Pub Date : 2020-01-01DOI: 10.35248/2167-0277.20.9.309
D. Neutel, Tathiana A. Alvarenga, C. Reis, T. Paiva
Insomnia is a prevalent sleep disorder. We examined chronic insomnia in terms of subjective and objective measures, according to self-reported duration of disorder. 443 patients were included from a sleep clinic diagnosed with chronic insomnia (ICSD3 criteria). Patients were retrospectively evaluated in terms of medical interview, sleep questionnaires, a standard polysomnography study, and subdivided in subgroups according to disorder duration. We compared patient’s results to a control group. Insomnia and control groups were significantly different in terms of TST, SE, SOL, N1 sleep, REM sleep, REM latency and number of REM episodes (p<0.05). For the group of ≤1 year of insomnia disorder all PSG parameters were statistically different from controls, except N2% and N3%, REM latency, and number of REM episodes. In the groups of 2 to 4 years, 10 to 19 years, and ≥ 20 years of insomnia we found the same differences except for REM sleep. On the contrary, in a subgroup analysis of 5 to 9 years of insomnia disorder duration, no differences to control group were found in TST, N1 or REM sleep to control group, adjusted for age. The polysomnographic sleep profile of chronic insomnia patients is different over time. It sketches an initial attempt of compensation in initial years of insomnia, which seems to disappear in long time chronic insomnia patients, as we usually see in others neurodegenerative disorders. Future studies are needed to clarify the natural history of chronic insomnia disorder and its behaviour as a neurodegenerative disorder.
{"title":"A Retrospective Study Suggests that Chronic Insomnia Behaves as a Neurodegenerative Disorder","authors":"D. Neutel, Tathiana A. Alvarenga, C. Reis, T. Paiva","doi":"10.35248/2167-0277.20.9.309","DOIUrl":"https://doi.org/10.35248/2167-0277.20.9.309","url":null,"abstract":"Insomnia is a prevalent sleep disorder. We examined chronic insomnia in terms of subjective and objective measures, according to self-reported duration of disorder. 443 patients were included from a sleep clinic diagnosed with chronic insomnia (ICSD3 criteria). Patients were retrospectively evaluated in terms of medical interview, sleep questionnaires, a standard polysomnography study, and subdivided in subgroups according to disorder duration. We compared patient’s results to a control group. Insomnia and control groups were significantly different in terms of TST, SE, SOL, N1 sleep, REM sleep, REM latency and number of REM episodes (p<0.05). For the group of ≤1 year of insomnia disorder all PSG parameters were statistically different from controls, except N2% and N3%, REM latency, and number of REM episodes. In the groups of 2 to 4 years, 10 to 19 years, and ≥ 20 years of insomnia we found the same differences except for REM sleep. On the contrary, in a subgroup analysis of 5 to 9 years of insomnia disorder duration, no differences to control group were found in TST, N1 or REM sleep to control group, adjusted for age. The polysomnographic sleep profile of chronic insomnia patients is different over time. It sketches an initial attempt of compensation in initial years of insomnia, which seems to disappear in long time chronic insomnia patients, as we usually see in others neurodegenerative disorders. Future studies are needed to clarify the natural history of chronic insomnia disorder and its behaviour as a neurodegenerative disorder.","PeriodicalId":73946,"journal":{"name":"Journal of sleep disorders & therapy","volume":"9 1","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69988673","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 : 2020-01-01DOI: 10.35248/2167-0277.20.9.312
T. Buset, E. Boutremans, Xavier, en Eynden, I. Loeb, M. Bruyneel
The mandibular advancement device (MAD) is an important part of the treatment of obstructive sleep apnea syndrome (OSA). The objective of our study was to evaluate the compliance of MAD in the short, medium and long term and the predictive factors of withdrawal. Among the 78 patients using MAD for OSA treatment, we successfully contacted by phone 64 patients (73% men, age 53 ± 10 years old, body mass index 25,6 kg/m2 ± 2,86) 3,9 years (1,9-4,9) after MAD placement. Among the 64 patients, 35 of them (55%) were still carriers of their MAD. The higher risk of withdrawal in the 29 patients (45%) who abandoned their MAD was observed during the first eight months of treatment and was mainly due for 8 patients (28%) to pain in the temporomandibular joint. Maxillomandibular dysmorphosis appears as the only predictor of abandonment. In conclusion, the MAD provides an effective and sustained solution in the treatment of mild to moderate OSA with good long-term compliance, except in case of maxillo-mandibular dysmorphosis. A close follow up during the first months could improve treatment compliance.
