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Rayward L, Ho SWK, Green D, Little JP. Sleep disruption and sleep position: Increased wake frequency in supine predicts lateral position preference. J Sleep Res 2024:e14325. [PMID: 39191505 DOI: 10.1111/jsr.14325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2024] [Revised: 08/11/2024] [Accepted: 08/12/2024] [Indexed: 08/29/2024]
Abstract
Little is known about the physiological and biomechanical factors that determine individual preferences in lying posture during sleep. This study investigated relationships between position preference and position-specific arousals, awakenings, limb movements and limb movement arousals to explore the mechanisms by which biomechanical factors influence position preference. Forty-one mature-aged adults underwent 2 nights of at-home polysomnography ~2 weeks apart, on a standardised firm foam mattress, measuring nocturnal sleep architecture and position. The lateral supine ratio and restlessness indices specific to lateral and supine positions including limb movement index, limb movement arousal index, arousal index, wake index, respiratory arousal index and apnea-hypopnea index were calculated and analysed via linear mixed-effects regression. In the supine position, all restlessness indices were significantly increased compared with the lateral position, including a 379% increase in respiratory arousals (β = 7.0, p < 0.001), 108% increase in arousal index (β = 10.3, p < 0.001) and 107% increase in wake index (β = 2.5, p < 0.001). Wake index in the supine position increased significantly with more lateral sleep (β = 1.9, p = 0.0013), and significant correlation between lateral supine ratio polysomnography 1 and lateral supine ratio polysomnography 2 (β = 0.95, p < 0.001) indicated strong consistency in sleep preference. Overall, the findings suggest that some individuals have low tolerance to supine posture, represented by a comparatively high wake index in the supine position, and that these individuals compensate by sleeping a greater proportion in the lateral position.
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Affiliation(s)
- Lionel Rayward
- Centre for Biomechanics and Sleep Research, Queensland University of Technology, Brisbane, Australia
| | - Selina W K Ho
- Centre for Biomechanics and Sleep Research, Queensland University of Technology, Brisbane, Australia
| | | | - J Paige Little
- Centre for Biomechanics and Sleep Research, Queensland University of Technology, Brisbane, Australia
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Gao Y, Zhang J, Zou C, Bi L, Huang C, Nie J, Yan Y, Yu X, Zhang F, Yao F, Ding L. A method for calculating vector forces at human-mattress interface during sleeping positions utilizing image registration. Sci Rep 2024; 14:15238. [PMID: 38956282 PMCID: PMC11220148 DOI: 10.1038/s41598-024-66035-8] [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: 03/25/2024] [Accepted: 06/26/2024] [Indexed: 07/04/2024] Open
Abstract
The vector forces at the human-mattress interface are not only crucial for understanding the distribution of vertical and shear forces exerted on the human body during sleep but also serves as a significant input for biomechanical models of sleeping positions, whose accuracy determines the credibility of predicting musculoskeletal system loads. In this study, we introduce a novel method for calculating the interface vector forces. By recording indentations after supine and lateral positions using a vacuum mattress and 3D scanner, we utilize image registration techniques to align body pressure distribution with the mattress deformation scanning images, thereby calculating the vector force values for each unit area (36.25 mm × 36.25 mm). This method was validated through five participants attendance from two perspectives, revealing that (1) the mean summation of the vertical force components is 98.67% ± 7.21% body weight, exhibiting good consistency, and mean ratio of horizontal component force to body weight is 2.18% ± 1.77%. (2) the predicted muscle activity using the vector forces as input to the sleep position model aligns with the measured muscle activity (%MVC), with correlation coefficient over 0.7. The proposed method contributes to the vector force distribution understanding and the analysis of musculoskeletal loads during sleep, providing valuable insights for mattress design and evaluation.
