day of the week and time of the day into consideration. The participants' sleep duration on weekdays exhibited significant difference before and after starting work (F = 4.55; p = 0.04); the mean sleep duration was 492 min (SD = 44 min) before admission to the job to decrease to 405 min (SD = 58 min) after starting work. The mid-sleep time exhibited significant difference on weekdays before and after starting work (04:57 h; SD = 45 min versus 03:30 h; SD = 54 min; F = 4.91; p = 0.03). Finally, also sleepiness on weekdays (F = 6.41; p = 0.04) and at the waking time (F = 10.75; p sleep restriction. Brazilian governmental incentives notwithstanding, simultaneous performance of several activities by young workers should be considered as an occupational health hazard. Employment policies targeting young workers should take the dual shift - study and work

  9. Effect of religious practices of Ramadan on sleep and perceived sleepiness of medical students.

    Science.gov (United States)

    Margolis, Stephen A; Reed, Richard L

    2004-01-01

    Observant Muslims substantially alter their normal routines, including daytime fasting and day-night activity patterns during the month of Ramadan. It is unknown whether observing the religious practices of Ramadan impacts negatively on daytime somnolence, a factor known to impair learning. A cross-sectional survey measuring self-reported sleep time and the Epworth Sleepiness Scale of observant Muslim medical students before, during, and after Ramadan. There was no significant variation in sleep score pre-Ramadan (10.04 +/- 3.47), during Ramadan (10.46 +/- 3.57)m and post Ramadan(9.73 +/- 3.33), F(2,355) = 1.278, p = .280. Night sleep hours were significantly longer both before (6.22 +/- 1.45) and after (6.22 +/- 1.59) than during Ramadan (5.22 +/- 1.85), F(2,366) = 15.289, p sleep hours pre-Ramadan (1.05 +/- 1.36) and post Ramadan (0.70 +/- 1.21) were significantly shorter than during Ramadan (1.48 +/- 1.46; pre: z = 2.654, p = .08; z = -4.940, p sleep hours during Ramadan.

  10. Adherence to positive airway pressure therapy in U.S. military personnel with sleep apnea improves sleepiness, sleep quality, and depressive symptoms.

    Science.gov (United States)

    Mysliwiec, Vincent; Capaldi, Vincent F; Gill, Jessica; Baxter, Tristin; O'Reilly, Brian M; Matsangas, Panagiotis; Roth, Bernard J

    2015-04-01

    Obstructive sleep apnea (OSA) is frequently diagnosed in U.S. military personnel. OSA is associated with sleepiness, poor sleep quality, and service-related illnesses of insomnia, depression, post-traumatic stress disorder, and traumatic brain injury. Observational study of active duty military personnel with OSA and adherence to positive airway pressure (PAP) assessed with smart chip technology. 58 men with mean age 36.2 ± 7.7 years, mean body mass index 31.4 ± 3.7 with mean apnea-hypopnea index (AHI) 19.1 ± 19.0 are reported. 23 (39.7%) participants were adherent to PAP, and 35 (60.3%) were nonadherent. No significant differences in baseline demographics, apnea-hypopnea index, service-related illnesses, or clinical instrument scores. Military personnel adherent to PAP had significantly improved sleepiness (p = 0.007), sleep quality (p = 0.013), depressive symptoms (p = 0.01), energy/fatigue (p = 0.027), and emotional well-being (p = 0.024). Participants with moderate-severe OSA were more likely to be in the adherent group when compared with participants diagnosed with mild OSA. Military personnel with OSA have low adherence to PAP. Adherence is associated with improved depressive symptoms, sleepiness, sleep quality, energy/fatigue, emotional well-being, and social functioning. Future research should focus on interventions to improve the management of OSA in military personnel. Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.

  11. Pitolisant, an inverse agonist of the histamine H3 receptor: an alternative stimulant for narcolepsy-cataplexy in teenagers with refractory sleepiness.

    Science.gov (United States)

    Inocente, Clara; Arnulf, Isabelle; Bastuji, Hélène; Thibault-Stoll, Anne; Raoux, Aude; Reimão, Rubens; Lin, Jian-Sheng; Franco, Patricia

    2012-01-01

    Narcolepsy is a rare disabling sleep disorder characterized by excessive daytime sleepiness and cataplexy (sudden loss of muscle tone). Drugs such as pitolisant, which block histamine H3 autoreceptors, constitute a newly identified class of stimulants because they increase brain histamine and enhance wakefulness in animal and human adult narcolepsy. We report our experience with the off-label use of pitolisant in 4 teenagers with narcolepsy/cataplexy with severe daytime sleepiness, refractory to available treatments (modafinil, methylphenidate, mazindol, sodium oxybate, and D-amphetamine). All teenagers developed their disease during childhood (11.3 ± 2.4 years; 50% boys) and were 17.3 ± 0.8 years old at the time of pitolisant therapy. Pitolisant treatment was increased from 10 to 30 mg (n = 1) and 40 mg (n = 3). The adapted Epworth Sleepiness Score decreased from 14.3 ± 1.1 to 9.5 ± 2.9 (P = 0.03) with pitolisant alone to 7 ± 3.4 when combined with mazindol (n = 1), methylphenidate (n = 1), or sodium oxybate plus modafinil (n = 1). Mean sleep onset latency increased from 31 ± 14 minutes to 36 ± 8 minutes (P = 0.21) on the maintenance of wakefulness test. The severity and frequency of cataplexy were slightly improved. Adverse effects were minor (insomnia, headache, hot flushes, leg pain, and hallucinations) and transitory, except for insomnia, which persisted in 2 teenagers. The benefit was maintained after a mean of 13 months. Pitolisant could constitute an acceptable alternative for the treatment of refractory sleepiness in teenagers with narcolepsy.

  12. Vigilance on the civil flight deck: incidence of sleepiness and sleep during long-haul flights and associated changes in physiological parameters.

    Science.gov (United States)

    Wright, N; McGown, A

    2001-01-15

    The study investigated sleepiness and sleep in aircrew during long-haul flights. The objectives were to identify loss of alertness and to recommend a practical approach to the design of an alerting system to be used by aircrew to prevent involuntary sleep. The flights were between London and Miami, covering both day- and night-time sectors, each with a duration of approximately 9 h. The subjects were 12 British Airways pilots. Various physiological variables were measured that could potentially be used to indicate the presence of drowsiness and involuntary sleep: brain electrical activity (electroencephalogram, EEG), eye movements via the electro-oculogram (EOG), wrist activity, head movements and galvanic skin resistance. The EEG and EOG identified sleepiness and sleep, as well as being potential measures on which to base an alarm system. Ten pilots either slept or showed evidence of sleepiness as assessed by the EEG and EOG. Many of the episodes of sleepiness lasted sleep, although only the EEG and EOG were modified by sleepiness. During sleep, skin resistance was increased, and wrist activity and head movements were absent for long periods. The study indicated that the measurement of eye movements (either alone or in combination with the EEG), wrist activity or head movement may be used as the basis of an alarm system to prevent involuntary sleep. Skin resistance is considered to be unsuitable, however, being related in a more general way to fatigue rather than to sleep episodes. The optimal way to monitor the onset of sleep would be to measure eye movements; however, this is not feasible in the flight deck environment at the present time due to the intrusive nature of the recording methodology. Wrist activity is therefore recommended as the basis of an alertness alarm. Such a device would alert the pilot after approximately 4-5 min of wrist inactivity, since this duration has been shown by the present study to be associated with sleep. The possibility that

  13. Prevalence of coronary artery calcium scores and silent myocardial ischaemia was similar in Indian Asians and European whites in a cross-sectional study of asymptomatic subjects from a U.K. population (LOLIPOP-IPC).

    Science.gov (United States)

    Jain, Piyush; Kooner, Jaspal S; Raval, Usha; Lahiri, Avijit

    2011-05-01

    Coronary heart disease (CHD) mortality is 70% higher among Indian Asians (IA) than European whites (EW), the reasons for this excess remain unexplained. Coronary artery calcification (CAC) is highly correlated with coronary plaque burden and silent myocardial ischaemia in EW; but fails to identify excess risk in IA. We hypothesised that IA have a higher prevalence of silent myocardial ischaemia compared to EW, despite similar CAC, and this may explain their excess CHD mortality. CAC was measured for 2,369 asymptomatic men and women, aged 35 to 75 years, as part of the London Life Sciences Population (LOLIPOP) study. 518 subjects had CAC scores >100 Agatston units and of these 256 (49%) patients underwent myocardial perfusion scintigraphy (MPS). CAC scores were similar among IA and EW, after adjustment for conventional risk factors. MPS abnormalities were seen in 56 (22%) subjects. Presence of diabetes (P = .03) and increasing CAC (P < .001) were independent predictors for severity of silent myocardial ischaemia. Ethnicity did not influence the prevalence or the extent of silent myocardial ischaemia. MPS did not identify greater ischaemia among IA compared with EW. This appears incongruent with almost 2-fold higher risk of CHD mortality observed in IA.

  14. Objective measurement of daytime napping, cognitive dysfunction and subjective sleepiness in Parkinson's disease

    National Research Council Canada - National Science Library

    Bolitho, Samuel J; Naismith, Sharon L; Salahuddin, Pierre; Terpening, Zoe; Grunstein, Ron R; Lewis, Simon J G

    2013-01-01

    .... The current study used daytime actigraphy, a novel objective measure of napping and related this to neuropsychological performance in a sample of PD patients and healthy, age and gender-matched controls...

  15. Objective Measurement of Daytime Napping, Cognitive Dysfunction and Subjective Sleepiness in Parkinsons Disease: e81233

    National Research Council Canada - National Science Library

    Samuel J Bolitho; Sharon L Naismith; Pierre Salahuddin; Zoe Terpening; Ron R Grunstein; Simon J G Lewis

    2013-01-01

    .... The current study used daytime actigraphy, a novel objective measure of napping and related this to neuropsychological performance in a sample of PD patients and healthy, age and gender-matched controls...

  16. Armodafinil for treatment of excessive sleepiness associated with shift work disorder: a randomized controlled study

    National Research Council Canada - National Science Library

    Czeisler, Charles A; Walsh, James K; Wesnes, Keith A; Arora, Sanjay; Roth, Thomas

    2009-01-01

    To assess the effect of armodafinil, 150 mg, on the physiologic propensity for sleep and cognitive performance during usual night shift hours in patients with excessive sleepiness associated with chronic (> or =3 months...

  17. Prevalence, Patterns, and Predictors of Sleep Problems and Daytime Sleepiness in Young Adolescents With ADHD.

    Science.gov (United States)

    Langberg, Joshua M; Molitor, Stephen J; Oddo, Lauren E; Eadeh, Hana-May; Dvorsky, Melissa R; Becker, Stephen P

    2017-01-01

    The primary objective of this study was to evaluate the prevalence of multiple types of sleep problems in young adolescents with ADHD. Adolescents comprehensively diagnosed with ADHD (N = 262) and their caregivers completed well-validated measures of sleep problems and daytime sleepiness. Participants also completed measures related to medication use, comorbidities, and other factors that could predict sleep problems. Daytime sleepiness was by far the most common sleep problem, with 37% of adolescents meeting the clinical threshold according to parent report and 42% according to adolescent report. In contrast, prevalence rates for specific nighttime sleep problems ranged from 1.5% to 7.6%. Time spent in bed, bedtime resistance, ADHD inattentive symptoms, and Sluggish Cognitive Tempo (SCT) symptoms were significant in the final model predicting daytime sleepiness. Adolescents with ADHD commonly experience problems with daytime sleepiness that may significantly affect their functioning, but this may not be directly attributable to specific sleep problems.

  18. Associations between physical activity, sedentary time, sleep duration and daytime sleepiness in US adults

    National Research Council Canada - National Science Library

    McClain, James J; Lewin, Daniel S; Laposky, Aaron D; Kahle, Lisa; Berrigan, David

    2014-01-01

    To examine the associations between objectively measured physical activity (PA) or sedentary behavior and self-reported sleep duration or daytime sleepiness in a nationally representative sample of healthy US adults (N=2128...

  19. A pictorial Sleepiness and Sleep Apnoea Scale to recognize individuals with high risk for obstructive sleep apnea syndrome

    Directory of Open Access Journals (Sweden)

    Edelmann C

    2017-10-01

    Full Text Available Cathrin Edelmann,1 Ramesh Ghiassi,2 Deborah R Vogt,3 Martyn R Partridge,2 Ramin Khatami,4 Jörg D Leuppi,1,5 David Miedinger1,5 1Medical Faculty, University of Basel, Basel, Switzerland; 2National Heart and Lung Institute, Imperial College London, London, UK; 3Clinical Trial Unit, University of Basel, University Hospital Basel, Basel, 4Barmelweid Clinic, Barmelweid, 5University Clinic of Medicine, Kantonsspital Baselland, Liestal, Switzerland Purpose: The aim of this study was to evaluate the validity of a new pictorial form of a screening test for obstructive sleep apnea syndrome (OSAS – the pictorial Sleepiness and Sleep Apnoea Scale (pSSAS. Validation was performed in a sample of patients admitted to sleep clinics in the UK and Switzerland.Patients and methods: All study participants were investigated with objective sleep tests such as full-night-attended polysomnography or polygraphy. The pSSAS was validated by taking into account the individual result of the sleep study, sleep-related questionnaires and objective parameters such as body mass index (BMI or neck circumference. Different scoring schemes of the pSSAS were evaluated, and an internal validation was undertaken.Results: The full data set consisted of 431 individuals (234 patients from the UK, 197 patients from Switzerland. The pSSAS showed good predictive performance for OSAS with an area under the curve between 0.77 and 0.81 depending on which scoring scheme was used. The subscores of the pSSAS had a moderate-to-strong correlation with widely used screening questionnaires for OSAS or excessive daytime sleepiness as well as with BMI and neck circumference.Conclusion: The pSSAS can be used to select patients with a high probability of having OSAS. Due to its simple pictorial design with short questions, it might be suitable for screening in populations with low health literacy and in non-native English or German speakers. Keywords: questionnaire, excessive daytime sleepiness

  20. Apgar Scores

    Science.gov (United States)

    ... Stages Listen Español Text Size Email Print Share Apgar Scores Page Content Article Body As soon as ... baby's general condition at birth. What Does the Apgar Test Measure? The test measures your baby's: Heart ...

  1. Having to stop driving at night because of dangerous sleepiness--awareness, physiology and behaviour.

    Science.gov (United States)

    Akerstedt, Torbjörn; Hallvig, David; Anund, Anna; Fors, Carina; Schwarz, Johanna; Kecklund, Göran

    2013-08-01

    A large number of accidents are due to the driver falling asleep at the wheel, but details of this link have not been studied on a real road. The purpose of the present study was to describe the development of sleepiness indicators, leading to the drive being terminated prematurely by the onboard expert driving instructor because of imminent danger. Eighteen individuals participated during a day drive and a night drive on a motorway (both 90 min). Eight drivers terminated (N) prematurely (after 43 min) because of sleep-related imminent danger [according to the driving instructor or their own judgement (two cases)]. The results showed very high sleepiness ratings (8.5 units on the Karolinska Sleepiness Scale) immediately before termination (drive). Group N also showed significantly higher levels of sleep intrusions on the electroencephalography/electro-oculography (EEG/EOG) than those who completed the drive (group C). The sleep intrusions were increased in group N during the first 40 min of the night drive. During the day drive, sleep intrusions were increased significantly in group N. The night drive showed significant increases of all sleepiness indicators compared to the day drive, but also reduced speed and driving to the left in the lane. It was concluded that 44% of drivers during late-night driving became dangerously sleepy, and that this group showed higher perceived sleepiness and more sleep intrusions in the EEG/EOG. © 2013 European Sleep Research Society.

  2. Recognizing problem sleepiness in your patients. National Center on Sleep Disorders Research Working Group.

    Science.gov (United States)

    1999-02-15

    Normal sleep is required for optimal functioning. Normal wakefulness should be effortless and free of unintended sleep episodes. Problem sleepiness is common and occurs when the quantity of sleep is inadequate because of primary sleep disorders, other medical conditions or lifestyle factors. Medications and substances that disturb sleep, such as caffeine and nicotine, or those that have sedating side effects, may also cause problem sleepiness. This condition can lead to impairment in attention, performance problems at work and school, and potentially dangerous situations when the patient is driving or undertaking other safety-sensitive tasks. However, problem sleepiness is generally correctable when it is recognized. Asking a patient and his or her bed partner about the likelihood of drowsiness or of falling asleep during specific activities, as well as questions that uncover factors contributing to the sleepiness, helps the physician to recognize the disorder. Accurate diagnosis of specific sleep disorders may require evaluation by a specialist. The primary care physician is in an ideal position to identify signs and symptoms of problem sleepiness and initiate appropriate care of the patient, including educating the patient about the dangers of functioning while impaired by sleepiness.

  3. Excessive daytime sleepiness in the elderly: association with cardiovascular risk, obesity and depression.

    Science.gov (United States)

    Lopes, Johnnatas Mikael; Dantas, Fabio Galvao; Medeiros, Jovany Luis Alves de

    2013-12-01

    To observe the relationship between Excessive Daytime Sleepiness (EDS) and the presence of risk factors for cardiovascular dysfunction, depression and obesity in the elderly. We interviewed 168 elderly from the community of Campina Grande, Paraíba. They were selected according to health districts in the period of 2010. We used the Epworth Sleepiness Scale to diagnose excessive daytime sleepiness (> 10 points); waist circumference for the risk of cardiovascular dysfunction (> 94 or > 80 cm); Geriatric Depression Scale for depression (>10 points) and body mass index for obesity (> 25 kg/m2). Association analysis was performed by the Chi-square test adjusted for sex and age group, adopting α obesity, in 95 (64.46%); and risk of cardiovascular dysfunction, in 129 (79.6%). Depressed men (78.6%, p = 0.0005) and risk of cardiovascular dysfunction (57.1%, p = 0.02) were more prone to EDS. In women, only obesity was related to sleepiness (42.1%, p = 0.01). Only those aged between 70 - 79 years old showed association between sleepiness and obesity. It was found that obesity for women, and depression and cardiovascular dysfunction risking for men were associated with EDS in the elderly. The variable sex is a confusion condition for the association with sleepiness.

  4. Thermophysiologic aspects of the three-process-model of sleepiness regulation.

    Science.gov (United States)

    Kräuchi, Kurt; Cajochen, Christian; Wirz-Justice, Anna

    2005-04-01

    The following overview reconsiders the three-process model of sleepiness regulation (homeostatic, circadian, and sleep inertia) from a thermophysiologic point of view. Our results gathered over the last decade indicate that the homeostatic aspect of sleepiness regulation (ie, buildup of sleepiness during wakefulness and its decay during sleep) is not related to the thermoregulatory system, whereas the two other processes of sleepiness regulation (ie, circadian and sleep inertia process) are clearly related to thermoregulation in humans. Distal skin temperature of hands and feet seems to be the crucial variable for the association between thermophysiology, sleepiness, and sleep. Increased distal skin temperature before a nocturnal sleep episode is a good predictor for short sleep-onset latency. The disappearance of sleep inertia after sleep or a nap episode shows very similar kinetics as distal vasoconstriction. Furthermore, relaxation-induced sleepiness (eg, after lying down, at lights-off, with thermal biofeedback training) also evokes an increase in distal skin temperatures. The reverse effect occurs at lights-on or a posture change from supine to standing, Therefore, in terms of thermophysiology, sleep inertia can be explained as the reverse of a relaxation process (ie, decrease in distal skin temperatures). Our results reinterpret the so-called "sleep-evoked" reduction of core body temperature as a consequence of relaxation-induced vasodilatation after lights-off. Sleep per se has no further thermoregulatory effect. Taken together, a thermophysiologic approach may provide a successful strategy to treat sleep-onset insomnia and alleviate sleep inertia.

  5. Assessment of relationship among sleepiness with polysomnographic parameters in patients with OSA

    Directory of Open Access Journals (Sweden)

    abolfazl Mozafari

    2015-05-01

    Full Text Available Background: Sleepiness that occurs at inappropriate or undesirable times or that interferes with daytime activities is generally considered excessive daytime sleepiness. Obstructive Sleep Apnea (OSA is one of the most common causes of excessive daytime sleepiness. The aim of this study is to finds out the most important nocturnal polysomnographic parameters influencing daytime sleepiness in patients with OSA. Materials and Methods: Considering the inclusion and exclusion criteria, 112 patients referred to Baqiyatallah subspeciality sleep clinic in Qom city were selected. Patients, demographic and Epworth Sleepiness Scale (ESS data were gathered and then comparison among ESS with polysomnography and anthropometric parameter was performed. Chi-square was used for analysis of qualitative parameters. Data analysis was done by SPSS v.18. P value was significant (˂0.05. Results: The mean age of the cases was 55.07 with male frequency 58.9% and female 41.1%. Body mass index was 34.34, apnea hypopnea index 43.62, mean Arousal Index 30.64 and mean ESS was 12.83. There was significant relationship among ESS>10 with arousal index (p=0.009 and mean O2 saturation (p=0.029, But we didn’t detected correlation between ESS>10 with other polysomnographic parameters. Conclusion: According to the data, the most important parameters of sleepiness in obstructive sleep apnea patients were sleep fragmentation and mean O2 saturation.

  6. Subjective sleep disturbance in Chinese adults with epilepsy: Associations with affective symptoms.

    Science.gov (United States)

    Shen, Yeru; Zhang, Mengmeng; Wang, Yu; Wang, Lanlan; Xu, Xiangjun; Xiao, Gairong; Chen, Jing; Zhang, Ting; Zhou, Nong

    2017-09-01

    As well as being a very common neurological disease worldwide, epilepsy significantly impairs patients' emotional, behavioral, and cognitive functioning. Sleep disturbances are the most frequent complaint in patients with epilepsy. The present study assesses the impact of a range of affective symptoms on subjective sleep quality and sleep disturbances in Chinese adults with epilepsy. Adults with epilepsy who visited our epilepsy clinic from July 2015 to March 2016 were enrolled in our study. Both patients and healthy controls completed the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), Insomnia Severity Index (ISI), Beck Depression Inventory-II (BDI-II), Beck Anxiety Inventory (BAI), and Mini-mental State Examination (MMSE). Subjective sleep quality and sleep disturbances were examined with regard to self-reported symptoms of depression and anxiety, seizure-related factors, and demographic factors. The PSQI scores and ISI scores of patients were significantly higher (indicating lower quality sleep and more serious insomnia) than those of the control group. Symptoms associated with depression and anxiety were independently related to impaired subjective sleep quality and insomnia. Affective symptoms explained more of the variance in PSQI scores and ISI scores than did seizure-related or demographic variables. In addition, these variables also seemed to be less powerful contributing factors to subjective sleep quality and insomnia than affective symptoms, several seizure-related factors, such as seizure control, partial seizures and duration of epilepsy, which are also significantly associated with subjective sleep quality and insomnia. In addition, use of lamotrigine (LTG) was also associated with insomnia and use of clonazepam (CZP) and phenobarbital (PB) with daytime sleepiness in patients with epilepsy. Chinese adults with epilepsy have poorer self-reported subjective sleep quality and a higher prevalence of insomnia than the control group

  7. Restless legs syndrome and daytime sleepiness are prominent in myotonic dystrophy type 2.

    Science.gov (United States)

    Lam, Erek M; Shepard, Paul W; St Louis, Erik K; Dueffert, Lucas G; Slocumb, Nancy; McCarter, Stuart J; Silber, Michael H; Boeve, Bradley F; Olson, Eric J; Somers, Virend K; Milone, Margherita

    2013-07-09

    Although sleep disturbances are common in myotonic dystrophy type 1 (DM1), sleep disturbances in myotonic dystrophy type 2 (DM2) have not been well-characterized. We aimed to determine the frequency of sleep disturbances in DM2. We conducted a case-control study of 54 genetically confirmed DM2 subjects and 104 medical controls without DM1 or DM2, and surveyed common sleep disturbances, including symptoms of probable restless legs syndrome (RLS), excessive daytime sleepiness (EDS), sleep quality, fatigue, obstructive sleep apnea (OSA), probable REM sleep behavior disorder (pRBD), and pain. Thirty patients with DM2 and 43 controls responded to the survey. Group comparisons with parametric statistical tests and multiple linear and logistic regression analyses were conducted for the dependent variables of EDS and poor sleep quality. The mean ages of patients with DM2 and controls were 63.8 and 64.5 years, respectively. Significant sleep disturbances in patients with DM2 compared to controls included probable RLS (60.0% vs 14.0%, p DM2 diagnosis (p DM2, while OSA and pRBD symptoms are not. EDS was independently associated with DM2 diagnosis, suggesting possible primary CNS hypersomnia mechanisms. Further studies utilizing objective sleep measures are needed to better characterize sleep comorbidities in DM2.

