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Thorisdottir K, Hrubos-Strøm H, Karhu T, Nikkonen S, Dammen T, Nordhus IH, Leppänen T, Jónsdóttir MK, Arnardottir ES. Verbal memory is linked to average oxygen saturation during sleep, not the apnea-hypopnea index nor novel hypoxic load variables. Sleep Med 2024; 123:29-36. [PMID: 39232262 DOI: 10.1016/j.sleep.2024.08.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 07/15/2024] [Accepted: 08/26/2024] [Indexed: 09/06/2024]
Abstract
INTRODUCTION The apnea-hypopnea index (AHI) is the current diagnostic parameter for diagnosing and estimating the severity of obstructive sleep apnea (OSA). It is, however, poorly associated with the main clinical symptom of OSA, excessive daytime sleepiness, and with the often-seen cognitive decline among OSA patients. To better evaluate OSA severity, novel hypoxic load parameters have been introduced that consider the duration and depth of oxygen saturation drops associated with apneas or hypopneas. The aim of this paper was to compare novel hypoxic load parameters and traditional OSA parameters to verbal memory and executive function in OSA patients. METHOD A total of 207 adults completed a one-night polysomnography at sleep laboratory and two neuropsychological assessments, the Rey Auditory Verbal Learning Test and Stroop test. RESULTS Simple linear regression analyses were used to evaluate independent associations between each OSA parameter and cognitive performance. Associations were found between immediate recall and arousal index, hypoxia <90 %, average SpO2 during sleep, and DesSev100+RevSev100. Total recall was associated with all OSA parameters, and no associations were found with the Stroop test. Subsequently, sex, age, and education were included as covariates in multiple linear regression analyses for each OSA parameter and cognitive performance. The main findings of the study were that average SpO2 during sleep was a significant predictor of total recall (p < .007, β = -.188) with the regression model explaining 21.2 % of performance variation. Average SpO2 during sleep was also a significant predictor of immediate recall (p < .022, β = -.171) with the regression model explaining 11.4 % of performance variation. Neither traditional OSA parameters nor novel hypoxic load parameters predicted cognitive performance after adjustment for sex, age, and education. CONCLUSION The findings validate that the AHI is not an effective indicator of cognitive performance in OSA and suggest that average oxygen saturation during sleep may be the strongest PSG predictor of cognitive decline seen in OSA. The results also underline the importance of considering age when choosing neurocognitive tests, the importance of including more than one test for each cognitive domain as most tests are not pure measures of a single cognitive factor, and the importance of including tests that cover all cognitive domains as OSA is likely to have diffuse cognitive effects.
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Affiliation(s)
- K Thorisdottir
- Reykjavik University Sleep Institute, School of Technology, Reykjavik University, Reykjavik, Iceland; Department of Psychology, Reykjavik University, Reykjavik, Iceland
| | - H Hrubos-Strøm
- Akershus University Hospital, Akershus, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - T Karhu
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland; Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland
| | - S Nikkonen
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland; Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland
| | - T Dammen
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Research and Innovation, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - I H Nordhus
- Department of Clinical Psychology, University of Bergen, Bergen, Norway
| | - T Leppänen
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland; Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland; School of Information Technology and Electrical Engineering, The University of Queensland, Brisbane, Australia
| | - M K Jónsdóttir
- Reykjavik University Sleep Institute, School of Technology, Reykjavik University, Reykjavik, Iceland; Department of Psychology, Reykjavik University, Reykjavik, Iceland; Landspitali - The National University Hospital of Iceland, Iceland
| | - E S Arnardottir
- Reykjavik University Sleep Institute, School of Technology, Reykjavik University, Reykjavik, Iceland; Landspitali - The National University Hospital of Iceland, Iceland
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Gyasi RM, Aikins E, Dumedah G, Gyasi-Boadu N, Frimpong PB, Boampong MS, Buor D, Mariwah S, Naab F, Phillips DR. Risk of Sleep Problems in Middle-Aged and Older Adults Experiencing Bodily Pains: Serial Multiple Mediation Estimates of Emotional Distress and Activity Limitations. Am J Geriatr Psychiatry 2024; 32:1231-1243. [PMID: 38702252 DOI: 10.1016/j.jagp.2024.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Revised: 04/10/2024] [Accepted: 04/11/2024] [Indexed: 05/06/2024]
Abstract
OBJECTIVES Pain is increasingly becoming common among middle-aged and older adults. While research on the association between pain characteristics and sleep problems (SP) is limited in low- and middle-income countries, the underlying mechanisms of the association are poorly understood. This study examines the association of bodily pain intensity and pain interference with SP and investigates the mediating role of activity limitation and emotional distress in this association. METHODS We analyzed population-based data, including 1,201 individuals aged ≥50 (mean [SD] age 66.14 [11.85] years) from the 2016-2018 AgeHeaPsyWel-HeaSeeB study in Ghana. Multiple OLS regressions and serial multiple mediation modeling using bootstrapping analyses examined direct and indirect effects from pain to SP through activity limitation and emotional distress. RESULTS Regressions demonstrated that pain intensity and interference were significantly associated with higher levels of activity limitation, emotional distress, and SP (range: β = 0.049-0.658). Bootstrapping analysis showed that activity limitation and emotional distress serially mediated the relationship between pain intensity and SP (total effect: β = 0.264, Bootstrap 95% confidence interval [CI] = 0.165-0.362; direct effect: (β = 0.107, Bootstrap 95% CI = 0.005-0.210; total indirect effect: β = 0.156, Bootstrap 95% CI = 0.005-0.210) accounting for ∼59%. Activity limitation and emotional distress mediated pain interference and SP association (total effect: β = 0.404, Bootstrap 95% CI = 0.318-0.490; direct effect: β = 0.292, Bootstrap 95% CI = 0.201-0.384; and total indirect effect: β = 0.112, Bootstrap 95% CI = 0.069-0.156) yielding ∼28%. CONCLUSION Our data suggest that activity limitation and emotional distress may convey stress-related risks of pain on SP. Future research should evaluate if activity limitation and emotional distress could be effective targets to reduce the effect of pain on sleep in later-life.
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Affiliation(s)
- Razak M Gyasi
- African Population and Health Research Center, Nairobi, Kenya; National Centre for Naturopathic Medicine (NCNM), Southern Cross University, Lismore, Australia.
| | - Emelia Aikins
- Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Gift Dumedah
- Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Nelson Gyasi-Boadu
- Department of Sociology and Social Work, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Prince Boakye Frimpong
- Department of Economics, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Mary Sefa Boampong
- Department of Sociology and Social Work, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Daniel Buor
- Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Simon Mariwah
- Department of Geography and Regional Planning, University of Cape Coast, Cape Coast, Ghana
| | - Francis Naab
- Perivoli Africa Research Centre (PARC), University of Bristol, Bristol, United Kingdom
| | - David R Phillips
- Department of Sociology and Social Policy, Lingnan University, Hong Kong, Hong Kong
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Owusu-Sarpong OJ, Abass K, Tutu SO, Gyasi RM. Anxiety and sleep mediate the effect of food insecurity on depression in single parents in Ghana. BMC Public Health 2024; 24:2612. [PMID: 39334047 PMCID: PMC11438176 DOI: 10.1186/s12889-024-20087-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Accepted: 09/13/2024] [Indexed: 09/30/2024] Open
Abstract
BACKGROUND Data on the association between food insecurity and depression in single parents in low- and middle-income countries (LMICs) are limited, and no study has reported the serial mediation effects of psychosocial factors in this association. This study examines the extent to which anxiety and sleep serially explain the food insecurity and depression link among single parents in Ghana. METHODS Data on 627 single parents were obtained through a multi-stage stratified sampling technique. Food insecurity was assessed using the Food and Agriculture Organization Food Insecurity Experience Scale (FIES), and depression was assessed using the Center for Epidemiological Studies Depression Scale (CES-D-10). Multivariable OLS models and bootstrapping serial mediation analyses were performed to evaluate the hypothesized associations. RESULTS The mean age (SD) was 45.0 (14.7) years; 67.3% females. After full adjustment, food insecurity was significantly associated with increases in anxiety symptoms (β = 0.61, 95%CI = 0.476 - 0.737), sleep problems (β = 0.04, 95%CI = 0.02 - 0.07), and depression (β = 0.24, 95%CI = 0.12 - 0.36). Food insecurity indirectly related to depression via anxiety (β = 0.35, 95%CI = 0.26-0.44) representing 55.8%, sleep (β = 0.03, 95%CI = 0.0032-0.0575) suggesting 4.0%, and anxiety→sleep (β = 0.013, 95%CI = 0.0024-0.0265) yielding 2.0% of the total effect. CONCLUSIONS Food insecurity was positively associated with depression. This association was partially and serially explained by generalized anxiety and sleep problems. Efforts to address depression among single parents should consider interventions for food insecurity and psychosocial problems, particularly in LMICs.
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Affiliation(s)
- Obed Jones Owusu-Sarpong
- Department of Geography and Rural Development, Faculty of Social Sciences, PBM University Post Office Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
| | - Kabila Abass
- Department of Geography and Rural Development, Faculty of Social Sciences, PBM University Post Office Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Solomon Osei Tutu
- Department of Social Science, Offinso College of Education, Offinso, Ashanti Region, Ghana
| | - Razak M Gyasi
- African Population and Health Research Center, Nairobi, Kenya
- National Centre for Naturopathic Medicine, Faculty of Health, Southern Cross University, Lismore, NSW, Australia
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McCloy K, Herrero Babiloni A, Sessle BJ. Sleep disorders and orofacial pain: insights for dental practice. Aust Dent J 2024. [PMID: 39304335 DOI: 10.1111/adj.13037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2024] [Indexed: 09/22/2024]
Abstract
In dental sleep medicine several sleep disorders commonly coexist with pain, contributing to complex clinical presentations which might affect the provision of appropriate and timely treatment. There are associations between sleep disorders and pain in general, as well as with specific orofacial pain conditions. As many as five of six patients with orofacial pain can present with sleep problems. The comorbidity of orofacial pain and sleep disorders overlays a complex web of altered neurobiological mechanisms that predispose to the chronification of orofacial pain. This review discusses the relationship between orofacial pain and sleep disorders and highlights their interactions and the neurobiological mechanisms underlying those relationships.
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Affiliation(s)
- K McCloy
- Pain Management and Research Institute Sydney University, Sydney, New South Wales, Australia
| | - A Herrero Babiloni
- Faculty of Medicine, Division of Experimental Medicine, McGill University, Montreal, Quebec, Canada
| | - B J Sessle
- Faculty of Dentistry, Faculty of Medicine Department of Physiology, and Centre for the Study of Pain, University of Toronto, Toronto, Canada
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Gyasi RM, Yebo-Julius EB, Nketiah JOM, Bavemba J, Adevor BS, Ankapong JB, Arthur DD, Siaw LP, Abass K, Osei-Wusu Adjei P, Phillips DR. More Movement, Less Bodily Pain? Findings From a Large, Representative Multi-District Aging Study in Ghana. J Am Med Dir Assoc 2024; 25:105153. [PMID: 39009067 DOI: 10.1016/j.jamda.2024.105153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 06/10/2024] [Accepted: 06/11/2024] [Indexed: 07/17/2024]
Abstract
OBJECTIVE The association of physical activity (PA) with pain has been characterized. Although the literature largely comes from high-income countries, the mechanistic pathways underlying this association remain unknown, particularly in low- and middle-income countries (LMICs). We aim to examine the association between meeting the World Health Organization (WHO) PA guidelines and pain among aging adults and identify the factors that may mediate this association. DESIGN We used a quantitative cross-sectional study design. SETTING AND PARTICIPANTS Representative data from adults aged ≥50 years who participated in the Aging, Health, Psychological Well-being, and Health-seeking Behavior Study were used. METHODS PA was defined using the International Physical Activity Questionnaire (IPAQ). Self-reported pain experience using a cross-culturally validated item over the past month assessed pain severity. Adjusted multivariable ordinal logistic regression and mediation models quantified the hypothesized associations. RESULTS The analysis included 1201 adults (mean 66.1 ± 11.9 years; 63.3% female). After adjusting for confounders, adhering to the WHO-recommended PA guidelines was associated with 42% lower odds for severe/extreme pain [odds ratio (OR) 0.58, 95% CI 0.44-0.77]. The association was much stronger among men (OR 0.52, 95% CI 0.31-0.85) than women (OR 0.60, 95% CI 0.42-0.87). The PA-pain association was explained by functional limitations (84.7%), self-rated health (76.6%), sleep problems (20.4%), and injury (6.6%). CONCLUSIONS AND IMPLICATIONS Moving more was associated with less pain in older adults from LMICs. Interventions for pain management in old age may focus on enhancing compliance with PA doses, particularly in LMICs. However, longitudinal data will need to confirm these findings.
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Affiliation(s)
- Razak M Gyasi
- Aging and Development Unit, African Population and Health Research Center, Nairobi, Kenya; National Centre for Naturopathic Medicine, Faculty of Health, Southern Cross University, Lismore, NSW, Australia.
| | - Emefa Baaba Yebo-Julius
- Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Jude Owusu Mensah Nketiah
- Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Jonathan Bavemba
- Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Boniface Smith Adevor
- Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Joel Banor Ankapong
- Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Dominic Degraft Arthur
- Department of History and Political Studies, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Lawrencia Pokuah Siaw
- Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Kabila Abass
- Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Prince Osei-Wusu Adjei
- Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - David R Phillips
- Department of Sociology and Social Policy, Lingnan University, Hong Kong, China
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Gyasi RM, Quansah N, Boateng PA, Akomeah E, Yakubu AF, Ahiabli PA, Aikins E, Owusu-Sarpong OJ, Dumbe Y, Nimoh M, Phillips DR, Hajek A. Meeting the WHO Physical Activity Guidelines is Associated With Lower Odds of Depression in Older Adults: Potential Psychosomatic Mechanisms. Am J Geriatr Psychiatry 2024; 32:1105-1118. [PMID: 38641509 DOI: 10.1016/j.jagp.2024.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 03/31/2024] [Accepted: 04/01/2024] [Indexed: 04/21/2024]
Abstract
OBJECTIVES Limited data exist on the association between physical activity (PA) and depression in older adults from low- and middle-income countries (LMICs). In this study, we examine the association between meeting the World Health Organization (WHO) PA guidelines and depression in adults aged ≥50 years in Ghana and investigate the psychosomatic factors explaining this association. METHODS Cross-sectional data from the Aging, Health, Psychological Well-being, and Health-seeking Behavior Study in Ghana (2016-18) were analyzed. Depression was assessed with the Center for Epidemiological Studies Depression Scale (CES-D-10). PA was assessed using the International Physical Activity Questionnaire Short Form (IPAQ-SF). Multivariable logistic regression and Hayes PROCESS macro with bootstrapping mediation analyses were performed to evaluate the hypothesized associations. RESULTS The study included 1201 individuals (mean [SD] age 66.1 [11.9] years; 63.3% women). The prevalence of meeting PA guidelines and depression was 36.7% and 29.5%, respectively. Meeting the WHO-recommended PA guidelines was associated with a 16% lower rate of developing depression even after adjusting for potential confounders (OR = 0.84, p <0.001). This association was much stronger among men and those aged 50-64 years. Loneliness, social isolation, sleep problems, functional limitations, and pain characteristics largely mediated the association of PA with depression. CONCLUSIONS PA was negatively associated with depression among older adults in Ghana, and psychosocial and physical factors partially explained the association. The promotion of PA in old age may aid in the prevention of depression, especially in men and those aged 50-64 years. Longitudinal data may confirm our findings.
