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The Effect of Sleep Stage and Position on Postoperative Polysomnography 睡眠阶段和体位对术后多导睡眠图的影响
Pub Date : 2018-01-01 DOI: 10.4172/2167-0277.1000E145
J. Stanley
Polysomnography is the gold standard for the diagnosis of obstructive sleep apnea (OSA), evaluation of its severity, and assessment of treatment response. Sleep apnea syndrome has been defined as an apnea hypopnea index (AHI) greater than 5 with the presence of associated symptoms such as excessive daytime sleepiness. Because the correlation between AHI and morbidity and mortality is well established, it is frequently used as the primary parameter to describe surgical treatment outcomes. However, recent reports suggest that polysomnographic indices such as AHI may be discordant with quality of life measures [1-4].
多导睡眠图是诊断阻塞性睡眠呼吸暂停(OSA)、评估其严重程度和评估治疗反应的金标准。睡眠呼吸暂停综合征被定义为呼吸暂停低通气指数(AHI)大于5,并伴有白天过度嗜睡等相关症状。由于AHI与发病率和死亡率之间的相关性已经很好地确立,因此它经常被用作描述手术治疗结果的主要参数。然而,最近的报道表明,多导睡眠图指标如AHI可能与生活质量测量不一致[1-4]。
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引用次数: 0
Relation of Snoring Habits with Body Mass Index and Neck Circumference among Adult Population 成人打鼾习惯与体重指数、颈围的关系
Pub Date : 2018-01-01 DOI: 10.4172/2167-0277.1000293
Biswas Rsr, Rahman Mh, F. Chowdhury
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引用次数: 3
Debunking Myths about Treatment Emergent Central Sleep Apnea 揭穿治疗突发性中枢性睡眠呼吸暂停的神话
Pub Date : 2018-01-01 DOI: 10.4172/2167-0277.1000e147
Nikita Malaiya, Mallika Sinha
Treatment Emergent Central Sleep Apnea (TECSA) is a polysomnographic phenomenon whereby there is emergence of new central respiratory events (central apneas and hypopneas) after preexisting obstructive events have mostly resolved while patient is being titrated with positive airway pressure (PAP) therapy [1]. The acronym TECSA was first used by Nigam et al. in 2016 while describing the prevalence and risk factors related to central sleep apnea developing instantaneously with PAP use [2]. They found that the aggregate point prevalence of TECSA is around 8% while the estimated range varies from 5% to 20% in patients with untreated OSA [2]. This phenomenon can occur at any CPAP setting including very low pressure settings [3]. Few years later, Nigam et al. in a sentinel paper demonstrated that TECSA may not always be transient after all. While most cases of newly identified TECSA resolve in few weeks to few months of PAP use, this is not true for all cases. In a rigorous systematic review, they found that about a third of patients with TECSA may continue to exhibit persistence of PAP related central apneas on re-evaluation [4]. A small proportion may experience what they call delayed-TECSA (DTECSA), referring to patients that do not show TECSA on first titration but go on to develop TECSA few weeks to several months after initial exposure to PAP therapy [4,5].
紧急中枢性睡眠呼吸暂停(TECSA)是一种多导睡眠图现象,在患者接受气道正压(PAP)治疗[1]时,先前存在的阻塞性事件大部分解决后,出现新的中枢性呼吸事件(中枢性呼吸暂停和呼吸不足)。首字母缩略词TECSA由Nigam等人于2016年首次使用,用于描述与PAP使用[2]立即发生的中央性睡眠呼吸暂停相关的患病率和风险因素。他们发现,在未经治疗的OSA患者中,TECSA的总点患病率约为8%,而估计范围为5%至20%。这种现象可以发生在任何CPAP设置,包括非常低的压力设置[3]。几年后,Nigam等人在一篇前哨论文中证明,TECSA可能并不总是短暂的。虽然大多数新发现的TECSA病例在PAP使用几周到几个月后消退,但并非所有病例都如此。在一项严格的系统回顾中,他们发现大约三分之一的TECSA患者在重新评估bbb时可能会继续表现出PAP相关的中枢呼吸暂停的持久性。一小部分患者可能会出现所谓的延迟性TECSA (DTECSA),指的是首次滴定时未出现TECSA,但在首次接受PAP治疗后几周到几个月出现TECSA的患者[4,5]。
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引用次数: 1
Obstructive Sleep Apnea as a Risk Factor for Atrial Fibrillation: A Meta-Analysis. 阻塞性睡眠呼吸暂停是心房颤动的危险因素:一项荟萃分析。
Pub Date : 2018-01-01 Epub Date: 2018-02-12 DOI: 10.4172/2167-0277.1000282
Irini Youssef, Haroon Kamran, Mena Yacoub, Nirav Patel, Clive Goulbourne, Shweta Kumar, Jesse Kane, Haley Hoffner, Moro Salifu, Samy I McFarlane

Objectives: To conducted a meta-analysis assessing the relationship between Obstructive Sleep Apnea (OSA) and the risk of Atrial Fibrillation (AF).

