Objectives: The coronavirus disease (COVID-19) pandemic and news of daily increasing cases inside Nepal and worldwide is adding to the fear that leads to anger, anxiety, frustration, and stress, emotions that directly affect sleep quality. This study aimed to assess sleep disturbances during the COVID-19 pandemic in a Nepalese population.Methods: This cross-sectional study recruited 206 Nepali residents who completed anonymous self-administered questionnaires. The Insomnia Severity Index (ISI) questionnaire was used to measure sleep disturbances before and after the COVID-19 pandemic. The gathered data were analyzed using descriptive statistics and inferential statistics using SPSS version 20 statistical software.Results: There was a significant variation in sleep disturbances among Nepalese residents before versus after the COVID-19 pandemic (p<0.001). The prevalence of clinical moderate insomnia has increased tremendously in Nepalese individuals. Before the pandemic’s onset, only 3.9% of the participants had moderate to severe levels of clinical insomnia; after its onset, this value increased to 17.5%. The mean ISI scores were 6.35±4.65 and 8.01±6.01 before and after the pandemic’s onset, respectively.Conclusions: Our study findings suggest that people are suffering tremendously with sleep disturbances and calls for further research and active measures to help increase sleep quality during the COVID-19 pandemic.
{"title":"Prevalence of Sleep Disturbances During COVID-19 Pandemic in a Nepalese Population: A Cross-Sectional Study","authors":"A. Chandra, P. Prakash, Nabina Sharma, A. Chandra","doi":"10.13078/jsm.210012","DOIUrl":"https://doi.org/10.13078/jsm.210012","url":null,"abstract":"Objectives: The coronavirus disease (COVID-19) pandemic and news of daily increasing cases inside Nepal and worldwide is adding to the fear that leads to anger, anxiety, frustration, and stress, emotions that directly affect sleep quality. This study aimed to assess sleep disturbances during the COVID-19 pandemic in a Nepalese population.Methods: This cross-sectional study recruited 206 Nepali residents who completed anonymous self-administered questionnaires. The Insomnia Severity Index (ISI) questionnaire was used to measure sleep disturbances before and after the COVID-19 pandemic. The gathered data were analyzed using descriptive statistics and inferential statistics using SPSS version 20 statistical software.Results: There was a significant variation in sleep disturbances among Nepalese residents before versus after the COVID-19 pandemic (p<0.001). The prevalence of clinical moderate insomnia has increased tremendously in Nepalese individuals. Before the pandemic’s onset, only 3.9% of the participants had moderate to severe levels of clinical insomnia; after its onset, this value increased to 17.5%. The mean ISI scores were 6.35±4.65 and 8.01±6.01 before and after the pandemic’s onset, respectively.Conclusions: Our study findings suggest that people are suffering tremendously with sleep disturbances and calls for further research and active measures to help increase sleep quality during the COVID-19 pandemic.","PeriodicalId":90527,"journal":{"name":"Indian journal of sleep medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78588114","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}
Obstructive sleep apnea (OSA), a common comorbidity in patients with stroke, has shown increasing prevalence over the past few decades. OSA is an important risk factor for stroke in addition to other well-known contributors, including hypertension, hyperlipidemia, atrial fibrillation, and diabetes mellitus. Moreover, OSA is an independent predictor of neurological outcomes and mortality. The pathological mechanisms underlying the association between OSA and stroke include autonomic dysfunction, hypertension, cardiac arrhythmia, dyslipidemia, impaired glucose tolerance, hypoxia, and inflammation. Continuous positive airway pressure (CPAP) therapy has proven clinical utility in improvement of neurological symptoms in patients with stroke. Findings from a CPAP withdrawal model have shown increased sympathetic activity in OSA with a consequent significant elevation in blood pressure, relevant cerebral hypoxia, and disturbed cardiac repolarization. In this review, we present an overview of the literature that describes an association between OSA and stroke in addition to the vascular risk factors, including hypertension, hyperlipidemia, atrial fibrillation, and diabetes mellitus. This study highlights the importance of early and accurate diagnosis and management of OSA for stroke prevention and care and will benefit physicians in clinical practice.