{"title":"Predictors of Long-Term Withdrawal to Mandibular Advancement Device Treatment in Obstructive Sleep Apnea Syndrome","authors":"T. Buset, E. Boutremans, Xavier, en Eynden, I. Loeb, M. Bruyneel","doi":"10.35248/2167-0277.20.9.312","DOIUrl":"https://doi.org/10.35248/2167-0277.20.9.312","url":null,"abstract":"The mandibular advancement device (MAD) is an important part of the treatment of obstructive sleep apnea syndrome (OSA). The objective of our study was to evaluate the compliance of MAD in the short, medium and long term and the predictive factors of withdrawal. Among the 78 patients using MAD for OSA treatment, we successfully contacted by phone 64 patients (73% men, age 53 ± 10 years old, body mass index 25,6 kg/m2 ± 2,86) 3,9 years (1,9-4,9) after MAD placement. Among the 64 patients, 35 of them (55%) were still carriers of their MAD. The higher risk of withdrawal in the 29 patients (45%) who abandoned their MAD was observed during the first eight months of treatment and was mainly due for 8 patients (28%) to pain in the temporomandibular joint. Maxillomandibular dysmorphosis appears as the only predictor of abandonment. In conclusion, the MAD provides an effective and sustained solution in the treatment of mild to moderate OSA with good long-term compliance, except in case of maxillo-mandibular dysmorphosis. A close follow up during the first months could improve treatment compliance.","PeriodicalId":73946,"journal":{"name":"Journal of sleep disorders & therapy","volume":"9 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69988335","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 : 2020-01-01DOI: 10.35248/2167-0277.20.9.310
Francisco Silva, Lucas Cavalieri Pereira, G.Q.B. Brancher, G. P. Oliveira, C. J. O. Macedo, L. Cerezetti, Samuel Pereira
Obstructive sleep apnea (OSA) is a common sleep disorder classically characterized by apneic events that lead to intermittent hypoxia and sleep fragmentation. Its consequences are serious, mainly in terms of quality of life and cardiovascular risk. Orthognathic surgery of the maxillomandibular advancement has increased in popularity as a treatment option for OSAS due to the increase in the entire velo-oro-hypopharyngeal air system. A modified osteotomy is indicated for patients with severe obstructive sleep apnea who already have a prominent profile. In these cases, it is necessary to advance the suprahyoid muscles without changing the facial profile. The genioglossus is crucial to maintaining a pharyngeal patent in the air due to the anterior traction of the tongue. The advancement of the genioglossus muscle has been reported as an option for the surgical treatment of obstructive sleep apnea syndrome, which through its traction can increase the retrolingual airway without altering facial or dental appearance. The present study aims to report a clinical case of a female patient (N.M.A.T.), 52 years old, presenting complaints of lack of concentration and fatigue on light effort, OSAS confirmed by polysomnography and snoring. On facial tomography, retrognathism and reduction of the upper airways were observed. Orthognathic surgery with counterclockwise rotation of the maxillary-mandibular complex, associated mandibular and maxillary advancement was the treatment of choice, associated with the advancement of the genioglossus muscle through modified osteotomy in the anterior portion of the mandible. The virtual planning was carried out for the case, with the preparation of pre and transoperative guides and with the purpose of visualizing the growth of the airways. The patient improved his facial profile and airways due to anterior muscle traction, evolving without complaints.
