Sleep disturbances are among the most prevalent neuropsychiatric symptoms in individuals who have recovered from severe acute respiratory syndrome coronavirus 2 infections.Previous studies have demonstrated abnormal b...Sleep disturbances are among the most prevalent neuropsychiatric symptoms in individuals who have recovered from severe acute respiratory syndrome coronavirus 2 infections.Previous studies have demonstrated abnormal brain structures in patients with sleep disturbances who have recovered from coronavirus disease 2019(COVID-19).However,neuroimaging studies on sleep disturbances caused by COVID-19 are scarce,and existing studies have primarily focused on the long-term effects of the virus,with minimal acute phase data.As a result,little is known about the pathophysiology of sleep disturbances in the acute phase of COVID-19.To address this issue,we designed a longitudinal study to investigate whether alterations in brain structure occur during the acute phase of infection,and verified the results using 3-month follow-up data.A total of 26 COVID-19 patients with sleep disturbances(aged 51.5±13.57 years,8 women and 18 men),27 COVID-19 patients without sleep disturbances(aged 47.33±15.98 years,9 women and 18 men),and 31 age-and gender-matched healthy controls(aged 49.19±17.51 years,9 women and 22 men)were included in this study.Eleven COVID-19 patients with sleep disturbances were included in a longitudinal analysis.We found that COVID-19 patients with sleep disturbances exhibited brain structural changes in almost all brain lobes.The cortical thicknesses of the left pars opercularis and left precuneus were significantly negatively correlated with Pittsburgh Sleep Quality Index scores.Additionally,we observed changes in the volume of the hippocampus and its subfield regions in COVID-19 patients compared with the healthy controls.The 3-month follow-up data revealed indices of altered cerebral structure(cortical thickness,cortical grey matter volume,and cortical surface area)in the frontal-parietal cortex compared with the baseline in COVID-19 patients with sleep disturbances.Our findings indicate that the sleep disturbances patients had altered morphology in the cortical and hippocampal structures during the acute phase of infection and persistent changes in cortical regions at 3 months post-infection.These data improve our understanding of the pathophysiology of sleep disturbances caused by COVID-19.展开更多
Dear Editor,Sleep plays a vital role in physical health,influencing chronic diseases,memory,and overall quality of life[1,2].In recent years,the relationship between sleep health and physical activity has gained atten...Dear Editor,Sleep plays a vital role in physical health,influencing chronic diseases,memory,and overall quality of life[1,2].In recent years,the relationship between sleep health and physical activity has gained attention,with a particular focus on how daily step count affects various sleep metrics.展开更多
BACKGROUND Mild cognitive impairment(MCI)has a high risk of progression to Alzheimer’s disease.The disease is often accompanied by sleep disorders,and whether sleep disorders have an effect on brain function in patie...BACKGROUND Mild cognitive impairment(MCI)has a high risk of progression to Alzheimer’s disease.The disease is often accompanied by sleep disorders,and whether sleep disorders have an effect on brain function in patients with MCI is unclear.AIM To explore the near-infrared brain function characteristics of MCI with sleep disorders.METHODS A total of 120 patients with MCI(MCI group)and 50 healthy subjects(control group)were selected.All subjects underwent the functional near-infrared spec-troscopy test.Collect baseline data,Mini-Mental State Examination,Montreal Cognitive Assessment scale,fatigue severity scale(FSS)score,sleep parameter,and oxyhemoglobin(Oxy-Hb)concentration and peak time of functional near-infrared spectroscopy test during the task period.The relationship between Oxy-RESULTS Compared with the control group,the FSS score of the MCI group was higher(t=11.310),and the scores of Pittsburgh sleep quality index,sleep time,sleep efficiency,nocturnal sleep disturbance,and daytime dysfunction were higher(Z=-10.518,-10.368,-9.035,-10.661,-10.088).Subjective sleep quality and total sleep time scores were lower(Z=-11.592,-9.924).The sleep efficiency of the MCI group was lower,and the awakening frequency,rem sleep latency period,total sleep time,and oxygen desaturation index were higher(t=5.969,5.829,2.887,3.003,5.937).The Oxy-Hb concentration at T0,T1,and T2 in the MCI group was lower(t=14.940,11.280,5.721),and the peak time was higher(t=18.800,13.350,9.827).In MCI patients,the concentration of Oxy-Hb during T0 was negatively correlated with the scores of Pittsburgh sleep quality index,sleep time,total sleep time,and sleep efficiency(r=-0.611,-0.388,-0.563,-0.356).It was positively correlated with sleep efficiency and total sleep time(r=0.754,0.650),and negatively correlated with oxygen desaturation index(r=-0.561)and FSS score(r=-0.526).All comparisons were P<0.05.CONCLUSION Patients with MCI and sleep disorders have lower near-infrared brain function than normal people,which is related to sleep quality.Clinically,a comprehensive assessment of the near-infrared brain function of patients should be carried out to guide targeted treatment and improve curative effect.展开更多
Despite that sleep disturbance and poor neurocognitive performance are common complaints among coronavirus disease 2019(COVID-19)survivors,few studies have focused on the effect of post-COVID-19 sleep disturbance(PCSD...Despite that sleep disturbance and poor neurocognitive performance are common complaints among coronavirus disease 2019(COVID-19)survivors,few studies have focused on the effect of post-COVID-19 sleep disturbance(PCSD)on cognitive function.This study aimed to identify the impact of PCSD on neurocognitive function and explore the associated risk factors for the worsening of this condition.This cross-sectional study was conducted via the web-based assessment in Chinese mainland.Neurocognitive function was evaluated by the modified online Integrated Cognitive Assessment(ICA)and the Number Ordering Test(NOT).Propensity score matching(PSM)was utilized to match the confounding factors between individuals with and without PCSD.Univariate analyses were performed to evaluate the effect of PCSD on neurocognitive function.The risk factors associated with worsened neurocognitive performance in PCSD individuals were explored using binary logistic regression.A total of 8692 individuals with COVID-19 diagnosis were selected for this study.Nearly half(48.80%)of the COVID-19 survivors reported sleep disturbance.After matching by PSM,a total of 3977 pairs(7954 individuals in total)were obtained.Univariate analyses revealed that PCSD was related to worse ICA and NOT performance(P<0.05).Underlying disease,upper respiratory infection,loss of smell or taste,severe pneumonia,and self-reported cognitive complaints were associated with worsened neurocognitive performance among PCSD individuals(P<0.05).Furthermore,aging,ethnicity(minority),and lower education level were found to be independent risk factors for worsened neurocognitive performance in PCSD individuals(P<0.05).PCSD was related to impaired neurocognitive performance.Therefore,appropriate prevention and intervention measures should be taken to minimize or prevent PCSD and eliminate its potential adverse effect on neurocognitive function.展开更多
Objective This study examines the sequential mediating roles of body pain and self-reported health in the association between sleep duration and self-reported life satisfaction among elderly Chinese adults.Methods Dat...Objective This study examines the sequential mediating roles of body pain and self-reported health in the association between sleep duration and self-reported life satisfaction among elderly Chinese adults.Methods Data from the fifth wave of the China Health and Retirement Longitudinal Survey(CHARLS)were used to analyse the relationships between sleep duration and body pain,self-reported health,and life satisfaction through logistic regression and Restricted Cubic Spline(RCS)analyses.The sequential mediation effects of body pain and self-reported health status were examined via chain mediation analysis.Results Logistic regression analysis showed that sleeping fewer than 6 hours or 6-7 hours was linked to higher risks of body pain,poor health,and dissatisfaction with life compared to sleeping 7-8 hours(all P<0.05).Additionally,those sleeping more than 9 hours also had increased risks of poor health and dissatisfaction with life compared to those sleeping 7-8 hours(all P<0.05).Chain mediation analysis showed that body pain and self-reported health status sequentially mediated 46.15%of the association between sleep duration and life satisfaction.Conclusion Body pain and self-reported health may shape the relationship between sleep duration and life satisfaction in elderly Chinese adults.展开更多