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Affiliation(s)
- Ying Gao
- Beijing Advanced Innovation Center for Biomedical Engineering, Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, Beijing, 100191, China
| | - Jing Zhang
- Beijing Advanced Innovation Center for Biomedical Engineering, Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, Beijing, 100191, China
| | - Chengzhao Zou
- Beijing Advanced Innovation Center for Biomedical Engineering, Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, Beijing, 100191, China
| | - Liwen Bi
- Beijing Advanced Innovation Center for Biomedical Engineering, Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, Beijing, 100191, China
| | - Chengzhen Huang
- Beijing Advanced Innovation Center for Biomedical Engineering, Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, Beijing, 100191, China
| | - Jiachen Nie
- Beijing Advanced Innovation Center for Biomedical Engineering, Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, Beijing, 100191, China
| | - Yongli Yan
- Beijing Advanced Innovation Center for Biomedical Engineering, Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, Beijing, 100191, China
| | - Xinli Yu
- Beijing Advanced Innovation Center for Biomedical Engineering, Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, Beijing, 100191, China
| | - Fujun Zhang
- De Rucci Healthy Sleep Co., Ltd, Dongguan, 523960, Guangdong, China
| | - Fanglai Yao
- De Rucci Healthy Sleep Co., Ltd, Dongguan, 523960, Guangdong, China
| | - Li Ding
- Beijing Advanced Innovation Center for Biomedical Engineering, Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, Beijing, 100191, China.
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Grandner MA, Valencia DY, Seixas AA, Oliviér K, Gallagher RA, Killgore WDS, Hale L, Branas C, Alfonso-Miller P. Development and Initial Validation of the Assessment of Sleep Environment (ASE): Describing and Quantifying the Impact of Subjective Environmental Factors on Sleep. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13599. [PMID: 36294179 PMCID: PMC9602531 DOI: 10.3390/ijerph192013599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 10/17/2022] [Accepted: 10/18/2022] [Indexed: 06/16/2023]
Abstract
The purpose of this study was to develop and test the reliability and validity of a 13-item self-report Assessment of Sleep Environment (ASE). This study investigates the relationship between subjective experiences of environmental factors (light, temperature, safety, noise, comfort, humidity, and smell) and sleep-related parameters (insomnia symptoms, sleep quality, daytime sleepiness, and control over sleep). The ASE was developed using an iterative process, including literature searches for item generation, qualitative feedback, and pilot testing. It was psychometrically assessed using data from the Sleep and Healthy Activity Diet Environment and Socialization (SHADES) study (N = 1007 individuals ages 22-60). Reliability was determined with an internal consistency and factor analysis. Validity was evaluated by comparing ASE to questionnaires of insomnia severity, sleep quality, daytime sleepiness, sleep control, perceived stress, and neighborhood disorder. The ASE demonstrated high internal consistency and likely reflects a single factor. ASE score was associated with insomnia symptoms (B = 0.09, p < 0.0001), sleep quality (B = 0.07, p < 0.0001), and sleep control (B = -0.01, p < 0.0001), but not daytime sleepiness. The ASE was also associated with perceived stress (B = 0.20, p < 0.0001) and neighborhood disorder (B = -0.01, p < 0.0001). Among sleep environment factors, only smell was not associated with sleep quality; warmth and safety were negatively associated with sleepiness; and of the sleep environment factors, only light/dark, noise/quiet, and temperature (warm/cool) were not associated with insomnia symptoms. The ASE is a reliable and valid measure of sleep environment. Physical environment (light, temperature, safety, noise, comfort, humidity, and smell) was associated with insomnia symptoms and sleep quality but not sleepiness.
