1
|
YAZICI S, ÖNCÜ ÇETİNKAYA B. Sleep Disorders during Adolescence. PSIKIYATRIDE GUNCEL YAKLASIMLAR - CURRENT APPROACHES IN PSYCHIATRY 2023. [DOI: 10.18863/pgy.1105463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
Sleep disorders during adolescence period increase each year and adversely affect the physical and mental health of adolescents. After-school social activities and various work outside the school may cause delays in bedtime. In addition, there can be shifts in the circadian rhythm due to a number of biological changes seen in the transition to adolescence, which can result in a wide range of sleep problems, such as not being able to fall asleep at night, difficulty waking up in the morning, daytime sleepiness, sleep deprivation and deterioration in sleep quality. It is important to know the causes of sleep disorders, possible effects on physical health and mental health, and protective and risk-forming factors seen in adolescent period; to intervene in these disorders and to develop preventive measures. Preventive measures, such as increasing awareness about sleep disorders in adolescents, informing families and adolescents about the issue, and organizing school start-up times for this age group, may contribute significantly to solving this important issue, which has increased year-to-year.
Collapse
|
2
|
Martin VP, Lopez R, Dauvilliers Y, Rouas JL, Philip P, Micoulaud-Franchi JA. Sleepiness in adults: An umbrella review of a complex construct. Sleep Med Rev 2023; 67:101718. [PMID: 36455433 DOI: 10.1016/j.smrv.2022.101718] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 10/21/2022] [Accepted: 11/10/2022] [Indexed: 11/21/2022]
Abstract
Sleepiness involves many dimensions that require investigation. Since sleepiness is often defined operationally, we exhaustively inventoried all the assessment tools designed to measure it in an umbrella review, without any preconceptions, i.e. a review of reviews. We included all reviews and systematic reviews related to sleepiness assessment tools published up to March 2021. Three investigators independently assessed the eligibility of studies for inclusion and identified 36 relevant reviews. In total, 99 tools were identified and classified into 8 categories. We classified them depending on their category, their publication year and the number of mentions in the 36 included reviews. The 6 most frequently cited were the Epworth sleepiness scale, the multiple sleep latency test, the maintenance of wakefulness test, the Stanford sleepiness scale, the Karolinska sleepiness scale, and the psychomotor vigilance task. Despite the limitation that we may have missed some recently developed tools, this historical perspective on sleepiness measurement is a first step toward a better delineation of the different dimensions underlying the constructs of sleepiness, and will serve as a basis for further discussion in the clinical and research sleep community.
Collapse
Affiliation(s)
- Vincent P Martin
- Univ. Bordeaux, CNRS, Bordeaux INP, LaBRI, UMR 5800, F-33400, Talence, France; Université de Bordeaux, SANPSY UMR 6033, F-33000, Bordeaux, France.
| | - Régis Lopez
- National Reference Center for Orphan Diseases, Narcolepsy, Idiopathic Hypersomnia and Kleine-Levin Syndrome, Sleep Disorders Center, Department of Neurology, Gui-de-Chauliac Hospital, CHU Montpellier, France; Institute for Neurosciences of Montpellier (INM), Montpellier University, INSERM, Montpellier, France
| | - Yves Dauvilliers
- National Reference Center for Orphan Diseases, Narcolepsy, Idiopathic Hypersomnia and Kleine-Levin Syndrome, Sleep Disorders Center, Department of Neurology, Gui-de-Chauliac Hospital, CHU Montpellier, France; Institute for Neurosciences of Montpellier (INM), Montpellier University, INSERM, Montpellier, France
| | - Jean-Luc Rouas
- Univ. Bordeaux, CNRS, Bordeaux INP, LaBRI, UMR 5800, F-33400, Talence, France
| | - Pierre Philip
- Service de Médecine Universitaire du sommeil, CHU de Bordeaux, Place Amélie Raba-Leon, Bordeaux, France; Université de Bordeaux, SANPSY UMR 6033, F-33000, Bordeaux, France
| | - Jean-Arthur Micoulaud-Franchi
- Service de Médecine Universitaire du sommeil, CHU de Bordeaux, Place Amélie Raba-Leon, Bordeaux, France; Université de Bordeaux, SANPSY UMR 6033, F-33000, Bordeaux, France.
| |
Collapse
|
3
|
Nurses’ Work Environment during the COVID-19 Pandemic in a Person-Centred Practice—A Systematic Review. SUSTAINABILITY 2022. [DOI: 10.3390/su14105785] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
The work environment and especially the psychosocial work environment influence the mental and physical well-being of employees. The aim of this study was to identify and analyse the state of knowledge regarding nurses’ work situation, health, and person-centred work during the COVID-19 pandemic through a systematic review. Methods: Systematic Review, nine included articles. The theoretical swAge model was used as the framework in a deductive content analysis. Results: The result was presented in the nine determinate areas from the swAge model and showed that all nine determinate areas of the swAge model were of importance to both the nurses’ sustainable work situation during the COVID-19 pandemic and to person-centred care. The COVID-19 pandemic has had a negative effect on nurses’ health, both physically but especially psychologically, with high levels of depression, anxiety, and burnout. Nurses experienced a lack of control and support from organizations. They had to work with limited resources and sometimes care for patients beyond their expertise. Conclusion: There is a further need for more studies that address person-centredness from an organisational perspective with the intention to develop strategies and measure activities on how to make the nurses’ work situation more sustainable, and to increase their ability to give more person-centred care.