Introduction:Alzheimer 's disease(AD) is a common neurodegenerative disorder and the primary cause of dementia. Considerable evidence supports the “amyloid hypothesis,” stating that the pathogenesis of AD is pri...Introduction:Alzheimer 's disease(AD) is a common neurodegenerative disorder and the primary cause of dementia. Considerable evidence supports the “amyloid hypothesis,” stating that the pathogenesis of AD is primarily caused by the deposition of amyloid-β(Aβ), which drives tau phosphorylation, neuroinflammation, and neurodegeneration in the brain. The amyloid hypothesis is strengthened by the significant and moderate benefit of lecanemab, a humanized antibody through an anti-amyloid mechanism,showing slowed clinical decline(van Dyck et al.,2023). The recent positive results of anti-amyloid trials have brought back focus on the amyloid hypothesis through biochemical, genetic, and pharmacological approaches(Zhang, 2023).展开更多
Sleep quality in young adults is compromised. Instead of the recommended 7 hours, young adults’ schedule interruptions disturb sleep to a typical six and a half hours, with common disturbances in falling asleep and s...Sleep quality in young adults is compromised. Instead of the recommended 7 hours, young adults’ schedule interruptions disturb sleep to a typical six and a half hours, with common disturbances in falling asleep and staying asleep. Recent literature has identified an association between academic performance, negative mood state and low activity level in young adults with sleep disturbances. Young adulthood is a time for the installation of sleep health. Both individual and schedule impositions to the young adults’ sleep schedule are to be modified to obtain Sleep Health. Recent research has identified daytime light effects on sleep such as blue light from electronics as alerting and low level light for relaxation. The aim of this study was to identify sleep quality effects with varying light exposures. It was hypothesized that bright (>450 lux) light conditions would be considered focusing and low light (<220 lux) would be considered calming. We hypothesized that sleep quality would improve by 5% with the introduction of a calm light condition. Undergraduates from a small midwestern university were invited to participate in the study in exchange for a gift card. Six participants completed the study, two males, four females all between 21 - 24 years old. Both hypotheses were supported by qualitative analysis.展开更多
Purpose:The aim of the current study was to investigate the association of accelerometer-measured sleep duration and different intensities of physical activity(PA)with the risk of incident type 2 diabetes in a populat...Purpose:The aim of the current study was to investigate the association of accelerometer-measured sleep duration and different intensities of physical activity(PA)with the risk of incident type 2 diabetes in a population-based prospective cohort study.Methods:Altogether,88,000 participants(mean age=62.2±7.9 years,mean±SD)were included from the UK Biobank.Sleep duration(short:<6 h/day;normal:6-8 h/day;long:>8 h/day)and PA of different intensities were measured using a wrist-won accelerometer over a 7-day period between 2013 and 2015.PA was classified according to the median or World Health Organization-recommendation:total volume of PA(high,low),moderate-to-vigorous PA(MVPA)(recommended,not recommended),and light-intensity PA(high,low).Incidence of type 2diabetes was ascertained using hospital records or death registries.Results:During a median follow-up of 7.0 years,1615 incident type 2 diabetes cases were documented.Compared with normal sleep duration,short(hazard ratio(HR)=1.21,95%confidence interval(95%CI):1.03-1.41)but not long sleep duration(HR=1.01,95%CI:0.89-1.15)was associated with excessive type 2 diabetes risk.This increased risk among short sleepers seems to be protected against by PA.Compared with normal sleepers with high or recommended PA,short sleepers with low volume of PA(HR=1.81,95%CI:1.46-2.25),not recommended(below the World Health Organization-recommended level of)MVPA(HR=1.92,95%CI:1.55-2.36),or low light-intensity PA(HR=1.49,95%CI:1.13-1.90)had a higher risk of type 2 diabetes,while short sleepers with a high volume of PA(HR=1.14,95%CI:0.88-1.49),recommended MVPA(HR=1.02,95%CI:0.71-1.48),or high light-intensity PA(HR=1.14,95%CI:0.92-1.41)did not.Conclusion:Accelerometer-measured short but not long sleep duration was associated with a higher risk of incident type 2 diabetes.A higher level of PA,regardless of intensity,potentially ameliorates this excessive risk.展开更多
Obstructive sleep apnea-hypopnea syndrome(OSAHS)significantly impairs children's growth and cognition.This study aims to elucidate the pathophysiological mechanisms underlying OSAHS in children,with a particular f...Obstructive sleep apnea-hypopnea syndrome(OSAHS)significantly impairs children's growth and cognition.This study aims to elucidate the pathophysiological mechanisms underlying OSAHS in children,with a particular focus on the alterations in cortical information interaction during respiratory events.We analyzed sleep electroencephalography before,during,and after events,utilizing Symbolic Transfer Entropy(STE)for brain network construction and information flow assessment.The results showed a significant increase in STE after events in specific frequency bands during N2 and rapid eye movement(REM)stages,along with increased STE during N3 stage events.Moreover,a noteworthy rise in the information flow imbalance within and between hemispheres was found after events,displaying unique patterns in central sleep apnea and hypopnea.Importantly,some of these alterations were correlated with symptom severity.These findings highlight significant changes in brain region coordination and communication during respiratory events,offering novel insights into OSAHS pathophysiology in children.展开更多
In anticipation of the massive burden of neurodegenerative disease within super-aged societies, great efforts have been made to utilize neural stem and progenitor cells for regenerative medicine. The capacity of intri...In anticipation of the massive burden of neurodegenerative disease within super-aged societies, great efforts have been made to utilize neural stem and progenitor cells for regenerative medicine. The capacity of intrinsic neural stem and progenitor cells to regenerate damaged brain tissue remains unclear, due in part to the lack of knowledge about how these newly born neurons integrate into functional circuitry. As sizable integration of adult-born neurons naturally occurs in the dentate gyrus region of the hippocampus, clarifying the mechanisms of this process could provide insights for applying neural stem and progenitor cells in clinical settings. There is convincing evidence of functional correlations between adult-born neurons and memory consolidation and sleep; therefore, we describe some new advances that were left untouched in our recent review.展开更多
Sleep hygiene and knowledge about sleep basics is unknown in college student populations. The college student population have abbreviated sleep due to social schedules and busy academic schedules. A measurement of sle...Sleep hygiene and knowledge about sleep basics is unknown in college student populations. The college student population have abbreviated sleep due to social schedules and busy academic schedules. A measurement of sleep hygiene and knowledge about sleep in the college student population indicates that there are varying levels along with sleep knowledge. The objective of the study was to examine young adult sleep quality because of providing an educative intervention. A sleep class of one hour provided once a week for ten weeks was provided following the administration of a ten-item sleep survey. Following the sleep class, the sleep survey was read ministered. Measures of central tendency and non-parametric analysis of nominal data were conducted. The results indicated two of the five cohorts had statistically significant differences. Further, the measures of sleep quality differed, statistically, for two of the cohorts receiving the classroom instruction. This research finding indicates a continued need to educate college student populations about their sleep health.展开更多