{"title":"Association Between Obstructive Sleep Apnea and Stroke and Contributory Risk Factors","authors":"H. Woo, K. Yang, T. Song","doi":"10.13078/jsm.210020","DOIUrl":"https://doi.org/10.13078/jsm.210020","url":null,"abstract":"Obstructive sleep apnea (OSA), a common comorbidity in patients with stroke, has shown increasing prevalence over the past few decades. OSA is an important risk factor for stroke in addition to other well-known contributors, including hypertension, hyperlipidemia, atrial fibrillation, and diabetes mellitus. Moreover, OSA is an independent predictor of neurological outcomes and mortality. The pathological mechanisms underlying the association between OSA and stroke include autonomic dysfunction, hypertension, cardiac arrhythmia, dyslipidemia, impaired glucose tolerance, hypoxia, and inflammation. Continuous positive airway pressure (CPAP) therapy has proven clinical utility in improvement of neurological symptoms in patients with stroke. Findings from a CPAP withdrawal model have shown increased sympathetic activity in OSA with a consequent significant elevation in blood pressure, relevant cerebral hypoxia, and disturbed cardiac repolarization. In this review, we present an overview of the literature that describes an association between OSA and stroke in addition to the vascular risk factors, including hypertension, hyperlipidemia, atrial fibrillation, and diabetes mellitus. This study highlights the importance of early and accurate diagnosis and management of OSA for stroke prevention and care and will benefit physicians in clinical practice.","PeriodicalId":90527,"journal":{"name":"Indian journal of sleep medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84271177","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}
Jae Wook Cho, J. Sunwoo, S. Yim, Daeyoung Kim, D. Koo, H. Im, Hyeyun Kim, Kyung Min Kim, Kwang Ik Yang
Narcolepsy is a chronic sleep disorder characterized by irresistible sleep attacks, hypersomnolence, cataplexy (sudden loss of muscle tone provoked by emotion), and sleep paralysis. Individuals with narcolepsy are at a high risk of experiencing sleepiness while driving leading to road traffic accidents. To prevent such accidents, some countries have regulations for commercial and noncommercial drivers with narcolepsy. Evaluating sleepiness is essential. Therefore, several subjective reports and objective tests were used to predict the possibility of car crashes or near-misses. Brain stimulants are effective in treating narcolepsy and can reduce daytime sleepiness in these patients. However, no guideline has been established for the driving safety of patients with narcolepsy in Korea. The Korean Sleep Research Society has prepared this proposal for preventing motor vehicle accidents caused by drowsy driving in patients with narcolepsy.
{"title":"Proposal for Preventing Motor Vehicle Accident Related to Drowsy Driving in Patients With Narcolepsy","authors":"Jae Wook Cho, J. Sunwoo, S. Yim, Daeyoung Kim, D. Koo, H. Im, Hyeyun Kim, Kyung Min Kim, Kwang Ik Yang","doi":"10.13078/jsm.210025","DOIUrl":"https://doi.org/10.13078/jsm.210025","url":null,"abstract":"Narcolepsy is a chronic sleep disorder characterized by irresistible sleep attacks, hypersomnolence, cataplexy (sudden loss of muscle tone provoked by emotion), and sleep paralysis. Individuals with narcolepsy are at a high risk of experiencing sleepiness while driving leading to road traffic accidents. To prevent such accidents, some countries have regulations for commercial and noncommercial drivers with narcolepsy. Evaluating sleepiness is essential. Therefore, several subjective reports and objective tests were used to predict the possibility of car crashes or near-misses. Brain stimulants are effective in treating narcolepsy and can reduce daytime sleepiness in these patients. However, no guideline has been established for the driving safety of patients with narcolepsy in Korea. The Korean Sleep Research Society has prepared this proposal for preventing motor vehicle accidents caused by drowsy driving in patients with narcolepsy.","PeriodicalId":90527,"journal":{"name":"Indian journal of sleep medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82265721","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}
J. Sunwoo, Jae Wook Cho, S. Yim, Daeyoung Kim, D. Koo, H. Im, Hyeyun Kim, Kyung Min Kim, Kwang Ik Yang