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Affiliation(s)
- Michael A. Grandner
- Sleep and Health Research Program, Department of Psychiatry, University of Arizona, Tucson, AZ 85724, USA
| | - Dora Y. Valencia
- Sleep and Health Research Program, Department of Psychiatry, University of Arizona, Tucson, AZ 85724, USA
| | - Azizi A. Seixas
- Department of Population Health, NYU Langone Medical Center, New York, NY 10016, USA
| | - Kayla Oliviér
- Sleep and Health Research Program, Department of Psychiatry, University of Arizona, Tucson, AZ 85724, USA
| | - Rebecca A. Gallagher
- Center for Sleep and Circadian Neurobiology, University of Pennsylvania, Philadelphia, PA 19104, USA
| | | | - Lauren Hale
- Department of Family, Population, and Preventive Medicine, Program in Public Health, Stony Brook University, Stony Brook, NY 11794, USA
| | - Charles Branas
- Department of Epidemiology, Columbia University, New York, NY 10032, USA
| | - Pamela Alfonso-Miller
- Northumbria Sleep Research, Department of Psychology, Northumbria University, Newcastle upon Tyne NE1 8ST, UK
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Hong TTH, Wang Y, Wong DWC, Zhang G, Tan Q, Chen TLW, Zhang M. The Influence of Mattress Stiffness on Spinal Curvature and Intervertebral Disc Stress-An Experimental and Computational Study. BIOLOGY 2022; 11:1030. [PMID: 36101411 PMCID: PMC9311775 DOI: 10.3390/biology11071030] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 06/30/2022] [Accepted: 06/30/2022] [Indexed: 06/15/2023]
Abstract
Sleeping support systems can influence spinal curvature, and the misalignment of the spinal curvature can lead to musculoskeletal problems. Previous sleep studies on craniocervical support focused on pillow variants, but the mattress supporting the pillow has rarely been considered. This study used a cervical pillow and three mattresses of different stiffnesses, namely soft, medium, and hard, with an indentation load deflection of 20, 42, and 120 lbs, respectively. A novel electronic curvature measurement device was adopted to measure the spinal curvature, whereby the intervertebral disc loading was computed using the finite element method. Compared with the medium mattress, the head distance increased by 30.5 ± 15.9 mm, the cervical lordosis distance increased by 26.7 ± 14.9 mm, and intervertebral disc peak loading increased by 49% in the soft mattress environment. Considering that the pillow support may increase when using a soft mattress, a softer or thinner pillow is recommended. The head distance and cervical lordosis distance in the hard mattress environment were close to the medium mattress, but the lumbar lordosis distance reduced by 10.6 ± 6.8 mm. However, no significant increase in intervertebral disc loading was observed, but contact pressure increased significantly, which could cause discomfort and health problems.
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Affiliation(s)
- Tommy Tung-Ho Hong
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China; (T.T.-H.H.); (Y.W.); (D.W.-C.W.); (G.Z.); (Q.T.); (T.L.-W.C.)
| | - Yan Wang
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China; (T.T.-H.H.); (Y.W.); (D.W.-C.W.); (G.Z.); (Q.T.); (T.L.-W.C.)
- The Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen 518057, China
| | - Duo Wai-Chi Wong
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China; (T.T.-H.H.); (Y.W.); (D.W.-C.W.); (G.Z.); (Q.T.); (T.L.-W.C.)
- The Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen 518057, China
| | - Guoxin Zhang
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China; (T.T.-H.H.); (Y.W.); (D.W.-C.W.); (G.Z.); (Q.T.); (T.L.-W.C.)
| | - Qitao Tan
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China; (T.T.-H.H.); (Y.W.); (D.W.-C.W.); (G.Z.); (Q.T.); (T.L.-W.C.)
| | - Tony Lin-Wei Chen
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China; (T.T.-H.H.); (Y.W.); (D.W.-C.W.); (G.Z.); (Q.T.); (T.L.-W.C.)
| | - Ming Zhang
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China; (T.T.-H.H.); (Y.W.); (D.W.-C.W.); (G.Z.); (Q.T.); (T.L.-W.C.)
- The Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen 518057, China
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Caggiari G, Talesa GR, Toro G, Jannelli E, Monteleone G, Puddu L. What type of mattress should be chosen to avoid back pain and improve sleep quality? Review of the literature. J Orthop Traumatol 2021; 22:51. [PMID: 34878594 PMCID: PMC8655046 DOI: 10.1186/s10195-021-00616-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 11/27/2021] [Indexed: 02/08/2023] Open
Abstract
Energy spent during daily activities is recuperated by humans through sleep, ensuring optimal performance on the following day. Sleep disturbances are common: a meta-analysis on sleep quality showed that 15–30% of adults report sleep disorders, such as sleep onset latency (SOL), insufficient duration of sleep and frequently waking up at night. Low back pain (LBP) has been identified as one of the main causes of poor sleep quality. Literature findings are discordant on the type of mattress that might prevent onset of back pain, resulting in an improved quality of sleep. We conducted a systematic literature review of articles published until 2019, investigating the association of different mattresses with sleep quality and low back pain. Based on examined studies, mattresses were classified according to the European Committee for Standardization (2000) as: soft, medium-firm, extra-firm or mattresses customized for patients affected by supine decubitus. A total of 39 qualified articles have been included in the current systematic review. Results of this systematic review show that a medium-firm mattress promotes comfort, sleep quality and rachis alignment.
