Pub Date : 2023-10-01DOI: 10.1093/sleepadvances/zpad035.008
S He, Y Bin, P Cistulli, P de Chazal
Abstract Introduction Intermittent hypoxia is a key mechanism linking Obstructive Sleep Apnoea (OSA) to cardiovascular disease (CVD). Oximetry analysis could enhance understanding of which OSA phenotypes are associated with CVD risk. The hypoxic burden (HB) is a measure calculated from the oximetry signal that shows promise for predicting CVD mortality, but its calculation is complex. With a view to simplifying its calculation, we investigated three different baseline calculation methods and its impact on predicting CVD mortality for the HB algorithm. Methods Data from Sleep Heart Health Study (SHHS) with CVD mortality outcome and complete covariate information was used. We implemented the HB method of Azarbarzin et al 2018 ERJ. The three baseline methods included an event-based baseline (same as Azarbarzin et al 2018 ERJ), a record-based baseline, and a fixed baseline. The performance of each parameter in predicting CVD mortality was assessed using an adjusted Cox proportional hazard ratio (HR) analysis. Results The best performing method was the record-based baseline method which returned a fully adjusted model hazard ratio of 1.83 (95% CI: 1.03-3.27, p<0.05). The results for the event-based and record-based baseline methods were 1.60 (95% CI: 0.86-3.00, p=0.14) and 1.73 (95% CI: 0.93-3.22, p=0.08) respectively. Discussion HB with the record-based baseline was easier to calculate than the original event-based baseline method by Azarbarzin at al. and resulted in improved CVD mortality prediction performance. We believe that this method provides a step towards providing a novel parameter with easy calculation providing early risk stratification in cardiovascular patients.
间歇性缺氧是阻塞性睡眠呼吸暂停(OSA)与心血管疾病(CVD)相关的重要机制。血氧饱和度分析有助于了解哪些OSA表型与CVD风险相关。低氧负荷(HB)是一种由血氧测量信号计算出来的指标，有望预测心血管疾病的死亡率，但其计算比较复杂。为了简化其计算，我们研究了三种不同的基线计算方法及其对HB算法预测心血管疾病死亡率的影响。方法采用睡眠心脏健康研究(SHHS)的数据，包括CVD死亡结局和完整的协变量信息。我们实现了Azarbarzin et al 2018 ERJ的HB方法。三种基线方法包括基于事件的基线(与Azarbarzin et al . 2018 ERJ相同)、基于记录的基线和固定基线。采用调整后的Cox比例风险比(HR)分析评估各参数在预测心血管疾病死亡率方面的表现。结果以记录基线法为最佳方法，其校正后的模型风险比为1.83 (95% CI: 1.03-3.27, p<0.05)。事件基线法和记录基线法的结果分别为1.60 (95% CI: 0.86-3.00, p=0.14)和1.73 (95% CI: 0.93-3.22, p=0.08)。与Azarbarzin等人最初的基于事件的基线方法相比，基于记录基线的HB更容易计算，并导致CVD死亡率预测性能的提高。我们相信，这种方法为提供一个易于计算的新参数提供了一步，为心血管患者提供了早期风险分层。
{"title":"O008 Refining the Hypoxic Burden Algorithm by Investigating different Methods for Calculating the SpO2 Baseline","authors":"S He, Y Bin, P Cistulli, P de Chazal","doi":"10.1093/sleepadvances/zpad035.008","DOIUrl":"https://doi.org/10.1093/sleepadvances/zpad035.008","url":null,"abstract":"Abstract Introduction Intermittent hypoxia is a key mechanism linking Obstructive Sleep Apnoea (OSA) to cardiovascular disease (CVD). Oximetry analysis could enhance understanding of which OSA phenotypes are associated with CVD risk. The hypoxic burden (HB) is a measure calculated from the oximetry signal that shows promise for predicting CVD mortality, but its calculation is complex. With a view to simplifying its calculation, we investigated three different baseline calculation methods and its impact on predicting CVD mortality for the HB algorithm. Methods Data from Sleep Heart Health Study (SHHS) with CVD mortality outcome and complete covariate information was used. We implemented the HB method of Azarbarzin et al 2018 ERJ. The three baseline methods included an event-based baseline (same as Azarbarzin et al 2018 ERJ), a record-based baseline, and a fixed baseline. The performance of each parameter in predicting CVD mortality was assessed using an adjusted Cox proportional hazard ratio (HR) analysis. Results The best performing method was the record-based baseline method which returned a fully adjusted model hazard ratio of 1.83 (95% CI: 1.03-3.27, p&lt;0.05). The results for the event-based and record-based baseline methods were 1.60 (95% CI: 0.86-3.00, p=0.14) and 1.73 (95% CI: 0.93-3.22, p=0.08) respectively. Discussion HB with the record-based baseline was easier to calculate than the original event-based baseline method by Azarbarzin at al. and resulted in improved CVD mortality prediction performance. We believe that this method provides a step towards providing a novel parameter with easy calculation providing early risk stratification in cardiovascular patients.","PeriodicalId":21861,"journal":{"name":"SLEEP Advances","volume":"38 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136055117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-01DOI: 10.1093/sleepadvances/zpad035.088
E Toriola