Methods: We searched PUBMED, Medline, and Cochrane Library using the keywords "atrial fibrillation", "obstructive sleep apnea" and "sleep disordered breathing (SDB)". All subjects included had established diagnosis of OSA/SDB. We then compared the occurrence of AF versus no AF. Analysis done with Comprehensive Meta-Analysis package V3 (Biostat, USA).

Results: A total of 579 results were generated. Duplicates were removed and 372 records were excluded based on irrelevant abstracts, titles, study design not consistent with the stated outcome, or full-text unavailable. Twelve studies meeting the inclusion criteria were reviewed in full-text; 2 of these articles were eventually removed due to unconfirmed OSA diagnostic modality, and one was also removed based on a control group inconsistent with the other studies. Therefore, a total of 9 studies were included (n=19,837). Sample sizes ranged from n=160 patients to n=6841 patients. The risk of AF was found to be higher among OSA/SDB versus control group (OR; 2.120, C.I: 1.845-2.436, Z; 10.598 p: <0.001). The heterogeneity observed for the pooled analysis was Q-value; 22.487 df (Q); 8 P-value; 0.004, I-squared; 64.424 Tau2; 0.098, suggesting appropriate study selection and moderate heterogeneity.

Conclusion: OSA/SDB is strongly associated with AFib confirming the notion that OSA/SDB populations are high risk for development of AF. Prospective studies are needed to ascertain the effect of the treatment of OSA/SDB for the prevention of AF, a growing health burden with serious consequences.

目的:进行一项meta分析,评估阻塞性睡眠呼吸暂停(OSA)与心房颤动(AF)风险之间的关系。方法:采用关键词“心房颤动”、“阻塞性睡眠呼吸暂停”、“睡眠呼吸障碍(SDB)”检索PUBMED、Medline、Cochrane Library。所有受试者均确诊为OSA/SDB。然后,我们比较了房颤的发生与无房颤的发生。分析使用综合荟萃分析包V3 (Biostat,美国)完成。结果:共生成579条结果。根据不相关的摘要、标题、研究设计与所述结果不一致或无法获得全文,删除了重复的记录,并排除了372条记录。对符合纳入标准的12项研究进行全文综述;其中2篇文章由于未证实的OSA诊断方式最终被删除,1篇文章也基于与其他研究不一致的对照组而被删除。因此,共纳入9项研究(n= 19837)。样本量从n=160例到n=6841例不等。与对照组相比,OSA/SDB组发生房颤的风险更高(OR;2.120, c.i.: 1.845-2.436, z;10.598 p:结论:OSA/SDB与房颤密切相关,证实OSA/SDB人群是房颤发展的高危人群。需要前瞻性研究来确定OSA/SDB治疗对房颤的预防作用,房颤是一种日益严重的健康负担,后果严重。
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引用次数: 59
Age and Gender Related Differences in Patient Awareness of Conditions Associated with Untreated Obstructive Sleep Apnea 患者对未经治疗的阻塞性睡眠呼吸暂停相关疾病认知的年龄和性别差异
Pub Date : 2018-01-01 DOI: 10.4172/2167-0277.1000284
J. Stanley, J. Palmisano, Steven G. Hoshal, Lizabeth A. Binns, L. O’Brien
Introduction: Patient education has been shown to improve continuous positive airway pressure (CPAP) compliance in the treatment of obstructive sleep apnea (OSA). This is facilitated by improving patient awareness of both the goals of treatment, proper use of the device and consequences of inadequate treatment. The most obvious outcome of successful therapy is an improvement in excessive daytime sleepiness. However, it is hypothesized that the long-term benefits of disease prevention and lessening the severity of conditions known to be associated with untreated OSA are less well recognized by patients. The purpose of this study was to document the degree of patient awareness of conditions associated with OSA. It is anticipated that a lack of knowledge exists in some patient subgroups; that if educated more intensely about these associations might be more diligent in participating in the treatment of their OSA. Methods: This study was a cross-sectional survey of patients who had been prescribed positive airway pressure (PAP) therapy for OSA. This survey assessed patient knowledge of co-morbid medical conditions associated with untreated OSA. Results: The vast majority of participants failed to recognize all of the most common co-morbid conditions. Significant differences in awareness were noted between different age groups and genders. Conclusions: Patient education is important in achieving CPAP compliance. Patient education, as demonstrated by a relative lack of knowledge of associated co-morbidities, appears to be inadequate. Greater efforts at patient education during each and every patient encounter in the sleep disorders clinic are recommended.
