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Shriane AE, Vincent GE, Ferguson SA, Rebar A, Kolbe-Alexander T, Rigney G. Improving sleep health in paramedics through an app-based intervention: a randomised waitlist control pilot trial. BMC Public Health 2024; 24:2395. [PMID: 39227826 PMCID: PMC11373143 DOI: 10.1186/s12889-024-19823-w] [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: 10/16/2023] [Accepted: 08/16/2024] [Indexed: 09/05/2024] Open
Abstract
BACKGROUND Due to work commitments, shiftworkers often obtain inadequate sleep, consequently experiencing negative health, wellbeing, and safety outcomes. Given shiftworkers may have limited control over their work commitments, lifestyle and environmental factors within their control may present an intervention opportunity. However, such interventions require tailoring to ensure applicability for this sleep-vulnerable population. METHODS A randomised waitlist control pilot trial investigated the effectiveness of mobile health application Sleepfit, which delivered a tailored sleep health intervention aimed at improving sleep health and sleep hygiene outcomes amongst paramedic shiftworkers. Outcome measures of self-reported sleep health (sleep need, duration, and quality, fatigue, Insomnia Severity Index, Fatigue Severity Scale, and Epworth Sleepiness Scale scores) and sleep hygiene (Sleep Hygiene Index score) were collected at baseline, post-intervention, and 3-month follow-up. RESULTS Fifty-eight paramedics (aged 33.4 ± 8.0 years; 50% male) were recruited, and trialed Sleepfit for a 14-day intervention period between August 2021-January 2022. For all participants, there was a significant reduction in Insomnia Severity Index and Sleep Hygiene index scores after intervention engagement. Regression models demonstrated no significant intervention effect on sleep health or sleep hygiene outcomes (intervention versus waitlist control group). A high study drop-out rate (91.4%) prevented assessment of outcomes at 3-month follow-up. CONCLUSIONS Pilot trial findings demonstrate that Sleepfit may elicit improvements in sleep health and sleep hygiene outcomes amongst paramedic shiftworkers. However, low enrolment and retention means that findings should be interpreted with caution, further highlighting potential engagement challenges, especially among paramedics who are particularly in need of support for improved sleep. TRIAL REGISTRATION Prospectively registered with the Australian New Zealand Clinical Trial Registry 24/01/2020 (reference no. ACTRN12620000059965).
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Affiliation(s)
- Alexandra E Shriane
- Appleton Institute, School of Health, Medical and Applied Sciences, Central Queensland University, 44 Greenhill Road, Wayville, Adelaide, SA, 5034, Australia.
| | - Grace E Vincent
- Appleton Institute, School of Health, Medical and Applied Sciences, Central Queensland University, 44 Greenhill Road, Wayville, Adelaide, SA, 5034, Australia
| | - Sally A Ferguson
- Appleton Institute, School of Health, Medical and Applied Sciences, Central Queensland University, 44 Greenhill Road, Wayville, Adelaide, SA, 5034, Australia
| | - Amanda Rebar
- Motivation of Health Behaviours Lab, Appleton Institute, School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, QLD, Australia
| | - Tracy Kolbe-Alexander
- School of Health and Medical Sciences, and Centre for Health Research, University of Southern Queensland, Ipswich, QLD, Australia
- UCT Research Centre for Health through Physical Activity, Lifestyle and Sport (HPALS), Division of Research Unit for Exercise Science and Sports Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Gabrielle Rigney
- Appleton Institute, School of Health, Medical and Applied Sciences, Central Queensland University, 44 Greenhill Road, Wayville, Adelaide, SA, 5034, Australia
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Paranicova I, Bodnarova S, Trojova I, Hertelyova Z, Gulasova Z, Cimbolakova I, Genzor S, Joppa P, Tkacova R, Pobeha P. Long-term myocardial effects of noninvasive ventilation in patients with obesity hypoventilation syndrome. Respir Med 2024; 231:107735. [PMID: 38977108 DOI: 10.1016/j.rmed.2024.107735] [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: 03/26/2024] [Revised: 06/24/2024] [Accepted: 07/05/2024] [Indexed: 07/10/2024]
Abstract
INTRODUCTION Chronic effects of noninvasive ventilation on myocardial function in patients with obesity hypoventilation syndrome (OHS) are scarcely understood. The aim of the present study was to evaluate the long-term effects of volume-targeted bilevel positive airway pressure ventilation (BiPAP) on cardiac parameters and myocardial biomarkers in patients with OHS. METHODS Clinically stable patients with OHS referred to the tertiary center for the initiation of long-term BiPAP therapy were consecutively enrolled. At baseline, all participants underwent overnight cardiorespiratory polygraphy. BiPAP therapy using volume-targeted spontaneous/timed mode delivered via an oro-nasal mask was initiated. Beat-to-beat noninvasive monitoring by impedance cardiography was used to assess heart function at baseline and after 3 and 12 months of BiPAP use. Serum troponin 1, N-Terminal Pro-B-Type Natriuretic Peptide (NT-ProBNP), tumor necrosis factor-alpha (TNF-α), and interleukin-6 (IL-6) were monitored. RESULTS Thirteen patients (10 men; mean age, 55.8 ± 9.8 years; mean body mass index of 47.8 ± 5.9 kg/m2) were recruited. From baseline to 3, and to 12 months of BiPAP use, left ventricular stroke volume (SV), ejection time (LVET), and ejection time index significantly increased (P = 0.030; P < 0.001; P = 0.003, respectively), while heart rate and systolic time ratio significantly decreased (P = 0.004; P = 0.034, respectively). Reductions in serum NT-proBNP, IL-6 and TNF-α were observed (P = 0.045; P = 0.018; P = 0.003, respectively). No significant changes in serum troponin were detected throughout the study. CONCLUSIONS The present findings of increased SV, in association with lengthening of LVET, reductions of NT-proBNP and reductions in circulatory inflammatory markers in patients with stable OHS and chronic moderate-to-severe daytime hypercapnia treated with BiPAP over 1 year support the role of this therapeutic mode in such patients.
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Affiliation(s)
- I Paranicova
- Department of Respiratory Medicine and Tuberculosis, P.J. Safarik University, Faculty of Medicine, and L. Pasteur University Hospital, Kosice, Slovakia
| | - S Bodnarova
- Department of Respiratory Medicine and Tuberculosis, P.J. Safarik University, Faculty of Medicine, and L. Pasteur University Hospital, Kosice, Slovakia
| | - I Trojova
- Department of Respiratory Medicine and Tuberculosis, P.J. Safarik University, Faculty of Medicine, and L. Pasteur University Hospital, Kosice, Slovakia
| | - Z Hertelyova
- Center of Clinical and Preclinical Research MEDIPARK, P.J. Safarik University, Faculty of Medicine, Kosice, Slovakia
| | - Z Gulasova
- Center of Clinical and Preclinical Research MEDIPARK, P.J. Safarik University, Faculty of Medicine, Kosice, Slovakia
| | - I Cimbolakova
- Institute of Physical Education and Sport, P.J. Safarik University, Kosice, Slovakia
| | - S Genzor
- Department of Respiratory Medicine and Tuberculosis, University Hospital Olomouc and Faculty of Medicine and Dentistry Palacky University, Olomouc, Czech Republic
| | - P Joppa
- Department of Respiratory Medicine and Tuberculosis, P.J. Safarik University, Faculty of Medicine, and L. Pasteur University Hospital, Kosice, Slovakia
| | - R Tkacova
- Department of Respiratory Medicine and Tuberculosis, P.J. Safarik University, Faculty of Medicine, and L. Pasteur University Hospital, Kosice, Slovakia
| | - P Pobeha
- Department of Respiratory Medicine and Tuberculosis, P.J. Safarik University, Faculty of Medicine, and L. Pasteur University Hospital, Kosice, Slovakia.
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Milinovic K, Pavlinac Dodig I, Lusic Kalcina L, Pecotic R, Ivkovic N, Valic M, Dogas Z. Adherence to CPAP Therapy in Obstructive Sleep Apnea: A Prospective Study on Quality of Life and Determinants of Use. Eur J Investig Health Psychol Educ 2024; 14:2463-2475. [PMID: 39329831 DOI: 10.3390/ejihpe14090163] [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: 07/13/2024] [Revised: 08/22/2024] [Accepted: 08/23/2024] [Indexed: 09/28/2024] Open
Abstract
Obstructive sleep apnea (OSA) often goes unrecognized despite common symptoms, such as excessive daytime sleepiness, fatigue, and impaired quality of life (QoL). Continuous positive airway pressure (CPAP) is the gold standard treatment for OSA, but optimal daily usage and time needed for observable effects remain unclear. This study aimed to investigate the short-term effects of CPAP on daytime sleepiness and QoL in patients with severe OSA. Medical records were collected from 87 patients with severe OSA who initiated CPAP therapy. Also, validated questionnaires were used before and after one month of CPAP to analyze QoL-the Calgary Sleep Apnea Quality of Life Index (SAQLI), the Cues to CPAP Use Questionnaire (CCUQ), and daytime sleepiness-the Epworth Sleepiness Scale (ESS). Multiple regression analysis was conducted to identify predictors of CPAP usage. Of the total participants aged 55.6 ± 12.5, 77% were males, and 62% were CPAP adherent. Reductions in daytime sleepiness (ESS) were noted, as well as improvements in both overall QoL (SAQLI) and specifically in the domains of daily functioning, social interactions, emotional well-being, and symptom perception. Important cues for CPAP usage recognized by patients were physicians' instructions and physicians' concern regarding their patients' condition. Furthermore, multiple regression revealed higher SAQLI scores and lower ESS scores as positive predictors of CPAP usage, along with lower AHI after one month of CPAP being associated with sufficient adherence.
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Affiliation(s)
- Karla Milinovic
- Department of Family Medicine, Split-Dalmatia Health Center, 21000 Split, Croatia
| | - Ivana Pavlinac Dodig
- Department for Neuroscience, University of Split School of Medicine, 21000 Split, Croatia
| | - Linda Lusic Kalcina
- Department for Neuroscience, University of Split School of Medicine, 21000 Split, Croatia
| | - Renata Pecotic
- Department for Neuroscience, University of Split School of Medicine, 21000 Split, Croatia
| | - Natalija Ivkovic
- Department for Neuroscience, University of Split School of Medicine, 21000 Split, Croatia
| | - Maja Valic
- Department for Neuroscience, University of Split School of Medicine, 21000 Split, Croatia
| | - Zoran Dogas
- Department for Neuroscience, University of Split School of Medicine, 21000 Split, Croatia
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Zheng YB, Huang YT, Gong YM, Li MZ, Zeng N, Wu SL, Zhang ZB, Tian SS, Yuan K, Liu XX, Vitiello MV, Wang YM, Wang YX, Zhang XJ, Shi J, Shi L, Yan W, Lu L, Bao YP. Association of lifestyle with sleep health in general population in China: a cross-sectional study. Transl Psychiatry 2024; 14:320. [PMID: 39098892 PMCID: PMC11298538 DOI: 10.1038/s41398-024-03002-x] [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: 11/22/2023] [Revised: 06/24/2024] [Accepted: 07/02/2024] [Indexed: 08/06/2024] Open
Abstract
The concept of a healthy lifestyle is receiving increasing attention. This study sought to identify an optimal healthy lifestyle profile associated with sleep health in general population of China. An online cross-sectional survey was conducted from June to July 2022. Six healthy lifestyle factors were assessed: healthy diet, regular physical exercise, never smoking, never drinking alcohol, low sedentary behavior, and normal weight. Participants were categorized into the healthy lifestyle (5-6 factors), average (3-4 factors), and unhealthy lifestyle groups (0-2 factors). The study's primary outcome was sleep health, which included sleep quality, duration, pattern, and the presence of any sleep disorder or disturbance, including insomnia, excessive daytime sleepiness, obstructive apnea syndrome, and narcolepsy. Multivariable logistic regression analysis was applied to explore lifestyles associated with the selected sleep health outcomes. 41,061 individuals were included, forming 18.8% healthy, 63.8% average, and 17.4% unhealthy lifestyle groups. After adjusting for covariates, participants with healthy lifestyle were associated with a higher likelihood of good sleep quality (OR = 1.56, 95% CI = 1.46-1.68), normal sleep duration (OR = 1.60, 95% CI = 1.49-1.72), healthy sleep pattern (OR = 2.15, 95% CI = 2.00-2.31), and lower risks of insomnia (OR = 0.66, 95% CI = 0.61-0.71), excessive daytime sleepiness (OR = 0.66, 95% CI = 0.60-0.73), and obstructive apnea syndrome (OR = 0.40, 95% CI = 0.37-0.43), but not narcolepsy (OR = 0.92, 95% CI = 0.83-1.03), compared to those with unhealthy lifestyle. This large cross-sectional study is the first to our knowledge to quantify the associations of a healthy lifestyle with specific aspects of sleep health. The findings offer support for efforts to improve sleep health by modulating lifestyle.
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Affiliation(s)
- Yong-Bo Zheng
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing, China
- Peking-Tsinghua Centre for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing, China
| | - Yue-Tong Huang
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing, China
| | - Yi-Miao Gong
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing, China
| | - Ming-Zhe Li
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing, China
- Peking-Tsinghua Centre for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing, China
| | - Na Zeng
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
- School of Public Health, Peking University, Beijing, China
| | - Shui-Lin Wu
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
- School of Public Health, Peking University, Beijing, China
| | - Zhi-Bo Zhang
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing, China
| | - Shan-Shan Tian
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing, China
| | - Kai Yuan
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing, China
| | - Xiao-Xing Liu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing, China
| | - Michael V Vitiello
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
| | - Yu-Mei Wang
- Institute of Brain Science and Brain-inspired Research, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong Province, 250117, China
| | - Yong-Xiang Wang
- Institute of Brain Science and Brain-inspired Research, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong Province, 250117, China
| | - Xiu-Jun Zhang
- School of Psychology, College of Public Health, North China University of Science and Technology, Tangshan, 063210, Hebei Province, China
| | - Jie Shi
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
| | - Le Shi
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing, China.
| | - Wei Yan
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing, China.
| | - Lin Lu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing, China.
- Peking-Tsinghua Centre for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing, China.
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China.
- Chinese Academy of Medical Sciences Research Unit (No. 2018RU006), Peking University, Beijing, China.
- Shandong Institute of Brain Science and Brain-inspired Research; Medical Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong Province, 271016, China.
| | - Yan-Ping Bao
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China.
- School of Public Health, Peking University, Beijing, China.
