Pub Date : 2023-08-10DOI: 10.3389/frsle.2023.1225808
Maureen E. McQuillan, Ian C. Jones, Haneen F. Abu Mayyaleh, Shajna Khan, S. Honaker
Pediatric Obstructive Sleep Apnea (OSA) is associated with negative health outcomes, behavior problems, and poor academic performance when left untreated. Prior research has shown that children from racial and ethnic minority backgrounds and those living in lower socioeconomic status (SES) homes or neighborhoods have higher prevalence of OSA but lower likelihood of receiving evidence-based care for OSA. Disparities in pediatric OSA detection (e.g., timely assessment and diagnosis) likely contribute to this observed inequity in receiving treatment. A polysomnogram (PSG) is the gold standard for diagnosing OSA but completing PSG can be challenging. Study aims were to examine racial, ethnic, and SES differences in (1) OSA prevalence and severity and (2) OSA detection, specifically PSG completion rates, timing since referral, and age of diagnosis.Children (aged 1–18, N = 1,860, 56% male) were referred for PSG during a 6-month period. Participants' racial/ethnic background were as follows: 64.8% White non-Hispanic, 23.5% Black non-Hispanic, 9.4% White Hispanic, and 2.4% other. Children predominantly had Medicaid insurance (64.5%). SES was measured by insurance type and neighborhood SES using the Distressed Communities Index (DCI) for each participant's zip code (Economic Innovations Group; https://eig.org/dc). Covariates included child age and sex, BMI, premature birth status, and smoke exposure in the home.We replicated previous research by showing that children from minority racial/ethnic backgrounds and lower SES backgrounds had higher prevalence rates of OSA and worse disease severity. Across racial, ethnic, and socioeconomic backgrounds, only 31.6% of the children referred successfully completed PSG. Insurance coverage (Medicaid or private vs. self-pay), was an important factor in predicting earlier timing and better completion rates of PSG, which is essential for successful diagnosis and treatment of pediatric OSA.
{"title":"Health disparities in the detection and prevalence of pediatric obstructive sleep apnea","authors":"Maureen E. McQuillan, Ian C. Jones, Haneen F. Abu Mayyaleh, Shajna Khan, S. Honaker","doi":"10.3389/frsle.2023.1225808","DOIUrl":"https://doi.org/10.3389/frsle.2023.1225808","url":null,"abstract":"Pediatric Obstructive Sleep Apnea (OSA) is associated with negative health outcomes, behavior problems, and poor academic performance when left untreated. Prior research has shown that children from racial and ethnic minority backgrounds and those living in lower socioeconomic status (SES) homes or neighborhoods have higher prevalence of OSA but lower likelihood of receiving evidence-based care for OSA. Disparities in pediatric OSA detection (e.g., timely assessment and diagnosis) likely contribute to this observed inequity in receiving treatment. A polysomnogram (PSG) is the gold standard for diagnosing OSA but completing PSG can be challenging. Study aims were to examine racial, ethnic, and SES differences in (1) OSA prevalence and severity and (2) OSA detection, specifically PSG completion rates, timing since referral, and age of diagnosis.Children (aged 1–18, N = 1,860, 56% male) were referred for PSG during a 6-month period. Participants' racial/ethnic background were as follows: 64.8% White non-Hispanic, 23.5% Black non-Hispanic, 9.4% White Hispanic, and 2.4% other. Children predominantly had Medicaid insurance (64.5%). SES was measured by insurance type and neighborhood SES using the Distressed Communities Index (DCI) for each participant's zip code (Economic Innovations Group; https://eig.org/dc). Covariates included child age and sex, BMI, premature birth status, and smoke exposure in the home.We replicated previous research by showing that children from minority racial/ethnic backgrounds and lower SES backgrounds had higher prevalence rates of OSA and worse disease severity. Across racial, ethnic, and socioeconomic backgrounds, only 31.6% of the children referred successfully completed PSG. Insurance coverage (Medicaid or private vs. self-pay), was an important factor in predicting earlier timing and better completion rates of PSG, which is essential for successful diagnosis and treatment of pediatric OSA.","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78492827","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 : 2023-08-03DOI: 10.3389/frsle.2023.1212936
S. Mashaqi, Anas Rihawi, P. Rangan, K. Ho, Mateen Khokhar, Sonia Helmick, Y. Ashouri, D. Combs, Iman Ghaderi, S. Parthasarathy
We conducted this systematic review and meta-analysis (SRMA) to evaluate the impact of bariatric surgery on obstructive sleep apnea (OSA) as represented by the following polysomnography (PSG) parameters: apnea-hypopnea index (AHI), oxygen desaturation index (ODI), mean oxygen desaturation (mean SpO2), total sleep time spent with SpO2 < 90% (T-90), and the nadir of oxygen saturation (L SpO2).A comprehensive search of the literature was conducted in Ovid MEDLINE, Embase, and Scopus databases from inception to March 31, 2023. Only articles written in English were reviewed. The analysis of all outcomes was performed using a random-effects model. We included 30 studies (two randomized controlled trials and 28 observational studies) in the final quantitative synthesis with a total of 1,369 patients.We concluded that bariatric surgery (regardless of the type) was associated with reduction in AHI [MD 23.2 events/h (95%CI 19.7, 26.8)], ODI [MD 26.8 events/h (95%CI 21.6, 32.1)], mean SpO2 [MD−1.94% (95%CI −2.5, −1.4)], T-90 [MD 7.5min (95%CI 5.0, 10.0)], and L SpO2 [MD 9.0% (95%CI −11.8, −6.3)].Our SRMA results are updates to previously published results and continue to support the positive impact of bariatric surgery on OSA and sleep-related hypoxia.
