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Sawatari H, Kumagai H, Kawaguchi K, Kiyohara Y, Konishi N, Arita A, Hayashi M, Shiomi T. Risk factors for collisions attributed to microsleep-related behaviors while driving in professional truck drivers. Sci Rep 2024; 14:6378. [PMID: 38493230 PMCID: PMC10944504 DOI: 10.1038/s41598-024-57021-1] [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: 08/17/2023] [Accepted: 03/13/2024] [Indexed: 03/18/2024] Open
Abstract
Sleep-disordered breathing (SDB) is prevalent among professional drivers. Although SDB is a known risk factor for truck collisions attributed to microsleep-related behaviors at the wheel (TC-MRBs), the usefulness of overnight pulse oximetry for predicting TC-MRBs is debatable. This retrospective study assessed the association between overnight pulse oximetry parameters, the Epworth Sleepiness Scale (ESS), and TC-MRBs, confirmed by dashcam footage. This study included 108 matched professional truck drivers (TC-MRBs: N = 54; non-TC-MRBs: N = 54), with a mean age and body mass index of 41.9 ± 11.3 years and 23.0 ± 3.7 kg/m2, respectively. Night-time drivers, 4% oxygen desaturation index (ODI), and nadir oxygen saturation (SpO2) were associated with TC-MRBs (odds ratio [95% confidence interval]: 25.63 [5.88-111.77], p < 0.0001; 2.74 [1.02-7.33], p = 0.045; and 3.87 [1.04-14.39], p = 0.04, respectively). The area under the curve of 4% ODI and nadir SpO2 for TC-MRBs were 0.50 and 0.57, respectively. In conclusion, night-time driving, 4% ODI, and nadir SpO2 were significantly associated with TC-MRBs in professional truck drivers. However, the sensitivity of overnight pulse oximetry parameters to predict TC-MRBs in a real-world application was poor. Therefore, combining subjective and objective assessments such as dashcam video footage may be needed to achieve high accuracy for predicting TC-MRBs among professional truck drivers.
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Affiliation(s)
- Hiroyuki Sawatari
- Department of Perioperative and Critical Care Management, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Hajime Kumagai
- Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 7348533, Japan.
- Sleep Disorders Center, Hiroshima University Hospital, Hiroshima, Japan.
| | - Kengo Kawaguchi
- Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 7348533, Japan
| | - Yuka Kiyohara
- Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 7348533, Japan
- Sleep Disorders Center, Hiroshima University Hospital, Hiroshima, Japan
| | - Noriyuki Konishi
- Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 7348533, Japan
| | - Aki Arita
- Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 7348533, Japan
| | - Mitsuo Hayashi
- Graduate School of Integrated Arts and Sciences, Hiroshima University, Hiroshima, Japan
| | - Toshiaki Shiomi
- Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 7348533, Japan
- Sleep Disorders Center, Hiroshima University Hospital, Hiroshima, Japan
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2
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Kumagai H, Tsuda H, Kawaguchi K, Sawatari H, Kiyohara Y, Konishi N, Taniyama Y, Takaoka T, Shiomi T. Truck collisions attributed to falling asleep at the wheel in two commercial drivers prescribed oral appliance therapy for obstructive sleep apnea. J Clin Sleep Med 2023; 19:2117-2122. [PMID: 37551827 PMCID: PMC10692933 DOI: 10.5664/jcsm.10758] [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: 05/18/2023] [Revised: 08/03/2023] [Accepted: 08/03/2023] [Indexed: 08/09/2023]
Abstract
Falling asleep at the wheel is attributed to sleepiness, and obstructive sleep apnea is a significant cause of sleepiness that increases the risk of motor vehicle collisions due to falling asleep at the wheel. Although continuous positive airway pressure therapy for obstructive sleep apnea reduces the risk of motor vehicle collisions, similar evidence for alternatives such as oral appliance therapy is lacking. We discuss two truck collisions attributed to microsleep confirmed with dashcam video footage of commercial drivers with obstructive sleep apnea. Our results highlight the current situation where there is insufficient evidence for the prevention and reduction of the risk of motor vehicle collisions by oral appliance therapy, objective adherence monitoring of oral appliance therapy, and effectiveness confirmation tests. Therefore, it is suggested that for commercial truck drivers who require a high level of driving safety, careful selection for oral appliance therapy, systematic follow-up, and monitoring of the driver and truck status with dashcam video footage are crucial. CITATION Kumagai H, Tsuda H, Kawaguchi K, et al. Truck collisions attributed to falling asleep at the wheel in two commercial drivers prescribed oral appliance therapy for obstructive sleep apnea. J Clin Sleep Med. 2023;19(12):2117-2122.
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Affiliation(s)
- Hajime Kumagai
- Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
- Sleep Disorders Center, Hiroshima University Hospital, Hiroshima, Japan
| | - Hiroko Tsuda
- Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
- General Dentistry, Kyushu University Hospital, Fukuoka, Japan
| | - Kengo Kawaguchi
- Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Hiroyuki Sawatari
- Department of Perioperative and Critical Care Management, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yuka Kiyohara
- Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
- Sleep Disorders Center, Hiroshima University Hospital, Hiroshima, Japan
| | - Noriyuki Konishi
- Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yukari Taniyama
- Department of Internal Medicine, Kagoshima Takaoka Hospital, Kagoshima, Japan
| | - Toshio Takaoka
- Department of Internal Medicine, Kagoshima Takaoka Hospital, Kagoshima, Japan
| | - Toshiaki Shiomi
- Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
- Sleep Disorders Center, Hiroshima University Hospital, Hiroshima, Japan
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Kumagai H, Tsuda H, Shiomi T. Which treatments are effective in preventing motor vehicle accidents in patients with obstructive sleep apnea? Sleep Breath 2023; 27:1941-1942. [PMID: 36869988 DOI: 10.1007/s11325-023-02804-5] [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] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 11/16/2022] [Accepted: 02/28/2023] [Indexed: 03/05/2023]
Affiliation(s)
- Hajime Kumagai
- Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 7348533, Japan.
- Sleep Disorders Center, Hiroshima University Hospital, Hiroshima, Japan.
| | - Hiroko Tsuda
- Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 7348533, Japan
- Department of General Dentistry, Kyushu University Hospital, Fukuoka, Japan
| | - Toshiaki Shiomi
- Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 7348533, Japan
- Sleep Disorders Center, Hiroshima University Hospital, Hiroshima, Japan
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Kumagai H, Kawaguchi K, Sawatari H, Kiyohara Y, Hayashi M, Shiomi T. Dashcam video footage-based analysis of microsleep-related behaviors in truck collisions attributed to falling asleep at the wheel. Accid Anal Prev 2023; 187:107070. [PMID: 37060664 DOI: 10.1016/j.aap.2023.107070] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 03/23/2023] [Accepted: 04/05/2023] [Indexed: 05/12/2023]
Abstract
OBJECTIVE With the rapid spread of dashcams, many car accidents have been recorded; however, behavioral approaches using these dashcam video footage have not been sufficiently examined. We employed dashcam video footage to evaluate microsleep-related behaviors immediately prior to real-world truck collisions in professional drivers to explore a new solution to reduce collisions attributed to falling asleep at the wheel. METHODS In total, 3,120 s of video footage (60 s/case × 52 cases) from real-world truck collisions of 52 professional drivers obtained from interior and exterior dashcams were used and visually analyzed in a second-by-second manner to simultaneously evaluate any eye changes and microsleep-related behaviors (the driver's anti-sleepiness behavior, behavioral signs of microsleep, and abnormal vehicle behavior) during driving. RESULTS Assessment of the frequency of occurrence of each item of microsleep-related behavior in the 52 collisions revealed that the item "touching" in terms of anti-sleepiness behavior, "absence of body movement" in terms of behavioral signs of microsleep, and "inappropriate line crossing" in terms of abnormal vehicle behavior were observed at the highest rate in all drivers (46.2%, 75.0%, and 78.8%, respectively). Decreases in anti-sleepiness behavior coincided with increases in behavioral signs of microsleep and abnormal vehicle behavior, with collisions occurring within approximately 40 s of these changes. Collisions were more common among young people and in the early morning and evening. CONCLUSION Our dashcam video footage-based analysis in truck collisions attributed to falling asleep at the wheel revealed the process of changes in microsleep-related driver and vehicle behaviors, classified as anti-sleepiness behavior, behavioral signs of microsleep, and abnormal vehicle behavior. Based on these findings, to prevent collisions caused by falling asleep at the wheel, it is crucial to monitor not only the driver's eyes, but also the driver's whole body and vehicle behavior simultaneously to reliably detect microsleep-related behaviors.
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Affiliation(s)
- Hajime Kumagai
- Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 7348553, Japan.
| | - Kengo Kawaguchi
- Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 7348553, Japan
| | - Hiroyuki Sawatari
- Department of Perioperative and Critical Care Management, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 7348553, Japan
| | - Yuka Kiyohara
- Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 7348553, Japan
| | - Mitsuo Hayashi
- Graduate School of Integrated Arts and Sciences, Hiroshima University, 1-7-1 Kagamiyama, Higashi-Hiroshima 7398521, Japan
| | - Toshiaki Shiomi
- Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 7348553, Japan
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5
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Arita A, Kumagai H, Sawatari H, Hoshino T, Konishi N, Murase Y, Urabe A, Nomura A, Sasanabe R, Shiomi T. Advanced emergency braking system reduces the risk of motor vehicle collisions caused by falling asleep while driving in patients with untreated obstructive sleep apnea. J Sleep Res 2023; 32:e13713. [PMID: 36053798 DOI: 10.1111/jsr.13713] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 07/13/2022] [Accepted: 07/21/2022] [Indexed: 02/03/2023]
Abstract
Obstructive sleep apnea leads to excessive daytime sleepiness and cognitive dysfunction, which are risk factors for motor vehicle collisions. We aimed to clarify if vehicles with an advanced emergency braking system could reduce motor vehicle collisions caused by falling asleep while driving among patients with untreated obstructive sleep apnea. We enrolled patients with untreated obstructive sleep apnea who underwent polysomnography. The questionnaires included the Epworth Sleepiness Scale, Pittsburgh Sleep Quality Index, history of drowsy driving accidents, and use of an advanced emergency braking system. Multivariate analysis was performed, and odds ratios and 95% confidence intervals were calculated. This study included 1097 patients (mean age, 51.2 ± 12.9 years). Collisions caused by falling asleep while driving were recorded in 59 (5.4%) patients, and were more frequently observed in vehicles without an advanced emergency braking system (p = 0.045). Multivariate analysis showed that these collisions were associated with use of an advanced emergency braking system (odds ratio [95% confidence interval]: 0.39 [0.16-0.97], p = 0.04), length of driving (2.79 [1.19-6.50], p = 0.02), total sleep time (2.40 [1.62-3.55], p < 0.0001), sleep efficiency (0.94 [0.90-0.98], p = 0.003) and periodic limb movement index (1.02 [1.01-1.03], p = 0.004). The collision risk caused by falling asleep while driving in vehicles with an advanced emergency braking system was significantly lower. This study indicates that advanced emergency braking systems may be a preventive measure to reduce motor vehicle collisions among patients with untreated obstructive sleep apnea.