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Affiliation(s)
- Gianfilippo Caggiari
- Orthopaedic and Traumatology Department, Università degli Studi di Sassari, 07100, Sassari, Italy.
| | - Giuseppe Rocco Talesa
- Orthopaedic and Traumatologic Clinic, University of Perugia, Santa Maria della Misericordia Hospital, 06129, Perugia, Italy
| | - Giuseppe Toro
- Department of Medical and Surgical Specialties and Dentistry, University of Campania "Luigi Vanvitelli", 80138, Naples, Italy
| | - Eugenio Jannelli
- Department of Orthopaedics and Traumatology, Fondazione Policlinico IRCCS San Matteo, University of Pavia, 27100, Pavia, Italy
| | - Gaetano Monteleone
- Orthopaedic, Trauma and Spine Unit, Department of Basic Medical Sciences, Neuroscience and Sense Organs, School of Medicine, AOU Policlinico Consorziale, University of Bari "Aldo Moro", 70100, Bari, Italy
| | - Leonardo Puddu
- Orthopaedic and Traumatology Department, Rovereto - Arco Hospital, 38068, Rovereto, Italy
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Pillow Support Model with Partitioned Matching Based on Body Pressure Distribution Matrix. Healthcare (Basel) 2021; 9:healthcare9050571. [PMID: 34066098 PMCID: PMC8151739 DOI: 10.3390/healthcare9050571] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 05/05/2021] [Accepted: 05/06/2021] [Indexed: 11/17/2022] Open
Abstract
(1) Objective: Sleep problems have become one of the current serious public health issues. The purpose of this research was to construct an ideal pressure distribution model for head and neck support through research on the partitioned support surface of a pillow in order to guide the development of ergonomic pillows. (2) Methods: Seven typical memory foam pillows were selected as samples, and six subjects were recruited to carry out a body pressure distribution experiment. The average value of the first 10% of the samples in the comfort evaluation was calculated to obtain the relative ideal body pressure distribution matrix. Fuzzy clustering was performed on the ideal matrix to obtain the support surface partition. The ideal body pressure index of each partition was calculated, and a hierarchical analysis of each partition was then performed to determine the pressure sensitivity weight of each partition. Using these approaches, the key ergonomic node coordinates of the partitions of four different groups of people were extracted. The ergonomic node coordinates and the physical characteristics of the material were used to design a pillow prototype. Five subjects were recruited for each of the four groups to repeat the body pressure distribution experiment to evaluate the pillow prototype. (3) Results: An ideal support model with seven partitions, including three partitions in the supine position and four partitions in the lateral position, was constructed. The ideal body pressure distribution matrix and ideal body pressure indicators and pressure sensitivity weights for each partition were provided. The pillow that was designed and manufactured based on this model reproduced the ideal pressure distribution matrix evaluated by various groups of people. (4) Conclusion: The seven-partition ideal support model can effectively describe the head and neck support requirements of supine and lateral positions, which can provide strong support for the development of related products.
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Hamanishi S. Cardboard Bed Without Mattress Is Ineffective in Improving the body Contact Pressure-a Preliminary Study Using a Dummy Model. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2021; 58:469580211065693. [PMID: 34918577 PMCID: PMC8721681 DOI: 10.1177/00469580211065693] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
OBJECTIVE This study aimed to describe and evaluate the dispersion of body-mattress contact pressure on a cardboard bed and investigate whether the cardboard bed has a positive effect on evacuees' musculoskeletal burden. MATERIALS AND METHODS A high-performance nursing simulator was used to measure the contact pressure and the body surface contour area of the bed, and these values were collected with the patient in the supine position using the Body Pressure Measurement System. Data of each test were acquired 10 times and were compared among 4 conditions (plastic sheet, cardboard bed, cardboard bed with a blanket, and cardboard bed with a mattress-topper). The data analysis for body-mattress contacts pressure and the surface contour area of the whole body, head, chest, and buttocks were conducted by one-way repeated analysis of variance and Bonferroni post-hoc test. RESULTS The average body-contact pressure on the cardboard bed did not decrease compared with that on the floor with plastic sheets. In contrast, the body surface contour area was significantly different among any other conditions, but the gap was only approximately 16%. However, the body-contact pressure and the body surface contour area were improved when a mattress-topper was added on the cardboard bed. When a blanket was laid on the cardboard bed, the contact area was increased. CONCLUSION Our results indicate that the pressure dispersion ability of the cardboard bed was not sufficient; however, adding the mattress-topper or the blanket could contribute to an improvement in the evacuees' musculoskeletal burden. Many evacuees lay a mattress topper or futon on a cardboard bed after installing cardboard beds. Our findings may also support the scientific validity of the evacuees' actual sleeping style in Japan. This preliminary study provides the basis for future research on exploring an appropriate sleeping bed condition in evacuee shelters.