{"title":"The impact of bariatric surgery on breathing-related polysomnography parameters—Updated systematic review and meta-analysis","authors":"S. Mashaqi, Anas Rihawi, P. Rangan, K. Ho, Mateen Khokhar, Sonia Helmick, Y. Ashouri, D. Combs, Iman Ghaderi, S. Parthasarathy","doi":"10.3389/frsle.2023.1212936","DOIUrl":"https://doi.org/10.3389/frsle.2023.1212936","url":null,"abstract":"We conducted this systematic review and meta-analysis (SRMA) to evaluate the impact of bariatric surgery on obstructive sleep apnea (OSA) as represented by the following polysomnography (PSG) parameters: apnea-hypopnea index (AHI), oxygen desaturation index (ODI), mean oxygen desaturation (mean SpO2), total sleep time spent with SpO2 < 90% (T-90), and the nadir of oxygen saturation (L SpO2).A comprehensive search of the literature was conducted in Ovid MEDLINE, Embase, and Scopus databases from inception to March 31, 2023. Only articles written in English were reviewed. The analysis of all outcomes was performed using a random-effects model. We included 30 studies (two randomized controlled trials and 28 observational studies) in the final quantitative synthesis with a total of 1,369 patients.We concluded that bariatric surgery (regardless of the type) was associated with reduction in AHI [MD 23.2 events/h (95%CI 19.7, 26.8)], ODI [MD 26.8 events/h (95%CI 21.6, 32.1)], mean SpO2 [MD−1.94% (95%CI −2.5, −1.4)], T-90 [MD 7.5min (95%CI 5.0, 10.0)], and L SpO2 [MD 9.0% (95%CI −11.8, −6.3)].Our SRMA results are updates to previously published results and continue to support the positive impact of bariatric surgery on OSA and sleep-related hypoxia.","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81041366","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 : 2023-07-26DOI: 10.3389/frsle.2023.1118384
T. Lajunen, E. Gaygısız, Wen Wang
Getting enough sleep is one of the essential lifestyle factors influencing health and well-being. However, there are considerable differences between countries in how much people sleep on average. The present study investigated how socio-economic factors, population variables, and cultural value dimensions are related to sleep duration in a sample of 52 countries.The study design was ecological, i.e., the aggregate values for each country were obtained, and their correlations to national average sleep duration were analysed. The sleep duration estimates were based on Sleep Cycle Application (Sleep Cycle AB, Gothenburg, Sweden) data. The socio-economic variables included the economic health of a country (GDP per capita), how well a country is governed (governance quality measured with WGI), and the economic inequality (the gap between rich and poor measured with the Gini index) within a nation. The population variables included the urbanisation rate (proportion of people living in urbanised areas), life expectancy at birth, mean years of schooling among the population aged 25 years and older, median age of the population, and the prevalence of obesity (% of adults with BMI ≥ 30). The cultural value dimensions were measured with Hofstede's cultural value dimensions (power distance, individualism, masculinity, uncertainty avoidance, long-term orientation, and indulgence). The data were analysed by using zero-order correlations, partial correlations, and canonical correlation analyses.Results showed a relatively strong intercorrelation between the national average of sleep duration and national happiness, i.e., subjective well-being. Among the socio-economic variables, WGI had the strongest relationship to sleep, whereas among population variables, schooling and obesity had the strongest correlations with sleep. Zero-order correlations between sleep and power distance and individualism were statistically significant, whereas in the partial correlations, individualism and masculinity appeared as important factors. Canonical correlation analysis showed strong correlations between the well-being variables (sleep and happiness) and the socio-economic variables, well-being variables and population variables, and cultural values and well-being variables.The present study is an opening for a new line of research in which sleep is seen as an essential part of societal life and collective well-being.