Obstructive sleep apnea (OSA) is known to be associated with various health concerns, including sleepiness, fatigue, cognitive dysfunction, diminished quality of life, hypertension, cardiovascular diseases, and stroke. OSA-induced sleepiness at the wheel reduces vigilance and driving performance, which significantly increase the risk of motor vehicle accidents. Sleepiness-induced motor vehicle accidents are characterized by high morbidity and mortality. OSA is a well-established significant risk factor for drowsy driving-related motor vehicle accidents, which can be prevented through appropriate treatment. However, currently no clinical guidelines or regulations are available for evaluation or management of the risk of motor vehicle accidents in patients with OSA in Korea. In this review, we discuss the risk of motor vehicle accidents in patients with OSA, the effects of positive airway pressure therapy as a preventive measure to reduce this risk, and the published recommendations for OSA in other countries with regard to fitness to drive. We propose recommendations for screening, evaluation, and treatment of OSA with regard to the risk of motor vehicle accidents, which would serve as useful practical guidelines for sleep specialists in clinical practice. Further research is warranted to establish optimal strategies for effective improvements in OSA-related traffic safety.
{"title":"Proposal for Prevention of Drowsy Driving-Related Motor Vehicle Accidents in Patients With Obstructive Sleep Apnea","authors":"J. Sunwoo, Jae Wook Cho, S. Yim, Daeyoung Kim, D. Koo, H. Im, Hyeyun Kim, Kyung Min Kim, Kwang Ik Yang","doi":"10.13078/jsm.210024","DOIUrl":"https://doi.org/10.13078/jsm.210024","url":null,"abstract":"Obstructive sleep apnea (OSA) is known to be associated with various health concerns, including sleepiness, fatigue, cognitive dysfunction, diminished quality of life, hypertension, cardiovascular diseases, and stroke. OSA-induced sleepiness at the wheel reduces vigilance and driving performance, which significantly increase the risk of motor vehicle accidents. Sleepiness-induced motor vehicle accidents are characterized by high morbidity and mortality. OSA is a well-established significant risk factor for drowsy driving-related motor vehicle accidents, which can be prevented through appropriate treatment. However, currently no clinical guidelines or regulations are available for evaluation or management of the risk of motor vehicle accidents in patients with OSA in Korea. In this review, we discuss the risk of motor vehicle accidents in patients with OSA, the effects of positive airway pressure therapy as a preventive measure to reduce this risk, and the published recommendations for OSA in other countries with regard to fitness to drive. We propose recommendations for screening, evaluation, and treatment of OSA with regard to the risk of motor vehicle accidents, which would serve as useful practical guidelines for sleep specialists in clinical practice. Further research is warranted to establish optimal strategies for effective improvements in OSA-related traffic safety.","PeriodicalId":90527,"journal":{"name":"Indian journal of sleep medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86837519","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 : 2021-10-13DOI: 10.5005/jp-journals-10069-0083
Keyur M Patel, N. Shah
Background: Incidence of sleep apnea is rising globally. STOP-BANG (Snoring, Tiredness, Observed choking, Pressure, Body Mass Index (BMI), Age, Neck girth, Gender) Score and Epworth sleepiness scale (ESS) are outpatient assessment scores available to suspect and estimate the severity of obstructive sleep apnea (OSA) that is compared with gold standard test overnight polysomnography. Objective: The objective of the article was to validate and establish a correlation of variables of STOP-BANG Score, ESS, and Apnea–Hypopnea Index (AHI) from polysomnography. Methods: Retrospective study in patients aged 18 or more who were referred to the Department of Pulmonary Medicine, BJMC, Ahmedabad, between April 2017 and December 2020 who had complaints of excessive daytime sleepiness underwent overnight polysomnography after physical examination in the outpatient department. Results: Of our study population (n = 200), number of men were 137 (68.5%) and women were 63 (31.5%) with a male:female ratio of 2.17:1. Mean BMI, neck girth, ESS, STOP-BANG Score, and AHI were 32.78 ± 6.9 kg/m2, 39.49 ± 5.97 cm, 14.48 ± 3.91, 5.34 ± 1.7, and 48.22 ± 23, respectively, and the number of patients according to severity was mild 16 (8%), moderate 36 (18%), and severe 146 (73%). The Pearson correlation counted between neck girth (r = 0.68), ESS (r = 0.73) and STOP-BANG Score (r = 0.55) with AHI with a significant p value (<0.0001). Conclusion: Snoring is the most common symptom in suspected OSA individuals. The study showed a positive correlation of BMI, neck girth, ESS >10, STOP-BANG Score >3 with severity of OSA depicted in polysomnography.
