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Sansom K, Reynolds A, Windred D, Phillips A, Dhaliwal SS, Walsh J, Maddison K, Singh B, Eastwood P, McArdle N. The interrelationships between sleep regularity, obstructive sleep apnea, and hypertension in a middle-aged community population. Sleep 2024; 47:zsae001. [PMID: 38180870 PMCID: PMC10925954 DOI: 10.1093/sleep/zsae001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 12/20/2023] [Indexed: 01/07/2024] Open
Abstract
STUDY OBJECTIVES Little is known about the interrelationships between sleep regularity, obstructive sleep apnea (OSA) and important health markers. This study examined whether irregular sleep is associated with OSA and hypertension, and if this modifies the known association between OSA and hypertension. METHODS Six hundred and two adults (age mean(SD) = 56.96(5.51) years, female = 60%) from the Raine Study who were not evening or night shift workers were assessed for OSA (in-laboratory polysomnography; apnea-hypopnea index ≥ 15 events/hour), hypertension (doctor diagnosed, or systolic blood pressure ≥140 mmHg and/or diastolic ≥90 mmHg) and sleep (wrist actigraphy for ≥5 days). A sleep regularity index (SRI) was determined from actigraphy. Participants were categorized by tertiles as severely irregular, mildly irregular, or regular sleepers. Logistic regression models examined the interrelationships between SRI, OSA and hypertension. Covariates included age, sex, body mass index, actigraphy sleep duration, insomnia, depression, activity, alcohol, smoking, and antihypertensive medication. RESULTS Compared to regular sleepers, participants with mildly irregular (OR 1.97, 95% confidence intervals [CI] 1.20 to 3.27) and severely irregular (OR 2.06, 95% CI: 1.25 to 3.42) sleep had greater odds of OSA. Compared to those with no OSA and regular sleep, OSA and severely irregular sleep combined had the highest odds of hypertension (OR 2.34 95% CI: 1.07 to 5.12; p for interaction = 0.02) while those with OSA and regular/mildly irregular sleep were not at increased risk (p for interaction = 0.20). CONCLUSIONS Sleep irregularity may be an important modifiable target for hypertension among those with OSA.
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Affiliation(s)
- Kelly Sansom
- Centre for Sleep Science, School of Human Sciences, University of Western Australia, Perth, WA, Australia
- Queen Elizabeth II Medical Centre, West Australian Sleep Disorders Research Institute, Nedlands, WA, Australia
- Flinders University, College of Medicine and Public Health, Flinders Health and Medical Research Institute - Sleep Health, Adelaide, SA, Australia
| | - Amy Reynolds
- Flinders University, College of Medicine and Public Health, Flinders Health and Medical Research Institute - Sleep Health, Adelaide, SA, Australia
| | - Daniel Windred
- School of Psychological Sciences, Monash University, Turner Institute for Brain and Mental Health, Clayton, VIC, Australia
| | - Andrew Phillips
- School of Psychological Sciences, Monash University, Turner Institute for Brain and Mental Health, Clayton, VIC, Australia
| | - Satvinder S Dhaliwal
- Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University, Bentley, WA, Australia
- Office of the Provost, Singapore University of Social Sciences, Clementi, Singapore
- Duke-NUS Medical School, National University of Singapore, Singapore
- Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia, Pulau Pinang, Malaysia
| | - Jennifer Walsh
- Centre for Sleep Science, School of Human Sciences, University of Western Australia, Perth, WA, Australia
- Queen Elizabeth II Medical Centre, West Australian Sleep Disorders Research Institute, Nedlands, WA, Australia
- Department of Pulmonary Physiology and Sleep Medicine, Sir Charles Gairdner Hospital, Perth, WA, Australia
| | - Kathleen Maddison
- Centre for Sleep Science, School of Human Sciences, University of Western Australia, Perth, WA, Australia
- Queen Elizabeth II Medical Centre, West Australian Sleep Disorders Research Institute, Nedlands, WA, Australia
- Department of Pulmonary Physiology and Sleep Medicine, Sir Charles Gairdner Hospital, Perth, WA, Australia
| | - Bhajan Singh
- Centre for Sleep Science, School of Human Sciences, University of Western Australia, Perth, WA, Australia
- Queen Elizabeth II Medical Centre, West Australian Sleep Disorders Research Institute, Nedlands, WA, Australia
- Department of Pulmonary Physiology and Sleep Medicine, Sir Charles Gairdner Hospital, Perth, WA, Australia
| | - Peter Eastwood
- Health Futures Institute, Murdoch University, Perth, WA, Australia
| | - Nigel McArdle
- Centre for Sleep Science, School of Human Sciences, University of Western Australia, Perth, WA, Australia
- Queen Elizabeth II Medical Centre, West Australian Sleep Disorders Research Institute, Nedlands, WA, Australia
- Department of Pulmonary Physiology and Sleep Medicine, Sir Charles Gairdner Hospital, Perth, WA, Australia
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Olaithe M, Eastwood P, Bucks R. OSA onset: An algorithm for determining the onset and duration of obstructive sleep apnea (OSA). Sleep Med 2024; 113:411. [PMID: 37778885 DOI: 10.1016/j.sleep.2023.08.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 08/29/2023] [Indexed: 10/03/2023]
Affiliation(s)
- Michelle Olaithe
- School of Psychological Science, University of Western Australia 2, Australia.
| | | | - Romola Bucks
- School of Psychological Science, University of Western Australia 2, Australia
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Shimamoto H, Eastwood P, Anderson M, Mizuno K. Prevalence of excessive daytime sleepiness and its association with daily life factors in Japanese first-year university students. Sleep Biol Rhythms 2024; 22:33-40. [PMID: 38476855 PMCID: PMC10899967 DOI: 10.1007/s41105-023-00470-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 06/12/2023] [Indexed: 03/14/2024]
Abstract
As lifestyles have shifted to favor nighttime activities, daytime sleepiness and sleep-related problems have become increasingly common in Japan. Excessive daytime sleepiness (EDS) is an adverse consequence of sleep loss and an important public health concern. EDS may cause academic difficulties, behavioral abnormalities, and psychological dysfunction; therefore, it is a particularly important issue among university students. We conducted a cross-sectional study to investigate the prevalence of EDS and its associated lifestyle factors among Japanese university students. A questionnaire was completed by 1470 first-year university students, aged 19.0 (± 1.0) years. Using the questionnaire, we collected information on (1) demographic variables, (2) lifestyle variables, and (3) sleep habits and daytime sleepiness. Daytime sleepiness was measured using the Japanese version of the Epworth Sleepiness Scale, a frequently used subjective scale for assessing sleepiness. The overall prevalence of EDS was 57% (53% in men and 61% in women). Multivariate logistic regression analysis revealed that the following factors were associated with EDS: female sex, exercise habits, long commuting times, later wake-up times, and shorter sleep duration. Given that more than 50% of first-year university students reported having EDS, interventions should be considered to decrease its risk, including educational programs that provide strategies to extend sleep duration and delay wake-up time. Such strategies may also be valuable for students with other potential risk factors, such as exercise habits or long commute times, that are associated with EDS.
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Affiliation(s)
- Hideki Shimamoto
- Center for Education in Liberal Arts and Sciences, Osaka University, 1-16 Machikaneyama-cho, Toyonaka, Osaka 560-0043 Japan
| | - Peter Eastwood
- Health Futures Institute, Murdoch University, Perth, WA Australia
| | - Martin Anderson
- School of Human Sciences (Sport Science, Exercise and Health), University of Western Australia, Perth, WA Australia
| | - Koh Mizuno
- Faculty of Education, Tohoku Fukushi University, Sendai, Miyagi Japan
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Reynolds AC, Coenen P, Lechat B, Straker L, Zabatiero J, Maddison KJ, Adams RJ, Eastwood P. Insomnia and workplace productivity loss among young working adults: a prospective observational study of clinical sleep disorders in a community cohort. Med J Aust 2023; 219:107-112. [PMID: 37357134 DOI: 10.5694/mja2.52014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 04/18/2023] [Accepted: 04/19/2023] [Indexed: 06/27/2023]
Abstract
OBJECTIVE To examine associations between three clinically significant sleep disorders (chronic insomnia, obstructive sleep apnoea, restless legs syndrome) and workplace productivity losses among young Australian adults. DESIGN, SETTING Prospective, observational study; 22-year follow-up of participants in the longitudinal birth cohort Raine Study (Perth, Western Australia). PARTICIPANTS Currently employed 22-year-old Raine Study participants who underwent in-laboratory sleep disorder screening for moderate to severe obstructive sleep apnoea (apnoea-hypopnea index of more than fifteen events/hour or obstructive sleep apnoea syndrome) and were assessed for insomnia and restless legs syndrome using validated measures. MAIN OUTCOME MEASURES Total workplace productivity loss over twelve months, assessed with the World Health Organization Health and Work Performance Questionnaire. RESULTS Of 1235 contactable 22-year-old Raine Study cohort members, 554 people (44.9%; 294 women [53%]) underwent overnight polysomnography, completed the baseline sleep questionnaire, and completed at least three quarterly workplace productivity assessments. One or more clinically significant sleep disorders were identified in 120 participants (21.7%); 90 participants had insomnia (17%), thirty clinically significant obstructive sleep apnoea (5.4%), and two restless legs syndrome (0.4%). Seventeen people (14% of those with sleep disorders) had previously been diagnosed with a sleep disturbance by a health professional, including fourteen with insomnia. Median total workplace productivity loss was greater for participants with sleep disorders (164 hours/year; interquartile range [IQR], 0-411 hours/year) than for those without sleep disorders (30 hours/year; IQR, 0-202 hours/year); total workplace productivity loss was 40% greater for participants with sleep disorders (adjusted incidence rate ratio, 1.40; bias-corrected and accelerated 95% confidence interval, 1.10-1.76). The estimated population total productivity loss (weighted for disorder prevalence) was 28 644 hours per 1000 young workers per year, primarily attributable to insomnia (28 730 hours/1000 workers/year). CONCLUSION Insomnia is a risk factor for workplace productivity loss in young workers. Tailored interventions are needed to identify and manage sleep disorders, particularly as most of the sleep disorders detected in the Raine Study had not previously been diagnosed.
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Affiliation(s)
- Amy C Reynolds
- Flinders Health and Medical Research Institute, Flinders University, Adelaide, SA
| | - Pieter Coenen
- Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Bastien Lechat
- Flinders Health and Medical Research Institute, Flinders University, Adelaide, SA
| | | | | | - Kath J Maddison
- The University of Western Australia, Perth, WA
- West Australian Sleep Disorders Research Institute, Perth, WA
- Sir Charles Gairdner Hospital, Perth, WA
| | | | - Peter Eastwood
- Flinders Health and Medical Research Institute, Flinders University, Adelaide, SA
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Metse AP, Eastwood P, Ree M, Lopresti A, Scott JJ, Bowman J. Sleep health of young adults in Western Australia and associations with physical and mental health: A population-level cross-sectional study. Aust N Z J Public Health 2023; 47:100070. [PMID: 37474415 DOI: 10.1016/j.anzjph.2023.100070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Revised: 05/09/2023] [Accepted: 05/19/2023] [Indexed: 07/22/2023] Open
Abstract
OBJECTIVES This article aims to report on the sleep health characteristics of a population-level sample of young Australian adults and examine associations with measures of physical and mental health. METHODS A cross-sectional study using data from the Raine Study. Data from participants (n = 1234) born into the study (Generation 2) at the 22-year follow-up were used, including data from a self-report questionnaire and polysomnography. RESULTS The highest prevalence of suboptimal sleep health was seen on measures of sleep duration (30%), onset latency (18%), satisfaction (25%) and regularity (60%). Dissatisfaction with sleep (physical health: β =0.08; mental health: β =0.34) and impaired daytime alertness (physical health: β =0.09; mental health: β =0.08) were significantly associated with poorer physical and mental health and inadequate polysomnography-measured sleep duration was associated poorer mental health (β =0.07) (all ps<0.05). CONCLUSIONS Satisfaction with sleep and daytime alertness, both of which are assessed via self-report, are essential aspects of sleep health for young adults. IMPLICATIONS FOR PUBLIC HEALTH Findings could inform public health interventions, including screening guidelines, to improve the sleep health and, in turn, the physical and mental health of young adults in Australia.