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

    Directory of Open Access Journals (Sweden)

    Ahmed S BaHammam

    2012-01-01

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

  9. "Sleepiness" is serious in adolescence: two surveys of 3235 Canadian students.

    Science.gov (United States)

    Gibson, Edward S; Powles, A C Peter; Thabane, Lehana; O'Brien, Susan; Molnar, Danielle Sirriani; Trajanovic, Nik; Ogilvie, Robert; Shapiro, Colin; Yan, Mi; Chilcott-Tanser, Lisa

    2006-05-02

    Evidence is growing that sleep problems in adolescents are significant impediments to learning and negatively affect behaviour, attainment of social competence and quality of life. The objectives of the study were to determine the level of sleepiness among students in high school, to identify factors to explain it, and to determine the association between sleepiness and performance in both academic and extracurricular activities A cross-sectional survey of 2201 high school students in the Hamilton Wentworth District School Board and the Near North District School Board in Ontario was conducted in 1998/9. A similar survey was done three years later involving 1034 students in the Grand Erie District School Board in the same Province. The Epworth Sleepiness Scale (ESS) was used to measure sleepiness and we also assessed the reliability of this tool for this population. Descriptive analysis of the cohort and information on various measures of performance and demographic data were included. Regression analysis, using the generalised estimating equation (GEE), was utilized to investigate factors associated with risk of sleepiness (ESS>10). Seventy per cent of the students had less than 8.5 hours weeknight sleep. Bedtime habits such as a consistent bedtime routine, staying up late or drinking caffeinated beverages before bed were statistically significantly associated with ESS, as were weeknight sleep quantity and gender. As ESS increased there was an increase in the proportion of students who felt their grades had dropped because of sleepiness, were late for school, were often extremely sleepy at school, and were involved in fewer extracurricular activities. These performance measures were statistically significantly associated with ESS. Twenty-three percent of the students felt their grades had dropped because of sleepiness. Most students (58-68%) reported that they were "really sleepy" between 8 and 10 A.M. Sleep deprivation and excessive daytime sleepiness were common

  10. Determining the level of sleepiness in the American population and its correlates.

    Science.gov (United States)

    Ohayon, Maurice M

    2012-04-01

    To assess the prevalence, to determine the risk factors and to evaluate the impacts of excessive sleepiness in the general population. It is a cross-sectional telephone study using a representative sample consisting of 8937 non-institutionalized individuals aged 18 or over living in Texas, New York and California. They represented a total of 62.8 million inhabitants. The participation rate was 85.6% in California, 81.3% in New York and 83.2% in Texas. Interviews were managed by the Sleep-EVAL expert system. The questionnaire included questions on sleeping habits, life habits, health, DSM-IV mental disorders, DSM-IV and ICSD sleep disorders. As many as 19.5% of the sample reported having moderate excessive sleepiness and 11.0% reported severe excessive sleepiness. Moderate excessive sleepiness was comparable between men and women but severe excessive sleepiness was higher in women (8.6% vs. 13.0%). Factors associated with moderate excessive sleepiness were sleeping 6 h or less per main sleep episode (OR:2.0); OSAS (OR:2.0); insomnia disorder (OR:2.4); Restless Legs Syndrome (OR: 1.8) major depressive disorder (OR: 1.7); anxiety disorder (OR:1.5) and use of tricyclic antidepressant (OR: 2.1) presence of heart disease (OR: 1.5), cancer (1.8) and chronic pain (1.3). Factors associated with severe excessive sleepiness were similar with the addition of being a woman (OR:1.5), alcohol dependence (OR: 1.4), bipolar disorder (OR: 2.1), use of over-the-counter sleeping pills (OR: 2.5), narcotic analgesics (OR: 3.4), Antidepressants (other than SSRI or tricyclic) and presence of gastro-esophageal reflux disease (OR:1.6). Sleepy individuals were twice as likely than non-sleepy participants to have had accidents while they were at the wheel of a vehicle during the previous year. Excessive sleepiness is highly prevalent in the American population. It was strongly associated with insufficient sleep and various sleep disorders as well as mental and organic diseases. Copyright

  11. "Sleepiness" is serious in adolescence: Two surveys of 3235 Canadian students

    Directory of Open Access Journals (Sweden)

    Ogilvie Robert

    2006-05-01

    Full Text Available Abstract Background Evidence is growing that sleep problems in adolescents are significant impediments to learning and negatively affect behaviour, attainment of social competence and quality of life. The objectives of the study were to determine the level of sleepiness among students in high school, to identify factors to explain it, and to determine the association between sleepiness and performance in both academic and extracurricular activities Methods A cross-sectional survey of 2201 high school students in the Hamilton Wentworth District School Board and the Near North District School Board in Ontario was conducted in 1998/9. A similar survey was done three years later involving 1034 students in the Grand Erie District School Board in the same Province. The Epworth Sleepiness Scale (ESS was used to measure sleepiness and we also assessed the reliability of this tool for this population. Descriptive analysis of the cohort and information on various measures of performance and demographic data were included. Regression analysis, using the generalised estimating equation (GEE, was utilized to investigate factors associated with risk of sleepiness (ESS>10. Results Seventy per cent of the students had less than 8.5 hours weeknight sleep. Bedtime habits such as a consistent bedtime routine, staying up late or drinking caffeinated beverages before bed were statistically significantly associated with ESS, as were weeknight sleep quantity and gender. As ESS increased there was an increase in the proportion of students who felt their grades had dropped because of sleepiness, were late for school, were often extremely sleepy at school, and were involved in fewer extracurricular activities. These performance measures were statistically significantly associated with ESS. Twenty-three percent of the students felt their grades had dropped because of sleepiness. Most students (58–68% reported that they were "really sleepy" between 8 and 10 A

  12. Subjective assessment of facial aesthetics after maxillofacial orthognathic surgery for obstructive sleep apnoea.

    Science.gov (United States)

    Islam, Shofiq; Aleem, Fahd; Ormiston, Ian W

    2015-03-01

    We aimed to evaluate the subjective perception of facial appearance by patients after maxillofacial surgery for obstructive sleep apnoea (OSA), and explored the possible correlation between satisfaction and surgical outcome. A total of 26 patients, 24 men and 2 women (mean (SD) age 45 (7) years), subjectively assessed their facial appearance before and after operation using a visual analogue scale (VAS). To investigate a possible association between postoperative facial appearance and surgical outcome, we analysed postoperative scores for the apnoea/hypopnoea index (AHI) and Epworth sleepiness scale (ESS). Postoperatively, 14 (54%) indicated that their facial appearance had improved, 4 (15%) recorded a neutral score, and 8 (31%) a lower score. The rating of facial appearance did not correlate with changes in the AHI or ESS following surgery. This study supports the view that most patients are satisfied with their appearance after maxillofacial orthognathic surgery for OSA. The subjective perception of facial aesthetics was independent of the surgical outcome. Copyright © 2014 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  13. Criterion validity of the Pittsburgh Sleep Quality Index and Epworth Sleepiness Scale for the diagnosis of sleep disorders.

    Science.gov (United States)

    Nishiyama, Takeshi; Mizuno, Tomoki; Kojima, Masayo; Suzuki, Sadao; Kitajima, Tsuyoshi; Ando, Kayoko Bhardwaj; Kuriyama, Shinichi; Nakayama, Meiho

    2014-04-01

    (1) To examine criterion validity of the Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS) using obstructive sleep apnea (OSA), periodic limb movement disorder (PLMD), rapid eye movement sleep behavior disorder (RBD), and narcolepsy as criterion standard. (2) To summarize the evidence for criterion validity of the ESS for the diagnosis of OSA by a meta-analysis that combines the current and previous studies. (3) To investigate the determinants of the PSQI and ESS scores. The PSQI and ESS as well as the Hospital Anxiety and Depression Scale (HADS), which measures anxiety and depression levels, were administered to 367 patients consecutively referred to a sleep clinic. They underwent overnight polysomnography (PSG) and the multiple sleep latency test if narcolepsy was suspected. The area under the receiver operating characteristic curves for the ESS and PSQI (and its subscale) were <0.9, meaning that these questionnaires were not highly accurate for predicting the four sleep disorders. The meta-analysis found that the ESS had no value in identifying OSA. The variable that most strongly influenced PSQI or ESS scores was the HADS score. The PSQI and ESS should no longer be used as a screening or diagnostic instrument for the four PSG-defined sleep disorders, especially in a low-risk population. Copyright © 2014 Elsevier B.V. All rights reserved.

  14. Time to response with sodium oxybate for the treatment of excessive daytime sleepiness and cataplexy in patients with narcolepsy.

    Science.gov (United States)

    Bogan, Richard K; Roth, Thomas; Schwartz, Jonathan; Miloslavsky, Maja

    2015-04-15

    This post hoc analysis evaluated the time to response that can be expected with sodium oxybate (SXB) for treatment of excessive daytime sleepiness (EDS) and cataplexy in patients with narcolepsy. Data were from a 4-week, double-blind, randomized, placebo-controlled trial (GHB-2; N = 136) of oral SXB 3 g, 6 g, and 9 g nightly, and its 12-month open-label extension (GHB-3). Two response definitions were utilized: ≥ 20% improvement in Epworth Sleepiness Scale (ESS) score (EDS responders), and ≥ 50% reduction in weekly cataplexy attacks (cataplexy responders). These thresholds were previously determined to be clinically relevant based on analysis of the relationship of Clinical Global Impression of Change with ESS and number of cataplexy attacks. Kaplan-Meier curves and median times to first response, based on above criteria, and to maximum response were estimated. Among 86 patients randomized to SXB in GHB-2 and continued into GHB-3, 77.6% and 90.7% were EDS and cataplexy responders, respectively. The median (95% CI) times to first response were 37 (31-50) days for EDS and 25 (17-29) days for cataplexy, and median times to maximum response were 106 (85-164) days for EDS and 213 (94-279) days for cataplexy. GHB-3 results among 31 patients initially randomized to placebo were consistent with those treated with SXB throughout, but with longer times to maximum response. Response onset, assessed as clinically meaningful improvements in EDS and cataplexy, was observed in most patients within 2 months; a longer period is needed to achieve maximum response. Clinicians should recognize that time to initial and maximum response may take weeks to months. © 2015 American Academy of Sleep Medicine.

  15. School Maladjustment and External Locus of Control Predict the Daytime Sleepiness of College Students With ADHD.

    Science.gov (United States)

    Langberg, Joshua M; Dvorsky, Melissa R; Becker, Stephen P; Molitor, Stephen J

    2016-09-01

    The primary aim of this study was to evaluate whether school maladjustment longitudinally predicts the daytime sleepiness of college students with ADHD above and beyond symptoms of ADHD and to determine whether internalizing dimensions mediate the relationship between maladjustment and sleepiness. A prospective longitudinal study of 59 college students comprehensively diagnosed with ADHD who completed ratings at the beginning, middle, and end of the school year. School maladjustment at the beginning of the year significantly predicted daytime sleepiness at the end of the year above and beyond symptoms of ADHD. Locus of control mediated the relationship between maladjustment and daytime sleepiness. The significant school maladjustment difficulties that students with ADHD experience following the transition to college may lead to the development of problems with daytime sleepiness, particularly for those students with high external locus of control. This pattern is likely reciprocal, whereby sleep problems in turn result in greater school impairment, reinforcing the idea that life events are outside of one's control. © The Author(s) 2014.

  16. Excessive Daytime Sleepiness and Unintended Sleep Episodes Associated with Parkinson’s Disease

    Directory of Open Access Journals (Sweden)

    Fatai Salawu

    2015-01-01

    Full Text Available This article looks at the issues of excessive daytime sleepiness and unintended sleep episodes in patients with Parkinson’s disease (PD and explores the reasons why patients might suffer from these symptoms, and what steps could be taken to manage them. During the last decade, understanding of sleep/wake regulation has increased. Several brainstem nuclei and their communication pathways in the ascending arousing system through the hypothalamus and thalamus to the cortex play key roles in sleep disorders. Insomnia is the most common sleep disorder in PD patients, and excessive daytime sleepiness is also common. Excessive daytime sleepiness affects up to 50% of PD patients and a growing body of research has established this sleep disturbance as a marker of preclinical and premotor PD. It is a frequent and highly persistent feature in PD, with multifactorial underlying pathophysiology. Both age and disease-related disturbances of sleep-wake regulation contribute to hypersomnia in PD. Treatment with dopamine agonists also contribute to excessive daytime sleepiness. Effective management of sleep disturbances and excessive daytime sleepiness can greatly improve the quality of life for patients with PD.

  17. A 19-SNP coronary heart disease gene score profile in subjects with type 2 diabetes: the coronary heart disease risk in type 2 diabetes (CoRDia study) study baseline characteristics.

    Science.gov (United States)

    Beaney, Katherine E; Ward, Claire E; Bappa, Dauda A S; McGale, Nadine; Davies, Anna K; Hirani, Shashivadan P; Li, KaWah; Howard, Philip; Vance, Dwaine R; Crockard, Martin A; Lamont, John V; Newman, Stanton; Humphries, Steve E

    2016-10-03

    The coronary risk in diabetes (CoRDia) trial (n = 211) compares the effectiveness of usual diabetes care with a self-management intervention (SMI), with and without personalised risk information (including genetics), on clinical and behavioural outcomes. Here we present an assessment of randomisation, the cardiac risk genotyping assay, and the genetic characteristics of the recruits. Ten-year coronary heart disease (CHD) risk was calculated using the UKPDS score. Genetic CHD risk was determined by genotyping 19 single nucleotide polymorphisms (SNPs) using Randox's Cardiac Risk Prediction Array and calculating a gene score (GS). Accuracy of the array was assessed by genotyping a subset of pre-genotyped samples (n = 185). Overall, 10-year CHD risk ranged from 2-72 % but did not differ between the randomisation groups (p = 0.13). The array results were 99.8 % concordant with the pre-determined genotypes. The GS did not differ between the Caucasian participants in the CoRDia SMI plus risk group (n = 66) (p = 0.80) and a sample of UK healthy men (n = 1360). The GS was also associated with LDL-cholesterol (p = 0.05) and family history (p = 0.03) in a sample of UK healthy men (n = 1360). CHD risk is high in this group of T2D subjects. The risk array is an accurate genotyping assay, and is suitable for estimating an individual's genetic CHD risk. Trial registration This study has been registered at ClinicalTrials.gov; registration identifier NCT01891786.

  18. Effect of Oral JZP-110 (ADX-N05) on Wakefulness and Sleepiness in Adults with Narcolepsy: A Phase 2b Study.

    Science.gov (United States)

    Ruoff, Chad; Swick, Todd J; Doekel, Robert; Emsellem, Helene A; Feldman, Neil T; Rosenberg, Russell; Bream, Gary; Khayrallah, Moise A; Lu, Yuan; Black, Jed

    2016-07-01

    To evaluate the efficacy and safety of oral JZP-110, a second-generation wake-promoting agent with dopaminergic and noradrenergic activity, for treatment of impaired wakefulness and excessive sleepiness in adults with narcolepsy. This was a phase 2b, randomized, double-blind, placebo-controlled, parallel-group trial conducted at 28 centers in the United States. Patients were adults with narcolepsy who had baseline scores ≥ 10 on the Epworth Sleepiness Scale (ESS) and baseline sleep latency ≤ 10 min on the Maintenance of Wakefulness Test (MWT). Patients received a daily placebo (n = 49) or JZP-110 (n = 44) 150 mg/day weeks 1-4 and 300 mg/day weeks 5-12. Primary efficacy endpoints were change from baseline in average MWT sleep latency, and the Clinical Global Impression-Change (CGI-C); secondary endpoints were change from baseline in ESS score and Patient Global Impression-Change. Improvements were significantly greater with JZP-110 versus placebo on mean MWT sleep latency (4 w, 9.5 versus 1.4 min, P narcolepsy. Clinicaltrials.gov identifier NCT01681121. © 2016 Associated Professional Sleep Societies, LLC.

  19. Placebo response to caffeine improves reaction time performance in sleepy people.

    Science.gov (United States)

    Anderson, Clare; Horne, James A

    2008-06-01

    Caffeine is the most widely used stimulant to counteract sleepiness. However, little is known about any placebo effect of caffeine in sleepy people and the effect of suggestibility. Over a 95 min test period, and in a counterbalanced design, 16 young healthy adults underwent 3 x 30 min sessions at the psychomotor vigilance test (PVT), during an early afternoon 'dip' enhanced by a prior night's sleep restriction (5 h). On both occasions they were given a cup of a decaffeinated coffee; once when the participant was verbally primed to suggest the coffee was caffeinated (Placebo) and on the other under neutral priming (Control). There were significantly fewer lapses and shorter reaction times following Placebo, for the initial two 30 min sessions, indicating that suggestion about consuming caffeine was effective in improving performance in moderately sleepy people. (c) 2008 John Wiley & Sons, Ltd.

  20. Recent advances in the treatment and management of excessive daytime sleepiness.

    Science.gov (United States)

    Black, Jed; Duntley, Stephen P; Bogan, Richard K; O'Malley, Mary B

    2007-02-01

    Excessive daytime sleepiness (EDS) is a prevalent complaint among patients in psychiatric care. Patients with conditions of EDS have often been misdiagnosed with depression due to their complaints of lack of energy, poor concentration, memory disturbance, and a reduced interest in life. Impaired alertness associated with EDS can be detrimental to a person's quality of life by causing decreased work performance, self-consciousness, low self esteem, and social isolation. Excessive sleepiness is also associated with various health problems, comorbid medical and psychiatric conditions, and fatal accidents occurring after the driver has fallen asleep at the wheel. Contributing factors leading to EDS range from insufficient sleep hours to central nervous system-mediated debilitating hypersomnolence. Circadian rhythm disorders, sleep disorders such as obstructive sleep apnea and narcolepsy, and medications that cause sleepiness may also contribute to symptoms of EDS. Recognition of the symptoms of sleep deprivation is essential, as many such patients do not have a clear awareness of their own sleepiness. Treatment options, depending upon the condition, include light therapy or appropriate airway management techniques such as nasal continuous positive airway pressure (CPAP). Occasionally, wakefulness-promoting medications are necessary, particularly in patients with narcolepsy. In this expert roundtable supplement, Stephen P. Duntley, MD, reviews the definition and prevalence of EDS and discusses the contributing factors and consequences of daytime sleepiness. Next, Richard K. Bogan, MD, FCCP, gives an overview of the differential diagnosis of EDS and the assessment tools available for identifying sleepiness in symptomatic patients. Finally, Mary B. O'Malley, MD, PhD, reviews treatment of EDS, including counseling on sleep hygiene and duration of sleep, mechanical treatments, bright-light therapy, and wake-promoting medications.

  1. Daytime Sleepiness, Circadian Preference, Caffeine Consumption and Khat Use among College Students in Ethiopia.

    Science.gov (United States)

    Robinson, Darve; Gelaye, Bizu; Tadesse, Mahlet G; Williams, Michelle A; Lemma, Seblewengel; Berhane, Yemane

    2013-12-20

    To estimate the prevalence of daytime sleepiness and circadian preferences, and to examine the extent to which caffeine consumption and Khat (a herbal stimulant) use are associated with daytime sleepiness and evening chronotype among Ethiopian college students. A cross-sectional study was conducted among 2,410 college students. A self-administered questionnaire was used to collect information about sleep, behavioral risk factors such as caffeinated beverages, tobacco, alcohol, and Khat consumption. Daytime sleepiness and chronotype were assessed using the Epworth Sleepiness Scale (ESS) and the Horne & Ostberg Morningness /Eveningness Questionnaire (MEQ), respectively. Linear and logistic regression models were used to evaluate associations. Daytime sleepiness (ESS≥10) was present in 26% of the students (95% CI: 24.4-27.8%) with 25.9% in males and 25.5% in females. A total of 30 (0.8%) students were classified as evening chronotypes (0.7% in females and 0.9% in males). Overall, Overall, Khat consumption, excessive alcohol use and cigarette smoking status were associated with evening chronotype. Use of any caffeinated beverages (OR=2.18; 95%CI: 0.82-5.77) and Khat consumption (OR=7.43; 95%CI: 3.28-16.98) increased the odds of evening chronotype. The prevalence of daytime sleepiness among our study population was high while few were classified as evening chronotypes. We also found increased odds of evening chronotype with caffeine consumption and Khat use amongst Ethiopian college students. Prospective cohort studies that examine the effects of caffeinated beverages and Khat use on sleep disorders among young adults are needed.

  2. Excessive daytime sleepiness in the elderly: association with cardiovascular risk, obesity and depression

    Directory of Open Access Journals (Sweden)

    Johnnatas Mikael Lopes

    2013-12-01

    Full Text Available OBJECTIVE: To observe the relationship between Excessive Daytime Sleepiness (EDS and the presence of risk factors for cardiovascular dysfunction, depression and obesity in the elderly. METHODS: We interviewed 168 elderly from the community of Campina Grande, Paraíba. They were selected according to health districts in the period of 2010. We used the Epworth Sleepiness Scale to diagnose excessive daytime sleepiness (> 10 points; waist circumference for the risk of cardiovascular dysfunction (> 94 or > 80 cm; Geriatric Depression Scale for depression (>10 points and body mass index for obesity (> 25 kg/m2. Association analysis was performed by the Chi-square test adjusted for sex and age group, adopting α < 0.05. RESULTS: One hundred and sixty eight elderly individuals with mean age of 72.34 ± 7.8 years old participated in this study, being 122 (72.6% women. EDS was identified in 53 (31.5% of them; depression, in 72 (42.9%; overweight/obesity, in 95 (64.46%; and risk of cardiovascular dysfunction, in 129 (79.6%. Depressed men (78.6%, p = 0.0005 and risk of cardiovascular dysfunction (57.1%, p = 0.02 were more prone to EDS. In women, only obesity was related to sleepiness (42.1%, p = 0.01. Only those aged between 70 - 79 years old showed association between sleepiness and obesity. CONCLUSION: It was found that obesity for women, and depression and cardiovascular dysfunction risking for men were associated with EDS in the elderly. The variable sex is a confusion condition for the association with sleepiness.