{"title":"A Predictive Performance of STOP-BANG Score and Epworth Sleepiness Scale in Suspected Sleep Apnea Individuals","authors":"Keyur M Patel, N. Shah","doi":"10.5005/jp-journals-10069-0083","DOIUrl":"https://doi.org/10.5005/jp-journals-10069-0083","url":null,"abstract":"Background: Incidence of sleep apnea is rising globally. STOP-BANG (Snoring, Tiredness, Observed choking, Pressure, Body Mass Index (BMI), Age, Neck girth, Gender) Score and Epworth sleepiness scale (ESS) are outpatient assessment scores available to suspect and estimate the severity of obstructive sleep apnea (OSA) that is compared with gold standard test overnight polysomnography. Objective: The objective of the article was to validate and establish a correlation of variables of STOP-BANG Score, ESS, and Apnea–Hypopnea Index (AHI) from polysomnography. Methods: Retrospective study in patients aged 18 or more who were referred to the Department of Pulmonary Medicine, BJMC, Ahmedabad, between April 2017 and December 2020 who had complaints of excessive daytime sleepiness underwent overnight polysomnography after physical examination in the outpatient department. Results: Of our study population (n = 200), number of men were 137 (68.5%) and women were 63 (31.5%) with a male:female ratio of 2.17:1. Mean BMI, neck girth, ESS, STOP-BANG Score, and AHI were 32.78 ± 6.9 kg/m2, 39.49 ± 5.97 cm, 14.48 ± 3.91, 5.34 ± 1.7, and 48.22 ± 23, respectively, and the number of patients according to severity was mild 16 (8%), moderate 36 (18%), and severe 146 (73%). The Pearson correlation counted between neck girth (r = 0.68), ESS (r = 0.73) and STOP-BANG Score (r = 0.55) with AHI with a significant p value (<0.0001). Conclusion: Snoring is the most common symptom in suspected OSA individuals. The study showed a positive correlation of BMI, neck girth, ESS >10, STOP-BANG Score >3 with severity of OSA depicted in polysomnography.","PeriodicalId":90527,"journal":{"name":"Indian journal of sleep medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41503604","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 : 2021-10-13DOI: 10.5005/jp-journals-10069-0079
Priya Kapoor, P. Ish, Nitesh Gupta, B. Virk, Aman Chowdhry
Pediatric obstructive sleep apnea (OSA) is an underdiagnosed and often ignored entity. Besides, its management needs a multimodality approach including medical, surgical, dental, and positive airway pressure therapy. This short review discusses the approach, management, and screening options for pediatric OSA along with a glimpse of the latest innovations and the road ahead.