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5
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Chen Z, Shang Y, Ou Y, Shen C, Cao Y, Hu H, Yang R, Liu T, Liu Q, Song M, Zong D, Xiang X, Peng Y, Ouyang R. Obstructive Sleep Apnea Plasma-Derived Exosomes Mediate Cognitive Impairment Through Hippocampal Neuronal Cell Pyroptosis. Am J Geriatr Psychiatry 2024; 32:922-939. [PMID: 38290937 DOI: 10.1016/j.jagp.2024.01.017] [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: 07/21/2023] [Revised: 12/25/2023] [Accepted: 01/11/2024] [Indexed: 02/01/2024]
Abstract
OBJECTIVE Obstructive sleep apnea (OSA) is associated with impaired cognitive function. Exosomes are secreted by most cells and play a role in OSA-associated cognitive impairment (CI). The aim of this study was to investigate whether OSA plasma-derived exosomes cause CI through hippocampal neuronal cell pyroptosis, and to identify exosomal miRNAs in OSA plasma-derived. MATERIALS AND METHODS Plasma-derived exosomes were isolated from patients with severe OSA and healthy comparisons. Daytime sleepiness and cognitive function were assessed using the Epworth Sleepiness Scale (ESS) and the Beijing version of the Montreal Cognitive Assessment Scale (MoCA). Exosomes were coincubated with mouse hippocampal neurons (HT22) cells to evaluate the effect of exosomes on pyroptosis and inflammation of HT22 cells. Meanwhile, exosomes were injected into C57BL/6 male mice via caudal vein, and then morris water maze was used to evaluate the spatial learning and memory ability of the mice, so as to observe the effects of exosomes on the cognitive function of the mice. Western blot and qRT-PCR were used to detect the expressions of Gasdermin D (GSDMD) and Caspase-1 to evaluate the pyroptosis level. The expression of IL-1β, IL-6, IL-18 and TNF-α was detected by qRT-PCR to assess the level of inflammation. Correlations of GSDMD and Caspase-1 expression with clinical parameters were evaluated using Spearman's rank correlation analysis. In addition, plasma exosome miRNAs profile was identified, followed by Gene Ontology (GO) term and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways. RESULTS Compared to healthy comparisons, body mass index (BMI), apnea-hypopnea index (AHI), oxygen desaturation index (ODI), and ESS scores were increased in patients with severe OSA, while lowest oxygen saturation during sleep (LSaO2), mean oxygen saturation during sleep (MSaO2) and MoCA scores were decreased. Compared to the PBS group (NC) and the healthy comparison plasma-derived exosomes (NC-EXOS), the levels of GSDMD and Caspase-1 and IL-1β, IL-6, IL-18 and TNF-α were increased significantly in the severe OSA plasma-derived exosomes (OSA-EXOS) coincubated with HT22 cells. Compared to the NC and NC-EXOS groups, the learning and memory ability of mice injected with OSA-EXOS was decreased, and the expression of GSDMD and Caspase-1 in hippocampus were significantly increased, along with the levels of IL-1β, IL-6, IL-18 and TNF-α. Spearman correlation analysis found that clinical AHI in HCs and severe OSA patients was positively correlated with GSDMD and Caspase-1 in HT22 cells from NC-EXOS and OSA-EXOS groups, while negatively correlated with clinical MoCA. At the same time, clinical MoCA in HCs and severe OSA patients was negatively correlated with GSDMD and Caspase-1 in HT22 cells from NC-EXOS and OSA-EXOS groups. A unique exosomal miRNAs profile was identified in OSA-EXOS group compared to the NC-EXOS group, in which 28 miRNAs were regulated and several KEGG and GO pathways were identified. CONCLUSIONS The results of this study show a hypothesis that plasma-derived exosomes from severe OSA patients promote pyroptosis and increased expression of inflammatory factors in vivo and in vitro, and lead to impaired cognitive function in mice, suggesting that OSA-EXOS can mediate CI through pyroptosis of hippocampal neurons. In addition, exosome cargo from OSA-EXOS showed a unique miRNAs profile compared to NC-EXOS, suggesting that plasma exosome associated miRNAs may reflect the differential profile of OSA related diseases, such as CI.
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Affiliation(s)
- Zhifeng Chen
- Department of Respiratory Medicine (ZC, YO, CS, YC, HH, RY, TL, QL, MS, DZ, YP, RO), The Second Xiangya Hospital, Central South University, Changsha, Hunan, China; Research Unit of Respiratory Disease (ZC, YO, CS, YC, HH, RY, TL, QL, MS, DZ, YP, RO), Central South University, Changsha, Hunan, China; Clinical Medical Research Center for Pulmonary (ZC, YO, CS, YC, HH, RY, TL, QL, MS, DZ, YP, RO), Critical Care Medicine in Hunan Province, Changsha, Hunan, China; Diagnosis and Treatment Center of Respiratory Disease (ZC, YO, CS, YC, HH, RY, TL, QL, MS, DZ, YP, RO), Central South University, Changsha, Hunan, China
| | - Yulin Shang
- Ophthalmology and Otorhinolaryngology (YS), Zigui County Traditional Chinese Medicine Hospital, Zigui, China
| | - Yanru Ou
- Department of Respiratory Medicine (ZC, YO, CS, YC, HH, RY, TL, QL, MS, DZ, YP, RO), The Second Xiangya Hospital, Central South University, Changsha, Hunan, China; Research Unit of Respiratory Disease (ZC, YO, CS, YC, HH, RY, TL, QL, MS, DZ, YP, RO), Central South University, Changsha, Hunan, China; Clinical Medical Research Center for Pulmonary (ZC, YO, CS, YC, HH, RY, TL, QL, MS, DZ, YP, RO), Critical Care Medicine in Hunan Province, Changsha, Hunan, China; Diagnosis and Treatment Center of Respiratory Disease (ZC, YO, CS, YC, HH, RY, TL, QL, MS, DZ, YP, RO), Central South University, Changsha, Hunan, China
| | - Chong Shen
- Department of Respiratory Medicine (ZC, YO, CS, YC, HH, RY, TL, QL, MS, DZ, YP, RO), The Second Xiangya Hospital, Central South University, Changsha, Hunan, China; Research Unit of Respiratory Disease (ZC, YO, CS, YC, HH, RY, TL, QL, MS, DZ, YP, RO), Central South University, Changsha, Hunan, China; Clinical Medical Research Center for Pulmonary (ZC, YO, CS, YC, HH, RY, TL, QL, MS, DZ, YP, RO), Critical Care Medicine in Hunan Province, Changsha, Hunan, China; Diagnosis and Treatment Center of Respiratory Disease (ZC, YO, CS, YC, HH, RY, TL, QL, MS, DZ, YP, RO), Central South University, Changsha, Hunan, China
| | - Ying Cao
- Department of Respiratory Medicine (ZC, YO, CS, YC, HH, RY, TL, QL, MS, DZ, YP, RO), The Second Xiangya Hospital, Central South University, Changsha, Hunan, China; Research Unit of Respiratory Disease (ZC, YO, CS, YC, HH, RY, TL, QL, MS, DZ, YP, RO), Central South University, Changsha, Hunan, China; Clinical Medical Research Center for Pulmonary (ZC, YO, CS, YC, HH, RY, TL, QL, MS, DZ, YP, RO), Critical Care Medicine in Hunan Province, Changsha, Hunan, China; Diagnosis and Treatment Center of Respiratory Disease (ZC, YO, CS, YC, HH, RY, TL, QL, MS, DZ, YP, RO), Central South University, Changsha, Hunan, China
| | - Hui Hu
- Department of Respiratory Medicine (ZC, YO, CS, YC, HH, RY, TL, QL, MS, DZ, YP, RO), The Second Xiangya Hospital, Central South University, Changsha, Hunan, China; Research Unit of Respiratory Disease (ZC, YO, CS, YC, HH, RY, TL, QL, MS, DZ, YP, RO), Central South University, Changsha, Hunan, China; Clinical Medical Research Center for Pulmonary (ZC, YO, CS, YC, HH, RY, TL, QL, MS, DZ, YP, RO), Critical Care Medicine in Hunan Province, Changsha, Hunan, China; Diagnosis and Treatment Center of Respiratory Disease (ZC, YO, CS, YC, HH, RY, TL, QL, MS, DZ, YP, RO), Central South University, Changsha, Hunan, China
| | - Ruibing Yang
- Department of Respiratory Medicine (ZC, YO, CS, YC, HH, RY, TL, QL, MS, DZ, YP, RO), The Second Xiangya Hospital, Central South University, Changsha, Hunan, China; Research Unit of Respiratory Disease (ZC, YO, CS, YC, HH, RY, TL, QL, MS, DZ, YP, RO), Central South University, Changsha, Hunan, China; Clinical Medical Research Center for Pulmonary (ZC, YO, CS, YC, HH, RY, TL, QL, MS, DZ, YP, RO), Critical Care Medicine in Hunan Province, Changsha, Hunan, China; Diagnosis and Treatment Center of Respiratory Disease (ZC, YO, CS, YC, HH, RY, TL, QL, MS, DZ, YP, RO), Central South University, Changsha, Hunan, China
| | - Ting Liu
- Department of Respiratory Medicine (ZC, YO, CS, YC, HH, RY, TL, QL, MS, DZ, YP, RO), The Second Xiangya Hospital, Central South University, Changsha, Hunan, China; Research Unit of Respiratory Disease (ZC, YO, CS, YC, HH, RY, TL, QL, MS, DZ, YP, RO), Central South University, Changsha, Hunan, China; Clinical Medical Research Center for Pulmonary (ZC, YO, CS, YC, HH, RY, TL, QL, MS, DZ, YP, RO), Critical Care Medicine in Hunan Province, Changsha, Hunan, China; Diagnosis and Treatment Center of Respiratory Disease (ZC, YO, CS, YC, HH, RY, TL, QL, MS, DZ, YP, RO), Central South University, Changsha, Hunan, China
| | - Qingqing Liu
- Department of Respiratory Medicine (ZC, YO, CS, YC, HH, RY, TL, QL, MS, DZ, YP, RO), The Second Xiangya Hospital, Central South University, Changsha, Hunan, China; Research Unit of Respiratory Disease (ZC, YO, CS, YC, HH, RY, TL, QL, MS, DZ, YP, RO), Central South University, Changsha, Hunan, China; Clinical Medical Research Center for Pulmonary (ZC, YO, CS, YC, HH, RY, TL, QL, MS, DZ, YP, RO), Critical Care Medicine in Hunan Province, Changsha, Hunan, China; Diagnosis and Treatment Center of Respiratory Disease (ZC, YO, CS, YC, HH, RY, TL, QL, MS, DZ, YP, RO), Central South University, Changsha, Hunan, China
| | - Min Song
- Department of Respiratory Medicine (ZC, YO, CS, YC, HH, RY, TL, QL, MS, DZ, YP, RO), The Second Xiangya Hospital, Central South University, Changsha, Hunan, China; Research Unit of Respiratory Disease (ZC, YO, CS, YC, HH, RY, TL, QL, MS, DZ, YP, RO), Central South University, Changsha, Hunan, China; Clinical Medical Research Center for Pulmonary (ZC, YO, CS, YC, HH, RY, TL, QL, MS, DZ, YP, RO), Critical Care Medicine in Hunan Province, Changsha, Hunan, China; Diagnosis and Treatment Center of Respiratory Disease (ZC, YO, CS, YC, HH, RY, TL, QL, MS, DZ, YP, RO), Central South University, Changsha, Hunan, China
| | - Dandan Zong
- Department of Respiratory Medicine (ZC, YO, CS, YC, HH, RY, TL, QL, MS, DZ, YP, RO), The Second Xiangya Hospital, Central South University, Changsha, Hunan, China; Research Unit of Respiratory Disease (ZC, YO, CS, YC, HH, RY, TL, QL, MS, DZ, YP, RO), Central South University, Changsha, Hunan, China; Clinical Medical Research Center for Pulmonary (ZC, YO, CS, YC, HH, RY, TL, QL, MS, DZ, YP, RO), Critical Care Medicine in Hunan Province, Changsha, Hunan, China; Diagnosis and Treatment Center of Respiratory Disease (ZC, YO, CS, YC, HH, RY, TL, QL, MS, DZ, YP, RO), Central South University, Changsha, Hunan, China
| | - Xudong Xiang
- Department of Emergency (XX), The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yating Peng
- Department of Respiratory Medicine (ZC, YO, CS, YC, HH, RY, TL, QL, MS, DZ, YP, RO), The Second Xiangya Hospital, Central South University, Changsha, Hunan, China; Research Unit of Respiratory Disease (ZC, YO, CS, YC, HH, RY, TL, QL, MS, DZ, YP, RO), Central South University, Changsha, Hunan, China; Clinical Medical Research Center for Pulmonary (ZC, YO, CS, YC, HH, RY, TL, QL, MS, DZ, YP, RO), Critical Care Medicine in Hunan Province, Changsha, Hunan, China; Diagnosis and Treatment Center of Respiratory Disease (ZC, YO, CS, YC, HH, RY, TL, QL, MS, DZ, YP, RO), Central South University, Changsha, Hunan, China.
| | - Ruoyun Ouyang
- Department of Respiratory Medicine (ZC, YO, CS, YC, HH, RY, TL, QL, MS, DZ, YP, RO), The Second Xiangya Hospital, Central South University, Changsha, Hunan, China; Research Unit of Respiratory Disease (ZC, YO, CS, YC, HH, RY, TL, QL, MS, DZ, YP, RO), Central South University, Changsha, Hunan, China; Clinical Medical Research Center for Pulmonary (ZC, YO, CS, YC, HH, RY, TL, QL, MS, DZ, YP, RO), Critical Care Medicine in Hunan Province, Changsha, Hunan, China; Diagnosis and Treatment Center of Respiratory Disease (ZC, YO, CS, YC, HH, RY, TL, QL, MS, DZ, YP, RO), Central South University, Changsha, Hunan, China.
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6
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Neshat S, Daneii P, Neshat N, Faridizad R, Raeisi S, Malakooti SM, Sadeghi S, Ghadiri M, Ghiasi F. Does cosmetic rhinoplasty affect sleep quality and/or contribute to the development of obstructive sleep apnea? Cranio 2024; 42:394-399. [PMID: 34511047 DOI: 10.1080/08869634.2021.1977900] [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] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Rhinoplasty can reduce nasal airways' resistance. This study evaluates the effects of rhinoplasty on sleep quality, daytime drowsiness, and obstructive sleep apnea (OSA). METHODS In this prospective cohort study, 80 rhinoplasty candidates were examined before and six months after rhinoplasty to evaluate symptom changes. STOP-BANG, Pittsburgh Sleep Quality Index (PSQI), and Epworth Sleepiness Scale (ESS) questionnaires, and nocturnal polysomnography were used, respectively, to screen for OSA, assess sleep quality, assess daytime drowsiness, and confirm results. RESULTS Seventeen men (21.2%) and 63 women (78.8%) were studied. PSQI results showed an increase only in post-operative sleep disturbance items (p = 0.04). STOP-BANG showed an increase in apnea (p = 0.06) and a decrease in snoring (p = 0.06), which were both insignificant. The polysomnography tests confirmed the results of the questionnaires. CONCLUSION Contrary to popular belief, rhinoplasty does not increase snoring, sleep disorders, or apnea.