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Affiliation(s)
- Razak M Gyasi
- African Population and Health Research Center (RMG), Nairobi, Kenya; National Centre for Naturopathic Medicine, Faculty of Health (RMG), Southern Cross University, Lismore, New South Wales, Australia.
| | - Nicholas Quansah
- Department of Geography and Rural Development (NQ, PAB, EA, AFY, PAA, EA, OJOS), Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Paul Antwi Boateng
- Department of Geography and Rural Development (NQ, PAB, EA, AFY, PAA, EA, OJOS), Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Eric Akomeah
- Department of Geography and Rural Development (NQ, PAB, EA, AFY, PAA, EA, OJOS), Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Abdul-Fatawu Yakubu
- Department of Geography and Rural Development (NQ, PAB, EA, AFY, PAA, EA, OJOS), Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Patience Aku Ahiabli
- Department of Geography and Rural Development (NQ, PAB, EA, AFY, PAA, EA, OJOS), Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Emelia Aikins
- Department of Geography and Rural Development (NQ, PAB, EA, AFY, PAA, EA, OJOS), Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Obed Jones Owusu-Sarpong
- Department of Geography and Rural Development (NQ, PAB, EA, AFY, PAA, EA, OJOS), Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Yunus Dumbe
- Department of Religious Studies (YD), Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Michael Nimoh
- Department of History and Political Studies (MN), Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - David R Phillips
- Department of Sociology and Social Policy (DRP), Lingnan University, Tuen Mun, New Territories, Hong Kong
| | - André Hajek
- Department of Health Economics and Health Services Research (AH), University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, Hamburg, Germany
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Gyasi RM, Aikins E, Hajek A, Opoku-Ware J, Osei BA, Kwabena-Adade J, Jacob L, Rahmati M, Dakurah G, Peltzer K. Cross-sectional association of food insecurity with loneliness in older adults: The role of sex, age, and psychosomatic factors. J Nutr Health Aging 2024; 28:100328. [PMID: 39096770 DOI: 10.1016/j.jnha.2024.100328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Revised: 07/26/2024] [Accepted: 07/28/2024] [Indexed: 08/05/2024]
Abstract
OBJECTIVE Food insecurity (FI) is a critical social determinant of poor psychosocial health. While data on the specific roles of sex and age in the FI-loneliness link among older adults are limited, the underlying mechanisms are largely unknown. This study examines the age-sex-specific associations of FI with loneliness among older adults in Ghana and quantifies the extent to which psychosomatic factors mediate the association. METHODS We analyzed cross-sectional data from the Aging, Health, Psychological, and Health-seeking Behavior Study in Ghana. The past 30-day FI was assessed using items on hunger and breakfast skipping frequency due to a lack of resources. We assessed loneliness severity with the University of California, Los Angeles 3-item Loneliness Scale. Multivariable OLS regressions and bootstrapping mediation analysis using the Hayes PROCESS macro plug-in were used to evaluate the associations. RESULTS We included 1,201 individuals aged ≥50 years (mean = 62.9 [SD = 11.9]; women = 63.3%). The prevalence of loneliness was 17.7%. The prevalence of moderate and severe FI was 44.0% and 8.5%, respectively. In the adjusted model, greater FI was significantly associated with loneliness severity (B = .22, SE = .029, p < .001). We found significant interactive effects of FI × age (B = -.17, SE = .023, p < .01) and FI × sex (B = -.28, SE = .036, p < .001) on loneliness. Thus, the FI-loneliness link was respectively more marked among women (B = .25, SE = .035, p < .001) and ≥65 age groups (B = .34, SE = .041, p < .001) than men (B = .16, SE = .051, p < .01) and those aged 50-64 (B = .22; SE = .040, p < .001). Finally, comorbid depression/anxiety (41.07%), hopelessness (48.6%), worthlessness (42.1%), functional limitations (8.2%), and pain severity (6.4%) mediated the FI-loneliness association. CONCLUSIONS Age- and sex-specific associations between FI and loneliness exist among older Ghanaians. Addressing FI in concert with psychosomatic problems in older adults may contribute meaningfully to reducing loneliness in later life.
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Affiliation(s)
- Razak M Gyasi
- African Population and Health Research Center, Nairobi, Kenya; National Centre for Naturopathic Medicine, Faculty of Health, Southern Cross University, Lismore, NSW, Australia.
| | - Emelia Aikins
- Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - André Hajek
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, Hamburg, Germany
| | - Jones Opoku-Ware
- Department of Sociology and Social Work, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Benjamin Appiah Osei
- Department of Hospitality and Tourism Studies, School of Business, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Joana Kwabena-Adade
- Department of General and Liberal Studies, School of Basic and Biomedical Sciences, University of Health and Allied Sciences, Ho, Ghana
| | - Louis Jacob
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, ISCIII, Dr. Antoni Pujadas, 42, 08830 Sant Boi de Llobregat, Spain; AP-HP, Université Paris Cité, Lariboisière-Fernand Widal Hospital, Department of Physical Medicine and Rehabilitation, 75010 Paris, France; Université Paris Cité, Inserm U1153, Epidemiology of Ageing and Neurodegenerative Diseases (EpiAgeing), 75010 Paris, France
| | - Masoud Rahmati
- CEReSS-Health Service Research and Quality of Life Center, Aix-Marseille University, Marseille, France; Department of Physical Education and Sport Sciences, Faculty of Literature and Human Sciences, Lorestan University, Khoramabad, Iran; Department of Physical Education and Sport Sciences, Faculty of Literature and Humanities, Vali-E-Asr University of Rafsanjan, Rafsanjan, Iran
| | - George Dakurah
- Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Karl Peltzer
- Department of Health Education and Behavioral Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand; Department of Psychology, University of the Free State, Bloemfontein, South Africa; Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan
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Marghalani TY, Salamah RM, Alangari HM. A Novel Design of an Oral Appliance for Monitoring Electromyograms of the Genioglossus Muscle in Obstructive Sleep Apnea Syndrome. Life (Basel) 2024; 14:952. [PMID: 39202694 PMCID: PMC11355909 DOI: 10.3390/life14080952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2024] [Revised: 07/15/2024] [Accepted: 07/26/2024] [Indexed: 09/03/2024] Open
Abstract
Obstructive sleep apnea (OSA) is a prevalent source of sleep-disordered breathing. OSA is most commonly associated with dysfunctions in the genioglossus (GG) muscle. In this study, we present the first version of a medical device that produces an electromyogram (EMG) of the GG. The prototype is composed of a (custom-made) 3D-printed mouthpiece. Impressions were taken for the lower arch and scanned with a lab scanner to be converted into digital impressions. ExoCad software was used to design the appliance. Fusion 360 software was then used to modify the design and create tubes to house the electrodes in a bilateral configuration to secure excellent and continuous contact with the GG muscle. Silver-silver chloride electrodes were incorporated within the appliance through the created tubes to produce a muscle EMG. In this preliminary prototype, an EMG amplifier was placed outside the mouth, and isolated electric wires were connected to the amplifier input. To test the design, we ran experiments to acquire EMG signals from a group of OSA patients and a control group in wakefulness. The GG EMGs were acquired from the participants for 60 s in a resting state whereby they rested their tongues without performing any movement. Then, the subjects pushed their tongues against the fontal teeth with steady force while keeping the mouth closed (active state). Several features were extracted from the acquired EMGs, and statistical tests were applied to evaluate the significant differences in these features between the two groups. The results showed that the mean power and standard deviation were higher in the control group than in the OSA group (p < 0.01). Regarding the wavelength during the active state, the control group had a significantly longer wavelength than the OSA group (p < 0.01). Meanwhile, the mean frequency was higher in the OSA group (p < 0.01) at rest. These findings support research that showed that impairment in GG activity continues in the daytime and does not only occur during sleep. Future research should focus on developing the device to be more user-friendly and easily used at home during wakefulness and sleep.
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Affiliation(s)
- Thamer Y. Marghalani
- Department of Oral and Maxillofacial Prosthodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah 21589, Saudi Arabia;
| | - Ruwaa M. Salamah
- Department of Oral and Maxillofacial Prosthodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah 21589, Saudi Arabia;
- Ministry of Health, Madinah 42351, Saudi Arabia
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Coiffier O, Tondo P, Joyeux-Faure M, Tamisier R, Amrani K, Cornu JC, Terrail R, Caussé C, Bailly S, Pépin JL. Multidimensional phenotyping to distinguish among distinct obstructive sleep apnea, chronic obstructive pulmonary disease, and overlap syndrome phenotypes. Sleep Med 2024; 119:281-288. [PMID: 38718597 DOI: 10.1016/j.sleep.2024.04.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Revised: 03/14/2024] [Accepted: 04/29/2024] [Indexed: 06/18/2024]
Abstract
OBJECTIVE/BACKGROUND Chronic obstructive pulmonary disease (COPD), obstructive sleep apnea (OSA) and their comorbid association called Overlap Syndrome (OS) are frequent chronic diseases with high individual and societal burdens. Precise descriptions of the respective symptoms, comorbidities, and medications associated with these three conditions are lacking. We used a multidimensional phenotyping approach to identify relevant phenotypes characterizing these 3 disorders. PATIENTS/METHODS 308 patients with OSA, COPD and OS were prospectively assessed using a combination of body shape measurements and multidimensional questionnaires evaluating sleep, fatigue, depression and respiratory symptoms. Comorbidities and medications were confirmed by physicians. Patients made home blood pressure self-measurements using a connected wearable device to identify undiagnosed or uncontrolled hypertension. RESULTS Three distinct relevant phenotypes were identified. OSA patients were round in shape with a balanced waist-to-hip ratio, frequent witnessed apneas, nocturia, daytime sleepiness, depression, and high diastolic blood pressure. COPD patients had a thinner body shape with a high waist-to-hip ratio, complained mainly of fatigue, and exhibited a higher resting heart rate. OS patients were round in shape with a balanced waist-to-hip ratio, reported little sleepiness and depression, but had impaired sleep and the highest rate of cardio-metabolic comorbidities. Diminished fitness-to-drive was most apparent in patients with OSA and OS. Home blood pressure measurements identified undiagnosed hypertension in 80 % of patients and in nearly 80 % of those with hypertension it was uncontrolled by their current medications. CONCLUSIONS Our systematic multidimensional phenotyping approach identified distinct body shapes, symptoms, and comorbidity profiles among patients with OSA, COPD, and OS.
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Affiliation(s)
- Ophélie Coiffier
- Univ. Grenoble Alpes, INSERM, CHU Grenoble Alpes, HP2 Laboratory, Grenoble, France
| | - Pasquale Tondo
- Univ. Grenoble Alpes, INSERM, CHU Grenoble Alpes, HP2 Laboratory, Grenoble, France; Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Marie Joyeux-Faure
- Univ. Grenoble Alpes, INSERM, CHU Grenoble Alpes, HP2 Laboratory, Grenoble, France; Pole Thorax et Vaisseaux, Laboratoire EFCR (Explorations Fonctionnelles Cardiovasculaire et Respiratoire), CHU Grenoble Alpes, Grenoble, France
| | - Renaud Tamisier
- Univ. Grenoble Alpes, INSERM, CHU Grenoble Alpes, HP2 Laboratory, Grenoble, France; Pole Thorax et Vaisseaux, Laboratoire EFCR (Explorations Fonctionnelles Cardiovasculaire et Respiratoire), CHU Grenoble Alpes, Grenoble, France
| | - Khier Amrani
- Pneumology Department, Verdun Hospital, Verdun, France
| | | | - Robin Terrail
- Pole Thorax et Vaisseaux, Laboratoire EFCR (Explorations Fonctionnelles Cardiovasculaire et Respiratoire), CHU Grenoble Alpes, Grenoble, France
| | | | - Sebastien Bailly
- Univ. Grenoble Alpes, INSERM, CHU Grenoble Alpes, HP2 Laboratory, Grenoble, France; Pole Thorax et Vaisseaux, Laboratoire EFCR (Explorations Fonctionnelles Cardiovasculaire et Respiratoire), CHU Grenoble Alpes, Grenoble, France
| | - Jean-Louis Pépin
- Univ. Grenoble Alpes, INSERM, CHU Grenoble Alpes, HP2 Laboratory, Grenoble, France; Pole Thorax et Vaisseaux, Laboratoire EFCR (Explorations Fonctionnelles Cardiovasculaire et Respiratoire), CHU Grenoble Alpes, Grenoble, France.
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10
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Gauld C, Baillieul S, Martin VP, Richaud A, Lopez R, Pelou M, Abi-Saab P, Coelho J, Philip P, Pépin JL, Micoulaud-Franchi JA. Symptom content analysis of OSA questionnaires: time to identify and improve relevance of diversity of OSA symptoms? J Clin Sleep Med 2024; 20:1105-1117. [PMID: 38420966 PMCID: PMC11217627 DOI: 10.5664/jcsm.11086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Revised: 02/06/2024] [Accepted: 02/10/2024] [Indexed: 03/02/2024]
Abstract
STUDY OBJECTIVES Obstructive sleep apnea (OSA) is a heterogeneous condition covering many clinical phenotypes in terms of the diversity of symptoms. Patient-based OSA screening questionnaires used in routine practice contain significantly varying contents that can impact the reliability and validity of the screening. We investigated to what extent common patient-based OSA screening questionnaires differ or overlap in their item content by conducting a rigorous, methodical, and quantified content overlap analysis. METHODS We conducted an item content analysis of 11 OSA screening questionnaires validated in adult populations and characterized their overlap using a 4-step approach: (1) selection of OSA screening questionnaires, (2) item extraction and selection, (3) extraction of symptoms from items, and (4) assessment of content overlap with the Jaccard index (from 0, no overlap, to 1, full overlap). RESULTS We extracted 72 items that provided 25 distinct symptoms from 11 selected OSA questionnaires. The overlap between them was weak (mean Jaccard index: 0.224; ranging from 0.138 to 0.329). All questionnaires contained symptoms of the "OSA symptom" dimension (eg, snoring or witnessed apneas). The STOP-BANG (0.329) and the Berlin (0.280) questionnaires exhibited the highest overlap content. Ten symptoms (40%) were investigated in only 1 questionnaire. CONCLUSIONS The heterogeneity of content and the low overlap across these questionnaires reflect the challenges of screening OSA. The different OSA questionnaires potentially capture varying aspects of the disorder, with the risk of biased results in studies. Suggestions are made for better OSA screening and refinement of clinical OSA phenotypes. CITATION Gauld C, Baillieul S, Martin VP, et al. Symptom content analysis of OSA questionnaires: time to identify and improve relevance of diversity of OSA symptoms? J Clin Sleep Med. 2024;20(7):1105-1117.
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Affiliation(s)
- Christophe Gauld
- Service Psychopathologie du Développement de l’Enfant et de l’Adolescent, Hospices Civils de Lyon and Université de Lyon 1, Lyon, France
- Institut des Sciences Cognitives Marc Jeannerod, UMR 5229 CNRS and Université Claude Bernard Lyon 1, Lyon, France
| | - Sébastien Baillieul
- University Grenoble Alpes, Inserm, U1300, CHU Grenoble Alpes, Service Universitaire de Pneumologie Physiologie, Grenoble, France
| | - Vincent P. Martin
- University Bordeaux, CNRS, Bordeaux INP, LaBRI, UMR 5800, Talence, France
- University Bordeaux, CNRS, SANPSY, UMR 6033, Bordeaux, France
| | | | - Régis Lopez
- Institut des Neurosciences de Montpellier (INM), University Montpellier, Montpellier, France
- Unité des Troubles du Sommeil, Département de Neurologie, CHU Montpellier, Montpellier, France
| | - Marie Pelou
- University Bordeaux, CNRS, SANPSY, UMR 6033, Bordeaux, France
| | - Poeiti Abi-Saab
- University Bordeaux, CNRS, SANPSY, UMR 6033, Bordeaux, France
| | - Julien Coelho
- University Bordeaux, CNRS, SANPSY, UMR 6033, Bordeaux, France
- University Sleep Clinic, University Hospital of Bordeaux, Place Amélie Raba-Leon, Bordeaux, France
| | - Pierre Philip
- University Bordeaux, CNRS, SANPSY, UMR 6033, Bordeaux, France
- University Sleep Clinic, University Hospital of Bordeaux, Place Amélie Raba-Leon, Bordeaux, France
| | - Jean Louis Pépin
- University Grenoble Alpes, Inserm, U1300, CHU Grenoble Alpes, Service Universitaire de Pneumologie Physiologie, Grenoble, France
| | - Jean-Arthur Micoulaud-Franchi
- University Bordeaux, CNRS, SANPSY, UMR 6033, Bordeaux, France
- University Sleep Clinic, University Hospital of Bordeaux, Place Amélie Raba-Leon, Bordeaux, France
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11
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Filosa J, Omland PM, Hagen K, Langsrud K, Engstrøm M, Sand T. Validation of Trøndelag Apnoea Score Proxy for Obstructive Sleep Apnoea in the General Population of Norway: The HUNT Study. SLEEP DISORDERS 2024; 2024:1242505. [PMID: 38961856 PMCID: PMC11222008 DOI: 10.1155/2024/1242505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 03/29/2024] [Accepted: 04/02/2024] [Indexed: 07/05/2024]
Abstract
The aim was to validate a new seven-item "TASC" (Trøndelag Apnoea Score) proxy for obstructive sleep apnoea (OSA) against polysomnography in the general population. Objectives included validation against different polysomnographic criteria, stratification by age and gender, and estimation of OSA prevalence. From the fourth wave of the Trøndelag Health Study (HUNT4), 1,201 participants were randomly invited to a substudy focusing on sleep and headaches, of whom 232 accepted and 84 (64% women, mean age 55.0 years, and standard deviation 11.5 years) underwent polysomnography. The TASC proxy sums seven binary items for snoring, observed breathing pauses, restricted daytime activities, hypertension, body mass index (≥30 kg/m2), age (≥50 years), and gender (male). A single night of ambulatory (home) polysomnography was analysed using both the recommended and optional hypopnoea criteria of the American Academy of Sleep Medicine (AASM). We found 65% sensitivity and 87% specificity (Cohen's κ = 0.53, 95% confidence interval 0.34-0.72) for TASC ≥ 3 against AHI ≥ 15 (recommended AASM criteria). Validity was similar against AHI ≥ 30 but lower against AHI ≥ 5 and against the optional AASM criteria. Sensitivity and overall validity were higher among men and those above 50 years of age. The prevalence of an apnoea-hypopnoea index (AHI) of at least 5, 15, or 30 using the recommended (and optional) AASM criteria was 73% (46%), 37% (18%), or 15% (5%). A seven-item TASC proxy for OSA showed good validity and may be useful in screening and epidemiological settings. Sensitivity, specificity, and validity vary considerably by cut-off, by polysomnographic scoring criteria, and by gender and age strata.