  3. Comparing sleep-loss sleepiness and sleep inertia: lapses make the difference.

    Science.gov (United States)

    Miccoli, Laura; Versace, Francesco; Koterle, Sara; Cavallero, Corrado

    2008-09-01

    To compare the behavioral effects of sleep-loss sleepiness (performance impairment due to sleep loss) and sleep inertia (period of impaired performance that follows awakening), mean response latencies and number of lapses from a visual simple reaction-time task were analyzed. Three experimental conditions were designed to manipulate sleepiness and sleep-inertia levels: uninterrupted sleep, partial sleep reduction, and total sleep deprivation. Each condition included two consecutive nights (the first always a night of uninterrupted sleep, and the second either a night of uninterrupted sleep, a night when sleep was reduced to 3 h, or a night of total sleep deprivation), as well as two days in which performance was assessed at 10 different time points (08:00, 08:30, 09:00, 09:30, 10:00, 11:00, 14:00, 17:00, 20:00, and 23:00 h). From 08:00 to 09:00 h, reaction times in the partial sleep-reduction and total sleep-deprivation conditions were at a similar level and were slower than those observed in the uninterrupted sleep condition. In the same time period, the frequency of lapses in the total sleep-deprivation condition was higher than in the partial sleep-reduction condition, while this latter condition never differed from the uninterrupted sleep condition. The results indicate that both sleep inertia and sleep-loss sleepiness lead to an increase in response latencies, but only extreme sleepiness leads to an increase in lapse frequency. We conclude that while reaction times slow as a result of both sleep inertia and sleep-loss sleepiness, lapses appear to be a specific feature of sleep-loss sleepiness.

  4. "Silent" Sleep Apnea in Dentofacial Deformities and Prevalence of Daytime Sleepiness After Orthognathic and Intranasal Surgery.

    Science.gov (United States)

    Posnick, Jeffrey C; Adachie, Anayo; Singh, Neeru; Choi, Elbert

    2017-09-11

    The purposes of this study were to determine the occurrence of undiagnosed "silent" obstructive sleep apnea (OSA) in dentofacial deformity (DFD) patients at initial surgical presentation and to report on the level of daytime sleepiness in DFD patients with OSA and chronic obstructive nasal breathing (CONB) after undergoing bimaxillary, chin, and intranasal surgery. A retrospective cohort study of patients with a bimaxillary DFD and CONB was implemented. Patients were divided into those with no OSA (group I) and those with OSA (group II). Group II was further subdivided into patients referred with polysomnogram (PSG)-confirmed OSA (group IIa) and those with a diagnosis of OSA only after surgical consultation, airway evaluation, and a positive PSG (group IIb). Group II patients were analyzed at a minimum of 1 year after surgery (range, 1 to 10 years) for daytime sleepiness with the Epworth Sleepiness Scale. Patients with postoperative excessive daytime sleepiness were assessed for risk factors and continued need for OSA treatment. Patients in group II were studied to determine which DFD patterns were most associated with OSA. We compared the prevalence of OSA between our study population and the general population. Two hundred sixty-two patients met the inclusion criteria. Of these, 23% (60 of 262) had PSG-confirmed OSA (group II). This rate was much higher than that found in the general population. Of the patients, 7% (19 of 262) were known to have OSA at initial surgical consultation (group IIa). An additional 16% (41 of 262) were later confirmed by PSG to have OSA (group IIb). Patients with primary mandibular deficiency and short face DFDs were most likely to have OSA (P surgery. A significant association was found between group II patients with postoperative excessive daytime sleepiness ("sleepy" or "very sleepy") and a preoperative body mass index category of overweight (P = .026). Our study found silent OSA to be frequent in the DFD population. The

  5. Sleep-Wake Cycle, Daytime Sleepiness, and Attention Components in Children Attending Preschool in the Morning and Afternoon Shifts

    Science.gov (United States)

    Belísio, Aline S.; Kolodiuk, Fernanda F.; Louzada, Fernando M.; Valdez, Pablo; Azevedo, Carolina V. M.

    2017-01-01

    Children tend to sleep and wake up early and to exhibit daytime sleep episodes. To evaluate the impact of school start times on sleepiness and attention in preschool children, this study compared the temporal patterns of sleep, daytime sleepiness, and the components of attention between children aged 4-6 years that study in the morning (n = 66)…

  6. The Epworth Sleepiness Scale: Self-Administration Versus Administration by the Physician, and Validation of a French Version

    Directory of Open Access Journals (Sweden)

    Marta Kaminska

    2010-01-01

    Full Text Available BACKGROUND/OBJECTIVES: The Epworth Sleepiness Scale (ESS measures sleepiness and is used for, among others, patients with obstructive sleep apnea (OSA. The questionnaire is usually self-administered, but may be physician administered. The aim was to compare the two methods of administration and to validate a French version.

  7. Prevalence of abnormal sleep duration and excessive daytime sleepiness in pregnancy and the role of socio-demographic factors: comparing pregnant women with women in the general population.

    Science.gov (United States)

    Signal, T Leigh; Paine, Sarah-Jane; Sweeney, Bronwyn; Priston, Monique; Muller, Diane; Smith, Alexander; Lee, Kathryn A; Huthwaite, Mark; Reid, Papaarangi; Gander, Philippa

    2014-12-01

    To compare the prevalence of self-reported abnormal sleep duration and excessive daytime sleepiness in pregnancy among Māori (indigenous New Zealanders) and non-Māori women versus the general population, and to examine the influence of socio-demographic factors. Self-reported total sleep time (TST) in 24-hrs, Epworth Sleepiness Scale scores and socio-demographic information were obtained from nullipara and multipara women aged 20-46 yrs at 35-37 weeks pregnant (358 Māori and 717 non-Māori), and women in the general population (381 Māori and 577 non-Māori). After controlling for ethnicity, age, socio-economic status, and employment status, pregnant women average 30 min less TST than women in the general population. The distribution of TST was also greater in pregnant women, who were 3 times more likely to be short sleepers (≤6 h) and 1.9 times more likely to be long sleepers (>9 h). In addition, pregnant women were 1.8 times more likely to report excessive daytime sleepiness (EDS). Pregnant women >30 years of age experienced greater age-related declines in TST. Identifying as Māori, being unemployed, and working at night increased the likelihood of reporting abnormal sleep duration across all women population in this study. EDS also more likely occurred among Māori women and women who worked at night. Pregnancy increases the prevalence of abnormal sleep duration and EDS, which are also higher among Māori than non-Māori women and those who do night work. Health professionals responsible for the care of pregnant women need to be well-educated about the importance of sleep and discuss sleep issues with the women they care for. Copyright © 2014 Elsevier B.V. All rights reserved.

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

    Science.gov (United States)

    Herrera, Christopher P

    2012-01-01

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

  9. Predictive abilities of the STOP-Bang and Epworth Sleepiness Scale in identifying sleep clinic patients at high risk for obstructive sleep apnea.

    Science.gov (United States)

    Vana, Kimberly D; Silva, Graciela E; Goldberg, Rochelle

    2013-02-01

    This study compared the predictive abilities of the STOP-Bang and Epworth Sleepiness Scale (ESS) for screening sleep clinic patients for obstructive sleep apnea (OSA) and sleep-disordered breathing (SDB). Forty-seven new adult patients without previous diagnoses of OSA or SDB were administered the STOP-Bang and ESS and were assigned to OSA or SDB risk groups based on their scores. STOP-Bang responses were scored with two Body Mass Index cut points of 35 and 30 kg/m(2) (SB35 and SB30). The tools' predictive abilities were determined by comparing patients' predicted OSA and SDB risks to their polysomnographic results. The SB30 correctly identified more patients with OSA and SDB than the ESS alone. The ESS had the highest specificity for OSA and SDB. Copyright © 2012 Wiley Periodicals, Inc.

  10. Depressive Symptoms are the Main Predictor for Subjective Sleep Quality in Patients with Mild Cognitive Impairment--A Controlled Study.

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    Stefan Seidel

    Full Text Available Controlled data on predictors of subjective sleep quality in patients with memory complaints are sparse. To improve the amount of comprehensive data on this topic, we assessed factors associated with subjective sleep quality in patients from our memory clinic and healthy individuals.Between February 2012 and August 2014 patients with mild cognitive impairment (MCI and subjective cognitive decline (SCD from our memory clinic and healthy controls were recruited. Apart from a detailed neuropsychological assessment, the subjective sleep quality, daytime sleepiness and depressive symptoms were assessed using the Pittsburgh Sleep Quality Index (PSQI, the Epworth Sleepiness Scale (ESS and the Beck Depression Inventory (BDI-II.One hundred fifty eight consecutive patients (132 (84% MCI patients and 26 (16% SCD patients and 75 healthy controls were included in the study. Pairwise comparison of PSQI scores showed that non-amnestic MCI (naMCI patients (5.4 ± 3.5 had significantly higher PSQI scores than controls (4.3 ± 2.8, p = .003 Pairwise comparison of PSQI subscores showed that naMCI patients (1.1 ± 0.4 had significantly more "sleep disturbances" than controls (0.9 ± 0.5, p = .003. Amnestic MCI (aMCI (0.8 ± 1.2, p = .006 and naMCI patients (0.7 ± 1.2, p = .002 used "sleep medication" significantly more often than controls (0.1 ± 0.6 Both, aMCI (11.5 ± 8.6, p < .001 and naMCI (11.5 ± 8.6, p < .001 patients showed significantly higher BDI-II scores than healthy controls (6.1 ± 5.3. Linear regression analysis showed that the subjective sleep quality was predicted by depressive symptoms in aMCI (p < .0001 and naMCI (p < .0001 patients as well as controls (p < .0001. This means, that more depressive symptoms worsened subjective sleep quality. In aMCI patients we also found a significant interaction between depressive symptoms and global cognitive function (p = .002.Depressive symptoms were the main predictor of subjective sleep quality in MCI

  11. A case-control study on excessive daytime sleepiness in chronic migraine.

    Science.gov (United States)

    Barbanti, Piero; Aurilia, Cinzia; Egeo, Gabriella; Fofi, Luisa; Vanacore, Nicola

    2013-03-01

    Excessive daytime sleepiness is a major clinical and health concern that can have varied and sometimes harmful consequences. Findings from uncontrolled studies suggest a high prevalence in patients with chronic migraine. In a case-control study, we compared frequency data for excessive daytime sleepiness in 100 patients with chronic migraine and 100 healthy controls paired for sex and age, and assessed risk factors including lifestyle, sleep quality, anxiety, depression, concomitant disease and medications. The frequency of excessive daytime sleepiness was higher in migraineurs (especially in those with medication overuse) than in controls (20% versus 6%; odds ratio 3.92, 95% CI 1.5-10.22), but was lower than previously reported and correlated with poor quality sleep and anxiolytic and antidepressant use. Again confirming that disability in chronic migraine is multifactorial in origin, excessive daytime sleepiness, especially in migraineurs who overuse medications, adds to the multiple factors known to impair social and working function. Patients with chronic migraine might benefit from diagnostic interviews focussing also on sleep problems and from targeted psychoactive drug prescribing. Copyright © 2012 Elsevier B.V. All rights reserved.

  12. The Psychosocial Problems of Children with Narcolepsy and Those with Excessive Daytime Sleepiness of Uncertain Origin

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    Stores, Gregory; Montgomery, Paul; Wiggs, Luci

    2007-01-01

    Background: Narcolepsy is a predominantly rapid eye movement sleep disorder with onset usually in the second decade but often in earlier childhood. Classically it is characterized by combinations of excessive sleepiness especially sleep attacks, cataplexy, hypnagogic hallucinations, and sleep paralysis. The psychosocial effects of this lifelong…

  13. Poor sleep quality and fatigue but no excessive daytime sleepiness in myotonic dystrophy type 2.

    NARCIS (Netherlands)

    Tieleman, A.A.; Knoop, H.; Logt, A.E. van de; Bleijenberg, G.; Engelen, B.G.M. van; Overeem, S.

    2010-01-01

    BACKGROUND: In myotonic dystrophy type 1 (DM1), sleep disorders are common, with excessive daytime sleepiness (EDS) as a predominant feature. In myotonic dystrophy type 2 (DM2), the presence of sleep disturbances is unknown. OBJECTIVE: To investigate the frequency of EDS, poor sleep quality and

  14. Insomnia, Sleepiness, and Depression in Adolescents Living in Residential Care Facilities

    Science.gov (United States)

    Moreau, Vincent; Belanger, Lynda; Begin, Gilles; Morin, Charles M.

    2009-01-01

    The main objective of this study was to document sleep patterns and disturbances reported by youths temporarily living in residential care facilities. A secondary objective was to examine the relationships between sleep disturbances and mood and daytime sleepiness. A self-reported questionnaire on sleep patterns and habits assessing duration,…

  15. Judgment of Daytime Sleepiness in Self-Reported Short, Long and Midrange Sleepers

    Science.gov (United States)

    Mairesse, Olivier; Neu, Daniel; Migeotte, Pierre-Francois; Pattyn, Nathalie; Hofmans, Joeri; Theuns, Peter; Cluydts, Raymond; De Valck, Elke

    2012-01-01

    Sleep-wake behavior, as well as sleepiness, is regulated by the joint action of an exponentially increasing drive for sleep--sleep homeostasis--and by variations in sleep propensity due to a biological circadian oscillator. However, large inter-individual differences remain. Short and long sleepers have been known to differ in the amount of…

  16. "Koi Sleepy Disease" voor het eerst in Nederland aangetoond in koikarpers

    NARCIS (Netherlands)

    Haenen, O.L.M.; Way, K.; Stone, D.; Engelsma, M.Y.

    2014-01-01

    Eind september 2013 is de koikarperziekte 'Koi Sleepy Disease'(KSD) voor het eerst aangetoond in Nederland door het Vis-, schaal- en schelpdierziektelaboratorium van Central Veterinary Institute, onderdeel van Wageningen UR. De klinische verdenking werd bevestigd door het zusterlab CEFAS in

  17. Koi Sleepy Disease (KSD) door 'Carp Edema virus' : eerste detectie in Nederlandse Koi

    NARCIS (Netherlands)

    Haenen, O.L.M.; Way, K.; Stone, D.; Engelsma, M.Y.

    2013-01-01

    De koi sector is bekend met verschillende ziekten van koi, zoals koi herpesvirus (KHV) en columnaris disease door Flavobacterium columnare. Dit najaar is echter een in Nederland nog niet eerder aangetoonde ziekte aangetroffen in koi: het koi sleepy disease (KSD). We gaan in dit artikel in op deze

  18. Daytime Sleepiness, Poor Sleep Quality, Eveningness Chronotype, and Common Mental Disorders among Chilean College Students

    Science.gov (United States)

    Concepcion, Tessa; Barbosa, Clarita; Vélez, Juan Carlos; Pepper, Micah; Andrade, Asterio; Gelaye, Bizu; Yanez, David; Williams, Michelle A.

    2014-01-01

    Objectives: To evaluate whether daytime sleepiness, poor sleep quality, and morningness and eveningness preferences are associated with common mental disorders (CMDs) among college students. Methods: A total of 963 college students completed self-administered questionnaires that collected information about sociodemographic characteristics, sleep…

  19. Subjective and objective measures of adaptation and readaptation to night work on an oil rig in the North Sea.

    Science.gov (United States)

    Bjorvatn, Bjørn; Stangenes, Kristine; Oyane, Nicolas; Forberg, Knut; Lowden, Arne; Holsten, Fred; Akerstedt, Torbjørn

    2006-06-01

    To study the adaptation and readaptation processes to 1 week of night work (6:30 PM to 6:30 AM) followed by 1 week of day work (6:30 AM to 6:30 PM). Part of a randomized, placebo-controlled, crossover field study. Here, data from the placebo arm are presented. Oil rig in the North Sea. Work schedule: 2 weeks on a 12-hour shift, with the first week on the night shift and the second week on the day shift. Subjects complaining about problems with adjusting to shift work. Seventeen workers completed the study. N/A. Subjective and objective measures of sleepiness (Karolinska Sleepiness Scale and simple serial reaction time test) and sleep (diary and actigraphy). Both subjective and objective measures improved gradually during night work. The return to day work after 1 week on the night shift led to a clear increase in subjective sleepiness and worsening of sleep parameters. During the week on the day shift, sleepiness and sleep gradually improved, similar to the improvement seen during night work. The workers indicated that the day shift was worse than the night shift on some of the measures, e.g., sleep length was significantly longer during the night-shift period. This is one of few studies showing how shift workers in a real-life setting adjust to night work. Both subjective and objective sleepiness and subjective sleep improved across days. The effects were especially pronounced for the subjective data.

  20. Daytime Sleepiness, Circadian Preference, Caffeine Consumption and Use of Other Stimulants among Thai College Students.

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    Tran, Jason; Lertmaharit, Somrat; Lohsoonthorn, Vitool; Pensuksan, Wipawan C; Rattananupong, Thanapoom; Tadesse, Mahlet G; Gelaye, Bizu; Williams, Michelle A

    2014-06-01

    We conducted this study to evaluate the prevalence of daytime sleepiness and evening chronotype, and to assess the extent to which both are associated with the use of caffeinated stimulants among 3,000 Thai college students. Demographic and behavioral characteristics were collected using a self-administered questionnaire. The Epworth Sleepiness Scale and the Horne and Ostberg Morningness-Eveningness Questionnaire were used to evaluate prevalence of daytime sleepiness and circadian preference. Multivariable logistic regression models were used to evaluate the association between sleep disorders and consumption of caffeinated beverages. Overall, the prevalence of daytime sleepiness was 27.9 % (95% CI: 26.2-29.5%) while the prevalence of evening chronotype was 13% (95% CI: 11.8-14.2%). Students who use energy drinks were more likely to be evening types. For instance, the use of M100/M150 energy drinks was associated with a more than 3-fold increased odds of evening chronotype (OR 3.50; 95% CI 1.90-6.44), while Red Bull users were more than twice as likely to have evening chronotype (OR 2.39; 95% CI 1.02-5.58). Additionally, those who consumed any energy drinks were more likely to be daytime sleepers. For example, Red Bull (OR 1.72; 95% CI 1.08-2.75) or M100/M150 (OR 1.52; 95% CI 1.10-2.11) consumption was associated with increased odds of daytime sleepiness. Our findings emphasize the importance of implementing educational and prevention programs targeted toward improving sleep hygiene and reducing the consumption of energy drinks among young adults.

  1. Sleepiness, long distance commuting and night work as predictors of driving performance.

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    Lee Di Milia

    Full Text Available Few studies have examined the effect of working night shift and long distance commuting. We examined the association between several sleep related and demographic variables, commuting distance, night work and use of mobile phones on driving performance. We used a prospective design to recruit participants and conducted a telephone survey (n = 649. The survey collected demographic and journey details, work and sleep history and driving performance concerning the day the participant was recruited. Participants also completed the Karolinska Sleepiness Scale and the Epworth Sleepiness Scale. Night workers reported significantly more sleepiness, shorter sleep duration and commuting longer distances. Seven variables were significant predictors of lane crossing. The strongest predictor was acute sleepiness (OR = 5.25, CI, 1.42-19.49, p<0.01 followed by driving ≥150 kms (OR = 3.61, CI, 1.66-7.81, p<0.001, obtaining less than 10 hours sleep in the previous 48 hours (OR = 2.58, CI, 1.03-6.46, p<0.05, driving after night shift (OR = 2.19, CI, 1.24-3.88, p<0.001, being <43 years old (OR = 1.95, CI, 1.11-3.41, p<0.05 and using mobile phones during the journey (OR = 1.90, CI, 1.10-3.27, p<0.05. Sleep related variables, long-distance commuting and night work have a major impact on lane crossing. Several interventions should be considered to reduce the level of sleepiness in night workers.

  2. Gustatory Salivation Is Associated with Body Mass Index, Daytime Sleepiness, and Snoring in Healthy Young Adults.

    Science.gov (United States)

    Izumi, Satoshi; Hong, Guang; Iwasaki, Koh; Izumi, Masayuki; Matsuyama, Yusuke; Chiba, Mirei; Toda, Takashi; Kudo, Tada-Aki

    2016-10-01

    The taste detection system for oral fatty acid may be related to obesity. In addition, sleep is intrinsically and closely related to food intake and metabolism. However, the association of gustatory salivation with body mass index (BMI), daytime sleepiness, or sleep habits is largely unknown. Therefore, we evaluated the relationship between gustatory salivation and BMI, Epworth sleepiness scale (ESS, a daytime sleepiness scale) or sleep habits among 26 healthy young individuals (20 males and 6 females; mean age: 26.0 ± 4.3 years). We also measured the saliva flow rate (SFR) that was induced by gum-chewing or each of three prototypical tastants (acetic acid, sucrose, and NaCl). Further, the SFR was induced by fatty acid, provided as oleic acid (OA) homogenized in non-fat milk. All participants showed normal rates of salivation during resting and gum-chewing states. The increase in the SFR induced by OA, but not by each of the three tastants, was associated with BMI. Moreover, both daytime sleepiness level and frequency of snoring were associated with the increase in the SFR induced by NaCl. These results suggest that BMI is associated with salivation induced by oral fatty acid exposure. Additionally, the regulatory mechanism for the NaCl-induced salivation reflex may have a relationship with impairments of the respiratory control system that are related to snoring during sleep and lead to daytime sleepiness because of insufficient sleep. Thus, measurement of gustatory salivation might contribute to the evaluation and prevention of obesity and sleep-related breathing disorders.

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

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    Ahmed S BaHammam

    2013-01-01

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

  4. Operational definitions and algorithms for excessive sleepiness in the general population: implications for DSM-5 nosology.

    Science.gov (United States)

    Ohayon, Maurice M; Dauvilliers, Yves; Reynolds, Charles F

    2012-01-01

    Excessive sleepiness (ES) is poorly defined in epidemiologic studies, although its adverse implications for safety, health, and optimal social and vocational functioning have been extensively reported. To determine the importance of ES definition, measurement, and prevalence in the general population, together with its coexisting conditions. Cross-sectional telephone study. A total of 15 929 individuals representative of the adult general population of 15 states in the United States. Interviews were carried out using Sleep-EVAL, a knowledge-based expert system for use in epidemiologic studies, focusing on sleep, as well as physical and mental disorders, according to classification in DSM-IV and the second edition of the International Classification of Sleep Disorders. The interviews elicited information on ES, naps, frequency, duration, impairment, and distress associated with ES symptoms. Excessive sleepiness was reported by 27.8% (95% CI, 27.1%-28.5%) of the sample. Excessive sleepiness with associated symptoms was found in 15.6% of the participants (95% CI, 15.0%-16.2%). Adding an ES frequency of at least 3 times per week for at least 3 months despite normal sleep duration dropped the prevalence to 4.7% of the sample (95% CI, 4.4%-5.0%). The proportion of individuals having social or professional impairment and psychological distress increased with the frequency of ES symptoms during the week and within the same day. In multivariate models, the number of ES episodes per day and severity of ES were identified as the best predictors for impairment/distress. Prevalence of hypersomnia disorder was 1.5% of the participants (95% CI, 1.3%-1.7%). The most common coexisting conditions were mood and substance use disorders. Excessive sleepiness is an important problem in the US population, even when using restrictive criteria to define it. Hypersomnia disorder is more prevalent than previously estimated. Excessive sleepiness has to be recognized and given attention by

  5. Circadian rhythm characteristics, poor sleep quality, daytime sleepiness and common psychiatric disorders among Thai college students.