{"title":"Sleep and happiness: socio-economic, population and cultural correlates of sleep duration and subjective well-being in 52 countries","authors":"T. Lajunen, E. Gaygısız, Wen Wang","doi":"10.3389/frsle.2023.1118384","DOIUrl":"https://doi.org/10.3389/frsle.2023.1118384","url":null,"abstract":"Getting enough sleep is one of the essential lifestyle factors influencing health and well-being. However, there are considerable differences between countries in how much people sleep on average. The present study investigated how socio-economic factors, population variables, and cultural value dimensions are related to sleep duration in a sample of 52 countries.The study design was ecological, i.e., the aggregate values for each country were obtained, and their correlations to national average sleep duration were analysed. The sleep duration estimates were based on Sleep Cycle Application (Sleep Cycle AB, Gothenburg, Sweden) data. The socio-economic variables included the economic health of a country (GDP per capita), how well a country is governed (governance quality measured with WGI), and the economic inequality (the gap between rich and poor measured with the Gini index) within a nation. The population variables included the urbanisation rate (proportion of people living in urbanised areas), life expectancy at birth, mean years of schooling among the population aged 25 years and older, median age of the population, and the prevalence of obesity (% of adults with BMI ≥ 30). The cultural value dimensions were measured with Hofstede's cultural value dimensions (power distance, individualism, masculinity, uncertainty avoidance, long-term orientation, and indulgence). The data were analysed by using zero-order correlations, partial correlations, and canonical correlation analyses.Results showed a relatively strong intercorrelation between the national average of sleep duration and national happiness, i.e., subjective well-being. Among the socio-economic variables, WGI had the strongest relationship to sleep, whereas among population variables, schooling and obesity had the strongest correlations with sleep. Zero-order correlations between sleep and power distance and individualism were statistically significant, whereas in the partial correlations, individualism and masculinity appeared as important factors. Canonical correlation analysis showed strong correlations between the well-being variables (sleep and happiness) and the socio-economic variables, well-being variables and population variables, and cultural values and well-being variables.The present study is an opening for a new line of research in which sleep is seen as an essential part of societal life and collective well-being.","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72544886","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 : 2023-07-25DOI: 10.3389/frsle.2023.1132935
Olivia Bruce, Sayedeh Fatemeh Sajjadi, B. Galland, J. Gross, G. Dainty
Autistic children experience sleep disturbances at a higher rate than do neurotypical children. It has been argued that sleep disturbances negatively impact behavior, exacerbate learning difficulties, and decrease the quality of life among autistic children. Increasing exercise has been proposed to address sleep disturbances, however, little is known about how exercise might best be promoted for autistic children in Aotearoa New Zealand. Here, we explored caregivers' lived experiences of their autistic child's sleep disturbances and participation in exercise.Semi-structured interviews were conducted with 15 mothers of autistic children aged between 5 and 10. Mothers also completed the Sleep Disturbances Scale for Children (SDSC).Scores on the SDSC indicated that there was considerable variation in sleep disturbance severity. Eight themes were identified from the interviews: sleep disturbances, the impact of exercise on sleep, exercise activities, whānau involvement in exercise, barriers for participation in exercise, support for participation in exercise, sensory considerations for participation in exercise, and activities specifically for children with special needs.Our findings highlight how challenging sleep disturbances can be for autistic children and their families and how participation in exercise can be promoted to potentially minimize their negative impact.