{"title":"OSAS Treatment with Mandibular Osteotomy Modified Associated with Virtually Planned Orthognathic Surgery","authors":"Francisco Silva, Lucas Cavalieri Pereira, G.Q.B. Brancher, G. P. Oliveira, C. J. O. Macedo, L. Cerezetti, Samuel Pereira","doi":"10.35248/2167-0277.20.9.310","DOIUrl":"https://doi.org/10.35248/2167-0277.20.9.310","url":null,"abstract":"Obstructive sleep apnea (OSA) is a common sleep disorder classically characterized by apneic events that lead to intermittent hypoxia and sleep fragmentation. Its consequences are serious, mainly in terms of quality of life and cardiovascular risk. Orthognathic surgery of the maxillomandibular advancement has increased in popularity as a treatment option for OSAS due to the increase in the entire velo-oro-hypopharyngeal air system. A modified osteotomy is indicated for patients with severe obstructive sleep apnea who already have a prominent profile. In these cases, it is necessary to advance the suprahyoid muscles without changing the facial profile. The genioglossus is crucial to maintaining a pharyngeal patent in the air due to the anterior traction of the tongue. The advancement of the genioglossus muscle has been reported as an option for the surgical treatment of obstructive sleep apnea syndrome, which through its traction can increase the retrolingual airway without altering facial or dental appearance. The present study aims to report a clinical case of a female patient (N.M.A.T.), 52 years old, presenting complaints of lack of concentration and fatigue on light effort, OSAS confirmed by polysomnography and snoring. On facial tomography, retrognathism and reduction of the upper airways were observed. Orthognathic surgery with counterclockwise rotation of the maxillary-mandibular complex, associated mandibular and maxillary advancement was the treatment of choice, associated with the advancement of the genioglossus muscle through modified osteotomy in the anterior portion of the mandible. The virtual planning was carried out for the case, with the preparation of pre and transoperative guides and with the purpose of visualizing the growth of the airways. The patient improved his facial profile and airways due to anterior muscle traction, evolving without complaints.","PeriodicalId":73946,"journal":{"name":"Journal of sleep disorders & therapy","volume":"9 1","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69988726","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 : 2020-01-01DOI: 10.35248/2167-0277.20.9.317
S. Hosseini, A. Seddighi, A. Seddighi, A. Nikouei
Objectives: The purpose of this study was to evaluate the reliability and validity of Mini Sleep Questionnaire (MSQ) has been translated into several languages and is used after it is approved. Methods: This study is an observational and case-controls, with a sample size of 121 people were performed. The validity and reliability of the Persian version of the MSQ were done based on Pittsburgh Sleep Quality Index-Persian (PSQI-P). Results: α-Cronbach’s was performed to evaluate the reliability of MSQ-P and is equal 0/753. The face validity and content validity of the MSQ - P was approved. The Pearson correlation coefficients between the both questionnaire were calculated and the results. All express the validity of the MSQ have been translated into Persian. Conclusions: reliability and validity of MSQ-Persian version confirmed and can be used in the population of Persian language.