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Affiliation(s)
- Sina Neshat
- Department of Internal Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Padideh Daneii
- Department of Internal Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Negar Neshat
- Department of Internal Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Romina Faridizad
- Department of Internal Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sina Raeisi
- Department of Internal Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Somayeh Sadeghi
- Department of Pulmonology, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Farzin Ghiasi
- Department of Pulmonology, Isfahan University of Medical Sciences, Isfahan, Iran
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7
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Sharma A, Austerlitz J, Najjar F, McDermott J, Matalon J, Varma M. Measuring Sleep Quality Among Medical Students Using the Epworth Sleepiness Scale. Cureus 2024; 16:e63319. [PMID: 39070409 PMCID: PMC11283370 DOI: 10.7759/cureus.63319] [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: 06/27/2024] [Indexed: 07/30/2024] Open
Abstract
Introduction While existing literature establishes the positive impact of sleep on test performance among medical students and its correlation with better outcomes among physicians, there is a notable gap in the quantitative understanding of how the transition from preclinical to clinical training affects sleep quality. Methods Our survey was sent to all medical students attending the California University of Science and Medicine between April 2023 and January 2024. The relative risks for having an Epworth sleepiness scale (ESS) greater than 10 were calculated and compared for various subgroups in our sample. Univariate logistic regression analysis was also carried out to assess the effect of covariates on our primary outcome. Results In total, our sample consisted of 124 medical students. Only 11.3% (n=14) were somewhat dissatisfied or very dissatisfied with their medical school experience. The relative risk of having an ESS > 10 when on clinical rotations was 2.06 (95% CI: 1.22-3.49). Conclusion This study demonstrates that the risk of medical students experiencing excessive sleepiness, defined by an ESS > 10, doubles when students are on clinical rotations. Despite being limited by information bias and a smaller sample size, this study provides interesting pilot data on the quantitative examination of sleepiness among medical students and may be used to guide areas for future work.
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Affiliation(s)
- Arjun Sharma
- School of Medicine, California University of Science and Medicine, Colton, USA
| | - Joaquin Austerlitz
- School of Medicine, California University of Science and Medicine, Colton, USA
| | - Fabian Najjar
- School of Medicine, California University of Science and Medicine, Colton, USA
| | - James McDermott
- School of Medicine, California University of Science and Medicine, Colton, USA
| | - Jacob Matalon
- School of Medicine, California University of Science and Medicine, Colton, USA
| | - Madhu Varma
- School of Medicine, California University of Science and Medicine, Colton, USA
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8
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Holland-Winkler AM, Greene DR, Oberther TJ. The Cyclical Battle of Insomnia and Mental Health Impairment in Firefighters: A Narrative Review. J Clin Med 2024; 13:2169. [PMID: 38673442 PMCID: PMC11050272 DOI: 10.3390/jcm13082169] [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: 03/04/2024] [Revised: 03/27/2024] [Accepted: 04/05/2024] [Indexed: 04/28/2024] Open
Abstract
The occupational requirements of full-time non-administrative firefighters include shift-work schedules and chronic exposure to alerting emergency alarms, hazardous working conditions, and psychologically traumatic events that they must attend and respond to. These compiling and enduring aspects of the career increase the firefighter's risk for insomnia and mental health conditions compared to the general population. Poor sleep quality and mental health impairments are known to coincide with and contribute to the symptom severity of one another. Thus, it is important to determine approaches that may improve sleep and/or mental health specifically for firefighters, as their occupation varies in many aspects from any other occupation. This review will discuss symptoms of insomnia and mental health conditions such as PTSD, anxiety, depression, substance abuse, and suicide in firefighters. The influencing factors of sleep and mental health will be examined including anxiety sensitivity, emotional regulation, and distress tolerance. Current sleep and mental health interventions specific to full-time firefighters are limited in number; however, the existing experimental studies will be outlined. Lastly, this review will provide support for exploring exercise as a possible intervention that may benefit the sleep and mental health of this population.
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Affiliation(s)
- Angelia M. Holland-Winkler
- Department of Kinesiology, Augusta University, 3109 Wrightsboro Road, Augusta, GA 30909, USA; (D.R.G.); (T.J.O.)
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9
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Noce A, Marrone G, Di Lauro M, Vita C, Montalto G, Giorgino G, Chiaramonte C, D’Agostini C, Bernardini S, Pieri M. Potential Anti-Inflammatory and Anti-Fatigue Effects of an Oral Food Supplement in Long COVID Patients. Pharmaceuticals (Basel) 2024; 17:463. [PMID: 38675423 PMCID: PMC11053797 DOI: 10.3390/ph17040463] [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: 03/14/2024] [Revised: 03/28/2024] [Accepted: 04/03/2024] [Indexed: 04/28/2024] Open
Abstract
Long coronavirus disease (COVID) syndrome leads to chronic inflammatory state onset that can have a multisystem impact and compromise organ function. Moreover, long COVID syndrome is often characterized by the presence of chronic fatigue, which affects subjects' daily activities and worsens their quality of life. The aim of our double-blind, placebo-controlled randomized trial (protocol code RS 150.21, approved on 4 November 2021) was to evaluate the beneficial effects of the consumption of 2 cps/day, for two months, of an oral food supplement (OFS), based on Echinacea angustifolia, rosehip, propolis, royal jelly and zinc, in long COVID patients, compared to a two-month placebo period. The OFS's vitamin C content was equal to 22.17 mg/g (8.87 mg/capsule). The OFS's total polyphenol content was 43.98 mg/g gallic acid equivalents. At the end of the in vivo study, we highlighted a significant decrease in the inflammatory parameters in the OFS period, compared to the placebo period (neutrophil-to-lymphocyte ratio, p = 0.0455; monocyte to-lymphocyte ratio, p = 0.0005; C-reactive protein, p = 0.0145). Our study also highlighted a significant increase in vitamin D serum values (p = 0.0005) and, at the same time, an improvement in patients' life quality and a reduction in fatigue, monitored by the fatigue severity scale. This study showed the OFS's beneficial effects on the inflammatory state, fatigue and quality of life in long COVID patients.
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Affiliation(s)
- Annalisa Noce
- UOSD Nephrology and Dialysis, Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy;
| | - Giulia Marrone
- UOSD Nephrology and Dialysis, Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy;
| | - Manuela Di Lauro
- UOSD Nephrology and Dialysis, Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy;
| | - Chiara Vita
- QuMAP-PIN, University Center “Città di Prato” Educational and Scientific Services for the University of Florence, 59100 Prato, Italy
| | - Giulia Montalto
- School of Specialization in Nephrology, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Gloria Giorgino
- School of Specialization in Nephrology, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Carlo Chiaramonte
- Department of Statistics, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Cartesio D’Agostini
- Department of Experimental Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
- Laboratory of Clinical Microbiology, Policlinico Tor Vergata, 00133 Rome, Italy
| | - Sergio Bernardini
- Department of Experimental Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
- Department of Laboratory Medicine, Tor Vergata University Hospital, 00133 Rome, Italy
| | - Massimo Pieri
- Department of Experimental Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
- Department of Laboratory Medicine, Tor Vergata University Hospital, 00133 Rome, Italy
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10
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Cai S, Li Z, Wang J, Wang Q, Chen R. Excessive daytime sleepiness in young and middle-aged Chinese adults with obstructive sleep apnea: implications for cognitive dysfunction. Sleep Breath 2024; 28:113-121. [PMID: 37428350 DOI: 10.1007/s11325-023-02854-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 05/11/2023] [Accepted: 05/19/2023] [Indexed: 07/11/2023]
Abstract
OBJECTIVE The objective of this study was to investigate the effects of excessive daytime sleepiness (EDS) on cognitive function among Chinese young and middle-aged Chinese patients with obstructive sleep apnea (OSA). METHODS Chinese adults struggling from moderate to severe OSA with apnea-hypopnea index (AHI) ≥ 15 events per hour and adults with primary snoring and mild OSA (AHI < 15 events per hour) were included in the study. The Epworth Sleepiness Scale measured hypersomnia, and cognitive function was assessed using the Mini-mental State Examination (MMSE) and Montreal Cognitive Assessment (MOCA). RESULTS In comparison to the primary snoring and mild OSA group (n=635), the moderate to severe OSA group (n=1423) tended to be older men with higher scores on the Epworth Sleepiness Scale (ESS), as well as higher levels of oxygen desaturation (ODI) and a higher body mass index (BMI). Patients with moderate to severe OSA had fewer years of education, lower minimum arterial oxygen saturation (min-SaO2), and more severe sleep disturbances, such as decreased slow wave sleep (SWS) and rapid eye movement (REM) and increased non-REM stages (N1 and N2). Comorbid conditions such as hypertension and diabetes mellitus were more common in these patients (P < 0.01 and P < 0.05, accordingly). Only the delayed recall scores were statistically lower in the moderate to severe OSA group than the primary snoring and mild OSA group (P < 0.05). The main factor associated with delayed recall was the ESS score rather than age or years of education among moderate-severe OSA patients ≤ 40 years of age (P < 0.05). After controlling for potential confounding factors such as age, gender, BMI, education, hypertension, diabetes, sleep stages (SWS and REM), minimum arterial oxygen saturation (min-SaO2), oxygen ODI, and AHI, there was a negative correlation between the Epworth Sleepiness Scale (ESS) score and the delayed recall scores. CONCLUSION Patients with moderate to severe OSA had cognitive dysfunction, particularly impairment of delayed recall. Excessive daytime sleepiness (EDS) was significantly associated with cognitive dysfunction in young and middle-aged patients with OSA.
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Affiliation(s)
- Sijie Cai
- Department of Respiratory and Critical Care Medicine, Sleep Center, The Second Affiliated Hospital of Soochow University, Soochow University, Suzhou, China
- Department of Pulmonary and Critical Care Medicine, Affiliated Kunshan Hospital of Jiangsu University, Suzhou, China
| | - Zhiqiang Li
- Department of Respiratory and Critical Care Medicine, Sleep Center, The Second Affiliated Hospital of Soochow University, Soochow University, Suzhou, China
| | - Jing Wang
- Department of Respiratory and Critical Care Medicine, Sleep Center, The Second Affiliated Hospital of Soochow University, Soochow University, Suzhou, China
| | - Qiaojun Wang
- Department of Respiratory and Critical Care Medicine, Sleep Center, The Second Affiliated Hospital of Soochow University, Soochow University, Suzhou, China
| | - Rui Chen
- Department of Respiratory and Critical Care Medicine, Sleep Center, The Second Affiliated Hospital of Soochow University, Soochow University, Suzhou, China.
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Benjamin JI, Pollock DM. Current perspective on circadian function of the kidney. Am J Physiol Renal Physiol 2024; 326:F438-F459. [PMID: 38134232 PMCID: PMC11207578 DOI: 10.1152/ajprenal.00247.2023] [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: 08/17/2023] [Revised: 11/28/2023] [Accepted: 12/18/2023] [Indexed: 12/24/2023] Open
Abstract
Behavior and function of living systems are synchronized by the 24-h rotation of the Earth that guides physiology according to time of day. However, when behavior becomes misaligned from the light-dark cycle, such as in rotating shift work, jet lag, and even unusual eating patterns, adverse health consequences such as cardiovascular or cardiometabolic disease can arise. The discovery of cell-autonomous molecular clocks expanded interest in regulatory systems that control circadian physiology including within the kidney, where function varies along a 24-h cycle. Our understanding of the mechanisms for circadian control of physiology is in the early stages, and so the present review provides an overview of what is known and the many gaps in our current understanding. We include a particular focus on the impact of eating behaviors, especially meal timing. A better understanding of the mechanisms guiding circadian function of the kidney is expected to reveal new insights into causes and consequences of a wide range of disorders involving the kidney, including hypertension, obesity, and chronic kidney disease.
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Affiliation(s)
- Jazmine I Benjamin
- Section of Cardio-Renal Physiology and Medicine, Division of Nephrology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, United States
| | - David M Pollock
- Section of Cardio-Renal Physiology and Medicine, Division of Nephrology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, United States
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Altuna M, Estanga A, Garrido A, Saldias J, Cañada M, Echeverria M, Larrea JÁ, Ayo P, Fiz A, Muñoz M, Santa-Inés J, García-Landarte V, García-Sebastián M. Down Syndrome-Basque Alzheimer Initiative (DS-BAI): Clinic-Biological Cohort. J Clin Med 2024; 13:1139. [PMID: 38398452 PMCID: PMC10889106 DOI: 10.3390/jcm13041139] [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: 01/14/2024] [Revised: 02/14/2024] [Accepted: 02/15/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Down syndrome (DS) is the most common genetically determined intellectual disability. In recent decades, it has experienced an exponential increase in life expectancy, leading to a rise in age-related diseases, including Alzheimer's disease (AD). Specific health plans for the comprehensive care of the DS community are an unmet need, which is crucial for the early and accurate diagnosis of main medical comorbidities. We present the protocol of a newly created clinical and research cohort and its feasibility in real life. METHODS The Down Syndrome-Basque Alzheimer Initiative (DS-BAI) is a population-based, inclusive, multidisciplinary initiative for the clinical-assistance and clinical-biological research approach to aging in DS led by the CITA-Alzheimer Foundation (Donostia, Basque Country). It aims to achieve the following: (1) provide comprehensive care for adults with DS, (2) optimize access to rigorous and quality training for socio-family and healthcare references, and (3) create a valuable multimodal clinical-biological research platform. RESULTS During the first year, 114 adults with DS joined the initiative, with 36% of them showing symptoms indicative of AD. Furthermore, adherence to training programs for healthcare professionals and families has been high, and the willingness to collaborate in basic and translational research has been encouraging. CONCLUSION Specific health plans for DS and conducting clinical and translational research on the challenges of aging, including AD, are necessary and feasible.