    Science.gov (United States)

    Haregu, Alazar; Gelaye, Bizu; Pensuksan, Wipawan C; Lohsoonthorn, Vitool; Lertmaharit, Somrat; Rattananupong, Thanapoom; Tadesse, Mahlet G; Williams, Michelle A

    2015-06-01

    To investigate the relationship between common psychiatric disorders (CPDs) and sleep characteristics (evening chronotype, poor sleep quality and daytime sleepiness) among Thai college students. A cross-sectional study was conducted among 2,970 undergraduate students in Thailand. Students were asked to complete a self-administered questionnaire that collected information about lifestyle and demographic characteristics. The Horne and Ostberg Morningness-Eveningness Questionnaire (MEQ), Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS) were used to evaluate circadian preference, sleep quality and daytime sleepiness, respectively. The General Health Questionnaire-12 (GHQ-12) was used to evaluate presence of CPDs. Logistic regression models were used to estimate adjusted odds ratios (ORs) and 95% confidence intervals (95% CIs) of CPDs in relation to the covariates of interest. A total of 337 students were classified as having CPDs (11.2%; 95% CI 10.1-12.3%). Evening chronotype (OR = 3.35; 95% CI 2.09-5.37), poor sleep quality (OR = 4.89; 95% CI 3.66-6.54) and excessive daytime sleepiness (OR = 1.95; 95% CI 1.54-2.47) were statistically significantly associated with CPDs. Our study demonstrated that CPDs are common among Thai college students. Further, evening chronotype, poor sleep quality and excessive daytime sleepiness were strongly associated with increased risk of CPDs. These findings highlight the importance of educating students and school administrators about the importance of sleep and their impact on mental health. Copyright © 2014 Wiley Publishing Asia Pty Ltd.

  6. Obesity in urban women: associations with sleep and sleepiness, fatigue and activity.

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    Jarosz, Patricia A; Davis, Jean E; Yarandi, Hossein N; Farkas, Rochelle; Feingold, Edna; Shippings, Sheila H; Smith, Arlanda L; Williams, Dorothy

    2014-01-01

    African-American women (AAW) have the highest prevalence of obesity and therefore are at greater risk for obesity-related symptoms and diseases. Obese individuals frequently report poorer sleep quality, more daytime sleepiness, more severe fatigue, and higher physical inactivity than normal weight individuals. The relationships among these variables have not been well-characterized in obese, urban-dwelling, AAW. This descriptive, correlational study examined the relationships among sleep quality, daytime sleepiness, fatigue, level of physical activity, and body mass index (BMI) in AAW living in an urban setting. A convenience sample of 69 young adult women with a BMI of greater than 30 kg/m(2) completed measures of sleep quality, sleepiness, fatigue severity, sense of community, and physical activity. Further analysis was done to determine if any of the study variables predicted level of physical activity. There was a strong and significant correlation between BMI and overall fatigue severity and a significant, negative correlation between BMI and physical activity performance. BMI was significantly correlated with sleep latency but not global sleep quality. There were significant relationships between fatigue severity and poorer global sleep quality and daytime sleepiness. Multiple regression analysis showed BMI and age accounted for a significant amount of the variance in physical activity. Higher BMI was associated with significant fatigue. Fatigue severity was associated with poorer global sleep quality, daytime sleepiness, and a sense of community. Higher BMI may be a barrier to having an active lifestyle. Copyright © 2014 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

  7. Pharmacological interventions for sleepiness and sleep disturbances caused by shift work

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    Juha Liira

    Full Text Available BACKGROUND: Shift work results in sleep-wake disturbances, which cause sleepiness during night shifts and reduce sleep length and quality in daytime sleep after the night shift. In its serious form it is also called shift work sleep disorder. Various pharmacological products are used to ameliorate symptoms of sleepiness or poor sleep length and quality. OBJECTIVES: To evaluate the effects of pharmacological interventions to reduce sleepiness or to improve alertness at work and decrease sleep disturbances whilst of work, or both, in workers undertaking shift work. METHODS: Search methods: We searched CENTRAL, MEDLINE, EMBASE, PubMed and PsycINFO up to 20 September 2013 and ClinicalTrials.gov up to July 2013. We also screened reference lists of included trials and relevant reviews. Selection criteria: We included all eligible randomised controlled trials (RCTs, including cross-over RCTs, of pharmacological products among workers who were engaged in shift work (including night shifts in their present jobs and who may or may not have had sleep problems. Primary outcomes were sleep length and sleep quality while of work, alertness and sleepiness, or fatigue at work. Data collection and analysis: Two authors independently selected studies, extracted data and assessed risk of bias in included trials. We performed meta-analyses where appropriate. MAIN RESULTS: We included 15 randomised placebo-controlled trials with 718 participants. Nine trials evaluated the effect of melatonin and two the effect of hypnotics for improving sleep problems. One trial assessed the effect of modafinil, two of armodafinil and one examined cafeine plus naps to decrease sleepiness or to increase alertness.

  8. Effects of a selective educational system on fatigue, sleep problems, daytime sleepiness, and depression among senior high school adolescents in Taiwan

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    Chen TY

    2015-03-01

    Full Text Available Tien-Yu Chen,1,2 Yu-Ching Chou,3 Nian-Sheng Tzeng,1,2,4 Hsin-An Chang,1,2,4 Shin-Chang Kuo,1,2,5 Pei-Yin Pan,1,2 Yi-Wei Yeh,1,2,5 Chin-Bin Yeh,1,2 Wei-Chung Mao1,2,6 1Department of Psychiatry, Tri-Service General Hospital, 2School of Medicine, National Defense Medical Center, 3School of Public Health, National Defense Medical Center, 4Student Counseling Center, National Defense Medical Center, 5Graduate Institute of Medical Sciences, National Defense Medical Center, 6Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan, Republic of China Objective: The aim of the study reported here was to clarify the effects of academic pressure on fatigue, sleep problems, daytime sleepiness, and depression among senior high school adolescents in Taiwan. Methods: This cross-sectional study enrolled 757 senior high school adolescents who were classified into four groups: Grade 1 (n=261, Grade 2 (n=228, Grade 3T (n=199; Grade 3 students who had another college entrance test to take, and Grade 3S (n=69; Grade 3 students who had succeeded in their college application. Fatigue, sleep quality, daytime sleepiness, and depression were assessed using the Chinese version of the Multidimensional Fatigue Symptom Inventory – Short Form, Pittsburgh Sleep Quality Index-Taiwan Form, the Chinese version of the Epworth Sleepiness Scale, and the Chinese version of the Beck Depression Inventory®-II (BDI-II, respectively. Results: Physical, emotional, and mental fatigue scores were all higher in higher-grade groups. The Grade 3T (test students had the worst fatigue severity, and the Grade 3S (success students had the least fatigue severity. More than half of the students (60.9% went to bed after 12 am, and they had on average 6.0 hours of sleep per night. More than 30% of the students in Grade 2 (37.3% and Grades 3T/S (30.2%/30.4% possibly had daily sleepiness problems. The students in Grade 3T had the worst BDI-II score (13.27±9.24, and the Grade 3S

  9. The Epworth Sleepiness Scale for screening of the drowsy driving: comparison with the maintenance of wakefulness test in an Iranian sample of commercial drivers.

    Science.gov (United States)

    Sadeghniiat-Haghighi, Khosro; Moller, Henry J; Saraei, Maryam; Aminian, Omid; Khajeh-Mehrizi, Ahmad

    2014-01-01

    Traffic fatalities are a major cause of morbidity and mortality in Iran. Occupational sleep medicine field needs more cost-effective and applicable tests for screening purposes. This study reports on a pilot screening study for drowsy drivers in an urban Iranian sample of commercial drivers. The Maintenance of Wakefulness Test (MWT) measures the ability to remain awake objectively. Sleep latency in MWT is a reasonable predictor of driving simulator performance in drivers. In this study, we evaluate whether the Epworth Sleepiness Scale (ESS) and MWT are equally useful in drivers with possible Excessive Daytime Sleepiness (EDS). 46 consecutive road truck drivers in a transportation terminal entered into this study. The ESS score of patients with normal and abnormal MWT was 3.24±2.4 and 4.08±3 respectively which was not significantly differenced (P value = 0.34). No significant correlation was found between the ESS and sleep latency in MWT (r=-0.28, 95%CI= -0.58 to 0.02). By using the receiver operating characteristic analysis, the area under the curve was found to be 0.57 (95% confidence interval = 0.37- 0.77) which is not statistically acceptable (P value=0.46). Our finding showed that the MWT and ESS do not measure the same parameter.

  10. The Epworth Sleepiness Scale for screening of the drowsy driving: comparison with the maintenance of wakefulness test in an Iranian sample of commercial drivers.

    Directory of Open Access Journals (Sweden)

    Khosro Sadeghniiat-Haghighi

    2014-02-01

    Full Text Available Traffic fatalities are a major cause of morbidity and mortality in Iran. Occupational sleep medicine field needs more cost-effective and applicable tests for screening purposes. This study reports on a pilot screening study for drowsy drivers in an urban Iranian sample of commercial drivers. The Maintenance of Wakefulness Test (MWT measures the ability to remain awake objectively. Sleep latency in MWT is a reasonable predictor of driving simulator performance in drivers. In this study, we evaluate whether the Epworth Sleepiness Scale (ESS and MWT are equally useful in drivers with possible Excessive Daytime Sleepiness (EDS. 46 consecutive road truck drivers in a transportation terminal entered into this study. The ESS score of patients with normal and abnormal MWT was 3.24±2.4 and 4.08±3 respectively which was not significantly differenced (P value = 0.34. No significant correlation was found between the ESS and sleep latency in MWT (r=-0.28, 95%CI= -0.58 to 0.02. By using the receiver operating characteristic analysis, the area under the curve was found to be 0.57 (95% confidence interval = 0.37- 0.77 which is not statistically acceptable (P value=0.46. Our finding showed that the MWT and ESS do not measure the same parameter.

  11. Armodafinil versus Modafinil in Patients of Excessive Sleepiness Associated with Shift Work Sleep Disorder: A Randomized Double Blind Multicentric Clinical Trial

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    D. V. Tembe

    2011-01-01

    Full Text Available Aim. To compare the efficacy and safety of armodafinil, the R-enantiomer of modafinil, with modafinil in patients of shift work sleep disorder (SWSD. Material and Methods. This was a 12-week, randomized, comparative, double-blind, multicentric, parallel-group study in 211 patients of SWSD, receiving armodafinil (150 mg or modafinil (200 mg one hour prior to the night shift. Outcome Measures. Efficacy was assessed by change in stanford sleepiness score (SSS by at least 2 grades (responder and global assessment for efficacy. Safety was assessed by incidence of adverse events, change in laboratory parameters, ECG, and global assessment of tolerability. Results. Both modafinil and armodafinil significantly improved sleepiness mean grades as compared to baseline (<.0001. Responder rates with armodafinil (72.12% and modafinil (74.29% were comparable (=.76. Adverse event incidences were comparable. Conclusion. Armodafinil was found to be safe and effective in the treatment of SWSD in Indian patients. The study did not demonstrate any difference in efficacy and safety of armodafinil 150 mg and modafinil 200 mg.

  12. Effects of a 12-hour shift on mood states and sleepiness of Neonatal Intensive Care Unit nurses.

    Science.gov (United States)

    Ferreira, Tadeu Sartini; Moreira, Clarice Zinato; Guo, James; Noce, Franco

    2017-03-09

    To assess the effect of a 12-hour shift on mood states and sleepiness at the beginning and end of the shift. Quantitative, cross-sectional and descriptive study.It was conducted with 70 neonatal intensive care unit nurses. The Brunel Mood Scale (BRUMS), Karolinska Sleepiness Scale (KSS), and a socio-demographic profile questionnaire were administered. When the KSS and BRUMS scores were compared at the beginning of the shift associations were found with previous sleep quality (p ≤ 0.01), and quality of life (p ≤ 0.05). Statistical significant effects on BRUMS scores were also associated with previous sleep quality, quality of life, liquid ingestion, healthy diet, marital status, and shift work stress. When the beginning and end of the shift were compared, different KSS scores were seen in the group of all nurses and in the night shift one. Significant vigor and fatigue scores were observed within shift groups. A good night's sleep has positive effects on the individual`s mood states both at the beginning and the end of the shift. The self-perception of a good quality of life also positively influenced KSS and BRUMS scores at the beginning and end of the shift. Proper liquid ingestion led to better KSS and BRUMS scores. Evaluar el efecto de un turno de 12 horas en estados de ánimo y somnolencia al principio y al final del turno. Estudio cuantitativo, transversal y descriptivo.Se realizó con 70 enfermeras de unidades de cuidados intensivos neonatales. Se administró la Escala de Humor Brunel (BRUMS), la Escala de Somnolencia de Karolinska (KSS) y un cuestionario de perfil sociodemográfico. Cuando se compararon las puntuaciones de KSS y BRUMS al comienzo del turno se encontraron asociaciones con calidad de sueño previa (p ≤ 0,01) y calidad de vida (p ≤ 0,05). Los efectos estadísticos significativos en las puntuaciones de BRUMS también se asociaron con la calidad previa del sueño, la calidad de vida, la ingestión de líquidos, la dieta saludable, el

  13. The influence of sleep deprivation and oscillating motion on sleepiness, motion sickness, and cognitive and motor performance.

    Science.gov (United States)

    Kaplan, Janna; Ventura, Joel; Bakshi, Avijit; Pierobon, Alberto; Lackner, James R; DiZio, Paul

    2017-01-01

    Our goal was to determine how sleep deprivation, nauseogenic motion, and a combination of motion and sleep deprivation affect cognitive vigilance, visual-spatial perception, motor learning and retention, and balance. We exposed four groups of subjects to different combinations of normal 8h sleep or 4h sleep for two nights combined with testing under stationary conditions or during 0.28Hz horizontal linear oscillation. On the two days following controlled sleep, all subjects underwent four test sessions per day that included evaluations of fatigue, motion sickness, vigilance, perceptual discrimination, perceptual learning, motor performance and learning, and balance. Sleep loss and exposure to linear oscillation had additive or multiplicative relationships to sleepiness, motion sickness severity, decreases in vigilance and in perceptual discrimination and learning. Sleep loss also decelerated the rate of adaptation to motion sickness over repeated sessions. Sleep loss degraded the capacity to compensate for novel robotically induced perturbations of reaching movements but did not adversely affect adaptive recovery of accurate reaching. Overall, tasks requiring substantial attention to cognitive and motor demands were degraded more than tasks that were more automatic. Our findings indicate that predicting performance needs to take into account in addition to sleep loss, the attentional demands and novelty of tasks, the motion environment in which individuals will be performing and their prior susceptibility to motion sickness during exposure to provocative motion stimulation. Copyright © 2016 Elsevier B.V. All rights reserved.

  14. Effect of oral JZP-110 (ADX-N05) treatment on wakefulness and sleepiness in adults with narcolepsy.

    Science.gov (United States)

    Bogan, Richard K; Feldman, Neil; Emsellem, Helene A; Rosenberg, Russell; Lu, Yuan; Bream, Gary; Khayrallah, Moise; Lankford, D Alan

    2015-09-01

    JZP-110 is a wake-promoting agent with dopaminergic and noradrenergic activity. This double-blind, crossover study, randomized adults with narcolepsy with or without cataplexy (N = 33) to placebo or JZP-110 at 150 mg/day (weeks 1 and 3) increased to 300 mg/day (weeks 2 and 4). Patients had to have baseline Epworth Sleepiness Scale (ESS) scores ≥10 and mean sleep latencies ≤10 min on the Maintenance of Wakefulness Test (MWT). Efficacy end points included MWT sleep latency and ESS, and the percentage of patients improved on the Clinical Global Impression of Change. Patients were primarily male (57.6%) and white (69.7%), with a mean (standard deviation) age of 37.1 (12.4) years. At two weeks, the change in the mean MWT sleep latency was 11.8 min longer with JZP-110 than with placebo (P = 0.0002); JZP-110 resulted in greater changes in sleep latency on each MWT trial (P treatment (Clinicaltrials.gov identifier NCT01485770). Copyright © 2015 The Authors. Published by Elsevier B.V. All rights reserved.

  15. Subjective deficits of attention, cognition and depression in patients with narcolepsy.

    Science.gov (United States)

    Zamarian, Laura; Högl, Birgit; Delazer, Margarete; Hingerl, Katharina; Gabelia, David; Mitterling, Thomas; Brandauer, Elisabeth; Frauscher, Birgit

    2015-01-01

    Patients with narcolepsy often complain about attention deficits in everyday situations. In comparison with these subjective complaints, deficits in objective testing are subtler. The present study assessed the relationships between subjective complaints, objectively measured cognitive performance, disease-related variables, and mood. A total of 51 patients with narcolepsy and 35 healthy controls responded to questionnaires regarding subjectively perceived attention deficits, sleepiness, anxiety and depression. Moreover, they performed an extensive neuropsychological assessment tapping into attention, executive functions, and memory. Patients rated their level of attention in everyday situations to be relatively poor. In an objective assessment of cognitive functioning, they showed only slight attention and executive function deficits. The subjective ratings of attention deficits significantly correlated with ratings of momentary sleepiness, anxiety, and depression, but not with objectively measured cognitive performance. Momentary sleepiness and depression predicted almost 39% of the variance in the ratings of subjectively perceived attention deficits. The present study showed that sleepiness and depression, more than objective cognitive deficits, might play a role in the subjectively perceived attention deficits of patients with narcolepsy. The results suggested that when counselling and treating patients with narcolepsy, clinicians should pay attention to potential depression because subjective cognitive complaints may not relate to objective cognitive impairments. Copyright © 2014 Elsevier B.V. All rights reserved.

  16. Pilot Study to Assess the Quality of Life, Sleepiness and Mood Disorders among First Year Undergraduate Students of Medical, Engineering and Arts.

    Science.gov (United States)

    Singh, Ruchi; Shriyan, Rhea; Sharma, Renuka; Das, Shobha

    2016-05-01

    College students, who are in a phase of transition from adolescence to adulthood, face numerous challenges. Due to stress overload, students easily fall prey to mood disturbances like stress, anxiety and depression compromising their quality of life. Present study was undertaken to see the effect of choice of professional course on quality of life and mood of the first year students of medical, engineering and arts students. A cross-sectional study was conducted amongst 150 students, 50 participants from each stream. Enrolled subjects were administered questionnaires pertaining to their quality of life (WHOQOL-BREF), mood disorders (DASS-42) and sleepiness (ESS). Medical students showed significantly higher levels of stress (p-value=0.0001), depression (p-value=0.002) and anxiety (p-value=0.002), 30% of medicos labelled their quality of life as very good compared to 48% and 50% of engineering and arts students. A 38% of medical student's reported daytime sleepiness compared to 12% engineering and 6% arts students. Present study shows that medical students are maximally vulnerable to mood disorders and have a poor quality life. As the student community forms the backbone of any nation, we as, educators should try to strengthen each individual by promoting not only physical and mental development but also aiming for overall holistic development.

  17. Pilot Study to Assess the Quality of Life, Sleepiness and Mood Disorders among First Year Undergraduate Students of Medical, Engineering and Arts

    Science.gov (United States)

    Shriyan, Rhea; Sharma, Renuka; Das, Shobha

    2016-01-01

    Introduction College students, who are in a phase of transition from adolescence to adulthood, face numerous challenges. Due to stress overload, students easily fall prey to mood disturbances like stress, anxiety and depression compromising their quality of life. Aim Present study was undertaken to see the effect of choice of professional course on quality of life and mood of the first year students of medical, engineering and arts students. Materials and Methods A cross-sectional study was conducted amongst 150 students, 50 participants from each stream. Enrolled subjects were administered questionnaires pertaining to their quality of life (WHOQOL-BREF), mood disorders (DASS-42) and sleepiness (ESS). Results Medical students showed significantly higher levels of stress (p-value=0.0001), depression (p-value=0.002) and anxiety (p-value=0.002), 30% of medicos labelled their quality of life as very good compared to 48% and 50% of engineering and arts students. A 38% of medical student’s reported daytime sleepiness compared to 12% engineering and 6% arts students. Conclusion Present study shows that medical students are maximally vulnerable to mood disorders and have a poor quality life. As the student community forms the backbone of any nation, we as, educators should try to strengthen each individual by promoting not only physical and mental development but also aiming for overall holistic development. PMID:27437246

  18. Assessment of agreement among diplomates of the American College of Veterinary Anesthesia and Analgesia for scoring the recovery of horses from anesthesia by use of subjective grading scales and development of a system for evaluation of the recovery of horses from anesthesia by use of accelerometry.

    Science.gov (United States)

    Clark-Price, Stuart C; Lascola, Kara M; Carter, Jennifer E; da Cunha, Anderson F; Donaldson, Lydia L; Doherty, Thomas J; Martin-Flores, Manuel; Hofmeister, Erik H; Keating, Stephanie C J; Mama, Khursheed R; Mason, Diane E; Posner, Lysa P; Sano, Hiroki; Seddighi, Reza; Shih, Andre C; Weil, Ann B; Schaeffer, David J

    2017-06-01

    OBJECTIVE To evaluate agreement among diplomates of the American College of Veterinary Anesthesia and Analgesia for scores determined by use of a simple descriptive scale (SDS) or a composite grading scale (CGS) for quality of recovery of horses from anesthesia and to investigate use of 3-axis accelerometry (3AA) for objective evaluation of recovery. ANIMALS 12 healthy adult horses. PROCEDURES Horses were fitted with a 3AA device and then were anesthetized. Eight diplomates evaluated recovery by use of an SDS, and 7 other diplomates evaluated recovery by use of a CGS. Agreement was tested with κ and AC1 statistics for the SDS and an ANOVA for the CGS. A library of mathematical models was used to map 3AA data against CGS scores. RESULTS Agreement among diplomates using the SDS was slight (κ = 0.19; AC1 = 0.22). The CGS scores differed significantly among diplomates. Best fit of 3AA data against CGS scores yielded the following equation: RS = 9.998 × SG0.633 × ∑UG0.174, where RS is a horse's recovery score determined with 3AA, SG is acceleration of the successful attempt to stand, and ∑UG is the sum of accelerations of unsuccessful attempts to stand. CONCLUSIONS AND CLINICAL RELEVANCE Subjective scoring of recovery of horses from anesthesia resulted in poor agreement among diplomates. Subjective scoring may lead to differences in conclusions about recovery quality; thus, there is a need for an objective scoring method. The 3AA system removed subjective bias in evaluations of recovery of horses and warrants further study.