Abstract Introduction An innovative service that was developed within a tertiary paediatric centre, involved the use of a home-based sleep study model of care (MOC) between March 2022 to September 2022. This MOC allowed low risk children to be able to undergo a sleep study earlier than, when compared to the traditional in-house sleep studies conducted within the hospital setting. Methods The MOC involved a sleep technician travelling to the patients’ home and then attaching sensors onto the child’s body. The at home sleep system used is a full, portable polysomnography system that gently simplifies the task of performing a sleep study while delivery secure and precise measurements from the comfort of the patient’s home. The system provides data collection via the use of electrocardiogram (ECG), electroencephalography (EEG), oximeter, plethsmography belts and facial electroculargraphs which are attached comfortably onto the patient’s body. An outpatient’s service run by Clinical Nurse Consultants then provided 24 hour support to families for troubleshooting overnight. Results A total of 49 home based sleep studies were performed during this period. Almost 90% of children tested had an abnormal sleep study result and 1 in 3 had moderate to severe findings. Eight studies (19%) were below the expected quality. This is comparable to in-hospital poor quality sleep study rates. Discussion The MOC reduced hospital admission for a diagnostic sleep study, provided quicker assessment and in the comfort of the child’s home.
{"title":"P003 Home-based sleep study paediatric model of care","authors":"E Toriola","doi":"10.1093/sleepadvances/zpad035.088","DOIUrl":"https://doi.org/10.1093/sleepadvances/zpad035.088","url":null,"abstract":"Abstract Introduction An innovative service that was developed within a tertiary paediatric centre, involved the use of a home-based sleep study model of care (MOC) between March 2022 to September 2022. This MOC allowed low risk children to be able to undergo a sleep study earlier than, when compared to the traditional in-house sleep studies conducted within the hospital setting. Methods The MOC involved a sleep technician travelling to the patients’ home and then attaching sensors onto the child’s body. The at home sleep system used is a full, portable polysomnography system that gently simplifies the task of performing a sleep study while delivery secure and precise measurements from the comfort of the patient’s home. The system provides data collection via the use of electrocardiogram (ECG), electroencephalography (EEG), oximeter, plethsmography belts and facial electroculargraphs which are attached comfortably onto the patient’s body. An outpatient’s service run by Clinical Nurse Consultants then provided 24 hour support to families for troubleshooting overnight. Results A total of 49 home based sleep studies were performed during this period. Almost 90% of children tested had an abnormal sleep study result and 1 in 3 had moderate to severe findings. Eight studies (19%) were below the expected quality. This is comparable to in-hospital poor quality sleep study rates. Discussion The MOC reduced hospital admission for a diagnostic sleep study, provided quicker assessment and in the comfort of the child’s home.","PeriodicalId":21861,"journal":{"name":"SLEEP Advances","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136055219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-01DOI: 10.1093/sleepadvances/zpad035.095
A O'Connor, V Saddi, G Thambipillay, A Teng
Abstract INTRODUCTION Volume assured pressure support (VAPS) allows the ventilator to deliver a constant pre-set tidal volume or alveolar ventilation by automatically adjusting the inspiratory pressures within a set range, providing targeted pressure support. Data on its use in children are limited. We describe a series of four children effectively and safely ventilated using VAPS mode through tracheostomy. METHODS Retrospective review of patient notes. PROGRESS TO DATE Four paediatric patients were identified in our cohort who were successfully and safely ventilated using the VAPS mode through tracheostomy. The patients were between 6-14 years of age inclusive, with four differing underlying disease processes – Prader-Willi syndrome, congenital central hypoventilation syndrome, Guillain-Barré syndrome and Moebius-type syndrome. INTENDED OUTCOME AND IMPACT Whilst there have been previous paediatric case reports and case series which have demonstrated efficacy of VAPS mode used non-invasively, the use of VAPS mode to provide effective and safe ventilation through tracheostomy in children has been described in only one recent case series. The advantages of its use over conventional bilevel positive airway pressure support include its ability to compensate for changes in tidal volume, which can occur with changes in lung compliance and during different stages of sleep. This case series highlights safe and effective use of VAPS mode in children with tracheostomy.