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Affiliation(s)
- Miren Altuna
- Fundación CITA-Alzheimer Fundazioa, 20009 Donostia, Spain
- Debabarrena Integrated Health Organization, Osakidetza Basque Health Service, 20690 Gipuzkoa, Spain
- Department of Medicine, Faculty of Health Sciences, University of Deusto, 48007 Bilbo, Spain
| | - Ainara Estanga
- Fundación CITA-Alzheimer Fundazioa, 20009 Donostia, Spain
| | - Adolfo Garrido
- Donostialdea Integrated Health Organisation, Clinical Biochemistry Department, Osakidetza Basque Health Service, 20014 Donostia, Spain
| | - Jon Saldias
- Fundación CITA-Alzheimer Fundazioa, 20009 Donostia, Spain
| | - Marta Cañada
- Fundación CITA-Alzheimer Fundazioa, 20009 Donostia, Spain
| | - Maitane Echeverria
- Donostialdea Integrated Health Organisation, Clinical Biochemistry Department, Osakidetza Basque Health Service, 20014 Donostia, Spain
| | - José Ángel Larrea
- Department of Medicine, Faculty of Health Sciences, University of Deusto, 48007 Bilbo, Spain
- Donostialdea Integrated Health Organisation, Radiology Department, Osakidetza Basque Health Service, 20014 Donostia, Spain
| | | | | | - María Muñoz
- Fundación Goyeneche de San Sebastián, 20018 Donostia, Spain
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Scardua-Silva L, Amorim da Costa B, Karmann Aventurato Í, Batista Joao R, Machado de Campos B, Rabelo de Brito M, Bechelli JF, Santos Silva LC, Ferreira Dos Santos A, Koutsodontis Machado Alvim M, Vieira Nunes Ludwig G, Rocha C, Kaue Alves Silva Souza T, Mendes MJ, Waku T, de Oliveira Boldrini V, Silva Brunetti N, Nora Baptista S, da Silva Schmitt G, Duarte de Sousa JG, Marchiori de Oliveira Cardoso TA, Schwambach Vieira A, Barbosa Santos LM, Dos Santos Farias A, Nogueira MH, Cendes F, Lin Yasuda C. Microstructural brain abnormalities, fatigue, and cognitive dysfunction after mild COVID-19. Sci Rep 2024; 14:1758. [PMID: 38242927 PMCID: PMC10798999 DOI: 10.1038/s41598-024-52005-7] [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: 12/03/2022] [Accepted: 01/12/2024] [Indexed: 01/21/2024] Open
Abstract
Although some studies have shown neuroimaging and neuropsychological alterations in post-COVID-19 patients, fewer combined neuroimaging and neuropsychology evaluations of individuals who presented a mild acute infection. Here we investigated cognitive dysfunction and brain changes in a group of mildly infected individuals. We conducted a cross-sectional study of 97 consecutive subjects (median age of 41 years) without current or history of psychiatric symptoms (including anxiety and depression) after a mild infection, with a median of 79 days (and mean of 97 days) after diagnosis of COVID-19. We performed semi-structured interviews, neurological examinations, 3T-MRI scans, and neuropsychological assessments. For MRI analyses, we included a group of non-infected 77 controls. The MRI study included white matter (WM) investigation with diffusion tensor images (DTI) and functional connectivity with resting-state functional MRI (RS-fMRI). The patients reported memory loss (36%), fatigue (31%) and headache (29%). The quantitative analyses confirmed symptoms of fatigue (83% of participants), excessive somnolence (35%), impaired phonemic verbal fluency (21%), impaired verbal categorical fluency (13%) and impaired logical memory immediate recall (16%). The WM analyses with DTI revealed higher axial diffusivity values in post-infected patients compared to controls. Compared to controls, there were no significant differences in the functional connectivity of the posterior cingulum cortex. There were no significant correlations between neuropsychological scores and neuroimaging features (including DTI and RS-fMRI). Our results suggest persistent cognitive impairment and subtle white matter abnormalities in individuals mildly infected without anxiety or depression symptoms. The longitudinal analyses will clarify whether these alterations are temporary or permanent.
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Affiliation(s)
- Lucas Scardua-Silva
- Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), University of Campinas, Campinas, Brazil
- Department of Neurology, Clinics Hospital, University of Campinas, Campinas, Brazil
| | - Beatriz Amorim da Costa
- Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), University of Campinas, Campinas, Brazil
- Department of Neurology, Clinics Hospital, University of Campinas, Campinas, Brazil
| | - Ítalo Karmann Aventurato
- Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), University of Campinas, Campinas, Brazil
- Department of Neurology, Clinics Hospital, University of Campinas, Campinas, Brazil
| | - Rafael Batista Joao
- Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), University of Campinas, Campinas, Brazil
- Department of Neurology, Clinics Hospital, University of Campinas, Campinas, Brazil
| | - Brunno Machado de Campos
- Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), University of Campinas, Campinas, Brazil
| | - Mariana Rabelo de Brito
- Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), University of Campinas, Campinas, Brazil
- Department of Neurology, Clinics Hospital, University of Campinas, Campinas, Brazil
| | - José Flávio Bechelli
- Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), University of Campinas, Campinas, Brazil
- Department of Neurology, Clinics Hospital, University of Campinas, Campinas, Brazil
| | - Leila Camila Santos Silva
- Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), University of Campinas, Campinas, Brazil
- Department of Neurology, Clinics Hospital, University of Campinas, Campinas, Brazil
| | - Alan Ferreira Dos Santos
- Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), University of Campinas, Campinas, Brazil
- Department of Neurology, Clinics Hospital, University of Campinas, Campinas, Brazil
| | - Marina Koutsodontis Machado Alvim
- Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), University of Campinas, Campinas, Brazil
- Department of Neurology, Clinics Hospital, University of Campinas, Campinas, Brazil
| | - Guilherme Vieira Nunes Ludwig
- Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), University of Campinas, Campinas, Brazil
- Institute of Mathematics, Statistics and Scientific Computing, University of Campinas, Campinas, Brazil
| | - Cristiane Rocha
- Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), University of Campinas, Campinas, Brazil
- Molecular Genetics Laboratory, Faculty of Medical Sciences, University of Campinas, Campinas, Brazil
| | - Thierry Kaue Alves Silva Souza
- Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), University of Campinas, Campinas, Brazil
- Department of Neurology, Clinics Hospital, University of Campinas, Campinas, Brazil
| | - Maria Julia Mendes
- Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), University of Campinas, Campinas, Brazil
- Department of Neurology, Clinics Hospital, University of Campinas, Campinas, Brazil
| | - Takeshi Waku
- Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), University of Campinas, Campinas, Brazil
| | | | | | - Sophia Nora Baptista
- Autoimmune Research Lab, Institute of Biology, University of Campinas, Campinas, Brazil
| | | | | | | | - André Schwambach Vieira
- Molecular Genetics Laboratory, Faculty of Medical Sciences, University of Campinas, Campinas, Brazil
- Autoimmune Research Lab, Institute of Biology, University of Campinas, Campinas, Brazil
| | | | | | - Mateus Henrique Nogueira
- Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), University of Campinas, Campinas, Brazil.
- Department of Neurology, Clinics Hospital, University of Campinas, Campinas, Brazil.
| | - Fernando Cendes
- Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), University of Campinas, Campinas, Brazil.
- Department of Neurology, Clinics Hospital, University of Campinas, Campinas, Brazil.
| | - Clarissa Lin Yasuda
- Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), University of Campinas, Campinas, Brazil.
- Department of Neurology, Clinics Hospital, University of Campinas, Campinas, Brazil.
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Patwardhan A, Kamble N, Bhattacharya A, Holla V, Yadav R, Pal PK. Impact of Non-Motor Symptoms on Quality of Life in Patients with Early-Onset Parkinson's Disease. Can J Neurol Sci 2024:1-10. [PMID: 38178714 DOI: 10.1017/cjn.2023.336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2024]
Abstract
BACKGROUND Early-onset Parkinson's disease (EOPD) refers to patients with Parkinson's disease (PD) whose age at disease onset is less than 50 years. Literature on the non-motor symptoms (NMS) in these patients is very limited in the Indian context. We aimed to study the NMS in patients with EOPD and its impact on the quality of life (QoL). METHODS We included 124 patients with EOPD with a mean age at disease onset between 21 and 45 years and 60 healthy controls (HC). NMS were assessed using validated scales, and the QoL domains were evaluated using the PD QoL-39 scale (PDQ-39). RESULTS The mean age at disease onset in EOPD patients was 37.33 ± 6.36 years. Majority of the patients were male (66.12%). The average disease duration was 6.62 ± 5.3 years. EOPD patients exhibited a significantly higher number of NMS per patient (7.97 ± 4.69) compared to HC (1.3 ± 1.39; p < 0.001). The most common NMS reported were urinary dysfunction, body pain, poor sleep quality, constipation, anxiety, depression, cognitive impairment, and REM sleep behavior disorder. The total NMS burden correlated with the QoL measures. Distinctive patterns of QoL subdomain involvement were identified, with sleep/fatigue, mood/cognition, and urinary dysfunction independently influencing QoL metrics. CONCLUSIONS Our study provides valuable insights into the NMS profile and its impact on QoL in patients with EOPD, addressing an important knowledge gap in the Indian context. By understanding the specific NMS and their influence on QoL, healthcare professionals can develop targeted interventions to address these symptoms and improve the overall QoL.
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Affiliation(s)
- Ameya Patwardhan
- Department of Neurology, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, Karnataka, India
| | - Nitish Kamble
- Department of Neurology, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, Karnataka, India
| | - Amitabh Bhattacharya
- Department of Neurology, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, Karnataka, India
| | - Vikram Holla
- Department of Neurology, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, Karnataka, India
| | - Ravi Yadav
- Department of Neurology, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, Karnataka, India
| | - Pramod Kumar Pal
- Department of Neurology, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, Karnataka, India
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Hamilton NA, Russell J, Hamadah K, Youngren W, Toon A, Nguyen TA, Joles K. Screening for Comorbidity of Sleep Disorders in Career Firefighters. J Occup Environ Med 2024; 66:43-50. [PMID: 37853663 DOI: 10.1097/jom.0000000000002993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2023]
Abstract
BACKGROUND The purpose of this study was to assess the prevalence and sequelae of insomnia, obstructive sleep apnea (OSA), and comorbid OSA and insomnia (COMISA). METHOD In the morning, after a shift end, Midwest career firefighters ( N = 89) in a midsized city completed an electronic battery of questionnaire to screen for OSA, daytime sleepiness, insomnia, presleep arousal, nightmares, mental and physical health symptoms, and a one-night sleep diary. RESULTS Prevalence of firefighters exceeding screening thresholds: OSA: 54%; insomnia: 30%; COMISA: 17%; four or more nightmares per month: 15%. Firefighters who met criteria for COMISA had shorter total sleep time, less restful and worse sleep quality, higher depression and anxiety symptoms, and presleep arousal symptoms than firefighters without self-reported sleep problems. CONCLUSIONS Many firefighters are at elevated risk of individual behavioral sleep disorders, COMISA, and daytime dysfunction.
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Affiliation(s)
- Nancy A Hamilton
- From the University of Kansas, Lawrence, Kansas (N.A.H., J.R., K.H., W.Y., A.T., T.A.N.); and Lawrence, Douglas County Fire and Medical, Lawrence, Kansas (K.J.)
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Li C, Gao Y, Huang W, Xu H, Liu Y, Zou J, Zhu H, Li X, Han F, Liu J, Wu K, Yi H, Guan J, Yin S. The use of the sleep apnea-specific hypoxic burden to predict obstructive sleep apnea hypopnea syndrome: Evidence from a large cross-sectional study. Sleep Med 2023; 111:94-100. [PMID: 37742592 DOI: 10.1016/j.sleep.2023.09.007] [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: 04/17/2023] [Revised: 09/05/2023] [Accepted: 09/05/2023] [Indexed: 09/26/2023]
Abstract
OBJECTIVES Obstructive sleep apnea hypopnea syndrome (OSA) is an independent risk factor for neurocognitive and behavioral problems and cardiovascular and metabolic morbidities, ultimately increasing mortality. However, OSA diagnosis is time-consuming, labor-intensive, and expensive. We evaluated the predictive utility of the sleep apnea-specific hypoxic burden (SASHB) in terms of OSA and the severity thereof in Han Chinese individuals. METHODS From January 2019 to July 2022, subjects with suspected OSA were recruited in the sleep center of the Shanghai Sixth People's Hospital during sleep evaluation via standard polysomnography. Basic anthropometric measurements and polysomnographic indicators were collected; SASHB was calculated based on the SpO2 trends of apnea or hypopnea events. Models predictive of OSA were established via logistic regression in the experimental group and verified in an independent group by drawing receiver operating characteristic (ROC) curves. RESULTS A total of 2303 subjects with suspected OSA (1200 in the experimental group and 1103 in the validation group) were included. SASHB was positively correlated with the apnea-hyponea index (AHI) in all subjects (r = 0.823, P < 0.001). SASHB distinguished OSA from non-OSA subjects in both the experimental group {area under the curve (AUC) 0.948 [0.934∼0.962]} and the validation group (AUC 0.931 [0.913∼0.949]). SASHB predicted OSA severity well, better than did the neck, waist, or hip circumference; the lowest or mean oxygen saturation; and the Epworth sleepiness scale score. CONCLUSION SASHB predicted OSA both accurately and efficiently in a Chinese Han population. Further studies are warranted to verify our findings in community samples.