{"title":"Validity and Reliability of the Mini Sleep Questionnaire-Persian Version (MSQP)","authors":"S. Hosseini, A. Seddighi, A. Seddighi, A. Nikouei","doi":"10.35248/2167-0277.20.9.317","DOIUrl":"https://doi.org/10.35248/2167-0277.20.9.317","url":null,"abstract":"Objectives: The purpose of this study was to evaluate the reliability and validity of Mini Sleep Questionnaire (MSQ) has been translated into several languages and is used after it is approved. Methods: This study is an observational and case-controls, with a sample size of 121 people were performed. The validity and reliability of the Persian version of the MSQ were done based on Pittsburgh Sleep Quality Index-Persian (PSQI-P). Results: α-Cronbach’s was performed to evaluate the reliability of MSQ-P and is equal 0/753. The face validity and content validity of the MSQ - P was approved. The Pearson correlation coefficients between the both questionnaire were calculated and the results. All express the validity of the MSQ have been translated into Persian. Conclusions: reliability and validity of MSQ-Persian version confirmed and can be used in the population of Persian language.","PeriodicalId":73946,"journal":{"name":"Journal of sleep disorders & therapy","volume":"87 1","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69988752","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 : 2020-01-01DOI: 10.35248/2167-0277.20.9.320
Vrushali Bhore, J. Chitra, Jowena Parikh
Background: OSA is related to cognitive disturbances and poor sleep quality. The lifetime prevalence of OSA is 21.7% causing collapse of Upper Airway muscles which then leads to recurrent hypoxia and wakening of the individual. When intensity worsens, patients tend to feel sluggish during tasks that usually require alertness (e.g., education, work, driving), daytime fatigue/tiredness, cognitive deficits (short-term memory, concentration), decreased attention, morning agitation, changes in temperament and mood like depression and anxiety. Aim: The objective of the current research was to determine impact of Oropharyngeal Stimulation and Tongue Proprioceptive Neuromuscular Facilitation (PNF) on Cognition, Quality of Sleep and glycated hemoglobin in OSA patients. Methods: 30 adults were recruited in the study and were randomized to 2 groups. A 4 week session of Oropharyngeal Stimulation was given to the subjects for 20 minutes for Group A and Tongue PNF for Group B. The outcome measures used in the study were Epworth Sleepiness Scale, Pittsburgh Sleep Quality Index, Mindful Attention Awareness Scale, Addenbrooke Cognitive Examination- III, Trail Making Test, Digit Span Test and Glycated Hemoglobin. Results: The results state that there was a statistical noteworthy change in the all the outcome measures for all the participants of Group A and B. Improvements were also seen in the parameters for within group analysis. (p<0.05). Daytime sleepiness reduced in terms of both the interventions along with quality of sleep. In terms of cognition, significant change was seen in the Tongue PNF group. Conclusion: This study concluded that a 4 week intervention of Oropharyngeal Stimulation and Tongue PNF improved Cognition, Hba1c and Quality of Sleep in patients with Obstructive Sleep Apnea.
{"title":"Effect of Oropharyngeal Stimulation and Tongue PNF on Cognition, Quality of Sleep and Hba1c in Patients with Obstructive Sleep Apnea- A Randomized Clinical Trial","authors":"Vrushali Bhore, J. Chitra, Jowena Parikh","doi":"10.35248/2167-0277.20.9.320","DOIUrl":"https://doi.org/10.35248/2167-0277.20.9.320","url":null,"abstract":"Background: OSA is related to cognitive disturbances and poor sleep quality. The lifetime prevalence of OSA is 21.7% causing collapse of Upper Airway muscles which then leads to recurrent hypoxia and wakening of the individual. When intensity worsens, patients tend to feel sluggish during tasks that usually require alertness (e.g., education, work, driving), daytime fatigue/tiredness, cognitive deficits (short-term memory, concentration), decreased attention, morning agitation, changes in temperament and mood like depression and anxiety. Aim: The objective of the current research was to determine impact of Oropharyngeal