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Affiliation(s)
- Alexandra P Metse
- School of Health, University of the Sunshine Coast, QLD, 4556, Australia; School of Psychological Sciences, University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia.
| | - Peter Eastwood
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Bedford Park, SA, 5042, Australia
| | - Melissa Ree
- School of Psychological Sciences, University of Western Australia, Crawley, WA, 6009, Australia
| | - Adrian Lopresti
- College of Health and Education, Murdoch University, Murdoch, WA, 6150, Australia
| | - Joseph J Scott
- School of Education and Tertiary Access, University of the Sunshine Coast, QLD, 4556, Australia; School of Education, Edith Cowan University, Mount Lawley, WA, 6050, Australia
| | - Jenny Bowman
- School of Psychological Sciences, University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia; Hunter Medical Research Institute, New Lambton Heights, NSW, 2305, Australia
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Sansom K, Reynolds A, McVeigh J, Mazzotti DR, Dhaliwal SS, Maddison K, Walsh J, Singh B, Eastwood P, McArdle N. Estimating sleep duration: performance of open-source processing of actigraphy compared to in-laboratory polysomnography in the community. Sleep Adv 2023; 4:zpad028. [PMID: 37485312 PMCID: PMC10362889 DOI: 10.1093/sleepadvances/zpad028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 05/19/2023] [Indexed: 07/25/2023]
Abstract
Comparisons of actigraphy findings between studies are challenging given differences between brand-specific algorithms. This issue may be minimized by using open-source algorithms. However, the accuracy of actigraphy-derived sleep parameters processed in open-source software needs to be assessed against polysomnography (PSG). Middle-aged adults from the Raine Study (n = 835; F 58%; Age 56.7 ± 5.6 years) completed one night of in-laboratory PSG and concurrent actigraphy (GT3X+ ActiGraph). Actigraphic measures of total sleep time (TST) were analyzed and processed using the open-source R-package GENEActiv and GENEA data in R (GGIR) with and without a sleep diary and additionally processed using proprietary software, ActiLife, for comparison. Bias and agreement (intraclass correlation coefficient) between actigraphy and PSG were examined. Common PSG and sleep health variables associated with the discrepancy between actigraphy, and PSG TST were examined using linear regression. Actigraphy, assessed in GGIR, with and without a sleep diary overestimated PSG TST by (mean ± SD) 31.0 ± 50.0 and 26.4 ± 69.0 minutes, respectively. This overestimation was greater (46.8 ± 50.4 minutes) when actigraphy was analyzed in ActiLife. Agreement between actigraphy and PSG TST was poor (ICC = 0.27-0.44) across all three methods of actigraphy analysis. Longer sleep onset latency and longer wakefulness after sleep onset were associated with overestimation of PSG TST. Open-source processing of actigraphy in a middle-aged community population, agreed poorly with PSG and, on average, overestimated TST. TST overestimation increased with increasing wakefulness overnight. Processing of actigraphy without a diary in GGIR was comparable to when a sleep diary was used and comparable to actigraphy processed with proprietary algorithms in ActiLife.
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Affiliation(s)
- Kelly Sansom
- Centre for Sleep Science, School of Human Sciences, University of Western Australia, Perth, WA, Australia
- West Australian Sleep Disorders Research Institute, Sir Charles Gairdner Hospital, Perth, WA, Australia
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Amy Reynolds
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Joanne McVeigh
- Curtin School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
- Movement Physiology Laboratory, School of Physiology, University of Witwatersrand, South Africa
| | - Diego R Mazzotti
- Division of Medical Informatics, Department of Internal Medicine, University of Kansas Medical Center, KS, USA
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, University of Kansas Medical Center, KS, USA
| | - Satvinder S Dhaliwal
- Curtin Health Innovation Research Institute, Faculty of Health Sciences, B305, Curtin University, Bentley, WA, Australia
- Office of the Provost, Singapore University of Social Sciences, Clementi Road, Singapore
- Duke-NUS Medical School, National University of Singapore, 8 College Road, Singapore
- Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia, Pulau Pinang, Malaysia
| | - Kathleen Maddison
- Centre for Sleep Science, School of Human Sciences, University of Western Australia, Perth, WA, Australia
- West Australian Sleep Disorders Research Institute, Sir Charles Gairdner Hospital, Perth, WA, Australia
- Department of Pulmonary Physiology and Sleep Medicine, Sir Charles Gairdner Hospital, Perth, WA, Australia
| | - Jennifer Walsh
- Centre for Sleep Science, School of Human Sciences, University of Western Australia, Perth, WA, Australia
- West Australian Sleep Disorders Research Institute, Sir Charles Gairdner Hospital, Perth, WA, Australia
- Department of Pulmonary Physiology and Sleep Medicine, Sir Charles Gairdner Hospital, Perth, WA, Australia
| | - Bhajan Singh
- Centre for Sleep Science, School of Human Sciences, University of Western Australia, Perth, WA, Australia
- West Australian Sleep Disorders Research Institute, Sir Charles Gairdner Hospital, Perth, WA, Australia
- Department of Pulmonary Physiology and Sleep Medicine, Sir Charles Gairdner Hospital, Perth, WA, Australia
| | - Peter Eastwood
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Nigel McArdle
- Corresponding author. Nigel McArdle, Centre for Sleep Science, School of Human Sciences, The University of Western Australia, Perth, Western Australia, Australia.
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Yuan H, Plekhanova T, Walmsley R, Reynolds AC, Maddison KJ, Bucan M, Gehrman P, Rowlands A, Ray DW, Bennett D, McVeigh J, Straker L, Eastwood P, Kyle SD, Doherty A. Self-supervised learning of accelerometer data provides new insights for sleep and its association with mortality. medRxiv 2023:2023.07.07.23292251. [PMID: 37461532 PMCID: PMC10350137 DOI: 10.1101/2023.07.07.23292251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 07/27/2023]
Abstract
Background Sleep is essential to life. Accurate measurement and classification of sleep/wake and sleep stages is important in clinical studies for sleep disorder diagnoses and in the interpretation of data from consumer devices for monitoring physical and mental well-being. Existing non-polysomnography sleep classification techniques mainly rely on heuristic methods developed in relatively small cohorts. Thus, we aimed to establish the accuracy of wrist-worn accelerometers for sleep stage classification and subsequently describe the association between sleep duration and efficiency (proportion of total time asleep when in bed) with mortality outcomes. Methods We developed and validated a self-supervised deep neural network for sleep stage classification using concurrent laboratory-based polysomnography and accelerometry data from three countries (Australia, the UK, and the USA). The model was validated within-cohort using subject-wise five-fold cross-validation for sleep-wake classification and in a three-class setting for sleep stage classification wake, rapid-eye-movement sleep (REM), non-rapid-eye-movement sleep (NREM) and by external validation. We assessed the face validity of our model for population inference by applying the model to the UK Biobank with 100,000 participants, each of whom wore a wristband for up to seven days. The derived sleep parameters were used in a Cox regression model to study the association of sleep duration and sleep efficiency with all-cause mortality. Findings After exclusion, 1,448 participant nights of data were used to train the sleep classifier. The difference between polysomnography and the model classifications on the external validation was 34.7 minutes (95% limits of agreement (LoA): -37.8 to 107.2 minutes) for total sleep duration, 2.6 minutes for REM duration (95% LoA: -68.4 to 73.4 minutes) and 32.1 minutes (95% LoA: -54.4 to 118.5 minutes) for NREM duration. The derived sleep architecture estimate in the UK Biobank sample showed good face validity. Among 66,214 UK Biobank participants, 1,642 mortality events were observed. Short sleepers (<6 hours) had a higher risk of mortality compared to participants with normal sleep duration (6 to 7.9 hours), regardless of whether they had low sleep efficiency (Hazard ratios (HRs): 1.69; 95% confidence intervals (CIs): 1.28 to 2.24 ) or high sleep efficiency (HRs: 1.42; 95% CIs: 1.14 to 1.77). Interpretation Deep-learning-based sleep classification using accelerometers has a fair to moderate agreement with polysomnography. Our findings suggest that having short overnight sleep confers mortality risk irrespective of sleep continuity.
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Affiliation(s)
- Hang Yuan
- Nuffield Department of Population Health, University of Oxford, UK
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, UK
| | | | - Rosemary Walmsley
- Nuffield Department of Population Health, University of Oxford, UK
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, UK
| | - Amy C Reynolds
- College of Medicine and Public Health, Flinders University, Australia
| | - Kathleen J Maddison
- Centre of Sleep Science, School of Human Sciences, University of Western Australia, Australia
- West Australian Sleep Disorders Research Institute, Department of Pulmonary Physiology, Sir Charles Gairdner Hospital, Australia
| | - Maja Bucan
- Department of Genetics, University of Pennsylvania, USA
| | - Philip Gehrman
- Department of Psychiatry, University of Pennsylvania, USA
| | - Alex Rowlands
- Diabetes Research Centre, University of Leicester, UK
- NIHR Leicester Biomedical Research Centre, University of Leicester, UK
| | - David W Ray
- NIHR Oxford Biomedical Research Centre, John Radcliffe Hospital, Oxford, UK
| | - Derrick Bennett
- Nuffield Department of Population Health, University of Oxford, UK
- Medical Research Council Population Health Research Unit, University of Oxford, UK
| | - Joanne McVeigh
- Curtin School of Allied Health, Curtin University, Australia
| | - Leon Straker
- Curtin School of Allied Health, Curtin University, Australia
| | | | - Simon D Kyle
- Sir Jules Thorn Sleep & Circadian Neuroscience Institute, Nuffield Department of Clinical Neurosciences, University of Oxford, UK
| | - Aiden Doherty
- Nuffield Department of Population Health, University of Oxford, UK
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, UK
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Sansom K, Reynolds A, Dhaliwal SS, Walsh J, Maddison K, Singh B, Eastwood P, McArdle N. Cross-sectional interrelationships between chronotype, obstructive sleep apnea and blood pressure in a middle-aged community cohort. J Sleep Res 2023; 32:e13778. [PMID: 36330799 PMCID: PMC10909412 DOI: 10.1111/jsr.13778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 09/29/2022] [Accepted: 10/19/2022] [Indexed: 11/06/2022]
Abstract
Chronotype is linked to adverse health measures and may have important associations with obstructive sleep apnea and blood pressure, but data are limited. This study aimed to determine the separate and combined associations of chronotype with obstructive sleep apnea and blood pressure in a middle-aged community population. Adults (n = 811) from the Raine Study (female = 59.2%; age mean [range] = 56.6 [42.1-76.6] years) were assessed for chronotype (Morningness-Eveningness Questionnaire), blood pressure and hypertension (doctor diagnosed or systolic blood pressure ≥ 140 mmHg and/or diastolic ≥ 90 mmHg), and obstructive sleep apnea at different in-laboratory apnea-hypopnea index thresholds (5, 10, 15 events per hr). Linear and logistic regression models examined relationships between chronotype and the presence and severity of obstructive sleep apnea, blood pressure, hypertension, and blood pressure stratified by obstructive sleep apnea severity at above-mentioned apnea-hypopnea index thresholds. Covariates included age, sex, body mass index, alcohol consumption, smoking, physical activity, sleep duration, anti-hypertensive medication, insomnia, and depressive symptoms. Most participants were categorised as morning (40%) or intermediate (43%), with 17% meeting criteria for evening chronotypes. Participants with apnea-hypopnea index ≥ 15 events per hr and morning chronotype had higher systolic (9.9 mmHg, p < 0.001) and a trend for higher diastolic blood pressure (3.4 mmHg, p = 0.07) compared with those with an evening chronotype, and higher systolic blood pressure compared with those with an intermediate chronotype (4.8 mmHg, p = 0.03). Across chronotype categories, no differences in systolic or diastolic blood pressure or odds of hypertension were found at apnea-hypopnea index thresholds of ≥ 5 or ≥ 10 events per hr. Among participants with apnea-hypopnea index ≥ 15 events per hr, systolic blood pressure is higher in those with a morning chronotype than evening and intermediate chronotypes. Assessment for morning chronotype may improve risk stratification for hypertension in patients with obstructive sleep apnea.