  19. Associations of objectively and subjectively measured sleep quality with subsequent cognitive decline in older community-dwelling men: the MrOS sleep study.

    Science.gov (United States)

    Blackwell, Terri; Yaffe, Kristine; Laffan, Alison; Ancoli-Israel, Sonia; Redline, Susan; Ensrud, Kristine E; Song, Yeonsu; Stone, Katie L

    2014-04-01

    To examine associations of objectively and subjectively measured sleep with subsequent cognitive decline. A population-based longitudinal study. Six centers in the United States. Participants were 2,822 cognitively intact community-dwelling older men (mean age 76.0 ± 5.3 y) followed over 3.4 ± 0.5 y. None. OBJECTIVELY MEASURED SLEEP PREDICTORS FROM WRIST ACTIGRAPHY: total sleep time (TST), sleep efficiency (SE), wake after sleep onset (WASO), number of long wake episodes (LWEP). Self-reported sleep predictors: sleep quality (Pittsburgh Sleep Quality Index [PSQI]), daytime sleepiness (Epworth Sleepiness Scale [ESS]), TST. Clinically significant cognitive decline: five-point decline on the Modified Mini-Mental State examination (3MS), change score for the Trails B test time in the worse decile. Associations of sleep predictors and cognitive decline were examined with logistic regression and linear mixed models. After multivariable adjustment, higher levels of WASO and LWEP and lower SE were associated with an 1.4 to 1.5-fold increase in odds of clinically significant decline (odds ratio 95% confidence interval) Trails B test: SE sleep efficiency, greater nighttime wakefulness, greater number of long wake episodes, and poor self-reported sleep quality were associated with subsequent cognitive decline.

  20. Mood states and sleepiness in college students: influences of age, sex, habitual sleep, and substance use.

    Science.gov (United States)

    Jean-Louis, G; von Gizycki, H; Zizi, F; Nunes, J

    1998-10-01

    Survey and laboratory evidence suggests several factors affecting sleep-wake patterns of college students. These factors include social and academic demands, diminution of parental guidance, reduction of total sleep time, delayed bedtime, and increased nap episodes. In this study, we examined the problem of falling asleep in school as a correlate of negative moods in this population (N = 294). A multivariate analysis showed significant main effects of sleepiness on mood states based on the Profile of Mood States. Students who fell asleep in school reported higher negative mood states. Significant interactions were observed among sleepiness and age, sex, race, and duration of sleep. Specifically, younger men reported higher negative moods. No interactions were noted for alcohol and marijuana consumption; however, students who fell asleep in school consumed more alcoholic beverages and smoked more than those who did not. Perhaps falling asleep in school could be used as an index that characterizes students who manifest adaptive or psychological difficulty.

  1. Driver sleepiness, fatigue, careless behavior and risk of motor vehicle crash and injury: Population based case and control study

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    Abdulbari Bener

    2017-10-01

    Conclusion: The current study confirmed that drivers with chronic fatigue, acute sleepiness, and careless driver behavior may significantly increases the risk of road crash which can be lead to serious injury.

  2. [Fatigue and sleepiness in interprovincial road bus drivers: comparative study between formality and informality].

    Science.gov (United States)

    Liendo, Gustavo R; Castro, Carla L; Rey de Castro, Jorge

    2010-06-01

    To compare the levels of fatigue, sleepiness and their consequences between formal and informal drivers of interprovincial buses. To evaluate labor conditions between both study groups. A comparative cross-sectional study was performed with non-probabilistic sampling. 100 companies of land transport were included, out of which 17 were formal according to the official registries of the Ministry of Transport and Communications (MTC), the drivers were also classified as formal or informal. The survey included one questionnaire and a Peruvian validated version of the Epworth sleepiness scale. 71 formal drivers and 274 informal drivers participated, all were males. Out of the 134 drivers that worked for the formal companies according to the MTC, only 43 (32%) belong to the formal group based on the proposed criteria. 48% (34) of the formal drivers and 43% (118) of the informal sleep less than 7 hours a day. 48% (34) of the formal and 49% (135) of the informal admitted having had an accident or "almost" having had it, the most frequent time of the day was between 01.00 and 04.00 in the morning. The dawn is the period in which both groups feel most tired. 44% (30) of the formal drivers and 54% (144) of the informal ones perform 5 or more night shifts per week. Out of the total of interviewed, 16% (56) had sleepiness. The association with road traffic accidents was similar. The fatigue and sleepiness levels were similar between formal and informal drivers. Companies classified as formal, have a high percentage of informality amongst their drivers.

  3. Medico-legal aspects of sleep disorders: sleepiness and civil liability.

    Science.gov (United States)

    Ellis, Elizabeth; Grunstein, Ronald R.

    2001-02-01

    Excessive sleepiness is associated with motor vehicle accidents and is responsible for enormous social and financial loss. The specific legal obligations for an individual with a sleep disorder, their employer and those health care practitioners associated with that individual are reviewed. Although there are related implications within the criminal law and in particular criminal negligence, the arguments developed in this paper will be largely confined to the context of the civil liability. The legal concepts of foreseeability and proximity are discussed in the context of sleep-related accidents. The reasoning of a recent Australian High Court judgement is discussed in view of the differences in legal and medical opinion on the extent of foreseeability of accidents as a result of sleepiness. Many countries have legislation designed to protect employees from injury at work and to protect the general public from injury. What is not clear is the extent to which an employer will be required to accept liability for an employee's sleepiness and the duty to monitor the health of their employees. Factors which influence this liability include: the extent to which the implications of the condition is known and understood generally; the extent to which the condition is suspected or identified in an individual employee; the extent of a proper screening and treatment program and the way in which risk management programs have been implemented. Although the issue of sleepiness and civil liability is examined from an Australian legal context, the principles have direct relevance to other legal systems. The authors highlight the degree of uncertainty provided by the common law and statutory provisions, and that decisions rest on the balance of public interests, which mean that many of the current dilemmas facing practitioners may only be solved in the courts.

  4. Quality of life, sleepiness and depressive symptoms in adolescents with insomnia: A cross-sectional study.

    Science.gov (United States)

    Amaral, Maria Odete Pereira; de Almeida Garrido, António José; de Figueiredo Pereira, Carlos; Master, Nélio Veiga; de Rosário Delgado Nunes, Carla; Sakellarides, Constantino Theodor

    2017-01-01

    To determine the prevalence of insomnia in a sample of Portuguese adolescents and assess its repercussions on HRQoL, daytime sleepiness and depressive symptomatology. We carried out a cross-sectional school-based study evaluating students from Viseu. Students from twenty-six public secondary schools in the county of Viseu, Portugal. Of 9237 questionnaires distributed, 7581 were collected (82.1%). We excluded from analysis all questionnaires from adolescents younger than 12 or older than 18 years of age (211) and unfilled forms (451). The sample comprised 6919 adolescents, the 7th to 12th grade, from 26 public secondary schools. None. Data gathering was done using a self-applied questionnaire. Insomnia was defined based on the Diagnostic and Statistical Manual of Mental Disorders - IV criteria. HRQoL was evaluated with the Quality of Life Health Survey SF-36, depressive symptomatology with BDI-II and daytime sleepiness with the Epworth Sleepiness Scale. Prevalence of insomnia was 8.3% and the prevalence of adolescents with symptoms of insomnia without daytime impairment (disturbed sleepers) was 13.1%. HRQoL was significantly reduced among adolescents with insomnia compared to normal sleepers (p<0.001) and even when compared to disturbed sleepers (p<0.001). There was an increase in daytime sleepiness from normal sleepers to disturbed sleepers and to adolescents with insomnia (p<0.001). There was also an increase in the prevalence and severity of depressive symptoms (p<0.001). Our results show that insomnia is associated with a significantly lower health related quality of life among adolescents. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  5. Slow wave sleep enhancement with gaboxadol reduces daytime sleepiness during sleep restriction.

    Science.gov (United States)

    Walsh, James K; Snyder, Ellen; Hall, Janine; Randazzo, Angela C; Griffin, Kara; Groeger, John; Eisenstein, Rhody; Feren, Stephen D; Dickey, Pam; Schweitzer, Paula K

    2008-05-01

    To evaluate the impact of enhanced slow wave sleep (SWS) on behavioral, psychological, and physiological changes resulting from sleep restriction. A double-blind, parallel group, placebo-controlled design was used to compare gaboxadol (GBX) 15 mg, a SWS-enhancing drug, to placebo during 4 nights of sleep restriction (5 h/night). Behavioral, psychological, and physiological measures of the impact of sleep restriction were assessed in both groups at baseline, during sleep restriction and following recovery sleep. Sleep research laboratory. Forty-one healthy adults; 9 males and 12 females (mean age: 32.0 +/- 9.9 y) in the placebo group and 10 males and 10 females (mean age: 31.9 +/- 10.2 y) in the GBX group. Both experimental groups underwent 4 nights of sleep restriction. Each group received either GBX 15 mg or placebo on all sleep restriction nights, and both groups received placebo on baseline and recovery nights. Polysomnography documented a SWS-enhancing effect of GBX with no group difference in total sleep time during sleep restriction. The placebo group displayed the predicted deficits due to sleep restriction on the multiple sleep latency test (MSLT) and on introspective measures of sleepiness and fatigue. Compared to placebo, the GBX group showed significantly less physiological sleepiness on the MSLT and lower levels of introspective sleepiness and fatigue during sleep restriction. There were no differences between groups on the psychomotor vigilance task (PVT) and a cognitive test battery, but these measures were minimally affected by sleep restriction in this study. The correlation between change from baseline in MSLT on Day 6 and change from baseline in SWS on Night 6 was significant in the GBX group and in both group combined. The results of this study are consistent with the hypothesis that enhanced SWS, in this study produced by GBX, reduces physiological sleep tendency and introspective sleepiness and fatigue which typically result from sleep

  6. Sleep, sleepiness, and fatigue outcomes for parents of critically ill children.

    Science.gov (United States)

    Stremler, Robyn; Dhukai, Zahida; Pullenayegum, Eleanor; Weston, Julie; Wong, Lily; Parshuram, Christopher

    2014-02-01

    To describe sleep quantity, sleep patterns, fatigue, and sleepiness for parents of critically ill hospitalized children. Prospective observational study. Quaternary academic PICU. One hundred eighteen parents of 91 children recruited during their child's PICU stay. None. For 5 days and nights, parents wore an actigraph to determine objective sleep-wake times and reported sleep location, level of fatigue (Fatigue Visual Analogue Scale), and sleepiness (Stanford Sleepiness Scale). Mean amounts of nocturnal sleep were less than recommended for optimal health (398 min, fathers vs 422 min, mothers; p = 0.04). Parents woke frequently (7.8 wakes, fathers; 7.2 wakes, mothers) and spent over an hour awake at night (65 min, fathers; 60 min, mothers). On 130 nights (26%), parents slept less than 6 hours and 209 nights (44%) were evaluated as "worse" sleep than usual. Fifty-four parents (53%) experienced more than 30% difference in minutes of sleep between consecutive nights. Mean morning fatigue levels (41 mm, fathers vs 46 mm, mothers; p = 0.03) indicated clinically significant fatigue. Sleeping in a hotel, parent room, or residence was associated with 3.2 more wakes per night (95% CI, 0.61-5.78; p = 0.015) than sleeping in a hospital lounge or waiting room. We performed a prospective observational study of 118 parents of critically ill children using objective measures of sleep and validated scales to assess fatigue and sleepiness. We found that more than a quarter of nights met criteria for acute sleep deprivation, there was considerable variability in the amount of nocturnal sleep that individual participants slept on different nights, and sleep was fragmented with a large portion of the night spent awake. Future research should focus on interventions that improve parents' ability to return to sleep upon awakening and maintain regular sleep-wake schedules.

  7. Decoupling of sleepiness from sleep time and intensity during chronic sleep restriction: evidence for a role of the adenosine system.

    Science.gov (United States)

    Kim, Youngsoo; Bolortuya, Yunren; Chen, Lichao; Basheer, Radhika; McCarley, Robert W; Strecker, Robert E

    2012-06-01

    Sleep responses to chronic sleep restriction (CSR) might be very different from those observed after short-term total sleep deprivation. For example, after sleep restriction continues for several consecutive days, animals no longer express compensatory increases in daily sleep time and sleep intensity. However, it is unknown if these allostatic, or adaptive, sleep responses to CSR are paralleled by behavioral and neurochemical measures of sleepiness. This study was designed to investigate CSR-induced changes in (1) sleep time and intensity as a measure of electrophysiological sleepiness, (2) sleep latency as a measure of behavioral sleepiness, and (3) brain adenosine A1 (A1R) and A2a receptor (A2aR) mRNA levels as a putative neurochemical correlate of sleepiness. Male Sprague-Dawley rats A 5-day sleep restriction (SR) protocol consisting of 18-h sleep deprivation and 6-h sleep opportunity each day. Unlike the first SR day, rats did not sleep longer or deeper on days 2 through 5, even though they exhibited significant elevations of behavioral sleepiness throughout all 5 SR days. For all SR days and recovery day 1, A1R mRNA in the basal forebrain was maintained at elevated levels, whereas A2aR mRNA in the frontal cortex was maintained at reduced levels. CSR LEADS TO A DECOUPLING OF SLEEPINESS FROM SLEEP TIME AND SLEEP INTENSITY, SUGGESTING THAT THERE ARE AT LEAST TWO DIFFERENT SLEEP REGULATORY SYSTEMS: one mediating sleepiness (homeostatic) and the other mediating sleep time/intensity (allostatic). The time course of changes observed in adenosine receptor mRNA levels suggests that the basal forebrain and cortical adenosine system might mediate sleepiness rather than sleep time or intensity.

  8. Excessive daytime sleepiness and adherence to antihypertensive medications among Blacks: analysis of the counseling African Americans to control hypertension (CAATCH trial

    Directory of Open Access Journals (Sweden)

    Williams NJ

    2014-03-01

    Full Text Available Natasha J Williams,1 Girardin Jean-Louis,1 Abhishek Pandey,2 Joseph Ravenell,1 Carla Boutin-Foster,3 Gbenga Ogedegbe1 1Center for Healthful Behavior Change, Division of Internal Medicine, NYU Medical Center, New York, 2Department of Family Medicine, SUNY Downstate Medical Center, Brooklyn, 3Center of Excellence in Disparities Research, Weill Cornell Medical College, New York, NY, USA Background: Excessive daytime sleepiness (EDS often occurs as a result of insufficient sleep, sleep apnea, illicit substance use, and other medical and psychiatric conditions. This study tested the hypothesis that blacks exhibiting EDS would have poorer self-reported adherence to hypertensive medication using cross-sectional data from the Counseling African-Americans to Control Hypertension (CAATCH trial. Methods: A total of 1,058 hypertensive blacks (average age 57±12 years participated in CAATCH, a randomized controlled trial evaluating the effectiveness of a multilevel intervention for participants who receive care from community health centers in New York City. Data analyzed in this study included baseline sociodemographics, medical history, EDS, and medication adherence. We used the Epworth Sleepiness Scale, with a cutoff score of ≥10, to define EDS. Medication adherence was measured using an abbreviated Morisky Medication Adherence scale, with a score >0 indicating nonadherence. Results: Of the sample, 71% were female, 72% received at least a high school education, 51% reported a history of smoking, and 33% had a history of alcohol consumption. Overall, 27% of the participants exhibited EDS, and 44% of those who exhibited EDS were classified as adherent to prescribed antihypertensive medications. Multivariable logistic regression analysis, adjusting for effects of age, body mass index, sex, education, and smoking and drinking history indicated that participants who exhibited EDS were more than twice as likely to be nonadherent (odds ratio 2.28, 95

  9. Syncopation and the score.

    Directory of Open Access Journals (Sweden)

    Chunyang Song

    Full Text Available The score is a symbolic encoding that describes a piece of music, written according to the conventions of music theory, which must be rendered as sound (e.g., by a performer before it may be perceived as music by the listener. In this paper we provide a step towards unifying music theory with music perception in terms of the relationship between notated rhythm (i.e., the score and perceived syncopation. In our experiments we evaluated this relationship by manipulating the score, rendering it as sound and eliciting subjective judgments of syncopation. We used a metronome to provide explicit cues to the prevailing rhythmic structure (as defined in the time signature. Three-bar scores with time signatures of 4/4 and 6/8 were constructed using repeated one-bar rhythm-patterns, with each pattern built from basic half-bar rhythm-components. Our manipulations gave rise to various rhythmic structures, including polyrhythms and rhythms with missing strong- and/or down-beats. Listeners (N = 10 were asked to rate the degree of syncopation they perceived in response to a rendering of each score. We observed higher degrees of syncopation in time signatures of 6/8, for polyrhythms, and for rhythms featuring a missing down-beat. We also found that the location of a rhythm-component within the bar has a significant effect on perceived syncopation. Our findings provide new insight into models of syncopation and point the way towards areas in which the models may be improved.

  10. Daytime sleepiness, poor sleep quality, eveningness chronotype, and common mental disorders among Chilean college students.

    Science.gov (United States)

    Concepcion, Tessa; Barbosa, Clarita; Vélez, Juan Carlos; Pepper, Micah; Andrade, Asterio; Gelaye, Bizu; Yanez, David; Williams, Michelle A

    2014-01-01

    To evaluate whether daytime sleepiness, poor sleep quality, and morningness and eveningness preferences are associated with common mental disorders (CMDs) among college students. A total of 963 college students completed self-administered questionnaires that collected information about sociodemographic characteristics, sleep quality characteristics, CMDs, and other lifestyle behaviors. The prevalence of CMDs was 24.3% (95% confidence interval [CI] [21.5%, 27.1%]) among all students. Prevalence estimates of both excessive daytime sleepiness and poor sleep quality were higher among females (35.4% and 54.4%) than males (22.0% and 45.8%). Cigarette smoking was statistically significantly and positively associated with having CMDs (p = .034). Excessive daytime sleepiness (odds ratio [OR] = 3.65; 95% CI [2.56, 4.91]) and poor sleep quality (OR = 4.76; 95% CI [3.11, 7.29]) were associated with increased odds of CMDs. Given the adverse health consequences associated with both sleep disorders and CMDs, improving sleep hygiene among college students is imperative to public health.

  11. Emerging drugs for common conditions of sleepiness: obstructive sleep apnea and narcolepsy.

    Science.gov (United States)

    Sullivan, Shannon S; Guilleminault, Christian

    2015-01-01

    Obstructive sleep apnea (OSA) and narcolepsy are sleep disorders associated with high prevalence and high symptomatic burden including prominent sleepiness, daytime dysfunction and poor nocturnal sleep. Both have elevated risk of poor health outcomes. Current therapies are often underutilized, cumbersome, costly or associated with residual symptoms. This review covers current available therapies for OSA and narcolepsy as well as discusses areas for potential drug development, and agents in the therapeutic pipeline, including the cannabinoid dronabinol (OSA), the histamine inverse agonist/ antagonist pitolisant (narcolepsy), and stimulants with uncertain and/or multiple activities such as JZP-110 and JZP-386 (narcolepsy, possibly OSA). Finally it addresses new approaches and uses for therapies currently on the market such as the carbonic anhydrase inhibitor acetazolamide (OSA). Both OSA and narcolepsy are conditions of sleepiness for which lifelong treatments are likely to be required. In OSA, while continuous positive airway pressure will likely remain the gold standard therapy for the foreseeable future, there is plenty of room for integrating phenotypes and variants of OSA into therapeutic strategies to lead to better, more personalized disease modification. In narcolepsy, unlike OSA, drug therapy is the current mainstay of treatment. Advances using novel mechanisms to treat targeted symptoms such as sleepiness and/or novel agents that can treat more than one symptom of narcolepsy, hold promise. However, cost, convenience and side effects remain challenges.

  12. Regularity of cardiac rhythm as a marker of sleepiness in sleep disordered breathing.

    Directory of Open Access Journals (Sweden)

    Marc Guaita

    Full Text Available The present study aimed to analyse the autonomic nervous system activity using heart rate variability (HRV to detect sleep disordered breathing (SDB patients with and without excessive daytime sleepiness (EDS before sleep onset.Two groups of 20 patients with different levels of daytime sleepiness -sleepy group, SG; alert group, AG- were selected consecutively from a Maintenance of Wakefulness Test (MWT and Multiple Sleep Latency Test (MSLT research protocol. The first waking 3-min window of RR signal at the beginning of each nap test was considered for the analysis. HRV was measured with traditional linear measures and with time-frequency representations. Non-linear measures -correntropy, CORR; auto-mutual-information function, AMIF- were used to describe the regularity of the RR rhythm. Statistical analysis was performed with non-parametric tests.Non-linear dynamic of the RR rhythm was more regular in the SG than in the AG during the first wakefulness period of MSLT, but not during MWT. AMIF (in high-frequency and in Total band and CORR (in Total band yielded sensitivity > 70%, specificity >75% and an area under ROC curve > 0.80 in classifying SG and AG patients.The regularity of the RR rhythm measured at the beginning of the MSLT could be used to detect SDB patients with and without EDS before the appearance of sleep onset.

  13. Risky drug use and effects on sleep quality and daytime sleepiness.

    Science.gov (United States)

    Ogeil, Rowan P; Phillips, James G; Rajaratnam, Shantha M W; Broadbear, Jillian H

    2015-09-01

    Sleep problems are commonly reported following alcohol and cannabis abuse, but our understanding of sleep in non-clinical drug using populations is limited. The present study examined the sleep characteristics of alcohol and cannabis users recruited from the wider community. Two hundred forty-eight self-identified alcohol and/or cannabis users (131 women and 117 men) with a mean age of 26.41 years completed an online study that was advertised via online forums, print media and flyers. As part of the study, participants completed validated sleep scales assessing sleep quality (Pittsburgh Sleep Quality Index) and excessive daytime sleepiness (Epworth Sleepiness Scale) in addition to validated drug scales assessing alcohol (Alcohol Use Disorders Identification Test) and cannabis (Marijuana Screening Inventory) use. Problems with sleep quality were more commonly reported than were complaints of excessive daytime sleepiness. Clinically significant poor sleep quality was associated with comorbid problem alcohol and cannabis use. Women reporting problem alcohol and cannabis use had poorer sleep outcomes than men. Social drug users who report risky alcohol and cannabis use also report poor sleep. Poor sleep quality likely exacerbates any drug-associated problems in non-clinical populations. Copyright © 2015 John Wiley & Sons, Ltd.

  14. [The effects of sleep deprivation on sleepiness, performance, stress and immune system].

    Science.gov (United States)

    2009-01-01

    Sleep loss has been a common practice in modern society. However, it has been only recently that the effects of sleep loss on human health have received more attention. This review summarizes the experimental findings of the effects of total and partial sleep deprivation on stress hormones and pro-inflammatory cytokines. Specifically, studies have consistently demonstrated that total or partial sleep loss is associated with increased sleepiness and decreased performance and elevation of pro-inflammatory cytokines, i. e., IL-6 and TNF-alpha, which have been proposed as mediators of excessive daytime sleepiness and cardiometabolic morbidity in humans. In addition, non-stressful sleep loss is not associated with elevation of cortisol, the end-product of the hypothalamic-pituitary-adrenal (HPA) axis. Also, alertness and performance measured with objective tests (Multiple Sleep Latency Test and Performance Vigilance Test) are significantly impaired following total or partial sleep loss. Furthermore, napping or extended sleep have been shown to decrease sleepiness, improve performance and cause beneficial changes in cortisol and IL-6 secretion. Collectively, these studies show that sleep loss has adverse effects on alertness, performance and inflammation markers suggesting that insufficient sleep may influence health and longevity in a negative manner. On the other hand it appears that more sleep either in the form of napping or extended sleep may protect from these adverse effects of sleep loss.