{"title":"P010 Delivery of volume assured pressure support (VAPS) through tracheostomy in paediatric patients","authors":"A O'Connor, V Saddi, G Thambipillay, A Teng","doi":"10.1093/sleepadvances/zpad035.095","DOIUrl":"https://doi.org/10.1093/sleepadvances/zpad035.095","url":null,"abstract":"Abstract INTRODUCTION Volume assured pressure support (VAPS) allows the ventilator to deliver a constant pre-set tidal volume or alveolar ventilation by automatically adjusting the inspiratory pressures within a set range, providing targeted pressure support. Data on its use in children are limited. We describe a series of four children effectively and safely ventilated using VAPS mode through tracheostomy. METHODS Retrospective review of patient notes. PROGRESS TO DATE Four paediatric patients were identified in our cohort who were successfully and safely ventilated using the VAPS mode through tracheostomy. The patients were between 6-14 years of age inclusive, with four differing underlying disease processes – Prader-Willi syndrome, congenital central hypoventilation syndrome, Guillain-Barré syndrome and Moebius-type syndrome. INTENDED OUTCOME AND IMPACT Whilst there have been previous paediatric case reports and case series which have demonstrated efficacy of VAPS mode used non-invasively, the use of VAPS mode to provide effective and safe ventilation through tracheostomy in children has been described in only one recent case series. The advantages of its use over conventional bilevel positive airway pressure support include its ability to compensate for changes in tidal volume, which can occur with changes in lung compliance and during different stages of sleep. This case series highlights safe and effective use of VAPS mode in children with tracheostomy.","PeriodicalId":21861,"journal":{"name":"SLEEP Advances","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136055118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-01DOI: 10.1093/sleepadvances/zpad035.079
M O'Reilly, S Mukherjee, C Chai Coetzer, J Mercer, S Ullah, G Naik, P Catcheside, A Walker
Abstract Introduction This study aims to evaluate the characteristics of patients with Narcolepsy Type 1 (NT1), Narcolepsy Type 2 (NT2), and Idiopathic Hypersomnolence (IH) along with diagnostic outcomes in patients referred for a multiple sleep latency test (MSLT) at an Australian hospital. Methods A retrospective audit was performed of all patients who completed an MSLT between January 2018 to January 2023. Results 431 participants (62.4% female; mean±SD age 40.2±16.4 years; BMI 28.6±7.4 kg/m²) who completed MSLTs were included. 95 participants (22%) had a positive MSLT of ≤ 8 minutes, of which 87% (n=83) had a prior night total sleep time on polysomnography of > 6 hours. Gender, age, and BMI did not vary significantly between participants with a mean sleep latency (MSL) ≤ 8 versus >8 minutes (p=0.9, p>0.9, p=0.1 0, respectively). Participants with an MSL ≤ 8 minutes had higher Epworth Sleepiness Scale scores 14.6 ± 5.1 vs 12.5 ± 5.0 (p < 0.001), with more sleep onset REM periods (SOMREPs) 0.82 ± 1.35 vs 0.14 ± 0.49 compared to those with MSL >8 minutes. Further data collection is in progress, but to date, diagnoses were available for 34 participants with MSL ≤ 8 minutes (6 NT1, 8 NT2, 8 IH, 12 Other [i.e., shiftwork disorder, sleep restriction, medication-induced]). Discussion This study seeks to estimate diagnostic frequency and characteristics of patients presenting for evaluation of hypersomnolence. The prevalence of MSL < 8 minutes (22.0%) is consistent with prior studies1,2. Analysis of diagnostic outcomes is pending further data collection in progress.
摘要:本研究旨在评估1型嗜睡症(NT1)、2型嗜睡症(NT2)和特发性嗜睡症(IH)患者的特征，以及在澳大利亚一家医院进行多次睡眠潜伏期试验(MSLT)的患者的诊断结果。方法对2018年1月至2023年1月期间完成MSLT的所有患者进行回顾性审计。结果431人，其中女性62.4%;平均±SD年龄40.2±16.4岁;BMI(28.6±7.4 kg/m²)完成MSLTs的患者纳入。95名参与者(22%)的MSLT阳性≤8分钟，其中87% (n=83)的多导睡眠图显示，他们之前的总睡眠时间为>6小时。性别、年龄和BMI在平均睡眠潜伏期(MSL)≤8和>8分钟的参与者之间没有显著差异(p=0.9， >0.9, p=0.1)。睡眠时间≤8分钟的受试者Epworth嗜睡量表得分更高(14.6±5.1 vs 12.5±5.0)。0.001)，与睡眠时间为8分钟的患者相比，睡眠开始期(somrep)(0.82±1.35 vs 0.14±0.49)更长。进一步的数据收集正在进行中，但迄今为止，34名MSL≤8分钟的参与者(6名NT1, 8名NT2, 8名IH, 12名其他[即轮班障碍，睡眠限制，药物引起的])可诊断。本研究旨在评估嗜睡患者的诊断频率和特征。MSL的患病率<8分钟(22.0%)与先前研究一致1,2。诊断结果的分析有待进一步的数据收集。