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Affiliation(s)
- Kelly Sansom
- Centre for Sleep Science, School of Human SciencesThe University of Western AustraliaPerthWestern AustraliaAustralia
- West Australian Sleep Disorders Research InstituteQueen Elizabeth II Medical CentrePerthWestern AustraliaAustralia
| | - Amy Reynolds
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders UniversityAdelaideSouth AustraliaAustralia
| | - Satvinder S. Dhaliwal
- Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin UniversityBentleyWestern AustraliaAustralia
- Singapore University of Social SciencesClementiSingapore
- Duke‐NUS Medical SchoolNational University of SingaporeQueenstownSingapore
- Institute for Research in Molecular Medicine (INFORMM), Universiti Sains MalaysiaGelugorMalaysia
| | - Jennifer Walsh
- Centre for Sleep Science, School of Human SciencesThe University of Western AustraliaPerthWestern AustraliaAustralia
- West Australian Sleep Disorders Research InstituteQueen Elizabeth II Medical CentrePerthWestern AustraliaAustralia
- Department of Pulmonary Physiology & Sleep MedicineSir Charles Gairdner HospitalPerthWestern AustraliaAustralia
| | - Kathleen Maddison
- Centre for Sleep Science, School of Human SciencesThe University of Western AustraliaPerthWestern AustraliaAustralia
- West Australian Sleep Disorders Research InstituteQueen Elizabeth II Medical CentrePerthWestern AustraliaAustralia
- Department of Pulmonary Physiology & Sleep MedicineSir Charles Gairdner HospitalPerthWestern AustraliaAustralia
| | - Bhajan Singh
- Centre for Sleep Science, School of Human SciencesThe University of Western AustraliaPerthWestern AustraliaAustralia
- West Australian Sleep Disorders Research InstituteQueen Elizabeth II Medical CentrePerthWestern AustraliaAustralia
- Department of Pulmonary Physiology & Sleep MedicineSir Charles Gairdner HospitalPerthWestern AustraliaAustralia
| | - Peter Eastwood
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders UniversityAdelaideSouth AustraliaAustralia
| | - Nigel McArdle
- Centre for Sleep Science, School of Human SciencesThe University of Western AustraliaPerthWestern AustraliaAustralia
- West Australian Sleep Disorders Research InstituteQueen Elizabeth II Medical CentrePerthWestern AustraliaAustralia
- Department of Pulmonary Physiology & Sleep MedicineSir Charles Gairdner HospitalPerthWestern AustraliaAustralia
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9
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Chan E, Chong EW, Lee SSY, Franchina M, Yazar S, Eastwood P, McArdle N, Mackey DA, Lingham G. Incidence and Prevalence of Keratoconus Based on Scheimpflug Imaging. Ophthalmology 2023; 130:445-448. [PMID: 36464154 DOI: 10.1016/j.ophtha.2022.11.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 11/12/2022] [Accepted: 11/28/2022] [Indexed: 12/03/2022] Open
Affiliation(s)
- Elsie Chan
- Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia; Centre for Eye Research Australia, University of Melbourne, Melbourne, Australia
| | - Elaine W Chong
- Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia; Centre for Eye Research Australia, University of Melbourne, Melbourne, Australia; Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Samantha Sze-Yee Lee
- Centre for Ophthalmology and Visual Science (incorporating Lions Eye Institute), University of Western Australia, Perth, Western Australia, Australia
| | - Maria Franchina
- Centre for Ophthalmology and Visual Science (incorporating Lions Eye Institute), University of Western Australia, Perth, Western Australia, Australia
| | - Seyhan Yazar
- Centre for Ophthalmology and Visual Science (incorporating Lions Eye Institute), University of Western Australia, Perth, Western Australia, Australia; Garvan Institute of Medical Research, Sydney, Australia
| | - Peter Eastwood
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Nigel McArdle
- Centre for Sleep Science, School of Human Sciences, University of Western Australia, Crawley, WA, Australia; Department of Pulmonary Physiology & Sleep Medicine, Sir Charles Gairdner Hospital, Nedlands, WA, Australia
| | - David A Mackey
- Centre for Eye Research Australia, University of Melbourne, Melbourne, Australia; Centre for Ophthalmology and Visual Science (incorporating Lions Eye Institute), University of Western Australia, Perth, Western Australia, Australia; School of Medicine, Menzies Institute of Medical Research, University of Tasmania, Hobart, Tasmania, Australia.
| | - Gareth Lingham
- Centre for Ophthalmology and Visual Science (incorporating Lions Eye Institute), University of Western Australia, Perth, Western Australia, Australia; Centre for Eye Research Ireland, Technological University Dublin, Dublin, Ireland.
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10
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Kosky C, Madeira N, Boulton K, Hunter MT, Ling I, Reynor A, Sturdy G, Walsh J, Dhaliwal S, Singh B, Eastwood P, McArdle N. Telemedicine compared to standard face-to-face care for CPAP treatment: real-world Australian experience. Sleep 2022; 45:6643327. [PMID: 35830509 DOI: 10.1093/sleep/zsac157] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 06/21/2022] [Indexed: 11/14/2022] Open
Abstract
STUDY OBJECTIVES We tested a telemedicine model of care to initiate continuous positive airway pressure (CPAP) for patients with obstructive sleep apnea (OSA) living in remote Western Australia. METHODS A prospective study comparing telemedicine for CPAP initiation in a remote population versus standard face-to-face CPAP initiation in a metropolitan population. The primary outcome was average nightly CPAP use in the final week of a CPAP trial. RESULTS A total of 186 participants were allocated to either telemedicine (n=56) or standard care (n=130). The average distance from the study centre for the telemedicine group was 979 km (±792km) compared to 19km (±14km) for the standard care group. The CPAP trial duration in the standard care group was less than the telemedicine group (37.6 vs 69.9 days, p<0.001). CPAP adherence in the telemedicine group was not inferior to standard care (Standard 4.7±0.2 hours, Telemedicine 4.7±0.3 hours, p=0.86). No differences were found between groups in residual apnea-hypopnea index, symptom response, sleep specific quality of life at the end of the trial and continued CPAP use (3 to 6 months). Participant satisfaction was high in both groups. Total health care costs of the telemedicine model were less than the standard model of care. An estimated A$4,538 per participant in travel costs was saved within the telemedicine group by reducing the need to travel to the sleep center for in-person management. CONCLUSIONS In remote dwelling adults starting CPAP for the treatment of OSA, outcomes using telemedicine were comparable to in-person management in a metropolitan setting.
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Affiliation(s)
- Christopher Kosky
- West Australian Sleep Disorders Research Institute, Department of Pulmonary Physiology and Sleep Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia.,Centre for Sleep Science, University of Western Australia, Crawley, Western Australia
| | - Neill Madeira
- West Australian Sleep Disorders Research Institute, Department of Pulmonary Physiology and Sleep Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia
| | - Kate Boulton
- West Australian Sleep Disorders Research Institute, Department of Pulmonary Physiology and Sleep Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia
| | - Marie-Therese Hunter
- West Australian Sleep Disorders Research Institute, Department of Pulmonary Physiology and Sleep Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia
| | - Ivan Ling
- West Australian Sleep Disorders Research Institute, Department of Pulmonary Physiology and Sleep Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia.,Centre for Sleep Science, University of Western Australia, Crawley, Western Australia
| | - Ayesha Reynor
- West Australian Sleep Disorders Research Institute, Department of Pulmonary Physiology and Sleep Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia.,Centre for Sleep Science, University of Western Australia, Crawley, Western Australia
| | - Gavin Sturdy
- West Australian Sleep Disorders Research Institute, Department of Pulmonary Physiology and Sleep Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia.,Centre for Sleep Science, University of Western Australia, Crawley, Western Australia
| | - Jennifer Walsh
- West Australian Sleep Disorders Research Institute, Department of Pulmonary Physiology and Sleep Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia.,Centre for Sleep Science, University of Western Australia, Crawley, Western Australia
| | - Satvinder Dhaliwal
- Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University, Bentley, Western Australia.,Duke-NUS Medical School, National University of Singapore, 8 College Rd, Singapore.,Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia, Minden, Pulau Pinang, Malaysia.,Singapore University of Social Sciences, Office of the Provost. 463 Clementi Road, Singapore
| | - Bhajan Singh
- West Australian Sleep Disorders Research Institute, Department of Pulmonary Physiology and Sleep Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia.,Centre for Sleep Science, University of Western Australia, Crawley, Western Australia
| | - Peter Eastwood
- Flinders Health & Medical Research Institute, College of Medicine and Public Health, Flinders University, South Australia
| | - Nigel McArdle
- West Australian Sleep Disorders Research Institute, Department of Pulmonary Physiology and Sleep Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia.,Centre for Sleep Science, University of Western Australia, Crawley, Western Australia
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11
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McArdle N, Reynolds AC, Hillman D, Moses E, Maddison K, Melton P, Eastwood P. Prevalence of common sleep disorders in a middle-aged community sample. J Clin Sleep Med 2022; 18:1503-1514. [DOI: 10.5664/jcsm.9886] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Nigel McArdle
- University of Western Australia, School of health sciences, Nedlands, Western Australia
- West Australian Sleep Disorders Research Institute, Nedlands, Western Australia
| | - Amy C. Reynolds
- Flinders Health and Medical Research Institute (Sleep Health), College of Medicine & Public Health, Flinders University, South Australia
| | - David Hillman
- University of Western Australia, School of health sciences, Nedlands, Western Australia
- West Australian Sleep Disorders Research Institute, Nedlands, Western Australia
| | - Eric Moses
- Menzies Institute for Medical Research, College of Health and Medicine, University of Tasmania, Hobart Tasmania
- School of Biological Sciences, University of Western Australia, Crawley, Western Australia
| | - Kath Maddison
- University of Western Australia, School of health sciences, Nedlands, Western Australia
- West Australian Sleep Disorders Research Institute, Nedlands, Western Australia
| | - Phillip Melton
- Menzies Institute for Medical Research, College of Health and Medicine, University of Tasmania, Hobart Tasmania
- School of Global and Population Health, University of Western Australia, Nedlands, Western Australia
| | - Peter Eastwood
- Flinders Health and Medical Research Institute (Sleep Health), College of Medicine & Public Health, Flinders University, South Australia
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12
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Pépin JL, Eastwood P, Eckert DJ. Novel avenues to approach non-CPAP therapy and implement comprehensive OSA care. Eur Respir J 2021; 59:13993003.01788-2021. [PMID: 34824053 DOI: 10.1183/13993003.01788-2021] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 09/16/2021] [Indexed: 11/05/2022]
Abstract
Recent advances in obstructive sleep apnoea (OSA) pathophysiology and translational research have opened new lines of investigation for OSA treatment and management. Key goals of such investigations are to provide efficacious, alternative treatment and management pathways that are better tailored to individual risk profiles to move beyond the traditional, continuous positive airway pressure (CPAP)-focused, "one size fits all", trial and error approach which is too frequently inadequate for many patients. Identification of different clinical manifestations of OSA (clinical phenotypes) and underlying pathophysiological phenotypes (endotypes), that contribute to OSA have provided novel insights into underlying mechanisms and have underpinned these efforts. Indeed, this new knowledge has provided the framework for precision medicine for OSA to improve treatment success rates with existing non-CPAP therapies such as mandibular advancement devices and upper airway surgery, and newly developed therapies such as hypoglossal nerve stimulation and emerging therapies such as pharmacotherapies and combination therapy. These concepts have also provided insight into potential physiological barriers to CPAP adherence for certain patients. This review summarises the recent advances in OSA pathogenesis, non-CPAP treatment, clinical management approaches and highlights knowledge gaps for future research. OSA endotyping and clinical phenotyping, risk stratification and personalised treatment allocation approaches are rapidly evolving and will further benefit from the support of recent advances in e-health and artificial intelligence.