Stimulation and Tongue Proprioceptive Neuromuscular Facilitation (PNF) on Cognition, Quality of Sleep and glycated hemoglobin in OSA patients. Methods: 30 adults were recruited in the study and were randomized to 2 groups. A 4 week session of Oropharyngeal Stimulation was given to the subjects for 20 minutes for Group A and Tongue PNF for Group B. The outcome measures used in the study were Epworth Sleepiness Scale, Pittsburgh Sleep Quality Index, Mindful Attention Awareness Scale, Addenbrooke Cognitive Examination- III, Trail Making Test, Digit Span Test and Glycated Hemoglobin. Results: The results state that there was a statistical noteworthy change in the all the outcome measures for all the participants of Group A and B. Improvements were also seen in the parameters for within group analysis. (p<0.05). Daytime sleepiness reduced in terms of both the interventions along with quality of sleep. In terms of cognition, significant change was seen in the Tongue PNF group. Conclusion: This study concluded that a 4 week intervention of Oropharyngeal Stimulation and Tongue PNF improved Cognition, Hba1c and Quality of Sleep in patients with Obstructive Sleep Apnea.","PeriodicalId":73946,"journal":{"name":"Journal of sleep disorders & therapy","volume":"9 1","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69988411","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 : 2020-01-01DOI: 10.35248/2167-0277.19.9.E107
Samy I McFarlane
{"title":"Editorial Note for Journal of Sleep Disorders & Therapy","authors":"Samy I McFarlane","doi":"10.35248/2167-0277.19.9.E107","DOIUrl":"https://doi.org/10.35248/2167-0277.19.9.E107","url":null,"abstract":"","PeriodicalId":73946,"journal":{"name":"Journal of sleep disorders & therapy","volume":"80 1","pages":"1-1"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69988259","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 : 2020-01-01DOI: 10.35248/2167-0277.20.9.318
M. Lipford, Carrie O'Neill, K. Eibner, S. Donlinger, Daniel L. Herold, T. Morgenthaler, C. Loprinzi
Study objectives: To evaluate, in a pilot fashion, efficacy and tolerability of electrical counter-stimulation using the Scrambler device in alleviating discomfort and urge to move in patients with medically refractory restless legs syndrome/Willis Ekbom Disease (RLS/WED). Methods: Eligible patients had moderate to very severe RLS/WED symptoms for ≥ 3 months, based on the International Restless Legs Syndrome Study Group (IRLS) Rating Scale. Subjects were treated with Scrambler Therapy for up to ten daily 1-2 hour sessions. Symptoms were monitored using the IRLS as well as questionnaires regarding daily symptoms and global impression of change. Questionnaires were administered at baseline, during therapy, and one-week after the last Scrambler session. Subjects were also queried regarding any adverse effects. Results: Eight subjects were enrolled (M=F). Subjects were on an average of 3 RLS drugs at time of enrollment. Two patients were asked to taper off of gabapentin or pregabalin prior to starting treatments with Scrambler. The IRLS score decreased from a baseline of 27.6 ± 6.2 (mean ± SD) to 19.5 ± 8.0 (p=0.03) following therapy, and to 20.3 ± 10.8 (p=0.07) one week after the last Scrambler treatment. No adverse effects were noted by subjects. Conclusions: Scrambler therapy may be associated with symptom improvements in patients with severe, medically refractory RLS/WED. No adverse effects were associated with therapy. Further work is necessary to characterize this possible treatment option. This study is registered in Clinicaltrials.gov as “Treatment of RLS/WED Symptoms through Sensory Counterstimulation.” ClinicalTrials.gov identifier: NCT03249779.