患者教育已被证明可以改善阻塞性睡眠呼吸暂停(OSA)治疗中持续气道正压通气(CPAP)的依从性。通过提高患者对治疗目标、设备的正确使用和治疗不当后果的认识,可以促进这一点。治疗成功后最明显的结果是白天过度嗜睡的改善。然而,据推测,疾病预防和减轻与未经治疗的OSA相关的疾病严重程度的长期益处尚未被患者充分认识到。本研究的目的是记录患者对阻塞性睡眠呼吸暂停相关疾病的认知程度。预计在一些患者亚组中存在缺乏知识的情况;如果更深入地了解这些关联,他们可能会更积极地参与到OSA的治疗中。方法:本研究对接受气道正压(PAP)治疗OSA的患者进行横断面调查。这项调查评估了患者对未经治疗的阻塞性睡眠呼吸暂停相关的合并症的知识。结果:绝大多数参与者未能识别所有最常见的合并症。不同年龄组和性别之间的认知存在显著差异。结论:患者教育是实现CPAP依从性的重要因素。对患者的教育似乎是不够的,因为患者对相关合并症的知识相对缺乏。在每一个病人遇到睡眠障碍诊所建议更大的努力患者教育。
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引用次数: 2
Functional Cognitive Disorders: Can Sleep Disturbance Contribute to a Positive Diagnosis? 功能性认知障碍:睡眠障碍是否有助于诊断?
Pub Date : 2018-01-01 DOI: 10.4172/2167-0277.1000291
Elhadd K, Bharambe V, Larner Aj
Study background: Sleep disturbance may contribute to subjective memory complaints which are frequently encountered in cognitive disorders clinics. Identification of sleep disturbance may contribute to a positive diagnosis of functional cognitive disorders (FCD) compared to dementia or mild cognitive impairment. Methods: Jenkins Sleep Scale (JSS), a validated sleep scale, was administered to consecutive new patients attending a dedicated cognitive disorders clinic based in a regional neuroscience Centre. Results: Sleep disturbance identified using JSS was more frequent in patients with functional cognitive disorders (p 0.8) for FCD when used as a diagnostic test. Conclusion: Identifying sleep disturbance using a simple sleep screening scale may contribute to a positive diagnosis of functional cognitive disorders in a dedicated cognitive disorders clinic. This may have pragmatic implications for the treatment of subjective memory complaints.
研究背景:睡眠障碍可能导致主观记忆抱怨,这是认知障碍诊所经常遇到的问题。与痴呆或轻度认知障碍相比,识别睡眠障碍可能有助于功能性认知障碍(FCD)的积极诊断。方法:Jenkins睡眠量表(JSS)是一种经过验证的睡眠量表,对连续在区域神经科学中心专门的认知障碍诊所就诊的新患者进行管理。结果:当使用JSS作为FCD的诊断测试时,功能性认知障碍患者更容易发现睡眠障碍(p < 0.8)。结论:在专门的认知障碍诊所,使用简单的睡眠筛查量表识别睡眠障碍可能有助于功能性认知障碍的积极诊断。这可能对主观记忆疾患的治疗有实际意义。
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引用次数: 14
Sleep Deprivation in First Responders-How Much of a Contributing Factor to Reported Suicide Rates? 第一反应人员的睡眠剥夺——报告的自杀率有多大影响因素?
Pub Date : 2018-01-01 DOI: 10.4172/2167-0277.1000E144
K. Sexton-Radek
Suicide rates are estimated to be 30,000 deaths per year in the United States. Recent news stations and periodicals have been covering reporting of increased deaths by suicides of first responders in a 2016 Center for Disease Control report [1]. The first responder group of firefighters, paramedics and police officers now represents a high risk group. Within this population of suicide deaths, features of more males and use of firearms comprises the highest levels of suicides. The identified risk factors associated with first responders are marital discord, trauma, increased stress and role diffusion with the sudden fame associated with event they responded to. Additional triggers to first responders have, to date, been described as stress and loss of health. Sleep deprivation has been identified as a significant trigger factor linked to depression and suicide [2]. However, the specifics of the extent and history of the sleep deprivation as well as other factors such as mood levels are not provided in the news reporting’s.