Collapse
|
4
|
The association between Diabetes and Excessive Daytime Sleepiness among American adults aged 20-79 years: Findings from the 2015-2018 National Health and Nutrition Examination Surveys. Ann Epidemiol 2022; 68:54-63. [PMID: 35121113 DOI: 10.1016/j.annepidem.2022.01.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 01/04/2022] [Accepted: 01/25/2022] [Indexed: 11/24/2022]
Abstract
PURPOSE To examine the association between diabetes and EDS. METHODS Using the 2015-2018 cycles of the National Health and Nutrition Examination Survey, we applied survey-featured modified Poisson regression to estimate the association between diabetes and EDS among American adults aged 20-79 years, adjusting for confounding demographic, clinical and lifestyle variables. Effect modification by age, sex, race, education, income, sleep apnea and inadequate sleep was assessed. We performed sensitivity analyses using propensity score matched (PS) data and applied ordinal logistic regression using multiple levels of daytime sleepiness. Among people with diabetes, we assessed the association between EDS and diabetes-care variables. RESULTS Of the 6,289 participants, 895 (10%) had diabetes. The estimated prevalence of EDS was higher among adults with diabetes (30.6%) than counterparts without diabetes (26.3%). After adjusting for confounding variables, diabetes remained associated with EDS (aPR:1.20; 95%CI:1.06 1.36). There was no statistically significant effect modification. Sensitivity analyses confirmed our main results. Among people with diabetes, there was limited evidence that the diabetes-care variables were related to EDS. CONCLUSIONS Among American adults, diabetes is associated with EDS after controlling for confounding variables. Although the cross-sectional design is a limitation, our findings support further exploration of the role of diabetes in EDS.
Collapse
|
5
|
El-Mekkawy L, El Salmawy D, Basheer MA, Maher E, Nada MM. Screening of non-restorative sleep by quantitative EEG. THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2022. [DOI: 10.1186/s41983-022-00446-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Non-restorative sleep is the major cause of excessive daytime sleepiness and causes injures of the central nervous system. The most common cause of Excessive day sleepiness in a clinical setting is obstructive sleep apnea. Sleepiness scales can assess multiple aspects of the sleep and include subjective and objective measures. The present study aim to disclose the capability of quantitative electroencephalography to screen, as well as to know the pathogenesis of non-restorative sleep in patients with excessive day time sleepiness.
Results
Twenty obstructive sleep apnea patients and 20 healthy control subjects were recruited. All patients were subjected to Epworth sleepiness scale and polysomnography. Quantitative electroencephalography and Karolinska sleepiness scale were done before and after sleep for patients as well as controls. The patients group revealed a significant power reduction in delta and alpha bands, comparing before and after sleep records. Interestingly, there was a significant change in delta power in the temporal delta waves power. Yet, the changes were opposite among cases (significant decrease) versus controls (significant increase). In addition, there were significant correlations between sleepiness scales; Epworth sleepiness scale and Karolinska Sleepiness Scale scores, and alpha band results in quantitative electroencephalography.
Conclusion
Quantitative electroencephalography with further research, could provide us with clues to the pathogenesis of EDS and non-restorative sleep accompanying OSA and an objective screening tool.
Collapse
|
6
|
Zhao J, Kong Q, Wang M, Huang H, Zhou X, Guo Y, Zhang Y, Wu L, Yu Z, Luo X. Association of Excessive Daytime Sleepiness with Cerebral Small Vessel Disease in Community-Dwelling Older Adults. Nat Sci Sleep 2022; 14:765-773. [PMID: 35478722 PMCID: PMC9037722 DOI: 10.2147/nss.s357586] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Accepted: 04/05/2022] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Excessive daytime sleepiness (EDS) and cerebral small vessel disease (CSVD) are common problems among older adults; however, their association is not clear. The present study aimed to investigate the frequency of EDS in CSVD patients and the relationship between EDS and neuroimaging markers of CSVD. PATIENTS AND METHODS We conducted a cross-sectional study among 1076 community-dwelling older adults aged 55-85 years. EDS was measured using the Epworth Sleepiness Scale (ESS), and EDS was defined as an ESS score greater than 10. Binary logistic regression was performed to assess the association between EDS and neuroimaging markers of CSVD. RESULTS Of the 1076 participants (mean age: 65.58 ± 6.46 years, 60.5% female), the prevalence of EDS was 10.0%. EDS was more frequent in participants with CSVD than in the total sample (20.0% vs 10.0%, p <0.001). In fully adjusted models, EDS was significantly correlated with CSVD burden (OR = 1.39, 95% CI 1.16 to 1.68, p <0.001), the severity of white matter hyperintensities (WMH) (OR = 1.33, 95% CI 1.14 to 1.54, p <0.001), and presence of lacunes (OR = 2.47, 95% CI 1.53 to 4.00, p <0.001) but not with the presence of cerebral microbleeds (CMBs) (OR=1.54, 95% CI 0.92 to 2.56, p = 0.099) or severity of enlarged perivascular spaces (EPVS) in basal ganglia (OR = 1.16, 95% CI 0.70 to 1.92, p = 0.564). CONCLUSION We found a high frequency of EDS symptoms in CSVD individuals. Further, EDS was significantly associated with WMH, lacunes, and CSVD burden. Our findings further suggest patients with CSVD may exhibit abnormal sleep-wake patterns.