  15. Sleep disorders, sleepiness, and near-miss accidents among long-distance highway drivers in the summertime.

    Science.gov (United States)

    Quera Salva, Maria Antonia; Barbot, Frédéric; Hartley, Sarah; Sauvagnac, Rebecca; Vaugier, Isabelle; Lofaso, Frédéric; Philip, Pierre

    2014-01-01

    We aimed to investigate sleepiness, sleep hygiene, sleep disorders, and driving risk among highway drivers. We collected data using cross-sectional surveys, including the Epworth Sleepiness Scale (ESS) questionnaire, Basic Nordic Sleep Questionnaire (BNSQ), and a travel questionnaire; we also obtained sleep data from the past 24 h and information on usual sleep schedules. Police officers invited automobile drivers to participate. There were 3051 drivers (mean age, 46±13 y; 75% men) who completed the survey (80% participation rate). Eighty-seven (2.9%) drivers reported near-miss sleepy accidents (NMSA) during the trip; 8.5% of NMSA occurred during the past year and 2.3% reported sleepiness-related accidents occurring in the past year. Mean driving time was 181±109 min and mean sleep duration in the past 24 h was 480±104 min; mean sleep duration during workweeks was 468±74 min. Significant risk factors for NMSA during the trip were NMSA in the past year, nonrestorative sleep and snoring in the past 3 months, and sleepiness during the interview. Neither sleep time in the past 24 h nor acute sleep debt (sleep time difference between workweeks and the past 24 h) correlated with the occurrence of near misses. Unlike previous studies, acute sleep loss no longer explains sleepiness at the wheel. Sleep-related breathing disorders or nonrestorative sleep help to explain NMSA more adequately than acute sleep loss. Copyright © 2013 Elsevier B.V. All rights reserved.

  16. Pharmacological interventions for daytime sleepiness and sleep disorders in Parkinson's disease: Systematic review and meta-analysis.

    Science.gov (United States)

    Rodrigues, Tiago Martins; Castro Caldas, Ana; Ferreira, Joaquim J

    2016-06-01

    Daytime sleepiness and sleep disorders are frequently reported in Parkinson's disease (PD). However, their impact on quality of life has been underestimated and few clinical trials have been performed. We aimed to assess the efficacy and safety of pharmacological interventions for daytime sleepiness and sleep disorders in PD. Systematic review of randomized controlled trials comparing any pharmacological intervention with no intervention or placebo for the treatment of daytime sleepiness and sleep problems in PD patients. Ten studies (n = 338 patients) were included. Four trials addressed interventions for excessive daytime sleepiness. Meta-analysis of the three trials evaluating modafinil showed a significant reduction in sleepiness, as assessed by the Epworth Sleepiness Scale (ESS) (- 2.24 points, 95% CI - 3.90 to - 0.57, p sleep Behaviour Disorder (RBD). Single study results suggest that doxepin and YXQN granules might be efficacious, while pergolide may be deleterious for insomnia and that rivastigmine may be used to treat RBD in PD patients. However, there is insufficient evidence to support or refute the efficacy of any of these interventions. No relevant side effects were reported. Whilst providing recommendations, this systematic review depicts the lack of a body of evidence regarding the treatment of sleep disorders in PD patients; hence, further studies are warranted. Copyright © 2016 Elsevier Ltd. All rights reserved.

  17. Subjective Global Assessment (SGA) Score Could Be a Predictive Factor for Radiation Pneumonitis in Lung Cancer Patients With Normal Pulmonary Function Treated by Intensity-Modulated Radiation Therapy and Concurrent Chemotherapy.

    Science.gov (United States)

    Ma, Li; Ye, WenFeng; Li, QiWen; Wang, Bin; Luo, GuangYu; Chen, ZhaoLin; Guo, SuPing; Qiu, Bo; Liu, Hui

    2017-09-19

    To investigate the relationship between malnutrition and the severity of radiation pneumonitis (RP) in patients with lung cancer with normal baseline pulmonary function and lungs' V20 SGA) scores; radiation esophagitis grade; V20 of lungs; and mean lung dose. These factors were correlated with RP using univariate and multivariate regression analyses. Of 150 patients, 12 patients (8.0%) developed Grade 3 to 5 RP, 37 (24.6%) patients developed grade 3 to 5 esophageal toxicity. In univariate analysis, ALB level (P = .002), radiation esophagitis (P SGA score (P SGA (P SGA could be a predictor for RP in patients with lung cancer treated with definitive IMRT and concurrent chemotherapy. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. How French subjects describe well-being from food and eating habits? Development, item reduction and scoring definition of the Well-Being related to Food Questionnaire (Well-BFQ©).

    Science.gov (United States)

    Guillemin, I; Marrel, A; Arnould, B; Capuron, L; Dupuy, A; Ginon, E; Layé, S; Lecerf, J-M; Prost, M; Rogeaux, M; Urdapilleta, I; Allaert, F-A

    2016-01-01

    Providing well-being and maintaining good health are main objectives subjects seek from diet. This manuscript describes the development and preliminary validation of an instrument assessing well-being associated with food and eating habits in a general healthy population. Qualitative data from 12 groups of discussion (102 subjects) conducted with healthy subjects were used to develop the core of the Well-being related to Food Questionnaire (Well-BFQ). Twelve other groups of discussion with subjects with joint (n = 34), digestive (n = 32) or repetitive infection complaints (n = 30) were performed to develop items specific to these complaints. Five main themes emerged from the discussions and formed the modular backbone of the questionnaire: "Grocery shopping", "Cooking", "Dining places", "Commensality", "Eating and drinking". Each module has a common structure: items about subject's food behavior and items about immediate and short-term benefits. An additional theme - "Eating habits and health" - assesses subjects' beliefs about expected benefits of food and eating habits on health, disease prevention and protection, and quality of ageing. A preliminary validation was conducted with 444 subjects with balanced diet; non-balanced diet; and standard diet. The structure of the questionnaire was further determined using principal component analyses exploratory factor analyses, with confirmation of the sub-sections food behaviors, immediate benefits (pleasure, security, relaxation), direct short-term benefits (digestion and satiety, energy and psychology), and deferred long-term benefits (eating habits and health). Thirty-three subscales and 14 single items were further defined. Confirmatory analyses confirmed the structure, with overall moderate to excellent convergent and divergent validity and internal consistency reliability. The Well-BFQ is a unique, modular tool that comprehensively assesses the full picture of well-being related to food and eating habits in

  19. Construct validity and factor structure of the pittsburgh sleep quality index and epworth sleepiness scale in a multi-national study of African, South East Asian and South American college students.

    Directory of Open Access Journals (Sweden)

    Bizu Gelaye

    scores to assess sleep quality and excessive daytime sleepiness.

  20. Construct validity and factor structure of the pittsburgh sleep quality index and epworth sleepiness scale in a multi-national study of African, South East Asian and South American college students.

    Science.gov (United States)

    Gelaye, Bizu; Lohsoonthorn, Vitool; Lertmeharit, Somrat; Pensuksan, Wipawan C; Sanchez, Sixto E; Lemma, Seblewengel; Berhane, Yemane; Zhu, Xiaotong; Vélez, Juan Carlos; Barbosa, Clarita; Anderade, Asterio; Tadesse, Mahlet G; Williams, Michelle A

    2014-01-01

    The Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS) are questionnaires used to assess sleep quality and excessive daytime sleepiness in clinical and population-based studies. The present study aimed to evaluate the construct validity and factor structure of the PSQI and ESS questionnaires among young adults in four countries (Chile, Ethiopia, Peru and Thailand). A cross-sectional study was conducted among 8,481 undergraduate students. Students were invited to complete a self-administered questionnaire that collected information about lifestyle, demographic, and sleep characteristics. In each country, the construct validity and factorial structures of PSQI and ESS questionnaires were tested through exploratory and confirmatory factor analyses (EFA and CFA). The largest component-total correlation coefficient for sleep quality as assessed using PSQI was noted in Chile (r = 0.71) while the smallest component-total correlation coefficient was noted for sleep medication use in Peru (r = 0.28). The largest component-total correlation coefficient for excessive daytime sleepiness as assessed using ESS was found for item 1 (sitting/reading) in Chile (r = 0.65) while the lowest item-total correlation was observed for item 6 (sitting and talking to someone) in Thailand (r = 0.35). Using both EFA and CFA a two-factor model was found for PSQI questionnaire in Chile, Ethiopia and Thailand while a three-factor model was found for Peru. For the ESS questionnaire, we noted two factors for all four countries. Overall, we documented cross-cultural comparability of sleep quality and excessive daytime sleepiness measures using the PSQI and ESS questionnaires among Asian, South American and African young adults. Although both the PSQI and ESS were originally developed as single-factor questionnaires, the results of our EFA and CFA revealed the multi- dimensionality of the scales suggesting limited usefulness of the global PSQI and ESS scores

  1. Risk of Motor Vehicle Accidents Related to Sleepiness at the Wheel: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Bioulac, Stéphanie; Franchi, Jean-Arthur Micoulaud; Arnaud, Mickael; Sagaspe, Patricia; Moore, Nicholas; Salvo, Francesco; Philip, Pierre

    2017-10-01

    Sleepiness at the wheel is widely believed to be a cause of motor vehicle accidents. Nevertheless, a systematic review of studies investigating this relationship has not yet been published. The objective of this study was to quantify the relationship between sleepiness at the wheel and motor vehicle accidents. A systematic review was performed using Medline, Scopus, and ISI Web of Science. The outcome measure of interest was motor vehicle accident defined as involving four- or two-wheeled vehicles in road traffic, professional and nonprofessional drivers, with or without objective consequences. The exposure was sleepiness at the wheel defined as self-reported sleepiness at the wheel. Studies were included if they provided adjusted risk estimates of motor vehicle accidents related to sleepiness at the wheel. Risk estimates and 95% confidence intervals (95% CIs) were extracted and pooled as odds ratios (ORs) using a random-effect model. Heterogeneity was quantified using Q statistics and the I2 index. The potential causes of heterogeneity were investigated using meta-regressions. Ten cross-sectional studies (51,520 participants), six case-control studies (4904 participants), and one cohort study (13,674 participants) were included. Sleepiness at the wheel was associated with an increased risk of motor vehicle accidents (pooled OR 2.51 [95% CI 1.87; 3.39]). A significant heterogeneity was found between the individual risk estimates (Q = 93.21; I2 = 83%). Sleepiness at the wheel increases the risk of motor vehicle accidents and should be considered when investigating fitness to drive. Further studies are required to explore the nature of this relationship. PROSPERO 2015 CRD42015024805.

  2. Job demands and resting and napping opportunities for nurses during night shifts: impact on sleepiness and self-evaluated quality of healthcare

    OpenAIRE

    BARTHE, B?atrice; Tirilly, Ghislaine; Gentil, Catherine; TOUPIN, Cathy

    2015-01-01

    The aim of this field study is to describe night shift resting and napping strategies and to examine their beneficial effects on sleepiness and quality of work. The study was carried out with 16 nurses working in an intensive care unit. Data collected during 20 night shifts were related to job demands (systematic observations), to the duration and timing of rests and naps taken by nurses (systematic observations, sleep diaries), to sleepiness (Karolinska Sleepiness Scale), and to quality of w...

  3. Association of current work and sleep situations with excessive daytime sleepiness and medical incidents among Japanese physicians.

    Science.gov (United States)

    Kaneita, Yoshitaka; Ohida, Takashi

    2011-10-15

    The aim of the present study was to clarify the current work and sleep situations of physicians in Japan and to clarify the association between these situations and excessive daytime sleepiness as well as medical incidents. A self-administered questionnaire survey was conducted among the members of the Japan Medical Association in 2008. The randomly selected subjects comprised 3,000 male physicians and 1,500 female physicians. Valid responses were obtained from 3,486 physicians (2,298 men and 1,188 women). Mean sleep duration was 6 h 36 min for men and 6 h 8 min for women. The prevalence of lack of rest due to sleep deprivation was 30.4% among men and 36.6% among women; the prevalence of insomnia was 21.0% and 18.1%, respectively; and the prevalence of EDS was 3.5%. The adjusted odds ratio for EDS was high for physicians who reported short sleep duration, lack of rest due to sleep deprivation, and a high frequency of on-call/overnight work. Physicians who had experienced a medical incident within the previous one month accounted for 19.0% of participants. The adjusted odds ratio for medical incidents was high for those subjected to long working hours, high frequency of on-call/overnight works, lack of rest due to sleep deprivation, and insomnia. In order to facilitate optimal health management for physicians as well as securing medical safety, it is important to fully consider the work and sleep situations of physicians.

  4. A systematic review of the effect of various interventions on reducing fatigue and sleepiness while driving

    Directory of Open Access Journals (Sweden)

    Seyed Saeed Hashemi Nazari

    2017-10-01

    Full Text Available Purpose: To identify and appraise the published studies assessing interventions accounting for reducing fatigue and sleepiness while driving. Methods: This systematic review searched the following electronic databases: Medline, Science direct, Scopus, EMBASE, PsycINFO, Transport Database, Cochrane, BIOSIS, ISI Web of Knowledge, specialist road injuries journals and the Australian Transport and Road Index database. Additional searches included websites of relevant organizations, reference lists of included studies, and issues of major injury journals published within the past 15 years. Studies were included if they investigated interventions/exposures accounting for reducing fatigue and sleepiness as the outcome, measured any potential interventions for mitigation of sleepiness and were written in English. Meta-analysis was not attempted because of the heterogeneity of the included studies. Results: Of 63 studies identified, 18 met the inclusion criteria. Based on results of our review, many interventions in the world have been used to reduce drowsiness while driving such as behavioral (talking to passengers, face washing, listening to the radio, no alcohol use, limiting the driving behavior at the time of 12 p.m. – 6 a.m. etc, educational interventions and also changes in the environment (such as rumble strips, chevrons, variable message signs, etc. Meta-analysis on the effect of all these interventions was impossible due to the high heterogeneity in methodology, effect size and interventions reported in the assessed studies. Conclusion: Results of present review showed various interventions in different parts of the world have been used to decrease drowsy driving. Although these interventions can be used in countries with high incidence of road traffic accidents, precise effect of each intervention is still unknown. Further studies are required for comparison of the efficiency of each intervention and localization of each intervention

  5. Brain white matter changes in CPAP-treated obstructive sleep apnea patients with residual sleepiness.

    Science.gov (United States)

    Xiong, Ying; Zhou, Xiaohong Joe; Nisi, Robyn A; Martin, Kelly R; Karaman, M Muge; Cai, Kejia; Weaver, Terri E

    2017-05-01

    To investigate white matter (WM) structural alterations using diffusion tensor imaging (DTI) in obstructive sleep apnea (OSA) patients, with or without residual sleepiness, following adherent continuous positive airway pressure (CPAP) treatment. Possible quantitative relationships were explored between the DTI metrics and two clinical assessments of somnolence. Twenty-nine male patients (30-55 years old) with a confirmed diagnosis of OSA were recruited. The patients were treated with CPAP therapy only. The Psychomotor Vigilance Task (PVT) and Epworth Sleepiness Scale (ESS) were performed after CPAP treatment and additionally administered at the time of the magnetic resonance imaging (MRI) scan. Based on the PVT results, the patients were divided into a nonsleepy group (lapses ≤5) and a sleepy group (lapses >5). DTI was performed at 3T, followed by an analysis using tract-based spatial statistics (TBSS) to investigate the differences in fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (λ1 ), and radial diffusivity (λ23 ) between the two groups. A higher MD (P brain TBSS analysis in the WM. The increased MD (17.8% of the fiber tracts; P 0.17). The alterations in FA or MD of individual fiber tracts occurred mainly in the internal/external capsule, corona radiata, corpus callosum, and sagittal stratum regions. The FA and MD values correlated with the PVT and ESS assessments from all patients (R ≥ 0.517, P < 0.05). Global and regional WM alterations, as revealed by DTI, can be a possible mechanism to explain why OSA patients with high levels of CPAP use can have differing responses to treatment. Compromised myelin sheath, indicated by increased radial diffusivity, can be involved in the underlying WM changes. Evidence level: 1 J. MAGN. RESON. IMAGING 2017;45:1371-1378. © 2016 International Society for Magnetic Resonance in Medicine.

  6. Natural History of Excessive Daytime Sleepiness: Role of Obesity, Weight Loss, Depression, and Sleep Propensity

    Science.gov (United States)

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

    2015-01-01

    Study Objectives: Excessive daytime sleepiness (EDS) is highly prevalent in the general population and is associated with occupational and public safety hazards. However, no study has examined the clinical and polysomnographic (PSG) predictors of the natural history of EDS. Design: Representative longitudinal study. Setting: Sleep laboratory. Participants: From a random, general population sample of 1,741 individuals of the Penn State Adult Cohort, 1,395 were followed up after 7.5 years. Measurements and Results: Full medical evaluation and 1-night PSG at baseline and standardized telephone interview at follow-up. The incidence of EDS was 8.2%, while its persistence and remission were 38% and 62%, respectively. Obesity and weight gain were associated with the incidence and persistence of EDS, while weight loss was associated with its remission. Significant interactions between depression and PSG parameters on incident EDS showed that, in depressed individuals, incident EDS was associated with sleep disturbances, while in non-depressed individuals, incident EDS was associated with increased physiologic sleep propensity. Diabetes, allergy/asthma, anemia, and sleep complaints also predicted the natural history of EDS. Conclusions: Obesity, a disorder of epidemic proportions, is a major risk factor for the incidence and chronicity of excessive daytime sleepiness (EDS), while weight loss is associated with its remission. Interestingly, objective sleep disturbances predict incident EDS in depressed individuals, whereas physiologic sleep propensity predicts incident EDS in those without depression. Weight management and treatment of depression and sleep disorders should be part of public health policies. Citation: Fernandez-Mendoza J, Vgontzas AN, Kritikou I, Calhoun SL, Liao D, Bixler EO. Natural history of excessive daytime sleepiness: role of obesity, weight loss, depression, and sleep propensity. SLEEP 2015;38(3):351–360. PMID:25581913

  7. Right prefrontal activity reflects the ability to overcome sleepiness during working memory tasks: a functional near-infrared spectroscopy study.

    Directory of Open Access Journals (Sweden)

    Motoyasu Honma

    Full Text Available It has been speculated that humans have an inherent ability to overcome sleepiness that counteracts homeostatic sleep pressure. However, it remains unclear which cortical substrate activities are involved in the ability to overcome sleepiness during the execution of cognitive tasks. Here we sought to confirm that this ability to overcome sleepiness in task execution improves performance on cognitive tasks, showing activation of neural substrates in the frontal cortex, by using a modified n-back (2- and 0-back working memory task and functional near-infrared spectroscopy. The change in alertness was just correlated with performances on the 2-back task. Activity in the right prefrontal cortex changed depending on alertness changes on the 2- and 0-back tasks independently, which indicates that activity in this region clearly reflects the ability to overcome sleepiness; it may contribute to the function of providing sufficient activity to meet the task load demands. This study reveals characteristics of the ability to overcome sleepiness during the n-back working memory task which goes beyond the attention-control function traditionally proposed.

  8. Increased Daytime Sleepiness in Patients with Childhood Craniopharyngioma and Hypothalamic Tumor Involvement: Review of the Literature and Perspectives

    Directory of Open Access Journals (Sweden)

    Hermann L. Müller

    2010-01-01

    Full Text Available Childhood craniopharyngiomas are rare embryogenic malformations of the sellar region, presumably derived from Rathke cleft epithelium. The overall survival rates after neurosurgical intervention and/or irradiation are high (92%. However, the quality of survival is frequently impaired due to endocrine deficiencies, sleep disturbances, daytime sleepiness, and severe obesity caused by hypothalamic lesions. Based on self-assessment using nutritional diaries, caloric intake was similar in patients and BMI-matched controls. Analyses of physical activity by accelerometric measurements showed a markedly lower level of physical activity. Significant daytime sleepiness and disturbances of circadian rhythms have been demonstrated in obese childhood craniopharyngioma patients. Daytime sleepiness and obesity in these patients were both correlated with low nocturnal and early morning melatonin levels. Polysomnographic studies in patients with severe daytime sleepiness revealed sleeping patterns typical for secondary narcolepsy. Reports on a beneficial effect of treatment with central stimulating agents supported the hypothesis that secondary narcolepsy should be considered as a rare cause for severe daytime sleepiness in patients with childhood craniopharyngioma.

  9. Sleep habits, insomnia, and daytime sleepiness in a large and healthy community-based sample of New Zealanders.

    Science.gov (United States)

    Wilsmore, Bradley R; Grunstein, Ronald R; Fransen, Marlene; Woodward, Mark; Norton, Robyn; Ameratunga, Shanthi

    2013-06-15

    To determine the relationship between sleep complaints, primary insomnia, excessive daytime sleepiness, and lifestyle factors in a large community-based sample. Cross-sectional study. Blood donor sites in New Zealand. 22,389 individuals aged 16-84 years volunteering to donate blood. N/A. A comprehensive self-administered questionnaire including personal demographics and validated questions assessing sleep disorders (snoring, apnea), sleep complaints (sleep quantity, sleep dissatisfaction), insomnia symptoms, excessive daytime sleepiness, mood, and lifestyle factors such as work patterns, smoking, alcohol, and illicit substance use. Additionally, direct measurements of height and weight were obtained. One in three participants report healthy sample) was associated with insomnia (odds ratio [OR] 1.75, 95% confidence interval [CI] 1.50 to 2.05), depression (OR 2.01, CI 1.74 to 2.32), and sleep disordered breathing (OR 1.92, CI 1.59 to 2.32). Long work hours, alcohol dependence, and rotating work shifts also increase the risk of daytime sleepiness. Even in this relatively young, healthy, non-clinical sample, sleep complaints and primary insomnia with subsequent excess daytime sleepiness were common. There were clear associations between many personal and lifestyle factors-such as depression, long work hours, alcohol dependence, and rotating shift work-and sleep problems or excessive daytime sleepiness.

  10. The effects of consecutive night shifts and shift length on cognitive performance and sleepiness: a field study.

    Science.gov (United States)

    Haidarimoghadam, Rashid; Kazemi, Reza; Motamedzadeh, Majid; Golmohamadi, Rostam; Soltanian, Alireza; Zoghipaydar, Mohamad Reza

    2017-06-01

    The aim of this study was to evaluate the effects of consecutive night shifts (CNS) and shift length on cognitive performance and sleepiness. This study evaluated the sleepiness and performance of 30 control room operators (CROs) working in 7 nights, 7 days, 7 days off (7N7D7O) and 30 CROs working in 4 nights, 7 days, 3 nights, 7 days off (4N7D3N7O) shift patterns in a petrochemical complex on the last night shift before swinging into the day shift. To assess cognitive performance, the n-back test, continuous performance test and simple reaction time test were employed. To assess sleepiness, the Karolinska sleepiness scale was used. Both schedules indicated that the correct responses and response times of working memory were reduced (p = 0.001), while intentional errors and sleepiness increased during the shift work (p = 0.001). CNS had a significant impact on reaction time and commission errors (p = 0.001). The main duty of CROs at a petrochemical plant is checking hazardous processes which require appropriate alertness and cognitive performance. As a result, planning for appropriate working hours and suitable number of CNS in a rotating shift system is a contribution to improving CRO performance and enhancing safety.