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Affiliation(s)
- James Filosa
- Department of Neuromedicine and Movement ScienceFaculty of Medicine and Health SciencesNorwegian University of Science and Technology, Trondheim, Norway
| | - Petter Moe Omland
- Department of Neuromedicine and Movement ScienceFaculty of Medicine and Health SciencesNorwegian University of Science and Technology, Trondheim, Norway
- Department of Neurology and Clinical NeurophysiologySt. Olavs HospitalTrondheim University Hospital, Trondheim, Norway
- Department of Radiology and Nuclear MedicineSt. Olavs HospitalTrondheim University Hospital, Trondheim, Norway
- Norwegian Headache Research Centre (NorHEAD), Trondheim, Norway
| | - Knut Hagen
- Department of Neuromedicine and Movement ScienceFaculty of Medicine and Health SciencesNorwegian University of Science and Technology, Trondheim, Norway
- Norwegian Headache Research Centre (NorHEAD), Trondheim, Norway
- Clinical Research Unit Central NorwaySt. Olavs HospitalTrondheim University Hospital, Trondheim, Norway
| | - Knut Langsrud
- St. Olavs HospitalTrondheim University HospitalØstmarka, Trondheim, Norway
| | - Morten Engstrøm
- Department of Neuromedicine and Movement ScienceFaculty of Medicine and Health SciencesNorwegian University of Science and Technology, Trondheim, Norway
- Department of Neurology and Clinical NeurophysiologySt. Olavs HospitalTrondheim University Hospital, Trondheim, Norway
| | - Trond Sand
- Department of Neuromedicine and Movement ScienceFaculty of Medicine and Health SciencesNorwegian University of Science and Technology, Trondheim, Norway
- Department of Neurology and Clinical NeurophysiologySt. Olavs HospitalTrondheim University Hospital, Trondheim, Norway
- Norwegian Headache Research Centre (NorHEAD), Trondheim, Norway
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Bruun SN, Hansen C, Sonnesen L. Sleepiness in children with severe malocclusion compared with in children with neutral occlusion. Am J Orthod Dentofacial Orthop 2024; 165:593-601. [PMID: 38363255 DOI: 10.1016/j.ajodo.2023.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 12/01/2023] [Accepted: 12/01/2023] [Indexed: 02/17/2024]
Abstract
INTRODUCTION The study aimed to compare daytime sleepiness in children with severe malocclusion with healthy children with neutral occlusion (controls) and to analyze associations between daytime sleepiness and craniofacial morphology in children with severe malocclusion. METHODS In 120 children with severe malocclusion (73 girls, 47 boys; mean age, 11.96 years; mean body mass index [BMI] score, 18.97 kg/m2) and 35 controls (18 girls, 17 boys; mean age, 11.97 years; mean BMI score, 20.28 kg/m2), sleep and daytime sleepiness were recorded using Epworth Sleepiness Scale and Berlin Questionnaire. Occlusion was registered clinically, and craniofacial morphology was assessed on lateral cephalograms. Differences in daytime sleepiness and sleep between the groups and associations between daytime sleepiness and sleep and craniofacial morphology were analyzed by a general linear model adjusted for age, gender, and BMI score. RESULTS Daytime sleepiness occurred significantly more often in children with malocclusion than in control subjects (P = 0.015). There was a tendency for children with malocclusion to feel extremely tired during the day more often than controls (P = 0.054). There was no significant difference between the groups in sleeping hours during night-time, but the amount of sleep was negatively associated with age (P <0.001) and BMI score (P = 0.004). Only maxillary inclination was significantly associated with daytime sleepiness (P = 0.043). CONCLUSIONS Daytime sleepiness occurred significantly more often in children with severe malocclusion than in those with neutral occlusion, and the association between daytime sleepiness and craniofacial morphology may exist. The results might prove valuable in interdisciplinary collaboration between medical doctors and orthodontists in diagnostics, prevention, and treatment of children at risk for sleep-disordered breathing.
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Affiliation(s)
- Sanne Nygaard Bruun
- Section of Orthodontics, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Camilla Hansen
- Section of Orthodontics, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Liselotte Sonnesen
- Section of Orthodontics, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
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13
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Duarte RLM, Magalhães-da-Silveira FJ, Gozal D. Sex-dependent GOAL screening performance in adults at risk for obstructive sleep apnea. Pulmonology 2024; 30:265-271. [PMID: 35151621 DOI: 10.1016/j.pulmoe.2022.01.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 12/19/2021] [Accepted: 01/08/2022] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE To evaluate possible sex-related differences in the performance of the GOAL, a 4-item obstructive sleep apnea (OSA) screening instrument in adults. METHODS Between July 2019 and June 2021, this cross-sectional study included consecutively recruited patients from one Brazilian sleep laboratory undergoing overnight polysomnography. Individuals with GOAL scores ≥ 2 of a maximum of 4 points are classified at high risk for OSA diagnosis. Actual OSA severity was based on the apnea-hypopnea index: ≥ 5.0/h as any OSA, ≥ 15.0/h as moderate-to-severe OSA, and ≥ 30.0/h as severe OSA. Performance of the GOAL instrument in women and men was assessed by the discriminatory ability (obtained from area under the curve [AUC]-Receiver Operating Characteristic curves) and 2×2 contingency tables. RESULTS A total of 2,978 subjects (55.3% males) were evaluated. The frequency of GOAL-defined OSA high-risk was statistically higher in men when compared to women (p < 0.001). The GOAL predictive parameters for screening all severity OSA levels were as follows: in females, sensitivity ranging from 58.2% to 78.3% and specificity ranging from 60.0% to 77.6%, while in males, sensitivity ranging from 90.5% to 96.9% and specificity from 20.7% to 46.8%. The GOAL questionnaire had similar discriminatory properties, assessed by AUC, in women and in men: i) any OSA: 0.741 vs. 0.771 (p = 0.204), ii) moderate-to-severe OSA: 0.727 vs. 0.737 (p = 0.595), and iii) severe OSA: 0.728 vs. 0.703 (p = 0.240); respectively. CONCLUSIONS The GOAL instrument emerges as a useful tool for screening adult individuals and displays similar performance in both women and men.
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Affiliation(s)
- R L M Duarte
- SleepLab - Laboratório de Estudo dos Distúrbios do Sono, Rio de Janeiro, Brazil; Instituto de Doenças do Tórax - Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
| | | | - D Gozal
- Department of Child Health, University of Missouri School of Medicine, Columbia, MO, USA
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14
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Chaudhry RA, Zarmer L, West K, Chung F. Obstructive Sleep Apnea and Risk of Postoperative Complications after Non-Cardiac Surgery. J Clin Med 2024; 13:2538. [PMID: 38731067 PMCID: PMC11084150 DOI: 10.3390/jcm13092538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 04/03/2024] [Accepted: 04/15/2024] [Indexed: 05/13/2024] Open
Abstract
Obstructive sleep apnea (OSA), a common sleep disorder, poses significant challenges in perioperative management due to its complexity and multifactorial nature. With a global prevalence of approximately 22.6%, OSA often remains undiagnosed, and increases the risk of cardiac and respiratory postoperative complications. Preoperative screening has become essential in many institutions to identify patients at increased risk, and experts recommend proceeding with surgery in the absence of severe symptoms, albeit with heightened postoperative monitoring. Anesthetic and sedative agents exacerbate upper airway collapsibility and depress central respiratory activity, complicating intraoperative management, especially with neuromuscular blockade use. Additionally, OSA patients are particularly prone to opioid-induced respiratory depression, given their increased sensitivity to opioids and heightened pain perception. Thus, regional anesthesia and multimodal analgesia are strongly advocated to reduce perioperative complication risks. Postoperative care for OSA patients necessitates vigilant monitoring and tailored management strategies, such as supplemental oxygen and Positive Airway Pressure therapy, to minimize cardiorespiratory complications. Health care institutions are increasingly focusing on enhanced monitoring and resource allocation for patient safety. However, the rising prevalence of OSA, heterogeneity in disease severity, and lack of evidence for the efficacy of costly perioperative measures pose challenges. The development of effective screening and monitoring algorithms, alongside reliable risk predictors, is crucial for identifying OSA patients needing extended postoperative care. This review emphasizes a multidimensional approach in managing OSA patients throughout the perioperative period, aiming to optimize patient outcomes and minimize adverse outcomes.
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Affiliation(s)
- Rabail Arif Chaudhry
- Department of Anesthesiology and Pain Medicine, Banner University Medical Center, University of Arizona COM-T, Tucson, AZ 85724, USA
| | - Lori Zarmer
- Department of Anesthesiology and Pain Medicine, Banner University Medical Center, University of Arizona COM-T, Tucson, AZ 85724, USA
| | - Kelly West
- Memorial Hermann Hospital—TMC, Department of Anesthesiology and Critical Care Medicine, McGovern Medical School, University of Texas at Houston, Houston, TX 77030, USA;
| | - Frances Chung
- University Health Network, Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada;
- Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
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15
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Morey BN, Shi Y, Ryu S, Redline S, Kawachi I, Park HW, Lee S. Risk of sleep apnea associated with higher blood pressure among Chinese and Korean Americans. ETHNICITY & HEALTH 2024; 29:295-308. [PMID: 38303653 PMCID: PMC10987275 DOI: 10.1080/13557858.2024.2311417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 01/23/2024] [Indexed: 02/03/2024]
Abstract
OBJECTIVE This study examines associations between sleep apnea risk and hypertension in a sample of immigrant Chinese and Korean Americans. DESIGN The dataset included Chinese and Korean patients ages 50-75 recruited from primary care physicians' offices from April 2018 to June 2020 in the Baltimore-Washington DC Metropolitan Area (n = 394). Hypertension risk was determined using a combination of blood pressure measurements, self-reported diagnosis of hypertension by a medical professional, and/or self-reported use of antihypertensive medications. Linear regression models examined the associations between sleep apnea risk and blood pressure (systolic blood pressure [SBP] and diastolic blood pressure [DBP]). Poisson regression models examined associations sleep apnea risk and hypertension. Models controlled for body mass index (BMI), demographic, and socioeconomic risk factors. We further examined models for potential effect modification by age, gender, Asian subgroup, and obesity, as well as effect modification of daytime sleepiness on the association between snoring and hypertension risk. RESULTS High risk of sleep apnea appeared to be associated positively with SBP (β = 6.77, 95% CI: 0.00-13.53), but not with DBP. The association was positive for hypertension, but it was not statistically significant (PR = 1.11, 95% CI: 0.87-1.41). We did not find effect modification of the associations between sleep apnea and hypertension risk, but we did find that daytime sleepiness moderated the effect of snoring on SBP. Snoring was associated with higher SBP, primarily in the presence of daytime sleepiness, such that predicted SBP was 133.27 mmHg (95% CI: 126.52, 140.02) for someone with both snoring and daytime sleepiness, compared to 123.37 mmHg (95% CI: 120.40, 126.34) for someone neither snoring nor daytime sleepiness. CONCLUSION Chinese and Korean immigrants living in the U.S. who are at high risk of sleep apnea have higher SBP on average, even after accounting for sociodemographic characteristics and BMI. CLINICAL TRAIL REGISTRATION : NCT03481296, date of registration: 3/29/2018.
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Affiliation(s)
- Brittany N. Morey
- University of California, Irvine, Program in Public Health, Department of Health, Society, & Behavior, Irvine, CA, U.S.A
| | - Yuxi Shi
- University of California, Irvine, School of Medicine, Department of Medicine, Irvine, CA, U.S.A
| | - Soomin Ryu
- University of Michigan School of Public Health, Department of Epidemiology, Ann Arbor, MI, U.S.A
| | - Susan Redline
- Harvard Medical School, Brigham and Women’s Hospital, Department of Medicine, and Harvard T.H. Chan School of Public Health, Department of Epidemiology, Boston, MA, U.S.A
| | - Ichiro Kawachi
- Harvard T.H. Chan School of Public Health, Department of Social and Behavioral Sciences, Boston, MA, U.S.A
| | - Hye Won Park
- University of California, Irvine, School of Medicine, Department of Medicine, Irvine, CA, U.S.A
| | - Sunmin Lee
- University of California, Irvine, School of Medicine, Department of Medicine, Irvine, CA, U.S.A
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Pan Z, Liao S, Sun W, Zhou H, Lin S, Chen D, Jiang S, Long H, Fan J, Deng F, Zhang W, Chen B, Wang J, Huang Y, Li J, Chen Y. Screening and early warning system for chronic obstructive pulmonary disease with obstructive sleep apnoea based on the medical Internet of Things in three levels of healthcare: protocol for a prospective, multicentre, observational cohort study. BMJ Open 2024; 14:e075257. [PMID: 38418236 PMCID: PMC10910414 DOI: 10.1136/bmjopen-2023-075257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 02/12/2024] [Indexed: 03/01/2024] Open
Abstract
INTRODUCTION Chronic obstructive pulmonary disease (COPD) and obstructive sleep apnoea (OSA) are prevalent respiratory diseases in China and impose significant burdens on the healthcare system. Moreover, the co-occurrence of COPD and OSA exacerbates clinical outcomes significantly. However, comprehensive epidemiological investigations in China remain scarce, and the defining characteristics of the population affected by COPD and OSA, alongside their intrinsic relationship, remain ambiguous. METHODS AND ANALYSIS We present a protocol for a prospective, multicentre, observational cohort study based on a digital health management platform across three different healthcare tiers in five sites among Chinese patients with COPD. The study aims to establish predicative models to identify OSA among patients with COPD and to predict the prognosis of overlap syndrome (OS) and acute exacerbations of COPD through the Internet of Things (IoT). Moreover, it aims to evaluate the feasibility, effectiveness and cost-effectiveness of IoT in managing chronic diseases within clinical settings. Participants will undergo baseline assessment, physical examination and nocturnal oxygen saturation measuring. Specific questionnaires screening for OSA will also be administered. Diagnostic lung function tests and polysomnography will be performed to confirm COPD and OSA, respectively. All patients will undergo scheduled follow-ups for 12 months to record the changes in symptoms, lung functions and quality of life. Primary outcomes include the prevalence and characteristics of OS, while secondary outcomes encompass OS prognosis and the feasibility of the management model in clinical contexts. A total of 682 patients with COPD will be recruited over 12-24 months. ETHICS AND DISSEMINATION The study has been approved by Peking University Third Hospital, and all study participants will provide written informed consent. Study results will be published in an appropriate journal and presented at national and international conferences, as well as relevant social media and various stakeholder engagement activities. TRIAL REGISTRATION NUMBER NCT04833725.
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Affiliation(s)
- Zihan Pan
- Pulmonary and Critical Care Medicine, Peking University Third Hospital, Beijing, China
- General Practice Medicine, Peking University First Hospital, Beijing, China
| | - Sha Liao
- Pulmonary and Critical Care Medicine, Peking University Third Hospital, Beijing, China
| | - Wanlu Sun
- Department of Pulmonary and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Beijing, China
| | - Haoyi Zhou
- School of Software, Beihang University, Beijing, China
| | - Shuo Lin
- Air Liquide Healthcare (Beijing), Beijing, China
| | - Dian Chen
- Pulmonary and Critical Care Medicine, Peking University Third Hospital, Beijing, China
| | - Simin Jiang
- Pulmonary and Critical Care Medicine, Peking University Third Hospital, Beijing, China
| | - Huanyu Long
- Pulmonary and Critical Care Medicine, Peking University Third Hospital, Beijing, China
| | - Jing Fan
- Pulmonary and Critical Care Medicine, Peking University Third Hospital, Beijing, China
| | - Furong Deng
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Wenlou Zhang
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Baiqi Chen
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Junyi Wang
- Pulmonary and Critical Care Medicine, Peking University Third Hospital, Beijing, China
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Yongwei Huang
- Pulmonary and Critical Care Medicine, Peking University Third Hospital, Beijing, China
- Sleep Monitoring Center, Peking University Third Hospital, Beijing, China
| | - Jianxin Li
- School of Computer Science and Engineering, Beihang University, Beijing, China
| | - Yahong Chen
- Pulmonary and Critical Care Medicine, Peking University Third Hospital, Beijing, China
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Wei CR, Jalali I, Singh J, Nagaraj A, Dari MA, Mekonen Gdey M, Bai M, Palleti SK. Exploring the Prevalence and Characteristics of Obstructive Sleep Apnea Among Idiopathic Pulmonary Fibrosis Patients: A Systematic Review and Meta-Analysis. Cureus 2024; 16:e54562. [PMID: 38516439 PMCID: PMC10957153 DOI: 10.7759/cureus.54562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/20/2024] [Indexed: 03/23/2024] Open
Abstract
The aim of this meta-analysis was to scrutinize the prevalence, characteristics, and outcomes of obstructive sleep apnea (OSA) in individuals with ideopathic pulmonary fibrosis (IPF). We carried out this systematic review and meta-analysis in accordance with the guidelines outlined by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Statement (PRISMA). Two independent researchers systematically searched major databases, including MEDLINE/PubMed, EMBASE, and the Cochrane Library, from January 1, 2000, until December 31, 2023. We included all studies involving adult patients (age >18 years) with IPF that assessed the prevalence and characteristics of OSA in IPF patients. A total of seven studies involving a pooled sample of 411 patients were included in this meta-analysis. The pooled prevalence of OSA among individuals with IPF was found to be 70% (95% CI: 59 to 82%). Individuals with OSA exhibited a significantly higher mean body mass index (BMI) compared to their counterparts. While individuals with both IPF and OSA exhibited higher scores on the Epworth Sleepiness Scale (ESS) compared to those with IPF alone, the OSA group also showed lower oxygen saturation during sleep in comparison to non-OSA patients. In summary, OSA is a prevalent coexisting condition among individuals with IPF. This presence could worsen the nighttime oxygen saturation. Consequently, there is a need for more extensive studies involving more uniform participant groups.