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Affiliation(s)
- Aki Arita
- Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.,Department of Sleep Medicine and Sleep Disorders Center, Aichi Medical University Hospital, Aichi, Japan
| | - Hajime Kumagai
- Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.,Department of Sleep Medicine and Sleep Disorders Center, Aichi Medical University Hospital, Aichi, Japan
| | - Hiroyuki Sawatari
- Department of Sleep Medicine and Sleep Disorders Center, Aichi Medical University Hospital, Aichi, Japan.,Department of Perioperative and Critical Care Management, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Tetsuro Hoshino
- Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.,Department of Sleep Medicine and Sleep Disorders Center, Aichi Medical University Hospital, Aichi, Japan
| | - Noriyuki Konishi
- Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.,Department of Sleep Medicine and Sleep Disorders Center, Aichi Medical University Hospital, Aichi, Japan
| | - Yoko Murase
- Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.,Department of Sleep Medicine and Sleep Disorders Center, Aichi Medical University Hospital, Aichi, Japan
| | - Ayako Urabe
- Department of Sleep Medicine and Sleep Disorders Center, Aichi Medical University Hospital, Aichi, Japan
| | - Atsuhiko Nomura
- Department of Sleep Medicine and Sleep Disorders Center, Aichi Medical University Hospital, Aichi, Japan
| | - Ryujiro Sasanabe
- Department of Sleep Medicine and Sleep Disorders Center, Aichi Medical University Hospital, Aichi, Japan
| | - Toshiaki Shiomi
- Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.,Department of Sleep Medicine and Sleep Disorders Center, Aichi Medical University Hospital, Aichi, Japan
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6
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Kumagai H, Sawatari H, Kiyohara Y, Kanoh A, Asada K, Kawaguchi K, Arita A, Murase Y, Konishi N, Hoshino T, Hayashi M, Shiomi T. Nocturnal hypoxemia is related to morning negative affectivity in untreated patients with severe obstructive sleep apnea. Sci Rep 2022; 12:21262. [PMID: 36482199 PMCID: PMC9732184 DOI: 10.1038/s41598-022-25842-7] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 12/06/2022] [Indexed: 12/13/2022] Open
Abstract
The relationship between sleep apnea and morning affectivity remains unclear. We aimed to clarify how sleep disturbance in patients with obstructive sleep apnea (OSA) influences their affectivity. The enrolled participants underwent the Positive and Negative Affect Schedule on their beds immediately before and after overnight polysomnography. Thirty patients with OSA were divided into two groups according to the apnea-hypopnea index (AHI): mild to moderate OSA (5 ≤ AHI < 30/h) and severe OSA (AHI ≥ 30/h) groups. Additionally, 11 healthy participants (AHI < 5/h) were included as the control group. No independent association was found between affectivity and OSA severity markers in the whole population; however, the severe OSA group had a significantly higher cumulative percentage of sleep time at saturations < 90% (CT90) and worsened morning negative affectivity. Multiple regression analysis showed that CT90 was an independent factor for increasing negative affectivity in the severe OSA group (p = 0.0422). In patients with OSA, the receiver operating characteristic curve analysis showed that the best cutoff value for CT90 for predicting no decrease in negative affectivity after sleep was 1.0% (sensitivity = 0.56, specificity = 0.86); the corresponding area under the curve was 0.71. Worsening of negative affectivity in the morning was influenced by nocturnal hypoxemia in patients with severe OSA.
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Affiliation(s)
- Hajime Kumagai
- grid.257022.00000 0000 8711 3200Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, 7348553 Japan ,grid.470097.d0000 0004 0618 7953Sleep Disorders Center, Hiroshima University Hospital, Hiroshima, 7348553 Japan ,Hiroshima Minato Clinic, Hiroshima, 7340014 Japan
| | - Hiroyuki Sawatari
- grid.257022.00000 0000 8711 3200Department of Perioperative and Critical Care Management, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, 7348553 Japan
| | - Yuka Kiyohara
- grid.257022.00000 0000 8711 3200Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, 7348553 Japan ,grid.470097.d0000 0004 0618 7953Sleep Disorders Center, Hiroshima University Hospital, Hiroshima, 7348553 Japan
| | - Akiko Kanoh
- grid.470097.d0000 0004 0618 7953Division of Clinical Support, Hiroshima University Hospital, Hiroshima, 7348553 Japan
| | - Kana Asada
- grid.470097.d0000 0004 0618 7953Division of Clinical Support, Hiroshima University Hospital, Hiroshima, 7348553 Japan
| | - Kengo Kawaguchi
- grid.257022.00000 0000 8711 3200Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, 7348553 Japan
| | - Aki Arita
- grid.257022.00000 0000 8711 3200Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, 7348553 Japan
| | - Yoko Murase
- grid.257022.00000 0000 8711 3200Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, 7348553 Japan
| | - Noriyuki Konishi
- grid.257022.00000 0000 8711 3200Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, 7348553 Japan
| | - Tetsuro Hoshino
- grid.257022.00000 0000 8711 3200Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, 7348553 Japan
| | - Mitsuo Hayashi
- grid.257022.00000 0000 8711 3200Graduate School of Humanities and Social Sciences, Hiroshima University, Higashi-Hiroshima, 7398521 Japan
| | - Toshiaki Shiomi
- grid.257022.00000 0000 8711 3200Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, 7348553 Japan ,grid.470097.d0000 0004 0618 7953Sleep Disorders Center, Hiroshima University Hospital, Hiroshima, 7348553 Japan
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7
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Suzuki M, Shimamoto K, Tatsumi F, Tsuji T, Satoya N, Inoue Y, Hoshino T, Shiomi T, Hagiwara N. Long-term outcomes regarding arterial stiffness and carotid artery atherosclerosis in female patients with rapid eye movement obstructive sleep apnea. J Int Med Res 2022; 50:3000605221121941. [PMID: 36124891 PMCID: PMC9500274 DOI: 10.1177/03000605221121941] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objective Rapid eye movement (REM) obstructive sleep apnea (OSA) is associated with the
risk of cardiovascular events. Arterial stiffness and carotid artery
intima-media thickness (IMT) predict these events, but few relevant studies
have been conducted. We compared long-term changes in arterial stiffness and
IMT between patients with REM OSA and non-REM (NREM) OSA receiving
continuous positive airway pressure (CPAP) or oral appliance (OA)
therapy. Methods Newly diagnosed female patients with OSA received CPAP (n = 6) or OA (n = 7).
Pulse wave velocity (PWV) and carotid artery ultrasound were performed
before and 60 months after treatment. Results There were no differences in baseline characteristics (mean age: 56.0 vs.
61.3 years; mean body mass index: 22.6 vs. 21.7 kg/m2) between
the REM OSA and non-REM OSA groups. The median apnea-hypopnea index was
lower in the REM OSA group than in the non-REM OSA group. Increased PWV
(12.92 ± 1.64 to 14.56 ± 2.73 m/s) and deteriorated glucose metabolism were
observed in the REM OSA group after treatment. PWV, IMT, and cardiovascular
risk factors were unaffected in the non-REM OSA group. Conclusion Arterial stiffness and glucose metabolism are deteriorated in patients with
REM OSA compared with these parameters in patients with non-REM OSA after
CPAP or OA treatment.
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Affiliation(s)
- Mayumi Suzuki
- Division of Comprehensive Sleep Medicine, Tokyo Women's Medical University Hospital (TWMU), Tokyo, Japan
| | | | | | | | | | - Yuji Inoue
- Central Clinical Laboratory, TWMU, Tokyo, Japan
| | - Tetsuro Hoshino
- Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.,Hoshino ENT and Sleep Disordered Breathing Center, Hyogo, Japan
| | - Toshiaki Shiomi
- Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Nobuhisa Hagiwara
- Division of Comprehensive Sleep Medicine, Tokyo Women's Medical University Hospital (TWMU), Tokyo, Japan.,Department of Cardiology, TWMU, Tokyo, Japan
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Kumagai H, Sawatari H, Hoshino T, Konishi N, Kiyohara Y, Kawaguchi K, Murase Y, Urabe A, Arita A, Shiomi T. Effects of Continuous Positive Airway Pressure Therapy on Nocturnal Blood Pressure Fluctuation Patterns in Patients with Obstructive Sleep Apnea. Int J Environ Res Public Health 2022; 19:9906. [PMID: 36011538 PMCID: PMC9407792 DOI: 10.3390/ijerph19169906] [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] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 08/02/2022] [Accepted: 08/07/2022] [Indexed: 06/15/2023]
Abstract
This retrospective study was designed to evaluate the effects of continuous positive airway pressure (CPAP) therapy, a well-established treatment for obstructive sleep apnea (OSA), on nocturnal blood pressure fluctuations (NBPFs) during rapid eye movement (REM) and non-REM sleep, and to evaluate the NBPF patterns in patients with OSA. We included 34 patients with moderate-to-severe OSA who underwent polysomnography using pulse transit time before and at 3−6 months after CPAP therapy. Nocturnal BP and NBPF frequency in REM and non-REM sleep were investigated, as well as NBPF pattern changes after receiving CPAP therapy. CPAP therapy resulted in significant reductions in the apnea−hypopnea index (AHI), arousal index, nocturnal systolic and diastolic BP, and NBPF frequency in REM and non-REM sleep (all p < 0.01). A higher AHI before CPAP resulted in lower nocturnal systolic BP (r = 0.40, p = 0.019) and NBPFs (r = 0.51, p = 0.002) after CPAP. However, 58.8% of patients showed no change in NBPF patterns with CPAP therapy. CPAP therapy significantly improved almost all sleep-related parameters, nocturnal BP, and NBPF frequency in REM and non-REM sleep periods, but NBPF patterns showed various changes post-CPAP therapy. These results suggest that factors other than OSA influence changes in NBPF patterns.