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Affiliation(s)
- Chenyang Li
- Department of Otolaryngology-Head and Neck Surgery & Center of Sleep Medicine, Shanghai Jiao Tong University School of Medicine Affiliated Sixth People's Hospital, Shanghai, China; Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, China
| | - Yiqing Gao
- Department of Otolaryngology-Head and Neck Surgery & Center of Sleep Medicine, Shanghai Jiao Tong University School of Medicine Affiliated Sixth People's Hospital, Shanghai, China; Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, China
| | - Weijun Huang
- Department of Otolaryngology-Head and Neck Surgery & Center of Sleep Medicine, Shanghai Jiao Tong University School of Medicine Affiliated Sixth People's Hospital, Shanghai, China; Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, China
| | - Huajun Xu
- Department of Otolaryngology-Head and Neck Surgery & Center of Sleep Medicine, Shanghai Jiao Tong University School of Medicine Affiliated Sixth People's Hospital, Shanghai, China; Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, China.
| | - Yupu Liu
- Department of Otolaryngology-Head and Neck Surgery & Center of Sleep Medicine, Shanghai Jiao Tong University School of Medicine Affiliated Sixth People's Hospital, Shanghai, China; Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, China
| | - Jianyin Zou
- Department of Otolaryngology-Head and Neck Surgery & Center of Sleep Medicine, Shanghai Jiao Tong University School of Medicine Affiliated Sixth People's Hospital, Shanghai, China; Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, China
| | - Huaming Zhu
- Department of Otolaryngology-Head and Neck Surgery & Center of Sleep Medicine, Shanghai Jiao Tong University School of Medicine Affiliated Sixth People's Hospital, Shanghai, China; Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, China
| | - Xinyi Li
- Department of Otolaryngology-Head and Neck Surgery & Center of Sleep Medicine, Shanghai Jiao Tong University School of Medicine Affiliated Sixth People's Hospital, Shanghai, China; Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, China
| | - Fangkai Han
- Department of Oral & Maxillofacial Imaging, Shanghai Stomatological Hospital & School of Stomatology, Fudan University. Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Fudan University, Shanghai, China.
| | - Jingjing Liu
- Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, China
| | - Kejia Wu
- Department of Otolaryngology-Head and Neck Surgery & Center of Sleep Medicine, Shanghai Jiao Tong University School of Medicine Affiliated Sixth People's Hospital, Shanghai, China; Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, China
| | - Hongliang Yi
- Department of Otolaryngology-Head and Neck Surgery & Center of Sleep Medicine, Shanghai Jiao Tong University School of Medicine Affiliated Sixth People's Hospital, Shanghai, China; Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, China
| | - Jian Guan
- Department of Otolaryngology-Head and Neck Surgery & Center of Sleep Medicine, Shanghai Jiao Tong University School of Medicine Affiliated Sixth People's Hospital, Shanghai, China; Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, China.
| | - Shankai Yin
- Department of Otolaryngology-Head and Neck Surgery & Center of Sleep Medicine, Shanghai Jiao Tong University School of Medicine Affiliated Sixth People's Hospital, Shanghai, China; Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, China
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Scribante A, Pellegrini M, Pulicari F, Ghizzoni M, Modugno FP, Spadari F. Pain Assessment in Oral Medicine through Its Different Dimensions: A Comprehensive Review. Dent J (Basel) 2023; 11:246. [PMID: 37999011 PMCID: PMC10670171 DOI: 10.3390/dj11110246] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 10/14/2023] [Accepted: 10/20/2023] [Indexed: 11/25/2023] Open
Abstract
Orofacial pain is a complex experience made up of different features and involving various aspects of life. It has demonstrated a connection, especially when chronic, with conditions such as anxiety, depression, and sleep disorders, through paths that still have not been completely clarified. A deep understanding of orofacial pain and its impact on an individual's life is critical for planning accurate diagnostic and therapeutic approaches. This review seeks to provide a comprehensive overview of the components constituting the pain experience, its implications in an individual's life, the different tools for multidimensional pain assessment, and the specific applications for each tool. A comprehensive review was performed using the PubMed, Scopus, and Web of Science electronic databases. Ninety-five studies, including observational studies, clinical trials, case-control studies, and case reports, were included and analyzed in this review. Orofacial pain assessment exploits several methods, ranging from clinical evaluation to rating scales, questionnaires, and daily diaries. The choice of the correct instrument requires an evaluation of the type of pain experienced, of the patient's characteristics and abilities to complete particular tasks, and finally, of the assessment tool features.
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Affiliation(s)
- Andrea Scribante
- Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy; (M.G.); (F.P.M.)
| | - Matteo Pellegrini
- Maxillo-Facial Surgery and Dental Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (F.P.); (F.S.)
| | - Federica Pulicari
- Maxillo-Facial Surgery and Dental Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (F.P.); (F.S.)
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via della Commenda 10, 20122 Milan, Italy
| | - Martina Ghizzoni
- Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy; (M.G.); (F.P.M.)
| | - Francesco Paolo Modugno
- Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy; (M.G.); (F.P.M.)
| | - Francesco Spadari
- Maxillo-Facial Surgery and Dental Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (F.P.); (F.S.)
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via della Commenda 10, 20122 Milan, Italy
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Luo ZR, Bin-Yao, Huang ZY. Chronobiology discrepancies between patients with acute type a aortic dissection complicated with and without sleep apnea syndrome: a single-center seven-year retrospective study. BMC Cardiovasc Disord 2023; 23:508. [PMID: 37828436 PMCID: PMC10571263 DOI: 10.1186/s12872-023-03548-6] [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: 02/04/2023] [Accepted: 10/05/2023] [Indexed: 10/14/2023] Open
Abstract
BACKGROUND The present study aimed to investigate the differences in chronobiology and prevention between patients with acute type-A aortic dissection (ATAAD) complicated with sleep apnea syndrome (SAS) and without sleep apnea syndrome (non-SAS). METHODS We retrospectively analyzed the clinical information of ATAAD patients using hospital medical records and regional meteorological and chronological information between January 2013 and December 2019. RESULTS An early mortality rate of 16.9% (196 out of 1160 cases) was observed, comprising 95 cases of aortic rupture before surgery and 101 surgery-related deaths. Eighty-one of the 964 survivors were screened for SAS using complete morphological characteristics. Of these patients, 291 (33.0%) suffered from SAS, while 590 (67.0%) had no SAS. Based on a Circular Von Mises distribution analysis, the non-SAS patients experienced a significant morning peak in the occurrence of ATAAD at 10:04 (r1 = 0.148, p < 0.01). In contrast, the SAS patients experienced a significantly different (non-SAS vs. SAS, U2 = 0.947, p < 0.001) nighttime peak at 23:48 (r2 = 0.489, p < 0.01). Moreover, both non-SAS (Z = 39.770, P < 0.001) and SAS (Z = 55.663, P < 0.001) patients showed a comparable peak during January (non-SAS vs. SAS, U2 = 0.173, p > 0.05). Furthermore, SAS patients experienced a peak on Fridays (χ2 = 36.419, p < 0.001), whereas there was no significant difference in the weekly distribution in non-SAS patients (χ2 = 11.315, p = 0.079). CONCLUSIONS The analyses showed that both SAS and non-SAS patients showed distinct rhythmicity in ATAAD onset. These findings highlight the chronobiological triggers within different ATAAD subpopulations and may contribute to the prevention of this potentially fatal occurrence.
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Affiliation(s)
- Zeng-Rong Luo
- Department of Cardiovascular Surgery, Fujian Medical University Union Hospital, Fuzhou, 350001 P. R. China
- Key Laboratory of Cardio-Thoracic Surgery, Fujian Medical University, Fujian Province University, Fuzhou, P. R. China
| | - Bin-Yao
- Department of Cardiovascular Surgery, Fujian Medical University Union Hospital, Fuzhou, 350001 P. R. China
- Key Laboratory of Cardio-Thoracic Surgery, Fujian Medical University, Fujian Province University, Fuzhou, P. R. China
| | - Zhong-Yao Huang
- Department of Cardiovascular Surgery, Fujian Medical University Union Hospital, Fuzhou, 350001 P. R. China
- Key Laboratory of Cardio-Thoracic Surgery, Fujian Medical University, Fujian Province University, Fuzhou, P. R. China
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Vacca M, Spanetta M, Ballesio A, Fernandes M, Placidi F, Izzi F, Lombardo C, Mercuri NB, Laganà G, Liguori C. The Sleepiness-Depression Link in Obstructive Sleep Apnea: Preliminary Results on the Mediation of Impulsivity. J Clin Med 2023; 12:6467. [PMID: 37892605 PMCID: PMC10607807 DOI: 10.3390/jcm12206467] [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: 09/04/2023] [Revised: 09/23/2023] [Accepted: 10/07/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND Emotional impulsivity has been found to be relevant in explaining the association between sleep problems and depressive symptoms, suggesting the potential role of impulsivity as a key underlying mechanism of this link. The objective of this study was to take a preliminary step in understanding the mediating role of impulsivity in the relation between excessive daytime sleepiness (EDS) and depression in patients with obstructive sleep apnea syndrome (OSAS) and to compare psychological and demographic characteristics between different levels of daytime sleepiness. METHODS A total of 138 patients with OSAS underwent polygraphic cardiorespiratory monitoring and completed a series of questionnaires investigating perceived sleepiness, depression, impulsivity, and other psychological characteristics. A mediational model was tested in order to assess whether impulsivity mediated the relation between sleepiness and depressive symptoms while controlling for the effects of age, sex, BMI, and oxygen saturation parameters. RESULTS the mediation model showed that there was a significant indirect effect of impulsivity in the sleepiness-depression link (αβ = 0.084 [0.0243-0.1617]). CONCLUSIONS The here-presented results showed that the sleepiness-depression link is not direct as previous studies asserted, but instead it may be better explained by impulsivity. Research and practical implications are discussed.
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Affiliation(s)
- Mariacarolina Vacca
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy; (M.V.); (A.B.); (C.L.)
| | | | - Andrea Ballesio
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy; (M.V.); (A.B.); (C.L.)
| | - Mariana Fernandes
- Department of Systems Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; (M.F.); (F.P.); (N.B.M.)
| | - Fabio Placidi
- Department of Systems Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; (M.F.); (F.P.); (N.B.M.)
- Sleep Medicine Center, Neurology Unit, University Hospital of Rome “Tor Vergata”, 00133 Rome, Italy
| | - Francesca Izzi
- Sleep Medicine Center, Neurology Unit, University Hospital of Rome “Tor Vergata”, 00133 Rome, Italy
| | - Caterina Lombardo
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy; (M.V.); (A.B.); (C.L.)
| | - Nicola Biagio Mercuri
- Department of Systems Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; (M.F.); (F.P.); (N.B.M.)
- Sleep Medicine Center, Neurology Unit, University Hospital of Rome “Tor Vergata”, 00133 Rome, Italy
| | - Giuseppina Laganà
- Department of Orthodontics, University of Rome “Tor Vergata”, 00133 Rome, Italy;
| | - Claudio Liguori
- Department of Systems Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; (M.F.); (F.P.); (N.B.M.)
- Sleep Medicine Center, Neurology Unit, University Hospital of Rome “Tor Vergata”, 00133 Rome, Italy
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20
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You S, Cicchella A. Daytime sleepiness in Chinese professional, semi professional and students soccer players in the Shanghai lockdown. BMC Sports Sci Med Rehabil 2023; 15:119. [PMID: 37740241 PMCID: PMC10517451 DOI: 10.1186/s13102-023-00730-3] [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: 05/16/2023] [Accepted: 09/11/2023] [Indexed: 09/24/2023]
Abstract
PURPOSE April-May 2021 Shanghai city was under strict lockdown. Soccer players suffered from the restrictions, being unable to train and have a social life. The aim of this study was to compare differences in daytime sleepiness between genders and qualification levels in a cohort university Chinese soccer player under 0 Covid policy restrictions in the urban area of Shanghai. METHODS 491 questionnaires of Epworth Sleepiness Scales (ESS) were compiled online by male and female Soccer Students (SS), Semi-Professional players (SP) and Professional Players (PP) during the ongoing restriction measures post Shanghai lockdown. ANOVA was performed for players levels and gender. RESULTS Significant differences were found between the 3 levels and between males and females. PP showed a very low score in the ESS (5,97) well below the threshold of 8 for daytime sleepiness, while SS and SP showed an ESS score above the threshold. Female showed higher scores in comparison to males. Differences between males and females reflect the confinement conditions in the ESS items, showing more difference in the item of ESS which are related with indoor situations. CONCLUSIONS This study shows the first data on sleepiness in Chinese soccer players of different level of qualification immediately post lockdown condition. Professional male's players sleepiness was lower, than females, SS and SP after the exceptional lockdown measures. The reasons can reside in the more ordered lifestyle of PP in comparison to SS and SP, which mitigated the effects of the lockdown. Our results suggest that measures to improve sleep in females' soccer player should be adopted if these exceptional conditions will happen again.
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Affiliation(s)
- Songhui You
- Tongji University, International College of Football, 1239 Siping Road, Shanghai, P.R. China
| | - Antonio Cicchella
- Tongji University, International College of Football, 1239 Siping Road, Shanghai, P.R. China.
- Department for Quality-of-Life Studies, University of Bologna, Corso d' Augusto 237, Bologna, Rimini, 47921, Italy.
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21
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Pereira R, Hartescu I, Jackson RC, Morgan K. Napping behaviour, daytime sleepiness, and arousal in high performance athletes and non-athlete controls. J Sports Sci 2023; 41:1530-1537. [PMID: 37953624 DOI: 10.1080/02640414.2023.2281158] [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: 03/17/2023] [Accepted: 11/01/2023] [Indexed: 11/14/2023]
Abstract
Napping offers a strategy to manage sleep, aid recovery and enhance performance in elite sport. However, relatively little research attention has focussed on the natural history of athlete napping or tested the widely held assumption that athlete napping is mainly a consequence of degraded night-time sleep. Within a sample of 158 team (n = 76) and individual (n = 80) sport athletes, and 82 non-athlete controls, we analysed napping behaviour in relation to sleep quality, daytime sleepiness, and pre-sleep somatic and cognitive arousal. There was no significant association between athlete/non-athlete status and the prevalence, frequency, or duration of naps. Comparisons of athlete nappers and non-nappers found no significant differences in sleep quantity or quality. While nap propensity was significantly related to higher daytime sleepiness, this influence was moderated or augmented by levels of pre-sleep cognitive arousal. For some nappers, those with higher levels of arousal may need to be sleepier than those with lower levels of arousal in order to successfully initiate daytime sleep. Approximately 50% of athletes did not nap. If the benefits of athlete napping are to be fully exploited, the needs of this substantial group for whom napping may be problematic should be recognised and addressed.
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Affiliation(s)
- Rui Pereira
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, Leicestershire, UK
| | - Iuliana Hartescu
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, Leicestershire, UK
| | - Robin C Jackson
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, Leicestershire, UK
| | - Kevin Morgan
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, Leicestershire, UK
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Johnson T, Gurubhagavatula I. Assessment of Vigilance and Fatigue. Sleep Med Clin 2023; 18:349-359. [PMID: 37532374 DOI: 10.1016/j.jsmc.2023.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/04/2023]
Abstract
This article summarizes the definitions of vigilance, fatigue, and sleepiness, as well as tools used in their assessment. Consideration is given to the strengths and limitations of the different subjective and objective tools. Future directions for research are also discussed, as well as the public health importance of continued investigation in this subject.
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Affiliation(s)
- Tyler Johnson
- Division of Sleep Medicine, Perelman School of Medicine, University of Pennsylvania, 3624 Market Street, Suite 205, Philadelphia, PA 19104, USA.
| | - Indira Gurubhagavatula
- Division of Sleep Medicine, Perelman School of Medicine, University of Pennsylvania, 3624 Market Street, Suite 205, Philadelphia, PA 19104, USA; Crescenz VA Medical Center, Philadelphia, PA, USA.