{"title":"O079 Investigating Hypersomnolence Disorders in South Australia: A Retrospective Audit of Multiple Sleep Latency tests","authors":"M O'Reilly, S Mukherjee, C Chai Coetzer, J Mercer, S Ullah, G Naik, P Catcheside, A Walker","doi":"10.1093/sleepadvances/zpad035.079","DOIUrl":"https://doi.org/10.1093/sleepadvances/zpad035.079","url":null,"abstract":"Abstract Introduction This study aims to evaluate the characteristics of patients with Narcolepsy Type 1 (NT1), Narcolepsy Type 2 (NT2), and Idiopathic Hypersomnolence (IH) along with diagnostic outcomes in patients referred for a multiple sleep latency test (MSLT) at an Australian hospital. Methods A retrospective audit was performed of all patients who completed an MSLT between January 2018 to January 2023. Results 431 participants (62.4% female; mean±SD age 40.2±16.4 years; BMI 28.6±7.4 kg/m²) who completed MSLTs were included. 95 participants (22%) had a positive MSLT of ≤ 8 minutes, of which 87% (n=83) had a prior night total sleep time on polysomnography of &gt; 6 hours. Gender, age, and BMI did not vary significantly between participants with a mean sleep latency (MSL) ≤ 8 versus &gt;8 minutes (p=0.9, p&gt;0.9, p=0.1 0, respectively). Participants with an MSL ≤ 8 minutes had higher Epworth Sleepiness Scale scores 14.6 ± 5.1 vs 12.5 ± 5.0 (p &lt; 0.001), with more sleep onset REM periods (SOMREPs) 0.82 ± 1.35 vs 0.14 ± 0.49 compared to those with MSL &gt;8 minutes. Further data collection is in progress, but to date, diagnoses were available for 34 participants with MSL ≤ 8 minutes (6 NT1, 8 NT2, 8 IH, 12 Other [i.e., shiftwork disorder, sleep restriction, medication-induced]). Discussion This study seeks to estimate diagnostic frequency and characteristics of patients presenting for evaluation of hypersomnolence. The prevalence of MSL &lt; 8 minutes (22.0%) is consistent with prior studies1,2. Analysis of diagnostic outcomes is pending further data collection in progress.","PeriodicalId":21861,"journal":{"name":"SLEEP Advances","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136055233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-01DOI: 10.1093/sleepadvances/zpad035.020
L Nisbet, G Nixon, M Davey
Abstract Introduction Poor sleep is frequently reported in children with neuromuscular diseases (NMD) or cerebral palsy (CP) however ventilation is often the clinical focus. Periodic limb movements (PLMs) are frequently underdiagnosed in the paediatric population (prevalence of 5-8% in clinic-referred studies) and occur in up to 33% of children with Down syndrome. We assessed the prevalence of PLMs in children with NMD or CP. Methods Retrospective review of the first polysomnogram with leg electromyography in children with NMD (including Duchenne muscular dystrophy, myotonic dystrophy, and spinal muscular atrophy) or CP between 2005-2022. Results Leg electromyography was available in 238 children (124 NMD, 114 CP) with consent. 72 (30%) were female with a median age 9y (range 1-18y), BMI z-score 0.4 (-3.5 to 2.7), RDI 3.5/h (0-100/h) and arousal index of 11.7/h (1.3-65.6/h). Median PLM index was 0 (range 0-33/h) with %PLM arousals 0 (0-74%). The prevalence of elevated PLMs (>5/h) was 9.7% and 10.5% in the NMD and CP groups respectively, with median PLM arousals of 8.5% and 4.5% respectively. There were no differences in age or sex between those with or without elevated PLMs (p>0.05). Discussion Elevated PLM index occurred at a higher prevalence in children with NMD and CP than reported in the general paediatric population, though at lower rates than in Down syndrome. It is important that PLMs are not overlooked as identification and treatment may help improve sleep outcomes in this population. Further research is required to understand the pathophysiology of PLMs specifically in this population.