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Affiliation(s)
- Calvin R Wei
- Research and Development, Shing Huei Group, Taipei, TWN
| | - Illahay Jalali
- Medicine, Tehran University of Medical Sciences, Tehran, IRN
| | - Jovanpreet Singh
- Internal Medicine, Adesh Institute of Medical Sciences and Research, Bathinda, IND
| | - Aishwarya Nagaraj
- Surgery, Pharmacology, Our Lady of Fatima University, Bangalore, IND
| | - Mohammedsefa A Dari
- Otolaryngology-Head and Neck Surgery, Addis Ababa University, Addis Ababa, ETH
| | | | - Monika Bai
- Obstetrics and Gynaecology, Shaikh Zaid Women Hospital, Larkana, PAK
| | - Sujith K Palleti
- Nephrology, Louisiana State University Health Sciences Center, Shreveport, USA
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Lee S, Ryu S, Lee GE, Redline S, Morey BN. Risk of Sleep Apnea Is Associated with Abdominal Obesity Among Asian Americans: Comparing Waist-to-Hip Ratio and Body Mass Index. J Racial Ethn Health Disparities 2024; 11:157-167. [PMID: 36622567 PMCID: PMC9838535 DOI: 10.1007/s40615-022-01507-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 12/15/2022] [Accepted: 12/22/2022] [Indexed: 01/10/2023]
Abstract
OBJECTIVE This study examines associations between the risk of sleep apnea and abdominal obesity (assessed by waist-to-hip ratio (WHR)) and general obesity (assessed by body mass index (BMI)) in a sample of Chinese and Korean American immigrants. METHODS The dataset included Chinese and Korean participants aged 50-75 who were recruited from primary care physicians' clinics from April 2018 to June 2020 in the Baltimore-Washington D.C. Metropolitan area (n = 394). Abdominal obesity was determined if WHR ≥ 0.9 in men and WHR ≥ 0.85 in women. General obesity was determined if BMI ≥ 30. The risk of sleep apnea was determined by using the Berlin questionnaire. Poisson regression models examined associations between sleep apnea risk and obesity. Models controlled for socio-demographic risk factors. RESULTS Twelve percent of the study participants were classified as a high risk for sleep apnea, and 75% had abdominal obesity whereas 6.4% had general obesity. High risk of sleep apnea was positively associated with abdominal obesity (PR = 1.31, 95% CI: 1.17-1.47) and general obesity (PR = 2.19, 95% CI: 0.90-5.32), marginally significant at p < 0.1). CONCLUSIONS Chinese and Korean immigrants living in the USA who are at high risk of sleep apnea have higher abdominal obesity, even after accounting for sociodemographic characteristics. Abdominal obesity may be a better indicator than general obesity when examining the risk of sleep apnea among Asian Americans. INFORMATION ON CLINICAL TRIAL Name: Screening To Prevent ColoRectal Cancer (STOP CRC) among At-Risk Asian American Primary Care Patients NCT Number: NCT03481296; Date of registration: March 29, 2018 URL: https://clinicaltrials.gov/ct2/show/NCT03481296?term=Sunmin+Lee&draw=2&rank=1.
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Affiliation(s)
- Sunmin Lee
- Department of Medicine, School of Medicine, University of California-Irvine, 1001 Health Sciences Road, Bldg835, Ste 231, Irvine, CA, USA.
| | - Soomin Ryu
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Grace E Lee
- Department of Medicine, School of Medicine, University of California-Irvine, 1001 Health Sciences Road, Bldg835, Ste 231, Irvine, CA, USA
| | - Susan Redline
- Department of Medicine, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA
| | - Brittany N Morey
- Department of Health, Society, & Behavior, Program in Public Health, University of California, Irvine, CA, USA
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Huhta R, Sieminski M, Hirvonen K, Partinen E, Partinen M. A New Screening Tool (BAMSA) for Sleep Apnea in Male Professional Truck Drivers. J Clin Med 2024; 13:522. [PMID: 38256656 PMCID: PMC10816964 DOI: 10.3390/jcm13020522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 09/27/2023] [Accepted: 12/27/2023] [Indexed: 01/24/2024] Open
Abstract
Obstructive sleep apnea (OSA) is common in professional truck drivers. It is important that OSA is recognized since undiagnosed and/or untreated sleep apnea is a risk factor for sleepiness-related traffic accidents. In this study, we developed a new simple tool to screen for obstructive sleep apnea (OSA) in this population. Altogether, 2066 professional truck drivers received a structured questionnaire. A total of 175 drivers had a clinical examination and were invited to participate in sleep laboratory studies, including cardiorespiratory polygraphy. We studied associations of different risk factors with the presence of sleep apnea. We established a new simple screening tool for obstructive sleep apnea (OSA) that was compared to other existing screening tools. A total of 1095 drivers completed the questionnaire. Successful cardiorespiratory polygraphy was obtained for 172 drivers. Full data were available for 160 male drivers included in the analyses. The following five risk factors for sleep apnea formed the BAMSA score (0 to 5): BMI > 30 kgm-2, age > 50 years, male gender, snoring at least one night per week, and the presence of apnea at least sometimes. BAMSA showed a sensitivity of 85.7% and a specificity of 78.8% in detecting AHI ≥ 15 when using a cut-off point of 4, and the ROC area was 0.823. BAMSA is a sensitive and easy-to-use tool in predicting obstructive sleep apnea in male professional drivers.
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Affiliation(s)
- Riikka Huhta
- Department of Clinical Neurosciences, University of Helsinki, Clinicum, 00140 Helsinki, Finland; (E.P.); (M.P.)
- Helsinki Sleep Clinic, Terveystalo Healthcare, 00380 Helsinki, Finland
| | - Mariusz Sieminski
- Department of Emergency Medicine, University of Gdansk, 80-214 Gdansk, Poland;
| | | | - Eemil Partinen
- Department of Clinical Neurosciences, University of Helsinki, Clinicum, 00140 Helsinki, Finland; (E.P.); (M.P.)
- Helsinki Sleep Clinic, Terveystalo Healthcare, 00380 Helsinki, Finland
| | - Markku Partinen
- Department of Clinical Neurosciences, University of Helsinki, Clinicum, 00140 Helsinki, Finland; (E.P.); (M.P.)
- Helsinki Sleep Clinic, Terveystalo Healthcare, 00380 Helsinki, Finland
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Radtke MD, Steinberg FM, Scherr RE. Methods for Assessing Health Outcomes Associated with Food Insecurity in the United States College Student Population: A Narrative Review. Adv Nutr 2024; 15:100131. [PMID: 37865221 PMCID: PMC10831897 DOI: 10.1016/j.advnut.2023.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 10/03/2023] [Accepted: 10/12/2023] [Indexed: 10/23/2023] Open
Abstract
In the United States, college students experience disproportionate food insecurity (FI) rates compared to the national prevalence. The experience of acute and chronic FI has been associated with negative physical and mental health outcomes in this population. This narrative review aims to summarize the current methodologies for assessing health outcomes associated with the experience of FI in college students in the United States. To date, assessing the health outcomes of FI has predominately consisted of subjective assessments, such as self-reported measures of dietary intake, perceived health status, stress, depression, anxiety, and sleep behaviors. This review, along with the emergence of FI as an international public health concern, establishes the need for novel, innovative, and objective biomarkers to evaluate the short- and long-term impacts of FI on physical and mental health outcomes in college students. The inclusion of objective biomarkers will further elucidate the relationship between FI and a multitude of health outcomes to better inform strategies for reducing the pervasiveness of FI in the United States college student population.
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Affiliation(s)
- Marcela D Radtke
- Propel Postdoctoral Fellow, Department of Epidemiology and Population Health, Stanford School of Medicine, Stanford University, Palo Alto, CA, USA 94305
| | | | - Rachel E Scherr
- Family, Interiors, Nutrition & Apparel Department, San Francisco State University, 1600 Holloway Avenue, San Francisco, CA, USA, 94132; Scherr Nutrition Science Consulting, San Francisco, CA, 94115.
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21
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Nambiema A, Lisan Q, Vaucher J, Perier MC, Boutouyrie P, Danchin N, Thomas F, Guibout C, Solelhac G, Heinzer R, Jouven X, Marques-Vidal P, Empana JP. Healthy sleep score changes and incident cardiovascular disease in European prospective community-based cohorts. Eur Heart J 2023; 44:4968-4978. [PMID: 37860848 PMCID: PMC10719494 DOI: 10.1093/eurheartj/ehad657] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 06/20/2023] [Accepted: 07/25/2023] [Indexed: 10/21/2023] Open
Abstract
BACKGROUND AND AIMS Evidence on the link between sleep patterns and cardiovascular diseases (CVDs) in the community essentially relies on studies that investigated one single sleep pattern at one point in time. This study examined the joint effect of five sleep patterns at two time points with incident CVD events. METHODS By combining the data from two prospective studies, the Paris Prospective Study III (Paris, France) and the CoLaus|PsyCoLaus study (Lausanne, Switzerland), a healthy sleep score (HSS, range 0-5) combining five sleep patterns (early chronotype, sleep duration of 7-8 h/day, never/rarely insomnia, no sleep apnoea, and no excessive daytime sleepiness) was calculated at baseline and follow-up. RESULTS The study sample included 11 347 CVD-free participants aged 53-64 years (44.6% women). During a median follow-up of 8.9 years [interquartile range (IQR): 8.0-10.0], 499 first CVD events occurred (339 coronary heart disease (CHD) and 175 stroke). In multivariate Cox analysis, the risk of CVD decreased by 18% [hazard ratio (HR) 0.82, 95% confidence interval (CI) 0.76-0.89] per one-point increment in the HSS. After a median follow-up of 6.0 years (IQR: 4.0-8.0) after the second follow-up, 262 first CVD events occurred including 194 CHD and 72 stroke. After adjusting for baseline HSS and covariates, the risk of CVD decreased by 16% (HR 0.84, 95% CI 0.73-0.97) per unit higher in the follow-up HSS over 2-5 years. CONCLUSIONS Higher HSS and HSS improvement over time are associated with a lower risk of CHD and stroke in the community.
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Affiliation(s)
- Aboubakari Nambiema
- Université Paris Cité, INSERM U970, Paris Cardiovascular Research Centre (PARCC), Integrative Epidemiology of Cardiovascular Disease, 56 rue Leblanc, Paris 75015, France
| | - Quentin Lisan
- Université Paris Cité, INSERM U970, Paris Cardiovascular Research Centre (PARCC), Integrative Epidemiology of Cardiovascular Disease, 56 rue Leblanc, Paris 75015, France
- Department of Head and Neck Surgery, Foch Hospital, Suresnes, France
| | - Julien Vaucher
- Department of Medicine, Internal Medicine, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
| | - Marie-Cecile Perier
- Université Paris Cité, INSERM U970, Paris Cardiovascular Research Centre (PARCC), Integrative Epidemiology of Cardiovascular Disease, 56 rue Leblanc, Paris 75015, France
| | - Pierre Boutouyrie
- Université Paris Cité, INSERM U970, Paris Cardiovascular Research Centre (PARCC), Cellular, Molecular and Pathophysiological Mechanisms of Heart Failure, APHP, DMU CARTE, Pharmacology, Paris, France
| | - Nicolas Danchin
- Preventive and Clinical Investigation Center (IPC), Paris, France
| | | | - Catherine Guibout
- Université Paris Cité, INSERM U970, Paris Cardiovascular Research Centre (PARCC), Integrative Epidemiology of Cardiovascular Disease, 56 rue Leblanc, Paris 75015, France
| | - Geoffroy Solelhac
- Center for Investigation and Research in Sleep, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
| | - Raphael Heinzer
- Center for Investigation and Research in Sleep, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
| | - Xavier Jouven
- Université Paris Cité, INSERM U970, Paris Cardiovascular Research Centre (PARCC), Integrative Epidemiology of Cardiovascular Disease, 56 rue Leblanc, Paris 75015, France
| | - Pedro Marques-Vidal
- Center for Investigation and Research in Sleep, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
| | - Jean-Philippe Empana
- Université Paris Cité, INSERM U970, Paris Cardiovascular Research Centre (PARCC), Integrative Epidemiology of Cardiovascular Disease, 56 rue Leblanc, Paris 75015, France
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22
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Šnobrová B, Burdová K, Weiss V, Šonka K, Weiss P. Screening for sleep apnoea risk in testosterone-treated transgender men. Front Neurol 2023; 14:1289429. [PMID: 38116111 PMCID: PMC10729444 DOI: 10.3389/fneur.2023.1289429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 10/31/2023] [Indexed: 12/21/2023] Open
Abstract
Introduction Obstructive sleep apnoea (OSA) is more prevalent in men. Several studies suggested that higher testosterone levels were associated with a greater risk of OSA. We aimed to determine whether testosterone administration in transgender men would accentuate symptoms of OSA. Methods The study involved 94 adult people undergoing a female-to-male transition with testosterone administration. The participants answered the Berlin Questionnaire (BQ) and a separate question on snoring before starting testosterone treatment and after at least 1 year of being on testosterone treatment. Results A higher proportion of participants at the follow-up answered positively to the first category of BQ devoted to snoring. A lower proportion of participants at follow-up answered positively to the second category of BQ devoted to tiredness. The percentage of subjects with a high risk of sleep apnoea, according to BQ, and of those who answered the question on snoring positively did not change significantly. Conclusion An increased number of transgender men who reported snoring in BQ after testosterone administration indicate a higher risk of OSA development.
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Affiliation(s)
- Bára Šnobrová
- Department of Neurology and Centre of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czechia
| | - Kristina Burdová
- Department of Neurology and Centre of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czechia
| | - Vladimír Weiss
- Department of Endocrinology, Poliklinika Modrany, Prague, Czechia
| | - Karel Šonka
- Department of Neurology and Centre of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czechia
| | - Petr Weiss
- Institute of Sexology, General University Hospital, Prague, Czechia
- Department of Psychology, Faculty of Arts, Charles University, Prague, Czechia
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23
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Gyasi RM, Odei J, Hambali MG, Gyasi-Boadu N, Obeng B, Asori M, Hajek A, Jacob L, Adjakloe YAD, Opoku-Ware J, Smith L, Koyanagi A. Diabetes mellitus and functional limitations among older adults: Evidence from a large, representative Ghanaian aging study. J Psychosom Res 2023; 174:111481. [PMID: 37677886 DOI: 10.1016/j.jpsychores.2023.111481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 08/04/2023] [Accepted: 08/29/2023] [Indexed: 09/09/2023]
Abstract
OBJECTIVES Literature linking diabetes mellitus (DM) to functional status is limited in low- and middle-income countries. Importantly, factors influencing this association are even less understood. This study aims to examine the association of DM with functional limitations (FL) in older adults and to identify potential factors influencing this association. METHODS In a cross-sectional analysis, we examined the association between DM and basic and instrumental activities of daily living-related FL in 1201 adults aged ≥50 years from the Aging, Health, Psychological Well-being, and Health-seeking Behavior Study. DM was defined as a self-report of physician diagnosis. The associations were assessed using hierarchical regression estimates and bootstrapping technique via the Hayes PROCESS macro program. RESULTS The prevalence of DM and FL was 10.1% and 36.1%, respectively, with OR = 2.50 (95%CI = 1.59-3.92) after accounting for sociodemographic factors, smoking, alcohol use, self-rated health, loneliness, and sleep quality. After full adjustment, polytomous regressions showed that the association of DM with FL increased with the number of FL (i.e., OR = 1.60 for 1-2, OR = 1.88 for 3-5, and OR = 2.0o for >5 FL compared with no FL). However, this association was attenuated after controlling for physical activity (OR = 2.06, 95%CI = 1.28-3.31), hypertension (OR = 1.87, 95%CI = 1.14-2.99), stroke (OR = 1.82, 95%CI = 1.20-2.93), and pain facets (OR = 1.80, 95%CI = 1.04-3.02). PA thus mediated 40.39% of the DM-FL association. CONCLUSIONS In this representative study, older adults with DM showed higher odds for FL, and this association was partially explained by physical activity and health variables. Investing in a holistic management approach might be helpful for public health planning efforts to address DM-induced FL in old age.