Collapse
Affiliation(s)
- Jing Zhao
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
| | - Qianqian Kong
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
| | - Minghuan Wang
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
| | - Hao Huang
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
| | - Xirui Zhou
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
| | - Yinping Guo
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
| | - Yi Zhang
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
| | - Lingshan Wu
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
| | - Zhiyuan Yu
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
| | - Xiang Luo
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
| |
Collapse
|
7
|
Uygun SD, Bilbay NT. Psychometric evaluation of the Turkish adaptation of the Epworth sleepiness scale for children and adolescents. CHILDRENS HEALTH CARE 2021. [DOI: 10.1080/02739615.2021.2000413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Sabide Duygu Uygun
- Department of Child and Adolescent Psychiatry, Ankara University School of Medicine, Ankara, Turkey
| | - Nedime Tuğçe Bilbay
- Department of Neurology, University of Health Sciences, Ankara Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| |
Collapse
|
8
|
Abudoureyimu R, Heizhati M, Wang L, Li M, Zhang D, Wang Z, Yang Z, Hong J, Li N. Lower 24-h urinary potassium excretion is negatively associated with excessive daytime sleepiness in the general population. Sleep Breath 2021; 26:733-741. [PMID: 34331198 DOI: 10.1007/s11325-021-02444-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 07/11/2021] [Accepted: 07/14/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES Uncertainty remains about the association of potassium (K) intake and sleepiness. Therefore, we aimed to explore the relationship between K excretion using 24-h urine samples and excessive daytime sleepiness (EDS) in the general population. METHODS In a cross-sectional study, we used multi-stage proportional random sampling to obtain a study sample aged ≥ 18 years from Emin, China between March and June 2019. We collected timed 24-h urine specimens and conducted EDS assessments using the Epworth Sleepiness Scale (ESS) questionnaire. Subjects were divided into two groups by the median of 24-h urinary potassium (24-h UK). EDS was defined as ESS score ≥ 10. Multi-variable linear regression was used to examine the association between the 24-h UK and the odds of prevalent EDS. We performed a sensitivity analysis by excluding subjects under anti-hypertensive treatment and those with sleep disordered breathing by the NoSAS scale. RESULTS A total of 470 participants with complete 24-h urine samples and ESS data (62% women, mean age 49.6 years, mean ESS score of 9.0 ± 5.2) were enrolled. The mean ESS score was significantly lower in the upper half of 24-h UK group than in the lower half (9.5 ± 5.3 vs 8.5 ± 5.1, P = 0.044), and accordingly, prevalent EDS was significantly greater in the lower half than in the higher half (49% vs 40%, P = 0.039). In further improving the propensity matching score, the results remained consistent with the overall results. In multiple linear regression, 24-h UK was negatively correlated with ESS score (β = - 0.180 (- 0.276, - 0.085), < 0.001). Sensitivity analysis demonstrated augmented results in those without anti-hypertensive treatment. CONCLUSION Lower potassium intake, as suggested by lower UK excretion, may be implicated in the presence of EDS in the general population.
Collapse
Affiliation(s)
- Reyila Abudoureyimu
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, National Health Committee Key Laboratory of Hypertension Clinical Research China, No. 91 Tianchi Road, Urumqi, 830001, Xinjiang, China
| | - Mulalibieke Heizhati
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, National Health Committee Key Laboratory of Hypertension Clinical Research China, No. 91 Tianchi Road, Urumqi, 830001, Xinjiang, China
| | - Lin Wang
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, National Health Committee Key Laboratory of Hypertension Clinical Research China, No. 91 Tianchi Road, Urumqi, 830001, Xinjiang, China
| | - Mei Li
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, National Health Committee Key Laboratory of Hypertension Clinical Research China, No. 91 Tianchi Road, Urumqi, 830001, Xinjiang, China
| | - Delian Zhang
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, National Health Committee Key Laboratory of Hypertension Clinical Research China, No. 91 Tianchi Road, Urumqi, 830001, Xinjiang, China
| | - Zhongrong Wang
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, National Health Committee Key Laboratory of Hypertension Clinical Research China, No. 91 Tianchi Road, Urumqi, 830001, Xinjiang, China
| | - Zhikang Yang
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, National Health Committee Key Laboratory of Hypertension Clinical Research China, No. 91 Tianchi Road, Urumqi, 830001, Xinjiang, China
| | - Jing Hong
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, National Health Committee Key Laboratory of Hypertension Clinical Research China, No. 91 Tianchi Road, Urumqi, 830001, Xinjiang, China
| | - Nanfang Li
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, National Health Committee Key Laboratory of Hypertension Clinical Research China, No. 91 Tianchi Road, Urumqi, 830001, Xinjiang, China.
| |
Collapse
|
9
|
Aljasem AA, Alsahafi WM, Aljubour AA, Alobaid AA, Binsaeed AA, Alshamoosi MS, Alsadoon RA, Alasmari YA, Khalifa AFM. Sleep pattern and dozing chance among university students. J Family Med Prim Care 2021; 9:6249-6253. [PMID: 33681072 PMCID: PMC7928132 DOI: 10.4103/jfmpc.jfmpc_941_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 08/31/2020] [Accepted: 10/12/2020] [Indexed: 11/15/2022] Open
Abstract
Background: Sleep is defined as a naturally occurring state of the body within a relatively inhibited sensory activity, reduced metabolic rate and decreased interaction with the surrounding. Impaired sleep affects students’ productivity, this area is not fully covered in the literature. Objectives: To assess sleep patterns and dozing chance among university students. Methods: Institutional based cross-sectional study, a sample of 145 male university students from Almaarefa University aged between 19 and 27 years old, chosen randomly. A self-administered questionnaire developed specifically for this study after consulting literature and epidemiologist. It includes data about the Epworth Sleepiness scale and GPA. Data were analyzed using (SPSS, version 22.0) and (P values of ≤0.05) considered significant. The consent was obtained before data collection. Results: The majority of respondents (62, 1%) reported sleeping time of 5-8 hours per night. To fall asleep at night 13, 1% of participants indicated needing soporific. Overall, only 36, 6% of students showed good sleep behaviors. Among respondents (44, 1%) had moderate chances of dozing and 2, 8% had high chances of dozing, There was no significant statistical relationship between academic performance and bedtime (P-value = 0,231). Conclusion: The majority of respondents had poor sleep quality and moderate to high dosing chance, also, most of the participants go to bed after midnight. In addition, one fifth of participants reported sleeping less than 8 hour per day.