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Affiliation(s)
- Hajime Kumagai
- Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 7348553, Japan
- Hiroshima Minato Clinic, Hiroshima 7340014, Japan
| | - Hiroyuki Sawatari
- Department of Perioperative and Critical Care Management, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 7348553, Japan
| | - Tetsuro Hoshino
- Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 7348553, Japan
- Department of Sleep Medicine and Sleep Disorders Center, Aichi Medical University Hospital, Nagakute 4801195, Japan
| | - Noriyuki Konishi
- Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 7348553, Japan
- Department of Sleep Medicine and Sleep Disorders Center, Aichi Medical University Hospital, Nagakute 4801195, Japan
| | - Yuka Kiyohara
- Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 7348553, Japan
| | - Kengo Kawaguchi
- Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 7348553, Japan
| | - Yoko Murase
- Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 7348553, Japan
| | - Ayako Urabe
- Department of Psychology and Medical Science, Graduate School of Psychology and Medical Sciences, Aichi Shukutoku University, Nagakute 4801197, Japan
| | - Aki Arita
- Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 7348553, Japan
- Department of Sleep Medicine and Sleep Disorders Center, Aichi Medical University Hospital, Nagakute 4801195, Japan
| | - Toshiaki Shiomi
- Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 7348553, Japan
- Department of Sleep Medicine and Sleep Disorders Center, Aichi Medical University Hospital, Nagakute 4801195, Japan
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9
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Konishi N, Kumagai H, Sawatari H, Hoshino T, Murase Y, Yamaguchi M, Urabe A, Kiyohara Y, Arita A, Baku M, Sasanabe R, Shiomi T. Efficacy of a Combination Therapy for Difficulties Waking Up in Non-School-Attending Students. J Clin Med 2022; 11:jcm11123271. [PMID: 35743342 PMCID: PMC9225467 DOI: 10.3390/jcm11123271] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 05/31/2022] [Accepted: 06/06/2022] [Indexed: 11/29/2022] Open
Abstract
School non-attendance due to difficulties waking up is increasing in Japan, and affected students are commonly diagnosed with orthostatic dysregulation (OD); however, OD-associated sleep problems are overlooked. To date, no sleep-medicine-based treatment for wake-up difficulties in non-school-attending students has been established. This study aimed to assess the efficacy of a novel combination therapy for these students. We assessed the combined effect of sleep hygiene guidance, low-dose aripiprazole administration (3 mg/day), and blue-light exposure on wake-up difficulty in 21 non-school-attending teenage patients. The patients were evaluated using sleep studies and questionnaires before and after treatment. The average subjective total sleep time calculated from sleep diaries before treatment in the patients was 10.3 h. The therapy improved wake-up difficulty by 85.7% and further improved school non-attendance by 66.7%. The subjective sleep time significantly decreased by 9.5 h after treatment (p = 0.0004). The self-rating Depression Scale and mental component summary of the 36-item Short-Form Health Survey significantly improved after treatment (p = 0.002 and p = 0.01, respectively). Wake-up difficulties were caused by the addition of a delayed sleep phase to the patients’ long sleep times. The novel combination therapy was effective in improving wake-up difficulty and mental quality of life in non-school-attending teenage students.
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Affiliation(s)
- Noriyuki Konishi
- Department of Sleep Medicine and Sleep Disorders Center, Aichi Medical University Hospital, Nagakute 4801195, Japan; (N.K.); (H.S.); (T.H.); (Y.M.); (M.Y.); (A.U.); (Y.K.); (A.A.); (M.B.); (R.S.); (T.S.)
- Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 7348553, Japan
| | - Hajime Kumagai
- Department of Sleep Medicine and Sleep Disorders Center, Aichi Medical University Hospital, Nagakute 4801195, Japan; (N.K.); (H.S.); (T.H.); (Y.M.); (M.Y.); (A.U.); (Y.K.); (A.A.); (M.B.); (R.S.); (T.S.)
- Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 7348553, Japan
- Correspondence: ; Tel.: +81-82-257-1922
| | - Hiroyuki Sawatari
- Department of Sleep Medicine and Sleep Disorders Center, Aichi Medical University Hospital, Nagakute 4801195, Japan; (N.K.); (H.S.); (T.H.); (Y.M.); (M.Y.); (A.U.); (Y.K.); (A.A.); (M.B.); (R.S.); (T.S.)
- Department of Perioperative and Critical Care Management, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 7348553, Japan
| | - Tetsuro Hoshino
- Department of Sleep Medicine and Sleep Disorders Center, Aichi Medical University Hospital, Nagakute 4801195, Japan; (N.K.); (H.S.); (T.H.); (Y.M.); (M.Y.); (A.U.); (Y.K.); (A.A.); (M.B.); (R.S.); (T.S.)
- Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 7348553, Japan
| | - Yoko Murase
- Department of Sleep Medicine and Sleep Disorders Center, Aichi Medical University Hospital, Nagakute 4801195, Japan; (N.K.); (H.S.); (T.H.); (Y.M.); (M.Y.); (A.U.); (Y.K.); (A.A.); (M.B.); (R.S.); (T.S.)
- Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 7348553, Japan
| | - Maiko Yamaguchi
- Department of Sleep Medicine and Sleep Disorders Center, Aichi Medical University Hospital, Nagakute 4801195, Japan; (N.K.); (H.S.); (T.H.); (Y.M.); (M.Y.); (A.U.); (Y.K.); (A.A.); (M.B.); (R.S.); (T.S.)
| | - Ayako Urabe
- Department of Sleep Medicine and Sleep Disorders Center, Aichi Medical University Hospital, Nagakute 4801195, Japan; (N.K.); (H.S.); (T.H.); (Y.M.); (M.Y.); (A.U.); (Y.K.); (A.A.); (M.B.); (R.S.); (T.S.)
| | - Yuka Kiyohara
- Department of Sleep Medicine and Sleep Disorders Center, Aichi Medical University Hospital, Nagakute 4801195, Japan; (N.K.); (H.S.); (T.H.); (Y.M.); (M.Y.); (A.U.); (Y.K.); (A.A.); (M.B.); (R.S.); (T.S.)
- Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 7348553, Japan
| | - Aki Arita
- Department of Sleep Medicine and Sleep Disorders Center, Aichi Medical University Hospital, Nagakute 4801195, Japan; (N.K.); (H.S.); (T.H.); (Y.M.); (M.Y.); (A.U.); (Y.K.); (A.A.); (M.B.); (R.S.); (T.S.)
- Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 7348553, Japan
| | - Masayo Baku
- Department of Sleep Medicine and Sleep Disorders Center, Aichi Medical University Hospital, Nagakute 4801195, Japan; (N.K.); (H.S.); (T.H.); (Y.M.); (M.Y.); (A.U.); (Y.K.); (A.A.); (M.B.); (R.S.); (T.S.)
| | - Ryujiro Sasanabe
- Department of Sleep Medicine and Sleep Disorders Center, Aichi Medical University Hospital, Nagakute 4801195, Japan; (N.K.); (H.S.); (T.H.); (Y.M.); (M.Y.); (A.U.); (Y.K.); (A.A.); (M.B.); (R.S.); (T.S.)
| | - Toshiaki Shiomi
- Department of Sleep Medicine and Sleep Disorders Center, Aichi Medical University Hospital, Nagakute 4801195, Japan; (N.K.); (H.S.); (T.H.); (Y.M.); (M.Y.); (A.U.); (Y.K.); (A.A.); (M.B.); (R.S.); (T.S.)
- Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 7348553, Japan
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10
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Hoshino T, Sasanabe R, Murotani K, Hori R, Mano M, Nomura A, Konishi N, Baku M, Nishio Y, Kato C, Kuczynski W, Shiomi T. Estimated respiratory arousal threshold in patients with rapid eye movement obstructive sleep apnea. Sleep Breath 2021; 26:347-353. [PMID: 33999361 PMCID: PMC8857081 DOI: 10.1007/s11325-021-02399-9] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 05/04/2021] [Accepted: 05/05/2021] [Indexed: 12/20/2022]
Abstract
Purpose Rapid eye movement (REM) obstructive sleep apnea (OSA) is a prevalent clinical phenotype. However, the literature focusing on the pathophysiology of REM OSA is limited. This study compared the proportion of individuals with a low respiratory arousal threshold between patients with REM and non-REM OSA. Methods REM OSA was defined as having an apnea–hypopnea index (AHI) ≥ 5 and AHI during REM (AHI-REM)/AHI during NREM (AHI-NREM) ≥ 2. REM OSA was sub-divided into REM-predominant OSA and REM-isolated OSA. REM-predominant OSA was defined as satisfying the definition of REM OSA and having an AHI-NREM ≥ 5. REM-isolated OSA was defined as satisfying the definition of REM OSA and having an AHI-NREM < 5. Patients with an AHI-REM/AHI-NREM < 2 were defined as having non-REM OSA. A low respiratory arousal threshold was defined as having 2 or more of the following conditions: AHI < 30 events/h, proportion of hypopnea > 58.3%, and nadir SpO2 > 82.5%. Results The proportions of individuals with low respiratory arousal thresholds among individuals with REM-predominant OSA and REM-isolated OSA were significantly higher (77.2% and 93.7%, respectively) than that of patients with non-REM OSA (48.6%). This was also true when the analysis was performed according to sex. Conclusion These results indicate that a low respiratory arousal threshold might be an important endotype that contributes to the pathogenesis of REM OSA, especially in REM-isolated OSA.