{"title":"O020 Twitch in the Night: Periodic Limb Movements during Sleep in Children with Neuromuscular Disease or Cerebral Palsy","authors":"L Nisbet, G Nixon, M Davey","doi":"10.1093/sleepadvances/zpad035.020","DOIUrl":"https://doi.org/10.1093/sleepadvances/zpad035.020","url":null,"abstract":"Abstract Introduction Poor sleep is frequently reported in children with neuromuscular diseases (NMD) or cerebral palsy (CP) however ventilation is often the clinical focus. Periodic limb movements (PLMs) are frequently underdiagnosed in the paediatric population (prevalence of 5-8% in clinic-referred studies) and occur in up to 33% of children with Down syndrome. We assessed the prevalence of PLMs in children with NMD or CP. Methods Retrospective review of the first polysomnogram with leg electromyography in children with NMD (including Duchenne muscular dystrophy, myotonic dystrophy, and spinal muscular atrophy) or CP between 2005-2022. Results Leg electromyography was available in 238 children (124 NMD, 114 CP) with consent. 72 (30%) were female with a median age 9y (range 1-18y), BMI z-score 0.4 (-3.5 to 2.7), RDI 3.5/h (0-100/h) and arousal index of 11.7/h (1.3-65.6/h). Median PLM index was 0 (range 0-33/h) with %PLM arousals 0 (0-74%). The prevalence of elevated PLMs (&gt;5/h) was 9.7% and 10.5% in the NMD and CP groups respectively, with median PLM arousals of 8.5% and 4.5% respectively. There were no differences in age or sex between those with or without elevated PLMs (p&gt;0.05). Discussion Elevated PLM index occurred at a higher prevalence in children with NMD and CP than reported in the general paediatric population, though at lower rates than in Down syndrome. It is important that PLMs are not overlooked as identification and treatment may help improve sleep outcomes in this population. Further research is required to understand the pathophysiology of PLMs specifically in this population.","PeriodicalId":21861,"journal":{"name":"SLEEP Advances","volume":"179 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136054295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-01DOI: 10.1093/sleepadvances/zpad035.070
M Graco, W Ruehland, R Schembri, T Churchward, K Saravanan, N Sheers, D Berlowitz
Abstract Study Objectives Over 80% of people with tetraplegia have sleep disordered breathing, but whether this is predominantly obstructive or central is unclear. This study aimed to estimate the prevalence of central sleep apnoea (CSA) in tetraplegia and the contributions of central, obstructive and hypopnoea respiratory events to sleep disordered breathing summary indices in tetraplegia. Methods Research and clinical data from 606 individuals with tetraplegia and full overnight polysomnography were collated. The proportions of different respiratory event types were calculated; overall and for mild, moderate, and severe disease. The prevalence of Predominant CSA (central apnoea index 5 and more central than obstructive apnoeas) and Any CSA (central apnoea index 5) was estimated. Prevalence of sleep-related hypoventilation was estimated in a clinical sub-cohort. Results Respiratory events were primarily hypopnoeas (71%), followed by obstructive (23%), central (4%) and mixed apnoeas (2%). As severity increased, the relative contribution of hypopnoeas and central apnoeas decreased, while that of obstructive apnoeas increased. The prevalence of Predominant CSA and Any CSA were 4.3% (26/606) and 8.4% (51/606) respectively. Being male, on opiates and having a high tetraplegic spinal cord injury were associated with CSA. Sleep-related hypoventilation was identified in 26% (26/113) of the clinical sub-cohort. Conclusions This is the largest study to characterize sleep disordered breathing in tetraplegia. It provides strong evidence that obstructive sleep apnoea is the predominant sleep disordered breathing type; 9-18 times more prevalent than CSA. The prevalence of CSA was estimated to be 4-8%, significantly lower than previously reported.
{"title":"O070 Prevalence of central sleep apnoea in people with tetraplegic spinal cord injury: a retrospective analysis of research and clinical data","authors":"M Graco, W Ruehland, R Schembri, T Churchward, K Saravanan, N Sheers, D Berlowitz","doi":"10.1093/sleepadvances/zpad035.070","DOIUrl":"https://doi.org/10.1093/sleepadvances/zpad035.070","url":null,"abstract":"Abstract Study Objectives Over 80% of people with tetraplegia have sleep disordered breathing, but whether this is predominantly obstructive or central is unclear. This study aimed to estimate the prevalence of central sleep apnoea (CSA) in tetraplegia and the contributions of central, obstructive and hypopnoea respiratory events to sleep disordered breathing summary indices in tetraplegia. Methods Research and clinical data from 606 individuals with tetraplegia and full overnight polysomnography were collated. The proportions of different respiratory event types were calculated; overall and for mild, moderate, and severe disease. The prevalence of Predominant CSA (central apnoea index 5 and more central than obstructive apnoeas) and Any CSA (central apnoea index 5) was estimated. Prevalence of sleep-related hypoventilation was estimated in a clinical sub-cohort. Results Respiratory events were primarily hypopnoeas (71%), followed by obstructive (23%), central (4%) and mixed apnoeas (2%). As severity increased, the relative contribution of hypopnoeas and central apnoeas decreased, while that of obstructive apnoeas increased. The prevalence of Predominant CSA and Any CSA were 4.3% (26/606) and 8.4% (51/606) respectively. Being male, on opiates and having a high tetraplegic spinal cord injury were associated with CSA. Sleep-related hypoventilation was identified in 26% (26/113) of the clinical sub-cohort. Conclusions This is the largest study to characterize sleep disordered breathing in tetraplegia. It provides strong evidence that obstructive sleep apnoea is the predominant sleep disordered breathing type; 9-18 times more prevalent than CSA. The prevalence of CSA was estimated to be 4-8%, significantly lower than previously reported.","PeriodicalId":21861,"journal":{"name":"SLEEP Advances","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136054635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-01DOI: 10.1093/sleepadvances/zpad035.047