Collapse
Affiliation(s)
- Abdullah A Aljasem
- Medical Intern, College of Medicine, AlMaarefa University, Ad Diriyah, Saudi Arabia
| | - Waseem M Alsahafi
- Medical Intern, College of Medicine, AlMaarefa University, Ad Diriyah, Saudi Arabia
| | - Ahmad A Aljubour
- Medical Intern, College of Medicine, AlMaarefa University, Ad Diriyah, Saudi Arabia
| | - Ahmed A Alobaid
- Medical Intern, College of Medicine, AlMaarefa University, Ad Diriyah, Saudi Arabia
| | - Abdullah A Binsaeed
- Medical Intern, College of Medicine, AlMaarefa University, Ad Diriyah, Saudi Arabia
| | | | - Rsheed A Alsadoon
- Medical Intern, College of Medicine, AlMaarefa University, Ad Diriyah, Saudi Arabia
| | - Yaser A Alasmari
- Medical Intern, College of Medicine, AlMaarefa University, Ad Diriyah, Saudi Arabia
| | - Amar F M Khalifa
- Assistant Professor of Community Medicine, College of Medicine, AlMaarefa University, Ad Diriyah, Saudi Arabia
| |
Collapse
|
10
|
Nada MM, Maher EA, Basheer MA, El-Mekkawy LA. Can electrophysiological tests be used as screening tools in detection of cognitive impairment in obstructive sleep apnea hypopnea syndrome? THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2020. [DOI: 10.1186/s41983-020-00163-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
One of the most prevalent sleep disorders is obstructive sleep apnea (OSA). Patients with OSA have increased risk of car and work place accidents which may be attributed to cognitive impairment due to poor sleep quality. Thus, there is an increasing need to implement simple, reliable and rapid screening for cognitive impairment in OSA patients.
Objectives
To assess auditory event-related potentials (ERPs) and quantitative electroencephalography (QEEG) as screening tools for detection of cognitive impairment in OSA patients taking circadian effects into consideration.
Subjects and methods
Twenty OSA patients as well as 20 gender- and age-matched volunteers were subjected to trail making test (TMT), auditory ERPs and QEEG before and after at least 6 h polysomnographic recording. Correlating electrophysiological tools with TMT and clinical parameters was done as well
Results
Statistically significant changes in P300 latency and reaction time, in addition to occipital alpha power were noted in cases; however, TMT failed to detect such changes. Electrophysiological results were not constantly correlated to clinical parameters.
Conclusion
Auditory ERPs and QEEG before and after polysomnography can be of benefit as cognitive screening test for suspected cognitive impairment in OSA patients.
Collapse
|
11
|
Association between Excessive Daytime Sleepiness and Risk of Cardiovascular Disease and All-Cause Mortality: A Systematic Review and Meta-Analysis of Longitudinal Cohort Studies. J Am Med Dir Assoc 2020; 21:1979-1985. [DOI: 10.1016/j.jamda.2020.05.023] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 05/09/2020] [Accepted: 05/14/2020] [Indexed: 01/16/2023]
|
12
|
Sharma S. Periodic Hyper Somnolence as Initial Presenting Manifestation of Nocturnal Frontal Lobe Epilepsy. Neurol India 2020; 68:710-712. [DOI: 10.4103/0028-3886.288982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
13
|
Kim KM, Kim J, Cho SJ, Kim WJ, Yang KI, Yun CH, Chu MK. Excessive Daytime Sleepiness in Tension-Type Headache: A Population Study. Front Neurol 2019; 10:1282. [PMID: 31849830 PMCID: PMC6901618 DOI: 10.3389/fneur.2019.01282] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 11/19/2019] [Indexed: 11/13/2022] Open
Abstract
Excessive daytime sleepiness (EDS) is a prevalent sleep-related complaint across the general population and has been reported to be associated with headache. Tension-type headache (TTH) is the most commonly encountered headache and accounts for a significant amount of disease burden. However, the association between EDS and TTH is currently scarce. In the present study, we investigated the impact of EDS on the prevalence and clinical presentation of TTH. We utilized data from the Korean Headache-Sleep Study, a national survey that sought to identify headache and sleep characteristics in Korean adults. Participants with an Epworth sleepiness scale score greater or equal to 11 were considered as having EDS. Of the 2,695 participants enrolled, 570 (21.2%) and 313 (11.6%) had TTH and EDS, respectively. EDS was highly prevalent in individuals with chronic tension-type headache (CTTH) than in those without headache (35.7 vs. 9.4%, p < 0.001). The prevalence of EDS in episodic tension-type headache (ETTH) individuals with a headache frequency <1 per month (8.3%, p = 0.511) and ETTH individuals with a headache frequency of 1-14 per month (13.5%, p = 0.054) was not significantly different from that in individuals without headache (9.4%). TTH participants with EDS had a higher headache frequency per month (4.3 ± 8.1 vs. 1.7 ± 4.2, p = 0.013), more severe headache intensity (Visual Analog Scale, 5.0 [3.0-6.0] vs. 4.0 [3.0-6.0], p = 0.008), a higher impact of headache (Headache Impact Test-6 score, 47.1 ± 7.3 vs. 43.5 ± 7.6, p < 0.001), and a higher prevalence of depression (12.7 vs. 3.2%, p < 0.001) than TTH participants without EDS. Consequently, CTTH is associated with higher EDS prevalence compared to ETTH and without headache. Moreover, TTH with EDS had more severe TTH symptoms compared to TTH without EDS.