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Affiliation(s)
- Tetsuro Hoshino
- Department of Sleep Medicine and Sleep Disorder Center, Aichi Medical University Hospital, 1-1 Nagakute, Aichi, 4801195, Japan.
| | - Ryujiro Sasanabe
- Department of Sleep Medicine and Sleep Disorder Center, Aichi Medical University Hospital, 1-1 Nagakute, Aichi, 4801195, Japan
| | - Kenta Murotani
- Biostatistics Center, Graduate School of Medicine, Kurume University, 67 Asahimachi, Kurume, Fukuoka, 8300011, Japan
| | - Reiko Hori
- Department of Sleep Medicine and Sleep Disorder Center, Aichi Medical University Hospital, 1-1 Nagakute, Aichi, 4801195, Japan
| | - Mamiko Mano
- Department of Sleep Medicine and Sleep Disorder Center, Aichi Medical University Hospital, 1-1 Nagakute, Aichi, 4801195, Japan
| | - Atsuhiko Nomura
- Department of Sleep Medicine and Sleep Disorder Center, Aichi Medical University Hospital, 1-1 Nagakute, Aichi, 4801195, Japan
| | - Noriyuki Konishi
- Department of Sleep Medicine and Sleep Disorder Center, Aichi Medical University Hospital, 1-1 Nagakute, Aichi, 4801195, Japan
| | - Masayo Baku
- Department of Sleep Medicine and Sleep Disorder Center, Aichi Medical University Hospital, 1-1 Nagakute, Aichi, 4801195, Japan
| | - Yoshitomo Nishio
- Department of Oral and Maxillofacial Surgery, Aichi Medical University Hospital, 1-1 Nagakute, Aichi, 4801195, Japan
| | - Chihiro Kato
- Department of Sleep Medicine and Sleep Disorder Center, Aichi Medical University Hospital, 1-1 Nagakute, Aichi, 4801195, Japan
| | - Wojciech Kuczynski
- Department of Sleep Medicine and Metabolic Disorders, Medical University of Lodz, 90-001, Lodz, Poland
| | - Toshiaki Shiomi
- Department of Sleep Medicine and Sleep Disorder Center, Aichi Medical University Hospital, 1-1 Nagakute, Aichi, 4801195, Japan
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11
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Shiomi T. Bullous pemphigoid with neurofibroma-like histopathological change in two patients without neurofibromatosis type 1: Coincidence or association? Malays J Pathol 2020; 42:445-448. [PMID: 33361727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The author reports two cases of Bullous pemphigoid (BP) with neurofibroma (NF)-like histopathological change. The two patients without neurofibromatosis type 1 (NF1) presented with several bullae on their trunk. Based on the results of positivity for anti-BP180 antibody, direct immunofluorescence, and histopathological findings, they were diagnosed with BP. Histologically, another lesion in the dermis, which was composed of spindle cells with wavy nuclei, collagen fibers, and mast cells, was located close to the bulla. Immunohistochemically, the spindle cells were diffusely positive for S-100 protein and CD34, and weakly positive for epithelial membrane antigen in certain foci. These findings were considered to be "NF-like" histopathological change. This is the first two cases of BP with NF-like histopathological change in patients without NF1.
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Affiliation(s)
- T Shiomi
- Tottori Health Service Association, Tomiyasu 2-94-4, Tottori city, Tottori Japan 680-0845.
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12
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Takamatsu S, Kagiyama N, Shiomi T, Mizobuchi M, Sone N, Tougi K, Yamauchi S, Yuri T, Fukuyama S, Shibata M, Nakazawa R, Ii N, Masutani M, Hirohata A. Impact of radial compression protocols on the compression time and radial artery occlusion. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.3429] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Trans-radial access (TRA) has been established as a safe and established approach for invasive coronary catheter procedures. However, protocols for post-procedural hemostasis varies depending on institutes and an evidence-based protocol is lacking.
Purpose
The objective of this study was to investigate the clinical implications of procedural hemostasis.
Methods
Consecutive patients who were referred to outpatient catheter examination before and after April 2018 were treated with an old and a new protocol, respectively. In both protocols, we used the same commercially available hemostasis band with injecting an air of 16 ml for hemostasis. In the old protocol, the amount and timing of deflation were fixed, whereas the air was removed as much as possible for every 30 minutes in the new protocol. Time to complete hemostasis, the rate of major bleeding, and the rate of radial artery occlusion (RAO) at 6 months after the catheter examination were compared between the protocols.
Results
Total of 1,843 (71±10 years old, 77% male) patients was included in the study. Between patients in the old and the new protocol group (n=1,000 and 843, respectively), there was no significant difference in age, gender, body size, or systolic blood pressure. The new group had significantly higher prevalence of diabetes (47% vs 39%, p=0.002), slightly larger sheath size (4.1±0.3 vs 4.0±0.2 Fr, p<0.001), and lower rate of dual antiplatelet therapy (DAPT: 24% vs. 35%, p<0.001). Time for complete hemostasis was about one-third with the new protocol compared with the old protocol (65±32 vs. 190±16 min, p<0.001) and there was no major bleeding in either group. The rate of radial artery occlusion was 0.7% and 9.8% in the old and the new group (p<0.001). Multivariate analysis showed that the significant predictor of prolonged hemostasis time were the old protocol (odds ratio: OR 80.5, p<0.001) and the prescription of DAPT (OR 2.9, p<0.001), while the factors associated with higher risk of radial occlusion were the old protocol (OR 13.9, p<0.001), the number of previous TRA (OR 1.1, p<0.001), and smaller body size (OR 0.127 per 1 m2 increase p=0.005).
Conclusions
Our new protocol for hemostasis after TRA was strongly associated with shorter hemostasis time and a lower rate of radial artery occlusion. This approach will decrease the post-procedural hospital time with even fewer complication rates.
Study outline
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- S Takamatsu
- The Sakakibara Heart Institute of Okayama, Department of Nursing, Okayama, Japan
| | - N Kagiyama
- West Virginia University Hospital, Morgantown, United States of America
| | - T Shiomi
- The Sakakibara Heart Institute of Okayama, Cardiovascular Medicine, Okayama, Japan
| | - M Mizobuchi
- The Sakakibara Heart Institute of Okayama, Cardiovascular Medicine, Okayama, Japan
| | - N Sone
- The Sakakibara Heart Institute of Okayama, Cardiovascular Medicine, Okayama, Japan
| | - K Tougi
- The Sakakibara Heart Institute of Okayama, Cardiovascular Medicine, Okayama, Japan
| | - S Yamauchi
- The Sakakibara Heart Institute of Okayama, Cardiovascular Medicine, Okayama, Japan
| | - T Yuri
- The Sakakibara Heart Institute of Okayama, Cardiovascular Medicine, Okayama, Japan
| | - S Fukuyama
- The Sakakibara Heart Institute of Okayama, Cardiovascular Medicine, Okayama, Japan
| | - M Shibata
- The Sakakibara Heart Institute of Okayama, Department of Nursing, Okayama, Japan
| | - R Nakazawa
- The Sakakibara Heart Institute of Okayama, Department of Nursing, Okayama, Japan
| | - N Ii
- The Sakakibara Heart Institute of Okayama, Department of Nursing, Okayama, Japan
| | - M Masutani
- The Sakakibara Heart Institute of Okayama, Cardiovascular Medicine, Okayama, Japan
| | - A Hirohata
- The Sakakibara Heart Institute of Okayama, Cardiovascular Medicine, Okayama, Japan
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13
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Hoshino T, Sasanabe R, Mano M, Nomura A, Kato C, Sato M, Imai M, Murotani K, Guilleminault C, Shiomi T. Prevalence of Rapid Eye Movement-related Obstructive Sleep Apnea in Adult Narcolepsy. Intern Med 2019; 58:2151-2157. [PMID: 30996185 PMCID: PMC6709340 DOI: 10.2169/internalmedicine.2601-18] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 11/06/2022] Open
Abstract
Objective The association between narcolepsy and rapid eye movement (REM)-related obstructive sleep apnea (OSA) has not been reported. This study aimed to examine the prevalence of REM-related OSA in narcolepsy patients. Methods From January 2013 to April 2018, 141 adult patients were diagnosed with narcolepsy using nocturnal polysomnography and the multiple sleep latency test. The prevalence of REM-related OSA in narcolepsy patients was retrospectively reviewed. Three criteria were used to determine REM-related OSA: Definition #1, an overall apnea-hypopnea index (AHI) ≥5 and AHI during REM (AHIREM)/AHI during non-rapid eye movement (NREM) (AHINREM) ≥2; Definition #2, an overall AHI ≥5 and AHIREM/AHINREM≥2 and AHINREM <15; and Definition #3, an overall AHI ≥5 and AHIREM/AHINREM≥2 and AHINREM <8 plus an REM sleep duration >10.5 minutes. Results Of the 141 narcolepsy patients, 26 were diagnosed with narcolepsy with cataplexy (NA-CA) and 115 with narcolepsy without cataplexy (NA w/o CA). Seventeen patients with NA-CA and 39 with NA w/o CA had OSA. According to Definition #1, the prevalence of REM-related OSA was 47.1% and 41.0%, respectively, in OSA patients with NA-CA and NA w/o CA; according to Definition #2, the respective prevalence was 47.1% and 38.5%, while that according to Definition #3 was 41.2% and 25.6%. No significant differences were found in the prevalence of REM-related OSA for each definition. Conclusion A high prevalence of REM-related OSA was confirmed in adult narcolepsy patients with OSA. Compared to previous reports, we noted a high frequency of REM-related OSA satisfying the relatively strict Definition #3. These results might reflect the pathophysiological characteristics of narcolepsy.