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Affiliation(s)
- Jean-Louis Pépin
- HP2 Laboratory, INSERM U1042, University Grenoble Alpes, Grenoble, France .,EFCR Laboratory, Grenoble Alpes University Hospital, Grenoble, France
| | - Peter Eastwood
- Flinders Health and Medical Research Institute and Adelaide Institute for Sleep Health, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia
| | - Danny J Eckert
- Flinders Health and Medical Research Institute and Adelaide Institute for Sleep Health, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia
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13
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McVeigh JA, Smith A, Howie EK, Stamatakis E, Ding D, Cistulli PA, Eastwood P, Straker L. Developmental trajectories of sleep during childhood and adolescence are related to health in young adulthood. Acta Paediatr 2021; 110:2435-2444. [PMID: 33973271 DOI: 10.1111/apa.15911] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 04/28/2021] [Accepted: 05/07/2021] [Indexed: 02/04/2023]
Abstract
AIM Sleep behaviour is correlated and causally related to physical and mental health. Limited longitudinal data exist on the associations of poor sleep behaviour in childhood and adolescence with adult health. Parent-reported sleep behaviours from 1993 participants of the Raine Study (at ages 5, 8, 10, 14, 17) were used to determine sleep trajectories (using latent class growth analysis). METHODS Measures of physical and mental health were compared between sleep trajectories using generalised linear models (at age 20). RESULTS Three sleep trajectories were identified as follows: 43% of participants belonged to a trajectory with 'consistently minimal' sleep problems, 49% showed some 'declining' in reporting of sleep problems incidence and 8% had 'persistent' sleep problems. Participants in the 'consistently minimal' trajectory had better physical and mental health outcomes at age 20 compared to those in the 'declining' and 'persistent' trajectories. For example, 'consistently minimal' participants had significantly lower body fat percentage (mean difference: -3.89% (95% CI: -7.41 to -0.38)) and a higher (better) SF-12 mental component score (mean difference: 4.78 (95% CI: 2.35-7.21)) compared to participants in the 'persistent' trajectory. CONCLUSION Poor sleep behaviour across childhood and adolescent years is related to poorer physical and mental health in young adulthood.
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Affiliation(s)
- Joanne A. McVeigh
- Curtin School of Allied Health Curtin University Perth WA Australia
- Movement Physiology Laboratory University of Witwatersrand Johannesburg South Africa
| | - Anne Smith
- Curtin School of Allied Health Curtin University Perth WA Australia
| | - Erin K. Howie
- Curtin School of Allied Health Curtin University Perth WA Australia
- Department of Health Human Performance and Recreation University of Arkansas Fayetteville AR USA
| | - Emmanuel Stamatakis
- Charles Perkins Centre School of Health Sciences Faculty of Medicine and Health University of Sydney Sydney NSW Australia
| | - Ding Ding
- Sydney School of Public Health Faculty of Medicine and Health University of Sydney Sydney NSW Australia
| | - Peter A. Cistulli
- Sydney School of Public Health Faculty of Medicine and Health University of Sydney Sydney NSW Australia
| | - Peter Eastwood
- Centre for Sleep Science School of Anatomy, Physiology & Human Biology University of Western Australia Perth WA Australia
| | - Leon Straker
- Curtin School of Allied Health Curtin University Perth WA Australia
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14
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Eastwood P, Gilani SZ, McArdle N, Hillman D, Walsh J, Maddison K, Goonewardene M, Mian A. Predicting sleep apnea from three-dimensional face photography. J Clin Sleep Med 2021; 16:493-502. [PMID: 32003736 DOI: 10.5664/jcsm.8246] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
STUDY OBJECTIVES Craniofacial anatomy is recognized as an important predisposing factor in the pathogenesis of obstructive sleep apnea (OSA). This study used three-dimensional (3D) facial surface analysis of linear and geodesic (shortest line between points over a curved surface) distances to determine the combination of measurements that best predicts presence and severity of OSA. METHODS 3D face photographs were obtained in 100 adults without OSA (apnea-hypopnea index [AHI] < 5 events/h), 100 with mild OSA (AHI 5 to < 15 events/h), 100 with moderate OSA (AHI 15 to < 30 events/h), and 100 with severe OSA (AHI ≥ 30 events/h). Measurements of linear distances and angles, and geodesic distances were obtained between 24 anatomical landmarks from the 3D photographs. The accuracy with which different combinations of measurements could classify an individual as having OSA or not was assessed using linear discriminant analyses and receiver operating characteristic analyses. These analyses were repeated using different AHI thresholds to define presence of OSA. RESULTS Relative to linear measurements, geodesic measurements of craniofacial anatomy improved the ability to identify individuals with and without OSA (classification accuracy 86% and 89% respectively, P < .01). A maximum classification accuracy of 91% was achieved when linear and geodesic measurements were combined into a single predictive algorithm. Accuracy decreased when using AHI thresholds ≥ 10 events/h and ≥ 15 events/h to define OSA although greatest accuracy was always achieved using a combination of linear and geodesic distances. CONCLUSIONS This study suggests that 3D photographs of the face have predictive value for OSA and that geodesic measurements enhance this capacity.
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Affiliation(s)
- Peter Eastwood
- Centre for Sleep Science, School of Human Sciences, University of Western Australia, Perth, Western Australia, Australia.,West Australian Sleep Disorders Research, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Syed Zulqarnain Gilani
- School of Computer Science and Software Engineering, University of Western Australia, Perth, Western Australia, Australia.,School of Science, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Nigel McArdle
- Centre for Sleep Science, School of Human Sciences, University of Western Australia, Perth, Western Australia, Australia.,West Australian Sleep Disorders Research, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - David Hillman
- Centre for Sleep Science, School of Human Sciences, University of Western Australia, Perth, Western Australia, Australia.,West Australian Sleep Disorders Research, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Jennifer Walsh
- Centre for Sleep Science, School of Human Sciences, University of Western Australia, Perth, Western Australia, Australia.,West Australian Sleep Disorders Research, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Kathleen Maddison
- Centre for Sleep Science, School of Human Sciences, University of Western Australia, Perth, Western Australia, Australia.,West Australian Sleep Disorders Research, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Mithran Goonewardene
- Oral Development and Behavioural Sciences, University of Western Australia, Perth, Western Australia, Australia
| | - Ajmal Mian
- School of Computer Science and Software Engineering, University of Western Australia, Perth, Western Australia, Australia
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15
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Gilbertson M, Richardson C, Eastwood P, Wilson A, Jacoby P, Leonard H, Downs J. Determinants of sleep problems in children with intellectual disability. J Sleep Res 2021; 30:e13361. [PMID: 34032327 DOI: 10.1111/jsr.13361] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 03/22/2021] [Accepted: 04/05/2021] [Indexed: 10/21/2022]
Abstract
Children with intellectual disabilities are more likely to experience sleep disorders of insomnia, excessive daytime sleepiness and sleep breathing disorders than typically developing children. The present study examined risk factors for these sleep disorders in 447 children (aged 5-18 years), diagnosed with an intellectual disability and comorbid autism spectrum disorder, cerebral palsy, Down syndrome or Rett syndrome. Primary caregivers reported on their child's sleep using the Sleep Disturbance Scale for Children (SDSC), as well as medical comorbidities and functional abilities. Multivariate linear and logistic regressions were used to examine the effects of these factors on SDSC t scores and a binary indicator, respectively for the relevant subscales. Receiving operating characteristic curves were generated for each logistic regression model to determine their ability to discriminate between poor and good sleep. Comorbidities rather than functional abilities were associated with poorer sleep. In particular, recurrent pain, frequent seizures, frequent coughing, constipation and prescription of sleep medications were associated with abnormal sleep across the entire sample, but predictors differed between diagnostic groups. The present study suggests that comorbidities are more strongly associated with quality of sleep than functional impairments. The present study provides new information on potential associations between frequent coughing, prescription sleep medications and sleep quality that should be further investigated.
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Affiliation(s)
- Melissa Gilbertson
- Centre for Sleep Science, School of Human Sciences, The University of Western Australia, Perth, WA, Australia
| | - Cele Richardson
- Centre of Sleep Science, School of Psychological Science, The University of Western Australia, Perth, WA, Australia
| | - Peter Eastwood
- College of Medicine and Public Health, Flinders Health and Medical Research Institute, Flinders University, Adelaide, SA, Australia
| | - Andrew Wilson
- Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia.,Discipline of Paediatrics, School of Medicine, The University of Western Australia, Perth, WA, Australia.,Respiratory and Sleep Medicine, Perth Children's Hospital, Perth, WA, Australia
| | - Peter Jacoby
- Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia
| | - Helen Leonard
- Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia
| | - Jenny Downs
- Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia.,Curtin School of Allied Health, Curtin University, Perth, WA, Australia
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16
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Redhead K, Walsh J, Galbally M, Newnham JP, Watson SJ, Eastwood P. Obstructive sleep apnea is associated with depressive symptoms in pregnancy. Sleep 2021; 43:5648018. [PMID: 31782959 DOI: 10.1093/sleep/zsz270] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 08/23/2019] [Indexed: 12/13/2022] Open
Abstract
STUDY OBJECTIVES In pregnancy, the prevalence of both obstructive sleep apnea (OSA) and depression increases. Research reveals an association in the general population with up to 45% of patients diagnosed with OSA having depressive symptoms. Therefore, this study aimed to investigate the relationship between OSA and depression in pregnant women. METHODS One hundred and eighty-nine women ≥26 weeks pregnant were recruited from a tertiary perinatal hospital. This cross-sectional study measured OSA (Apnea Hypopnea Index, AHI, using an ApneaLink device) and symptoms of depression (Edinburgh Postnatal Depression Scale, EPDS). Data were collected from medical records including participant age, ethnicity, parity, BMI, smoking status, history of depression, and use of antidepressants. RESULTS Of the consenting women, data from 124 were suitable for analysis. Twenty women (16.1%) had OSA (AHI ≥ 5 events/h) and 11 (8.8%) had depressive symptoms (EPDS > 12). Women with OSA were more likely to have depressive symptoms after adjusting for covariates, odds ratio = 8.36, 95% CI [1.57, 44.46]. OSA was also related to higher EPDS scores and these were greater in women with a history of depression. CONCLUSIONS During late pregnancy women with OSA had eight times the odds of having depressive symptoms. Furthermore, an interaction was found between OSA and history of depression. Specifically, in women with no history of depression, OSA increases depressive symptoms. In women with a history of depression, OSA has an even stronger effect on depressive symptomology. This suggests screening for OSA in pregnancy may identify women prone to future depressive episodes and allow for targeted interventions.
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Affiliation(s)
- Karen Redhead
- School of Medicine, University of Notre Dame, Fremantle, Western Australia, Australia
| | - Jennifer Walsh
- Centre for Sleep Science, School of Human Sciences, University of Western Australia, Crawley, Western Australia, Australia
| | - Megan Galbally
- School of Medicine, University of Notre Dame, Fremantle, Western Australia, Australia.,Psychology Discipline, Murdoch University, Murdoch, Western Australia, Australia
| | - John P Newnham
- Centre for Sleep Science, School of Human Sciences, University of Western Australia, Crawley, Western Australia, Australia.,Division of Obstetrics and Gynaecology, School of Medicine, University of Western Australia, Perth, Western Australia, Australia
| | - Stuart J Watson
- School of Medicine, University of Notre Dame, Fremantle, Western Australia, Australia.,Psychology Discipline, Murdoch University, Murdoch, Western Australia, Australia
| | - Peter Eastwood
- Centre for Sleep Science, School of Human Sciences, University of Western Australia, Crawley, Western Australia, Australia
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17
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Lum V, Goonewardene MS, Mian A, Eastwood P. Three-dimensional assessment of facial asymmetry using dense correspondence, symmetry, and midline analysis. Am J Orthod Dentofacial Orthop 2020; 158:134-146. [DOI: 10.1016/j.ajodo.2019.12.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2019] [Revised: 12/01/2019] [Accepted: 12/01/2019] [Indexed: 11/30/2022]
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18
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Hingley L, Jeiranikhameneh A, Beirne S, Peoples G, Jones A, Sayyar S, Eastwood P, Lewis R, Wallace G, MacKay SG. Modeling the upper airway: A precursor to personalized surgical interventions for the treatment of sleep apnea. J Biomed Mater Res A 2020; 108:1419-1425. [PMID: 32134556 DOI: 10.1002/jbm.a.36913] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2019] [Revised: 02/20/2020] [Accepted: 02/24/2020] [Indexed: 02/06/2023]
Abstract
An accurate benchtop model was developed to mimic the different forms of human upper airway collapse in adult sleep apnea patients. This was done via modeling the airway through digital imaging. Airway representative models were then produced in two steps via a customized pneumatic extrusion 3D printing system. This allowed the pressure of collapse and planes of collapse to be manipulated to accurately represent those seen in sleep apnea patients. The pressure flow relationships of the collapsible airways were then studied by inserting the collapsible airways into a module that allowed the chamber pressure (Pc ) around the airways to be increased in order to cause collapse. Airways collapsed at physiologically relevant pressures (5.32-9.58 cmH2 O). Nickel and iron magnetic polymers were then printed into the airway in order to investigate the altering of the airway collapse. The introduction of the nickel and iron magnetic polymers increased the pressure of collapse substantially (7.38-17.51 cmH2 O). Finally, the force produced by the interaction of the magnetic polymer and the magnetic module was studied by measuring a sample of the magnetic airways. The peak force in (48.59-163.34 cN) and the distance over which the forces initially registered (6.8-9.7 mm) were measured using a force transducer. This data set may be used to inform future treatment of sleep apnea, specifically the production of an implantable polymer for surgical intervention.