A Voggenreiter, K Rossa, S Smith, J Maravilla, C Broccatelli, J Pfeffer
Abstract Introduction Social media platforms such as Tik Tok have broadened and potentially democratised access to health information. The narratives and quality of information about sleep on TikTok has not been studied. We sought to understand sentiment towards sleep, the types of sleep problems represented by users, and the nature and content of advice about sleep provided on TikTok. Methods All videos associated with the keyword “sleep” were collected twice daily using the keyword search function of the Ensemble data TikTok API between 4th-17th November 2022 for Great Britain, Australia, New Zealand and the USA. 7,373 unique videos were examined. After screening, videos were coded to a customised sleep narrative-specific code set. 1,913 discrete sleep-related videos were labelled according to 33 unique categories and underwent computational sentiment analysis. Results Overall, sleep was framed more positively than negatively, particularly for sleep advice. Videos about sleep problems were typically framed positively through humour. The main sleep narratives represented included (1) problems with sleep quality, initiation or maintenance due to factors such as children, worries or use of electronic media, and (2) advice for improving sleep quality through the use of sleep-promoting soundscapes, advice on improving children’s sleep, and implementation of routines/habits to support sleep. Discussion Platforms such as Tik Tok provide opportunities to disseminate timely, engaging, and evidence-based information about sleep health to a wide community. However, they equally carry risks of mass distribution of false information that warrants broader oversight and critical examination.
Tik Tok等社交媒体平台扩大了健康信息的获取范围，并可能使其民主化。TikTok上关于睡眠的信息的叙述和质量尚未得到研究。我们试图了解用户对睡眠的看法、用户代表的睡眠问题类型，以及TikTok上提供的睡眠建议的性质和内容。方法在2022年11月4日至17日期间，使用Ensemble data TikTok API的关键字搜索功能，每天两次收集英国、澳大利亚、新西兰和美国与“睡眠”关键字相关的视频。审查了7373个独特的视频。筛选后，视频被编码到一个定制的睡眠叙事特定代码集。研究人员根据33个独特的类别对1913个独立的睡眠相关视频进行了标记，并进行了计算情感分析。结果:总的来说，睡眠的正面影响大于负面影响，尤其是在睡眠建议方面。关于睡眠问题的视频通常以幽默的方式积极地呈现。主要的睡眠叙述包括(1)由于儿童、担忧或使用电子媒体等因素导致的睡眠质量问题、开始或维持睡眠的问题;(2)通过使用促进睡眠的声音环境来改善睡眠质量的建议，改善儿童睡眠的建议，以及支持睡眠的常规/习惯的实施。Tik Tok等讨论平台提供了向广泛社区传播有关睡眠健康的及时、有吸引力和基于证据的信息的机会。然而，它们同样存在大量传播虚假信息的风险，需要更广泛的监督和严格的审查。
{"title":"O047 Representations of Sleep in Social Media: A Tik Tok Case Study","authors":"A Voggenreiter, K Rossa, S Smith, J Maravilla, C Broccatelli, J Pfeffer","doi":"10.1093/sleepadvances/zpad035.047","DOIUrl":"https://doi.org/10.1093/sleepadvances/zpad035.047","url":null,"abstract":"Abstract Introduction Social media platforms such as Tik Tok have broadened and potentially democratised access to health information. The narratives and quality of information about sleep on TikTok has not been studied. We sought to understand sentiment towards sleep, the types of sleep problems represented by users, and the nature and content of advice about sleep provided on TikTok. Methods All videos associated with the keyword “sleep” were collected twice daily using the keyword search function of the Ensemble data TikTok API between 4th-17th November 2022 for Great Britain, Australia, New Zealand and the USA. 7,373 unique videos were examined. After screening, videos were coded to a customised sleep narrative-specific code set. 1,913 discrete sleep-related videos were labelled according to 33 unique categories and underwent computational sentiment analysis. Results Overall, sleep was framed more positively than negatively, particularly for sleep advice. Videos about sleep problems were typically framed positively through humour. The main sleep narratives represented included (1) problems with sleep quality, initiation or maintenance due to factors such as children, worries or use of electronic media, and (2) advice for improving sleep quality through the use of sleep-promoting soundscapes, advice on improving children’s sleep, and implementation of routines/habits to support sleep. Discussion Platforms such as Tik Tok provide opportunities to disseminate timely, engaging, and evidence-based information about sleep health to a wide community. However, they equally carry risks of mass distribution of false information that warrants broader oversight and critical examination.","PeriodicalId":21861,"journal":{"name":"SLEEP Advances","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136054791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-01DOI: 10.1093/sleepadvances/zpad035.105
Z Zeng, M Schenker, A Jordan
Abstract Background Maladaptive emotional memory processing is thought to underpin intrusion symptoms experienced by individuals with post-traumatic stress disorder (PTSD). Curtailment of rapid eye movement sleep (REMS) impairs emotional memory consolidation (EMC) and is proposed to contribute to the development of PTSD. However, the effects of altered REMS quality remain less explored. The present study aims to investigate the potential ability of REM percentage, REM latency, and REMS fragmentation to predict EMC. Methods The study forms part of a larger study investigating the effects of suvorexant and temazepam on REMS and EMC. Healthy participants view a series of emotionally positive, negative and neutral images, undergo overnight polysomnography with a study drug or placebo, and are assessed for recognition 48 hours after viewing the images. REMS architecture metrics are derived from polysomnographic data. EMC is calculated based on signal detection theory (d′ = z(hit rate) − z(false alarm rate)). Results Data collection is ongoing with 11 participants’ data being collected. A one-way ANOVA reveals a main effect of valence, with positive and negative images being recognised better than the neutral (p(positive-neutral) = .039, p(negative-neutral) = .039). REMS parameters do not significantly predict EMC when accounting for image valence, possibly due to low statistical power. Discussion Given existing literature supporting the contribution of REMS on emotional memory processing, promoting high-quality REMS may help facilitate adaptive EMC. Further data is required to examine this effect.