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Affiliation(s)
- Razak M Gyasi
- African Population and Health Research Center, Nairobi, Kenya; National Centre for Naturopathic Medicine, Faculty of Health, Southern Cross University, Lismore, NSW, Australia.
| | - Julius Odei
- Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Mohammed Gazali Hambali
- Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Nelson Gyasi-Boadu
- Department of Sociology and Social Work, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Bernard Obeng
- Department of Sociology and Social Work, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Moses Asori
- Department of Geography and Earth Sciences, University of North Carolina at Charlotte, Charlotte, NC, United States of America
| | - André Hajek
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, Martinistr. 52, Hamburg 20246, Germany
| | - Louis Jacob
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, ISCIII, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona, Spain; Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France
| | | | - Jones Opoku-Ware
- Department of Sociology and Social Work, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Lee Smith
- Centre for Health, Performance, and Wellbeing, Anglia Ruskin University, Cambridge CB1 1PT, United Kingdom
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, ISCIII, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona, Spain; Institució Catalana de Recerca i Estudis Avançats (ICREA), Pg. Lluis Companys 23, Barcelona, Spain
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24
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Gyasi RM, Hajek A, Owusu R, James PB, Boampong MS, Accam BT, Abass K, Owusu-Dabo E, Phillips DR. Sleep and Happiness in Urban-Dwelling Older Adults in Ghana: A Serial Multiple Mediation Model of Generalized Anxiety and Depressive Symptoms. Am J Geriatr Psychiatry 2023; 31:953-964. [PMID: 37270306 DOI: 10.1016/j.jagp.2023.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 05/04/2023] [Accepted: 05/06/2023] [Indexed: 06/05/2023]
Abstract
OBJECTIVE Sleep problems (SP) are highly prevalent and seriously affect health and well-being in old age. The aim of this study was to examine the association between SP and happiness in an urban-dwelling older sample. The authors further explore the effects of generalized anxiety and depressive symptoms in the SP-happiness link using serial mediating modeling. METHODS Data came from the 2016 to 2018 Aging, Health, Psychological Well-being, and Health-seeking Behavior Study in Ghana (n = 661). The authors measured happiness with the cross-culturally validated item on a five-point scale. The GAD-7 and the CESD-8, respectively, assessed generalized anxiety and depressive symptoms. Participants reported nighttime and daytime SP in the last 30 days. The SPSS-based Hayes' PROCESS macro program (Model 6) was constructed to quantify the hypothesized mediation effect. RESULTS The analysis included 661 adults aged greater than or equal to 50 years (mean age = 65.53 [SD] = 11.89 years; 65.20% women). After full adjustment, path models showed that SP was negatively associated with happiness (β = -0.1277, 95%CI = -0.15950 to -0.096). Bootstrapping estimates revealed that the SP-happiness link was serially mediated via generalized anxiety representing 8.77%, depressive symptoms yielding 18.95%, and anxiety symptoms→depressive symptoms accounting for 26.70% of the total effect. CONCLUSION Generalized anxiety and depressive symptoms may explain the negative association between SP and happiness in urban-dwelling older adults in the sub-Saharan African (SSA) context. Interventions, social and clinical, to improve happiness through sleep quality should include ways to improve mental health. Longitudinal and cross-cultural data are warranted to assess the bi-directionality of this relationship.
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Affiliation(s)
- Razak M Gyasi
- Aging and Development Unit, African Population and Health Research Center (RMG), Nairobi, Kenya; National Centre for Naturopathic Medicine, Faculty of Health, Southern Cross University (RMG, PBJ), Lismore, NSW, Australia.
| | - André Hajek
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics (AH), Hamburg, Germany
| | - Richmond Owusu
- Department of Health Policy, Planning, and Management, School of Public Health, University of Ghana (RO), Legon, Ghana
| | - Peter Bai James
- National Centre for Naturopathic Medicine, Faculty of Health, Southern Cross University (RMG, PBJ), Lismore, NSW, Australia
| | - Mary Sefa Boampong
- Department of Sociology and Social Work, Kwame Nkrumah University of Science and Technology (MSB), Kumasi, Ghana
| | - Burnett Tetteh Accam
- Department of Mathematics, Kwame Nkrumah University of Science and Technology (BTA), Kumasi, Ghana
| | - Kabila Abass
- Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology (KA), Kumasi, Ghana
| | - Ellis Owusu-Dabo
- School of Public Health, Kwame Nkrumah University of Science and Technology (EO-D), Kumasi, Ghana
| | - David R Phillips
- Department of Sociology and Social Policy, Lingnan University (DRP), Tuen Mun, New Territories, Hong Kong
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Maloney A, Mengesteab S, Kallas N, Bennett M, Kanaley JA. Sleep restriction by sleep timing late night or early wake: The impact on physical activity and dietary intake in adults. Appetite 2023; 189:106996. [PMID: 37544330 DOI: 10.1016/j.appet.2023.106996] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 08/03/2023] [Accepted: 08/04/2023] [Indexed: 08/08/2023]
Abstract
PURPOSE To date, few studies have assessed whether the timing of sleep restriction impacts physical activity and energy intake patterns. Thus, we aimed to quantify physical activity and energy intake during an early wake (EW) and late sleep (LS) period. METHODS Fourteen participants who met the inclusion criteria (sleep 7-9 h/night and a BMI of <40 kg/m2) participated in 3 crossover free-living conditions: normal sleep (NS, 7-9 h), EW (2-h early wake-time), and LS (2-h late to sleep) for 4 nights. Sleep duration (via Actiwatch), energy intake (via food diaries), and physical activity (via hip accelerometry) were recorded for 4 days/4 nights throughout each condition. RESULTS Sleep duration was reduced in both sleep restriction conditions compared to NS (p < 0.001) with no difference between sleep restriction conditions. Daily energy intake tended to increase in the LS condition (p = 0.056) but was unchanged during EW (p = 0.56). Fat (p = 0.031) and sodium (p = 0.039) intake were increased in the LS condition only compared to NS. During the EW condition, fat (p = 0.24) and sodium (p = 0.18) intake were not altered. No changes in carbohydrate or protein intake occurred between conditions. Daily steps tended to increase in the EW condition compared to NS (p = 0.058), while steps during the LS condition were unchanged (p = 0.28), with no differences between sleep restriction conditions. CONCLUSION The timing of sleep curtailment differentially influences physical activity and EI the following day, such that EW results in increased physical activity, while LS leads to poorer dietary choices.
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Affiliation(s)
- Alan Maloney
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO, USA
| | - Senay Mengesteab
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO, USA
| | - Nadine Kallas
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO, USA
| | - Maura Bennett
- Department of Exercise Science, Northern Kentucky University, USA
| | - Jill A Kanaley
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO, USA.
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26
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Deng H, Duan X, Huang J, Zheng M, Lao M, Weng F, Su QY, Zheng ZF, Mei Y, Huang L, Yang WH, Xing X, Ma X, Zhao W, Liu X. Association of adiposity with risk of obstructive sleep apnea: a population-based study. BMC Public Health 2023; 23:1835. [PMID: 37735660 PMCID: PMC10512644 DOI: 10.1186/s12889-023-16695-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 09/04/2023] [Indexed: 09/23/2023] Open
Abstract
BACKGROUND Obesity is a crucial risk factor for obstructive sleep apnea (OSA), but the association between adiposity deposition and OSA risk has not reached a consistent conclusion. This study sought to reveal the association of multiple adiposity indicators with OSA risk. METHODS This cross-sectional study included 9,733 participants aged 35-74 years, recruited from an ongoing population-based cohort. OSA was assessed by the Berlin Questionnaire. Six adiposity indicators, including neck circumference (NC), body fat percentage (BF%), waist-to-hip ratio (WHR), visceral adiposity index (VAI), lipid accumulation product (LAP), and resting metabolic rate (RMR), were selected. Multivariate logistic regression models were used to examine the association of adiposity indicators with OSA risk. RESULTS One thousand six hundred twenty-six participants (16.71%) were classified into the OSA group. NC, BF%, WHR, VAI, LAP, and RMR were all positively associated with the risk of OSA after adjusting for confounders, regardless of age, sex, and history of dyslipidemia. Every 1-unit increment of NC, BF%, and VAI was associated with a 13%, 9%, and 14% increased risk of OSA, respectively; every 0.01-unit increment of WHR was associated with a 3% increased risk of OSA; every 10-unit increment of LAP and RMR was associated with 2% and 4% increased risk of OSA, respectively. CONCLUSIONS NC, BF%, WHR, VAI, LAP, and RMR were all independently and positively associated with OSA risk, regardless of age, sex, history of dyslipidemia, and menopausal status. Application of these new indicators could help to more comprehensively reflect and predict the risk of OSA in the general population.
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Affiliation(s)
- Hai Deng
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Science, Southern Medical University, Guangzhou, 510080, China
| | - Xueru Duan
- Department of Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, China
- School of Public Health, Guangdong Pharmaceutical University, 283 Jianghai Avenue, Haizhu District, Guangzhou, 510310, China
| | - Jun Huang
- Department of Geriatrics, Guangdong Provincial Geriatrics Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Science, Southern Medical University, Guangzhou, 510080, China
| | - Murui Zheng
- Faculty of Health Sciences, University of Macau, Macau SAR, 999078, China
| | - Miaochan Lao
- Department of Sleep Center, Department of Geriatric Respiratory, Guangdong Provincial Geriatrics Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China
| | - Fan Weng
- Guangzhou Yuexiu District Center for Disease Control and Prevention, Guangzhou, 510080, China
| | - Qi-Ying Su
- Dadong Street Community Health Service Center, Guangzhou, 510080, China
| | - Zhen-Feng Zheng
- Nancun Community Health Service Center, Guangzhou, 511442, China
| | - Yunting Mei
- School of Public Health, Guangdong Pharmaceutical University, 283 Jianghai Avenue, Haizhu District, Guangzhou, 510310, China
| | - Li Huang
- School of Public Health, Guangdong Pharmaceutical University, 283 Jianghai Avenue, Haizhu District, Guangzhou, 510310, China
| | - Wen-Han Yang
- School of Public Health, Guangdong Pharmaceutical University, 283 Jianghai Avenue, Haizhu District, Guangzhou, 510310, China
| | - Xiaohui Xing
- Guangdong Provincial Engineering Technology Research Center of Public Health Detection and Assessment, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, 510310, China
| | - Xiaofeng Ma
- Qinghai Province Cardiovascular and Cerebrovascular Disease Specialist Hospital, 7 Zhuanchang Road, Xining, 810012, China.
| | - Wenjing Zhao
- School of Public Health and Emergency Management, Southern University of Science and Technology, Nanshan District, 1088 Xueyuan Avenue, Shenzhen, 518055, China.
| | - Xudong Liu
- School of Public Health, Guangdong Pharmaceutical University, 283 Jianghai Avenue, Haizhu District, Guangzhou, 510310, China.
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Gupta A, Barthel AB, Mahajan S, Dreyer RP, Yaggi H, Bueno H, Lichtman JH, Krumholz HM. Sex-Specific Associations of Obstructive Sleep Apnea Risk With Patient Characteristics and Functional Outcomes After Acute Myocardial Infarction: Evidence From the VIRGO Study. J Am Heart Assoc 2023; 12:e027225. [PMID: 37702090 PMCID: PMC10547292 DOI: 10.1161/jaha.122.027225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Accepted: 08/01/2023] [Indexed: 09/14/2023]
Abstract
Background Though associations between obstructive sleep apnea (OSA) and cardiovascular outcomes are well described, limited data exist regarding the impact of OSA on sex-specific outcomes after acute myocardial infarction (AMI). Methods and Results The VIRGO (Variation in Recovery: Role of Gender on Outcomes of Young AMI Patients) study enrolled 3572 adults aged 18 to 55 years with AMI from the United States and Spain during 2008 to 2012. We included patients for whom the Berlin Questionnaire for OSA was scored at the time of AMI admission (3141; 2105 women, 1036 men). We examined the sex-specific association between baseline OSA risk with functional outcomes including health status and depressive symptoms at 1 and 12 months after AMI. Among both groups, 49% of patients were at high risk for OSA (1040 women; 509 men), but only 4.7% (148) of patients had a diagnosed history of OSA. Though patients with a high OSA risk reported worse physical and mental health status and depression than low-risk patients in both sexes, the difference in these functional outcomes was wider in women than men. Moreover, women with a high OSA risk had worse health status, depression, and quality of life than high-risk men, both at baseline and at 1 and 12 months after AMI. Conclusions Young women with a high OSA risk have poorer health status and more depressive symptoms than men at the time of AMI, which may place them at higher risk of poorer health outcomes over the year following the AMI. Further, the majority of patients at high risk of OSA are undiagnosed at the time of presentation of AMI.
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Affiliation(s)
- Aakriti Gupta
- Division of Cardiology, Department of MedicineCedars‐Sinai Medical CenterLos AngelesCAUSA
- Clinical Trials CenterCardiovascular Research FoundationNew YorkNYUSA
- Center for Outcomes Research and EvaluationYale‐New Haven HospitalNew HavenCTUSA
| | - Andrea B. Barthel
- Center for Outcomes Research and EvaluationYale‐New Haven HospitalNew HavenCTUSA
| | - Shiwani Mahajan
- Center for Outcomes Research and EvaluationYale‐New Haven HospitalNew HavenCTUSA
- Section of Cardiovascular Medicine, Department of Internal MedicineYale School of MedicineNew HavenCTUSA
| | | | - Henry Yaggi
- Section of Pulmonary, Critical Care, and Sleep Medicine, Department of Internal MedicineYale UniversityNew HavenCTUSA
| | - Héctor Bueno
- Centro Nacional de Investigaciones Cardiovasculares (CNIC)MadridSpain
- Cardiology DepartmentHospital Universitario 12 de Octubre and Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12)MadridSpain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovaculares (CIBERCV)MadridSpain
- Facultad de MedicinaUniversidad Complutense de MadridMadridSpain
| | - Judith H. Lichtman
- Department of Chronic Disease EpidemiologyYale School of Public HealthNew HavenCTUSA
| | - Harlan M. Krumholz
- Center for Outcomes Research and EvaluationYale‐New Haven HospitalNew HavenCTUSA
- Section of Cardiovascular Medicine, Department of Internal MedicineYale School of MedicineNew HavenCTUSA
- Department of Health Policy and ManagementYale School of Public HealthNew HavenCTUSA
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Sindi MA, Mirdad M, Al-Sebaei M, Bamashmous M. Identification of Patients at Risk of Obstructive Sleep Apnea in Dental Settings. Cureus 2023; 15:e44646. [PMID: 37799224 PMCID: PMC10548844 DOI: 10.7759/cureus.44646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/04/2023] [Indexed: 10/07/2023] Open
Abstract
Objectives This study aims to assess the risk of obstructive sleep apnea (OSA) in the Saudi Arabian population at a dental hospital using the Berlin Questionnaire (BQ) and investigate the association of gender, age, neck circumference, systolic blood pressure (SBP), diastolic blood pressure (DBP), and smoking habits with the risk of OSA. Methodology Participants were recruited through random selection from walk-in patients aged between 18 and 80 years. BQ was used to screen for OSA. In addition, age, gender, smoking habits, neck circumference, and blood pressure were collected. Data were analyzed using descriptive statistics, Student's t-test, and chi-square test. Results In this study, 55 participants were screened for OSA using BQ. Of the participants, 44 (80%) were considered to be at low risk of OSA. Age, neck circumference, BMI, SBP, and DBP were statistically significantly associated with high risk of OSA (P < 0.05). Age and neck circumference were found to be statistically significant predictors of OSA, even after controlling for gender and smoking status (P < 0.05). Conclusions BQ is a reliable tool for assessing the risk of OSA in the Saudi Arabian population. Age, neck circumference, BMI, SBP, and DBP are all significant factors of OSA, while age and neck circumference are significant predictors of OSA. Dental practitioners can play a valuable role in the early detection and referral of patients at high risk of OSA.
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Affiliation(s)
| | | | - Maisa Al-Sebaei
- Oral and Maxillofacial Surgery, King Abdulaziz University, Jeddah, SAU
| | - Mohamed Bamashmous
- Dental Public Health, King Abdulaziz University, Jeddah, SAU
- Orthodontic and Dentofacial Orthopedics, Boston University, Boston, USA
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Gyasi RM, Hajek A, Asante F, Accam BT, Osei-Tutu S, Rahmati M, Hervie VM, Abass K, Phillips DR. Ageing Happily in Ghana: How Does Social Inclusion Contribute? Psychogeriatrics 2023; 23:821-830. [PMID: 37438150 DOI: 10.1111/psyg.13004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 06/15/2023] [Accepted: 06/28/2023] [Indexed: 07/14/2023]
Abstract
BACKGROUND Promoting happiness has become increasingly important in old age for a wide range of reasons. In this study, we aim to examine the association between social inclusion (SI) and happiness among older adults in Ghana and identify the mediating factors. METHODS The study included 1201 community-dwelling adults aged ≥50 (mean age = 66.4 ± SD 11.9 years; 63.3% female) from the 2016-2018 Ageing, Health, Psychological Well-being, and Health-seeking Behaviour Study. We assessed happiness with a self-rated and cross-culturally validated item on a five-point scale. SI was operationalised using the modified Berkman-Syme Social Network Index. The hypothesised associations were evaluated by hierarchical regressions and bootstrapping techniques from Hayes' PROCESS macro programme. RESULTS The prevalence of happiness was 24.3% (all of the time), 43.6% (most of the time), 28.3% (little of the time), and 3.7% (none of the time). After controlling for potential confounders, higher SI was associated with increased levels of happiness (odds ratio (OR) = 1.36; 95% confidence interval (CI) = 1.16-2.51). Aside from family/friends contacts, all other SI domains positively influenced happiness (OR = 1.45-1.81). The link between SI and happiness was mediated by depressive symptoms (65.2%), generalised anxiety (30.1%), and sleep problems (9.5%). CONCLUSIONS Our data suggest that psychological factors may largely explain the positive SI-happiness link. Efforts should target these factors to promote happiness in old age. Longitudinal analysis may confirm our findings.