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Affiliation(s)
- Tetsuro Hoshino
- Department of Sleep Medicine and Sleep Disorders Center, Aichi Medical University Hospital, Japan
| | - Ryujiro Sasanabe
- Department of Sleep Medicine and Sleep Disorders Center, Aichi Medical University Hospital, Japan
| | - Mamiko Mano
- Department of Sleep Medicine and Sleep Disorders Center, Aichi Medical University Hospital, Japan
| | - Atsuhiko Nomura
- Department of Sleep Medicine and Sleep Disorders Center, Aichi Medical University Hospital, Japan
| | - Chihiro Kato
- Department of Sleep Medicine and Sleep Disorders Center, Aichi Medical University Hospital, Japan
| | - Masako Sato
- Department of Sleep Medicine and Sleep Disorders Center, Aichi Medical University Hospital, Japan
| | - Masato Imai
- Department of Sleep Medicine and Sleep Disorders Center, Aichi Medical University Hospital, Japan
| | - Kenta Murotani
- Center for Clinical Research, Aichi Medical University Hospital, Japan
| | | | - Toshiaki Shiomi
- Department of Sleep Medicine and Sleep Disorders Center, Aichi Medical University Hospital, Japan
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14
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Mano M, Hoshino T, Sasanabe R, Murotani K, Nomura A, Hori R, Konishi N, Baku M, Shiomi T. Impact of Gender and Age on Rapid Eye Movement-Related Obstructive Sleep Apnea: A Clinical Study of 3234 Japanese OSA Patients. Int J Environ Res Public Health 2019; 16:ijerph16061068. [PMID: 30934646 PMCID: PMC6466410 DOI: 10.3390/ijerph16061068] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 03/20/2019] [Accepted: 03/21/2019] [Indexed: 12/12/2022]
Abstract
Rapid eye movement (REM)-related obstructive sleep apnea (OSA) is characterized by apnea and hypopnea events due to airway collapse occurring predominantly or exclusively during REM sleep. Previous studies have reported that REM-related OSA occurs more commonly in women and younger individuals. However, external validity of this tendency has not been confirmed in a large clinical sample. The objective of this study was to evaluate the effect of gender and age on REM-related OSA after adjustment for several covariates based on their established clinical relationships to gender difference in OSA. A total of 3234 Japanese patients with OSA were enrolled in this study. We confirmed that female sex is an important risk factor for REM-related OSA, as reported by previous studies. Moreover, we showed that women aged over 50 years were at a greater risk than those aged under 50 years. These results suggest that hormonal changes in women might play an important role in REM-related OSA and might reflect its unknown pathophysiological characteristics.
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Affiliation(s)
- Mamiko Mano
- Department of Sleep Medicine and Sleep Disorders Center, Aichi Medical University Hospital, 1-1 Nagakute, Aichi 4801195, Japan.
| | - Tetsuro Hoshino
- Department of Sleep Medicine and Sleep Disorders Center, Aichi Medical University Hospital, 1-1 Nagakute, Aichi 4801195, Japan.
| | - Ryujiro Sasanabe
- Department of Sleep Medicine and Sleep Disorders Center, Aichi Medical University Hospital, 1-1 Nagakute, Aichi 4801195, Japan.
| | - Kenta Murotani
- Biostatistics Center, Graduate School of Medicine, Kurume University, 67 Asahimachi, Kurume, Fukuoka 8300011, Japan.
| | - Atsuhiko Nomura
- Department of Sleep Medicine and Sleep Disorders Center, Aichi Medical University Hospital, 1-1 Nagakute, Aichi 4801195, Japan.
| | - Reiko Hori
- Department of Sleep Medicine and Sleep Disorders Center, Aichi Medical University Hospital, 1-1 Nagakute, Aichi 4801195, Japan.
| | - Noriyuki Konishi
- Department of Sleep Medicine and Sleep Disorders Center, Aichi Medical University Hospital, 1-1 Nagakute, Aichi 4801195, Japan.
| | - Masayo Baku
- Department of Sleep Medicine and Sleep Disorders Center, Aichi Medical University Hospital, 1-1 Nagakute, Aichi 4801195, Japan.
| | - Toshiaki Shiomi
- Department of Sleep Medicine and Sleep Disorders Center, Aichi Medical University Hospital, 1-1 Nagakute, Aichi 4801195, Japan.
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15
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Sasanabe R, Mano M, Nomura A, Shiomi T. Gender Differences in the Severity of Sleep Apnea. Intern Med 2018; 57:2103. [PMID: 29607964 PMCID: PMC6120843 DOI: 10.2169/internalmedicine.0634-17] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Ryujiro Sasanabe
- Department of Sleep Medicine, Aichi Medical University Hospital, Japan
| | - Mamiko Mano
- Department of Sleep Medicine, Aichi Medical University Hospital, Japan
| | - Atsuhiko Nomura
- Department of Sleep Medicine, Aichi Medical University Hospital, Japan
| | - Toshiaki Shiomi
- Department of Sleep Medicine, Aichi Medical University Hospital, Japan
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16
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Hoshino T, Sasanabe R, Tanigawa T, Murotani K, Arimoto M, Ueda H, Shiomi T. Effect of rapid eye movement-related obstructive sleep apnea on adherence to continuous positive airway pressure. J Int Med Res 2018; 46:2238-2248. [PMID: 29614906 PMCID: PMC6023053 DOI: 10.1177/0300060518758583] [Citation(s) in RCA: 14] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Objective Rapid eye movement (REM)-related obstructive sleep apnea (OSA) is characterized by respiratory events such as apnea and hypopnea predominately or exclusively during REM sleep. Several studies have revealed clinical predictors of adherence to the use of continuous positive airway pressure (CPAP). However, the effect of REM-related OSA on adherence to CPAP use remains unclear. Therefore, we investigated the effects of REM-related OSA on adherence to CPAP use 6 months after treatment initiation. Methods We enrolled 161 patients in this study and divided them into 3 groups: the good adherence, poor adherence, and dropout groups. We compared polysomnographic data and clinical findings, including those regarding morbidity of REM-related OSA, among the three groups to identify predictors of adherence to CPAP use. Results None of the 43 patients in the good adherence group had REM-related OSA. Multivariate logistic regression analysis of the good adherence and dropout groups indicated that REM-related OSA was the only factor associated with adherence to CPAP use (odds ratio, 41.984; 95% confidence interval, 2.257–781.007). Conclusions REM-related OSA is a reliable risk factor for dropout from CPAP therapy.
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Affiliation(s)
- Tetsuro Hoshino
- 1 Department of Otorhinolaryngology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Ryujiro Sasanabe
- 2 Department of Sleep Medicine, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Tohru Tanigawa
- 1 Department of Otorhinolaryngology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Kenta Murotani
- 3 Center for Clinical Research, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Mariko Arimoto
- 1 Department of Otorhinolaryngology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Hiromi Ueda
- 1 Department of Otorhinolaryngology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Toshiaki Shiomi
- 2 Department of Sleep Medicine, Aichi Medical University School of Medicine, Nagakute, Japan
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17
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Yurugi Y, Fujiwara W, Kidokoro Y, Hosoya K, Ohno T, Sakabe T, Kubouchi Y, Wakahara M, Takagi Y, Haruki T, Nosaka K, Miwa K, Araki K, Taniguchi Y, Shiomi T, Nakamura H, Umekita Y. P1.02-060 Podoplanin Expression in Cancer-Associated Fibroblasts Predicts Poor Prognosis in Patients with Squamous Cell Carcinoma of the Lung. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.793] [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: 11/24/2022]
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18
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Shibayama A, Sugita K, Narukawa K, Fujiwara Y, Goto H, Shiomi T, Yoshida Y, Yamamoto O. Granuloma annulare can occur on a scar, mimicking sarcoidosis. Clin Exp Dermatol 2017; 42:920-921. [PMID: 28929530 DOI: 10.1111/ced.13210] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2017] [Indexed: 02/01/2023]
Affiliation(s)
- A Shibayama
- Division of Dermatology, Department of Medicine of Sensory and Motor Organs, Yonago, Japan
| | - K Sugita
- Division of Dermatology, Department of Medicine of Sensory and Motor Organs, Yonago, Japan
| | - K Narukawa
- Division of Dermatology, Department of Medicine of Sensory and Motor Organs, Yonago, Japan
| | - Y Fujiwara
- Division of Dermatology, Department of Medicine of Sensory and Motor Organs, Yonago, Japan
| | - H Goto
- Division of Dermatology, Department of Medicine of Sensory and Motor Organs, Yonago, Japan
| | - T Shiomi
- Division of Organ Pathology, Department of Pathology, Tottori University Faculty of Medicine, Yonago, Japan
| | - Y Yoshida
- Division of Dermatology, Department of Medicine of Sensory and Motor Organs, Yonago, Japan
| | - O Yamamoto
- Division of Dermatology, Department of Medicine of Sensory and Motor Organs, Yonago, Japan
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Tsounapi P, Honda M, Dimitriadis F, Shimizu S, Shiomi T, Hikita K, Saito M, Tomita S, Sofikitis N, Takenaka A. Antioxidant treatment ameliorates diabetes-induced dysfunction of the vas deferens in a rat model. Andrologia 2017; 50. [PMID: 28224697 DOI: 10.1111/and.12795] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/13/2016] [Indexed: 12/20/2022] Open
Abstract
Diabetes mellitus (DM) affects the male ejaculatory function. This study was designed to evaluate the role of oxidative stress in the development of diabetes-induced dysfunction of vas deferens (VD) in the rat. DM was induced by streptozotocin in 40 male Wistar rats. Subsequently, the diabetic animals were divided into three groups: DM group, DM + Eda group and DM + Tau group. These groups were administered saline, edaravone and taurine, respectively, daily for 4 weeks. Another group of ten rats served as a control group. DM was diagnosed in the 40 streptozotocin-injected rats. DM significantly reduced the VD weight. Additionally, DM induced in vitro VD hypercontractility, VD histological abnormalities and increased the serum and VD tissue concentration of malondialdehyde. VD immunohistochemistry revealed overexpression of three markers of oxidative stress. DM significantly reduced serum testosterone levels. No live birth was documented in all DM rats in mating experiments. Antioxidants significantly improved all the aforementioned parameters, except the testosterone levels. This study indicates a deleterious impact of DM-induced oxidative stress on VD histological and functional features. Antioxidant treatment may provide an adjunct tool to alleviate ejaculatory disorders for male patients with type 1 diabetes.