{"title":"P020 Exploring the Roles of Individual Rapid Eye Movement Sleep Parameters in Emotional Memory Processing","authors":"Z Zeng, M Schenker, A Jordan","doi":"10.1093/sleepadvances/zpad035.105","DOIUrl":"https://doi.org/10.1093/sleepadvances/zpad035.105","url":null,"abstract":"Abstract Background Maladaptive emotional memory processing is thought to underpin intrusion symptoms experienced by individuals with post-traumatic stress disorder (PTSD). Curtailment of rapid eye movement sleep (REMS) impairs emotional memory consolidation (EMC) and is proposed to contribute to the development of PTSD. However, the effects of altered REMS quality remain less explored. The present study aims to investigate the potential ability of REM percentage, REM latency, and REMS fragmentation to predict EMC. Methods The study forms part of a larger study investigating the effects of suvorexant and temazepam on REMS and EMC. Healthy participants view a series of emotionally positive, negative and neutral images, undergo overnight polysomnography with a study drug or placebo, and are assessed for recognition 48 hours after viewing the images. REMS architecture metrics are derived from polysomnographic data. EMC is calculated based on signal detection theory (d′ = z(hit rate) − z(false alarm rate)). Results Data collection is ongoing with 11 participants’ data being collected. A one-way ANOVA reveals a main effect of valence, with positive and negative images being recognised better than the neutral (p(positive-neutral) = .039, p(negative-neutral) = .039). REMS parameters do not significantly predict EMC when accounting for image valence, possibly due to low statistical power. Discussion Given existing literature supporting the contribution of REMS on emotional memory processing, promoting high-quality REMS may help facilitate adaptive EMC. Further data is required to examine this effect.","PeriodicalId":21861,"journal":{"name":"SLEEP Advances","volume":"47 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136054882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-01DOI: 10.1093/sleepadvances/zpad035.094
L Walter, D Bhatnagar, M Ong, M Davey, G Nixon, R Horne
Abstract Background Children with Down syndrome (DS) have a higher predisposition to obstructive sleep apnoea (OSA) compared to typically developing (TD) children. Children with DS have more frequent dips <90% compared with TD children matched for age, sex and OSA severity. Intermittent hypoxia with repeated desaturations and resaturations is associated with cognitive impairment in children. New methods which calculate the time spent with SpO2 <90% have identified an association with cardiac dysfunction in adults with OSA. We aimed to determine if children with DS and OSA spent longer with SpO2 <90% during sleep compared with TD children. Methods 44 children with DS (3-19 y) and age, sex and OSA severity matched TD children underwent overnight polysomnography. Time spent with SpO2 <90% as a percentage of total sleep time (%TST) was calculated. SpO2 nadir when <90% was recorded. Results SpO2 fell <90% in 32 (73%) children with DS and 15 (34%) TD children. The %TST spent with SpO2 <90% was higher in the DS group (median [IQR] 0.029% [0.004, 0.114]) compared with the TD group (0.000% [0.000, 0.020]; p<0.001). There was no difference in SpO2 nadir between the groups (DS mean±sem 84%±1.1%; TD 85%±1.1) when the SpO2 fell <90%. Conclusion Twice as many children with DS experienced periods of oxygen desaturation below 90% as did TD children matched for age, sex and OSA severity. Although as a %TST, the time spent <90% was small, different physiologically-based metrics to characterise OSA severity and the consequences of recurrent hypoxia in children may be merited.