{"title":"Exercise and autism: exploring caregiver insights on exercise participation and sleep patterns in autistic children in Aotearoa New Zealand","authors":"Olivia Bruce, Sayedeh Fatemeh Sajjadi, B. Galland, J. Gross, G. Dainty","doi":"10.3389/frsle.2023.1132935","DOIUrl":"https://doi.org/10.3389/frsle.2023.1132935","url":null,"abstract":"Autistic children experience sleep disturbances at a higher rate than do neurotypical children. It has been argued that sleep disturbances negatively impact behavior, exacerbate learning difficulties, and decrease the quality of life among autistic children. Increasing exercise has been proposed to address sleep disturbances, however, little is known about how exercise might best be promoted for autistic children in Aotearoa New Zealand. Here, we explored caregivers' lived experiences of their autistic child's sleep disturbances and participation in exercise.Semi-structured interviews were conducted with 15 mothers of autistic children aged between 5 and 10. Mothers also completed the Sleep Disturbances Scale for Children (SDSC).Scores on the SDSC indicated that there was considerable variation in sleep disturbance severity. Eight themes were identified from the interviews: sleep disturbances, the impact of exercise on sleep, exercise activities, whānau involvement in exercise, barriers for participation in exercise, support for participation in exercise, sensory considerations for participation in exercise, and activities specifically for children with special needs.Our findings highlight how challenging sleep disturbances can be for autistic children and their families and how participation in exercise can be promoted to potentially minimize their negative impact.","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85435947","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 : 2023-07-21DOI: 10.3389/frsle.2023.1168209
T. Strasser, Inga Rothert, Thomas Heine, T. Peters
Within a large joint research project aiming for characterizing the nonvisual effects of light (NiviL), AuReTim, a low-cost and extensible open-source portable psychomotor vigilance test using auditory stimuli was developed, tailored for field testing. Currently, an unprepared simple reaction time and a go/no-go paradigm using acoustic stimuli are implemented. AuReTim is based on inexpensive hardware, e.g., its core is a Raspberry Pi leveraging a touch screen as input. Its software is developed in Java™ using open-source libraries, therefore providing connectivity with other research setups, e.g., EEG, and easy extensibility with other stimulus paradigms. A simulation study proved the precise timing of AuReTim with limits of agreement between −1.86 and 1.67 ms. AuReTim combines the mobility of tablet-based psychomotor vigilance tests with the usability of conventional computer-based tests, which is especially helpful in field studies. AuReTim was successfully applied to study the effects of different lighting on alertness and proved to be a valuable tool for studies using the central nervous activation level as an outcome measure.
{"title":"AuReTim: an inexpensive and extensible open-source auditory psychomotor vigilance test","authors":"T. Strasser, Inga Rothert, Thomas Heine, T. Peters","doi":"10.3389/frsle.2023.1168209","DOIUrl":"https://doi.org/10.3389/frsle.2023.1168209","url":null,"abstract":"Within a large joint research project aiming for characterizing the nonvisual effects of light (NiviL), AuReTim, a low-cost and extensible open-source portable psychomotor vigilance test using auditory stimuli was developed, tailored for field testing. Currently, an unprepared simple reaction time and a go/no-go paradigm using acoustic stimuli are implemented. AuReTim is based on inexpensive hardware, e.g., its core is a Raspberry Pi leveraging a touch screen as input. Its software is developed in Java™ using open-source libraries, therefore providing connectivity with other research setups, e.g., EEG, and easy extensibility with other stimulus paradigms. A simulation study proved the precise timing of AuReTim with limits of agreement between −1.86 and 1.67 ms. AuReTim combines the mobility of tablet-based psychomotor vigilance tests with the usability of conventional computer-based tests, which is especially helpful in field studies. AuReTim was successfully applied to study the effects of different lighting on alertness and proved to be a valuable tool for studies using the central nervous activation level as an outcome measure.","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83545192","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 : 2023-07-18DOI: 10.3389/frsle.2023.1214036
P. Castellanos, P. Satashia, Mantavya Punj, P. Castillo, B. Colaco, B. Dredla, E. Festic, J. Kaplan, C. Ruoff, L. Speicher, K. Walsh, N. Werninck, Mingyuan Yin, C. Burger, V. Arunthari, Joseph Cheung
We conducted a cross-sectional study to identify the presence of sleep disturbance and sleep disordered breathing in post-hospitalized patients with COVID-19 compared to a cohort of patients with no prior COVID-19 infection.Patients who were discharged from Mayo Clinic after hospitalization for COVID-19 and who had no existing diagnosis of sleep apnea or other sleep disorders were recruited for this study as cases. Patients who never had COVID-19 infection, nor any existing diagnosis of sleep apnea or other sleep disorders, were recruited from outpatient clinics as controls. Participants completed Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, and Fatigue Severity Scale questionnaires, as well as a home sleep apnea test.Forty-seven COVID-19 cases and 46 controls completed questionnaires. Cases were significantly older, with a median age of 56.0 vs. controls (50.5) and were found to have slightly worse sleep quality, a higher degree of daytime sleepiness, and a slightly higher degree of fatigue. In terms of sleep disordered breathing, 39 cases and 40 controls completed the home sleep apnea test. Obstructive sleep apnea, defined by an AHI score of 5 or higher, was found in a remarkable 97.4% of cases vs. 72.5% in controls. Severity of OSA also trended higher in the case group. However, the difference in AHI was not significant after adjusting for age and BMI.Patients who were hospitalized with COVID-19 showed a very high prevalence of OSA. In addition, they had a slightly higher degree of sleep disturbance, daytime sleepiness, and fatigue when compared to controls. Our results suggest that sleep medicine assessment in patients who had COVID-19 requiring hospitalization is warranted.