{"title":"Pediatric Sleep Apnea: A Multidisciplinary Diagnosis with a Multimodality Treatment","authors":"Priya Kapoor, P. Ish, Nitesh Gupta, B. Virk, Aman Chowdhry","doi":"10.5005/jp-journals-10069-0079","DOIUrl":"https://doi.org/10.5005/jp-journals-10069-0079","url":null,"abstract":"Pediatric obstructive sleep apnea (OSA) is an underdiagnosed and often ignored entity. Besides, its management needs a multimodality approach including medical, surgical, dental, and positive airway pressure therapy. This short review discusses the approach, management, and screening options for pediatric OSA along with a glimpse of the latest innovations and the road ahead.","PeriodicalId":90527,"journal":{"name":"Indian journal of sleep medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43483088","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 : 2021-10-13DOI: 10.5005/jp-journals-10069-0076
A. Halder, A. Halder
Aims and objectives: Obstructive sleep apnea (OSA) is a common disorder manifested with snoring, daytime sleepiness, fatigue, metabolic, and cardiovascular symptoms. Manual continuous positive airway pressure (CPAP) titration is the gold standard to determine the amount of positive pressure required to abolish the airflow limitations. The current American Academy of Sleep Medicine (AASM) criteria for manual titration are very stringent, elegant but difficult. The AASM protocol does not favor the use of automatic positive airway pressure (APAP) in a split-night study. This study was done to look into changes in sleep and respiratory parameters following diagnostic polysomnography (PSG) and subsequent APAP titration, as a split-night protocol. Materials and method: Records of 80 patients were scrutinized who had done level 1 PSG in a sleep laboratory in Kolkata, India. The laboratory used APAP titration for all kinds of titrations. This is a descriptive study, where data were compared between diagnostic and therapeutic nights of the same patients, done as a split-night study. Results: The diagnostic night was denoted by visit 1 and therapeutic night as visit 2; the study was done as a split-night study. The rapid eye movement (REM) sleep time was found to be significantly increased from 15.08 minutes in V1 (SD 16.26) to 29.69 minutes (24.45) in V2 with a p < 0.001. The total respiratory events were found to be significantly reduced from baseline median value of 206–14 in the follow-up visit posttreatment, p < 0.001 as computed by Wilcoxon’s signed-rank test. The REM SpO 2 was found to be significantly increased from baseline value of 90.87 ± 7.105 to 93.29 ± 6.312 in the follow-up visit posttreatment, p < 0.001 as computed by paired sample t -test. Discussion and conclusion: The wake stages, N1 and N2 sleep, were reduced significantly in the therapeutic night than diagnostic night, but N3 sleep was increased in therapeutic night, though statistically not significant. The total arousals and arousal index were also decreased significantly, although there were wide interindividual variations. So overall, patients had an improved sleep architecture during therapeutic night and often with REM rebound. Overall respiratory parameters showed very significant improvement in terms of apnea and hypopnea index (AHI). Oximetry data showed very significant improvements in terms of oxygen saturation, nadir oxygen saturation, and REM time oxygen level. So we can formulate the hypothesis that even a 2 hours split-night APAP titration can perform a good titration and significant improvements in sleep and respiratory parameters.
目的和目的:阻塞性睡眠呼吸暂停(OSA)是一种常见的疾病，表现为打鼾、白天嗜睡、疲劳、代谢和心血管症状。手动持续气道正压(CPAP)滴定是确定消除气流限制所需正压量的金标准。目前美国睡眠医学学会(AASM)的手动滴定标准非常严格，优雅但困难。AASM协议不赞成在分夜研究中使用自动气道正压通气(APAP)。这项研究的目的是观察诊断性多导睡眠图(PSG)和随后的APAP滴定后睡眠和呼吸参数的变化，作为一个分夜方案。材料与方法:对印度加尔各答某睡眠实验室进行1级多导睡眠监测(PSG)的80例患者的记录进行分析。实验室采用APAP滴定法进行各种滴定。这是一项描述性研究，将同一患者的诊断夜和治疗夜的数据进行比较，作为一项分夜研究。结果:诊断夜记为就诊1，治疗夜记为就诊2;这项研究是在夜间进行的。快速眼动(REM)睡眠时间由V1组15.08 min (SD值16.26)显著增加至V2组29.69 min (SD值24.45)，差异有统计学意义(p < 0.001)。经Wilcoxon 's sign -rank检验，治疗后随访总呼吸事件数较基线中位数206-14显著减少，p < 0.001。经配对样本t检验，治疗后随访时REM SpO 2由基线值90.87±7.105显著增加至93.29±6.312,p < 0.001。讨论与结论:治疗夜与诊断夜相比，N1、N2睡眠阶段明显减少，N3睡眠阶段明显增加，但差异无统计学意义。总唤醒量和唤醒指数也显著降低，但个体间差异较大。因此，总体而言，患者在治疗期间睡眠结构得到改善，并且经常出现快速眼动反弹。整体呼吸参数在呼吸暂停和低通气指数(AHI)方面显示出非常显著的改善。血氧测量数据显示，在氧饱和度、最低点氧饱和度和快速眼动时间氧水平方面有非常显著的改善。因此，我们可以提出这样的假设，即使是2小时的分夜APAP滴定也可以达到良好的滴定效果，并显著改善睡眠和呼吸参数。