Collapse
Affiliation(s)
- Kyung Min Kim
- Department of Neurology, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Jiyoung Kim
- Department of Neurology, Bio Medical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, South Korea
| | - Soo-Jin Cho
- Department of Neurology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, South Korea
| | - Won-Joo Kim
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Kwang Ik Yang
- Sleep Disorders Center, Department of Neurology, Soonchunhyang University College of Medicine, Cheonan Hospital, Cheonan, South Korea
| | - Chang-Ho Yun
- Department of Neurology, Bundang Clinical Neuroscience Institute, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Min Kyung Chu
- Department of Neurology, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| |
Collapse
|
14
|
Excessive daytime sleepiness in general hospital nurses: prevalence, correlates, and its association with adverse events. Sleep Breath 2018; 23:209-216. [DOI: 10.1007/s11325-018-1684-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Revised: 05/07/2018] [Accepted: 06/12/2018] [Indexed: 12/12/2022]
|
15
|
Liang T, Boulos MI, Murray BJ, Krishnan S, Katzberg H, Umapathy K. Detection of myasthenia gravis using electrooculography signals. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2016; 2016:896-899. [PMID: 28268468 DOI: 10.1109/embc.2016.7590845] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Myasthenia gravis (MG) is an autoimmune neuromuscular disorder resulting from skeletal muscle weakness and fatigue. An early common symptom is fatigable weakness of the extrinsic ocular muscles; if symptoms remain confined to the ocular muscles after a few years, this is classified as ocular myasthenia gravis (OMG). Diagnosis of MG when there are mild, isolated ocular symptoms can be difficult, and currently available diagnostic techniques are insensitive, non-specific or technically cumbersome. In addition, there are no accurate biomarkers to follow severity of ocular dysfunction in MG over time. Single-fiber electromyography (SFEMG) and repetitive nerve stimulation (RNS) offers a way of detecting and measuring ocular muscle dysfunction in MG, however, challenges of these methods include a poor signal to noise ratio in quantifying eye muscle weakness especially in mild cases. This paper presents one of the attempts to use the electric potentials from the eyes or electrooculography (EOG) signals but obtained from three different forms of sleep testing to differentiate MG patients from age- and gender-matched controls. We analyzed 8 MG patients and 8 control patients and demonstrated a difference in the average eye movements detected between the groups. A classification accuracy as high as 68.8% was achieved using a linear discriminant analysis based classifier.
Collapse
|
16
|
A Practical Approach to Excessive Daytime Sleepiness: A Focused Review. Can Respir J 2016; 2016:4215938. [PMID: 27445538 PMCID: PMC4904525 DOI: 10.1155/2016/4215938] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2015] [Revised: 03/25/2016] [Accepted: 04/21/2016] [Indexed: 11/24/2022] Open
Abstract
Excessive daytime sleepiness (EDS) is a common problem that is important to recognize and address. Initial steps in management are generally straightforward and only the most advanced cases would require referral to a subspecialist. Of particular concern is that of driving safety. There is a broad differential diagnosis for conditions contributing to EDS but a few common conditions account for the majority of clinical presentations. Subjective self-reporting will often lead to identification of potential problems, but this is often unreliable. Traditional neurophysiologic tests can help in objectively quantifying symptoms but current tests are not always practical clinically and may have little validation in real world situations. There are many treatment options that should generally be able to sufficiently manage most patients presenting with hypersomnolence. This review provides a practical clinical approach to the problem based on current guidelines.
Collapse
|
17
|
Spinal Taenia solium cysticercosis in Mexican and Indian patients: a comparison of 30-year experience in two neurological referral centers and review of literature. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2015; 25:1073-81. [PMID: 26474877 DOI: 10.1007/s00586-015-4271-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2015] [Revised: 09/30/2015] [Accepted: 09/30/2015] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To present a retrospective study from patients with spinal cysticercosis (SC), diagnosed within the last 30 years in Mexican and Indian neurological referral centers. METHODS This is a retrospective and comparative study of the clinical and radiological profile between Mexican and Indian patients with spinal neurocysticercosis during a 30-year period and a review of the literature during the same period. RESULTS Twenty-seven SC patients were included: 19 from Mexico and 8 from India. SC presented predominantly with motor symptoms (21/27 patients): paraparesis and paraplegia were the most common signs; one-third of patients presented sphincter dysfunction. Imaging studies showed that parasites in vesicular stage were more frequent in patients from Mexico, while degenerative stages predominated in India. Association of subarachnoid cysticerci and hydrocephalus was observed only in Mexican patients. CONCLUSIONS Despite the limitations of this study, the collected information supports the existence of differences in the clinical and radiological traits of SC patients between Asian and Latin-American hospitals. The possible biological factors that may underlie these differences are discussed.