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Affiliation(s)
- Razak M Gyasi
- African Population and Health Research Center, Nairobi, Kenya
- National Centre for Naturopathic Medicine, Faculty of Health, Southern Cross University, Lismore, New South Wales, Australia
| | - André Hajek
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, Hamburg, Germany
| | - Felix Asante
- Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Burnett Tetteh Accam
- Department of Mathematics, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Solomon Osei-Tutu
- Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Masoud Rahmati
- Department of Physical Education and Sport Sciences, Faculty of Literature and Human Sciences, Lorestan University, Khoramabad, Iran
| | | | - Kabila Abass
- Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - David R Phillips
- Department of Sociology and Social Policy, Lingnan University, Hong Kong, China
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30
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Chang JL, Goldberg AN, Alt JA, Alzoubaidi M, Ashbrook L, Auckley D, Ayappa I, Bakhtiar H, Barrera JE, Bartley BL, Billings ME, Boon MS, Bosschieter P, Braverman I, Brodie K, Cabrera-Muffly C, Caesar R, Cahali MB, Cai Y, Cao M, Capasso R, Caples SM, Chahine LM, Chang CP, Chang KW, Chaudhary N, Cheong CSJ, Chowdhuri S, Cistulli PA, Claman D, Collen J, Coughlin KC, Creamer J, Davis EM, Dupuy-McCauley KL, Durr ML, Dutt M, Ali ME, Elkassabany NM, Epstein LJ, Fiala JA, Freedman N, Gill K, Boyd Gillespie M, Golisch L, Gooneratne N, Gottlieb DJ, Green KK, Gulati A, Gurubhagavatula I, Hayward N, Hoff PT, Hoffmann OM, Holfinger SJ, Hsia J, Huntley C, Huoh KC, Huyett P, Inala S, Ishman SL, Jella TK, Jobanputra AM, Johnson AP, Junna MR, Kado JT, Kaffenberger TM, Kapur VK, Kezirian EJ, Khan M, Kirsch DB, Kominsky A, Kryger M, Krystal AD, Kushida CA, Kuzniar TJ, Lam DJ, Lettieri CJ, Lim DC, Lin HC, Liu SY, MacKay SG, Magalang UJ, Malhotra A, Mansukhani MP, Maurer JT, May AM, Mitchell RB, Mokhlesi B, Mullins AE, Nada EM, Naik S, Nokes B, Olson MD, Pack AI, Pang EB, Pang KP, Patil SP, Van de Perck E, Piccirillo JF, Pien GW, Piper AJ, Plawecki A, Quigg M, Ravesloot MJ, Redline S, Rotenberg BW, Ryden A, Sarmiento KF, Sbeih F, Schell AE, Schmickl CN, Schotland HM, Schwab RJ, Seo J, Shah N, Shelgikar AV, Shochat I, Soose RJ, Steele TO, Stephens E, Stepnowsky C, Strohl KP, Sutherland K, Suurna MV, Thaler E, Thapa S, Vanderveken OM, de Vries N, Weaver EM, Weir ID, Wolfe LF, Tucker Woodson B, Won CH, Xu J, Yalamanchi P, Yaremchuk K, Yeghiazarians Y, Yu JL, Zeidler M, Rosen IM. International Consensus Statement on Obstructive Sleep Apnea. Int Forum Allergy Rhinol 2023; 13:1061-1482. [PMID: 36068685 PMCID: PMC10359192 DOI: 10.1002/alr.23079] [Citation(s) in RCA: 62] [Impact Index Per Article: 62.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 08/12/2022] [Accepted: 08/18/2022] [Indexed: 11/08/2022]
Abstract
BACKGROUND Evaluation and interpretation of the literature on obstructive sleep apnea (OSA) allows for consolidation and determination of the key factors important for clinical management of the adult OSA patient. Toward this goal, an international collaborative of multidisciplinary experts in sleep apnea evaluation and treatment have produced the International Consensus statement on Obstructive Sleep Apnea (ICS:OSA). METHODS Using previously defined methodology, focal topics in OSA were assigned as literature review (LR), evidence-based review (EBR), or evidence-based review with recommendations (EBR-R) formats. Each topic incorporated the available and relevant evidence which was summarized and graded on study quality. Each topic and section underwent iterative review and the ICS:OSA was created and reviewed by all authors for consensus. RESULTS The ICS:OSA addresses OSA syndrome definitions, pathophysiology, epidemiology, risk factors for disease, screening methods, diagnostic testing types, multiple treatment modalities, and effects of OSA treatment on multiple OSA-associated comorbidities. Specific focus on outcomes with positive airway pressure (PAP) and surgical treatments were evaluated. CONCLUSION This review of the literature consolidates the available knowledge and identifies the limitations of the current evidence on OSA. This effort aims to create a resource for OSA evidence-based practice and identify future research needs. Knowledge gaps and research opportunities include improving the metrics of OSA disease, determining the optimal OSA screening paradigms, developing strategies for PAP adherence and longitudinal care, enhancing selection of PAP alternatives and surgery, understanding health risk outcomes, and translating evidence into individualized approaches to therapy.
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Affiliation(s)
- Jolie L. Chang
- University of California, San Francisco, California, USA
| | | | | | | | - Liza Ashbrook
- University of California, San Francisco, California, USA
| | | | - Indu Ayappa
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | | | | | | | | | - Maurits S. Boon
- Sidney Kimmel Medical Center at Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Pien Bosschieter
- Academic Centre for Dentistry Amsterdam, Amsterdam, The Netherlands
| | - Itzhak Braverman
- Hillel Yaffe Medical Center, Hadera Technion, Faculty of Medicine, Hadera, Israel
| | - Kara Brodie
- University of California, San Francisco, California, USA
| | | | - Ray Caesar
- Stone Oak Orthodontics, San Antonio, Texas, USA
| | | | - Yi Cai
- University of California, San Francisco, California, USA
| | | | | | | | | | | | | | | | | | - Susmita Chowdhuri
- Wayne State University and John D. Dingell VA Medical Center, Detroit, Michigan, USA
| | - Peter A. Cistulli
- Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - David Claman
- University of California, San Francisco, California, USA
| | - Jacob Collen
- Uniformed Services University, Bethesda, Maryland, USA
| | | | | | - Eric M. Davis
- University of Virginia, Charlottesville, Virginia, USA
| | | | | | - Mohan Dutt
- University of Michigan, Ann Arbor, Michigan, USA
| | - Mazen El Ali
- University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | | | | | | | | | - Kirat Gill
- Stanford University, Palo Alto, California, USA
| | | | - Lea Golisch
- University Hospital Mannheim, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany
| | | | | | | | - Arushi Gulati
- University of California, San Francisco, California, USA
| | | | | | - Paul T. Hoff
- University of Michigan, Ann Arbor, Michigan, USA
| | - Oliver M.G. Hoffmann
- University Hospital Mannheim, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany
| | | | - Jennifer Hsia
- University of Minnesota, Minneapolis, Minnesota, USA
| | - Colin Huntley
- Sidney Kimmel Medical Center at Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | | | | | - Sanjana Inala
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | | | | | | | | | | | | | | | | | | | - Meena Khan
- Ohio State University, Columbus, Ohio, USA
| | | | - Alan Kominsky
- Cleveland Clinic Head and Neck Institute, Cleveland, Ohio, USA
| | - Meir Kryger
- Yale School of Medicine, New Haven, Connecticut, USA
| | | | | | | | - Derek J. Lam
- Oregon Health and Science University, Portland, Oregon, USA
| | | | | | | | | | | | | | - Atul Malhotra
- University of California, San Diego, California, USA
| | | | - Joachim T. Maurer
- University Hospital Mannheim, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany
| | - Anna M. May
- Case Western Reserve University, Cleveland, Ohio, USA
| | - Ron B. Mitchell
- University of Texas, Southwestern and Children’s Medical Center Dallas, Texas, USA
| | | | | | | | | | - Brandon Nokes
- University of California, San Diego, California, USA
| | | | - Allan I. Pack
- University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | | | | | | | | | | | | | | | | | - Mark Quigg
- University of Virginia, Charlottesville, Virginia, USA
| | | | - Susan Redline
- Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | | | - Armand Ryden
- Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California, USA
| | | | - Firas Sbeih
- Cleveland Clinic Head and Neck Institute, Cleveland, Ohio, USA
| | | | | | | | | | - Jiyeon Seo
- University of California, Los Angeles, California, USA
| | - Neomi Shah
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | | | | | - Ryan J. Soose
- University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | | | - Erika Stephens
- University of California, San Francisco, California, USA
| | | | | | | | | | - Erica Thaler
- University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Sritika Thapa
- Yale School of Medicine, New Haven, Connecticut, USA
| | | | - Nico de Vries
- Academic Centre for Dentistry Amsterdam, Amsterdam, The Netherlands
| | | | - Ian D. Weir
- Yale School of Medicine, New Haven, Connecticut, USA
| | | | | | | | - Josie Xu
- University of Toronto, Ontario, Canada
| | | | | | | | | | | | - Ilene M. Rosen
- University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Duarte RLM, Magalhães-da-Silveira FJ, Gozal D. Screening for obstructive sleep apnea: comparing the American Academy of Sleep Medicine proposed criteria with the STOP-Bang, NoSAS, and GOAL instruments. J Clin Sleep Med 2023; 19:1239-1246. [PMID: 36872648 PMCID: PMC10315593 DOI: 10.5664/jcsm.10546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 02/25/2023] [Accepted: 02/27/2023] [Indexed: 03/07/2023]
Abstract
STUDY OBJECTIVES We evaluated the performance of the 2017 American Academy of Sleep Medicine criteria (AASM2017) in screening obstructive sleep apnea (OSA) and compared them with 3 other validated instruments: NoSAS score, STOP-Bang, and GOAL questionnaires. METHODS From July 2019 to December 2021, 4,499 adults undergoing overnight polysomnography were included. The AASM2017 instrument considers an increased high risk for moderate-to-severe OSA in the presence of excessive daytime sleepiness and at least 2 of the following 3 criteria: loud snoring; observed apnea, gasping, or choking; and hypertension. OSA severity was based on polysomnography-derived apnea-hypopnea index cutoffs: 5.0 events/h, 15.0 events/h, and 30.0 events/h. Predictive performance was evaluated by the area under the curve and contingency tables. RESULTS When screening for any OSA severity, AASM2017 displayed a sensitivity of 31.0-40.6% and a specificity of 80.8-89.6%. For all apnea-hypopnea index thresholds, AASM2017, unlike the GOAL, STOP-Bang, and NoSAS, exhibited superior specificity but markedly lower sensitivity. GOAL, STOP-Bang, and NoSAS, but not AASM2017 criteria, emerged as an adequate screening tool for any OSA severity (all areas under the curve > 0.7) and performed significantly better than AASM2017 in predicting any OSA severity (all P < .001). For all severity OSA levels, GOAL, STOP-Bang, and NoSAS displayed similar performance when compared to each other (all P > .05). CONCLUSIONS GOAL, STOP-Bang, and NoSAS instruments, but not AASM2017 criteria, emerge as useful OSA screening tools in a large referral single-center clinical cohort. CITATION Duarte RLM, Magalhães-da-Silveira FJ, Gozal D. Screening for obstructive sleep apnea: comparing the American Academy of Sleep Medicine proposed criteria with the STOP-Bang, NoSAS, and GOAL instruments. J Clin Sleep Med. 2023;19(7):1239-1246.
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Affiliation(s)
- Ricardo L. M. Duarte
- SleepLab, Laboratório de Estudo dos Distúrbios do Sono, Centro Médico BarraShopping, Rio de Janeiro, Brazil
- Instituto de Doenças do Tórax, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - David Gozal
- Department of Child Health, University of Missouri School of Medicine, Columbia, Missouri
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Argel M, Cunha Â, Conceição M, Abrantes T, Torres AS. Screening for Obstructive Sleep Apnea in truck drivers. CIENCIA & SAUDE COLETIVA 2023; 28:1863-1872. [PMID: 37255162 DOI: 10.1590/1413-81232023286.16022022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Accepted: 11/15/2022] [Indexed: 06/01/2023] Open
Abstract
Professional drivers show a higher prevalence of obstructive sleep apnea (OSA) compared with the general population. OSA has been widely associated with an increased risk of traffic accidents. This article aims to investigate the presence of risk factors for OSA, its prevalence and the value of screening tools in a truck drivers' cohort. Descriptive and analytical prospective study. Demographic, anthropometric, Epworth Sleepiness Scale, STOP-Bang and Berlin Questionnaire were used to select subjects with suspicion of OSA. Polysomnography (PSG) was performed in individuals with positive screening. Mean age was 44.6±7 years, mean body mass index was 28.7±4 kg/m². Of the 281 truck drivers screened, 88 were positive for potential OSA. Of these, 63 completed PSG study and the diagnosis was confirmed in 85.7% (prevalence of 19.2%). The following variables showed a positive correlation with the apnea-hypopnea index: neck circumference and STOP-Bang. The combination of a predominantly male population, obesity, age distribution and lifestyle could account for the high prevalence of OSA in this specific population. Questionnaires proved to be a valuable screening tool. Screening, treatment, and management of OSA should be a priority as a public safety policy.
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Affiliation(s)
- Mariana Argel
- Departamento de Pneumologia, Centro Hospitalar Tondela-Viseu, E.P.E. Avenida Rei D. Duarte, 3504-509. Viseu Portugal.
| | - Ângela Cunha
- Departamento de Pneumologia, Centro Hospitalar Tondela-Viseu, E.P.E. Avenida Rei D. Duarte, 3504-509. Viseu Portugal.
| | - Mariana Conceição
- Departamento de Pneumologia, Centro Hospitalar Tondela-Viseu, E.P.E. Avenida Rei D. Duarte, 3504-509. Viseu Portugal.
| | - Tito Abrantes
- Departamento de Pneumologia, Centro Hospitalar Tondela-Viseu, E.P.E. Avenida Rei D. Duarte, 3504-509. Viseu Portugal.
| | - António Simões Torres
- Departamento de Pneumologia, Centro Hospitalar Tondela-Viseu, E.P.E. Avenida Rei D. Duarte, 3504-509. Viseu Portugal.
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Balagny P, Vidal-Petiot E, Renuy A, Matta J, Frija-Masson J, Steg PG, Goldberg M, Zins M, d'Ortho MP, Wiernik E. Prevalence, treatment and determinants of obstructive sleep apnoea and its symptoms in a population-based French cohort. ERJ Open Res 2023; 9:00053-2023. [PMID: 37228279 PMCID: PMC10204811 DOI: 10.1183/23120541.00053-2023] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 03/13/2023] [Indexed: 05/27/2023] Open
Abstract
Background Obstructive sleep apnoea (OSA) is associated with increased morbidity and mortality. Although the disorder has been well studied in selected high-risk populations, few data exist on its prevalence in the general population. We aimed to assess the prevalence and determinants of OSA in France. Methods Data from participants of the French population-based CONSTANCES cohort aged 18-69 years at inclusion and being treated for sleep apnoea or screened for OSA in 2017 using the Berlin Questionnaire were analysed. Weighted analyses were performed to provide recent and representative results in the general population. Results Among 20 151 participants, the prevalence of treated sleep apnoea was 3.5% (95% CI 3.0-3.9%). The prevalence of untreated subjects with a positive Berlin Questionnaire was 18.1% (95% CI 17.3-19.2%) for a total weighted prevalence of treated sleep apnoea or high risk of OSA of 20.9% (95% CI 20.0-21.9%). Regarding prevalence of OSA symptoms, it was 37.2% (95% CI 36.1-38.3%) for severe snoring and 14.6% (95% CI 13.8-15.5%) for hypersomnolence. In multivariable logistic regression analysis, male sex, age, previous cardiovascular events, smoking, low educational level, low physical activity and depressive symptoms were associated with having either treated sleep apnoea or a positive Berlin Questionnaire. Conclusion In this large French population-based cohort, one in five participants had a high likelihood of OSA, whereas only 3.5% were treated for the disorder, suggesting major underdiagnosis in the general population. OSA diagnosis should be considered more often in people with risk factors such as depressive symptoms as well as unhealthy behaviours and socioeconomic conditions.