{"title":"Assessment of sleep quality and sleep disordered breathing among post-hospitalized patients with COVID-19","authors":"P. Castellanos, P. Satashia, Mantavya Punj, P. Castillo, B. Colaco, B. Dredla, E. Festic, J. Kaplan, C. Ruoff, L. Speicher, K. Walsh, N. Werninck, Mingyuan Yin, C. Burger, V. Arunthari, Joseph Cheung","doi":"10.3389/frsle.2023.1214036","DOIUrl":"https://doi.org/10.3389/frsle.2023.1214036","url":null,"abstract":"We conducted a cross-sectional study to identify the presence of sleep disturbance and sleep disordered breathing in post-hospitalized patients with COVID-19 compared to a cohort of patients with no prior COVID-19 infection.Patients who were discharged from Mayo Clinic after hospitalization for COVID-19 and who had no existing diagnosis of sleep apnea or other sleep disorders were recruited for this study as cases. Patients who never had COVID-19 infection, nor any existing diagnosis of sleep apnea or other sleep disorders, were recruited from outpatient clinics as controls. Participants completed Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, and Fatigue Severity Scale questionnaires, as well as a home sleep apnea test.Forty-seven COVID-19 cases and 46 controls completed questionnaires. Cases were significantly older, with a median age of 56.0 vs. controls (50.5) and were found to have slightly worse sleep quality, a higher degree of daytime sleepiness, and a slightly higher degree of fatigue. In terms of sleep disordered breathing, 39 cases and 40 controls completed the home sleep apnea test. Obstructive sleep apnea, defined by an AHI score of 5 or higher, was found in a remarkable 97.4% of cases vs. 72.5% in controls. Severity of OSA also trended higher in the case group. However, the difference in AHI was not significant after adjusting for age and BMI.Patients who were hospitalized with COVID-19 showed a very high prevalence of OSA. In addition, they had a slightly higher degree of sleep disturbance, daytime sleepiness, and fatigue when compared to controls. Our results suggest that sleep medicine assessment in patients who had COVID-19 requiring hospitalization is warranted.","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84674358","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 : 2023-07-07DOI: 10.3389/frsle.2023.1161857
T. Kendzerska, A. Malhotra, A. Gershon, M. Povitz, D. McIsaac, S. Aaron, G. Bryson, R. Talarico, Michael Godbout, P. Tanuseputro, F. Chung
Information is needed to guide safe opioid prescribing in adults referred for a sleep disorder assessment. Previous studies have shown that individuals referred for a sleep disorder assessment have a higher likelihood of long-acting opioids and higher opioid dosages prescription than the general population, suggesting that these individuals are more at risk for opioid-related adverse health consequences.We included all adults who underwent a diagnostic sleep study (index date) in Ontario, Canada, between 2013 and 2016 (n = 300,663) and filled an opioid prescription overlapping the index date (n = 15,713). Through provincial health administrative databases, individuals were followed over time to assess the association between opioid use characteristics and 1-year all-cause mortality, hospitalizations and emergency department (ED) visits, and opioid-related hospitalizations and ED visits within extended follow-up to 2018.Controlling for covariates, chronic opioid use (vs. not) was significantly associated with increased hazards of all-cause mortality [adjusted hazard ratio(aHR): 1.84; 95% confidence interval (CI): 1.12–3.02], hospitalization (aHR: 1.14; 95% CI: 1.02–1.28) and ED visit (aHR: 1.09; 95% CI: 1.01–1.17). A higher opioid dosage [morphine equivalent daily dose (MED) >90 vs. ≤ 90 mg/day] was significantly associated with increased hazards of all-cause or opioid-related hospitalization (aHR: 1.13; 95% CI: 1.02–1.26 and aHR: 2.27; 95% CI: 1.53–3.37, respectively). Morphine or hydromorphone prescription (vs. oxycodone) was significantly associated with an increased hazard of all-cause hospitalization (aHR: 1.30; 1.07–1.59 and aHR: 1.43; 95% CI: 1.20–1.70, respectively). Hydromorphone or fentanyl prescription (vs. oxycodone) was significantly associated with an increased hazard of opioid-related ED visit and/or hospitalization (aHR: 2.28, 95% CI: 1.16–4.47 and aHR: 2.47, 95% CI: 1.16–5.26, respectively).Findings from this retrospective study may inform the safe prescribing of opioids in adults referred for a sleep disorder assessment.