Collapse
|
18
|
Loomis S, McCarthy A, Baxter C, Kellett DO, Edgar DM, Tricklebank M, Gilmour G. Distinct pro-vigilant profile induced in rats by the mGluR5 potentiator LSN2814617. Psychopharmacology (Berl) 2015; 232:3977-89. [PMID: 25902875 PMCID: PMC4600478 DOI: 10.1007/s00213-015-3936-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Accepted: 04/02/2015] [Indexed: 12/30/2022]
Abstract
While treatment options are available, excessive daytime sleepiness (EDS) remains a significant unmet medical need for many patients. Relatively little rodent behavioural pharmacology has been conducted in this context to assess potential pro-vigilant compounds for their ability to restore functional capacity following experimentally induced sleep loss. Male Wistar rats were prepared for electroencephalographic (EEG) recording and subject to 11 h of sleep restriction using a biofeedback-induced cage rotation protocol. A simple response latency task (SRLT) was used to behaviourally index sleep restriction and the effects of pro-vigilant compounds: modafinil, D-amphetamine, caffeine, and the mGlu5-positive allosteric modulator LSN2814617. Sleep restriction resulted in a consistent, quantified loss of non-rapid eye movement (NREM) and REM sleep that impaired SRLT performance in a manner suggestive of progressive task disengagement. In terms of EEG parameters, all compounds induced wakefulness. Amphetamine treatment further decreased SRLT performance capacity, whereas the other three compounds decreased omissions and allowed animals to re-engage in the task. Caffeine and modafinil also significantly increased premature responses during this period, an effect not observed for LSN2814617. While all compounds caused compensatory sleep responses, the magnitude of compensation observed for LSN2814617 was much smaller than would be predicted to result from the prolongation of wakefulness exhibited. Using simple response latencies to index performance, an mGlu5 PAM dramatically increased wakefulness and improved functional capacity of sleep-restricted animals, without eliciting a proportionate compensatory sleep response. This effect was qualitatively distinct from that of amphetamine, caffeine and modafinil.
Collapse
Affiliation(s)
- Sally Loomis
- Lilly Research Laboratories, Eli Lilly & Co. Ltd, Erl Wood Manor, Sunninghill Road, Windlesham, Surrey, GU20 6PH England UK
| | - Andrew McCarthy
- Lilly Research Laboratories, Eli Lilly & Co. Ltd, Erl Wood Manor, Sunninghill Road, Windlesham, Surrey, GU20 6PH England UK
| | - Christopher Baxter
- Lilly Research Laboratories, Eli Lilly & Co. Ltd, Erl Wood Manor, Sunninghill Road, Windlesham, Surrey, GU20 6PH England UK
| | - Daniel O. Kellett
- Lilly Research Laboratories, Eli Lilly & Co. Ltd, Erl Wood Manor, Sunninghill Road, Windlesham, Surrey, GU20 6PH England UK
| | - Dale M. Edgar
- Lilly Research Laboratories, Eli Lilly & Co. Ltd, Erl Wood Manor, Sunninghill Road, Windlesham, Surrey, GU20 6PH England UK
| | - Mark Tricklebank
- Lilly Research Laboratories, Eli Lilly & Co. Ltd, Erl Wood Manor, Sunninghill Road, Windlesham, Surrey, GU20 6PH England UK
| | - Gary Gilmour
- Lilly Research Laboratories, Eli Lilly & Co. Ltd, Erl Wood Manor, Sunninghill Road, Windlesham, Surrey, GU20 6PH, England, UK.
| |
Collapse
|
19
|
Gangwisch JE, Rexrode K, Forman JP, Mukamal K, Malaspina D, Feskanich D. Daytime sleepiness and risk of coronary heart disease and stroke: results from the Nurses' Health Study II. Sleep Med 2014; 15:782-8. [PMID: 24841111 PMCID: PMC4078727 DOI: 10.1016/j.sleep.2014.04.001] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2013] [Revised: 03/25/2014] [Accepted: 04/01/2014] [Indexed: 12/22/2022]
Abstract
OBJECTIVE The objective of this study was to determine whether daytime sleepiness is independently associated with coronary heart disease (CHD) and stroke or whether the positive association is explained by short sleep duration, disturbed sleep, and circadian disruption, conditions that are associated with cardiometabolic risk factors for vascular events. METHODS Longitudinal analyses of data from the Nurses' Health Study II comprising 84,003 female registered nurses aged 37-54 at baseline were conducted in 2001 with follow-up until 2009. Multivariate Cox regression was used to explore the relationship between reported daytime sleepiness and the incidence of either CHD or stroke (n=500 cases). RESULTS Women who reported daytime sleepiness almost every day, compared with rarely/never, had an elevated adjusted risk of cardiovascular disease (CVD) (hazard ratio (HR)=1.58, 95% confidence interval (CI) 1.15-2.17). Controlling for sleep variables (sleep duration, snoring, shift work, and sleep adequacy) or potential metabolic biological mediators of disrupted sleep (diabetes, hypercholesterolemia, and hypertension) appreciably attenuated the relationship (HR=1.17, 95% CI 0.84-1.65; and HR=1.34, 95% CI 0.97-1.85, respectively). Controlling for both sleep variables and metabolic risk factors eliminated an independent association (HR=1.09, 95% CI 0.77-1.53). A similar pattern was observed for CHD and stroke individually. CONCLUSIONS Daytime sleepiness was not an independent risk factor for CVD in this cohort of women, but rather, was associated with sleep characteristics and metabolic abnormalities that are risk factors for CVD.
Collapse
Affiliation(s)
- James E Gangwisch
- Columbia University, College of Physicians and Surgeons, Department of Psychiatry, New York, NY, USA.