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Affiliation(s)
- Pauline Balagny
- Université Paris Cité, UFR de Médecine, Paris, France
- Service de Physiologie Explorations Fonctionnelles, AP-HP, Hôpital Bichat, Paris, France
- Université Paris Cité, Population-based Cohorts Unit, INSERM, Paris Saclay University, Université de Versailles Saint-Quentin-en-Yvelines, UMS 011, Paris, France
| | - Emmanuelle Vidal-Petiot
- Université Paris Cité, UFR de Médecine, Paris, France
- Service de Physiologie Explorations Fonctionnelles, AP-HP, Hôpital Bichat, Paris, France
- INSERM U1148, Laboratory for Vascular Translational Science, Paris, France
| | - Adeline Renuy
- Université Paris Cité, Population-based Cohorts Unit, INSERM, Paris Saclay University, Université de Versailles Saint-Quentin-en-Yvelines, UMS 011, Paris, France
| | - Joane Matta
- Université Paris Cité, Population-based Cohorts Unit, INSERM, Paris Saclay University, Université de Versailles Saint-Quentin-en-Yvelines, UMS 011, Paris, France
| | - Justine Frija-Masson
- Université Paris Cité, UFR de Médecine, Paris, France
- Service de Physiologie Explorations Fonctionnelles, AP-HP, Hôpital Bichat, Paris, France
- INSERM U1148, Laboratory for Vascular Translational Science, Paris, France
| | - Philippe Gabriel Steg
- Université Paris Cité, UFR de Médecine, Paris, France
- INSERM U1148, Laboratory for Vascular Translational Science, Paris, France
- Département de Cardiologie, AP-HP, Hôpital Bichat, Paris, France
- Institut Universitaire de France, Paris, France
| | - Marcel Goldberg
- Université Paris Cité, Population-based Cohorts Unit, INSERM, Paris Saclay University, Université de Versailles Saint-Quentin-en-Yvelines, UMS 011, Paris, France
| | - Marie Zins
- Université Paris Cité, UFR de Médecine, Paris, France
- Université Paris Cité, Population-based Cohorts Unit, INSERM, Paris Saclay University, Université de Versailles Saint-Quentin-en-Yvelines, UMS 011, Paris, France
| | - Marie-Pia d'Ortho
- Université Paris Cité, UFR de Médecine, Paris, France
- Service de Physiologie Explorations Fonctionnelles, AP-HP, Hôpital Bichat, Paris, France
- INSERM U1141, NeuroDiderot, Paris, France
| | - Emmanuel Wiernik
- Université Paris Cité, Population-based Cohorts Unit, INSERM, Paris Saclay University, Université de Versailles Saint-Quentin-en-Yvelines, UMS 011, Paris, France
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Chen Y, Zhou E, Wang Y, Wu Y, Xu G, Chen L. The past, present, and future of sleep quality assessment and monitoring. Brain Res 2023; 1810:148333. [PMID: 36931581 DOI: 10.1016/j.brainres.2023.148333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 03/09/2023] [Accepted: 03/12/2023] [Indexed: 03/17/2023]
Abstract
Sleep quality is considered to be an individual's self-satisfaction with all aspects of the sleep experience. Good sleep not only improves a person's physical, mental and daily functional health, but also improves the quality-of-life level to some extent. In contrast, chronic sleep deprivation can increase the risk of diseases such as cardiovascular diseases, metabolic dysfunction and cognitive and emotional dysfunction, and can even lead to increased mortality. The scientific evaluation and monitoring of sleep quality is an important prerequisite for safeguarding and promoting the physiological health of the body. Therefore, we have compiled and reviewed the existing methods and emerging technologies commonly used for subjective and objective evaluation and monitoring of sleep quality, and found that subjective sleep evaluation is suitable for clinical screening and large-scale studies, while objective evaluation results are more intuitive and scientific, and in the comprehensive evaluation of sleep, if we want to get more scientific monitoring results, we should combine subjective and objective monitoring and dynamic monitoring.
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Affiliation(s)
- Yanyan Chen
- School of Physical Education, Jianghan University, Wuhan Hubei, 430056, China
| | - Enyuan Zhou
- School of Physical Education, Jianghan University, Wuhan Hubei, 430056, China
| | - Yu Wang
- School of Physical Education, Jianghan University, Wuhan Hubei, 430056, China
| | - Yuxiang Wu
- School of Physical Education, Jianghan University, Wuhan Hubei, 430056, China
| | - Guodong Xu
- School of Physical Education, Jianghan University, Wuhan Hubei, 430056, China
| | - Lin Chen
- School of Physical Education, Jianghan University, Wuhan Hubei, 430056, China.
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Yoo A, Vgontzas A, Chung J, Mostofsky E, Li W, Rueschman M, Buysse D, Mittleman M, Bertisch S. The association between multidimensional sleep health and migraine burden among patients with episodic migraine. J Clin Sleep Med 2023; 19:309-317. [PMID: 36263856 PMCID: PMC9892733 DOI: 10.5664/jcsm.10320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Revised: 09/24/2022] [Accepted: 09/26/2022] [Indexed: 02/04/2023]
Abstract
STUDY OBJECTIVES Using the Sleep Regularity, Satisfaction, Alertness, Timing, Satisfaction, and Duration (Ru-SATED) sleep health framework, we examined the association between multidimensional sleep health and headache burden in a cohort of 98 adults with episodic migraine. METHODS Participants wore wrist actigraphs and completed twice-daily electronic diaries regarding sleep, headaches, and other health habits for 6 weeks. We calculated separate composite sleep health scores from diary and actigraphy assessed measures using the Ru-SATED framework. We used adjusted multivariable linear regression models to examine the association between composite sleep health scores and headache frequency, duration, and pain intensity. RESULTS Among 98 participants (mean age: 35 ± 12 years; 87.8% female), 83 had healthy ranges in ≥ 3 sleep dimensions. In models adjusted for age, sex, menopausal status, physical activity and alcohol intake, good sleep health was associated with fewer headache days/month (actigraphy: 3.1 fewer days; 95% confidence interval: 0.9, 5.7; diary: 4.0 fewer days; 95% confidence interval: 1.1, 6.9). Results did not change substantively with further adjustment for stress and depressive symptoms. We did not observe an association between sleep health and headache duration or intensity, respectively. CONCLUSIONS Among patients with episodic migraine, good multidimensional sleep health, but not the majority of singular dimensions of sleep, is associated with approximately 3-4 fewer headache days/month. In addition, there was no association with headache duration or intensity. These findings highlight the importance of assessing multiple dimensions of sleep and suggest that improving sleep health may be a potential clinical strategy to reduce headache frequency. CITATION Yoo A, Vgontzas A, Chung J, et al. The association between multidimensional sleep health and migraine burden among patients with episodic migraine. J Clin Sleep Med. 2023;19(2):309-317.
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Affiliation(s)
- Alexander Yoo
- Department of Neurology, University of Rochester, Rochester, New York
| | - Angeliki Vgontzas
- Department of Neurology, Brigham and Women’s Hospital, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | - Joon Chung
- Harvard Medical School, Boston, Massachusetts
- Program in Sleep Medicine Epidemiology, Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Elizabeth Mostofsky
- Harvard Medical School, Boston, Massachusetts
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Cardiovascular Epidemiology Research Unit, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Wenyuan Li
- Harvard Medical School, Boston, Massachusetts
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Cardiovascular Epidemiology Research Unit, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Michael Rueschman
- Program in Sleep Medicine Epidemiology, Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Daniel Buysse
- Department of Psychiatry, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Murray Mittleman
- Harvard Medical School, Boston, Massachusetts
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Cardiovascular Epidemiology Research Unit, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Suzanne Bertisch
- Harvard Medical School, Boston, Massachusetts
- Program in Sleep Medicine Epidemiology, Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
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Sethi PP, Pathania M, Gupta R, Sharma P, Saini LK. Poor quality sleep is associated with greater carotid intima media thickness among otherwise healthy resident doctors. FRONTIERS IN EPIDEMIOLOGY 2023; 2:1044111. [PMID: 38455319 PMCID: PMC10910945 DOI: 10.3389/fepid.2022.1044111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 12/13/2022] [Indexed: 03/09/2024]
Abstract
Background Sleep is important for maintaining the metabolic processes in the body, and hence, disruption in sleep leads to metabolic derangement and accelerated atherosclerosis. The effect of sleep duration on subclinical atherosclerosis has been examined in several studies; however, data regarding sleep quality is lacking. The study aimed to assess the association between sleep quality and carotid intima-media thickness among healthy young doctors. Materials and Methods This was an observational cross-sectional study among 110 healthy young resident doctors. Anthropometric data were recorded and morning fasting venous blood samples were collected to assess fasting blood sugar, lipid profile and glycosylated haemoglobin (HbA1c). Pittsburgh Sleep Quality Index and Berlin questionnaire assessed subjective sleep quality and risk for obstructive sleep apnea, respectively. Carotid ultrasonography was done to detect the intima-media thickness. Results Average age of the participants was 26.45 (±1.43) years, and 51.8% were male. Self-reported poor sleep quality was found in 54.5%. Carotid intima-media thickness (CIMT) was increased among 44.5% of participants. In the multivariate analysis, only poor sleep quality appeared to be associated with higher CIMT (P < 0.001, OR = 7.4; 95% CI = 2.70-20.32). When different components of sleep quality was analyzed through multivariate logistic regression, subjective sleep onset latency (>30 min), sleep efficiency (<85%) and sleep disturbance was found to be associated with the increased CIMT. Conclusion Poor sleep quality, especially prolonged sleep onset latency, poor sleep efficiency, and sleep disturbance are associated with increased carotid intima-media thickness among healthy young adults.
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Affiliation(s)
| | - Monika Pathania
- Department of Internal Medicine, All India Institute of Medical Science, Rishikesh, India
| | - Ravi Gupta
- Department of Psychiatry, All India Institute of Medical Science, Rishikesh, India
| | - Pankaj Sharma
- Department of Radiodiagnosis, All India Institute of Medical Science, Rishikesh, India
| | - Lokesh Kumar Saini
- Department of Pulmonary Medicine, All India Institute of Medical Science, Rishikesh, India
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Gyasi RM, Abass K, Segbefia AY, Afriyie K, Asamoah E, Boampong MS, Adam AM, Owusu-Dabo E. A two-mediator serial mediation chain of the association between social isolation and impaired sleep in old age. Sci Rep 2022; 12:22458. [PMID: 36577767 PMCID: PMC9797554 DOI: 10.1038/s41598-022-26840-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 12/21/2022] [Indexed: 12/29/2022] Open
Abstract
Poor sleep is a long-term public health issue that has become increasingly prevalent among socially isolated older adults. However, research on the mechanisms explaining the link between social isolation and impaired sleep (IS) remains limited, particularly in low- and middle-income countries. This study explored the serial mediating effects of loneliness and mental distress on the association of social isolation with IS among Ghanaian older adults. We analyzed data from 1201 adults aged ≥ 50 from Ghana's AgeHeaPsyWel-HeaSeeB study (mean age = 66.14, SD = 11.85, age range = 50-111; women = 63.28%). Measures included the UCLA 3-item Loneliness Scale, modified Berkman-Syme Social Network Index, Sleep Quality Scale, and Mental Distress Questionnaire. We used bootstrapping techniques from Hayes' PROCESS macro program to estimate the hypothesized serial mediation. Social isolation was significantly associated with IS (β = 0.242, p < 0.001). Crucially, social isolation indirectly predicted IS via three significant mediating pathways. Loneliness accounted for 17.6% (β = 0.054, CI = 0.096, 0.016), mental distress accounted for 6.5% (β = 0.020, 95% CI = 0.004, 0.040), and loneliness and mental distress accounted for 32.2% (β = 0.099, 95% CI = 0.065, 0.138) of the overall effect. The total mediating effect was 56.4%. These findings suggest that the social isolation-sleep link is respectively and serially explained by loneliness and mental distress. Social integrative interventions for sleep quality in old age should target mental and emotional well-being.
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Affiliation(s)
- Razak M Gyasi
- Aging and Development Program, African Population and Health Research Center (APHRC), Manga Close, Off-Kirawa Road, P. O. Box 10787-00100, Nairobi, Kenya.
- National Centre for Naturopathic Medicine, Faculty of Health, Southern Cross University, Lismore, NSW, Australia.
| | - Kabila Abass
- Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Alexander Yao Segbefia
- Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Kwadwo Afriyie
- Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Edward Asamoah
- Department of Sociology and Social Work, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Mary Sefa Boampong
- Department of Sociology and Social Work, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Anokye M Adam
- Department of Finance, School of Business, University of Cape Coast, Cape Coast, Ghana
| | - Ellis Owusu-Dabo
- School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Morey BN, Ryu S, Shi Y, Redline S, Kawachi I, Lee S. Associations between sleep apnea risk and cardiovascular disease indicators among Chinese and Korean Americans. SLEEP EPIDEMIOLOGY 2022; 2:100037. [PMID: 36250200 PMCID: PMC9555314 DOI: 10.1016/j.sleepe.2022.100037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
STUDY OBJECTIVES While sleep apnea has been associated with cardiovascular disease (CVD) risk factors in white individuals in the U.S., these associations in Chinese and Korean Americans are less well-understood, particularly how these associations vary by age, gender, Asian origin, obesity, chronic conditions, and daytime sleepiness. METHODS We used a sample of Chinese and Korean Americans ages 50-75 (n = 394) from the Baltimore-Washington DC Metropolitan Area to examine the associations of high risk (HR) sleep apnea with diagnoseable hypercholesterolemia and diabetes, as well as the following biomarkers: total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), total cholesterol/HDL-C ratio, triglycerides, and glucose (non-fasting). Poisson models included demographic factors, socioeconomic status, and body mass index (BMI). We tested for potential effect modifiers. RESULTS HR-sleep apnea was associated with higher LDL-C level (β = 14.56, p < 0.05) and higher total cholesterol/HDL ratio (β = 0.64, p < 0.01). Younger respondents had higher levels of triglycerides associated with HR-sleep apnea than older respondents. For men, HR-sleep apnea was associated with higher total cholesterol, total cholesterol/HDL-C ratio, and triglycerides. Obese and overweight respondents had positive associations between HR-sleep apnea and total cholesterol, total cholesterol/HDL ratio, and triglycerides, while underweight/normal weight individuals did not. The interactions between snoring and daytime sleepiness were associated with hypercholesterolemia and diabetes. CONCLUSIONS This study demonstrates associations between sleep apnea risk and dyslipidemia among Chinese and Korean Americans. Associations were particularly pronounced among younger, male, overweight/obese, and sicker individuals. Future research should examine how to improve sleep health in Asian American populations to improve CVD risk.
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Affiliation(s)
- Brittany N. Morey
- Department of Health, Society, & Behavior, Program in Public Health, University of California Irvine, 653 E. Peltason Dr., Anteater Instruction and Research Building (AIRB) 2022, Irvine, CA 92697-3957, USA
| | - Soomin Ryu
- School of Public Policy, University of Maryland, College Park, USA
| | - Yuxi Shi
- University of California, Irvine, USA
| | - Susan Redline
- Department of Medicine, and Harvard T.H. Chan School of Public Health, Department of Epidemiology, Harvard Medical School, Brigham and Women’s Hospital, USA
| | - Ichiro Kawachi
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, USA
| | - Sunmin Lee
- Department of Medicine, School of Medicine, University of California, Irvine, USA
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Monin J, Guiu G, Reybard C, Bompaire F, Bisconte S, Perrier E, Manen O. Prevalence of sleep disorders in a large French cohort of aircrew members and risk of in-flight sleepiness. Sleep Med 2022; 100:183-189. [PMID: 36087520 DOI: 10.1016/j.sleep.2022.08.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 08/17/2022] [Accepted: 08/18/2022] [Indexed: 01/12/2023]
Abstract
BACKGROUND /objectives: Sleep disorders are a critical issue for flight safety. Previous studies have shown a high prevalence of sleep disorders and excessive sleepiness in the general population and some aircrews. The objectives of this study are to measure the prevalence of excessive daytime sleepiness and sleep disorders in aircrews, and to determine the risk factors of falling asleep during a flight. METHODS this is a monocentric study based on questionnaires, including all professional civilian and military aircrews examined in an aeromedical center between January and May 2021. The questionnaire, created for this study, included information about socio-demographic characteristics, aeronautical experience, lifestyle, sleep habits, an Epworth sleepiness scale, and screening tests for chronic insomnia, sleep apnea syndrome and restless legs syndrome. RESULTS 749 aircrew members were included (86.2% male, 58.9% civilian, 74.1% pilot, mean age 43.4 ± 9.6 years), 45.9% of the population had at least one sleep disorder (chronic insomnia 39.5%, sleep apnea syndrome 10.5%, restless legs syndrome 4.1%), 15.5% had an excessive daytime sleepiness, and 24.6% reported in-flight sleep while on duty. Chronic insomnia, screen use before bedtime, use of sleeping pills, inadequate recovery time after a flight, female gender and civilian status were found as risk factors of in-flight sleep in the multivariate analysis. CONCLUSION this study emphasizes the need to improve the screening and prevention of sleep disorders in this particular population.