{"title":"Electrical Stimulation via the Scrambler Device as a Treatment for Refractory Restless Legs Syndrome/Willis Ekbom Disease","authors":"M. Lipford, Carrie O'Neill, K. Eibner, S. Donlinger, Daniel L. Herold, T. Morgenthaler, C. Loprinzi","doi":"10.35248/2167-0277.20.9.318","DOIUrl":"https://doi.org/10.35248/2167-0277.20.9.318","url":null,"abstract":"Study objectives: To evaluate, in a pilot fashion, efficacy and tolerability of electrical counter-stimulation using the Scrambler device in alleviating discomfort and urge to move in patients with medically refractory restless legs syndrome/Willis Ekbom Disease (RLS/WED). Methods: Eligible patients had moderate to very severe RLS/WED symptoms for ≥ 3 months, based on the International Restless Legs Syndrome Study Group (IRLS) Rating Scale. Subjects were treated with Scrambler Therapy for up to ten daily 1-2 hour sessions. Symptoms were monitored using the IRLS as well as questionnaires regarding daily symptoms and global impression of change. Questionnaires were administered at baseline, during therapy, and one-week after the last Scrambler session. Subjects were also queried regarding any adverse effects. Results: Eight subjects were enrolled (M=F). Subjects were on an average of 3 RLS drugs at time of enrollment. Two patients were asked to taper off of gabapentin or pregabalin prior to starting treatments with Scrambler. The IRLS score decreased from a baseline of 27.6 ± 6.2 (mean ± SD) to 19.5 ± 8.0 (p=0.03) following therapy, and to 20.3 ± 10.8 (p=0.07) one week after the last Scrambler treatment. No adverse effects were noted by subjects. Conclusions: Scrambler therapy may be associated with symptom improvements in patients with severe, medically refractory RLS/WED. No adverse effects were associated with therapy. Further work is necessary to characterize this possible treatment option. This study is registered in Clinicaltrials.gov as “Treatment of RLS/WED Symptoms through Sensory Counterstimulation.” ClinicalTrials.gov identifier: NCT03249779.","PeriodicalId":73946,"journal":{"name":"Journal of sleep disorders & therapy","volume":"9 1","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69988311","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 : 2020-01-01DOI: 10.35248/2167-0277.20.9.316
Y. Yamaguchi
Background: In a previous study, we have demonstrated that intermittent negative air pressure (iNAP®) therapy improves the apnea severity in patients with mild-to-moderate obstructive sleep apnea syndrome (OSAS). Purpose: This study was conducted to evaluate the effect of subjective daytime sleepiness for patients with moderate OSA. Methods and Materials: A total of seven men and one woman with moderate OSA were enrolled in this singlecenter, prospective, non-randomized clinical study. All patients used the iNAP® devices in their home during sleep between the diagnostic and second polysomnography assessment. To determine the changes in the subjective sleepiness between the diagnostic and iNAP®-treated PSGs, the Epworth Sleepiness Scale (ESS) score was estimated immediately before the first and second PSG. Results: At baseline the mean (standard deviation) age and body mass index of the study participants were 41.5 (± 6.3) years and 23.2 (± 2.6), respectively. The baseline apnea-hypopnea index (AHI) was 22.2 ± 2.2, and decreased to 15.6 ± 5.3 after the iNAP® therapy (p=0.007). The arousal index improved from 29.8 ± 9.2 at baseline to 19.3 ± 5.1 with the iNAP® device (p=0.0025). With the improvement of apnea severity, the ESS decreased from 14.0 ± 3.8 to 9.1 ± 4.4 (p=0.0076). Conclusions: The negative pressure therapy with the iNAP® Sleep Therapy System ameliorated both the apnea severity and the subjective daytime sleepiness in middle-aged patients with moderate OSA.
{"title":"The Effect of Intermittent Negative Air Pressure, iNAPandreg; on Subjective Daytime Sleepiness in Middle-aged Patients with Moderate Obstructive Sleep Apnea","authors":"Y. Yamaguchi","doi":"10.35248/2167-0277.20.9.316","DOIUrl":"https://doi.org/10.35248/2167-0277.20.9.316","url":null,"abstract":"Background: In a previous study, we have demonstrated that intermittent negative air pressure (iNAP®) therapy improves the apnea severity in patients with mild-to-moderate obstructive sleep apnea syndrome (OSAS). Purpose: This study was conducted to evaluate the effect of subjective daytime sleepiness for patients with moderate OSA. Methods and Materials: A total of seven men and one woman with moderate OSA were enrolled in this singlecenter, prospective, non-randomized clinical study. All patients used the iNAP® devices in their home during sleep between the diagnostic and second polysomnography assessment. To