| | - Kathryn Rexrode
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Brigham and Women's Hospital, Department of Medicine, Division of Preventive Medicine, Boston, MA, USA
| | - John P Forman
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Brigham and Women's Hospital, Department of Medicine, Renal Division, Boston, MA, USA; Harvard School of Public Health, Department of Epidemiology, Boston, MA, USA
| | - Kenneth Mukamal
- Beth Israel Deaconess Medical Center, Department of Medicine and Harvard Medical School, Boston, MA, USA
| | - Dolores Malaspina
- New York University Langone Medical Center, Department of Psychiatry, New York, NY, USA
| | - Diane Feskanich
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| |
Collapse
|
20
|
Cheng JY, Wallace DM, Lopez MR, Carrazana EJ. Nocturnal frontal lobe epilepsy presenting as excessive daytime sleepiness. J Family Med Prim Care 2014; 2:101-3. [PMID: 24479058 PMCID: PMC3894023 DOI: 10.4103/2249-4863.109969] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Excessive daytime sleepiness (EDS) is common in the general population. Etiologies include insufficient sleep and primary sleep disorders. Due to its high prevalence, physicians often overlook EDS as a significant problem. However, EDS may also be the presenting symptom of seizures, in particular Nocturnal Frontal Lobe Epilepsy (NFLE). Due to the clinical similarity between the nocturnal behaviors of NFLE and parasomnias, and poor patient-related history, NFLE remains a challenging diagnosis. We report the case of a patient with NFLE who presented with a primary complaint of EDS, and discuss the differential diagnosis and evaluation of patients with EDS associated with nocturnal behaviors. In the context of a patient presenting with EDS and stereotyped nocturnal events, clinical suspicion should be high for NFLE.
Collapse
Affiliation(s)
- Jocelyn Y Cheng
- Department of Neurology, University of Miami, USA ; Department of Neurology, Drexel University College of Medicine, USA
| | | | | | | |
Collapse
|
21
|
Burkhalter H, Wirz-Justice A, Cajochen C, Weaver TE, Steiger J, Fehr T, Venzin RM, De Geest S. Daytime sleepiness in renal transplant recipients is associated with immunosuppressive non-adherence: a cross-sectional, multi-center study. Clin Transplant 2013; 28:58-66. [PMID: 24325281 DOI: 10.1111/ctr.12279] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/14/2013] [Indexed: 11/26/2022]
Abstract
BACKGROUND The aims of this study were to determine the prevalence of immunosuppressive non-adherence (NA) in renal transplant patients and describe whether the degree of daytime sleepiness (DS) and depressive symptomatology are associated with immunosuppressive NA. METHODS Using a cross-sectional design, 926 home-dwelling renal transplant recipients who were transplanted at one of three Swiss transplant centers provided data by self-report. The Basel Assessment of Adherence Scale for immunosuppressive was used to measure the following: taking, timing, and overall NA to immunosuppressive medication. DS was assessed with the Epworth Sleepiness Scale (ESS) (cut-off ≥6 for DS) and the Swiss Transplant Cohort Study DS item (cut-off ≥4 for DS), and depressive symptomatology was assessed with the Depression, Anxiety, and Stress Scale (cut-off>10). An ordinal logistical regression model was applied for statistical analysis. RESULTS The prevalence of the ESS-DS was 51%. NA for taking, timing, and the median overall NA level assessed by 0-100% visual analog scale (VAS) was 16%, 42%, and 0%, respectively. Based on the multivariate analysis, DS was significantly associated (p < 0.001) with taking (1.08 [1.04-1.13]), timing (1.07 [1.03-1.10]), and overall NA (1.09 [1.05-1.13]). Very similar results were found for the Swiss Transplant Cohort Study DS item. CONCLUSION DS is associated with immunosuppressive medication NA in renal transplant recipients. Admittedly, the association's strength is limited.
Collapse
Affiliation(s)
- Hanna Burkhalter
- Institute of Nursing Science, University of Basel, Basel, Switzerland; Division of Transplant Immunology and Nephrology, University Hospital Basel, Basel, Switzerland
| | | | | | | | | | | | | | | |
Collapse
|
22
|
Lee YT, Tsai CF, Ouyang WC, Yang AC, Yang CH, Hwang JP. Daytime sleepiness: a risk factor for poor social engagement among the elderly. Psychogeriatrics 2013; 13:213-20. [PMID: 24289462 DOI: 10.1111/psyg.12020] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2011] [Revised: 08/13/2012] [Accepted: 04/29/2013] [Indexed: 11/29/2022]
Abstract
BACKGROUND The aim of this study was to investigate the relationship between social engagement and daytime sleepiness among aged residents of a veterans' housing facility in Taiwan. METHODS A total of 597 men were enrolled in this cross-sectional study. Each subject was assessed with the Resident Assessment Instrument-Minimum Data Set, Geriatric Depression Scale, Pittsburgh Sleep Quality Index, and Mini-Mental State Examination. Social engagement was measured with the Index of Social Engagement (ISE), and daytime sleepiness was defined according to the relevant Pittsburgh Sleep Quality Index subcomponent. Subjects were divided into two groups according to their ISE levels. A multivariate logistic regression model was used to examine the association between ISE and other variables. RESULTS The sample's mean age was 80.8 ± 5.0 years (range: 65-99 years). Mean ISE score was 1.5 ± 1.3 (range 0-5), with 52% of participants reporting poor social engagement (ISE = 0-1). Mean Pittsburgh Sleep Quality Index global score was 5.6 ± 3.6 (range: 0-18), and 31% of participants reported daytime sleepiness. The analysis was adjusted for level of depression, cognitive impairment, dependence in activities of daily life, unsettled relationships, and illiteracy. After adjustment, daytime sleepiness was found to be independently associated with subjects' level of social engagement (odds ratio: 2.5; 95% confidence interval: 1.7-3.8; P < 0.001). CONCLUSIONS Daytime sleepiness and poor social engagement are common among aged residents of a veterans' housing facility. Subjects experiencing daytime sleepiness but not poor general sleep quality were at increased risk of poor social engagement. The clinical care of older residents must focus on improving daytime sleepiness to enhance their social engagement.