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Affiliation(s)
- Lachlan Hingley
- School of Medicine, University of Wollongong, Wollongong, New South Wales, Australia
| | - Ali Jeiranikhameneh
- Australian Institute of Innovative Materials, University of Wollongong, Wollongong, New South Wales, Australia
| | - Stephen Beirne
- Australian Institute of Innovative Materials, University of Wollongong, Wollongong, New South Wales, Australia
| | - Gregory Peoples
- School of Medicine, University of Wollongong, Wollongong, New South Wales, Australia
| | - Andrew Jones
- School of Medicine, University of Wollongong, Wollongong, New South Wales, Australia.,Illawarra Shoalhaven Local Health District, Wollongong, New South Wales, Australia
| | - Sepidar Sayyar
- Australian Institute of Innovative Materials, University of Wollongong, Wollongong, New South Wales, Australia
| | - Peter Eastwood
- Centre for Sleep Science, School of Human Sciences, University of Western Australia, Perth, Western Australia, Australia.,West Australian Sleep Disorders Research Institute, Sir Charles Gardiner Hospital, Perth, Western Australia, Australia
| | - Richard Lewis
- Department of Otolaryngology Head & Neck Surgery, Royal Perth Hospital, Perth, Western Australia, Australia
| | - Gordon Wallace
- Australian Institute of Innovative Materials, University of Wollongong, Wollongong, New South Wales, Australia
| | - Stuart G MacKay
- School of Medicine, University of Wollongong, Wollongong, New South Wales, Australia.,Illawarra Shoalhaven Local Health District, Wollongong, New South Wales, Australia.,Illawarra ENT Head and Neck Clinic, Wollongong, New South Wales, Australia
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19
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Ohn M, Eastwood P, von Ungern-Sternberg BS. Preoperative identification of children at high risk of obstructive sleep apnea. Paediatr Anaesth 2020; 30:221-231. [PMID: 31841240 DOI: 10.1111/pan.13788] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 12/08/2019] [Accepted: 12/10/2019] [Indexed: 12/24/2022]
Abstract
Obstructive sleep apnea is a common childhood disorder which can lead to serious health problems if left untreated. Enlarged adenoid and tonsils are the commonest causes, and adenotonsillectomy is the recommended first line of treatment. Obstructive sleep apnea poses as an anesthetic challenge, and it is a well-known risk factor for perioperative adverse events. The presence and severity of an obstructive sleep apnea diagnosis will influence anesthesia, pain management, and level of monitoring in recovery period. Preoperative obstructive sleep apnea assessment is necessary, and anesthetists are ideally placed to do so. Currently, there is no standardized approach to the best method of preoperative screening for obstructive sleep apnea. Focused history, clinical assessments, and knowledge regarding the strengths and limitations of available obstructive sleep apnea assessment tools will help recognize a child with obstructive sleep apnea in the preoperative setting.
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Affiliation(s)
- Mon Ohn
- Department of Respiratory and Sleep Medicine, Perth Children's Hospital, Nedlands, WA, Australia.,Medical School, The University of Western Australia, Crawley, WA, Australia.,Telethon Kids Institute, Nedlands, WA, Australia
| | - Peter Eastwood
- Centre for Sleep Science, School of Human Sciences, The University of Western Australia, Crawley, WA, Australia.,West Australian Sleep Disorders Research Institute, Sir Charles Gairdner Hospital, Nedlands, WA, Australia
| | - Britta S von Ungern-Sternberg
- Medical School, The University of Western Australia, Crawley, WA, Australia.,Telethon Kids Institute, Nedlands, WA, Australia.,Department of Anaesthesia and Pain Management, Perth Children's Hospital, Nedlands, WA, Australia
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20
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Tate A, Walsh J, Kurup V, Shenoy B, Mann D, Freakley C, Eastwood P, Terrill P. An emerging technology for the identification and characterization of postural-dependent obstructive sleep apnea. J Clin Sleep Med 2020; 16:309-318. [PMID: 31992410 DOI: 10.5664/jcsm.8190] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES Body posture has a significant impact on the presence and severity of obstructive sleep apnea (OSA). The majority of polysomnography (PSG) systems have the capacity to categorize body (torso) posture as supine, left-lateral, right-lateral or prone, each within a 90-degree range. However, such broad categorization may limit the identification of subtle relationships between posture and OSA severity. The aim of this study was to quantify sleeping posture as a continuous variable; and to develop an intuitive tool for visualizing the relationship between body posture and OSA severity. METHODS A customized triaxial accelerometer-based posture sensor which quantifies torso posture as a continuous variable was developed. 38 participants attending the sleep laboratory for suspected OSA were recruited. Each participant underwent a diagnostic PSG with an additional customized posture sensor securely attached to the sternum. Individual data were presented using a novel circular histogram-based visualization which displays sleeping position and position-specific OSA severity. RESULTS Acceptable measurements were obtained in 21 participants. The mean ± standard deviation percentage of total sleep time spent within ± 15 degrees of the center of supine, left-lateral, right-lateral and prone was 59.7 ± 26.0%. A further 40.3 ± 26.0% of sleep time was spent in intermediate positions outside these traditional categorizations. The novel visualization revealed a wide variety of positional OSA phenotypes. CONCLUSIONS Quantification of torso posture as a continuous variable and analysis of these data using a novel visualization enables the identification of subtle relationships between body posture and OSA severity that are not apparent using standard clinical sensors and summary statistics.
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Affiliation(s)
- Albert Tate
- School of Information Technology and Electrical Engineering, The University of Queensland, Brisbane, Queensland, Australia
| | - Jennifer Walsh
- Centre for Sleep Science, School of Human Sciences, University of Western Australia.,West Australian Sleep Disorders Research Institute, Sir Charles Gairdner Hospital
| | - Veena Kurup
- Centre for Sleep Science, School of Human Sciences, University of Western Australia.,West Australian Sleep Disorders Research Institute, Sir Charles Gairdner Hospital
| | - Bindiya Shenoy
- Centre for Sleep Science, School of Human Sciences, University of Western Australia.,West Australian Sleep Disorders Research Institute, Sir Charles Gairdner Hospital
| | - Dwayne Mann
- School of Information Technology and Electrical Engineering, The University of Queensland, Brisbane, Queensland, Australia
| | - Craig Freakley
- School of Information Technology and Electrical Engineering, The University of Queensland, Brisbane, Queensland, Australia
| | - Peter Eastwood
- Centre for Sleep Science, School of Human Sciences, University of Western Australia.,West Australian Sleep Disorders Research Institute, Sir Charles Gairdner Hospital
| | - Philip Terrill
- School of Information Technology and Electrical Engineering, The University of Queensland, Brisbane, Queensland, Australia
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Shenoy B, Younes M, Dhaliwal S, King S, Rea C, Hatch K, Becu A, Ling I, Mukherjee S, Palmer L, Hillman D, Eastwood P, Mcardle N. Cross-sectional association of traditional and novel polysomnography metrics with atherosclerosis in obstructive sleep apnoea. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Eastwood P, Barnes M, Mackay S, Wheatley J, Hillman D, Nguyen XL, Lewis R, Campbell M, Petelle B, Walsh J, Jones A, Palme C, Bizon A, Meslier N, Bertolus C, Maddison K, Laccourreye L, Raux G, Denoncin K, Attali V, Gagnadoux F, Launois S. Bilateral hypoglossal nerve stimulation for treatment of obstructive sleep apnea. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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23
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Dunican I, Eastwood P, Murray K, Caldwell J, Reale R. The effect of water loading for acute weight loss following fluid restriction on sleep quality and quantity in combat sports athletes. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.274] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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24
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Dunican I, Walsh J, Higgins C, Jones M, Maddsion K, Caldwell J, Hillman D, Eastwood P. Prevalence of sleep disorders and sleep problems in an elite super rugby union team. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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25
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Olaithe M, Bucks RS, Eastwood P, Hillman D, Skinner T, James A, Hunter M, Gavett B. A brief report: The National Adult Reading Test (NART) is a stable assessment of premorbid intelligence across disease severity in obstructive sleep apnea (OSA). J Sleep Res 2019; 29:e12958. [PMID: 31782212 DOI: 10.1111/jsr.12958] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 09/04/2019] [Accepted: 11/06/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Michelle Olaithe
- School of Psychological Science University of Western Australia Crawley Western Australia Australia
| | - Romola S. Bucks
- School of Psychological Science University of Western Australia Crawley Western Australia Australia
| | - Peter Eastwood
- Centre for Sleep Science School of Human Sciences University of Western Australia Crawley Western Australia Australia
- Department of Pulmonary Physiology and Sleep Medicine West Australian Sleep Disorders Research Institute Sir Charles Gairdner Hospital Nedlands Western Australia Australia
| | - David Hillman
- Centre for Sleep Science School of Human Sciences University of Western Australia Crawley Western Australia Australia
- Department of Pulmonary Physiology and Sleep Medicine West Australian Sleep Disorders Research Institute Sir Charles Gairdner Hospital Nedlands Western Australia Australia
| | - Timothy Skinner
- Department of Psychology University of Copenhagen Copenhagen Denmark
| | - Alan James
- Busselton Population Medical Research Institute Busselton Western Australia Australia
| | - Michael Hunter
- Busselton Population Medical Research Institute Busselton Western Australia Australia
| | - Brandon Gavett
- School of Psychological Science University of Western Australia Crawley Western Australia Australia
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Abstract
PURPOSE The purpose of the Raine Study is to improve human health and well-being by studying the life-course of a cohort of Western Australians, based on a life-course conceptual framework that considers interactions between genetics, phenotypes, behaviours, the environment and developmental and social outcomes. PARTICIPANTS Between May 1989 and November 1991, 2900 pregnant women were enrolled in the Raine Study in Perth, Western Australia. In total, 2730 women gave birth to 2868 children (Generation 2) between August 1989 and April 1992. The mothers and fathers of Generation 2 are referred to as Generation 1 of the Raine Study. In the most recent Generation 1 follow-up, 636 mothers and 462 fathers participated. FINDINGS TO DATE Until the 26-year follow-up of Generation 1 the focus of research within the Raine Study was on outcomes in Generation 2, with information on the parents mainly being used to examine its influence on their children's outcomes. For example, recent findings showed that several characteristics of mothers, such as obesity, early mid-gestational weight gain and socioeconomic status were associated with non-alcoholic fatty liver disease, adiposity and cardiometabolic characteristics in offspring. Other findings showed that parents with back pain were more likely to have offspring who experienced back pain. Also, non-linear and dynamic relationships were found between maternal working hours and offspring overweight or obesity. FUTURE PLANS The Raine Study will continue to provide access to its dense longitudinal genetic, phenotypic, behavioural, environmental, developmental and social data to undertake studies with the ultimate goal of improving human health and well-being. Analyses of data from the recent Generation 1 year 26 follow-up are underway. TRIAL REGISTRATION NUMBER ACTRN12617001599369.