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Affiliation(s)
- Seiji Hamanishi
- Seiji Hamanishi, Fundamental Nursing, Nursing Faculty, Kansai University of Social Welfare, Shinden380-3, Ako-6780255, Japan.
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Kayaba M, Ogata H, Park I, Ishihara A, Kawana F, Kokubo T, Fukusumi S, Hayashi M, Tokuyama K, Yanagisawa M, Satoh M. Improvement of Slow Wave Sleep Continuity by Mattress with Better Body Pressure Dispersal. SLEEP MEDICINE RESEARCH 2019. [DOI: 10.17241/smr.2019.00423] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Wong DWC, Wang Y, Lin J, Tan Q, Chen TLW, Zhang M. Sleeping mattress determinants and evaluation: a biomechanical review and critique. PeerJ 2019; 7:e6364. [PMID: 30701143 PMCID: PMC6348954 DOI: 10.7717/peerj.6364] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Accepted: 12/30/2018] [Indexed: 11/20/2022] Open
Abstract
Background Sleeping mattress parameters significantly influence sleeping comfort and health, as reflected by the extensive investigations of sleeping support biomechanics to prevent sleep-related musculoskeletal problems. Methodology Herein, we review the current trends, research methodologies, and determinants of mattress biomechanics research, summarizing evidence published since 2008. In particular, we scrutinize 18 articles dealing with the development of new designs, recommendation criteria, instruments/methods of spine alignment evaluation, and comparative evaluation of different designs. Results The review demonstrated that mattress designs have strived for customization, regional features, and real-time active control to adapt to the biomechanical features of different body builds and postures. However, the suggested threshold or target values for desirable spine alignment and body pressure distribution during sleep cannot yet be justified in view of the lack of sufficient evidence. Conclusions It is necessary to formulate standard objectives and protocols for carrying out mattress evaluation.
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Affiliation(s)
- Duo Wai-Chi Wong
- Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen, China.,Department of Biomedical Engineering, Hong Kong Polytechnic University, Hong Kong, China
| | - Yan Wang
- Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen, China.,Department of Biomedical Engineering, Hong Kong Polytechnic University, Hong Kong, China
| | - Jin Lin
- Product Development-R&D Life Nurturing Products, Infinitus (China) Company Limited, Guangzhou, China
| | - Qitao Tan
- Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen, China.,Department of Biomedical Engineering, Hong Kong Polytechnic University, Hong Kong, China
| | - Tony Lin-Wei Chen
- Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen, China.,Department of Biomedical Engineering, Hong Kong Polytechnic University, Hong Kong, China
| | - Ming Zhang
- Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen, China.,Department of Biomedical Engineering, Hong Kong Polytechnic University, Hong Kong, China
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Kutbay Özçelik H, Bayram M, Doğanay E, Kart L, Sezer M, Akkoyunlu ME, Karaköse F, Yakar F. Effects of body position on sleep architecture and quality in subsyndromal adults without apparent obstructive sleep apnea. Sleep Biol Rhythms 2015. [DOI: 10.1111/sbr.12116] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Hatice Kutbay Özçelik
- Department of Pulmonology; Bezmialem Vakif University Medical Faculty; Istanbul Turkey
| | - Mehmet Bayram
- Department of Pulmonology; Bezmialem Vakif University Medical Faculty; Istanbul Turkey
| | - Emine Doğanay
- Biomedical Engineering Institute; Fatih University; Istanbul Turkey
| | - Levent Kart
- Fatih University Medical Faculty; Istanbul Turkey
| | - Murat Sezer
- Department of Pulmonology; Bezmialem Vakif University Medical Faculty; Istanbul Turkey
| | | | - Fatmanur Karaköse
- Department of Pulmonology; Bezmialem Vakif University Medical Faculty; Istanbul Turkey
| | - Fatih Yakar
- Department of Pulmonology; Bezmialem Vakif University Medical Faculty; Istanbul Turkey
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