Sleep apnea is a clinical condition characterized by cessation of breathing in the sleeper due to pharyngeal airway closure. The reduction in air exchange results in decreased cerebral blood circulation with consequen...Sleep apnea is a clinical condition characterized by cessation of breathing in the sleeper due to pharyngeal airway closure. The reduction in air exchange results in decreased cerebral blood circulation with consequential behavioral deficits cognitively and emotionally. Untreated sleep apnea is associated with chronic illnesses of depression, cardiovascular disorder, obesity and diabetes mellitus. Measured cognitive behavior before and following CPAP treatment demonstrates the cognitive deficit as the effectiveness of CPAP treatment. Emotional factors related to sleep apnea diagnosis and adherence to treatment are facilitated in patients with cognitive behavior therapy (CBT) interventions by sleep specialists. This is a brief review paper that presents findings about cognition and emotional factors related to sleep apnea. This is a brief review paper.展开更多
Obesity, sleep apnea, diabetes and cardiovascular diseases are some of the most common diseases encountered by the worldwide population, with high social and economic burdens. Significant emphasis has been placed on o...Obesity, sleep apnea, diabetes and cardiovascular diseases are some of the most common diseases encountered by the worldwide population, with high social and economic burdens. Significant emphasis has been placed on obtaining blood pressure, body mass index, and placing importance on screening for signs and symptoms pointing towards cardiovascular disease. Symptoms related to sleep, or screening for sleep apnea has been overlooked by cardiac, diabetic, pulmonary and general medicine clinics despite recommendations for screening by several societies. In recent years, there is mounting data where obesity and obstructive sleep apnea sit at the epicenter and its control can lead to improvement and prevention of diabetes and cardiovascular complications. This editorial raises questions as to why obstructive sleep apnea screening should be included as yet another vital sign during patient initial inpatient or outpatient visit.展开更多
An overview is presented of the literature dealing with sleep-like motility and concomitant neuronal activity patterns throughout the life cycle in vertebrates, ectothermic as well as endothermic. Spontaneous, periodi...An overview is presented of the literature dealing with sleep-like motility and concomitant neuronal activity patterns throughout the life cycle in vertebrates, ectothermic as well as endothermic. Spontaneous, periodically modulated, neurogenic bursts of non-purposive movements are a universal feature of larval and prenatal behavior, which in endothermic animals （i.e. birds and mammals） continue to occur periodically throughout life. Since the entire body musculature is involved in ever-shifting combinations, it is proposed that these spontaneously active periods be designated as ＇rapid-BODY-movement＇ （RBM） sleep. The term ＇rapid-EYE- movement （REM） sleep＇, characterized by attenuated muscle contractions and reduced tonus, can then be reserved for sleep at later stages of development. Mature stages of development in which sustained muscle atonia is combined with ＇paradoxical arousal＇ of cortical neuronal firing patterns indisputably represent the evolutionarily most recent aspect of REM sleep, but more research with ectothermic vertebrates, such as fish, amphibians and reptiles, is needed before it can be concluded （as many prematurely have） that RBM is absent in these species. Evidence suggests a link between RBM sleep in early development and the clinical condition known as ＇REM sleep behavior disorder （RBD）＇, which is characterized by the resurgence of periodic bouts of quasi-fetal motility that closely resemble RBM sleep. Early developmental neuromotor risk factors for RBD in humans also point to a relationship between RBM sleep and RBD.展开更多
Sleep is a complex process influenced by biological and environmental factors.Disturbances of sleep quantity and quality occur frequently in the critically ill and remain prevalent in survivors for at least 12 mo.Slee...Sleep is a complex process influenced by biological and environmental factors.Disturbances of sleep quantity and quality occur frequently in the critically ill and remain prevalent in survivors for at least 12 mo.Sleep disturbances are associated with adverse outcomes across multiple organ systems but are most strongly linked to delirium and cognitive impairment.This review will outline the predisposing and precipitating factors for sleep disturbance,categorised into patient,environmental and treatment-related factors.The objective and subjective methodologies used to quantify sleep during critical illness will be reviewed.While polysomnography remains the gold-standard,its use in the critical care setting still presents many barriers.Other methodologies are needed to better understand the pathophysiology,epidemiology and treatment of sleep disturbance in this population.Subjective outcome measures,including the Richards-Campbell Sleep Questionnaire,are still required for trials involving a greater number of patients and provide valuable insight into patients’experiences of disturbed sleep.Finally,sleep optimisation strategies are reviewed,including intervention bundles,ambient noise and light reduction,quiet time,and the use of ear plugs and eye masks.While drugs to improve sleep are frequently prescribed to patients in the ICU,evidence supporting their effectiveness is lacking.展开更多
AIM:To validate the sleep-disordered breathing components of a portable electrocardiography and hemodynamic monitor to be used for sleep apnea screening.METHODS:Sleep-disordered breathing(SDB) is associated with cardi...AIM:To validate the sleep-disordered breathing components of a portable electrocardiography and hemodynamic monitor to be used for sleep apnea screening.METHODS:Sleep-disordered breathing(SDB) is associated with cardiovascular disease.Patients with existing cardiovascular disease may have unrecognized SDB or may develop SDB while under the care of a cardiologist.A screening device for SDB,easy to use and appealing to cardiologists,would assist in referral of appropriate patients for full polysomnography(PSG).A cardiac and respiratory monitor(CPAM) was attached to patients undergoing PSG and an apnea/hypopnea index(AHI) generated.The CPAM device produced respiration rate,snoring rate,individual apnea/hypopnea events and an SDB severity score(SDBSS).In addition to AHI,an expert over-reader annotated individual breaths,snores and SDB breathing events to which the automated algorithms were compared.RESULTS:The test set consisted of data from 85 patients(age:50.5 ± 12.4 years).Of these,57 had a positive PSG defined as AHI ≥ 5.0(mean:30.0 ± 29.8,negative group mean:1.5 ± 1.2).The sensitivity and specificity of the SDBSS compared to AHI was 57.9% and 89.3%,respectively.The correlation of snoring rate by CPAM compared to the expert overreader was r = 0.58(mean error:1.52 snores/min),while the automated respiration rate had a correlation of r = 0.90(mean error:0.70 breaths/min).CONCLUSION:This performance assessment shows that CPAM can be a useful portable monitor for screening and follow-up of subjects for SDB.展开更多