determine the changes in the subjective sleepiness between the diagnostic and iNAP®-treated PSGs, the Epworth Sleepiness Scale (ESS) score was estimated immediately before the first and second PSG. Results: At baseline the mean (standard deviation) age and body mass index of the study participants were 41.5 (± 6.3) years and 23.2 (± 2.6), respectively. The baseline apnea-hypopnea index (AHI) was 22.2 ± 2.2, and decreased to 15.6 ± 5.3 after the iNAP® therapy (p=0.007). The arousal index improved from 29.8 ± 9.2 at baseline to 19.3 ± 5.1 with the iNAP® device (p=0.0025). With the improvement of apnea severity, the ESS decreased from 14.0 ± 3.8 to 9.1 ± 4.4 (p=0.0076). Conclusions: The negative pressure therapy with the iNAP® Sleep Therapy System ameliorated both the apnea severity and the subjective daytime sleepiness in middle-aged patients with moderate OSA.","PeriodicalId":73946,"journal":{"name":"Journal of sleep disorders & therapy","volume":"9 1","pages":"1-7"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69988681","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 : 2020-01-01DOI: 10.35248/2167-0277.20.9.324
O. Awopeju, O. Oninla, A. O. Odeyemi, A. Adebowale, F. O. Awoniyi, J. Zifodya, G. Erhabor
Background: Obesity and regional fat distribution are among the strongest risk factors for obstructive sleep apnea (OSA) in the general population. People living with HIV (PLHIV) may be at increased risk of OSA because of their distinct body fat composition. This study examined the association of body fat composition with the risk of OSA in PLHIV. Methods: We conducted a cross-sectional prospective study at a tertiary HIV care unit, recruiting 400 PLHIV [female: 317, 79.2%; median age of 44 years; median year of HIV duration of 5 years]. Participants were surveyed using standardized instruments to assess the risk of OSA, sleep duration and, sleepiness. Body fat composition was evaluated with anthropometric measurements and bioelectric impedance Results: Sixty-three of the participants (15.8%; 95% confidence interval [CI], 12.4%–19.8%) had risk of OSA, while 24 (6.0%) of them had risk of OSA and excessive day time sleepiness and 30 (7.5%) had risk of OSA with concomitant short sleep duration. BMI and markers of central obesity were significantly associated with risk of OSA in females but not in males. Waist circumference, Waist to hip ratio, Visceral fat level performed similarly in predicting the risk of OSA in females with Area Under the Curve (AUC) of 0.668, 95% CI (0.613, 0.719); 0.704, 95% CI (0.651, 0.754); 0.663, 95% CI (0.608, 0.715) respectively, with VFL having the best accuracy. Conclusions: The risk of OSA among PLHIV was associated with measures of visceral adiposity in females and not in males.
背景:肥胖和区域脂肪分布是一般人群中阻塞性睡眠呼吸暂停(OSA)的最强危险因素。艾滋病毒感染者(PLHIV)由于其独特的身体脂肪组成，可能会增加患阻塞性睡眠呼吸暂停的风险。本研究探讨了PLHIV患者体脂组成与OSA风险的关系。方法:我们在一家三级HIV护理单位进行了一项横断面前瞻性研究，招募了400名HIV感染者[女性:317人，79.2%;中位年龄44岁;艾滋病毒持续时间中位数为5年]。研究人员使用标准化的工具对参与者进行调查，以评估阻塞性睡眠呼吸暂停的风险、睡眠持续时间和困倦程度。通过人体测量和生物电阻抗评估体脂肪组成结果:63名参与者(15.8%;95%可信区间[CI]， 12.4% ~ 19.8%)存在OSA风险，其中24例(6.0%)存在OSA伴白天过度嗜睡风险，30例(7.5%)存在OSA伴睡眠时间不足风险。BMI和中心性肥胖指标与女性患OSA的风险显著相关，而与男性无关。腰围、腰臀比、内脏脂肪水平在预测女性OSA风险方面表现相似，曲线下面积(AUC)为0.668,95% CI (0.613, 0.719);0.704, 95% ci (0.651, 0.754);分别为0.663,95% CI(0.608, 0.715)，其中VFL准确率最高。结论:PLHIV患者发生OSA的风险与女性内脏脂肪相关，而与男性无关。
{"title":"Gender-Specific Association of Body Fat Composition with Risk of Obstructive Sleep Apnea among People Living With HIV/AIDS: A Cross-Sectional Study","authors":"O. Awopeju, O. Oninla, A. O. Odeyemi, A. Adebowale, F. O. Awoniyi, J. Zifodya, G. Erhabor","doi":"10.35248/2167-0277.20.9.324","DOIUrl":"https://doi.org/10.35248/2167-0277.20.9.324","url":null,"abstract":"Background: Obesity and regional fat distribution are among the strongest risk factors for obstructive sleep apnea (OSA) in the general population. People living with HIV (PLHIV) may be at increased risk of OSA because of their distinct body fat composition. This study examined the association of body fat composition with the risk of OSA in PLHIV. Methods: We conducted a cross-sectional prospective study at a tertiary HIV care unit, recruiting 400 PLHIV [female: 317, 79.2%; median age of 44 years; median year of