{"title":"P009 Time spent with SpO2 below 90% during Sleep is Greater in Children with Down syndrome and OSA than in Typically Developing Children","authors":"L Walter, D Bhatnagar, M Ong, M Davey, G Nixon, R Horne","doi":"10.1093/sleepadvances/zpad035.094","DOIUrl":"https://doi.org/10.1093/sleepadvances/zpad035.094","url":null,"abstract":"Abstract Background Children with Down syndrome (DS) have a higher predisposition to obstructive sleep apnoea (OSA) compared to typically developing (TD) children. Children with DS have more frequent dips &lt;90% compared with TD children matched for age, sex and OSA severity. Intermittent hypoxia with repeated desaturations and resaturations is associated with cognitive impairment in children. New methods which calculate the time spent with SpO2 &lt;90% have identified an association with cardiac dysfunction in adults with OSA. We aimed to determine if children with DS and OSA spent longer with SpO2 &lt;90% during sleep compared with TD children. Methods 44 children with DS (3-19 y) and age, sex and OSA severity matched TD children underwent overnight polysomnography. Time spent with SpO2 &lt;90% as a percentage of total sleep time (%TST) was calculated. SpO2 nadir when &lt;90% was recorded. Results SpO2 fell &lt;90% in 32 (73%) children with DS and 15 (34%) TD children. The %TST spent with SpO2 &lt;90% was higher in the DS group (median [IQR] 0.029% [0.004, 0.114]) compared with the TD group (0.000% [0.000, 0.020]; p&lt;0.001). There was no difference in SpO2 nadir between the groups (DS mean±sem 84%±1.1%; TD 85%±1.1) when the SpO2 fell &lt;90%. Conclusion Twice as many children with DS experienced periods of oxygen desaturation below 90% as did TD children matched for age, sex and OSA severity. Although as a %TST, the time spent &lt;90% was small, different physiologically-based metrics to characterise OSA severity and the consequences of recurrent hypoxia in children may be merited.","PeriodicalId":21861,"journal":{"name":"SLEEP Advances","volume":"68 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136055099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-01DOI: 10.1093/sleepadvances/zpad035.195
G Vincent, H Commins, P Owen, J Paterson, M Thomas, M Sprajcer, C Gupta, R Gibson, S Ferguson, A Reynolds
Abstract Introduction Carers who provide support for those living with a disability or long-term health conditions have been recognised as being at increased risk of negative health outcomes due to the demands of caregiving. In particular, carers are much more likely than their non-carer counterparts to experience poor sleep outcomes such as lower sleep quality and inadequate sleep duration. The aim of this study is to examine how nighttime awakenings, assistive technology use and help-seeking behaviours impact sleep quality among Australian adult carers. Methods A cross-sectional online survey was conducted with a sample of Australian carers aged 18 to 64 years. Participants were required to answer questions regarding their sleep, caregiving duties, night-time-awakenings and completed the 9-item self-report Pittsburgh Sleep Quality Index (PSQI). They also answered questions regarding their use of assistive technologies and help-seeking behaviours. Participants were eligible if they reported sleep time <7 h or dissatisfaction with their sleep. Results Participants (n=352) completed the online survey. Analyses of these data have just begun and will be presented in full at the conference. Conclusion The results of this study aim to extend current literature and provide valuable information in the formulation of sleep recommendations and interventions for Australian carers.
{"title":"P110 How do Night-time Awakenings, Assistive Technologies, and Help-seeking Behaviours Impact Australian Carers Sleep? A Cross-sectional Study","authors":"G Vincent, H Commins, P Owen, J Paterson, M Thomas, M Sprajcer, C Gupta, R Gibson, S Ferguson, A Reynolds","doi":"10.1093/sleepadvances/zpad035.195","DOIUrl":"https://doi.org/10.1093/sleepadvances/zpad035.195","url":null,"abstract":"Abstract Introduction Carers who provide support for those living with a disability or long-term health conditions have been recognised as being at increased risk of negative health outcomes due to the demands of caregiving. In particular, carers are much more likely than their non-carer counterparts to experience poor sleep outcomes such as lower sleep quality and inadequate sleep duration. The aim of this study is to examine how nighttime awakenings, assistive technology use and help-seeking behaviours impact sleep quality among Australian adult carers. Methods A cross-sectional online survey was conducted with a sample of Australian carers aged 18 to 64 years. Participants were required to answer questions regarding their sleep, caregiving duties, night-time-awakenings and completed the 9-item self-report Pittsburgh Sleep Quality Index (PSQI). They also answered questions regarding their use of assistive technologies and help-seeking behaviours. Participants were eligible if they reported sleep time &lt;7 h or dissatisfaction with their sleep. Results Participants (n=352) completed the online survey. Analyses of these data have just begun and will be presented in full at the conference. Conclusion The results of this study aim to extend current literature and provide valuable information in the formulation of sleep recommendations and interventions for Australian carers.","PeriodicalId":21861,"journal":{"name":"SLEEP Advances","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136055107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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