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Affiliation(s)
- Manon L Dontje
- School of Population and Global Health, University of Western Australia, Perth, Western Australia, Australia
| | - Peter Eastwood
- Centre for Sleep Science, School of Human Sciences, The University of Western Australia, Perth, Western Australia, Australia
| | - Leon Straker
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia
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Straker L, Mountain J, Jacques A, White S, Smith A, Landau L, Stanley F, Newnham J, Pennell C, Eastwood P. Cohort Profile: The Western Australian Pregnancy Cohort (Raine) Study-Generation 2. Int J Epidemiol 2019; 46:1384-1385j. [PMID: 28064197 DOI: 10.1093/ije/dyw308] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/13/2016] [Indexed: 12/11/2022] Open
Affiliation(s)
- Leon Straker
- School of Physiotherapy and Exercise Science, Curtin University, Perth, WA, Australia
| | - Jenny Mountain
- School of Population Health, University of Western Australia, Perth, WA, Australia
| | - Angela Jacques
- School of Population Health, University of Western Australia, Perth, WA, Australia
| | - Scott White
- Maternal Fetal Medicine Service, King Edward Memorial Hospital, Perth, WA, Australia
| | - Anne Smith
- School of Physiotherapy and Exercise Science, Curtin University, Perth, WA, Australia
| | - Louis Landau
- School of Medicine and Pharmacology, University of Western Australia, and Department of Health, Government of Western Australia, Perth, WA, Australia
| | | | | | | | - Peter Eastwood
- Centre for Sleep Science, School of Anatomy, Physiology and Human Biology, University of Western Australia, Perth, WA, Australia
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28
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McArdle N, Rea C, King S, Maddison K, Ramanan D, Ketheeswaran S, Erikli L, Baker V, Armitstead J, Richards G, Singh B, Hillman D, Eastwood P. Treating Chronic Hypoventilation With Automatic Adjustable Versus Fixed EPAP Intelligent Volume-Assured Positive Airway Pressure Support (iVAPS): A Randomized Controlled Trial. Sleep 2018; 40:4082801. [PMID: 28958052 DOI: 10.1093/sleep/zsx136] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Objectives New noninvasive ventilation (NIV) modes can automatically adjust pressure support settings to deliver effective ventilation in response to varying ventilation demands. It is recommended that fixed expiratory positive airway pressure (FixedEPAP) is determined by attended laboratory polysomnographic (PSG) titration. This study investigated whether automatically determined EPAP (AutoEPAP) was noninferior to FixedEPAP for the control of obstructive sleep apnea (OSA) during intelligent volume-assured pressure support (iVAPS) treatment of chronic hypoventilation. Methods In this randomized, double-blind, crossover study, patients with chronic hypoventilation and OSA used iVAPS with AutoEPAP or FixedEPAP over two separate nights of attended PSG. PSG recordings were scored by an independent scorer using American Academy of Sleep Medicine 2012 criteria. Results Twenty-five adults (14 male) with chronic hypoventilation secondary to obesity hypoventilation syndrome (n = 11), chronic obstructive pulmonary disease (n = 9), or neuromuscular disease (n = 5), all of whom were on established home NIV therapy, were included (age 57 ± 7 years, NIV for ≥3 months, apnea-hypopnea index [AHI] >5/hour). AutoEPAP was noninferior to FixedEPAP for the primary outcome measure (median [interquartile range] AHI 2.70 [1.70-6.05]/hour vs. 2.40 [0.25-5.95]/hour; p = .86). There were no significant between-mode differences in PSG sleep breathing and sleep quality, or self-reported sleep quality, device comfort, and patient preference. Mean EPAP with the Auto and Fixed modes was 10.8 ± 2.0 and 11.8 ± 3.9 cmH2O, respectively (p = .15). Conclusions In patients with chronic hypoventilation using iVAPS, the AutoEPAP algorithm was noninferior to FixedEPAP over a single night's therapy.
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Affiliation(s)
- Nigel McArdle
- Centre for Sleep Science, School of Anatomy, Physiology and Human Biology, University of Western Australia, Nedlands, Australia.,West Australian Sleep Disorders Research Institute, Department of Pulmonary Physiology and Sleep Medicine, Sir Charles Gairdner Hospital, Nedlands, Australia
| | - Clare Rea
- West Australian Sleep Disorders Research Institute, Department of Pulmonary Physiology and Sleep Medicine, Sir Charles Gairdner Hospital, Nedlands, Australia
| | - Stuart King
- Centre for Sleep Science, School of Anatomy, Physiology and Human Biology, University of Western Australia, Nedlands, Australia.,West Australian Sleep Disorders Research Institute, Department of Pulmonary Physiology and Sleep Medicine, Sir Charles Gairdner Hospital, Nedlands, Australia
| | - Kathleen Maddison
- Centre for Sleep Science, School of Anatomy, Physiology and Human Biology, University of Western Australia, Nedlands, Australia.,West Australian Sleep Disorders Research Institute, Department of Pulmonary Physiology and Sleep Medicine, Sir Charles Gairdner Hospital, Nedlands, Australia
| | | | | | - Lisa Erikli
- ResMed Science Centre, Bella Vista, Sydney, Australia
| | - Vanessa Baker
- Centre for Sleep Science, School of Anatomy, Physiology and Human Biology, University of Western Australia, Nedlands, Australia.,West Australian Sleep Disorders Research Institute, Department of Pulmonary Physiology and Sleep Medicine, Sir Charles Gairdner Hospital, Nedlands, Australia
| | | | | | - Bhajan Singh
- Centre for Sleep Science, School of Anatomy, Physiology and Human Biology, University of Western Australia, Nedlands, Australia.,West Australian Sleep Disorders Research Institute, Department of Pulmonary Physiology and Sleep Medicine, Sir Charles Gairdner Hospital, Nedlands, Australia
| | - David Hillman
- Centre for Sleep Science, School of Anatomy, Physiology and Human Biology, University of Western Australia, Nedlands, Australia.,West Australian Sleep Disorders Research Institute, Department of Pulmonary Physiology and Sleep Medicine, Sir Charles Gairdner Hospital, Nedlands, Australia
| | - Peter Eastwood
- Centre for Sleep Science, School of Anatomy, Physiology and Human Biology, University of Western Australia, Nedlands, Australia.,West Australian Sleep Disorders Research Institute, Department of Pulmonary Physiology and Sleep Medicine, Sir Charles Gairdner Hospital, Nedlands, Australia
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Jones M, Peeling P, Dawson B, Halson S, Miller J, Dunican I, Clarke M, Goodman C, Eastwood P. 0095 THE EFFECTS OF EVENING ELECTRONIC DEVICE USE ON SLEEP IN HIGHLY TRAINED ATHLETES. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.094] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Jones MJ, Peeling P, Dawson B, Halson S, Miller J, Dunican I, Clarke M, Goodman C, Eastwood P. Evening electronic device use: The effects on alertness, sleep and next-day physical performance in athletes. J Sports Sci 2017; 36:162-170. [DOI: 10.1080/02640414.2017.1287936] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- Maddison J. Jones
- Department of Sport Science, Exercise and Health, School of Human Sciences, The University of Western Australia, Crawley, WA, Australia
- Department of Physiology, Western Australian Institute of Sport, Mt Claremont, WA, Australia
| | - Peter Peeling
- Department of Sport Science, Exercise and Health, School of Human Sciences, The University of Western Australia, Crawley, WA, Australia
- Department of Physiology, Western Australian Institute of Sport, Mt Claremont, WA, Australia
| | - Brian Dawson
- Department of Sport Science, Exercise and Health, School of Human Sciences, The University of Western Australia, Crawley, WA, Australia
| | - Shona Halson
- Department of Physiology, Australian Institute of Sport, Bruce, ACT, Australia
| | - Joanna Miller
- Department of Physiology, Australian Institute of Sport, Bruce, ACT, Australia
| | - Ian Dunican
- Department of Sport Science, Exercise and Health, School of Human Sciences, The University of Western Australia, Crawley, WA, Australia
- Centre for Sleep Science, School of Human Sciences, The University of Western Australia, Crawley, WA, Australia
| | - Michael Clarke
- Centre for Metabolomics, The University of Western Australia, Crawley, WA, Australia
| | - Carmel Goodman
- Department of Physiology, Western Australian Institute of Sport, Mt Claremont, WA, Australia
| | - Peter Eastwood
- Centre for Sleep Science, School of Human Sciences, The University of Western Australia, Crawley, WA, Australia
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31
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Eastwood P. Message from the outgoing Editor-in-Chief. Respirology 2016; 21:1338-1339. [PMID: 27748020 DOI: 10.1111/resp.12907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Accepted: 08/30/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Peter Eastwood
- West Australian Sleep Disorders Research Institute, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia.,Centre for Sleep Science, School of Anatomy, Physiology and Human Biology, University of Western Australia, Perth, Western Australia, Australia
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32
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Bartlett D, Cruickshank T, Lazar A, Lampit A, Slater J, Rankin T, Hoult L, Pulverenti T, Govus A, Power B, Reyes A, Newton R, Hannan A, Eastwood P, Ziman M. M17 The effect of multidisciplinary therapy on objective and subjective sleep quality in premanifest huntington’s disease. J Neurol Neurosurg Psychiatry 2016. [DOI: 10.1136/jnnp-2016-314597.302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Thomas R, Azzopardi M, Muruganandan S, Read C, Murray K, Eastwood P, Jenkins S, Singh B, Lee YCG. Protocol of the PLeural Effusion And Symptom Evaluation (PLEASE) study on the pathophysiology of breathlessness in patients with symptomatic pleural effusions. BMJ Open 2016; 6:e013213. [PMID: 27489159 PMCID: PMC4985864 DOI: 10.1136/bmjopen-2016-013213] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Pleural effusion is a common clinical problem that can complicate many medical conditions. Breathlessness is the most common symptom of pleural effusion of any cause and the most common reason for pleural drainage. However, improvement in breathlessness following drainage of an effusion is variable; some patients experience either no benefit or a worsening of their breathlessness. The physiological mechanisms underlying breathlessness in patients with a pleural effusion are unclear and likely to be multifactorial with patient-related and effusion-related factors contributing. A comprehensive study of the physiological and symptom responses to drainage of pleural effusions may provide a clearer understanding of these mechanisms, and may identify predictors of benefit from drainage. The ability to identify those patients whose breathlessness will (or will not) improve after pleural fluid drainage can help avoid unnecessary pleural drainage procedures, their associated morbidities and costs. The PLeural Effusion And Symptom Evaluation (PLEASE) study is a prospective study to comprehensively evaluate factors contributing to pleural effusion-related breathlessness. METHODS AND ANALYSIS The PLEASE study is a single-centre prospective study of 150 patients with symptomatic pleural effusions that require therapeutic drainage. The study aims to identify key factors that underlie breathlessness in patients with pleural effusions and develop predictors of improvement in breathlessness following effusion drainage. Participants will undergo evaluation pre-effusion and post-effusion drainage to assess their level of breathlessness at rest and during exercise, respiratory and other physiological responses as well as respiratory muscle mechanics. Pre-drainage and post-drainage parameters will be collected and compared to identify the key factors and mechanisms that correlate with improvement in breathlessness. ETHICS AND DISSEMINATION Approved by the Sir Charles Gairdner Group Human Research Ethics Committee (HREC number 2014-079). Registered with the Australian New Zealand Clinical Trials Registry (ACTRN12616000820404). Results will be published in peer-reviewed journals and presented at scientific meetings. TRIAL REGISTRATION NUMBER ACTRN12616000820404; Pre-results.