PURPOSE: United Arab Emirates (UAE) is part of the GCC countries and ranks 18 on 2007 WHO list of the fattest countries with 68.3% of its citizens with an unhealthy weight. The WHO data in 2008 state that the prevalen...PURPOSE: United Arab Emirates (UAE) is part of the GCC countries and ranks 18 on 2007 WHO list of the fattest countries with 68.3% of its citizens with an unhealthy weight. The WHO data in 2008 state that the prevalence of overweight in UAE is 71%, while it is 61% in the UK, 54% in Germany, and 45% in France. The increasing overweight and obesity in the UAE are closely related to high social-economic development. Accordingly, the medical authority has observed that the rates of hypertension and diabetes mellitus type 2 appear to be one of the highest rates worldwide. We presume that the increase prevalence of obesity in the UAE would be linked to the increase in prevalence of obstructive sleep apnea syndrome (OSAS). The purpose of this study is to estimate the prevalence of symptoms and risk of OSAS in women followed up in the primary health care (PHC) setting in Dubai and the relationship between obesity and sleep apnea in females in the UAE. DESIGN: Prospective observational community-based survey. SETTING: 20 primary health centers in Dubai. PARTICI-PANTS: Consecutive female patients who were older than 14 years, regardless of the reason of their visit. METHODS: In this prospective survey, trained medical nurse administered the Berlin Questionnaire (which includes questions about self-reported snoring, witnessed apneas, daytime sleepiness, hypertension, and obesity) to a consecutive random sample of female patients in the age group older than 14 years, attending the PHC center in Dubai Health Authority, Dubai, UAE, from September 2011 to March 2012. Based on the questionnaire, individuals were classified into high-risk and low-risk groups for OSAS. RESULTS: Based on the responses and measurement of the Berlin Questionnaire of 704 female subjects studied, 137 respondents met the criteria for the high-risk scoring. This gives a prevalence rate of 19.5% while the remainders of the participants were classified as low risk. The overall mean age of the high risk for OSAS female respondents was 39.95 ± 11.73 years. The highest prevalence was noticed between age group 51 to 60 years. 70% of the high risk group patients had Body Mass Index (BMI) ≥30 kg/m2 and nearly 75% of the low risk group had BMI 2 and the Mean BMI was 33.59 ± 6.44 kg/m2. CONCLUSIONS: One in five women in Dubai, UAE is at high risk of having OSAS. Awareness by the primary care medical community about this disorder in females should be increased so that the patients would benefit from proper evaluation and treatment of OSAS.展开更多
BACKGROUND In the obese patient population,some patients have severe obstructive sleep apnea(OSA)with daytime hypoventilation.Such patients are generally identified on the basis of the presence or absence of daytime h...BACKGROUND In the obese patient population,some patients have severe obstructive sleep apnea(OSA)with daytime hypoventilation.Such patients are generally identified on the basis of the presence or absence of daytime hypercapnia,and the condition is called obesity hypoventilation syndrome.However,mechanisms for such daytime hypoventilation remain unclear.AIM To investigate metabolic syndrome and daytime hypercapnia association based on hypercapnia prevalence in obese OSA patients in a nested case-control study.METHODS Consecutive obese patients(body mass index≥30 kg/m2)who underwent polysomnography due to suspected OSA were included.Among them,patients with severe OSA(apnea hypopnea index≥30/h)were divided into two groups according to the presence or absence of hypercapnia during wakefulness(arterial partial pressure of carbon dioxide≥or<45 Torr,respectively).The characteristics and clinical features of these two groups were compared.RESULTS Among 97 eligible patients,25 patients(25.8%)had daytime hypercapnia.There were no significant differences in age,gender,body mass index,apnea-hypopnea index,and Epworth Sleepiness Scale scores between the two groups.However,patients with hypercapnia had a significantly lower arterial partial pressure of oxygen level(75.8±8.2 torr vs 79.9±8.7 torr,P=0.042)and higher arterial partial pressure of carbon dioxide level(46.6±2.5 torr vs 41.0±2.9 torr,P<0.001).Additionally,patients with hypercapnia were more likely to have metabolic syndrome(72.0%vs 48.6%,P=0.043)and a higher metabolic score(the number of satisfied criteria of metabolic syndrome).In multivariate logistic regression analysis,the presence of metabolic syndrome was associated with the presence of hypercapnia(OR=2.85,95%CI:1.04-7.84,P=0.042).CONCLUSION Among obese patients with severe OSA,26%of patients had hypercapnia during wakefulness.The presence of metabolic syndrome was independently correlated with the presence of daytime hypercapnia.展开更多
The purpose of this study was to assess factors associated with subjective sleep evaluation, chiefly excessive daytime sleepiness (EDS) in obstructive sleep apnea syndrome (OSAS) adult outpatients under continuous pos...The purpose of this study was to assess factors associated with subjective sleep evaluation, chiefly excessive daytime sleepiness (EDS) in obstructive sleep apnea syndrome (OSAS) adult outpatients under continuous positive airway pressure (CPAP) treatment. One thousand and forty-eight OSAS outpatients (mean age: 51.4% male: 90.5%) who were treated by CPAP were consecutively collected. Age, sex, CPAP compliance (CPAP usage as their device of nights with application-time of at least 4 hours per night objectively;%usage ≥ 4 h/d), and Japanese version of the Pittsburgh Sleep Quality Index (PSQI-J) of the patients showing EDS (Japanese version of the Epworth Sleepiness Scale;JESS ≥ 11) were compared cross-sectionally with those of the patients who did not show EDS (JESS < 11). Nineteen point two % of all patients showed EDS subjectively. Two hundred one patients were classified to an EDS(+) group and an 847 patients were classified to EDS(–) group. Age and global PSQI-J scores were significantly different between the two groups. Logistic regression showed that EDS was significantly associated with global PSQI-J scores, but not with age. Among PSQI-J components, overall sleep quality, duration of sleep, sleep disturbance, and day dysfunction due to sleepiness were significantly higher in the EDS(+) group. Especially, 19.4% of patient in the EDS(+) group reported actual sleep time during the past month to be less than 5 hours/day. Although functional relationship should be further evaluated, insufficient sleep is the main factor associated with EDS in the OSAS patients under CPAP treatment.展开更多
Introduction: Untreated sleep disorders can increase driver crash risk by up to 7 fold, and truck drivers have a variety of risk factors for sleep disorders. Measures currently used to identify drivers at risk depend ...Introduction: Untreated sleep disorders can increase driver crash risk by up to 7 fold, and truck drivers have a variety of risk factors for sleep disorders. Measures currently used to identify drivers at risk depend predominantly on the ability of the driver to identify and report themselves as sleepy. Methods: This case report presents a 54 year old long distance truck driver who participated in a case-control study, underwent at home breathing monitoring and was followed up with an in-depth interview. Results: Self-reported measures did not identify this driver as at risk of sleepiness or sleep apnea;yet he was subsequently diagnosed with severe sleep apnea using an at home monitor and polysomnography. Conclusions: Self-assessment of risk factors is insufficient as a screen for sleep apnea. General practitioners are in an ideal position to identify potential sleep apnea sufferers and can initiate the enquiry process that leads to diagnostic testing.展开更多
基金supported by grants from Major Project of Science and Technology of Guangxi Zhuang Autonomous Region,No.Guike-AA22096018(to JY)Guangxi Key Research and Development Program,No.AB22080053(to DD)+6 种基金Major Project of Science and Technology of Guangxi Zhuang Autonomous Region,No.Guike-AA23023004(to MZ)the National Natural Science Foundation of China,Nos.82260021(to MZ),82060315(to DD)the Natural Science Foundation of Guangxi Zhuang Autonomous Region,No.2021GXNSFBA220007(to GD)Clinical Research Center For Medical Imaging in Hunan Province,No.2020SK4001(to JL)Key Emergency Project of Pneumonia Epidemic of Novel Coronavirus Infection in Hunan Province,No.2020SK3006(to JL)Science and Technology Innovation Program of Hunan Province,No.2021RC4016(to JL)Key Project of the Natural Science Foundation of Hunan Province,No.2024JJ3041(to JL).