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Affiliation(s)
- P Tsounapi
- Division of Urology, Department of Surgery, Faculty of Medicine, Tottori University, Yonago, Japan
| | - M Honda
- Division of Urology, Department of Surgery, Faculty of Medicine, Tottori University, Yonago, Japan
| | - F Dimitriadis
- Department of Urology, School of Medicine, University of Ioannina, Ioannina, Greece
| | - S Shimizu
- Department of Pharmacology, Kochi Medical School, Kochi University, Nankoku, Kochi, Japan
| | - T Shiomi
- Division of Organ Pathology, Department of Pathology, Faculty of Medicine, Tottori University, Yonago, Japan
| | - K Hikita
- Division of Urology, Department of Surgery, Faculty of Medicine, Tottori University, Yonago, Japan
| | - M Saito
- Department of Pharmacology, Kochi Medical School, Kochi University, Nankoku, Kochi, Japan
| | - S Tomita
- Department of Pharmacology, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - N Sofikitis
- Department of Urology, School of Medicine, University of Ioannina, Ioannina, Greece
| | - A Takenaka
- Division of Urology, Department of Surgery, Faculty of Medicine, Tottori University, Yonago, Japan
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20
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Hori R, Shiomi T. [Depression and insomnia as risk factors of coronary artery disease]. Nihon Rinsho 2016; 74 Suppl 4 Pt 1:177-181. [PMID: 27534167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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21
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Hoshino T, Sasanabe R, Murotani K, Arimoto M, Inagawa S, Tanigawa T, Uchida Y, Ogawa T, Ueda H, Shiomi T. Polysomnographic parameters during non-rapid eye movement sleep predict continuous positive airway pressure adherence. Nagoya J Med Sci 2016; 78:195-203. [PMID: 27303106 PMCID: PMC4885819] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The aim of this study was to investigate the potential polysomnographic predictors of CPAP adherence using polysomnographic parameters at the time of obstructive sleep apnea diagnosis that distinguished between REM and NREM sleep. This was a retrospective cross-sectional study of 173 patients. Patients who used CPAP for more than 4 hours per night for at least 70% of nights over a 6-month period were considered to have good adherence. The poor adherence group included those who had used CPAP for 6 months from initiation, but did not fulfill the definition of good adherence or gave up the treatment within 6 months of treatment initiation. Of the 173 participants, 44 patients had good CPAP adherence and 129 patients had poor adherence. Univariate analysis showed that patients with good adherence had significantly higher apnea-hypopnea index during NREM sleep (p = 0.043), oxygen desaturation index during NREM sleep (p = 0.011), and cumulative percentage of time spent at saturations below 90% (CT90) during NREM sleep (p < .001). In multiple logistic regression analysis including all variables, CT90 during NREM sleep was the only factor independently associated with CPAP adherence (odds ratio, 0.693; 95% confidence interval, 0.582-0.824; p <.0001). The area under the receiver-operating characteristic curve of CT90 during NREM sleep was 0.823 (95% confidence interval, 0.745-0.901).Evaluating NREM sleep is important in reliably predicting CPAP adherence using polysomnographic parameters. CT90 during NREM sleep was the best predictor of CPAP adherence.
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Affiliation(s)
- Tetsurou Hoshino
- Department of Otorhinolaryngology, Aichi Medical Unversity School of Medicine,Nagakute, Japan
| | - Ryujiro Sasanabe
- Department of Sleep Medicine, Aichi Medical University School of Medicine,Nagakute, Japan
| | - Kenta Murotani
- Center for Clinical Research, Aichi Medical University School of Medicine,Nagakute, Japan
| | - Mariko Arimoto
- Department of Otorhinolaryngology, Aichi Medical Unversity School of Medicine,Nagakute, Japan
| | - Shuntaro Inagawa
- Department of Otorhinolaryngology, Aichi Medical Unversity School of Medicine,Nagakute, Japan
| | - Tohru Tanigawa
- Department of Otorhinolaryngology, Aichi Medical Unversity School of Medicine,Nagakute, Japan
| | - Yasue Uchida
- Department of Otorhinolaryngology, Aichi Medical Unversity School of Medicine,Nagakute, Japan
| | - Tetsuya Ogawa
- Department of Otorhinolaryngology, Aichi Medical Unversity School of Medicine,Nagakute, Japan
| | - Hiromi Ueda
- Department of Otorhinolaryngology, Aichi Medical Unversity School of Medicine,Nagakute, Japan
| | - Toshiaki Shiomi
- Department of Sleep Medicine, Aichi Medical University School of Medicine,Nagakute, Japan
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Sato M, Sasanabe R, Yamaguchi T, Shiomi T. [Polysomnography]. Nihon Rinsho 2015; 73:980-984. [PMID: 26065129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Polysomnography (PSG) is performed under monitoring each parameters include EEG derivations, EOG derivations, chin EMG, leg EMG derivations, airflow signals, respiratory effort signals, oxygen saturation, body position and EGG and checking digital video and audio. From these recordings, the sleep quality, sleep-disordered breathing, circulatory status and presence of parasomnia were evaluated. PSGs were based on the criteria "The AASM Manual for the Scoring of Sleep and Associated Events" published in 2007 detailed about technical specification and scoring rules for adult and pediatric. However, there are no specific criteria for the elderly. There already have been known about characteristics for the elderly such as lower amplitude of Δ wave in slow-wave sleep stage, PLMS and RWA in PSG.
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23
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Shiomi T, Azeyanagi Y, Yamadera A, Nakamura T. Measurement of Residual Radioactivity of Machine Elements and Concrete on the Cyclotron Decommissioning. J NUCL SCI TECHNOL 2014. [DOI: 10.1080/00223131.2000.10874906] [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: 10/24/2022]
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24
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Sasanabe R, Shiomi T. [Delayed sleep-wake phase disorder/advanced sleep-wake phase disorder]. Nihon Rinsho 2014; 72:1448-1452. [PMID: 25167751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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25
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Katsube T, Mori M, Tsuji H, Shiomi T, Wang B, Liu Q, Nenoi M, Onoda M. Most hydrogen peroxide-induced histone H2AX phosphorylation is mediated by ATR and is not dependent on DNA double-strand breaks. J Biochem 2014; 156:85-95. [DOI: 10.1093/jb/mvu021] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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26
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Yamamoto K, Kobayashi F, Hori R, Arita A, Sasanabe R, Shiomi T. Association between pupillometric sleepiness measures and sleep latency derived by MSLT in clinically sleepy patients. Environ Health Prev Med 2013; 18:361-7. [PMID: 23420264 PMCID: PMC3773097 DOI: 10.1007/s12199-013-0331-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [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: 12/04/2012] [Accepted: 01/30/2013] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVES The multiple sleep latency test (MSLT) has been employed extensively in clinical and research settings as a gold standard for objectively measuring sleepiness. In a general population or in a variety of work settings, however, a more convenient, rapidly administered measuring method is preferable. We examined the potential utility of pupillometry by comparing its objective measures, pupillary unrest index (PUI) and relative pupillary unrest index (RPUI), with MSLT-derived sleep latency (SL). METHODS The study cohort comprised 45 patients (39 males, 6 females, mean age 38.9 ± 11.3 years) referred to the Sleep Disorders Center for the two-nap SL test. SL was measured twice before noon, and pupillometric measurement was performed immediately before each SL test. Subjective sleepiness was measured by using the Epworth Sleepiness Scale (ESS). RESULTS The association between PUI and SL was significant and far closer than that between RPUI and SL. A significant difference was observed between the two groups, based on each subject's experience of drowsy driving accidents over the past 3 years in the PUI and RPUI, as well as in SL. The subjective sleepiness measure, ESS, did not relate to any other physiological sleepiness measures. CONCLUSIONS In our study cohort, the pupillometric sleepiness measure, PUI, was significantly correlated with, and behaved in a manner equivalent to, MSLT-derived SL in clinically sleepy patients. However, several points remain to be carefully examined before applying pupillometry for screening sleepiness in a general population, or in occupational settings.
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Affiliation(s)
- Keiko Yamamoto
- />Department of Health and Psychosocial Medicine, School of Medicine, Aichi Medical University, 1-1 Yazako Karimata, Nagakute, Aichi 480-1195 Japan
| | - Fumio Kobayashi
- />Department of Health and Psychosocial Medicine, School of Medicine, Aichi Medical University, 1-1 Yazako Karimata, Nagakute, Aichi 480-1195 Japan
| | - Reiko Hori
- />Department of Health and Psychosocial Medicine, School of Medicine, Aichi Medical University, 1-1 Yazako Karimata, Nagakute, Aichi 480-1195 Japan
| | - Aki Arita
- />Sleep Disorders Center, Aichi Medical University Hospital, Nagakute, Aichi Japan
| | - Ryujiro Sasanabe
- />Sleep Disorders Center, Aichi Medical University Hospital, Nagakute, Aichi Japan
| | - Toshiaki Shiomi
- />Sleep Disorders Center, Aichi Medical University Hospital, Nagakute, Aichi Japan
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Furuhashi A, Yamada S, Shiomi T, Sasanabe R, Aoki Y, Yamada Y, Kazaoka Y. Effective three-dimensional evaluation analysis of upper airway form during oral appliance therapy in patients with obstructive sleep apnoea. J Oral Rehabil 2013; 40:582-9. [DOI: 10.1111/joor.12059] [Citation(s) in RCA: 19] [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] [Accepted: 04/18/2013] [Indexed: 11/27/2022]
Affiliation(s)
- A. Furuhashi
- Department of Oral and Maxillofacial Surgery; Aichi Medical University; Nagakute Japan
| | - S. Yamada
- Department of Oral and Maxillofacial Surgery; Aichi Medical University; Nagakute Japan
| | - T. Shiomi
- Sleep Disorders Center; Aichi Medical University Hospital; Nagakute Japan
| | - R. Sasanabe
- Sleep Disorders Center; Aichi Medical University Hospital; Nagakute Japan
| | - Y. Aoki
- Department of Oral and Maxillofacial Surgery; Aichi Medical University; Nagakute Japan
| | - Y. Yamada
- Department of Oral and Maxillofacial Surgery; Aichi Medical University; Nagakute Japan
| | - Y. Kazaoka
- Department of Oral and Maxillofacial Surgery; Aichi Medical University; Nagakute Japan
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Shiomi T, Nakahodo T, Fujihara H. Enhanced Catalytic Activity in Suzuki–Miyaura Couplings by Shell Crosslinked Pd Nanoparticles from Alkene-terminated Phosphine Dendron-stabilized Pd Nanoparticles. CHEM LETT 2012. [DOI: 10.1246/cl.2012.1700] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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29
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Sasanabe R, Watanabe Y, Shiomi T. [A sleep disordered breathing as the lifestyle-related diseases]. Nihon Rinsho 2012; 70:1211-1215. [PMID: 22844807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Lifestyle related disease is a generic term for diseases such as cardiovascular diseases, diabetes mellitus and cancer caused by life style or life habit, and one of its fundamental causes is obesity. The reason why most people put on weight after their middle age is mainly because of the increase of visceral fat by the decrease in basal metabolism and the amount of momentum despite of unchanging appetite. Due to this sequence of weight gain, after middle age upper respiratory tract becomes narrower, and it worsens obstructive sleep apnea syndrome (OSAS). Since mastication is to provoke and maintain arousal, OSAS patients, who especially feel strong sleepiness, tend to encourage them to be obesity by frequent mastication that leads them to the tendency to overeat. Two main symptoms of OSAS are snoring and sleepiness; however, the essence of sleepiness is the worse quality of sleep due to apnea. In addition, a vicious circle is eventually generated because sleep deprivation and sleep disorders affects hypertension and glucose intolerance, and those worsen lifestyle disease. In order to break this off, it is necessary to review life style and habit, and improve not only on diet and exercise therapy but also on sleep.