{"title":"Association between opioid prescription profiles and adverse health outcomes in opioid users referred for sleep disorder assessment: a secondary analysis of health administrative data","authors":"T. Kendzerska, A. Malhotra, A. Gershon, M. Povitz, D. McIsaac, S. Aaron, G. Bryson, R. Talarico, Michael Godbout, P. Tanuseputro, F. Chung","doi":"10.3389/frsle.2023.1161857","DOIUrl":"https://doi.org/10.3389/frsle.2023.1161857","url":null,"abstract":"Information is needed to guide safe opioid prescribing in adults referred for a sleep disorder assessment. Previous studies have shown that individuals referred for a sleep disorder assessment have a higher likelihood of long-acting opioids and higher opioid dosages prescription than the general population, suggesting that these individuals are more at risk for opioid-related adverse health consequences.We included all adults who underwent a diagnostic sleep study (index date) in Ontario, Canada, between 2013 and 2016 (n = 300,663) and filled an opioid prescription overlapping the index date (n = 15,713). Through provincial health administrative databases, individuals were followed over time to assess the association between opioid use characteristics and 1-year all-cause mortality, hospitalizations and emergency department (ED) visits, and opioid-related hospitalizations and ED visits within extended follow-up to 2018.Controlling for covariates, chronic opioid use (vs. not) was significantly associated with increased hazards of all-cause mortality [adjusted hazard ratio(aHR): 1.84; 95% confidence interval (CI): 1.12–3.02], hospitalization (aHR: 1.14; 95% CI: 1.02–1.28) and ED visit (aHR: 1.09; 95% CI: 1.01–1.17). A higher opioid dosage [morphine equivalent daily dose (MED) >90 vs. ≤ 90 mg/day] was significantly associated with increased hazards of all-cause or opioid-related hospitalization (aHR: 1.13; 95% CI: 1.02–1.26 and aHR: 2.27; 95% CI: 1.53–3.37, respectively). Morphine or hydromorphone prescription (vs. oxycodone) was significantly associated with an increased hazard of all-cause hospitalization (aHR: 1.30; 1.07–1.59 and aHR: 1.43; 95% CI: 1.20–1.70, respectively). Hydromorphone or fentanyl prescription (vs. oxycodone) was significantly associated with an increased hazard of opioid-related ED visit and/or hospitalization (aHR: 2.28, 95% CI: 1.16–4.47 and aHR: 2.47, 95% CI: 1.16–5.26, respectively).Findings from this retrospective study may inform the safe prescribing of opioids in adults referred for a sleep disorder assessment.","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89766440","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 : 2023-07-04DOI: 10.3389/frsle.2023.1212784
N. Jiao, K. Pituch, M. Petrov
During the COVID-19 pandemic, sleep problems were highly prevalent. However, few studies assess sleep quality among parents and caregivers with young children. This study aimed to describe the impacts of the COVID-19 pandemic on sleep patterns among parents and caregivers with young children (<6 years) and identify the factors associated with insomnia and sleep efficiency.An internet sample of 136 caregivers (age: 35 ± 9.7 y, 70.6% female) were recruited internationally from May 21, 2020 to July 1, 2020. Participants completed the Center for Epidemiological Studies–Depression Scale-10 (CES-D-10), Sleep Hygiene and Practices Scale (SHPS), Coronavirus Impact Scale (CIS), Insomnia Severity Index (ISI), and sleep patterns prior to and during the pandemic. Hierarchical regressions were conducted to examine the factors associated with insomnia and sleep efficiency.Nearly 40% of the caregivers reported household incomes <$10,000. More than half reported clinical levels of depressive symptoms (59.2%) and low sleep efficiency (65.8%). Approximately 90% reported that their sleep-wake routine was altered with delayed bedtime and midpoint, and more naps and nightmares. Almost half (51.5%) were experiencing clinically meaningful insomnia symptoms. Greater insomnia symptom severity was independently associated with lower income, greater depressive symptoms, poor sleep hygiene behaviors, altered sleep-wake routine, and greater COVID-related disruptions in daily life. The predictors associated with poor sleep efficiency during the pandemic were lower income and poor sleep efficiency before the pandemic.The study highlighted the factors associated with insomnia and poor sleep efficiency during the COVID-19 pandemic. Interventions are needed to support caregivers' sleep during global crises.