文摘Sleep disturbances are among the most prevalent neuropsychiatric symptoms in individuals who have recovered from severe acute respiratory syndrome coronavirus 2 infections.Previous studies have demonstrated abnormal brain structures in patients with sleep disturbances who have recovered from coronavirus disease 2019(COVID-19).However,neuroimaging studies on sleep disturbances caused by COVID-19 are scarce,and existing studies have primarily focused on the long-term effects of the virus,with minimal acute phase data.As a result,little is known about the pathophysiology of sleep disturbances in the acute phase of COVID-19.To address this issue,we designed a longitudinal study to investigate whether alterations in brain structure occur during the acute phase of infection,and verified the results using 3-month follow-up data.A total of 26 COVID-19 patients with sleep disturbances(aged 51.5±13.57 years,8 women and 18 men),27 COVID-19 patients without sleep disturbances(aged 47.33±15.98 years,9 women and 18 men),and 31 age-and gender-matched healthy controls(aged 49.19±17.51 years,9 women and 22 men)were included in this study.Eleven COVID-19 patients with sleep disturbances were included in a longitudinal analysis.We found that COVID-19 patients with sleep disturbances exhibited brain structural changes in almost all brain lobes.The cortical thicknesses of the left pars opercularis and left precuneus were significantly negatively correlated with Pittsburgh Sleep Quality Index scores.Additionally,we observed changes in the volume of the hippocampus and its subfield regions in COVID-19 patients compared with the healthy controls.The 3-month follow-up data revealed indices of altered cerebral structure(cortical thickness,cortical grey matter volume,and cortical surface area)in the frontal-parietal cortex compared with the baseline in COVID-19 patients with sleep disturbances.Our findings indicate that the sleep disturbances patients had altered morphology in the cortical and hippocampal structures during the acute phase of infection and persistent changes in cortical regions at 3 months post-infection.These data improve our understanding of the pathophysiology of sleep disturbances caused by COVID-19.
文摘Dear Editor,Sleep plays a vital role in physical health,influencing chronic diseases,memory,and overall quality of life[1,2].In recent years,the relationship between sleep health and physical activity has gained attention,with a particular focus on how daily step count affects various sleep metrics.
文摘BACKGROUND Mild cognitive impairment(MCI)has a high risk of progression to Alzheimer’s disease.The disease is often accompanied by sleep disorders,and whether sleep disorders have an effect on brain function in patients with MCI is unclear.AIM To explore the near-infrared brain function characteristics of MCI with sleep disorders.METHODS A total of 120 patients with MCI(MCI group)and 50 healthy subjects(control group)were selected.All subjects underwent the functional near-infrared spec-troscopy test.Collect baseline data,Mini-Mental State Examination,Montreal Cognitive Assessment scale,fatigue severity scale(FSS)score,sleep parameter,and oxyhemoglobin(Oxy-Hb)concentration and peak time of functional near-infrared spectroscopy test during the task period.The relationship between Oxy-RESULTS Compared with the control group,the FSS score of the MCI group was higher(t=11.310),and the scores of Pittsburgh sleep quality index,sleep time,sleep efficiency,nocturnal sleep disturbance,and daytime dysfunction were higher(Z=-10.518,-10.368,-9.035,-10.661,-10.088).Subjective sleep quality and total sleep time scores were lower(Z=-11.592,-9.924).The sleep efficiency of the MCI group was lower,and the awakening frequency,rem sleep latency period,total sleep time,and oxygen desaturation index were higher(t=5.969,5.829,2.887,3.003,5.937).The Oxy-Hb concentration at T0,T1,and T2 in the MCI group was lower(t=14.940,11.280,5.721),and the peak time was higher(t=18.800,13.350,9.827).In MCI patients,the concentration of Oxy-Hb during T0 was negatively correlated with the scores of Pittsburgh sleep quality index,sleep time,total sleep time,and sleep efficiency(r=-0.611,-0.388,-0.563,-0.356).It was positively correlated with sleep efficiency and total sleep time(r=0.754,0.650),and negatively correlated with oxygen desaturation index(r=-0.561)and FSS score(r=-0.526).All comparisons were P<0.05.CONCLUSION Patients with MCI and sleep disorders have lower near-infrared brain function than normal people,which is related to sleep quality.Clinically,a comprehensive assessment of the near-infrared brain function of patients should be carried out to guide targeted treatment and improve curative effect.
基金supported by the National Key R&D Pro-gram of China(No.2021YFC2501500)the National Natural Science Foundation of China(Nos.82271525 and 82071488)the Nanfang Hospital Clinical Research Project of Southern Medical University(No.2021CR009),China。
文摘Despite that sleep disturbance and poor neurocognitive performance are common complaints among coronavirus disease 2019(COVID-19)survivors,few studies have focused on the effect of post-COVID-19 sleep disturbance(PCSD)on cognitive function.This study aimed to identify the impact of PCSD on neurocognitive function and explore the associated risk factors for the worsening of this condition.This cross-sectional study was conducted via the web-based assessment in Chinese mainland.Neurocognitive function was evaluated by the modified online Integrated Cognitive Assessment(ICA)and the Number Ordering Test(NOT).Propensity score matching(PSM)was utilized to match the confounding factors between individuals with and without PCSD.Univariate analyses were performed to evaluate the effect of PCSD on neurocognitive function.The risk factors associated with worsened neurocognitive performance in PCSD individuals were explored using binary logistic regression.A total of 8692 individuals with COVID-19 diagnosis were selected for this study.Nearly half(48.80%)of the COVID-19 survivors reported sleep disturbance.After matching by PSM,a total of 3977 pairs(7954 individuals in total)were obtained.Univariate analyses revealed that PCSD was related to worse ICA and NOT performance(P<0.05).Underlying disease,upper respiratory infection,loss of smell or taste,severe pneumonia,and self-reported cognitive complaints were associated with worsened neurocognitive performance among PCSD individuals(P<0.05).Furthermore,aging,ethnicity(minority),and lower education level were found to be independent risk factors for worsened neurocognitive performance in PCSD individuals(P<0.05).PCSD was related to impaired neurocognitive performance.Therefore,appropriate prevention and intervention measures should be taken to minimize or prevent PCSD and eliminate its potential adverse effect on neurocognitive function.