{"title":"Comparison of Sleep and Respiratory Parameters of Obstructive Sleep Apnea Patients during Diagnostic and 2 Hours Automatic Positive Airway Pressure Split-night Titration: A Descriptive Study","authors":"A. Halder, A. Halder","doi":"10.5005/jp-journals-10069-0076","DOIUrl":"https://doi.org/10.5005/jp-journals-10069-0076","url":null,"abstract":"Aims and objectives: Obstructive sleep apnea (OSA) is a common disorder manifested with snoring, daytime sleepiness, fatigue, metabolic, and cardiovascular symptoms. Manual continuous positive airway pressure (CPAP) titration is the gold standard to determine the amount of positive pressure required to abolish the airflow limitations. The current American Academy of Sleep Medicine (AASM) criteria for manual titration are very stringent, elegant but difficult. The AASM protocol does not favor the use of automatic positive airway pressure (APAP) in a split-night study. This study was done to look into changes in sleep and respiratory parameters following diagnostic polysomnography (PSG) and subsequent APAP titration, as a split-night protocol. Materials and method: Records of 80 patients were scrutinized who had done level 1 PSG in a sleep laboratory in Kolkata, India. The laboratory used APAP titration for all kinds of titrations. This is a descriptive study, where data were compared between diagnostic and therapeutic nights of the same patients, done as a split-night study. Results: The diagnostic night was denoted by visit 1 and therapeutic night as visit 2; the study was done as a split-night study. The rapid eye movement (REM) sleep time was found to be significantly increased from 15.08 minutes in V1 (SD 16.26) to 29.69 minutes (24.45) in V2 with a p < 0.001. The total respiratory events were found to be significantly reduced from baseline median value of 206–14 in the follow-up visit posttreatment, p < 0.001 as computed by Wilcoxon’s signed-rank test. The REM SpO 2 was found to be significantly increased from baseline value of 90.87 ± 7.105 to 93.29 ± 6.312 in the follow-up visit posttreatment, p < 0.001 as computed by paired sample t -test. Discussion and conclusion: The wake stages, N1 and N2 sleep, were reduced significantly in the therapeutic night than diagnostic night, but N3 sleep was increased in therapeutic night, though statistically not significant. The total arousals and arousal index were also decreased significantly, although there were wide interindividual variations. So overall, patients had an improved sleep architecture during therapeutic night and often with REM rebound. Overall respiratory parameters showed very significant improvement in terms of apnea and hypopnea index (AHI). Oximetry data showed very significant improvements in terms of oxygen saturation, nadir oxygen saturation, and REM time oxygen level. So we can formulate the hypothesis that even a 2 hours split-night APAP titration can perform a good titration and significant improvements in sleep and respiratory parameters.","PeriodicalId":90527,"journal":{"name":"Indian journal of sleep medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46185607","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 : 2021-10-13DOI: 10.5005/jp-journals-10069-0081
M. Jiandani, A. Deshpande, A. Athavale
Background: Sleep is an important component for person’s well-being. It is a basic human need. 1 Studies have reported increased incidence of cognitive errors and increased fatigue in sleep-deprived normal individuals after 8 hours of work. 2 Sleep quality is known to be affected in COPD patients but less studied in other chronic respiratory diseases though the symptoms may be the same. This study aims to assess sleep quality in patients suffering from both COPD and non-COPD respiratory conditions and correlate sleep quality with cognition, exercise capacity, and fatigue in patients with chronic respiratory diseases. Material and methodology: An observational cross-sectional study consisting of 142 stable chronic respiratory disease patients was conducted from September 2016 to March 2017. Sleep quality was evaluated using Pittsburgh sleep quality