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Affiliation(s)
- Rajesh Thomas
- Respiratory Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia Pleural Medicine Unit, Institute for Respiratory Health, Perth, Western Australia, Australia Centre for Respiratory Health, School of Medicine & Pharmacology, University of Western Australia, Perth, Western Australia, Australia
| | - Maree Azzopardi
- Respiratory Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia Pleural Medicine Unit, Institute for Respiratory Health, Perth, Western Australia, Australia
| | - Sanjeevan Muruganandan
- Respiratory Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia Pleural Medicine Unit, Institute for Respiratory Health, Perth, Western Australia, Australia Centre for Respiratory Health, School of Medicine & Pharmacology, University of Western Australia, Perth, Western Australia, Australia
| | - Catherine Read
- Centre for Respiratory Health, School of Medicine & Pharmacology, University of Western Australia, Perth, Western Australia, Australia
| | - Kevin Murray
- Centre for Applied Statistics, University of Western Australia, Perth, Western Australia, Australia
| | - Peter Eastwood
- West Australian Sleep Disorders Research Institute, Perth, Western Australia, Australia Centre for Sleep Science, School of Anatomy, Physiology & Human Biology, University of Western Australia, Perth, Western Australia, Australia Pulmonary Physiology & Sleep Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
| | - Sue Jenkins
- Physiotherapy Unit, Institute for Respiratory Health, Perth, Western Australia, Australia Physiotherapy Department, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
| | - Bhajan Singh
- West Australian Sleep Disorders Research Institute, Perth, Western Australia, Australia Centre for Sleep Science, School of Anatomy, Physiology & Human Biology, University of Western Australia, Perth, Western Australia, Australia Pulmonary Physiology & Sleep Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
| | - Y C Gary Lee
- Respiratory Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia Pleural Medicine Unit, Institute for Respiratory Health, Perth, Western Australia, Australia Centre for Respiratory Health, School of Medicine & Pharmacology, University of Western Australia, Perth, Western Australia, Australia
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Whitehouse AJO, Gilani SZ, Shafait F, Mian A, Tan DW, Maybery MT, Keelan JA, Hart R, Handelsman DJ, Goonawardene M, Eastwood P. Prenatal testosterone exposure is related to sexually dimorphic facial morphology in adulthood. Proc Biol Sci 2016; 282:20151351. [PMID: 26400740 DOI: 10.1098/rspb.2015.1351] [Citation(s) in RCA: 98] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Prenatal testosterone may have a powerful masculinizing effect on postnatal physical characteristics. However, no study has directly tested this hypothesis. Here, we report a 20-year follow-up study that measured testosterone concentrations from the umbilical cord blood of 97 male and 86 female newborns, and procured three-dimensional facial images on these participants in adulthood (range: 21-24 years). Twenty-three Euclidean and geodesic distances were measured from the facial images and an algorithm identified a set of six distances that most effectively distinguished adult males from females. From these distances, a 'gender score' was calculated for each face, indicating the degree of masculinity or femininity. Higher cord testosterone levels were associated with masculinized facial features when males and females were analysed together (n = 183; r = -0.59), as well as when males (n = 86; r = -0.55) and females (n = 97; r = -0.48) were examined separately (p-values < 0.001). The relationships remained significant and substantial after adjusting for potentially confounding variables. Adult circulating testosterone concentrations were available for males but showed no statistically significant relationship with gendered facial morphology (n = 85, r = 0.01, p = 0.93). This study provides the first direct evidence of a link between prenatal testosterone exposure and human facial structure.
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Affiliation(s)
- Andrew J O Whitehouse
- Telethon Kids Institute, University of Western Australia, 100 Roberts Road, Subiaco, Perth, Western Australia 6008, Australia
| | - Syed Zulqarnain Gilani
- School of Computer Science and Software Engineering, University of Western Australia, 35 Stirling Highway, Crawley, Perth, Western Australia 6009, Australia
| | - Faisal Shafait
- School of Computer Science and Software Engineering, University of Western Australia, 35 Stirling Highway, Crawley, Perth, Western Australia 6009, Australia School of Electrical Engineering and Computer Science, National University of Science and Technology, Islamabad, Pakistan
| | - Ajmal Mian
- School of Computer Science and Software Engineering, University of Western Australia, 35 Stirling Highway, Crawley, Perth, Western Australia 6009, Australia
| | - Diana Weiting Tan
- Telethon Kids Institute, University of Western Australia, 100 Roberts Road, Subiaco, Perth, Western Australia 6008, Australia Neurocognitive Development Unit, School of Psychology, University of Western Australia, 35 Stirling Highway, Crawley, Perth, Western Australia 6009, Australia
| | - Murray T Maybery
- Neurocognitive Development Unit, School of Psychology, University of Western Australia, 35 Stirling Highway, Crawley, Perth, Western Australia 6009, Australia
| | - Jeffrey A Keelan
- School of Women's and Infants' Health, University of Western Australia, 35 Stirling Highway, Crawley, Perth, Western Australia 6009, Australia
| | - Roger Hart
- School of Women's and Infants' Health, University of Western Australia, 35 Stirling Highway, Crawley, Perth, Western Australia 6009, Australia
| | - David J Handelsman
- ANZAC Research Institute, University of Sydney, Concord Hospital, New South Wales 2139, Australia
| | - Mithran Goonawardene
- School of Dentistry/Oral Health Centre of Western Australia, University of Western Australia, 35 Stirling Highway, Crawley, Perth, Western Australia 6009, Australia
| | - Peter Eastwood
- Centre for Sleep Science, School of Anatomy, Physiology and Human Biology, University of Western Australia, 35 Stirling Highway, Crawley, Perth, Western Australia 6009, Australia
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McArdle N, King S, Shepherd K, Baker V, Ramanan D, Ketheeswaran S, Bateman P, Wimms A, Armitstead J, Richards G, Hillman D, Eastwood P. Study of a Novel APAP Algorithm for the Treatment of Obstructive Sleep Apnea in Women. Sleep 2015; 38:1775-81. [PMID: 26039968 DOI: 10.5665/sleep.5162] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Accepted: 04/04/2015] [Indexed: 11/03/2022] Open
Abstract
STUDY OBJECTIVES To assess the efficacy of a novel female-specific autotitrating continuous positive airway pressure (CPAP) algorithm (AutoSet for her, AfH) in premenopausal women relative to a standard autotitrating algorithm (AutoSet, S9) (ResMed Ltd., Bella Vista, New South Wales, Australia). DESIGN Prospective randomised crossover noninferiority trial. SETTING Tertiary hospital sleep clinic and university research sleep laboratory. PARTICIPANTS 20 female patients with obstructive sleep apnea (OSA) established on long-term CPAP treatment. INTERVENTIONS Treatment with 1 night each of AfH and AutoSet while monitored with overnight laboratory-based polysomnography (PSG); order randomly allocated. MEASUREMENTS AND RESULTS The primary outcome variables were the apnea-hypopnea index (AHI) and 3% oxygen desaturation index (ODI 3%) determined from PSG. Treatment efficacy on the AfH night was noninferior to the AutoSet night as assessed by median (IQR) AHI (1.2 [0.60-1.85]/h versus 1.15 [0.40-2.85]/h, respectively, P = 0.51) and 3% ODI (0.85 [0.25-1.5]/h versus 0.5 [0.25-2.55]/h, respectively, P = 0.83). Other PSG measures were similar, except for the percentage of the night spent in flow limitation, which was lower on the AfH (0.14%) than the AutoSet night (0.19%, P = 0.007). The device-downloaded 95th centile pressure on the AfH night was also lower than on the AutoSet night (10.6 ± 1.7 versus 11.6 ± 2.6 cmH2O, respectively; mean difference [95% confidence interval]: -1.1 [-2.13 to -0.01] cm H2O). CONCLUSION Among premenopausal women a novel female-specific autotitrating algorithm (AfH) is as effective as the standard AutoSet algorithm in controlling obstructive sleep apnea (OSA). The new algorithm may reduce flow limitation more than the standard algorithm and achieve control of OSA at a lower (95th centile) pressure.
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Affiliation(s)
- Nigel McArdle
- School of Anatomy, Physiology and Human Biology, University of Western Australia, Nedlands, Australia.,West Australian Sleep Disorders Research Institute, Department of Pulmonary Physiology and Sleep Medicine, Sir Charles Gairdner Hospital, Nedlands, Australia
| | - Stuart King
- School of Anatomy, Physiology and Human Biology, University of Western Australia, Nedlands, Australia.,West Australian Sleep Disorders Research Institute, Department of Pulmonary Physiology and Sleep Medicine, Sir Charles Gairdner Hospital, Nedlands, Australia
| | - Kelly Shepherd
- School of Anatomy, Physiology and Human Biology, University of Western Australia, Nedlands, Australia.,West Australian Sleep Disorders Research Institute, Department of Pulmonary Physiology and Sleep Medicine, Sir Charles Gairdner Hospital, Nedlands, Australia
| | - Vanessa Baker
- School of Anatomy, Physiology and Human Biology, University of Western Australia, Nedlands, Australia.,West Australian Sleep Disorders Research Institute, Department of Pulmonary Physiology and Sleep Medicine, Sir Charles Gairdner Hospital, Nedlands, Australia
| | | | | | - Peter Bateman
- ResMed Science Centre, Bella Vista, Sydney, Australia
| | - Alison Wimms
- ResMed Science Centre, Bella Vista, Sydney, Australia
| | | | | | - David Hillman
- School of Anatomy, Physiology and Human Biology, University of Western Australia, Nedlands, Australia.,West Australian Sleep Disorders Research Institute, Department of Pulmonary Physiology and Sleep Medicine, Sir Charles Gairdner Hospital, Nedlands, Australia
| | - Peter Eastwood
- School of Anatomy, Physiology and Human Biology, University of Western Australia, Nedlands, Australia.,West Australian Sleep Disorders Research Institute, Department of Pulmonary Physiology and Sleep Medicine, Sir Charles Gairdner Hospital, Nedlands, Australia
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Whitehouse AJO, Gilani SZ, Shafait F, Mian A, Tan DW, Maybery MT, Keelan JA, Hart R, Handelsman DJ, Goonawardene M, Eastwood P. Prenatal testosterone exposure is related to sexually dimorphic facial morphology in adulthood. Proc Biol Sci 2015. [PMID: 26400740 DOI: 10.1098/rspb.2015.1351.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Prenatal testosterone may have a powerful masculinizing effect on postnatal physical characteristics. However, no study has directly tested this hypothesis. Here, we report a 20-year follow-up study that measured testosterone concentrations from the umbilical cord blood of 97 male and 86 female newborns, and procured three-dimensional facial images on these participants in adulthood (range: 21-24 years). Twenty-three Euclidean and geodesic distances were measured from the facial images and an algorithm identified a set of six distances that most effectively distinguished adult males from females. From these distances, a 'gender score' was calculated for each face, indicating the degree of masculinity or femininity. Higher cord testosterone levels were associated with masculinized facial features when males and females were analysed together (n = 183; r = -0.59), as well as when males (n = 86; r = -0.55) and females (n = 97; r = -0.48) were examined separately (p-values < 0.001). The relationships remained significant and substantial after adjusting for potentially confounding variables. Adult circulating testosterone concentrations were available for males but showed no statistically significant relationship with gendered facial morphology (n = 85, r = 0.01, p = 0.93). This study provides the first direct evidence of a link between prenatal testosterone exposure and human facial structure.