基金supported by This work was supported by the Ministry of Science and Technology of the People’s Republic of China(STI2030-Major Projects2021ZD0201900)。
文摘Objective This study examines the sequential mediating roles of body pain and self-reported health in the association between sleep duration and self-reported life satisfaction among elderly Chinese adults.Methods Data from the fifth wave of the China Health and Retirement Longitudinal Survey(CHARLS)were used to analyse the relationships between sleep duration and body pain,self-reported health,and life satisfaction through logistic regression and Restricted Cubic Spline(RCS)analyses.The sequential mediation effects of body pain and self-reported health status were examined via chain mediation analysis.Results Logistic regression analysis showed that sleeping fewer than 6 hours or 6-7 hours was linked to higher risks of body pain,poor health,and dissatisfaction with life compared to sleeping 7-8 hours(all P<0.05).Additionally,those sleeping more than 9 hours also had increased risks of poor health and dissatisfaction with life compared to those sleeping 7-8 hours(all P<0.05).Chain mediation analysis showed that body pain and self-reported health status sequentially mediated 46.15%of the association between sleep duration and life satisfaction.Conclusion Body pain and self-reported health may shape the relationship between sleep duration and life satisfaction in elderly Chinese adults.
基金supported by the Massachusetts General Hospital Scientific Projects to Accelerate Research and Collaboration (SPARC) awardCure Alzheimer’s Fund (to CZ)the National Institutes of Health (NIH),including R01NS102190,RF1NS120947,and R01HL161253 (to MBW),RF1NS120947 (to RJT)。
文摘Introduction:Alzheimer 's disease(AD) is a common neurodegenerative disorder and the primary cause of dementia. Considerable evidence supports the “amyloid hypothesis,” stating that the pathogenesis of AD is primarily caused by the deposition of amyloid-β(Aβ), which drives tau phosphorylation, neuroinflammation, and neurodegeneration in the brain. The amyloid hypothesis is strengthened by the significant and moderate benefit of lecanemab, a humanized antibody through an anti-amyloid mechanism,showing slowed clinical decline(van Dyck et al.,2023). The recent positive results of anti-amyloid trials have brought back focus on the amyloid hypothesis through biochemical, genetic, and pharmacological approaches(Zhang, 2023).
文摘Sleep quality in young adults is compromised. Instead of the recommended 7 hours, young adults’ schedule interruptions disturb sleep to a typical six and a half hours, with common disturbances in falling asleep and staying asleep. Recent literature has identified an association between academic performance, negative mood state and low activity level in young adults with sleep disturbances. Young adulthood is a time for the installation of sleep health. Both individual and schedule impositions to the young adults’ sleep schedule are to be modified to obtain Sleep Health. Recent research has identified daytime light effects on sleep such as blue light from electronics as alerting and low level light for relaxation. The aim of this study was to identify sleep quality effects with varying light exposures. It was hypothesized that bright (>450 lux) light conditions would be considered focusing and low light (<220 lux) would be considered calming. We hypothesized that sleep quality would improve by 5% with the introduction of a calm light condition. Undergraduates from a small midwestern university were invited to participate in the study in exchange for a gift card. Six participants completed the study, two males, four females all between 21 - 24 years old. Both hypotheses were supported by qualitative analysis.
基金supported by the National Key R&D Program of China(2021YFC2501500)National Natural Science Foundation of China(82171476)。
文摘Purpose:The aim of the current study was to investigate the association of accelerometer-measured sleep duration and different intensities of physical activity(PA)with the risk of incident type 2 diabetes in a population-based prospective cohort study.Methods:Altogether,88,000 participants(mean age=62.2±7.9 years,mean±SD)were included from the UK Biobank.Sleep duration(short:<6 h/day;normal:6-8 h/day;long:>8 h/day)and PA of different intensities were measured using a wrist-won accelerometer over a 7-day period between 2013 and 2015.PA was classified according to the median or World Health Organization-recommendation:total volume of PA(high,low),moderate-to-vigorous PA(MVPA)(recommended,not recommended),and light-intensity PA(high,low).Incidence of type 2diabetes was ascertained using hospital records or death registries.Results:During a median follow-up of 7.0 years,1615 incident type 2 diabetes cases were documented.Compared with normal sleep duration,short(hazard ratio(HR)=1.21,95%confidence interval(95%CI):1.03-1.41)but not long sleep duration(HR=1.01,95%CI:0.89-1.15)was associated with excessive type 2 diabetes risk.This increased risk among short sleepers seems to be protected against by PA.Compared with normal sleepers with high or recommended PA,short sleepers with low volume of PA(HR=1.81,95%CI:1.46-2.25),not recommended(below the World Health Organization-recommended level of)MVPA(HR=1.92,95%CI:1.55-2.36),or low light-intensity PA(HR=1.49,95%CI:1.13-1.90)had a higher risk of type 2 diabetes,while short sleepers with a high volume of PA(HR=1.14,95%CI:0.88-1.49),recommended MVPA(HR=1.02,95%CI:0.71-1.48),or high light-intensity PA(HR=1.14,95%CI:0.92-1.41)did not.Conclusion:Accelerometer-measured short but not long sleep duration was associated with a higher risk of incident type 2 diabetes.A higher level of PA,regardless of intensity,potentially ameliorates this excessive risk.
基金supported by the National Natural Science Foundation of China (82001919)the Guangdong Basic and Applied Basic Research Foundation (2022A1515010050)+2 种基金the China Postdoctoral Science Foundation (2022M711219)the Key Realm R&D Program of Guangdong Province (2019B03035001)the Foundation of Guangdong Provincial Key Laboratory of Sensor Technology and Biomedical Instruments (2020B1212060077).
文摘Obstructive sleep apnea-hypopnea syndrome(OSAHS)significantly impairs children's growth and cognition.This study aims to elucidate the pathophysiological mechanisms underlying OSAHS in children,with a particular focus on the alterations in cortical information interaction during respiratory events.We analyzed sleep electroencephalography before,during,and after events,utilizing Symbolic Transfer Entropy(STE)for brain network construction and information flow assessment.The results showed a significant increase in STE after events in specific frequency bands during N2 and rapid eye movement(REM)stages,along with increased STE during N3 stage events.Moreover,a noteworthy rise in the information flow imbalance within and between hemispheres was found after events,displaying unique patterns in central sleep apnea and hypopnea.Importantly,some of these alterations were correlated with symptom severity.These findings highlight significant changes in brain region coordination and communication during respiratory events,offering novel insights into OSAHS pathophysiology in children.