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Taylor SA. Clinical Evaluation of the Sleepy and Sleepless Patient. Continuum (Minneap Minn) 2023; 29:1031-1044. [PMID: 37590821 DOI: 10.1212/con.0000000000001281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/19/2023]
Abstract
OBJECTIVE This article addresses the approach to the evaluation of patients who present to a neurologist with excessive daytime sleepiness or difficulty sleeping. LATEST DEVELOPMENTS Greater emphasis on the importance of sleep reflects the growing scientific understanding that sleep is critical to overall health and well-being. Consumer sleep technologies, which measure parameters related to sleep, may provide insight into an individual's sleep-related symptoms and tendencies and have a role in patient-centered sleep evaluation when used within an appropriate clinical context. ESSENTIAL POINTS A thorough review of a patient's history and physical examination findings are important components of the assessment and management of their sleep-related symptoms. An understanding of how the clinical context relates to the categorization of sleep disorders can impact a patient's symptoms, comorbid neurologic disorders, and overall well-being. Many neurologic conditions are strongly associated with sleep disturbance, risk factors for the development of a sleep disorder, or both. Therefore, it is critical for neurologists to be familiar and comfortable with taking a focused sleep history. Modalities such as in-laboratory polysomnography, home sleep apnea testing, multiple sleep latency testing, and actigraphy, as well as contextualized and prudent use of data obtained from consumer sleep technologies, can be helpful in appropriately selected patients. Mindful integration of these objective data facilitates the diagnosis and management of sleep disorders.
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Zhou SJ, Yang R, Wang LL, Qi M, Yuan XF, Wang TT, Song TH, Zhuang YY, Li HJ, Tan YL, Wang X, Chen JX. Measuring Sleep Stages and Screening for Obstructive Sleep Apnea with a Wearable Multi-Sensor System in Comparison to Polysomnography. Nat Sci Sleep 2023; 15:353-362. [PMID: 37193215 PMCID: PMC10182819 DOI: 10.2147/nss.s406359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 05/04/2023] [Indexed: 05/18/2023] Open
Abstract
Objective To assess the performance of a wearable multi-sensor system (SensEcho) in comparison to polysomnography (PSG) in measuring sleep stages and searching for obstructive sleep apnea (OSA). Methods Participants underwent overnight simultaneous monitoring using SensEcho and PSG in a sleep laboratory. SensEcho analyzed the recordings spontaneously, and PSG was assessed as per standard guidelines. The degree of snoring was evaluated according to the guidelines for the diagnosis and treatment of OSA hypopnea syndrome (2011 revision). The Epworth Sleepiness Scale (ESS) was used to assess general daytime sleepiness. Results This study included 103 Han Chinese, 91 of whom (age 39.02 ± 13.84 years, body mass index 27.28 ± 5.12 kg/m2, 61.54% male) completed the assessments. The measures of total sleep time (P = 0.198); total wake time (P = 0.182); shallow sleep (P = 0.297), deep sleep (P = 0.422), rapid eye movement sleep (P = 0.570), and awake (P = 0.336) proportions were similar between SensEcho and PSG. Using an apnea-hypopnea index (AHI) cutoff of ≥ 5 events/h, the SensEcho had 82.69% sensitivity and 89.74% specificity. Almost the same results were obtained at an AHI threshold of ≥ 15 events/h. Although the specificity increased to 94.67%, it decreased to 43.75% at an AHI cutoff of ≥ 30 events/h. Conclusion This study demonstrated that SensEcho can be used to evaluate sleep status and screen for OSA. Nevertheless, improving the accuracy of its assessment of severe OSA and further testing its effectiveness in community and home environments is necessary.
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Affiliation(s)
- Shuang-Jiang Zhou
- Sleep Medicine Center, Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing, People’s Republic of China
| | - Rui Yang
- Beijing Anding Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Lei-Lei Wang
- Sleep Medicine Center, Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing, People’s Republic of China
| | - Meng Qi
- Sleep Medicine Center, Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing, People’s Republic of China
| | - Xiao-Fei Yuan
- Beijing Anding Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Ting-Ting Wang
- School of Mental Health, Bengbu Medical College, Bengbu, People’s Republic of China
| | - Tian-He Song
- Department of Psychology, Chengde Medical University, Chengde, People’s Republic of China
| | - Yun-Yue Zhuang
- Department of Psychology, Chengde Medical University, Chengde, People’s Republic of China
| | - Hong-Juan Li
- Sleep Medicine Center, Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing, People’s Republic of China
| | - Yun-Long Tan
- Sleep Medicine Center, Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing, People’s Republic of China
| | - Xue Wang
- Beijing Anding Hospital, Capital Medical University, Beijing, People’s Republic of China
- Correspondence: Xue Wang, Beijing Anding Hospital, Capital Medical University, Beijing, 100088, People’s Republic of China, Tel +86-10-58303034, Email
| | - Jing-Xu Chen
- Sleep Medicine Center, Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing, People’s Republic of China
- Jing-Xu Chen, Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing, 100096, People’s Republic of China, Tel +86-10-83024278, Email
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Scharf MT, Greenberg P, Wong S, Mani R. Sex differences in variables associated with excessive daytime sleepiness in patients with epilepsy. Epilepsy Behav 2023; 138:109015. [PMID: 36473303 DOI: 10.1016/j.yebeh.2022.109015] [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: 10/04/2022] [Revised: 11/08/2022] [Accepted: 11/21/2022] [Indexed: 12/09/2022]
Abstract
OBJECTIVE Excessive daytime sleepiness (EDS) is common in patients with epilepsy (PWE). The Epworth Sleepiness Scale (ESS) is a self-reported measure of sleepiness in widespread use. The purpose of this study was to identify contributors to the ESS score in PWE and to identify variables associated with a high score indicative of EDS. METHODS A cross-sectional study was performed on 115 PWE presenting to the epilepsy clinic. Self-reported questionnaires were administered and demographic and clinical information was gathered from the electronic medical record. Regression analyses were performed. RESULTS A high ESS score was found in nearly 20% of the cohort. Obstructive sleep apnea (OSA) risk, standardized anti-seizure drug (ASD) dose, and female sex were associated with an increased likelihood of a high ESS score. Assessment of the ESS without the use of a cutpoint showed that standardized ASD dose and OSA risk were associated with the ESS in men, but standardized ASD dose was not associated with the ESS in women. Higher use of valproic acid and oxcarbazepine in men and higher use of lamotrigine in women may be contributing factors. SIGNIFICANCE Sex is likely to be a key factor in determining contributors to EDS in PWE.
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Affiliation(s)
- Matthew T Scharf
- Sleep Center, Division of Pulmonary and Critical Care, Department of Medicine, Rutgers- Robert Wood Johnson Medical School, New Brunswick, NJ, United States; Department of Neurology, Rutgers- Robert Wood Johnson Medical School, New Brunswick, NJ, United States.
| | - Patricia Greenberg
- Biostatistics and Epidemiology Services Center, Rutgers School of Public Health, Rutgers University, Piscataway, NJ, United States.
| | - Stephen Wong
- Department of Neurology, Rutgers- Robert Wood Johnson Medical School, New Brunswick, NJ, United States.
| | - Ram Mani
- Department of Neurology, Rutgers- Robert Wood Johnson Medical School, New Brunswick, NJ, United States.
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Wang L, Zhang J, Guo C, He J, Zhang S, Wang Y, Zhao Y, Li L, Wang J, Hou L, Li S, Wang Y, Hao L, Zhao Y, Wu M, Fang J, Rong P. The efficacy and safety of transcutaneous auricular vagus nerve stimulation in patients with mild cognitive impairment: A double blinded randomized clinical trial. Brain Stimul 2022; 15:1405-1414. [PMID: 36150665 DOI: 10.1016/j.brs.2022.09.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 08/31/2022] [Accepted: 09/12/2022] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND There are 9.9 million new cases of dementia in the world every year. Short-term conversion rate from mild cognitive impairment (MCI) to dementia is between 20% and 40%, but long-term in 5-10 years ranges from 60% to 100%. It is particularly important to prevent or prolong the development of MCI into dementia. Both auriculotherapy and vagus nerve stimulation are effective on improving cognitive functions. However, there is no double blinded randomized clinical trial to support the effectiveness of transcutaneous electrical stimulation of auricular acupoints in patients with MCI. METHODS This randomized controlled trial involved patients with MCI, aged from 55 to 75 years old. Patients were randomly allocated to transcutaneous auricular vagus nerve stimulation (taVNS) group or sham taVNS group. In the taVNS group, two auricular acupoints were stimulated, including heart (concha, CO15) and kidney (CO10), which are in the distribution of vagus nerve. While in the sham taVNS group, two other auricular acupoints were stimulated, including elbow (scaphoid fossa, SF3) and shoulder (SF4,5), which are out of the distribution of vagus nerve. The primary outcome was the Montreal cognitive assessment-basic, MOCA-B. The secondary outcomes included auditory verbal learning test-HuaShan version (AVLT-H), shape trails test A&B (STT-A&B), animal fluence test (AFT), Boston naming test (BNT), Pittsburgh sleep quality index (PSQI), rapid eye movement sleep behavior disorder screening questionnaire (RBDSQ), Epworth sleepiness scale (ESS) and functional activities questionnaire (FAQ). These outcome measures were taken at baseline, 24 weeks later. RESULTS After 24 weeks of intervention, the data of 52 patients were intended for analysis. After intervention, there was significant difference in the overall scores of MoCA-B between taVNS group and sham taVNS group (p = 0.033 < 0.05). In taVNS group, compared with before intervention, the overall scores of MOCA-B increased significantly after intervention (p < 0.001). As for N5 and N7, the two sub-indicators of AVLT-H, in taVNS group, compared with before intervention, both N5 and N7 increased significantly after intervention (both ps < 0.001). As for STTB, in taVNS group, compared with before intervention, STTB was significantly reduced after intervention (p = 0.016). For BNT, in taVNS group, compared with before intervention, BNT increased significantly after intervention (p < 0.001). In taVNS group, compared with before intervention, PSQI, RBDSQ, ESS and FAQ decreased significantly after intervention (p = 0.002, 0.025, <0.001, 0.006 respectively). 1 patient with a history of tympanic membrane perforation in taVNS group was reported with mild adverse reactions which disappeared a week after termination of taVNS. The intervention of taVNS is effective on increasing the overall scores of MoCA-B, N5 and N7. CONCLUSION The clinical trial demonstrated that taVNS can improve cognitive performance in patients with MCI. This inexpensive, effective and innovative method can be recommended as a therapy for more patients with MCI in the prevention or prolonging of its development into dementia, but it is still required to be further investigated. TRIAL REGISTRATION http://www.chictr.org.cn. (ID: ChiCTR2000038868).
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Affiliation(s)
- Lei Wang
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, 100700, China
| | - Jinling Zhang
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, 100700, China
| | - Chunlei Guo
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China
| | - Jiakai He
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, 100700, China
| | - Shuai Zhang
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, 100700, China
| | - Yu Wang
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, 100700, China.
| | - Yanan Zhao
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, 100700, China
| | - Liang Li
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, 100700, China
| | - Junying Wang
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, 100700, China
| | - Liwei Hou
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, 100700, China
| | - Shaoyuan Li
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, 100700, China
| | - Yifei Wang
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, 100700, China
| | - Lixiao Hao
- Xuanwu Hospital, Capital Medical University, Beijing, 100053, China
| | - Yufeng Zhao
- National Data Center of Traditional Chinese Medicine, China Academy of Chinese Medical Sciences, Beijing, 100700, China
| | - Mozheng Wu
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, 100700, China
| | - Jiliang Fang
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China
| | - Peijing Rong
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, 100700, China.
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Neagos A, Dumitru M, Neagos CM, Mitroi M, Vrinceanu D. Correlations between Morphology, the Functional Properties of Upper Airways, and the Severity of Sleep Apnea. J Clin Med 2022; 11:jcm11185347. [PMID: 36142994 PMCID: PMC9502432 DOI: 10.3390/jcm11185347] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 08/31/2022] [Accepted: 09/08/2022] [Indexed: 11/16/2022] Open
Abstract
Obstructive sleep apnea (OSA) is considered the silent killer pathology of the new millennium. This is due to increased risk factors such as obesity. Healthcare systems face an increasing burden from severe cases of OSA. We performed a study on a group of 152 Romanian patients with OSA recording data obtained through polysomnography and cephalometric variables, recorded in lateral plain X-rays. The results confirmed some of the data available from previous studies worldwide, but some of the variables presented a positive statistical correlation specific to our study group. For example, the apnea-hypopnea index (AHI) correlated with the uvula length but surprisingly did not correlate with body mass index (BMI) because obesity tends to become endemic in Romania. To our knowledge, this is one of the first studies focusing on cephalometric data in Romanian OSA patients. The results obtained through this study will be further analyzed in research on larger groups of Romanian OSA patients.
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Affiliation(s)
- Adriana Neagos
- ENT Department, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540142 Tirgu Mures, Romania
- Correspondence: (A.N.); (M.D.)
| | - Mihai Dumitru
- ENT Department, Carol Davila University of Medicine and Pharmacy, 010271 Bucharest, Romania
- Correspondence: (A.N.); (M.D.)
| | - Cristian Mircea Neagos
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 010271 Bucharest, Romania
| | - Mihaela Mitroi
- ENT Department, University of Medicine and Pharmacy, 200349 Craiova, Romania
| | - Daniela Vrinceanu
- ENT Department, Carol Davila University of Medicine and Pharmacy, 010271 Bucharest, Romania
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The efficacy of acupuncture for patients with mild to moderate obstructive sleep apnea syndrome: A protocol for a randomized controlled clinical trial. WORLD JOURNAL OF ACUPUNCTURE-MOXIBUSTION 2022. [DOI: 10.1016/j.wjam.2022.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Susta M, Šonka K, Bizik G, Petranek S, Nevsimalova S. Idiopathic Hypersomnia-A Dynamic Simulation Model. Front Neurol 2022; 13:902637. [PMID: 35756941 PMCID: PMC9226714 DOI: 10.3389/fneur.2022.902637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 05/02/2022] [Indexed: 11/13/2022] Open
Abstract
Aims of the study Commonly used approach to illness assessment focuses on the patient's actual state supplemented by binary records of past events and conditions. This research project was designed to explain subjective experience in idiopathic hypersomnia (IH) patients influenced by their clinical symptoms and comorbidities. Material and Methods Forty-three IH patients of both sexes (female 60.5%, male 39.5%) were assessed using a detailed structured examination. The interview covered neurologic, psychiatric, and internal medicine anamnesis, medication past and current, substance abuse, work impairment, detailed sleep-related data, specific sleep medication, and a full-length set of questionnaires including depression, quality of life, sleepiness, anxiety, fatigue, insomnia, and sleep inertia. The data were digitized and imported into statistical software (SPSS by IBM), and dynamic simulation software (Vensim by Ventana Systems Inc.) was used to build a causal loop diagram and stocks and flows diagram as a simulation structure. Results The overall raw data and simulation-based patterns fit at 76.1%. The simulation results also identified the parameters that contribute the most to patients' subjective experience. These included sleep inertia, the refreshing potential of naps, the quality of nocturnal sleep, and the social aspects of the patient's life. Psychiatric disorders influence the overall pattern at a surprisingly low level. The influence of medication has been studied in detail. Although its contribution to the dynamics looks marginal at first sight, it significantly influences the contribution of other variables to the overall patient experience of the disease. Conclusion Even the simplified dynamic structure designed by the research team reflects the real-life events in patients with IH at the acceptable level of 76.1% and suggests that a similar structure plays an important role in the course of the disease. Therapeutic focus on the parameters identified by the model should enhance the patients' subjective experience throughout illness duration and might even turn the progress from negative into positive. Further research is needed to understand the dynamics of idiopathic hypersomnia in greater detail to better understand the causes and design therapeutic approaches to improve patients' quality of life.