据估计,美国每年有3万人死于自杀。最近的新闻台和期刊一直在报道2016年疾病控制中心报告中第一反应者自杀死亡人数增加的报道。消防员、护理人员和警察组成的第一反应小组现在代表了一个高风险群体。在这一自杀死亡人口中,男性较多的特点和使用火器构成了自杀的最高水平。已确定的与第一响应者相关的风险因素是婚姻不和谐、创伤、压力增加以及与他们响应的事件相关的突然成名的角色扩散。迄今为止,第一反应者的其他触发因素被描述为压力和健康损失。睡眠不足已被确定为与抑郁和自杀相关的一个重要触发因素。然而,关于睡眠剥夺的具体程度和历史,以及其他因素,如情绪水平,并没有在新闻报道中提供。
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引用次数: 0
Lessons Learned from a Narcolepsy Support Group 嗜睡症互助小组的经验教训
Pub Date : 2018-01-01 DOI: 10.4172/2167-0277.1000294
M. Rodgers
As a sleep physician for a military treatment facility our patient population consists of roughly forty thousand soldiers and beneficiaries. Of which we primarily care for an adult population. Part of my experience as a sleep physician has involved the use of group classes and support group sessions for obstructive sleep apnea, insomnia, oral appliance therapy and nightmare therapy groups. I wanted to establish a support group within our clinic for patients with narcolepsy.
作为一名军事治疗机构的睡眠医生,我们的病人大约有4万名士兵和受益者。我们主要针对的是成年人。作为一名睡眠医生,我的部分经验包括对阻塞性睡眠呼吸暂停、失眠、口腔器械治疗和噩梦治疗小组进行小组课程和支持小组会议。我想在我们的诊所里为嗜睡症患者建立一个支持小组。
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引用次数: 0
Is there an Order in Sleep? Is it recoverable when lost? 睡眠有规律吗?丢失后可以恢复吗?
Pub Date : 2017-12-07 DOI: 10.4172/2167-0277.1000e142
D. Liberati
Sleep is of paramount importance in our life: lot of it is spent in sleeping; whose quality heavily affects our awake remaining time. A newborn spends most of its time in sleeping, probably completing its maturation when out of the mother at the latest compatible moment with relative dimensions in delivery. The other necessary function is nourishing, now that the direct umbilical maternal feeding is lost, substituted by her breast (or surrogate): thus the first ordering in sleeping is just to interrupt it when needed in order to nourish, which is at least at the beginning every few hours, the baby needing enough, being not yet able to get a lot each time.
睡眠在我们的生活中至关重要:大部分时间都花在睡觉上;睡眠质量严重影响我们清醒的剩余时间。新生儿大部分时间是在睡眠中度过的,可能在与分娩的相对尺寸相适应的最后时刻离开母亲时完成其成熟。另一个必要的功能是滋养,现在直接的脐带母亲喂养已经失去,取而代之的是她的乳房(或代孕):因此,睡眠的第一个命令只是在需要滋养时中断它,这至少是每隔几个小时开始,婴儿需要足够的,还不能每次都得到很多。
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引用次数: 0
Sadly Awake: Short Sleep Duration and Depressive Symptoms among Adolescents 悲伤觉醒:青少年睡眠时间短和抑郁症状
Pub Date : 2017-11-20 DOI: 10.4172/2167-0277.1000277
S. Reisman
Background: Inappropriate sleep duration has been showed to be associated with increased suicidality among high school students in the United States. An association between inappropriate sleep duration and general depressive symptoms among this population has not been reported. Methods: The biennial Youth Risk Behavior Surveillance System uses national and local school-based surveys to measure the prevalence of health-risk behaviors among youth and young adults. Students reported how many hours a night they get on an average school night and whether their daily routine was altered for two consecutive weeks due to sadness or hopelessness. We analyzed whether 8-10 hours of sleep was associated with depressive symptoms. Covariates included sex, race, BMI, bullying, abuse, smoking, alcohol use, and drug use. Results: Students who reported <8 or ≥ 10 hours of sleep had an odds ratio of 1.66(1.49, 1.86) of concurrent depressive symptoms. Conclusion: Routine adolescent depression surveillance may be enhanced by sleep duration assessments.
背景:在美国,不适当的睡眠时间已被证明与高中生自杀行为的增加有关。在这一人群中,睡眠时间不合适与一般抑郁症状之间的关联尚未报道。方法:两年一度的青少年风险行为监测系统利用国家和地方的学校调查来衡量青少年和年轻人的健康风险行为的流行率。学生们报告了他们平均每晚上学的时间,以及他们的日常生活是否连续两周因悲伤或绝望而改变。我们分析了8-10小时的睡眠是否与抑郁症状有关。协变量包括性别、种族、BMI、欺凌、虐待、吸烟、饮酒和吸毒。结果:报告睡眠时间<8小时或≥10小时的学生并发抑郁症状的比值比为1.66(1.49,1.86)。结论:通过睡眠时间评估可以加强青少年抑郁的常规监测。
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引用次数: 1
期刊
Journal of sleep disorders & therapy
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