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Affiliation(s)
- Ryujiro Sasanabe
- Department of Sleep Medicine, Aichi Medical University School of Medicine
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Tamura S, Nishii T, Shiomi T, Yamazaki Y, Murase K, Yoshikawa H, Sugano N. Three-dimensional patterns of early acetabular cartilage damage in hip dysplasia; a high-resolutional CT arthrography study. Osteoarthritis Cartilage 2012; 20:646-52. [PMID: 22469852 DOI: 10.1016/j.joca.2012.03.015] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2011] [Revised: 02/28/2012] [Accepted: 03/21/2012] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The purpose of this study was to examine the three-dimensional (3D) progression patterns of early acetabular cartilage damage in hip dysplasia using high-resolutional computed tomography (CT) arthrography. DESIGN Thirty-two dysplastic hips of 26 Japanese symptomatic females including 21 hips in pre-stage of osteoarthritis (Kellgren-Lawrence (K-L) grade 0; mean patient age, 32.0 years) and 11 hips in early stage of osteoarthritis (K-L grade 1 or 2; mean patient age, 32.8 years) were examined. Isotropic high-resolutional CT arthrography with an image resolution of 0.5 mm in any orthogonal direction was performed. A 3D acetabular cartilage model was generated and we evaluated distribution of cartilage thickness in 12 zones after dividing the weight-bearing area of the hip joint in radial and lateral/medial directions. RESULTS In pre-stage of osteoarthritis, significant differences in cartilage thickness were observed between the lateral and medial zones in all radial regions, most prominently in the antero-superior region. In early stage of osteoarthritis, no significant differences in cartilage thickness were observed, except in the most posterior region. The lateral-medial (LM) ratio was defined as cartilage thickness in the lateral zone divided by that in the medial zone, and hips with the LM ratio in the antero-superior region of <1.4 had significantly more extensive involvement of labral tears than hips with the LM ratio of ≥1.4. CONCLUSIONS In hip dysplasia, acetabular cartilage damage was probably occurred in the antero-superior lateral area. The LM ratio may be a sensitive index to quantify early cartilage damage associated with extent of labral disorders.
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Affiliation(s)
- S Tamura
- Department of Orthopaedic Medical Engineering, Osaka University Medical School, Osaka, Japan
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31
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Shiomi T, Noguchi T, Nakayama H, Yoshida Y, Yamamoto O, Hayashi N, Ohara K. Clinicopathological study of invasive extramammary Paget’s disease: subgroup comparison according to invasion depth. J Eur Acad Dermatol Venereol 2012; 27:589-92. [DOI: 10.1111/j.1468-3083.2012.04489.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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32
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Takada H, Shimizu Y, Matsuura Y, Shiomi T, Miyao M. Non-linear analysis of stabilograms with alcoholic intake. Annu Int Conf IEEE Eng Med Biol Soc 2012; 2012:4208-4211. [PMID: 23366856 DOI: 10.1109/embc.2012.6346895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Equilibrium function in the cerebellum (vestibulo-cerebellar system) can deteriorate under the influence of alcohol. In the Romberg posture, the center of gravity, which was measured every 50 ms by stabilometry, appeared to shift with alcohol ingestion. In the previous study, a locus in the center of gravity (stabilogram) was converted to values of statistical indices such as area of sway, total locus length, and locus length per unit area, although these indices could not always distinguish between the statokinesigrams sampled from seven healthy young males in sober and intoxicated states. This measurement was made with an AMTI force plate. In this study, "translation error" was estimated in a d-dimensional embedding space in order to compare statokinesigrams recorded before and after the ingestion of doubly diluted brandy in 30 s (1 ≤ d ≤ 10). We succeeded in validating a stochastic differential equation as a mathematical model of the body sway. The randomness in the model was preserved after alcohol intake and significantly increased in the medial/lateral direction. Visual information referred by the postural control system when standing might be interfered by the effects of intoxication, which was regarded as disturbance. This method is considered to be useful to diagnose the disorders of the vestibulocerebellar system.
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Affiliation(s)
- H Takada
- Graduate School of Engineering, University of Fukui, 3-9-1 Bunkyo Fukui-City, Fukui, 910-8507 Japan.
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Affiliation(s)
- Toshiaki Shiomi
- Department of Sleep Medicine, Aichi Medical University School of Medicine
| | - Ryujiro Sasanabe
- Department of Sleep Medicine, Aichi Medical University School of Medicine
| | - Yuko Watanabe
- Department of Sleep Medicine, Aichi Medical University School of Medicine
| | - Yutaka Tokunaga
- Department of Sleep Medicine, Aichi Medical University School of Medicine
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Sasanabe R, Shiomi T. Improved accuracy for the detection of sleep apnea-related surges in blood pressure. Hypertens Res 2011; 34:909. [DOI: 10.1038/hr.2011.87] [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: 11/09/2022]
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Komada Y, Shiomi T, Mishima K, Inoue Y. [Associated factors for drowsy driving among licensed drivers]. Nihon Koshu Eisei Zasshi 2010; 57:1066-1074. [PMID: 21348281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
OBJECTIVE The aim of this study is to reveal factors associated with both dozing off at the wheel and motor vehicle accidents (MVAs) with sleep apnea syndrome (SAS) as well as other descriptive variables for driving set as independent factors. METHODS We conducted an anonymous questionnaire survey on drivers who visited the Tokyo Metropolitan Driver and Vehicle Licensing Center in order to renew their driver's license from September 25 to 29, 2006. The survey requested information regarding self reported experience of dozing off at the wheel, MVAs, usual mileage, length of license holding period, and the participants' awareness of SAS. We obtained data from 3,236 drivers (response rate: 61.8%). RESULTS The rates for previous experience of feeling sleepiness at the wheel, that of dozing off at the wheel, and that of near-miss or actual MVA due to dozing off at the wheel among the participants were 40.4%, 20.3%, and 10.4% respectively. Multivariate logistic regression analysis revealed that dozing off at the wheel was significantly associated with male gender, long-term holding of a driver's license (> or = 3, < 10 years: OR = 1.58, 95% CI: 1.04-2.42, > or = 10, < 20 years: OR = 2.23, 95% CI: 1.47-3.38, > or = 20,< 30 years: OR = 1.89, 95% CI: 1.23-2.90 > or = 30 years: OR = 1.85, 95%CI: 1.18-2.89), higher usual mileage (> or = 30 km per a week: OR = 1.35, 95% CI: 1.06-1.73), appearance of sleepiness shortly after starting driving (< 2 hrs: OR = 1.99, 95% CI: 1.60-2.47), either having awareness or a diagnosis of SAS. As to experience of near-miss or actual MVA due to dozing off at the wheel, factors including male gender, long-term holding period of driver's license (> or = 3, < 10 years: OR = 2.02, 95% CI: 1.15-3.55, > or = 10, < 20 years: OR = 2.10, 95% CI: 1.19-3.70), appearance of sleepiness shortly after starting driving (< 2 hrs: OR = 1.70, 95% CI: 1.30-2.24), either having awareness or diagnosis of SAS were significantly associated. CONCLUSION Not only habituation effects and fatigue due to long driving but also SAS have a significant impact on the occurrence of sleepiness related MVAs. Moreover, early diagnosis and treatment of SAS is necessary so that we can avoid dozing off at the wheel, resulting in near-miss or actual MVA.
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Affiliation(s)
- Yoko Komada
- Department of Somnology, Tokyo Medical University
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Shiomi T, Nishii T, Tanaka H, Yamazaki Y, Murase K, Myoui A, Yoshikawa H, Sugano N. Loading and knee alignment have significant influence on cartilage MRI T2 in porcine knee joints. Osteoarthritis Cartilage 2010; 18:902-8. [PMID: 20472084 DOI: 10.1016/j.joca.2010.05.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2009] [Revised: 04/27/2010] [Accepted: 05/03/2010] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Physiological magnetic resonance imaging (MRI) under loading or knee malalignment conditions has not been thoroughly investigated. We assessed the influence of static loading and knee alignment on T2 (transverse relaxation time) mapping of the knee femoral cartilage of porcine knee joints using a non-metallic pressure device. METHODS Ten porcine knee joints were harvested en bloc with intact capsules and surrounding muscles and imaged using a custom-made pressure device and 3.0-T MRI system. Sagittal T2 maps were obtained (1) at knee neutral alignment without external loading (no loading), (2) under mechanical compression of 140 N (neutral loading), and (3) under the same loading conditions as in (2) with the knee at 10 degrees varus alignment (varus loading). T2 values of deep, intermediate, and superficial zones of the medial and lateral femoral cartilages at the weight-bearing area were compared among these conditions using custom-made software. Cartilage contact pressure between the femoral and tibial cartilages, measured by a pressure-sensitive film, was correlated with cartilage T2 measurements. RESULTS In the medial cartilage, mean T2 values of the deep, intermediate, and superficial zones decreased by 1.4%, 13.0%, and 6.0% under neutral loading. They further decreased by 4.3%, 19.3%, and 17.2% under varus loading compared to no loading. In the lateral cartilage, these mean T2 values decreased by 3.9%, 7.7%, and 4.2% under neutral loading, but increased by 1.6%, 9.6%, and 7.2% under varus loading. There was a significant decrease in T2 values in the intermediate zone of the medial cartilage under both neutral and varus loading, and in the superficial zone of the medial cartilage under varus loading (P<0.05). Total contact pressure values under neutral loading and varus loading conditions significantly correlated with T2 values in the superficial and intermediate zones of the medial cartilages. CONCLUSIONS The response of T2 to change in static loading or alignment varied between the medial and lateral cartilages, and among the deep, intermediate, and superficial zones. These T2 changes were significantly related to the contact pressure measurements. Our results indicate that T2 mapping under loading allows non-invasive, biomechanical assessment of site-specific stress distribution in the cartilage.