{"title":"Impact of COVID-19 pandemic on insomnia and sleep efficiency in parents and caregivers of young children","authors":"N. Jiao, K. Pituch, M. Petrov","doi":"10.3389/frsle.2023.1212784","DOIUrl":"https://doi.org/10.3389/frsle.2023.1212784","url":null,"abstract":"During the COVID-19 pandemic, sleep problems were highly prevalent. However, few studies assess sleep quality among parents and caregivers with young children. This study aimed to describe the impacts of the COVID-19 pandemic on sleep patterns among parents and caregivers with young children (<6 years) and identify the factors associated with insomnia and sleep efficiency.An internet sample of 136 caregivers (age: 35 ± 9.7 y, 70.6% female) were recruited internationally from May 21, 2020 to July 1, 2020. Participants completed the Center for Epidemiological Studies–Depression Scale-10 (CES-D-10), Sleep Hygiene and Practices Scale (SHPS), Coronavirus Impact Scale (CIS), Insomnia Severity Index (ISI), and sleep patterns prior to and during the pandemic. Hierarchical regressions were conducted to examine the factors associated with insomnia and sleep efficiency.Nearly 40% of the caregivers reported household incomes <$10,000. More than half reported clinical levels of depressive symptoms (59.2%) and low sleep efficiency (65.8%). Approximately 90% reported that their sleep-wake routine was altered with delayed bedtime and midpoint, and more naps and nightmares. Almost half (51.5%) were experiencing clinically meaningful insomnia symptoms. Greater insomnia symptom severity was independently associated with lower income, greater depressive symptoms, poor sleep hygiene behaviors, altered sleep-wake routine, and greater COVID-related disruptions in daily life. The predictors associated with poor sleep efficiency during the pandemic were lower income and poor sleep efficiency before the pandemic.The study highlighted the factors associated with insomnia and poor sleep efficiency during the COVID-19 pandemic. Interventions are needed to support caregivers' sleep during global crises.","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83079641","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 : 2023-06-22DOI: 10.3389/frsle.2023.1162652
S. Maresh, Adhithi Keerthana Athikumar, Nabila Ahmed, Shivapriya Chandu, J. Prowting, Layth Tumah, Abed A. Najjar, H. Khan, Muna Sankari, O. Lasisi, L. Ravelo, P. Peppard, M. Badr, A. Sankari
Study objectives The objective of this study was to determine whether electrocardiogram (ECG) and heart rate accelerations that occur in the vicinity of respiratory events could predict the severity of sleep-disordered breathing (SDB). Methods De-identified polysomnogram (NPSG) recordings from 2091 eligible participants in the Sleep Heart Health Study (SHHS) were evaluated after developing and validating an automated algorithm using an initial set of recordings from 1,438 participants to detect RR interval (RRI) dips in ECG and heart rate accelerations from pulse rate signal. Within-subject comparisons were made between the apnea-hypopnea index (AHI) and both the total RRI dip index (total RRDI) and total heart rate acceleration index (total HRAI). Results The estimated AHIs using respiratory-related HRAI correlated with NPSG AHI both in the unadjusted and adjusted model (B: 0.83 and 0.81, respectively P < 0.05). Respiratory-related HRAI had a strong agreement with NPSG AHI (intraclass correlation coefficient-ICC: 0.64, whereas respiratory-related RRDI displayed weaker agreement and ICC: 0.38). Further assessment of respiratory-related HRAI (≥5 events/h) showed a strong diagnostic ability (78, 87, 81, and 56% agreement for traditional AHI cutoffs 5, 10, 15, and 30 events/h, respectively). At the AHI cutoff of 5 events/h the receiver operating curves (ROC) revealed an area under the curve (AUCs) of 0.90 and 0.96 for RE RRDI and RE HRAI respectively. Conclusion The automated respiratory-related heart rate measurements derived from pulse rate provide an accurate method to detect the presence of SDB. Therefore, the ability of mathematical models to accurately detect respiratory-related heart rate changes from pulse rate may enable an additional method to diagnose SDB.