  11. Rotating shift work, sleep, and accidents related to sleepiness in hospital nurses

    Science.gov (United States)

    Gold, D. R.; Rogacz, S.; Bock, N.; Tosteson, T. D.; Baum, T. M.; Speizer, F. E.; Czeisler, C. A.

    1992-01-01

    A hospital-based survey on shift work, sleep, and accidents was carried out among 635 Massachusetts nurses. In comparison to nurses who worked only day/evening shifts, rotators had more sleep/wake cycle disruption and nodded off more at work. Rotators had twice the odds of nodding off while driving to or from work and twice the odds of a reported accident or error related to sleepiness. Application of circadian principles to the design of hospital work schedules may result in improved health and safety for nurses and patients.

  12. The persistence of depression score

    NARCIS (Netherlands)

    Spijker, J.; de Graaf, R.; Ormel, J.; Nolen, W. A.; Grobbee, D. E.; Burger, H.

    2006-01-01

    Objective: To construct a score that allows prediction of major depressive episode (MDE) persistence in individuals with MDE using determinants of persistence identified in previous research. Method: Data were derived from 250 subjects from the general population with new MDE according to DSM-III-R.

  13. Pavement scores synthesis.

    Science.gov (United States)

    2009-02-01

    The purpose of this synthesis was to summarize the use of pavement scores by the states, including the : rating methods used, the score scales, and descriptions; if the scores are used for recommending pavement : maintenance and rehabilitation action...

  14. The Effect of Reported Sleep, Perceived Fatigue, and Sleepiness on Cognitive Performance in a Sample of Emergency Nurses.

    Science.gov (United States)

    Wolf, Lisa A; Perhats, Cydne; Delao, Altair; Martinovich, Zoran

    2017-01-01

    The aim of this study is to explore the relationship between reported sleep, perceived fatigue and sleepiness, and cognitive performance. Although evidence suggests that fatigue and sleepiness affect the provision of care in inpatient units, there is a lack of research on the sleep patterns of emergency nurses and the effects of disturbed sleep and fatigue on their cognitive abilities and susceptibility to medical errors. A quantitative correlational design was used in this study; in each of 7 different statistical models, zero-order relationships between predictors and the dependent variable were examined with appropriate inferential tests. Participants reported high levels of sleepiness and chronic fatigue that impeded full functioning both at work and at home. Although high levels of self-reported fatigue did not show any effects on cognitive function, other factors in the environment may contribute to delayed, missed, or inappropriate care. Further research is indicated.

  15. Effects of an alternating work shift on air traffic controllers and the relationship with excessive daytime sleepiness and stress.

    Science.gov (United States)

    Freitas, Ângela M; Portuguez, Mirna Wetters; Russomano, Thaís; Freitas, Marcos de; Silvello, Silvio Luis da Silva; Costa, Jaderson Costa da

    2017-10-01

    To evaluate symptoms of stress and excessive daytime sleepiness (EDS) in air traffic control (ATC) officers in Brazil. Fifty-two ATC officers participated, based at three air traffic control units, identified as A, B and C. Stress symptoms were assessed using the Lipp Inventory of Stress Symptoms for Adults, and EDS by the Epworth Sleepiness Scale. The sample mean age was 37 years, 76.9% of whom were male. Excessive daytime sleepiness was identified in 25% of the ATC officers, with 84.6% of these based at air traffic control unit A, which has greater air traffic flow, operating a 24-hour alternating work shift schedule. A total of 16% of the ATC officers had stress symptoms, and of these, 62% showed a predominance of physical symptoms. The high percentage of ATC officers with EDS identified in group A may be related to chronodisruption due to night work and alternating shifts.

  16. The effect of intermittent fasting during Ramadan on sleep, sleepiness, cognitive function, and circadian rhythm.

    Science.gov (United States)

    Qasrawi, Shaden O; Pandi-Perumal, Seithikurippu R; BaHammam, Ahmed S

    2017-09-01

    Studies have shown that experimental fasting can affect cognitive function, sleep, and wakefulness patterns. However, the effects of experimental fasting cannot be generalized to fasting during Ramadan due to its unique characteristics. Therefore, there has been increased interest in studying the effects of fasting during Ramadan on sleep patterns, daytime sleepiness, cognitive function, sleep architecture, and circadian rhythm. In this review, we critically discuss the current research findings in those areas during the month of Ramadan. Available data that controlled for sleep/wake schedule, sleep duration, light exposure, and energy expenditure do not support the notion that Ramadan intermittent fasting increases daytime sleepiness and alters cognitive function. Additionally, recent well-designed studies showed no effect of fasting on circadian rhythms. However, in non-constrained environments that do not control for lifestyle changes, studies have demonstrated sudden and significant delays in bedtime and wake time. Studies that controlled for environmental factors and sleep/wake schedule reported no significant disturbances in sleep architecture. Nevertheless, several studies have consistently reported that the main change in sleep architecture during fasting is a reduction in the proportion of REM sleep.

  17. Repeated sessions of transcranial direct current stimulation evaluation on fatigue and daytime sleepiness in Parkinson's disease.

    Science.gov (United States)

    Forogh, Bijan; Rafiei, Maryam; Arbabi, Amin; Motamed, Mohammad Reza; Madani, Seyed Pezhman; Sajadi, Simin

    2017-02-01

    Parkinson is a common and disabling disease that affects patient's and career's quality of life. Unfortunately, medications, such as dopaminergic and sedative-hypnotic drugs, as an effective treatment have unwilling side effects. Recently, Transcranial Direct Current Stimulation (tDCS) in conjunction with medication becomes popular as a complementary safe treatment and several studies have proved its effectiveness on controlling motor and specially non-motor aspects of Parkinson's disease. In this randomized double-blind parallel study, 23 patients with Parkinson's disease divided into two groups of real tDCS plus occupational therapy and sham tDCS plus occupational therapy and the effects of therapeutic sessions (eight sessions tDCS with 0.06 mA/cm(2) current, 20 min on dorsolateral prefrontal cortex) were evaluated on fatigue and daytime sleepiness just after therapeutic course and in 3-month follow-up. tDCS had a significant effect on fatigue and no effect on daytime sleepiness reduction in patients with Parkinson's disease. tDCS is an effective and safe complementary treatment on fatigue reduction in Parkinson's disease.

  18. Driver sleepiness and risk of motor vehicle crash injuries: a population-based case control study in Fiji (TRIP 12).

    Science.gov (United States)

    Herman, Josephine; Kafoa, Berlin; Wainiqolo, Iris; Robinson, Elizabeth; McCaig, Eddie; Connor, Jennie; Jackson, Rod; Ameratunga, Shanthi

    2014-03-01

    Published studies investigating the role of driver sleepiness in road crashes in low and middle-income countries have largely focused on heavy vehicles. We investigated the contribution of driver sleepiness to four-wheel motor vehicle crashes in Fiji, a middle-income Pacific Island country. The population-based case control study included 131 motor vehicles involved in crashes where at least one person died or was hospitalised (cases) and 752 motor vehicles identified in roadside surveys (controls). An interviewer-administered questionnaire completed by drivers or proxies collected information on potential risks for crashes including sleepiness while driving, and factors that may influence the quantity or quality of sleep. Following adjustment for confounders, there was an almost six-fold increase in the odds of injury-involved crashes for vehicles driven by people who were not fully alert or sleepy (OR 5.7, 95%CI: 2.7, 12.3), or those who reported less than 6 h of sleep during the previous 24 h (OR 5.9, 95%CI: 1.7, 20.9). The population attributable risk for crashes associated with driving while not fully alert or sleepy was 34%, and driving after less than 6 h sleep in the previous 24 h was 9%. Driving by people reporting symptoms suggestive of obstructive sleep apnoea was not significantly associated with crash risk. Driver sleepiness is an important contributor to injury-involved four-wheel motor vehicle crashes in Fiji, highlighting the need for evidence-based strategies to address this poorly characterised risk factor for car crashes in less resourced settings. Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.

  19. Impact of sodium oxybate, modafinil, and combination treatment on excessive daytime sleepiness in patients who have narcolepsy with or without cataplexy.

    Science.gov (United States)

    Black, Jed; Swick, Todd; Bogan, Richard; Lai, Chinglin; Carter, Lawrence P

    2016-08-01

    Effects of sodium oxybate (SXB) on patients with narcolepsy with cataplexy (NC) or without cataplexy (NWOC) have not been separately evaluated in clinical trials. Retrospective analysis evaluated data from a phase 3, randomized, placebo-controlled trial of SXB, modafinil, and SXB + modafinil versus placebo in adult NC patients (n = 95) or NWOC patients (n = 127). NC patients were identified based on medical history, concomitant medications, and sleep-onset REM periods on nocturnal polysomnography. The studied outcomes were changes from baseline at eight weeks on the Epworth Sleepiness Scale (ESS), the Maintenance of Wakefulness Test (MWT), and the Clinical Global Impression of Change (CGI-C). Among NC and NWOC patients, ESS improvement was significantly greater with SXB and SXB + modafinil versus placebo. In NC patients, mean MWT sleep latency was significantly increased with SXB + modafinil versus placebo. In NWOC patients, mean MWT sleep latency significantly increased in all groups versus placebo. Higher percentages of patients in the SXB and SXB + modafinil groups were "very much improved" or "much improved" on the CGI-C versus placebo in both NC and NWOC populations, although the difference did not reach statistical significance in the NWOC populations. Adverse events were consistent with previously-reported profiles for modafinil and SXB. Nausea was more common in the SXB and SXB + modafinil groups. Dizziness and tremor were more common in the SXB + modafinil group only. SXB alone and in combination with modafinil improved subjective ratings of excessive sleepiness and an objective measure of the ability to stay awake to similar extents in NC patients and NWOC patients. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

  20. A survey study of the association between mobile phone use and daytime sleepiness in California high school students

    OpenAIRE

    Nathan, Nila; Zeitzer, Jamie

    2013-01-01

    Background Mobile phone use is near ubiquitous in teenagers. Paralleling the rise in mobile phone use is an equally rapid decline in the amount of time teenagers are spending asleep at night. Prior research indicates that there might be a relationship between daytime sleepiness and nocturnal mobile phone use in teenagers in a variety of countries. As such, the aim of this study was to see if there was an association between mobile phone use, especially at night, and sleepiness in a group of U...

  1. Mobile phone text messaging intervention to improve alertness and reduce sleepiness and fatigue during shiftwork among emergency medicine clinicians: study protocol for the SleepTrackTXT pilot randomized controlled trial.

    Science.gov (United States)

    Patterson, Paul Daniel; Moore, Charity G; Weaver, Matthew D; Buysse, Daniel J; Suffoletto, Brian P; Callaway, Clifton W; Yealy, Donald M

    2014-06-21

    Mental and physical fatigue while at work is common among emergency medical services (EMS) shift workers. Extended shifts (for example 24 hours) and excessive amounts of overtime work increase the likelihood of negative safety outcomes and pose a challenge for EMS fatigue-risk management. Text message-based interventions are a potentially high-impact, low-cost platform for sleep and fatigue assessment and distributing information to workers at risk of negative safety outcomes related to sleep behaviors and fatigue. We will conduct a pilot randomized trial with a convenience sample of adult EMS workers recruited from across the United States using a single study website. Participants will be allocated to one of two possible arms for a 90-day study period. The intervention arm will involve text message assessments of sleepiness, fatigue, and difficulty with concentration at the beginning, during, and end of scheduled shifts. Intervention subjects reporting high levels of sleepiness or fatigue will receive one of four randomly selected intervention messages promoting behavior change during shiftwork. Control subjects will receive assessment only text messages. We aim to determine the performance characteristics of a text messaging tool for the delivery of a sleep and fatigue intervention. We seek to determine if a text messaging program with tailored intervention messages is effective at reducing perceived sleepiness and/or fatigue among emergency medicine clinician shift workers. Additional aims include testing whether a theory-based behavioral intervention, delivered by text message, changes 'alertness behaviors'. The SleepTrackTXT pilot trial could provide evidence of compliance and effectiveness that would support rapid widespread expansion in one of two forms: 1) a stand-alone program in the form of a tailored/individualized sleep monitoring and fatigue reduction support service for EMS workers; or 2) an add-on to a multi-component fatigue risk management program

  2. The influence of sleep quality, sleep duration and sleepiness on school performance in children and adolescents: A meta-analytic review

    NARCIS (Netherlands)

    Dewald, J.F.; Meijer, A.M.; Oort, F.J.; Kerkhof, G.A.; Bögels, S.M.

    2010-01-01

    Insufficient sleep, poor sleep quality and sleepiness are common problems in children and adolescents being related to learning, memory and school performance. The associations between sleep quality (k = 16 studies, N = 13,631), sleep duration (k = 17 studies, N = 15,199), sleepiness (k = 17, N =

  3. Effect of Positive Airway Pressure on Cardiovascular Outcomes in Coronary Artery Disease Patients with Non-Sleepy Obstructive Sleep Apnea : The RICCADSA Randomized Controlled Trial

    NARCIS (Netherlands)

    Peker, Yüksel; Glantz, Helena; Eulenburg, Christine; Wegscheider, Karl; Herlitz, Johan; Thunström, Erik

    2016-01-01

    RATIONALE: Obstructive sleep apnea is common in patients with coronary artery disease, many of whom do not report daytime sleepiness. First-line treatment for symptomatic obstructive sleep apnea is continuous positive airway pressure, but its value in patients without daytime sleepiness is

  4. Construct validity and factor structure of the pittsburgh sleep quality index and epworth sleepiness scale in a multi-national study of African, South East Asian and South American college students

    National Research Council Canada - National Science Library

    Gelaye, Bizu; Lohsoonthorn, Vitool; Lertmeharit, Somrat; Pensuksan, Wipawan C; Sanchez, Sixto E; Lemma, Seblewengel; Berhane, Yemane; Zhu, Xiaotong; Vélez, Juan Carlos; Barbosa, Clarita; Anderade, Asterio; Tadesse, Mahlet G; Williams, Michelle A

    2014-01-01

    The Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS) are questionnaires used to assess sleep quality and excessive daytime sleepiness in clinical and population-based studies...

  5. Clinical predictors of obesity hypoventilation syndrome in obese subjects with obstructive sleep apnea.

    Science.gov (United States)

    Bingol, Zuleyha; Pıhtılı, Aylin; Cagatay, Penbe; Okumus, Gulfer; Kıyan, Esen

    2015-05-01

    Arterial blood gas (ABG) analysis is not a routine test in sleep laboratories due to its invasive nature. Therefore, the diagnosis of obesity hypoventilation syndrome (OHS) is underestimated. We aimed to evaluate the differences in subjects with OHS and pure obstructive sleep apnea (OSA) and to determine clinical predictors of OHS in obese subjects. Demographics, body mass index (BMI), Epworth Sleepiness Scale score, polysomnographic data, ABG, spirometric measurements, and serum bicarbonate levels were recorded. Of 152 obese subjects with OSA (79 females/73 males, mean age of 50.3 ± 10.6 y, BMI of 40.1 ± 5.6 kg/m(2), 51.9% with severe OSA), 42.1% (n = 64) had OHS. Subjects with OHS had higher BMI (P = .02), neck circumference (P sleep time with S(pO2) sleep efficiency (P = .032), mean S(pO2) (P < .001), and nadir S(pO2) (P < .001). Serum bicarbonate levels and nadir S(pO2) were the only independent predictive factors for OHS. A serum bicarbonate level of ≥ 27 mmol/L as the cutoff gives a satisfactory discrimination for the diagnosis of OHS (sensitivity of 76.6%, specificity of 74.6%, positive predictive value of 54.5%, negative predictive value of 88.9%). A nadir S(pO2) of < 80% as the cutoff gives a satisfactory discrimination for the diagnosis of OHS (sensitivity of 82.8%, specificity of 54.5%, positive predictive value of 56.9%, negative predictive value of 81.4%). When we used a serum bicarbonate level of ≥ 27 mmol/L and/or a nadir S(pO2) of < 80% as a screening measure, only 3 of 64 subjects with OHS were missed. Serum bicarbonate level and nadir saturation were independent predictive factors for the diagnosis of OHS. Copyright © 2015 by Daedalus Enterprises.

  6. An objective fluctuation score for Parkinson's disease.

    Directory of Open Access Journals (Sweden)

    Malcolm K Horne

    Full Text Available Establishing the presence and severity of fluctuations is important in managing Parkinson's Disease yet there is no reliable, objective means of doing this. In this study we have evaluated a Fluctuation Score derived from variations in dyskinesia and bradykinesia scores produced by an accelerometry based system.The Fluctuation Score was produced by summing the interquartile range of bradykinesia scores and dyskinesia scores produced every 2 minutes between 0900-1800 for at least 6 days by the accelerometry based system and expressing it as an algorithm.This Score could distinguish between fluctuating and non-fluctuating patients with high sensitivity and selectivity and was significant lower following activation of deep brain stimulators. The scores following deep brain stimulation lay in a band just above the score separating fluctuators from non-fluctuators, suggesting a range representing adequate motor control. When compared with control subjects the score of newly diagnosed patients show a loss of fluctuation with onset of PD. The score was calculated in subjects whose duration of disease was known and this showed that newly diagnosed patients soon develop higher scores which either fall under or within the range representing adequate motor control or instead go on to develop more severe fluctuations.The Fluctuation Score described here promises to be a useful tool for identifying patients whose fluctuations are progressing and may require therapeutic changes. It also shows promise as a useful research tool. Further studies are required to more accurately identify therapeutic targets and ranges.

  7. Discussion of causes and consequences of sleepiness among college students, 2014

    Directory of Open Access Journals (Sweden)

    Wolgast B

    2016-05-01

    Full Text Available Brad WolgastCenter for Counseling and Student Development, University of Delaware, Newark, DE, USAI was recently directed to, “Causes and consequences of sleepiness among college students”, from Hershner and Chervin.1 As a psychologist who specializes in treating college student sleep problems, I was very pleased to see this article. Overall, it is a gem: thorough, well-conceived, and thoughtful. However, I have concerns about two sections. First, on page 74, Hershner and Chervin1 write, “How much sleep a young adult needs is not clearly known, but is thought to be 8 hours.” They then cite Wehr et al2 as well as Van Dongen et al.3 These choices are surprising as reference for the assertion that young adults need approximately 8 hours of sleep.View original paper by Hershner and Chervin.

  8. Effects of habitual variations in napping on psychomotor performance, memory and subjective states.

    Science.gov (United States)

    Taub, J M

    1979-01-01

    Effects of habitual variations in napping on psychomotor performance, short-term memory and subjective states were investigated. The subjects were 32 healthy male university students who napped twice or more weekly in themorning and at night. Sixteen were randomly assigned to a control group and 16 to a nap(treatment) group. The experiment comprised two conditions of electrographically (EEG) recorded sleep for the nap group and two EEG monitored conditions of wakefulness for the controls. These conditions were scheduled from 9:35 to 11:35 a.m. and 12 hr later between 9:35 p.m. and 11:35 p.m. Measurements were obtained from: (a) a continuous 10-min auditory reaction time task, (b) a free recall task of short-term memory, (c) an activation-mood adjective check list, and (d) the Stanford Sleepiness scale. Except for memory the dependent variables of waking function were assessed 20 min before and 20 min after all conditions. Following each sleep condition the nap group as opposed to the controls showed a statistically significant improvement in reaction time performance, higher short-term retention, less reported sleepiness and elevated subjective states reflected by fice factors on the adjective mood-activation check list. Among the correlations computed the largest significant coefficients were of stage 4 and REM with posttreatment Stanford Sleepiness ratings. After naps, increased postdormital sleepiness was correlated with stage 4 and decreased sleepiness with REM sleep. Although few strikingly divergent functional effects were associated with morning and nocturanal naps, these did covary with sleep psychophysiology. It is postulated that the phase, the EEG-sleep stages and possibly the duration of accustomed naps are less salient factors influencing performance when the time since awakening until behavioral assessment can be kept constant.

  9. The effects of glycine on subjective daytime performance in partially sleep-restricted healthy volunteers

    Directory of Open Access Journals (Sweden)

    Makoto eBannai

    2012-04-01

    Full Text Available Approximately 30% of the general population suffers from insomnia. Given that insomnia causes many problems, amelioration of the symptoms is crucial. Recently, we found that a nonessential amino acid, glycine subjectively and objectively improves sleep quality in humans who have difficulty sleeping. We evaluated the effects of glycine on daytime sleepiness, fatigue and performances in sleep-restricted healthy subjects. Sleep was restricted to 25% less than the usual sleep time for three consecutive nights. Before bedtime, 3 g of glycine or placebo were ingested, sleepiness and fatigue were evaluated using the visual analogue scale (VAS and a questionnaire, and performance were estimated by personal computer (PC performance test program on the following day. In subjects given glycine, the VAS data showed a significant reduction in fatigue and a tendency toward reduced sleepiness. These observations were also found via the questionnaire, indicating that glycine improves daytime sleepiness and fatigue induced by acute sleep restriction. PC performance test revealed significant improvement in psychomotor vigilance test. We also measured plasma melatonin and the expression of circadian-modulated genes expression in the rat suprachiasmatic nucleus (SCN to evaluate the effects of glycine on circadian rhythms. Glycine did not show significant effects on plasma melatonin concentrations during either the dark or light period. Moreover, the expression levels of clock genes such as Bmal1 and Per2 remained unchanged. However, we observed a glycine-induced increase in the neuropeptides arginine vasopressin and vasoactive intestinal polypeptide in the light period. Although no alterations in the circadian clock itself were observed, our results indicate that glycine modulated SCN function. Thus, glycine modulates certain neuropeptides in the SCN and this phenomenon may indirectly contribute to improving the occasional sleepiness and fatigue induced by sleep

  10. Dissociating effects of global SWS disruption and healthy aging on waking performance and daytime sleepiness.

    Science.gov (United States)

    Groeger, John A; Stanley, Neil; Deacon, Stephen; Dijk, Derk-Jan

    2014-06-01

    To contrast the effects of slow wave sleep (SWS) disruption and age on daytime functioning. Daytime functioning was contrasted in three age cohorts, across two parallel 4-night randomized groups (baseline, two nights of SWS disruption or control, recovery sleep). Sleep research laboratory. 44 healthy young (20-30 y), 35 middle-aged (40-55 y), and 31 older (66-83 y) men and women. Acoustic stimulation contingent on appearance of slow waves. Cognitive performance was assessed before sleep latency tests at five daily time-points. SWS disruption resulted in less positive affect, slower or impaired information processing and sustained attention, less precise motor control, and erroneous implementation, rather than inhibition, of well-practiced actions. These performance impairments had far smaller effect sizes than the increase in daytime sleepiness and differed from baseline to the same extent for each age group. At baseline, younger participants performed better than older participants across many cognitive domains, with largest effects on executive function, response time, sustained attention, and motor control. At baseline, the young were sleepier than other age groups. SWS has been considered a potential mediator of age-related decline in performance, although the effects of SWS disruption on daytime functioning have not been quantified across different cognitive domains nor directly compared to age-related changes in performance. The data imply that two nights of SWS disruption primarily leads to an increase in sleepiness with minor effects on other aspects of daytime functioning, which are different from the substantial effects of age.