HIV duration of 5 years]. Participants were surveyed using standardized instruments to assess the risk of OSA, sleep duration and, sleepiness. Body fat composition was evaluated with anthropometric measurements and bioelectric impedance Results: Sixty-three of the participants (15.8%; 95% confidence interval [CI], 12.4%–19.8%) had risk of OSA, while 24 (6.0%) of them had risk of OSA and excessive day time sleepiness and 30 (7.5%) had risk of OSA with concomitant short sleep duration. BMI and markers of central obesity were significantly associated with risk of OSA in females but not in males. Waist circumference, Waist to hip ratio, Visceral fat level performed similarly in predicting the risk of OSA in females with Area Under the Curve (AUC) of 0.668, 95% CI (0.613, 0.719); 0.704, 95% CI (0.651, 0.754); 0.663, 95% CI (0.608, 0.715) respectively, with VFL having the best accuracy. Conclusions: The risk of OSA among PLHIV was associated with measures of visceral adiposity in females and not in males.","PeriodicalId":73946,"journal":{"name":"Journal of sleep disorders & therapy","volume":"9 1","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69988811","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 : 2018-05-15DOI: 10.4172/2167-0277.1000290
Sajedeh Behtaj
This study aims to compare the effectiveness of acupuncture and medication therapy on improving sleep disorders in women suffering from Generalized Anxiety Disorder. This study is a quasi-experimental with pretestposttest, control group, and follow-up period. The study population included all women suffering from generalized anxiety disorder and sleep disorder. Purposive sampling was used to select the sample. Using this method, 45 participants were selected and randomly assigned to three groups: acupuncture, medication therapy, and control groups. Acupuncture group received 12 to 15 treatment sessions (2-3 times a week) in DU20, HT7, PC6, Kid6, Ren12, UB62, Sp6, Anmian and Ear-shen men. Medication therapy group were taken drugs under the supervision of a psychiatric while the control group received no intervention over this period. In order to analyze the data, repeated measures were used in the statistical SPSS software version 21. The results showed that both acupuncture and medication therapy programs improve sleep disorder in women with generalized anxiety disorder; however, the acupuncture was more effective than medication therapy.
{"title":"On the Comparison of the Effectiveness of Acupuncture and Medication Therapy on Improving Sleep Disorders in Women Suffering from Generalized Anxiety Disorder","authors":"Sajedeh Behtaj","doi":"10.4172/2167-0277.1000290","DOIUrl":"https://doi.org/10.4172/2167-0277.1000290","url":null,"abstract":"This study aims to compare the effectiveness of acupuncture and medication therapy on improving sleep disorders in women suffering from Generalized Anxiety Disorder. This study is a quasi-experimental with pretestposttest, control group, and follow-up period. The study population included all women suffering from generalized anxiety disorder and sleep disorder. Purposive sampling was used to select the sample. Using this method, 45 participants were selected and randomly assigned to three groups: acupuncture, medication therapy, and control groups. Acupuncture group received 12 to 15 treatment sessions (2-3 times a week) in DU20, HT7, PC6, Kid6, Ren12, UB62, Sp6, Anmian and Ear-shen men. Medication therapy group were taken drugs under the supervision of a psychiatric while the control group received no intervention over this period. In order to analyze the data, repeated measures were used in the statistical SPSS software version 21. The results showed that both acupuncture and medication therapy programs improve sleep disorder in women with generalized anxiety disorder; however, the acupuncture was more effective than medication therapy.","PeriodicalId":73946,"journal":{"name":"Journal of sleep disorders & therapy","volume":"7 1","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2018-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45736212","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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