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Affiliation(s)
- Marek Susta
- Department of Public Health, St. Elisabeth University, Bratislava, Slovakia
| | - Karel Šonka
- Department of Neurology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czechia
| | - Gustav Bizik
- Department of Psychiatry, Aalborg University, Aalborg, Denmark
| | - Svojmil Petranek
- Health Care Facility, Department of the Interior, Prague, Czechia
| | - Sona Nevsimalova
- Department of Neurology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czechia
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Kawaratani H, Miyaaki H, Hiraoka A, Nakao K, Hiasa Y, Yoshiji H, Okita K, Koike K. The Usefulness of the Athens Insomnia Scale for Evaluating Sleep Disturbance in Patients with Chronic Liver Disease Comparing with Pittsburgh Sleep Quality Index and Epworth Sleepiness Scale. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58060741. [PMID: 35744004 PMCID: PMC9229656 DOI: 10.3390/medicina58060741] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 05/24/2022] [Accepted: 05/28/2022] [Indexed: 11/16/2022]
Abstract
Background and Objectives: Sleep disturbance due to muscle cramps or hepatic encephalopathy in patients with chronic liver disease (CLD) can lead to a reduced quality of life. The Pittsburgh sleep quality index (PSQI) is commonly used for evaluating sleep disturbance; however, this questionnaire is time-consuming owing to the large number of questions. As the usefulness of the Athens insomnia scale (AIS) in patients with CLD is not sufficiently known, the present study aimed to determine whether the AIS and Epworth sleepiness scale (ESS) could be used as simple alternative questionnaires for evaluating sleep disturbances in patients with CLD. Materials and Methods: A total of 117 patients with CLD were retrospectively evaluated. Patients with overt hepatic encephalopathy were excluded. All patients were examined using the AIS, PSQI, and ESS, and their responses to these questionnaires were statistically analyzed. Results: The number of patients diagnosed with sleep disturbance using the AIS, PSQI, and ESS were 39 (33.3%), 37 (31.6%), and 9 (7.7%), respectively. There was no correlation between PSQI and ESS scores (r = 0.011, p = 0.910); in contrast, the AIS scores showed a significant correlation with the PSQI scores (r = 0.689, p < 0.001). When the PSQI was considered as the standard for evaluating sleep disturbance, the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the AIS were 76.9%, 91.0%, 81.1%, and 88.8%, respectively. In the sleep medication group, the sensitivity, specificity, PPV, and NPV of the AIS were 100%, 70%, 78.6%, and 100%, respectively. Conclusions: This is the first report to indicate that the AIS is an alternative questionnaire to the PSQI and that it can be a useful tool for detecting cirrhosis-related complications in patients with CLD.
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Affiliation(s)
- Hideto Kawaratani
- Department of Gastroenterology, Nara Medical University, Nara 634-8522, Japan;
- Correspondence: ; Tel.: +81-744223051 (ext. 3415)
| | - Hisamitsu Miyaaki
- Department of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8523, Japan; (H.M.); (K.N.)
| | - Atsushi Hiraoka
- Gastroenterology Center, Ehime Prefectural Central Hospital, Matsuyama 790-0024, Japan;
| | - Kazuhiko Nakao
- Department of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8523, Japan; (H.M.); (K.N.)
| | - Yoichi Hiasa
- Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Toon 791-0295, Japan;
| | - Hitoshi Yoshiji
- Department of Gastroenterology, Nara Medical University, Nara 634-8522, Japan;
| | - Kiwamu Okita
- Shunan Memorial Hospital, Yamaguchi 744-0033, Japan;
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Pelaia C, Armentaro G, Volpentesta M, Mancuso L, Miceli S, Caroleo B, Perticone M, Maio R, Arturi F, Imbalzano E, Andreozzi F, Perticone F, Sesti G, Sciacqua A. Effects of Sacubitril-Valsartan on Clinical, Echocardiographic, and Polygraphic Parameters in Patients Affected by Heart Failure With Reduced Ejection Fraction and Sleep Apnea. Front Cardiovasc Med 2022; 9:861663. [PMID: 35449875 PMCID: PMC9016131 DOI: 10.3389/fcvm.2022.861663] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 03/11/2022] [Indexed: 12/11/2022] Open
Abstract
Background Heart failure with reduced ejection fraction (HFrEF) is a clinical condition frequently diagnosed in clinical practice. In patients affected by HFrEF, sleep apnea (SA) can be detected among the most frequent comorbidities. Sacubitril–valsartan (sac/val) association has been proven to be effective in reducing disease progression and all-cause mortality in HFrEF patients. Sac/val treatment can potentially attenuate SA development via several pathophysiologic mechanisms, including improvement of global hemodynamics, reduction of extracellular fluid overload, and decrease of sympathetic neural activity. Methods We recruited 132 patients affected by HFrEF and SA, already under treatment with continuous positive airway pressure (CPAP), which was discontinued 24 h before the scheduled study timepoints. Physical examination, echocardiography, nocturnal cardio-respiratory monitoring, and laboratory tests were performed in each patient at baseline and after a 6-month treatment with sac/val. Results After 6 months, sac/val induced statistically significant changes in clinical, hemodynamic, biohumoral (NT-proBNP, serum electrolytes, creatinine, and uric acid), and echocardiographic parameters. In particular, cardiac index (CI), both atrial and ventricular volumes and global longitudinal strain (GLS) improved. Moreover, polysomnography, carried out during a temporary CPAP interruption, revealed a significant reduction in global apnea-hypopnea index (AHI) value (p < 0.0001), central AHI (p < 0.0001), obstructive AHI (p < 0.0001), oxygen desaturation index (ODI) (p < 0.0001), and percentage time of saturation below 90% (TC90) (p < 0.0001). The changes of CI, estimated glomerular filtration rate (eGFR), NT-proBNP, and tricuspid annular plane excursion (TAPSE) contributed to 23.6, 7.6, 7.3, and 4.8% of AHI variability, respectively, and the whole model accounted for a 43.3% of AHI variation. Conclusions Our results suggest that treatment with sac/val is able to significantly improve the cardiorespiratory performance of patients with HFrEF and SA, integrating the positive impact of CPAP. Thus, both CPAP and sac/val therapy may synergistically contribute to lower the risks of both cardiac and pulmonary complications in HFrEF patients with SA.
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Affiliation(s)
- Corrado Pelaia
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Catanzaro, Italy
| | - Giuseppe Armentaro
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Catanzaro, Italy
| | - Mara Volpentesta
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Catanzaro, Italy
| | - Luana Mancuso
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Catanzaro, Italy
| | - Sofia Miceli
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Catanzaro, Italy
| | - Benedetto Caroleo
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Catanzaro, Italy
| | - Maria Perticone
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Catanzaro, Italy
| | - Raffaele Maio
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Catanzaro, Italy
| | - Franco Arturi
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Catanzaro, Italy
| | - Egidio Imbalzano
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Francesco Andreozzi
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Catanzaro, Italy
| | - Francesco Perticone
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Catanzaro, Italy
| | - Giorgio Sesti
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Angela Sciacqua
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Catanzaro, Italy
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Short-Term Continuous Positive Air Pressure Treatment: Effects on Quality of Life and Sleep in Patients with Obstructive Sleep Apnea. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58030350. [PMID: 35334526 PMCID: PMC8951154 DOI: 10.3390/medicina58030350] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Revised: 02/13/2022] [Accepted: 02/21/2022] [Indexed: 02/03/2023]
Abstract
Background and Objectives: The aim of this study was to evaluate short-term continuous positive air pressure (CPAP) treatment for health-related quality of life (HRQL) in patients with obstructive sleep apnea. Materials and Methods: Our subjects were 18−65 years old, diagnosed with moderate-to-severe obstructive sleep apnea and treated with CPAP between January 2020 and June 2021 in Hospital of Lithuanian University of Health Sciences Kaunas clinics. All the patients completed the Epworth Sleepiness Scale (ESS), the 36-Item Short Form Health Survey (SF-36), the and Pittsburgh Sleep Quality Index (PSQI) before and after 3 months of treatment. Polysomnography was also repeated. Statistical analyses were performed using SPSS 27.0 software. The value of p < 0.05 was considered as statistically significant. Results: The active-treatment group comprised 17 subjects with a mean age of 51.9 ± 8.9 years. The total SF-36 questionnaire score improved from 499.8 ± 122.3 to 589.6 ± 124.7 (p = 0.012). The SF-36 role limitations due to emotional problems (p = 0.021), energy (fatigue) (p = 0.035), and general health (p = 0.042) domains score significantly improved after CPAP treatment for 3 months. The PSQI mean score at baseline was 12.6 ± 2.9 and in the post-treatment group, it was −5.5 ± 2.3 (p = 0.001). The ESS also changed significantly from a pretreatment mean score of 10.9 ± 5.7 to −5.3 ± 3.2 (p = 0.002) after 3 months. Conclusions: Improvement in HRQL is seen even after a short treatment period with CPAP. Questionnaires are a good tool to evaluate CPAP treatment efficacy.
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Ma H, Yan J, Sun W, Jiang M, Zhang Y. Melatonin Treatment for Sleep Disorders in Parkinson's Disease: A Meta-Analysis and Systematic Review. Front Aging Neurosci 2022; 14:784314. [PMID: 35185525 PMCID: PMC8855052 DOI: 10.3389/fnagi.2022.784314] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 01/11/2022] [Indexed: 12/19/2022] Open
Abstract
Objective The efficacy of melatonin on sleep disorders in Parkinson's disease (PD) is still unclear. The purpose of this study was to investigate the efficacy of melatonin on sleep disorders in PD by summarizing evidence from randomized clinical trials (RCTs). Methods PubMed, Cochrane Library, EMBASE, and Web of Science databases were searched for studies published before 20 August 2021. Results were analyzed using Review Manager 5.2 software. We used Trial Sequential Analysis (TSA) software to avoid false-positive results caused by random errors. Results We included 7 studies in this systematic review and meta-analysis. The results of the meta-analysis showed that compared with placebo, the subjective sleep quality of patients with PD significantly improved after melatonin treatment (MD = −2.19, 95% CI: −3.53 to −0.86, P = 0.001). In the systematic review, we qualitatively analyzed the efficacy of melatonin on the objective sleep quality of patients with PD, and the results showed that melatonin exerted a positive effect with good safety and tolerability. However, there was no significant improvement in excessive daytime sleepiness assessed by the Epworth Sleepiness Scale (ESS). Conclusion We found that melatonin can significantly improve the subjective and objective sleep quality of patients with PD with good safety and tolerability. Melatonin could be considered an effective treatment for insomnia in patients with PD.
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Affiliation(s)
- Hongxia Ma
- Key Laboratory of Neuromolecular Biology, The First Affiliated Hospital, College of Clinical Medicine of Henan University of Science and Technology, Luoyang, China
| | - Junqiang Yan
- Key Laboratory of Neuromolecular Biology, The First Affiliated Hospital, College of Clinical Medicine of Henan University of Science and Technology, Luoyang, China
- Department of Neurology, The First Affiliated Hospital, College of Clinical Medicine of Henan University of Science and Technology, Luoyang, China
- *Correspondence: Junqiang Yan
| | - Wenjie Sun
- Key Laboratory of Neuromolecular Biology, The First Affiliated Hospital, College of Clinical Medicine of Henan University of Science and Technology, Luoyang, China
| | - Menghan Jiang
- Key Laboratory of Neuromolecular Biology, The First Affiliated Hospital, College of Clinical Medicine of Henan University of Science and Technology, Luoyang, China
| | - Yongjiang Zhang
- Key Laboratory of Neuromolecular Biology, The First Affiliated Hospital, College of Clinical Medicine of Henan University of Science and Technology, Luoyang, China
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Peñacoba P, Llauger MA, Fortuna AM, Flor X, Sampol G, Pedro-Pijoan AM, Grau N, Santiveri C, Juvanteny J, Aoiz JI, Bayó J, Lloberes P, Mayos M. A new tool to screen patients with severe obstructive sleep apnea in the primary care setting: a prospective multicenter study. BMC Pulm Med 2022; 22:38. [PMID: 35033055 PMCID: PMC8761286 DOI: 10.1186/s12890-022-01827-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 12/16/2021] [Indexed: 11/13/2022] Open
Abstract
Background The coordination between different levels of care is essential for the management of obstructive sleep apnea (OSA). The objective of this multicenter project was to develop a screening model for OSA in the primary care setting. Methods Anthropometric data, clinical history, and symptoms of OSA were recorded in randomly selected primary care patients, who also underwent a home sleep apnea test (HSAT). Respiratory polygraphy or polysomnography were performed at the sleep unit to establish definite indication for continuous positive airway pressure (CPAP). By means of cross-validation, a logistic regression model (CPAP yes/no) was designed, and with the clinical variables included in the model, a scoring system was established using the β coefficients (PASHOS Test). In a second stage, results of HSAT were added, and the final accuracy of the model was assessed. Results 194 patients completed the study. The clinical test included the body mass index, neck circumference and observed apneas during sleep (AUC 0.824, 95% CI 0.763–0.886, P < 0.001). In a second stage, the oxygen desaturation index (ODI) of 3% (ODI3% ≥ 15%) from the HSAT was added (AUC 0.911, 95% CI 0.863–0.960, P < 0.001), with a sensitivity of 85.5% (95% CI 74.7–92.1) and specificity of 67.8% (95% CI 55.1–78.3). Conclusions The use of this model would prevent referral to the sleep unit for 55.1% of the patients. The two-stage PASHOS model is a useful and practical screening tool for OSA in primary care for detecting candidates for CPAP treatment. Clinical Trial Registration Registry: ClinicalTrials.gov; Name: PASHOS Project: Advanced Platform for Sleep Apnea Syndrome Assessment; URL: https://clinicaltrials.gov/ct2/show/NCT02591979; Identifier: NCT02591979. Date of registration: October 30, 2015. Supplementary Information The online version contains supplementary material available at 10.1186/s12890-022-01827-0.