  11. Scoring nail psoriasis

    NARCIS (Netherlands)

    Klaassen, K.M.G.; Kerkhof, P.C.M. van de; Bastiaens, M.T.; Plusje, L.G.; Baran, R.L.; Pasch, M.C.

    2014-01-01

    BACKGROUND: Scoring systems are indispensable in evaluating the severity of disease and monitoring treatment response. OBJECTIVE: We sought to evaluate the competence of various nail psoriasis severity scoring systems and to develop a new scoring system. METHODS: The authors conducted a prospective,

  12. Effects of blue pulsed light on human physiological functions and subjective evaluation

    Directory of Open Access Journals (Sweden)

    Katsuura Tetsuo

    2012-09-01

    Full Text Available Abstract Background It has been assumed that light with a higher irradiance of pulsed blue light has a much greater influence than that of light with a lower irradiance of steady blue light, although they have the same multiplication value of irradiance and duration. We examined the non-visual physiological effects of blue pulsed light, and determined whether it is sensed visually as being blue. Findings Seven young male volunteers participated in the study. We placed a circular screen (diameter 500 mm in front of the participants and irradiated it using blue and/or white light-emitting diodes (LEDs, and we used halogen lamps as a standard illuminant. We applied three steady light conditions of white LED (F0, blue LED + white LED (F10, and blue LED (F100, and a blue pulsed light condition of a 100-μs pulse width with a 10% duty ratio (P10. The irradiance of all four conditions at the participant's eye level was almost the same, at around 12 μW/cm2. We measured their pupil diameter, recorded electroencephalogram readings and Kwansei Gakuin Sleepiness Scale score, and collected subjective evaluations. The subjective bluish score under the F100 condition was significantly higher than those under other conditions. Even under the P10 condition with a 10% duty ratio of blue pulsed light and the F10 condition, the participant did not perceive the light as bluish. Pupillary light response under the P10 pulsed light condition was significantly greater than under the F10 condition, even though the two conditions had equal blue light components. Conclusions The pupil constricted under the blue pulsed light condition, indicating a non-visual effect of the lighting, even though the participants did not perceive the light as bluish.

  13. Effects of blue pulsed light on human physiological functions and subjective evaluation.

    Science.gov (United States)

    Katsuura, Tetsuo; Ochiai, Yukifumi; Senoo, Toshihiro; Lee, Soomin; Takahashi, Yoshika; Shimomura, Yoshihiro

    2012-09-03

    It has been assumed that light with a higher irradiance of pulsed blue light has a much greater influence than that of light with a lower irradiance of steady blue light, although they have the same multiplication value of irradiance and duration. We examined the non-visual physiological effects of blue pulsed light, and determined whether it is sensed visually as being blue. Seven young male volunteers participated in the study. We placed a circular screen (diameter 500 mm) in front of the participants and irradiated it using blue and/or white light-emitting diodes (LEDs), and we used halogen lamps as a standard illuminant. We applied three steady light conditions of white LED (F0), blue LED + white LED (F10), and blue LED (F100), and a blue pulsed light condition of a 100-μs pulse width with a 10% duty ratio (P10). The irradiance of all four conditions at the participant's eye level was almost the same, at around 12 μW/cm2. We measured their pupil diameter, recorded electroencephalogram readings and Kwansei Gakuin Sleepiness Scale score, and collected subjective evaluations. The subjective bluish score under the F100 condition was significantly higher than those under other conditions. Even under the P10 condition with a 10% duty ratio of blue pulsed light and the F10 condition, the participant did not perceive the light as bluish. Pupillary light response under the P10 pulsed light condition was significantly greater than under the F10 condition, even though the two conditions had equal blue light components. The pupil constricted under the blue pulsed light condition, indicating a non-visual effect of the lighting, even though the participants did not perceive the light as bluish.

  14. Effects on subjective and objective alertness and sleep in response to evening light exposure in older subjects.

    Science.gov (United States)

    Münch, M; Scheuermaier, K D; Zhang, R; Dunne, S P; Guzik, A M; Silva, E J; Ronda, J M; Duffy, J F

    2011-10-31

    Evening bright light exposure is reported to ameliorate daytime sleepiness and age-related sleep complaints, and also delays the timing of circadian rhythms. We tested whether evening light exposure given to older adults with sleep-wake complaints would delay the timing of their circadian rhythms with respect to their sleep timing, thereby reducing evening sleepiness and improving subsequent sleep quality. We examined the impact of evening light exposure from two different light sources on subjective alertness, EEG activity during wakefulness, and sleep stages. Ten healthy older adults with sleep complaints (mean age=63.3 years; 6F) participated in a 13-day study. After three baseline days, circadian phase was assessed. On the evening of days 5-8 the subjects were exposed for 2h to either polychromatic blue-enriched white light or standard white fluorescent light, and on the following day circadian phase was re-assessed. Subjects were allowed to leave the laboratory during all but the two days when the circadian phase assessment took place. Evening assessments of subjective alertness, and wake and sleep EEG data were analyzed. Subjective alertness and wake EEG activity in the alpha range (9.75-11.25 Hz) were significantly higher during light exposures when compared to the pre-light exposure evening (plight exposures produced circadian phase shifts and significantly prolonged latency to rapid eye-movement (REM) sleep for both light groups (plight exposures was negatively correlated with REM sleep duration (plight exposure could benefit older adults with early evening sleepiness, without negatively impacting the subsequent sleep episode. Copyright © 2011 Elsevier B.V. All rights reserved.

  15. Modafinil improves antipsychotic-induced parkinsonism but not excessive daytime sleepiness, psychiatric symptoms or cognition in schizophrenia and schizoaffective disorder: a randomized, double-blind, placebo-controlled study.

    Science.gov (United States)

    Lohr, James B; Liu, Lianqi; Caligiuri, Michael P; Kash, Taylor P; May, Todd A; Murphy, Jody Delapena; Ancoli-Israel, Sonia

    2013-10-01

    To examine the efficacy and safety of modafinil on parkinsonism and excessive daytime sleepiness (EDS), as well as on negative symptoms and cognitive abilities in patients with schizophrenia or schizoaffective disorder (DSM-IV criteria) in a randomized double-blind placebo-controlled 8-week study. Twenty-four male patients, who were aged 20-63 years and on stable dose of second generation antipsychotic medications and with a negative symptom score of ≥ 20 on the Positive and Negative Syndrome Scale (PANSS), were randomized into either the modafinil (n=12) or placebo (n=12) group. The modafinil group received flexible does of modafinil 50-200mg/day. Primary measurements were the Simpson-Angus Scale (SAS) for extrapyramidal side effects (EPS), the Epworth Sleepiness Scale (ESS), the PANSS and a neuropsychological (NP) test battery. Data were collected on Days 0, 14, 28, 42 and 56 for rating scales, and on Days 0, 28 and 56 for NP tests. Mixed model analyses showed a significant group-x-time interaction for total SAS scores (Pmodafinil group but remaining the same in the placebo group. There were no significant group-x-time interactions for scores of ESS (total), PANSS (total, positive and negative), and NP tests (composite and domains) (all P's>0.5). No significant adverse events were observed. The data suggest that modafinil was a safe adjunctive treatment which improved parkinsonian symptoms and signs in patients with schizophrenia or schizoaffective disorder. Further studies in larger samples and with longer study time are needed to test/confirm the beneficial effects of modafinil on motor function. © 2013.

  16. Patients previously treated for nonfunctioning pituitary macroadenomas have disturbed sleep characteristics, circadian movement rhythm, and subjective sleep quality.

    Science.gov (United States)

    Biermasz, N R; Joustra, S D; Donga, E; Pereira, A M; van Duinen, N; van Dijk, M; van der Klaauw, A A; Corssmit, E P M; Lammers, G J; van Kralingen, K W; van Dijk, J G; Romijn, J A

    2011-05-01

    Fatigue and excessive sleepiness have been reported after treatment of nonfunctioning pituitary macroadenomas (NFMA). Because these complaints may be caused by disturbed nocturnal sleep, we evaluated objective sleep characteristics in patients treated for NFMA. We conducted a controlled cross-sectional study. We studied 17 patients (8 women; mean age, 54 yr) in remission of NFMA during long-term follow-up (8 yr; range, 1-18 yr) after surgery (n = 17) and additional radiotherapy (n = 5) without comorbidity except for hypopituitarism and 17 controls matched for age, gender, and body mass index. Sleep was assessed by nocturnal polysomnography, sleep and diurnal movement patterns by actigraphy, and quality of life and subjective sleep characteristics by questionnaires. Compared to controls, patients had reduced sleep efficiency, less rapid eye movement sleep, more N1 sleep, and more awakenings in the absence of excessive apnea or periodic limb movements. Actigraphy revealed a longer sleep duration and profound disturbances in diurnal movement patterns, with more awakenings at night and less activity during the day. Patients scored higher on fatigue and reported impaired quality of life. Patients previously treated for NFMA suffer from decreased subjective sleep quality, disturbed distribution of sleep stages, and disturbed circadian movement rhythm. These observations indicate that altered sleep characteristics may be a factor contributing to impaired quality of life and increased fatigue in patients treated for NFMA.

  17. Avaliação da sonolência em estudantes universitários de turnos distintos Evaluación de la somnolencia en estudiantes universitarios de turnos distintos Evaluation of sleepiness in college students from different shifts

    Directory of Open Access Journals (Sweden)

    Danilo de Freitas Araújo

    2012-08-01

    Full Text Available Estudantes de graduação possuem altas chances de apresentar Sonolência Diurna Excessiva, devido aos horários escolares e às demandas acadêmicas. Por isso, pretendeu-se analisar níveis de sonolência de estudantes de turnos distintos. O universo foi constituído por 109 graduandos do turno matutino e 125 do noturno. Utilizou-se a Escala de Sonolência de Epworth. A amostra apresentou média total de 9,38 (DP=4,03, sendo 9,03 (DP=4,01 para o turno matutino e 9,7 (DP=3,93 para o noturno. Foram detectadas diferenças significativas nos níveis de sonolência entre turnos (η² =0,10;p Estudiantes de graduación poseen altas posibilidades de presentar Somnolencia Diurna Excesiva, debido a los horarios escolares y a las demandas académicas. Por eso, se pretendió analizar niveles de somnolencia de estudiantes de turnos distintos. El universo fue constituido por 109 graduandos del turno matutino y 125 del nocturno. Se utilizó la Escala de Somnolencia de Epworth. La muestra presentó promedio total de 9,38 (DP=4,03, siendo 9,03 (DP=4,01 para el turno matutino y 9,7 (DP=3,93 para el nocturno. Fueron detectadas diferencias significativas en los niveles de somnolencia entre turnos (η²=0,10; pUndergraduate students are a population with high chances of developing Excessive Daytime Sleepiness, due to school schedules and academic demands. Our aim was to examine the levels of sleepiness of students belonging to morning and night classes. The universe has consisted of 109 undergraduate students of the morning shift and 125 of the night shift. We have used the Epworth Sleepiness Scale. The sample had an average of 9.38 (SD=4.03, and 9.03 (SD=4.01 for the morning shift and 9.7 (SD=3.93 for the night shift. Statistical analysis showed significant differences in sleepiness between shifts (η²=0,10; p<0,00, and among male subjects and female in the two shifts (η²=0,45; p<0,00. It should therefore be considered the role of academic demands, since they

  18. Leisure-Time Physical Activity and Sedentary Behavior and Their Cross-Sectional Associations with Excessive Daytime Sleepiness in the French SU.VI.MAX-2 Study.

    Science.gov (United States)

    Andrianasolo, Roland M; Menai, Mehdi; Galan, Pilar; Hercberg, Serge; Oppert, Jean-Michel; Kesse-Guyot, Emmanuelle; Andreeva, Valentina A

    2016-04-01

    The potential benefit of physical activity in terms of decreasing excessive daytime sleepiness (EDS) prevalence is unclear, especially in aging adults. We aimed to elucidate the associations among physical activity, sedentariness, and EDS in middle-aged and older adults. We conducted a cross-sectional analysis using data from a subsample of participants in the SU.VI.MAX-2 observational study (2007-2009; N = 4179; mean age = 61.9 years). EDS was defined as a score >10 on the Epworth Sleepiness Scale. Leisure-time physical activity and different types of sedentary behavior were assessed with the Modifiable Activity Questionnaire. The associations were examined with multivariable logistic regression models. In the adjusted multivariable model, total leisure-time physical activity (modeled in quartiles, Q) was significantly, inversely associated with EDS (odds ratios (OR)Q4 vs Q1 = 0.70, 95 % confidence interval (CI) = 0.54-0.89). The association persisted in analyses restricted to individuals not taking sleep medication (ORQ4 vs Q1 = 0.72, 95 % CI = 0.54-0.95). In turn, time spent watching television and time spent reading appeared protective against EDS (ORQ4 vs Q1 = 0.73, 95 % CI = 0.57-0.94; ORQ4 vs Q1 = 0.76, 95 % CI = 0.60-0.97, respectively), whereas time spent on a computer appeared to confer an increased risk for EDS (ORQ4 vs Q1 = 1.30, 95 % CI = 1.05-1.62). When physical activity and sedentariness were modeled jointly, using WHO recommendation-based cutoffs for high/low levels, no significant associations were observed in the fully adjusted models. The findings reinforce public health recommendations promoting behavior modification and specifically moderate-intensity exercise in middle-aged and older adults. The association of high physical activity/low sedentariness with EDS, which was not supported by the data, merits further investigation before firm conclusions could be drawn.

  19. The association of dopamine agonists with daytime sleepiness, sleep problems and quality of life in patients with Parkinson's disease--a prospective study.

    Science.gov (United States)

    Happe, S; Berger, K

    2001-12-01

    Reports that dopamine agonists (DA) precipitate sudden daytime sleep episodes in Parkinson's disease (PD) patients have received widespread attention. It remains unclear if non-ergoline and ergoline DAs have differential sedating effects or if sedation rather represents a class effect of DAs. The aim of this study was the evaluation of sleep disturbances and the quality of life (QoL) in PD patients with different dopaminergic treatment strategies. This analysis is part of the FAQT-study, a prospective German cohort study evaluating determinants of QoL in PD patients. A subgroup of 111 PD patients was evaluated twice, at baseline and after one year of follow-up, using standardised and validated questionnaires (Unified Parkinson's disease rating scale (UPDRS), Hoehn and Yahr classification, Center for Epidemiologic Studies Depression Scale (CESD), Short Form-36 (SF-36), Parkinson Disease Questionnaire (PDQ-39)). The impact of treatment strategies on sleep problems, daytime sleepiness, bad dreams and hallucinations, depression and QoL in PD patients was analysed separately for ergoline DAs, non-ergoline DAs and the patient group taking no DA. At baseline, sleep problems were reported by about one third of the patients with and without DA medication. Excessive daytime sleepiness (EDS) was higher in the two DA groups (ergoline 11.9%, non-ergoline 9.1%) than among patients not taking DAs (4.5 %). At follow-up, sleep problems in general had decreased among patients taking DAs continuously and among those newly taking DAs, while the sleep problems increased in patients discontinuing DAs. However, EDS had increased to 25% in patients newly taking DAs, and decreased to 15.9% in those taking them continuously. QoL scores at follow-up were slightly increased in the patient groups newly taking and discontinuing DAs (the latter except in physical functioning) while those on continuing DA-medication remained unchanged. No differential effects of ergoline or non-ergoline DAs on

  20. Re-Scoring the Game’s Score

    DEFF Research Database (Denmark)

    Gasselseder, Hans-Peter

    2014-01-01

    -temporal alignment in the resulting emotional congruency of nondiegetic music. Whereas imaginary aspects of immersive presence are systemically affected by the presentation of dynamic music, sensory spatial aspects show higher sensitivity towards the arousal potential of the music score. It is argued......This study explores immersive presence as well as emotional valence and arousal in the context of dynamic and non-dynamic music scores in the 3rd person action-adventure video game genre while also considering relevant personality traits of the player. 60 subjects answered self......-report questionnaires of experiential states each time after playing the game 'Batman: Arkham City' in one of three randomized conditions accounting for [1] dynamic music, [2] non-dynamic music/low arousal potential and [3] non-dynamic music/high arousal potential, aiming to manipulate emotional arousal and structural...

  1. Expanding subjectivities

    DEFF Research Database (Denmark)

    Lundgaard Andersen, Linda; Soldz, Stephen

    2012-01-01

    A major theme in recent psychoanalytic thinking concerns the use of therapist subjectivity, especially “countertransference,” in understanding patients. This thinking converges with and expands developments in qualitative research regarding the use of researcher subjectivity as a tool to understa...

  2. Avaliação da escala de Epworth em pacientes com a Síndrome da apnéia e hipopnéia obstrutiva do sono Evaluation of Epworth Sleepiness Scale in patients with obstructive sleep apnea-hypopnea syndrome

    Directory of Open Access Journals (Sweden)

    Letícia Boari

    2004-12-01

    subjective, the questionnaire is simple, easy to be applied and free of charge. AIM: to compare Epworth Sleepiness Scale scores and apnea-hypopnea index (AHI, measured by polysomnography, in patients diagnosed with OSAHS. STUDY DESIGN: clinical retrospective study. METHOD: chart analysis of 66 patients complaining from snoring, who underwent surgery (uvulopalatopharyngoplasty with/without nasal surgery. ESS score and AHI were evaluated before and after surgery. RESULTS: 78% of patients with normal AHI, scored 10. There were no statistically significant results for groups presenting mild and moderate apnea. CONCLUSION: ESS can detect normal and severe levels of apnea, but is not able to detect mild and moderate levels. Therefore, ESS can be used in the follow-up of patients with OSAHS, however, it cannot replace polysomnography because it does not detect all levels of apnea.

  3. Sleepiness at the wheel across Europe: a survey of 19 countries.

    Science.gov (United States)

    Gonçalves, Marta; Amici, Roberto; Lucas, Raquel; Åkerstedt, Torbjörn; Cirignotta, Fabio; Horne, Jim; Léger, Damien; McNicholas, Walter T; Partinen, Markku; Téran-Santos, Joaquín; Peigneux, Philippe; Grote, Ludger

    2015-06-01

    The European Sleep Research Society aimed to estimate the prevalence, determinants and consequences of falling asleep at the wheel. In total, 12 434 questionnaires were obtained from 19 countries using an anonymous online questionnaire that collected demographic and sleep-related data, driving behaviour, history of drowsy driving and accidents. Associations were quantified using multivariate logistic regression. The average prevalence of falling asleep at the wheel in the previous 2 years was 17%. Among respondents who fell asleep, the median prevalence of sleep-related accidents was 7.0% (13.2% involved hospital care and 3.6% caused fatalities). The most frequently perceived reasons for falling asleep at the wheel were poor sleep in the previous night (42.5%) and poor sleeping habits in general (34.1%). Falling asleep was more frequent in the Netherlands [odds ratio = 3.55 (95% confidence interval: 1.97; 6.39)] and Austria [2.34 (1.75; 3.13)], followed by Belgium [1.52 (1.28; 1.81)], Portugal [1.34 (1.13, 1.58)], Poland [1.22 (1.06; 1.40)] and France [1.20 (1.05; 1.38)]. Lower odds were found in Croatia [0.36 (0.21; 0.61)], Slovenia [0.62 (0.43; 0.89)] and Italy [0.65 (0.53; 0.79)]. Individual determinants of falling asleep were younger age; male gender [1.79 (1.61; 2.00)]; driving ≥20 000 km year [2.02 (1.74; 2.35)]; higher daytime sleepiness [7.49 (6.26; 8.95)] and high risk of obstructive sleep apnea syndrome [3.48 (2.78; 4.36) in men]. This Pan European survey demonstrates that drowsy driving is a major safety hazard throughout Europe. It emphasizes the importance of joint research and policy efforts to reduce the burden of sleepiness at the wheel for European drivers.

  4. SCORE - A DESCRIPTION.

    Science.gov (United States)

    SLACK, CHARLES W.

    REINFORCEMENT AND ROLE-REVERSAL TECHNIQUES ARE USED IN THE SCORE PROJECT, A LOW-COST PROGRAM OF DELINQUENCY PREVENTION FOR HARD-CORE TEENAGE STREET CORNER BOYS. COMMITTED TO THE BELIEF THAT THE BOYS HAVE THE POTENTIAL FOR ETHICAL BEHAVIOR, THE SCORE WORKER FOLLOWS B.F. SKINNER'S THEORY OF OPERANT CONDITIONING AND REINFORCES THE DELINQUENT'S GOOD…

  5. Association between screen viewing duration and sleep duration, sleep quality, and excessive daytime sleepiness among adolescents in Hong Kong.

    Science.gov (United States)

    Mak, Yim Wah; Wu, Cynthia Sau Ting; Hui, Donna Wing Shun; Lam, Siu Ping; Tse, Hei Yin; Yu, Wing Yan; Wong, Ho Ting

    2014-10-28

    Screen viewing is considered to have adverse impacts on the sleep of adolescents. Although there has been a considerable amount of research on the association between screen viewing and sleep, most studies have focused on specific types of screen viewing devices such as televisions and computers. The present study investigated the duration with which currently prevalent screen viewing devices (including televisions, personal computers, mobile phones, and portable video devices) are viewed in relation to sleep duration, sleep quality, and daytime sleepiness among Hong Kong adolescents (N = 762). Television and computer viewing remain prevalent, but were not correlated with sleep variables. Mobile phone viewing was correlated with all sleep variables, while portable video device viewing was shown to be correlated only with daytime sleepiness. The results demonstrated a trend of increase in the prevalence and types of screen viewing and their effects on the sleep patterns of adolescents.

  6. Association between Screen Viewing Duration and Sleep Duration, Sleep Quality, and Excessive Daytime Sleepiness among Adolescents in Hong Kong

    Directory of Open Access Journals (Sweden)

    Yim Wah Mak

    2014-10-01

    Full Text Available Screen viewing is considered to have adverse impacts on the sleep of adolescents. Although there has been a considerable amount of research on the association between screen viewing and sleep, most studies have focused on specific types of screen viewing devices such as televisions and computers. The present study investigated the duration with which currently prevalent screen viewing devices (including televisions, personal computers, mobile phones, and portable video devices are viewed in relation to sleep duration, sleep quality, and daytime sleepiness among Hong Kong adolescents (N = 762. Television and computer viewing remain prevalent, but were not correlated with sleep variables. Mobile phone viewing was correlated with all sleep variables, while portable video device viewing was shown to be correlated only with daytime sleepiness. The results demonstrated a trend of increase in the prevalence and types of screen viewing and their effects on the sleep patterns of adolescents.

  7. Modafinil for Excessive Sleepiness Associated With Chronic Shift Work Sleep Disorder: Effects on Patien