基金partially supported by the MEXT World Premier International Research Center Initiative,CREST JST,MEXT KAKENHI for Scientific Research on Innovative Areas "Microendophenotype"(25116530)and "Memory Dynamism"(26115502)JSPS KAKENHI Grants(16K18359,15F15408)+12 种基金Research Foundation for Opto-Science and TechnologyKato Memorial Bioscience FoundationJapan Foundation for Applied EnzymologyUehara Memorial Foundation2016 Inamori Research Grants ProgramIchiro Kanehara Foundation for the Promotion of Medical Sciences and Medical CareLife Science Foundation of JapanKowa Life Science Foundation Research GrantGSK Japan Research GrantKANAE Foundation for the Promotion of Medical ScienceShimadzu Foundation for the Promotion of Science and TechnologyTakeda Science Foundation to MSThe Tokyo Biochemical Research Foundation to SS
文摘In anticipation of the massive burden of neurodegenerative disease within super-aged societies, great efforts have been made to utilize neural stem and progenitor cells for regenerative medicine. The capacity of intrinsic neural stem and progenitor cells to regenerate damaged brain tissue remains unclear, due in part to the lack of knowledge about how these newly born neurons integrate into functional circuitry. As sizable integration of adult-born neurons naturally occurs in the dentate gyrus region of the hippocampus, clarifying the mechanisms of this process could provide insights for applying neural stem and progenitor cells in clinical settings. There is convincing evidence of functional correlations between adult-born neurons and memory consolidation and sleep; therefore, we describe some new advances that were left untouched in our recent review.
文摘Sleep hygiene and knowledge about sleep basics is unknown in college student populations. The college student population have abbreviated sleep due to social schedules and busy academic schedules. A measurement of sleep hygiene and knowledge about sleep in the college student population indicates that there are varying levels along with sleep knowledge. The objective of the study was to examine young adult sleep quality because of providing an educative intervention. A sleep class of one hour provided once a week for ten weeks was provided following the administration of a ten-item sleep survey. Following the sleep class, the sleep survey was read ministered. Measures of central tendency and non-parametric analysis of nominal data were conducted. The results indicated two of the five cohorts had statistically significant differences. Further, the measures of sleep quality differed, statistically, for two of the cohorts receiving the classroom instruction. This research finding indicates a continued need to educate college student populations about their sleep health.
文摘Sleep apnea is a clinical condition characterized by cessation of breathing in the sleeper due to pharyngeal airway closure. The reduction in air exchange results in decreased cerebral blood circulation with consequential behavioral deficits cognitively and emotionally. Untreated sleep apnea is associated with chronic illnesses of depression, cardiovascular disorder, obesity and diabetes mellitus. Measured cognitive behavior before and following CPAP treatment demonstrates the cognitive deficit as the effectiveness of CPAP treatment. Emotional factors related to sleep apnea diagnosis and adherence to treatment are facilitated in patients with cognitive behavior therapy (CBT) interventions by sleep specialists. This is a brief review paper that presents findings about cognition and emotional factors related to sleep apnea. This is a brief review paper.
文摘Obesity, sleep apnea, diabetes and cardiovascular diseases are some of the most common diseases encountered by the worldwide population, with high social and economic burdens. Significant emphasis has been placed on obtaining blood pressure, body mass index, and placing importance on screening for signs and symptoms pointing towards cardiovascular disease. Symptoms related to sleep, or screening for sleep apnea has been overlooked by cardiac, diabetic, pulmonary and general medicine clinics despite recommendations for screening by several societies. In recent years, there is mounting data where obesity and obstructive sleep apnea sit at the epicenter and its control can lead to improvement and prevention of diabetes and cardiovascular complications. This editorial raises questions as to why obstructive sleep apnea screening should be included as yet another vital sign during patient initial inpatient or outpatient visit.
文摘An overview is presented of the literature dealing with sleep-like motility and concomitant neuronal activity patterns throughout the life cycle in vertebrates, ectothermic as well as endothermic. Spontaneous, periodically modulated, neurogenic bursts of non-purposive movements are a universal feature of larval and prenatal behavior, which in endothermic animals （i.e. birds and mammals） continue to occur periodically throughout life. Since the entire body musculature is involved in ever-shifting combinations, it is proposed that these spontaneously active periods be designated as ＇rapid-BODY-movement＇ （RBM） sleep. The term ＇rapid-EYE- movement （REM） sleep＇, characterized by attenuated muscle contractions and reduced tonus, can then be reserved for sleep at later stages of development. Mature stages of development in which sustained muscle atonia is combined with ＇paradoxical arousal＇ of cortical neuronal firing patterns indisputably represent the evolutionarily most recent aspect of REM sleep, but more research with ectothermic vertebrates, such as fish, amphibians and reptiles, is needed before it can be concluded （as many prematurely have） that RBM is absent in these species. Evidence suggests a link between RBM sleep in early development and the clinical condition known as ＇REM sleep behavior disorder （RBD）＇, which is characterized by the resurgence of periodic bouts of quasi-fetal motility that closely resemble RBM sleep. Early developmental neuromotor risk factors for RBD in humans also point to a relationship between RBM sleep and RBD.
基金supported through an Australian Government Research Training Program Scholarship
文摘Sleep is a complex process influenced by biological and environmental factors.Disturbances of sleep quantity and quality occur frequently in the critically ill and remain prevalent in survivors for at least 12 mo.Sleep disturbances are associated with adverse outcomes across multiple organ systems but are most strongly linked to delirium and cognitive impairment.This review will outline the predisposing and precipitating factors for sleep disturbance,categorised into patient,environmental and treatment-related factors.The objective and subjective methodologies used to quantify sleep during critical illness will be reviewed.While polysomnography remains the gold-standard,its use in the critical care setting still presents many barriers.Other methodologies are needed to better understand the pathophysiology,epidemiology and treatment of sleep disturbance in this population.Subjective outcome measures,including the Richards-Campbell Sleep Questionnaire,are still required for trials involving a greater number of patients and provide valuable insight into patients’experiences of disturbed sleep.Finally,sleep optimisation strategies are reviewed,including intervention bundles,ambient noise and light reduction,quiet time,and the use of ear plugs and eye masks.While drugs to improve sleep are frequently prescribed to patients in the ICU,evidence supporting their effectiveness is lacking.
基金Supported by An equipment grant from Inovise Medical,Inc.,Beaverton OR,United States,for clinical data collection
文摘AIM:To validate the sleep-disordered breathing components of a portable electrocardiography and hemodynamic monitor to be used for sleep apnea screening.METHODS:Sleep-disordered breathing(SDB) is associated with cardiovascular disease.Patients with existing cardiovascular disease may have unrecognized SDB or may develop SDB while under the care of a cardiologist.A screening device for SDB,easy to use and appealing to cardiologists,would assist in referral of appropriate patients for full polysomnography(PSG).A cardiac and respiratory monitor(CPAM) was attached to patients undergoing PSG and an apnea/hypopnea index(AHI) generated.The CPAM device produced respiration rate,snoring rate,individual apnea/hypopnea events and an SDB severity score(SDBSS).In addition to AHI,an expert over-reader annotated individual breaths,snores and SDB breathing events to which the automated algorithms were compared.RESULTS:The test set consisted of data from 85 patients(age:50.5 ± 12.4 years).Of these,57 had a positive PSG defined as AHI ≥ 5.0(mean:30.0 ± 29.8,negative group mean:1.5 ± 1.2).The sensitivity and specificity of the SDBSS compared to AHI was 57.9% and 89.3%,respectively.The correlation of snoring rate by CPAM compared to the expert overreader was r = 0.58(mean error:1.52 snores/min),while the automated respiration rate had a correlation of r = 0.90(mean error:0.70 breaths/min).CONCLUSION:This performance assessment shows that CPAM can be a useful portable monitor for screening and follow-up of subjects for SDB.