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Affiliation(s)
- Patricia Peñacoba
- Sleep Unit, Department of Respiratory Diseases, Hospital de La Santa Creu I Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain. .,Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.
| | - Maria Antònia Llauger
- Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.,Equip d'Atenció Primària Encants, Centre d'Atenció Primària (CAP) Maragall, Institut Català de La Salut, Barcelona, Spain
| | - Ana María Fortuna
- Sleep Unit, Department of Respiratory Diseases, Hospital de La Santa Creu I Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.,Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Xavier Flor
- Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.,CAP Chafarinas, Institut Català de La Salut, Barcelona, Spain
| | - Gabriel Sampol
- Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.,Sleep Unit, Service of Pneumology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red Enfermedades Respiratorias (CIBERES), Instituto de Investigación Carlos III, Madrid, Spain
| | | | - Núria Grau
- Centro de Investigación Biomédica en Red Enfermedades Respiratorias (CIBERES), Instituto de Investigación Carlos III, Madrid, Spain.,Sleep Unit, Department of Respiratory Medicine, Parc de Salut Mar-IMIM, Hospital del Mar, Barcelona, Spain
| | - Carme Santiveri
- Service of Pneumology, Hospital Dos de Maig, Consorci Sanitari Integral, Barcelona, Spain
| | - Joan Juvanteny
- Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.,CAP Trinitat Vella, Institut Català de La Salut, Barcelona, Spain
| | | | - Joan Bayó
- CAP El Clot, Institut Català de La Salut, Barcelona, Spain
| | - Patricia Lloberes
- Sleep Unit, Service of Pneumology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red Enfermedades Respiratorias (CIBERES), Instituto de Investigación Carlos III, Madrid, Spain
| | - Mercè Mayos
- Sleep Unit, Department of Respiratory Diseases, Hospital de La Santa Creu I Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.,Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red Enfermedades Respiratorias (CIBERES), Instituto de Investigación Carlos III, Madrid, Spain
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35
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Scharf MT. Reliability and Efficacy of the Epworth Sleepiness Scale: Is There Still a Place for It? Nat Sci Sleep 2022; 14:2151-2156. [PMID: 36536636 PMCID: PMC9759004 DOI: 10.2147/nss.s340950] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 12/05/2022] [Indexed: 12/14/2022] Open
Abstract
The Epworth sleepiness scale (ESS) is a commonly used questionnaire to evaluate patients for excessive daytime sleepiness (EDS). The ESS has been validated as a measure of EDS, but a number of studies have shown more test-retest variability in clinical settings compared to the original validation study. This observation of higher-than-expected test-retest variability has called into question the utility of the ESS as a clinical tool to assess EDS. The purpose of this review article is to summarize how studies of test-retest variability in clinical populations compare to the original validation study of Johns and to highlight where they differ. Furthermore, use of the ESS as a continuous variable (with no specified cutoff value) versus a categorical variable (normal versus high) is described. These observations are put into a clinical context by comparing the test-retest variability observed on the ESS with that of the multiple sleep latency test (MSLT). Finally, how contributors to ESS scores differ within certain subpopulations is described. The ESS remains an important tool to measure EDS in patient populations, but an awareness of its limitations needs to be considered.
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Affiliation(s)
- Matthew T Scharf
- Sleep Center, Division of Pulmonary and Critical Care, Department of Medicine and Department of Neurology, Rutgers- Robert Wood Johnson Medical School, New Brunswick, NJ, USA
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Wang X, Luo J, Huang R, Xiao Y. The Elevated Central Chemosensitivity in Obstructive Sleep Apnea Patients with Hypertension. Nat Sci Sleep 2022; 14:855-865. [PMID: 35547180 PMCID: PMC9081185 DOI: 10.2147/nss.s362319] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 04/20/2022] [Indexed: 11/25/2022] Open
Abstract
PURPOSE Hypertension is a common comorbidity in obstructive sleep apnea (OSA), in which dysfunction of the autonomic nervous system plays an integral part. Chemoreflex is essential for ventilatory control and cardiovascular activity. This study aimed to determine whether central chemosensitivity was increased in OSA patients with hypertension and the potential role of the autonomic nerve activity in this relationship. PATIENTS AND METHODS A total of 77 men with OSA were included in this cross-sectional study. We measured hypercapnic ventilatory response (HCVR) by the rebreathing method under isoxic hyperoxia to test the central ventilatory chemosensitivity since hyperoxia silences the peripheral chemoreceptors' response to CO2. To elevate the autonomic nerve activity, time-domain, frequency-domain, and non-linear variables of heart rate variability were calculated over 5-min records. Univariate and multivariate linear regression analyses were used to find the determinants of HCVR. RESULTS The median HCVR was 2.3 (1.8, 3.3), 2.1 (1.6, 3.0), and 3 (2.2, 3.7) L/min/mmHg in all participants, OSA patients, and OSA patients with hypertension, respectively. Hypertension was significantly associated with elevated HCVR after adjusting for age, central obesity, OSA severity, daytime sleepiness, and diabetes mellitus. Compared with OSA patients, OSA patients with hypertension had higher body mass index, worse nocturnal hypoxia, and lower time-domain variables and frequency-domain variables. After adjusting for age, apnea-hypopnea index, central obesity, and beta-blocker usage, approximate entropy was independently negatively associated with HCVR in OSA patients with hypertension. CONCLUSION This study demonstrated elevated central chemosensitivity in OSA patients with hypertension. Compared with OSA patients, OSA patients with hypertension had attenuated parasympathetic nerve activity. This study preliminarily illustrated that elevated central chemosensitivity might be associated with weak adaptability of the cardiac autonomic nervous system in OSA patients with hypertension.
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Affiliation(s)
- Xiaona Wang
- Department of Respiratory and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Jinmei Luo
- Department of Respiratory and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Rong Huang
- Department of Respiratory and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Yi Xiao
- Department of Respiratory and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
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Piekarska M, Pszczółka M, Parol D, Szewczyk P, Śliż D, Mamcarz A. Sleeping Disorders in Healthy Individuals with Different Dietary Patterns and BMI, Questionnaire Assessment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312285. [PMID: 34886011 PMCID: PMC8656560 DOI: 10.3390/ijerph182312285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 11/06/2021] [Accepted: 11/10/2021] [Indexed: 11/16/2022]
Abstract
The COVID-19 pandemic and abiding restrictions have affected every life domain. Sleep disturbances are a major health issue that is linked with a higher prevalence of metabolic syndrome, obesity, and psychological burdens. Research of sleeping disorders among vegetarian and non-vegetarian subpopulations is limited. The aim of the study was to assess the prevalence of sleeping disorders during the COVID-19 pandemic among people with different dietary patterns. Using a web-based cross-sectional survey, data were collected from 1987 people. A total of 1956 respondents met all study conditions. The questionnaire consisted of sociodemographic information, assessment of dietary habits, and assessment of the prevalence of insomnia and sleepiness, based on the Athens Insomnia Scale (AIS) and Epworth Sleepiness Scale (ESS). A total of 36.04% (n = 705) respondents declared that they noticed a change in the quality of their sleep during the last year. According to AIS and ESS, non-vegetarians suffered from insomnia or sleepiness more often than vegetarians. Insomnia and sleepiness were also more prevalent among those respondents who declared consumption of fruit and vegetables less often than once a day compared with those who consumed fruit and vegetables daily. Respondents with BMI within the recommended limit (18.5–24.99) suffered from insomnia less often when compared with underweight (BMI < 18.5) or obese (BMI ≥ 25) respondents. Those results may be useful for public health workers and medical professionals in terms of establishing new instruments that help treat sleeping disorders.
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Affiliation(s)
- Magda Piekarska
- Lifestyle Medicine Student Interest Club, 3rd Department of Internal Diseases and Cardiology, Medical University of Warsaw, 04-749 Warsaw, Poland;
- Correspondence: ; Tel.: +48-660509172
| | - Martyna Pszczółka
- Lifestyle Medicine Student Interest Club, 3rd Department of Internal Diseases and Cardiology, Medical University of Warsaw, 04-749 Warsaw, Poland;
| | - Damian Parol
- 3rd Department of Internal Diseases and Cardiology, Medical University of Warsaw, 04-749 Warsaw, Poland; (D.P.); (D.Ś.); (A.M.)
| | - Paweł Szewczyk
- Division of Dietetics, Department and Clinic of Gastroenterology and Hepatology, Wroclaw Medical University, 50-556 Wroclaw, Poland;
| | - Daniel Śliż
- 3rd Department of Internal Diseases and Cardiology, Medical University of Warsaw, 04-749 Warsaw, Poland; (D.P.); (D.Ś.); (A.M.)
- Public Health School Postgraduate Medical Education Center, 01-813 Warsaw, Poland
| | - Artur Mamcarz
- 3rd Department of Internal Diseases and Cardiology, Medical University of Warsaw, 04-749 Warsaw, Poland; (D.P.); (D.Ś.); (A.M.)
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Udut VV, Naumov SA, Evtushenko DN, Udut EV, Naumov SS, Zyuz'kov GN. A case of xenon inhalation therapy for respiratory failure and neuropsychiatric disorders associated with COVID-19. EXCLI JOURNAL 2021; 20:1517-1525. [PMID: 34924901 PMCID: PMC8678062 DOI: 10.17179/excli2021-4316] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 10/25/2021] [Indexed: 11/28/2022]
Abstract
Acute respiratory distress syndrome (ARDS) is the main danger to the life of patients with pneumonia caused by SARS-CoV-2. At the same time, respiratory failure (RF) after ARDS can persist for a long time despite intensive therapy. Therefore, it is important to develop new effective approaches for restoring the ventilation function of the lungs after COVID-19. Here, we present a case report of effective application of short-term inhalations of xenon-oxygen (Xe/O2) gas mixture for treatment of RF and neuropsychiatric disorders (NPD) associated with COVID-19. The patient inhaled a gas mixture of 70 % Xe and 30 % O2. We used multispiral computed tomography, evaluated psychometry, studied hematological and biochemical blood parameters, and applied some other methods of clinical studies to assess the therapeutic effectiveness of Xe inhalation. Also, we studied the mechanism of action of xenon with computer modeling. The clinical case showed the high efficacy of Xe/O2 mixture for treating severe RF and NPD after SARS-CoV-2 infection. Xenon inhalations dramatically increased oxygen saturation and the degree of pneumatization of the lungs. We found out that in coronavirus pneumonia, saturated phospholipids of surfactant are transferred to the solid-ordered phase, which disrupts the surface tension of the alveoli and alveolar gas exchange. Using molecular modeling methods, we demonstrated that the xenon atom increases the distance between the acyl chains of phospholipids due to the van der Waals dispersion interaction. These changes allow for the phase transition of phospholipids from the solid-ordered phase to the liquid phase and restore the functional activity of the surfactant. The findings suggest the feasibility of conducting studies on the effectiveness of Xe/O2 inhalations for treating ARDS in SARS-CoV-2 infection.
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Affiliation(s)
- Vladimir Vasil'evich Udut
- Tomsk National Research Medical Center, Russian Academy of Sciences, Goldberg Research Institute of Pharmacology and Regenerative Medicine, Tomsk, Russia
| | - Sergei Alexandrovich Naumov
- Tomsk National Research Medical Center, Russian Academy of Sciences, Goldberg Research Institute of Pharmacology and Regenerative Medicine, Tomsk, Russia
| | | | - Elena Vladimirovna Udut
- Tomsk National Research Medical Center, Russian Academy of Sciences, Goldberg Research Institute of Pharmacology and Regenerative Medicine, Tomsk, Russia,Siberian State Medical University, Tomsk, Russia
| | | | - Gleb Nikolaevich Zyuz'kov
- Tomsk National Research Medical Center, Russian Academy of Sciences, Goldberg Research Institute of Pharmacology and Regenerative Medicine, Tomsk, Russia,*To whom correspondence should be addressed: Gleb Nikolaevich Zyuz'kov, Tomsk National Research Medical Center, Russian Academy of Sciences, Goldberg Research Institute of Pharmacology and Regenerative Medicine, 634028, Lenin avenue, 3, Tomsk, Russia; Telephone: +73822418372, E-mail:
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Rosenberg R, Babson K, Menno D, Morris S, Baladi M, Hyman D, Black J. Test-retest reliability of the Epworth Sleepiness Scale in clinical trial settings. J Sleep Res 2021; 31:e13476. [PMID: 34545626 PMCID: PMC9285450 DOI: 10.1111/jsr.13476] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 08/09/2021] [Accepted: 08/19/2021] [Indexed: 11/28/2022]
Abstract
The present analysis examined the test–retest reliability of the Epworth Sleepiness Scale in participants with excessive daytime sleepiness associated with narcolepsy or obstructive sleep apnea in three clinical trials. Intraclass correlation coefficient estimates for Epworth Sleepiness Scale scores from two solriamfetol 12‐week placebo‐controlled trials (one narcolepsy, one obstructive sleep apnea) and one long‐term open‐label extension trial (narcolepsy or obstructive sleep apnea) were calculated using postbaseline time‐point pairs for the overall population in each trial, by treatment, and by primary obstructive sleep apnea therapy adherence. In the 12‐week narcolepsy trial, intraclass correlation coefficients (95% confidence intervals) were 0.83 (0.79, 0.87) for weeks 4 and 8 (n = 199), 0.87 (0.83, 0.90) for weeks 8 and 12 (n = 196), and 0.81 (0.76, 0.85) for weeks 4 and 12 (n = 196). In the 12‐week obstructive sleep apnea trial, intraclass correlation coefficients (95% confidence intervals) were 0.74 (0.69, 0.78) (n = 416), 0.80 (0.76, 0.83) (n = 405), and 0.74 (0.69, 0.78) (n = 405), respectively. In the open‐label extension trial, intraclass correlation coefficients (95% confidence intervals) were 0.82 (0.79, 0.85) for weeks 14 and 26/27 (n = 495), 0.85 (0.82, 0.87) for weeks 26/27 and 39/40 (n = 463), and 0.78 (0.74, 0.81) for weeks 14 and 39/40 (n = 463). Placebo/solriamfetol treatment or adherence to primary obstructive sleep apnea therapy did not affect reliability. In conclusion, across three large clinical trials of participants with narcolepsy or obstructive sleep apnea, Epworth Sleepiness Scale scores demonstrated a robust acceptable level of test–retest reliability in evaluating treatment response over time.
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Affiliation(s)
- Russell Rosenberg
- NeuroTrials Research, Atlanta, GA, USA.,Atlanta School of Sleep Medicine, Atlanta, GA, USA
| | | | | | | | | | | | - Jed Black
- Stanford Center for Sleep Sciences and Medicine, Palo Alto, CA, USA
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Use of Wake-Promoting Agents in OSA: When Patients Do Not Achieve a Minimum of 6 Hours of PAP Usage per Night? CURRENT SLEEP MEDICINE REPORTS 2020. [DOI: 10.1007/s40675-020-00188-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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