Collapse
Affiliation(s)
- Yao-Tung Lee
- Department of Psychiatry, Taipei Veterans General Hospital, New Taipei City, Taiwan; Department of Psychiatry, Shuang Ho Hospital, New Taipei City, Taiwan
| | | | | | | | | | | |
Collapse
|
23
|
Herring WJ, Liu K, Hutzelmann J, Snavely D, Snyder E, Ceesay P, Lines C, Michelson D, Roth T. Alertness and psychomotor performance effects of the histamine-3 inverse agonist MK-0249 in obstructive sleep apnea patients on continuous positive airway pressure therapy with excessive daytime sleepiness: a randomized adaptive crossover study. Sleep Med 2013; 14:955-63. [DOI: 10.1016/j.sleep.2013.04.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2012] [Revised: 03/20/2013] [Accepted: 04/11/2013] [Indexed: 11/15/2022]
|
24
|
Poli F, Overeem S, Lammers GJ, Plazzi G, Lecendreux M, Bassetti CL, Dauvilliers Y, Keene D, Khatami R, Li Y, Mayer G, Nohynek H, Pahud B, Paiva T, Partinen M, Scammell TE, Shimabukuro T, Sturkenboom M, van Dinther K, Wiznitzer M, Bonhoeffer J. Narcolepsy as an adverse event following immunization: Case definition and guidelines for data collection, analysis and presentation. Vaccine 2013; 31:994-1007. [PMID: 23246545 DOI: 10.1016/j.vaccine.2012.12.014] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2012] [Accepted: 12/05/2012] [Indexed: 01/11/2023]
Affiliation(s)
- Francesca Poli
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
25
|
MacGregor KL, Funderburk JS, Pigeon W, Maisto SA. Evaluation of the PHQ-9 Item 3 as a screen for sleep disturbance in primary care. J Gen Intern Med 2012; 27:339-44. [PMID: 21948205 PMCID: PMC3286572 DOI: 10.1007/s11606-011-1884-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2011] [Revised: 07/29/2011] [Accepted: 08/31/2011] [Indexed: 12/14/2022]
Abstract
BACKGROUND Sleep disturbance is a significant problem for adults presenting to primary care. Though it is recommended that primary care providers screen for sleep problems, a brief, effective screening tool is not available. OBJECTIVE The aim of this preliminary study was to test the utility of item three of the Patient Health Questionnaire-9-item (PHQ-9) as a self-report screening test for sleep disturbance in primary care. DESIGN This was a cross-sectional survey of male VA primary care patients in Syracuse and Rochester, NY. Sensitivity and specificity statistics were calculated as well as positive and negative predictive value to determine both whether the PHQ-9 item-3 can be used as an effective sleep screen in primary care and at what PHQ item-3 cut score patients should be further assessed for sleep disturbance. PARTICIPANTS One hundred and eleven male, VA primary care patients over the age of 18 and without gross neurological impairment participated in this one-session, in-person study. MEASURES During the research session, patients completed several questionnaires, including a basic demographic questionnaire, the PHQ-9, and the Insomnia Severity Index (ISI). KEY RESULTS PHQ-9 item 3 significantly correlated with the total score on the ISI (r = 0.75, p < 0.0001). A cut score of 1 on the PHQ-9 item 3, indicating sleep disturbance at least several days in the last two weeks, showed the best balance of sensitivity (82.5%) and specificity (84.5%) as well as positive (78.4%) and negative (91%) predictive value. CONCLUSIONS Item 3 of the PHQ-9 shows promise as a screener for sleep problems in primary care. Using this one-item of a popular screening measure for depression in primary care allows providers to easily screen for two important issues without unnecessarily adding significant burden.
Collapse
Affiliation(s)
- Kristin L MacGregor
- Department of Psychology, Syracuse University, 430 Huntington Hall, Syracuse, NY 13244, USA.
| | | | | | | |
Collapse
|
26
|
Abstract
PURPOSE OF REVIEW Recently published literature indicates that sleep disorders present with medical comorbidities quite frequently. The coexistence of a sleep disorder with a medical disorder has a substantial impact for both the patient and the health system. RECENT FINDINGS Insomnia and hypersomnia are highly comorbid with medical conditions, such as chronic pain and diabetes, as well as with various cardiovascular, respiratory, gastrointestinal, urinary and neurological disorders. Restless legs syndrome and periodic leg movement syndrome have been associated with iron deficiency, kidney disease, diabetes, and neurological, autoimmune, cardiovascular and respiratory disorders. Rapid eye movement behaviour disorder has been described as an early manifestation of serious central nervous system diseases; thus, close neurological monitoring of patients referring with this complaint is indicated. SUMMARY Identification and management of any sleep disorder in medical patients is important for optimizing the course and prognosis. Of equal importance is the search for undetected medical disorder in patients presenting with sleep disorders.
Collapse
|
27
|
Abstract
Narcolepsy is a lifelong sleep disorder characterized by a classic tetrad of excessive daytime sleepiness with irresistible sleep attacks, cataplexy (sudden bilateral loss of muscle tone), hypnagogic hallucination, and sleep paralysis. There are two distinct groups of patients, ie, those having narcolepsy with cataplexy and those having narcolepsy without cataplexy. Narcolepsy affects 0.05% of the population. It has a negative effect on the quality of life of its sufferers and can restrict them from certain careers and activities. There have been advances in the understanding of the pathogenesis of narcolepsy. It is thought that narcolepsy with cataplexy is secondary to loss of hypothalamic hypocretin neurons in those genetically predisposed to the disorder by possession of human leukocyte antigen DQB1*0602. The diagnostic criteria for narcolepsy are based on symptoms, laboratory sleep tests, and serum levels of hypocretin. There is no cure for narcolepsy, and the present mainstay of treatment is pharmacological treatment along with lifestyle changes. Some novel treatments are also being developed and tried. This article critically appraises the evidence for diagnosis and treatment of narcolepsy.
Collapse
|