index (PSQI), cognition using montreal cognitive assessment (MoCA), exercise capacity was measured with incremental shuttle walk test, and fatigue with fatigue severity scale (FSS). Results: Spearman’s test was used to assess correlation of sleep quality with cognition, exercise capacity, and fatigue. Significant but very weak and poor inverse correlation of sleep quality was found with cognition and exercise capacity, respectively, whereas there was weak and linear correlation of sleep quality with fatigue. There was no significant difference in sleep quality of COPD and non-COPD patients as well as hypoxemic and non-hypoxemic patients. Conclusion: Though there is very weak correlation of sleep quality with cognition, sleep quality is poor in 55.63% of patients and cognition is affected in 93.6% of patients ( n = 133). Clinical significance: Sleep quality should be assessed regularly as a part of primary assessment in all chronic respiratory disease patients. Key Message: of sleep quality must be included in routine assessment of patients with chronic respiratory diseases.
{"title":"Correlation of Sleep Quality with Cognition, Exercise Capacity, and Fatigue in Patients with Chronic Respiratory Diseases","authors":"M. Jiandani, A. Deshpande, A. Athavale","doi":"10.5005/jp-journals-10069-0081","DOIUrl":"https://doi.org/10.5005/jp-journals-10069-0081","url":null,"abstract":"Background: Sleep is an important component for person’s well-being. It is a basic human need. 1 Studies have reported increased incidence of cognitive errors and increased fatigue in sleep-deprived normal individuals after 8 hours of work. 2 Sleep quality is known to be affected in COPD patients but less studied in other chronic respiratory diseases though the symptoms may be the same. This study aims to assess sleep quality in patients suffering from both COPD and non-COPD respiratory conditions and correlate sleep quality with cognition, exercise capacity, and fatigue in patients with chronic respiratory diseases. Material and methodology: An observational cross-sectional study consisting of 142 stable chronic respiratory disease patients was conducted from September 2016 to March 2017. Sleep quality was evaluated using Pittsburgh sleep quality index (PSQI), cognition using montreal cognitive assessment (MoCA), exercise capacity was measured with incremental shuttle walk test, and fatigue with fatigue severity scale (FSS). Results: Spearman’s test was used to assess correlation of sleep quality with cognition, exercise capacity, and fatigue. Significant but very weak and poor inverse correlation of sleep quality was found with cognition and exercise capacity, respectively, whereas there was weak and linear correlation of sleep quality with fatigue. There was no significant difference in sleep quality of COPD and non-COPD patients as well as hypoxemic and non-hypoxemic patients. Conclusion: Though there is very weak correlation of sleep quality with cognition, sleep quality is poor in 55.63% of patients and cognition is affected in 93.6% of patients ( n = 133). Clinical significance: Sleep quality should be assessed regularly as a part of primary assessment in all chronic respiratory disease patients. Key Message: of sleep quality must be included in routine assessment of patients with chronic respiratory diseases.","PeriodicalId":90527,"journal":{"name":"Indian journal of sleep medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44395396","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 : 2021-10-13DOI: 10.5005/jp-journals-10069-0082
U. Devaraj, G. D. Souza, P. Ramachandran, Kimberley D Souza, U. Maheshwari
{"title":"Assessing Cognitive Impairment in Patients with Sleep-disordered Breathing Using Mini-mental State Score and Addenbrooke's Cognitive Examination—Revised","authors":"U. Devaraj, G. D. Souza, P. Ramachandran, Kimberley D Souza, U. Maheshwari","doi":"10.5005/jp-journals-10069-0082","DOIUrl":"https://doi.org/10.5005/jp-journals-10069-0082","url":null,"abstract":"","PeriodicalId":90527,"journal":{"name":"Indian journal of sleep medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42289663","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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