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Affiliation(s)
- Jonathan Monin
- Aeromedical Center, Percy Military Hospital, Clamart, France.
| | - Gaëtan Guiu
- Aeromedical Center, Percy Military Hospital, Clamart, France
| | | | - Flavie Bompaire
- Department of Neurology, Percy Military Hospital, Clamart, France
| | | | - Eric Perrier
- Aeromedical Center, Percy Military Hospital, Clamart, France; French Military Health Service Academy, Paris, France
| | - Olivier Manen
- Aeromedical Center, Percy Military Hospital, Clamart, France; French Military Health Service Academy, Paris, France
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Impact of a Weight-Loss Rehabilitation Program on Sleep Apnea Risk and Subjective Sleepiness in Patients with Overweight/Obesity: The DietSleep Study. J Clin Med 2022; 11:jcm11236890. [PMID: 36498465 PMCID: PMC9735960 DOI: 10.3390/jcm11236890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 11/18/2022] [Accepted: 11/20/2022] [Indexed: 11/24/2022] Open
Abstract
Obstructive sleep apnea (OSA) is one of the most frequent chronic diseases, and comorbid obesity occurs in more than 60% of cases. Variations in body weight influence both OSA severity and OSA-related symptoms. We prospectively assessed the impact of a weight-loss program using the Berlin score to reflect OSA risk, and we also used the Epworth Sleepiness Scale (ESS) to assess daytime sleepiness. DietSleep was a prospective multicentric cohort study investigating OSA risk and daytime sleepiness before and after weight-loss intervention. One hundred and twenty-seven patients were included (initial OSA risk 36%), most of whom were women (85.8%) with a median body mass index (BMI) of 29.7 kg/m2, and the interquartile range was (27.6; 34). The diet-based weight-loss program induced a median decrease in BMI of 3.7 kg/m2 (−5; −2.9) (body weight~12.1% (−16.0; −8.8)) over a period of 171 days (114; 269). Changes in anthropometric values were similar regarding OSA risk after adjusting for initial values. Berlin scores significantly improved from 3 (1; 5) to 1 (0; 2), p < 0.01; the proportion of patients with a Berlin score ≥2 decreased from 36% to 7% after the intervention. The proportion of patients with ESS ≥11 decreased from 13% to 2%. These results confirm that a weight-loss program produces clinically relevant weight loss and a significant improvement in both OSA and subjective daytime sleepiness.
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Prevalence and impact of obstructive sleep apnea in type 2 diabetes mellitus: A descriptive cross-sectional study. Med J Armed Forces India 2022. [DOI: 10.1016/j.mjafi.2022.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Duarte RLDM, Togeiro SMGP, Palombini LDO, Rizzatti FPG, Fagondes SC, Magalhães-da-Silveira FJ, Cabral MM, Genta PR, Lorenzi-Filho G, Clímaco DCS, Drager LF, Codeço VM, Viegas CADA, Rabahi MF. Brazilian Thoracic Association Consensus on Sleep-disordered Breathing. JORNAL BRASILEIRO DE PNEUMOLOGIA : PUBLICACAO OFICIAL DA SOCIEDADE BRASILEIRA DE PNEUMOLOGIA E TISILOGIA 2022; 48:e20220106. [PMID: 35830079 PMCID: PMC9262434 DOI: 10.36416/1806-3756/e20220106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 05/23/2022] [Indexed: 12/02/2022]
Abstract
Sleep is essential for the proper functioning of all individuals. Sleep-disordered breathing can occur at any age and is a common reason for medical visits. The objective of this consensus is to update knowledge about the main causes of sleep-disordered breathing in adult and pediatric populations, with an emphasis on obstructive sleep apnea. Obstructive sleep apnea is an extremely prevalent but often underdiagnosed disease. It is often accompanied by comorbidities, notably cardiovascular, metabolic, and neurocognitive disorders, which have a significant impact on quality of life and mortality rates. Therefore, to create this consensus, the Sleep-Disordered Breathing Department of the Brazilian Thoracic Association brought together 14 experts with recognized, proven experience in sleep-disordered breathing.
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Affiliation(s)
| | - Sonia Maria Guimarães Pereira Togeiro
- . Disciplina de Clínica Médica, Escola Paulista de Medicina - EPM - Universidade Federal de São Paulo - UNIFESP - São Paulo (SP) Brasil.,. Instituto do Sono, São Paulo (SP) Brasil
| | | | | | - Simone Chaves Fagondes
- . Serviço de Pneumologia, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul - UFRGS - Porto Alegre (RS) Brasil
| | | | | | - Pedro Rodrigues Genta
- . Laboratório de Investigação Médica 63 - LIM 63 (Laboratório do Sono) - Divisão de Pneumologia, Instituto do Coração - InCor - Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo - HCFMUSP - São Paulo (SP) Brasil
| | - Geraldo Lorenzi-Filho
- . Laboratório de Investigação Médica 63 - LIM 63 (Laboratório do Sono) - Divisão de Pneumologia, Instituto do Coração - InCor - Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo - HCFMUSP - São Paulo (SP) Brasil
| | | | - Luciano Ferreira Drager
- . Unidade de Hipertensão, Instituto do Coração - InCor - Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo - HCFMUSP - São Paulo (SP) Brasil
| | - Vitor Martins Codeço
- . Hospital Regional da Asa Norte, Secretaria de Estado de Saúde do Distrito Federal, Brasília (DF) Brasil
| | | | - Marcelo Fouad Rabahi
- . Faculdade de Medicina, Universidade Federal de Goiás - UFG - Goiânia (GO) Brasil
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Application value of joint NoSAS score and Epworth Sleepiness Scale for assessment of obstructive sleep apnea hypopnea syndrome. Sleep Med 2022; 97:36-42. [DOI: 10.1016/j.sleep.2022.05.845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 05/12/2022] [Accepted: 05/27/2022] [Indexed: 11/18/2022]
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Ranney RM, Gloria R, Metzler TJ, Huggins J, Neylan TC, Maguen S. Brief behavioral treatment for insomnia decreases trauma-related nightmare frequency in veterans. J Clin Sleep Med 2022; 18:1831-1839. [PMID: 35393934 DOI: 10.5664/jcsm.10002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES Trauma-related nightmares are highly prevalent among veterans and are associated with higher severity insomnia and PTSD. Cognitive behavioral therapy for insomnia (CBT-I, typically 6-8 sessions) has been shown to reduce trauma-related nightmares. Brief behavioral treatment for insomnia (BBTI, 4 sessions) has been found to be comparable to CBT-I in decreasing insomnia severity; however, the effects of BBTI on nightmares have not been investigated. The current study tested the effects of BBTI on both trauma-related nightmares and non-trauma-related bad dreams using an active control group, progressive muscle relaxation therapy (PMRT). Additionally, we tested whether baseline trauma-related nightmare frequency and baseline non-trauma-related bad dream frequency moderated changes in insomnia severity. METHODS Participants were 91 military veterans with insomnia disorder randomized to BBTI or PMRT. Participants reported insomnia severity on the Insomnia Severity Index and reported trauma-related nightmare frequency and non-trauma-related bad dream frequency on the Pittsburgh Sleep Quality Index--PTSD Addendum. RESULTS We found that BBTI significantly reduced trauma-related nightmares from baseline to post-treatment while PMRT did not. However, reductions in trauma-related nightmares were not maintained at six month follow up. Neither BBTI nor PMRT reduced non-trauma-related bad dreams from baseline to post-treatment. We also found that neither baseline trauma-related nightmare frequency nor baseline non-trauma-related bad dream frequency moderated changes in insomnia symptom severity. CONCLUSIONS Findings from the current study suggest that BBTI may help to reduce trauma-related nightmares. Further research is needed to better understand potential mechanisms underlying how improved sleep may reduce trauma-related nightmares. CLINICAL TRIAL REGISTRATION Registry: ClinicalTrials.gov; Name: Brief Behavioral Insomnia Treatment Study (BBTI); Identifier: NCT02571452; URL: https://clinicaltrials.gov/ct2/show/NCT02571452.
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Affiliation(s)
- Rachel M Ranney
- Veterans Affairs San Francisco Health Care System, San Francisco, CA.,Department of Psychiatry and Behavioral Sciences, University of California, San Francisco School of Medicine, San Francisco, CA.,Sierra Pacific Mental Illness Research Education, and Clinical Center, San Francisco, CA
| | - Rebecca Gloria
- Veterans Affairs San Francisco Health Care System, San Francisco, CA
| | - Thomas J Metzler
- Veterans Affairs San Francisco Health Care System, San Francisco, CA.,Department of Psychiatry and Behavioral Sciences, University of California, San Francisco School of Medicine, San Francisco, CA.,Sierra Pacific Mental Illness Research Education, and Clinical Center, San Francisco, CA
| | - Joy Huggins
- Veterans Affairs San Francisco Health Care System, San Francisco, CA
| | - Thomas C Neylan
- Veterans Affairs San Francisco Health Care System, San Francisco, CA.,Department of Psychiatry and Behavioral Sciences, University of California, San Francisco School of Medicine, San Francisco, CA.,Sierra Pacific Mental Illness Research Education, and Clinical Center, San Francisco, CA
| | - Shira Maguen
- Veterans Affairs San Francisco Health Care System, San Francisco, CA.,Department of Psychiatry and Behavioral Sciences, University of California, San Francisco School of Medicine, San Francisco, CA.,Sierra Pacific Mental Illness Research Education, and Clinical Center, San Francisco, CA
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Song HJ, Kim J. Validity Analysis of Neck Circumference as a Screening Test for Hypoxia Occurrence in Patients Undergoing Sedative Endoscopy. Healthcare (Basel) 2022; 10:healthcare10040679. [PMID: 35455856 PMCID: PMC9025010 DOI: 10.3390/healthcare10040679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 03/30/2022] [Accepted: 03/31/2022] [Indexed: 02/01/2023] Open
Abstract
This study was performed to check the validity of and propose a cutoff point for measuring the neck circumference for screening hypoxia occurrence in patients undergoing sedative endoscopy. Data were collected from 168 patients who visited the Endoscopy Center of G University Hospital between 27 April 2020 and 12 June 2020 to undergo sedative endoscopy. Hypoxia occurrences were measured using sleep questionnaires (STOP-BANG and Berlin questionnaires), and the neck circumference measurements of the patients were compared. Neck circumference as a predictor of hypoxia and its sensitivity and specificity according to the cutoff values were high; thus, it is a valid screening test for hypoxia in patients undergoing sedative endoscopy. The most appropriate cutoff values for sitting neck circumference and lying neck circumference in men were 40.5 and 40.3, respectively, and those for women were 35.3 and 35.8, respectively. Hypoxia can be predicted in patients undergoing sedative endoscopy by measuring their neck circumference.
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Affiliation(s)
- Hyun-Ji Song
- Gastrointestinal Endoscopy Center, Gachon University Gill Medical Center, Incheon 21565, Korea;
| | - Jiyun Kim
- School of Nursing, Gachon University, Incheon 21936, Korea
- Correspondence: ; Tel.: +82-31-820-4226
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Abbasi S, Rahpeyma A, Shooshtari Z, Rezaeetalab F, Vaezi T, Samieirad S. Bimaxillary Orthognathic Surgery does not Induce Obstructive Sleep Apnea in Skeletal Class III Patients, regarding ApneaLink Device Results. J Oral Maxillofac Surg 2022; 80:1340-1353. [DOI: 10.1016/j.joms.2022.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 04/18/2022] [Accepted: 04/18/2022] [Indexed: 10/18/2022]
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Monna F, Ben Messaoud R, Navarro N, Baillieul S, Sanchez L, Loiodice C, Tamisier R, Faure MJ, Pepin JL. Machine learning and geometric morphometrics to predict obstructive sleep apnea from 3D craniofacial scans. Sleep Med 2022; 95:76-83. [DOI: 10.1016/j.sleep.2022.04.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 03/23/2022] [Accepted: 04/23/2022] [Indexed: 12/21/2022]
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48
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Vgontzas A, Mostofsky E, Hagan K, Rueschman M, Mittleman MA, Bertisch SM. Napping behavior in adults with episodic migraine: a six-week prospective cohort study. Sleep 2022; 45:zsab273. [PMID: 34791487 PMCID: PMC8919195 DOI: 10.1093/sleep/zsab273] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 10/18/2021] [Indexed: 01/03/2023] Open
Abstract
STUDY OBJECTIVES Patients with migraine commonly endorse napping as a strategy for headache pain relief, but also experience high rates of sleep disturbance. To elucidate the relationship between napping behavior and migraine, we evaluated the association between napping and headache frequency, severity, and intensity among adults with episodic migraine. We also examined the association between daily napping and that night's sleep. METHODS In this six-week prospective cohort study, 97 adults with episodic migraine completed twice-daily headache and sleep electronic diaries and wore a wrist actigraph. We modeled the associations between napping (yes/no) and headaches with conditional logistic regression and daily napping and nighttime sleep with linear regression. RESULTS Over 4,353 study days, participants reported 1,059 headache days and 389 days with naps. More than 80% of participants napped during the study, with mean nap duration of 76.7 ± 62.4 min. Naps were more likely to occur on day 2 of headache 35/242 (14.5%) than on nonheadache days 279/3294 (8.5%, OR 2.2 [95% CI 1.4, 3.4]). Mean nap onset time (14:40 ± 3.3 h) was later than headache onset (12:48 ± 5.3 h). In adjusted models, napping was associated with an additional 1.1 (95% CI -1.4, 3.6) headache days/month. Naps were not associated with worse self-reported or objective sleep that night. CONCLUSIONS Our findings suggest that naps may be an uncommonly used behavioral strategy for prolonged migraine attacks and do not contribute to nightly sleep disturbance. Future studies are needed to examine the acute analgesic effects of daytime napping in patients with migraine.
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Affiliation(s)
- Angeliki Vgontzas
- Department of Neurology, Brigham and Women’s Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Elizabeth Mostofsky
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Cardiovascular Epidemiology Research Unit, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Kobina Hagan
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Michael Rueschman
- Program in Sleep Medicine Epidemiology, Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA, USA
| | - Murray A Mittleman
- Harvard Medical School, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Cardiovascular Epidemiology Research Unit, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Suzanne M Bertisch
- Harvard Medical School, Boston, MA, USA
- Program in Sleep Medicine Epidemiology, Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA, USA
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Gyasi RM, Asamoah E, Gyasi-Boadu N, Zornu O, Asiki G, Phillips DR. Food insecurity and sleep quality among older adults: Findings from a population-based study in Ghana. Maturitas 2022; 157:27-33. [DOI: 10.1016/j.maturitas.2021.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 09/21/2021] [Accepted: 10/18/2021] [Indexed: 11/24/2022]
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50
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Wang S, Li S, Zhao Y, Zhao X, Zhou Z, Hao Q, Luo A, Sun R. Preoperative screening of patients at high risk of obstructive sleep apnea and postoperative complications: A systematic review and meta-analysis. J Clin Anesth 2022; 79:110692. [PMID: 35217467 DOI: 10.1016/j.jclinane.2022.110692] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 01/28/2022] [Accepted: 02/16/2022] [Indexed: 10/19/2022]
Abstract
STUDY OBJECTIVE To determine the association between postoperative complications and a high versus low risk of obstructive sleep apnea (OSA) as determined via screening tools. DESIGN Systematic review and meta-analysis of cohort studies. PubMed, EMBASE, Web of Science, and the Cochrane Library were searched from their inception to January 5, 2021. SETTING Operating room, postoperative recovery area, and ward. PATIENTS Adult patients scheduled for surgery. INTERVENTIONS We used Review Manager 5.4 to pool the data. The quality of evidence was rated using the Grading of Recommendations, Assessment, Development and Evaluation system. MEASUREMENTS The primary outcome was the composite endpoint of postoperative respiratory complications. The secondary outcomes were postoperative cardiac and neurological complications, intensive care unit (ICU) admission, and mortality. MAIN RESULTS Twenty-six studies with 50,592 patients were included. A STOP-Bang score ≥ 3 (versus <3) was associated with higher incidences of postoperative respiratory (odds ratio [OR], 2.11; 95% confidence interval [CI], 1.66-2.68) and neurological complications (OR, 3.60; 95% CI, 1.56-8.31). A STOP-Bang score ≥ 5 (versus <5) was associated with higher incidences of postoperative respiratory (OR, 2.37; 95% CI, 1.11-5.04) and cardiac complications (OR, 4.95; 95% CI, 1.22-20.00) and higher in-hospital mortality (OR, 26.39; 95% CI, 2.89-241.30). A Berlin score ≥ 2 (versus <2) was not associated with the incidence of postoperative complications, ICU admission, or mortality. The quality of evidence for all outcomes was very low. CONCLUSIONS Very low-quality evidence suggested that a high risk of OSA, as assessed using the STOP-Bang questionnaire, was associated with a higher incidence of postoperative respiratory complications, and may also be associated with higher incidences of postoperative cardiac and neurological complications than a low risk of OSA. Since most of the included studies did not adjust for confounding factors, our findings need to be interpreted with caution. PROSPERO registration number: CRD42021220236.
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Affiliation(s)
- Shuo Wang
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Shiyong Li
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Yilin Zhao
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Xiaoping Zhao
- Center of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Zhiqiang Zhou
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Quanshui Hao
- Department of Anesthesiology, Huanggang Central Hospital, Huanggang 438000, China
| | - Ailin Luo
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Rao Sun
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
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