文摘PURPOSE: United Arab Emirates (UAE) is part of the GCC countries and ranks 18 on 2007 WHO list of the fattest countries with 68.3% of its citizens with an unhealthy weight. The WHO data in 2008 state that the prevalence of overweight in UAE is 71%, while it is 61% in the UK, 54% in Germany, and 45% in France. The increasing overweight and obesity in the UAE are closely related to high social-economic development. Accordingly, the medical authority has observed that the rates of hypertension and diabetes mellitus type 2 appear to be one of the highest rates worldwide. We presume that the increase prevalence of obesity in the UAE would be linked to the increase in prevalence of obstructive sleep apnea syndrome (OSAS). The purpose of this study is to estimate the prevalence of symptoms and risk of OSAS in women followed up in the primary health care (PHC) setting in Dubai and the relationship between obesity and sleep apnea in females in the UAE. DESIGN: Prospective observational community-based survey. SETTING: 20 primary health centers in Dubai. PARTICI-PANTS: Consecutive female patients who were older than 14 years, regardless of the reason of their visit. METHODS: In this prospective survey, trained medical nurse administered the Berlin Questionnaire (which includes questions about self-reported snoring, witnessed apneas, daytime sleepiness, hypertension, and obesity) to a consecutive random sample of female patients in the age group older than 14 years, attending the PHC center in Dubai Health Authority, Dubai, UAE, from September 2011 to March 2012. Based on the questionnaire, individuals were classified into high-risk and low-risk groups for OSAS. RESULTS: Based on the responses and measurement of the Berlin Questionnaire of 704 female subjects studied, 137 respondents met the criteria for the high-risk scoring. This gives a prevalence rate of 19.5% while the remainders of the participants were classified as low risk. The overall mean age of the high risk for OSAS female respondents was 39.95 ± 11.73 years. The highest prevalence was noticed between age group 51 to 60 years. 70% of the high risk group patients had Body Mass Index (BMI) ≥30 kg/m2 and nearly 75% of the low risk group had BMI 2 and the Mean BMI was 33.59 ± 6.44 kg/m2. CONCLUSIONS: One in five women in Dubai, UAE is at high risk of having OSAS. Awareness by the primary care medical community about this disorder in females should be increased so that the patients would benefit from proper evaluation and treatment of OSAS.
文摘BACKGROUND In the obese patient population,some patients have severe obstructive sleep apnea(OSA)with daytime hypoventilation.Such patients are generally identified on the basis of the presence or absence of daytime hypercapnia,and the condition is called obesity hypoventilation syndrome.However,mechanisms for such daytime hypoventilation remain unclear.AIM To investigate metabolic syndrome and daytime hypercapnia association based on hypercapnia prevalence in obese OSA patients in a nested case-control study.METHODS Consecutive obese patients(body mass index≥30 kg/m2)who underwent polysomnography due to suspected OSA were included.Among them,patients with severe OSA(apnea hypopnea index≥30/h)were divided into two groups according to the presence or absence of hypercapnia during wakefulness(arterial partial pressure of carbon dioxide≥or<45 Torr,respectively).The characteristics and clinical features of these two groups were compared.RESULTS Among 97 eligible patients,25 patients(25.8%)had daytime hypercapnia.There were no significant differences in age,gender,body mass index,apnea-hypopnea index,and Epworth Sleepiness Scale scores between the two groups.However,patients with hypercapnia had a significantly lower arterial partial pressure of oxygen level(75.8±8.2 torr vs 79.9±8.7 torr,P=0.042)and higher arterial partial pressure of carbon dioxide level(46.6±2.5 torr vs 41.0±2.9 torr,P<0.001).Additionally,patients with hypercapnia were more likely to have metabolic syndrome(72.0%vs 48.6%,P=0.043)and a higher metabolic score(the number of satisfied criteria of metabolic syndrome).In multivariate logistic regression analysis,the presence of metabolic syndrome was associated with the presence of hypercapnia(OR=2.85,95%CI:1.04-7.84,P=0.042).CONCLUSION Among obese patients with severe OSA,26%of patients had hypercapnia during wakefulness.The presence of metabolic syndrome was independently correlated with the presence of daytime hypercapnia.
文摘The purpose of this study was to assess factors associated with subjective sleep evaluation, chiefly excessive daytime sleepiness (EDS) in obstructive sleep apnea syndrome (OSAS) adult outpatients under continuous positive airway pressure (CPAP) treatment. One thousand and forty-eight OSAS outpatients (mean age: 51.4% male: 90.5%) who were treated by CPAP were consecutively collected. Age, sex, CPAP compliance (CPAP usage as their device of nights with application-time of at least 4 hours per night objectively;%usage ≥ 4 h/d), and Japanese version of the Pittsburgh Sleep Quality Index (PSQI-J) of the patients showing EDS (Japanese version of the Epworth Sleepiness Scale;JESS ≥ 11) were compared cross-sectionally with those of the patients who did not show EDS (JESS < 11). Nineteen point two % of all patients showed EDS subjectively. Two hundred one patients were classified to an EDS(+) group and an 847 patients were classified to EDS(–) group. Age and global PSQI-J scores were significantly different between the two groups. Logistic regression showed that EDS was significantly associated with global PSQI-J scores, but not with age. Among PSQI-J components, overall sleep quality, duration of sleep, sleep disturbance, and day dysfunction due to sleepiness were significantly higher in the EDS(+) group. Especially, 19.4% of patient in the EDS(+) group reported actual sleep time during the past month to be less than 5 hours/day. Although functional relationship should be further evaluated, insufficient sleep is the main factor associated with EDS in the OSAS patients under CPAP treatment.
文摘Introduction: Untreated sleep disorders can increase driver crash risk by up to 7 fold, and truck drivers have a variety of risk factors for sleep disorders. Measures currently used to identify drivers at risk depend predominantly on the ability of the driver to identify and report themselves as sleepy. Methods: This case report presents a 54 year old long distance truck driver who participated in a case-control study, underwent at home breathing monitoring and was followed up with an in-depth interview. Results: Self-reported measures did not identify this driver as at risk of sleepiness or sleep apnea;yet he was subsequently diagnosed with severe sleep apnea using an at home monitor and polysomnography. Conclusions: Self-assessment of risk factors is insufficient as a screen for sleep apnea. General practitioners are in an ideal position to identify potential sleep apnea sufferers and can initiate the enquiry process that leads to diagnostic testing.