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Affiliation(s)
- T Shiomi
- Department of Orthopaedic Surgery, Osaka University Medical School, Suita, Osaka, Japan
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37
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Sasanabe R, Shiomi T. [Heart failure]. Nihon Rinsho 2009; 67:1513-1517. [PMID: 19768933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
It seems that the causes of the insomnia are dyspnea and an orthopnea in the heart failure patient. But, only such a fit is not the cause of the insomnia because it complains about the insomnia even if heart failure is slight. An obstructive sleep apnea (OSA) is the risk of the heart failure. A heart failure patient often complicates a central sleep apnea (CSA) and a Cheyne-Stokes respiration (CSR), and has much sleep fragmentation and difficulty maintaining sleep. And sleep disorders are sometimes started by the medications such as the cardiovascular system agent thing; beta blocker and the statins. Sleep disorders represent a major challenge in terms of differential diagnosis in heart failure patients. This is particularly relevant to insomnia and sleep disordered breathing (SDB) such as OSA, CSA and CSR. Thus, expending the knowledge on both insomnia and SDB may contribute to improve medical quality among physician.
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38
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Sasanabe R, Shiomi T. [Hypertension]. Nihon Rinsho 2009; 67:1533-1537. [PMID: 19768936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
People are sleeping less in modern societies. It is said that short duration of sleep could play a role in the etiology of not only diabetes mellitus (DM) but also hypertension. Sleep disorders inducing sleep fragmentation and sleep deprivation, such as insomnia, obstructive sleep apnea syndrome (OSAS), and periodic limb movement disorder (PLMD), have been suggested to be independent risk factors for hypertension. OSAS is associated with a range of cardiovascular complications, in particular hypertension. All of hypertensive patients should be routinely screened for possible sleep disorders.
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Abstract
OBJECTIVE Obstructive sleep apnea syndrome (OSAS) often accompanies obesity and diabetes mellitus. This study was performed to investigate the prevalence of glucose intolerance and to determine independent predictors for insulin resistance in patients with OSAS. METHODS A cross-sectional study of 679 OSAS patients with an apnea-hypopnea index (AHI)>or=5/h and 73 controls subjects (AHI<5/h) was done in a tertiary university-based medical center. They were assessed by nocturnal polysomnography and underwent an oral glucose tolerance test. RESULTS The prevalence of diabetes mellitus in OSAS patients was higher than that of the control group (25.9% vs. 8.2%, p<0.001) and 424 patients (62.4%) received a new diagnosis of impaired glucose tolerance or diabetes mellitus. The very severe OSAS group (AHI >or=45/h) had significantly higher homeostasis model assessment of insulin resistance (HOMA-IR) and HOMA beta-cell function than the other OSAS groups (AHI<45/h) and the control group. In a logistic regression model adjusting for potential confounders: age, AHI, minimum SpO(2) and body mass index (BMI), only BMI was associated with insulin resistance (HOMA-IR>3) (odds ratio: 1.272, 95% confidence interval 1.206-1.343, p<0.0001). CONCLUSION Glucose intolerance was more common in patients with OSAS. Insulin resistance was associated not with AHI but rather with BMI.
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Affiliation(s)
- Kazuo Otake
- Sleep Disorders Center, Aichi Medical University Hospital, Aichi, Japan
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Okamoto N, Tanioka M, Yamamoto T, Shiomi T, Miyachi Y, Utani A. Intralymphatic histiocytosis associated with rheumatoid arthritis. Clin Exp Dermatol 2008; 33:516-8. [DOI: 10.1111/j.1365-2230.2008.02735.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Tanaka H, Nishio H, Sasanabe R, Shiomi T. [A case of multiple systemic atrophy (MSA) analyzed by acoustic sound for nocturnal inspiratory stridor]. Nihon Kokyuki Gakkai Zasshi 2007; 45:604-8. [PMID: 17763688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
A 70-year old woman was admitted because of sleep maintenance insomnia with severe respiratory sounds during sleep. Polysomnography (PSG) revealed frequent respiratory events, particularly hypopneas, throughout the night associated with severe oxygen desaturation, and inspiratory stridor, which was shown to have a high-pitched frequency by acoustic sound analysis. She also presented fine finger tremor due to parkisonism, increased bilateral tendon responses, cerebellar ataxic gait, and dysautonomia. Therefore, we concluded that she suffered from multiple systemic atrophy (MSA). Nasal continuous positive airway pressure (nCPAP) treatment was successful. Characteristic PSG findings and analysing the snoring sound are important in the early diagnosis of sleep-related disordered breathing in MSA.
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Sasanabe R, Shiomi T. [Sleep apnea syndrome and metabolic syndrome]. Nihon Rinsho 2006; 64 Suppl 9:755-9. [PMID: 17458315] [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] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
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Shiraishi Y, Asano K, Niimi K, Wakaki M, Kagyo J, Takihara T, Sayama K, Nakajima T, Oguma T, Suzuki Y, Shiomi T, Ikeda E, Ishizaka A. The Influence of Eosinophilic Airway Inflammation in Response to Double-Stranded RNA Instillation. J Allergy Clin Immunol 2006. [DOI: 10.1016/j.jaci.2005.12.1247] [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: 10/24/2022]
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45
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Niimi K, Asano K, Shiraishi Y, Takihara T, Kagyo J, Wakaki M, Nakajima T, Suzuki Y, Shiomi T, Oguma T, Ishizaka A. Toll-like Receptor 3 and Chemokine Synthesis in Human Bronchial Smooth Muscle Cells. J Allergy Clin Immunol 2006. [DOI: 10.1016/j.jaci.2005.12.1244] [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: 11/26/2022]
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Sasanabe R, Shiomi T. A Device for Nocturnal Hypertension with Sleep Apnea. Hypertens Res 2006; 29:641-2. [PMID: 17249517 DOI: 10.1291/hypres.29.641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Sasanabe R, Banno K, Otake K, Hasegawa R, Usui K, Morita M, Shiomi T. Metabolic Syndrome in Japanese Patients with Obstructive Sleep Apnea Syndrome. Hypertens Res 2006; 29:315-22. [PMID: 16832151 DOI: 10.1291/hypres.29.315] [Citation(s) in RCA: 85] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We investigated the prevalence of metabolic syndrome in patients with obstructive sleep apnea syndrome (OSAS) referred to a tertiary university-based medical center. A cross-sectional study of patients with a definite diagnosis of OSAS was performed using new diagnostic criteria for metabolic syndrome that were designed for the Japanese population. Clinical features and comorbidities related to metabolic syndrome were compared between 819 patients with OSAS (719 men and 100 women) and 89 control subjects without OSAS. Metabolic syndrome was significantly more common in the patients with OSAS than in the controls (49.5% vs. 22.0% for men, p < 0.01; 32.0% vs. 6.7% for women, p < 0.01). Men with OSAS (apnea-hypopnea index [AHI] > or =5/h) had a higher risk of metabolic syndrome compared with controls (odds ratio [OR]: 3.47; 95% confidence interval [CI]: 1.84-6.53). There was a significantly increased risk of metabolic syndrome in men with moderate OSAS (AHI: 15-29.9/h) (OR: 2.83; 95% CI: 1.42-5.66) and men with severe OSAS (AHI > or =30/h) (OR: 5.09; 95% CI: 2.67-9.71). Women with OSAS (AHI> or =5/h) also had an increased risk of metabolic syndrome (OR: 6.59; 95% CI: 1.47-29.38), and the risk was significantly higher in women with severe OSAS (AHI > or =30/h) (OR 14.00; 95% CI: 2.93-66.82). Risk factors for metabolic syndrome differed by gender: in men, age, body mass index (BMI), and OSAS (AHI > or =15/h) were significantly associated with metabolic syndrome, whereas, in women, BMI was the only risk factor for metabolic syndrome. The increase of metabolic syndrome in Japanese OSAS patients suggests that this patient population is burdened with multiple risk factors for cardiovascular disease.
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Affiliation(s)
- Ryujiro Sasanabe
- Sleep Disorders Center, Aichi Medical University Hospital, Japan
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Otake K, Shinobe R, Sato K, Shiomi T. [Sleep apnea syndrome]. Nihon Rinsho 2005; 63:1221-6. [PMID: 16001786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Obstructive sleep apnea syndrome (OSAS) is strongly associated with cardiovascular disease which means these patients could suffer sudden death from these cardiovascular diseases, but it is a rare case that common OSAS itself causes sudden death directly. On the other hand, we never wrongly diagnose serious sleep-related breathing disorders (SBDs) such as sleep hypoventilation syndrome, OSAS patients with cardiovascular disease (i.e. ischemic heart disease, cardiac arrhythmia and cardiac failure) and bilateral vocal cord paralysis caused by multiple system atrophy as common OSAS. This section describes how to distinguish these SBDs from common OSAS.
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Affiliation(s)
- Kazuo Otake
- Sleep Disorders Center, Aichi Medical University Hospital
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Shiraishi Y, Asano K, Nakajima T, Niimi K, Suzuki Y, Shiomi T, Sayama K, Oguma T, Ikeda E, Hirai H, Yamaguchi K, Ishizaka A. Prostaglandin D2-induced eosinophilic airway inflammation is mediated by CRTH2 receptor. J Allergy Clin Immunol 2005. [DOI: 10.1016/j.jaci.2004.12.203] [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: 10/25/2022]
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Niimi K, Asano K, Shiraishi Y, Wakaki M, Nakajima T, Kagyo J, Suzuki Y, Shiomi T, Oguma T, Sayama K, Yamaguchi K, Ishizaka A. Double-stranded RNA-induced CC chemokine synthesis in human bronchial smooth muscle cells and toll-like receptor 3. J Allergy Clin Immunol 2005. [DOI: 10.1016/j.jaci.2004.12.1088] [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: 11/24/2022]
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