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Affiliation(s)
- Andrew J O Whitehouse
- Telethon Kids Institute, University of Western Australia, 100 Roberts Road, Subiaco, Perth, Western Australia 6008, Australia
| | - Syed Zulqarnain Gilani
- School of Computer Science and Software Engineering, University of Western Australia, 35 Stirling Highway, Crawley, Perth, Western Australia 6009, Australia
| | - Faisal Shafait
- School of Computer Science and Software Engineering, University of Western Australia, 35 Stirling Highway, Crawley, Perth, Western Australia 6009, Australia School of Electrical Engineering and Computer Science, National University of Science and Technology, Islamabad, Pakistan
| | - Ajmal Mian
- School of Computer Science and Software Engineering, University of Western Australia, 35 Stirling Highway, Crawley, Perth, Western Australia 6009, Australia
| | - Diana Weiting Tan
- Telethon Kids Institute, University of Western Australia, 100 Roberts Road, Subiaco, Perth, Western Australia 6008, Australia Neurocognitive Development Unit, School of Psychology, University of Western Australia, 35 Stirling Highway, Crawley, Perth, Western Australia 6009, Australia
| | - Murray T Maybery
- Neurocognitive Development Unit, School of Psychology, University of Western Australia, 35 Stirling Highway, Crawley, Perth, Western Australia 6009, Australia
| | - Jeffrey A Keelan
- School of Women's and Infants' Health, University of Western Australia, 35 Stirling Highway, Crawley, Perth, Western Australia 6009, Australia
| | - Roger Hart
- School of Women's and Infants' Health, University of Western Australia, 35 Stirling Highway, Crawley, Perth, Western Australia 6009, Australia
| | - David J Handelsman
- ANZAC Research Institute, University of Sydney, Concord Hospital, New South Wales 2139, Australia
| | - Mithran Goonawardene
- School of Dentistry/Oral Health Centre of Western Australia, University of Western Australia, 35 Stirling Highway, Crawley, Perth, Western Australia 6009, Australia
| | - Peter Eastwood
- Centre for Sleep Science, School of Anatomy, Physiology and Human Biology, University of Western Australia, 35 Stirling Highway, Crawley, Perth, Western Australia 6009, Australia
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Affiliation(s)
- Mike Daube
- Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Peter Eastwood
- School of Anatomy, Physiology and Human Biology, University of Western Australia, Perth, Western Australia, Australia
| | - Michiaki Mishima
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Matthew Peters
- Faculty of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales, Australia
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Ng L, Jenkins S, Cecins N, Eastwood P, Hill K. A wheeled walker improves physical activity in chronic obstructive pulmonary disease. Physiotherapy 2015. [DOI: 10.1016/j.physio.2015.03.1974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Eastwood P, Bultynck L. Celebrating 20 years ofRespirology. Respirology 2014. [DOI: 10.1111/resp.12443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Peter Eastwood
- West Australian Sleep Disorders Research Institute; Sir Charles Gairdner Hospital; University of Western Australia; Perth Western Australia Australia
- Centre for Sleep Science; University of Western Australia; Perth Western Australia Australia
| | - Lieve Bultynck
- Respirology Editorial Office; School of Anatomy, Physiology and Human Biology; University of Western Australia; Perth Western Australia Australia
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Eastwood P, Bultynck L, van Eekelen A, Norman C. Towards better-quality research reporting in Respirology. Respirology 2014; 19:1093-4. [PMID: 25302754 DOI: 10.1111/resp.12386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Peter Eastwood
- West Australian Sleep Disorders Research Institute, Sir Charles Gairdner Hospital, University of Western Australia, Perth, Western Australia, Australia; Centre for Sleep Science, University of Western Australia, Perth, Western Australia, Australia
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Hillman D, Singh B, McArdle N, Eastwood P. Relationships between ventilatory impairment, sleep hypoventilation and type 2 respiratory failure. Respirology 2014; 19:1106-16. [PMID: 25219542 DOI: 10.1111/resp.12376] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Revised: 07/18/2014] [Accepted: 07/20/2014] [Indexed: 01/25/2023]
Affiliation(s)
- David Hillman
- Department of Pulmonary Physiology and Sleep Medicine; Sir Charles Gairdner Hospital; Perth Western Australia Australia
- West Australian Sleep Disorders Research Institute; Sir Charles Gairdner Hospital; Perth Western Australia Australia
- Centre for Sleep Science; School of Anatomy, Physiology and Human Biology; University of Western Australia; Perth Western Australia Australia
| | - Bhajan Singh
- Department of Pulmonary Physiology and Sleep Medicine; Sir Charles Gairdner Hospital; Perth Western Australia Australia
- West Australian Sleep Disorders Research Institute; Sir Charles Gairdner Hospital; Perth Western Australia Australia
| | - Nigel McArdle
- Department of Pulmonary Physiology and Sleep Medicine; Sir Charles Gairdner Hospital; Perth Western Australia Australia
- West Australian Sleep Disorders Research Institute; Sir Charles Gairdner Hospital; Perth Western Australia Australia
- Centre for Sleep Science; School of Anatomy, Physiology and Human Biology; University of Western Australia; Perth Western Australia Australia
| | - Peter Eastwood
- Department of Pulmonary Physiology and Sleep Medicine; Sir Charles Gairdner Hospital; Perth Western Australia Australia
- West Australian Sleep Disorders Research Institute; Sir Charles Gairdner Hospital; Perth Western Australia Australia
- Centre for Sleep Science; School of Anatomy, Physiology and Human Biology; University of Western Australia; Perth Western Australia Australia
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Affiliation(s)
- Karen Redhead
- Centre for Sleep Science, School of Anatomy, Physiology & Human Biology, University of Western Australia, Crawley, Western Australia, Australia
| | - Peter Eastwood
- Centre for Sleep Science, School of Anatomy, Physiology & Human Biology, University of Western Australia, Crawley, Western Australia, Australia West Australian Sleep Disorders Research Institute, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Christopher Griffin
- King Edward Memorial Hospital for Women, Subiaco, Western Australia, Australia
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Robey E, Dawson B, Halson S, Gregson W, King S, Goodman C, Eastwood P. Effect of evening postexercise cold water immersion on subsequent sleep. Med Sci Sports Exerc 2014; 45:1394-402. [PMID: 23377833 DOI: 10.1249/mss.0b013e318287f321] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
PURPOSE This study investigated the effect of cold water immersion after evening exercise on subsequent sleep quality and quantity in trained cyclists. METHODS In the evenings (~1900 h) on three separate occasions, male cyclists (n = 11) underwent either no exercise (control, CON), exercise only (EX), or exercise followed by cold water immersion (CWI). EX comprised cycling for 15 min at 75% peak power, then a 15-min maximal time trial. After each condition, a full laboratory-based sleep study (polysomnography) was performed. Core and skin temperature, heart rate, salivary melatonin, ratings of perceived fatigue, and recovery were measured in each trial. RESULTS No differences were observed between conditions for any whole night sleep measures, including total sleep time, sleep efficiency, sleep onset latency, rapid eye movement onset latency, wake after sleep onset, or proportion of the night spent in different sleep stages. Core temperature in EX and CWI trials was higher than CON, until it decreased below that of EX and CON until bedtime in CWI. After bedtime, core temperature was similar for all conditions throughout the night, except for a 90-min period where it was lower for CWI than EX and CON (3.5-4.5 h postexercise). Heart rates for EX and CWI were both significantly higher than CON postexercise until bedtime, whereas skin temperature after CWI was significantly lower than EX and CON, remaining lower than EX until 3 h postexercise. Melatonin levels and recovery ratings were similar between conditions. Fatigue ratings were significantly elevated after exercise in both CWI and EX conditions, with EX still being elevated compared with CON at bedtime. CONCLUSION Whole night sleep architecture is not affected by evening exercise alone or when followed by CWI.
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Affiliation(s)
- Elisa Robey
- School of Sport Science, Exercise and Health, The University of Western Australia, Crawley, Australia.
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Khadim M, Eastwood P, Price J, Morrison P, Khan K. Multidisciplinary one-stage risk-reducing gynaecological and breast surgery with immediate reconstruction in BRCA-gene carrier women. Eur J Surg Oncol 2013; 39:1346-50. [DOI: 10.1016/j.ejso.2013.09.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2013] [Revised: 09/10/2013] [Accepted: 09/14/2013] [Indexed: 10/26/2022] Open
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Robey E, Dawson B, Halson S, Gregson W, Goodman C, Eastwood P. Sleep quantity and quality ineliteyouth soccer players: A pilot study. Eur J Sport Sci 2013; 14:410-7. [DOI: 10.1080/17461391.2013.843024] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Skinner T, McNeil L, Olaithe M, Eastwood P, Hillman D, Phang J, de Regt T, Bucks RS. Predicting uptake of continuous positive airway pressure (CPAP) therapy in obstructive sleep apnoea (OSA): a belief-based theoretical approach. Sleep Breath 2013; 17:1229-40. [PMID: 23516025 DOI: 10.1007/s11325-013-0828-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2012] [Revised: 02/06/2013] [Accepted: 03/04/2013] [Indexed: 11/26/2022]
Abstract
PURPOSE Obstructive sleep apnoea (OSA) is a common disorder, for which continuous positive airway pressure (CPAP) therapy is a standard treatment. Despite its well-established efficacy, many patients choose not to initiate CPAP treatment. The present study investigated the degree to which biological measures (e.g. Apnoea-Hypopnoea Index [AHI]), symptom experiences (e.g. fatigue) and illness representations (e.g. perceived consequences) predict the decision of individuals newly diagnosed with OSA to undergo a trial of CPAP therapy. METHODS Four hundred forty-nine individuals (316 males) newly diagnosed with OSA. Epworth sleepiness scale (ESS), Fatigue Severity Scale, Depression Anxiety Stress Scale and Illness Perception Questionnaire-Revised (IPQ-R) were administered at time of sleep study. These, patient demographics and sleep study variables were used to determine factors predicting patient decision to proceed with a trial of CPAP. RESULTS The participants were most likely to attribute their OSA to unchangeable and psychological factors. For those with moderate OSA (AHI, 15 to 30) IPQ-R illness consequence was predictive of decision to initiate CPAP (p = 0.002). For severe OSA (AHI >30) age, ESS and IPQ illness causal beliefs were predictive of decision to initiate CPAP (p < 0.001). CONCLUSIONS Illness beliefs are important determinants of the choice of recently diagnosed OSA patients whether or not to undertake a trial of CPAP therapy. Concerns about illness consequences were important in those with moderate OSA. In severe OSA, sleepiness symptoms are more prominent and a more significant determinant of CPAP uptake along with age and causal beliefs.
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Affiliation(s)
- Timothy Skinner
- Psychological and Clinical Sciences, Charles Darwin University, Darwin, Northern Territory, 0909, Australia,
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Williamson J, Hillman D, James A, Eastwood P. Reply: Airway compliance studied by lumen area changes alone cannot discriminate between collapsibility and elasticity. Am J Respir Crit Care Med 2013; 187:108. [PMID: 23397613 DOI: 10.1164/ajrccm.187.1.108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Shepherd K, Hillman D, Eastwood P. Symptoms of aerophagia are common in patients on continuous positive airway pressure therapy and are related to the presence of nighttime gastroesophageal reflux. J Clin Sleep Med 2013; 9:13-7. [PMID: 23319899 DOI: 10.5664/jcsm.2328] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES Continuous positive airway pressure (CPAP), the mainstay treatment for obstructive sleep apnea (OSA), involves administration of air under pressure to the upper airway. A well-known but poorly understood side effect of positive airway pressure therapies is aerophagia, air entering the esophagus and stomach rather than the lungs. Gastric distension, a consequence of aerophagia, can increase gastroesophageal reflux (GER) by increasing transient lower esophageal sphincter relaxations, the most common cause of reflux. This study aimed to determine: (i) the prevalence of aerophagia symptoms in a group of OSA patients on CPAP therapy, and (ii) whether aerophagia symptoms are related to an increase in prevalence of GER symptoms. METHODS Consecutive OSA patients undergoing polysomnography for the purpose of optimizing their CPAP therapy completed a validated questionnaire regarding GER symptoms and aerophagia symptoms. Complete datasets were collected for 259 individuals (203 males). RESULTS The group with aerophagia symptoms (n = 130) had a greater prevalence of frequent (≥ once a week) GER symptoms (29% vs. 10%, p < 0.05) and nighttime GER symptoms (9 vs. 2%, p < 0.05) than those without aerophagia (n = 129). The group with nighttime GER symptoms (n = 27) had a greater prevalence of aerophagia symptoms (63% vs. 23%, p < 0.05) than those without nighttime GER symptoms (n = 232). CONCLUSIONS In patients with OSA being treated with CPAP, the prevalence of GER and nighttime GER symptoms is greater in those with symptoms of aerophagia than those without. CPAP-induced aerophagia might precipitate GER, particularly nighttime GER, by exacerbating transient lower esophageal relaxations through gastric distension.
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Affiliation(s)
- Kelly Shepherd
- West Australian Sleep Disorders Research Institute, Department of Pulmonary Physiology and Sleep Medicine, Sir Charles Gairdner Hospital, Nedlands, Australia
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50
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Simpson L, Hillman DR, Cooper MN, Ward KL, Hunter M, Cullen S, James A, Palmer LJ, Mukherjee S, Eastwood P. High prevalence of undiagnosed obstructive sleep apnoea in the general population and methods for screening for representative controls. Sleep Breath 2012; 17:967-73. [DOI: 10.1007/s11325-012-0785-0] [Citation(s) in RCA: 85] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2012] [Revised: 10/30/2012] [Accepted: 11/01/2012] [Indexed: 01/08/2023]
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