{"title":"Role of automated detection of respiratory related heart rate changes in the diagnosis of sleep disordered breathing","authors":"S. Maresh, Adhithi Keerthana Athikumar, Nabila Ahmed, Shivapriya Chandu, J. Prowting, Layth Tumah, Abed A. Najjar, H. Khan, Muna Sankari, O. Lasisi, L. Ravelo, P. Peppard, M. Badr, A. Sankari","doi":"10.3389/frsle.2023.1162652","DOIUrl":"https://doi.org/10.3389/frsle.2023.1162652","url":null,"abstract":"Study objectives The objective of this study was to determine whether electrocardiogram (ECG) and heart rate accelerations that occur in the vicinity of respiratory events could predict the severity of sleep-disordered breathing (SDB). Methods De-identified polysomnogram (NPSG) recordings from 2091 eligible participants in the Sleep Heart Health Study (SHHS) were evaluated after developing and validating an automated algorithm using an initial set of recordings from 1,438 participants to detect RR interval (RRI) dips in ECG and heart rate accelerations from pulse rate signal. Within-subject comparisons were made between the apnea-hypopnea index (AHI) and both the total RRI dip index (total RRDI) and total heart rate acceleration index (total HRAI). Results The estimated AHIs using respiratory-related HRAI correlated with NPSG AHI both in the unadjusted and adjusted model (B: 0.83 and 0.81, respectively P < 0.05). Respiratory-related HRAI had a strong agreement with NPSG AHI (intraclass correlation coefficient-ICC: 0.64, whereas respiratory-related RRDI displayed weaker agreement and ICC: 0.38). Further assessment of respiratory-related HRAI (≥5 events/h) showed a strong diagnostic ability (78, 87, 81, and 56% agreement for traditional AHI cutoffs 5, 10, 15, and 30 events/h, respectively). At the AHI cutoff of 5 events/h the receiver operating curves (ROC) revealed an area under the curve (AUCs) of 0.90 and 0.96 for RE RRDI and RE HRAI respectively. Conclusion The automated respiratory-related heart rate measurements derived from pulse rate provide an accurate method to detect the presence of SDB. Therefore, the ability of mathematical models to accurately detect respiratory-related heart rate changes from pulse rate may enable an additional method to diagnose SDB.","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78139616","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 : 2023-06-22DOI: 10.3389/frsle.2023.1111669
Melanie A. Baime, Prem Umang Satyavolu, A. Huhn, J. Ellis
Study objectives Chronic pain and insomnia commonly co-occur among individuals with opioid use disorder (OUD) and are associated with adverse treatment outcomes and reduced quality of life. Exploring factors that influence these relationships may help identify relevant treatment targets. The present study investigated whether pain catastrophizing moderates the presence of chronic pain and insomnia severity in individuals with OUD. Methods Participants with OUD symptoms (N = 154) were recruited from Amazon's Mechanical Turk, and completed screening measures for chronic pain, insomnia, and pain catastrophizing. Moderation analyses were used to explore whether pain catastrophizing moderated the relationship between chronic pain and insomnia severity. Results Results suggested that chronic pain was only associated with insomnia severity symptoms among individuals with higher levels of pain catastrophizing but was unrelated at lower levels of pain catastrophizing. Conclusions These results suggest that pain catastrophizing may represent a modifiable risk factor among individuals with co-occurring OUD, insomnia, and chronic pain. Future longitudinal and experimental research that examines changes in insomnia, pain severity, and pain catastrophizing over time in OUD may be beneficial.
{"title":"Pain catastrophizing moderates the relationship between chronic pain and insomnia severity in persons with opioid use disorder","authors":"Melanie A. Baime, Prem Umang Satyavolu, A. Huhn, J. Ellis","doi":"10.3389/frsle.2023.1111669","DOIUrl":"https://doi.org/10.3389/frsle.2023.1111669","url":null,"abstract":"Study objectives Chronic pain and insomnia commonly co-occur among individuals with opioid use disorder (OUD) and are associated with adverse treatment outcomes and reduced quality of life. Exploring factors that influence these relationships may help identify relevant treatment targets. The present study investigated whether pain catastrophizing moderates the presence of chronic pain and insomnia severity in individuals with OUD. Methods Participants with OUD symptoms (N = 154) were recruited from Amazon's Mechanical Turk, and completed screening measures for chronic pain, insomnia, and pain catastrophizing. Moderation analyses were used to explore whether pain catastrophizing moderated the relationship between chronic pain and insomnia severity. Results Results suggested that chronic pain was only associated with insomnia severity symptoms among individuals with higher levels of pain catastrophizing but was unrelated at lower levels of pain catastrophizing. Conclusions These results suggest that pain catastrophizing may represent a modifiable risk factor among individuals with co-occurring OUD, insomnia, and chronic pain. Future longitudinal and experimental research that examines changes in insomnia, pain severity, and pain catastrophizing over time in OUD may be beneficial.","PeriodicalId":73106,"journal":{"name":"Frontiers in sleep","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77268522","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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