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UPHS - Penn Sleep Centers Newsletter
Asleep at the Wheel?
Truck drivers who routinely get too little sleep or suffer from sleep apnea show signs of fatigue and impaired performance that can make them a hazard on the road, according to a major new study by Penn Sleep Centers researchers. The study results, entitled “Impaired Performance in Commercial Drivers: Role of Sleep Apnea and Short Sleep Duration,” were published in the August 15th issue of the American Journal of Respiratory and Critical Care Medicine.
Sleep Apnea and Heart Disease
Along with the epidemic of obesity, the incidence of sleep apnea has risen at an alarming rate. The most common form, known as obstructive sleep apnea (OSA), is caused by extra tissue in the upper airway that collapses and literally blocks the airflow to the lungs. The risk factors for OSA include male sex (women’s risk increases after menopause), obesity, and neck size greater than 17 inches. The symptoms of sleep apnea include fatigue, early morning headaches, snoring, falling asleep during the daytime, depression and witnessed episodes of irregular breathing while sleeping.
Cognitive-Behavioral Treatment of Insomnia
Insomnia is the most prevalent sleep disorder, representing one of the most common complaints reported to doctors by their patients. In an effort to provide non-pharmacologic treatment options for insomnia, research and clinical practice have focused on developing cognitive- behavior treatments as an alternative.
Do Flies and Worms Sleep?
Can you tell if a fly is asleep? This is precisely the question asked seven years ago by Dr. Joan Hendricks, who is now the Dean of the School of Veterinary Medicine at the University of Pennsylvania. In collaboration with Dr. Amita Sehgal and Dr. Allan Pack of the Penn Center for Sleep and Respiratory Neurobiology (CSRN), Dr. Hendricks wanted to determine if the fruit fly Drosophila melanogaster, an animal used since the early 1900s for genetic studies in biology, has a sleeplike state much as we do. But unlike human studies, where one can measure brain electrical activity to distinguish sleep from the waking state, one cannot easily measure fly brain waves. Instead, Dr. Hendricks used behavioral measures.
Advice for Sleepy Students
Each fall, Grace Pien, MD in the University of Pennsylvania Division of Sleep Medicine sees teenagers being brought into her office by parents. The teens complain about difficulty falling asleep at night. After several follow-up questions, Pien often determines that these patients suffer from a sleep disorder called delayed sleep phase syndrome (DSPS) - when the body's circadian rhythm delays the urge to sleep until much later than what is considered to be a normal bedtime.
New Headquarters for Penn Sleep
In April of this year, the practices and sleep laboratory facilities of the Penn Sleep Centers at the Hospital of the University of Pennsylvania and Penn Presbyterian Medical Center were merged into a single new site at 3624 Market St. which serves as headquarters for the Penn Sleep Centers. This newly renovated facility provides pleasant and spacious areas for both patients and staff.
SLEEP Articles
Sleep Promotes Generalization of Extinction of Conditioned Fear
Study Objective: To examine the effects of sleep on fear conditioning, extinction, extinction recall, and generalization of extinction recall in healthy humans. Design: During the Conditioning phase, a mild, 0.5-sec shock followed conditioned stimuli (CS+s), which consisted of 2 differently colored lamps. A third lamp color was interspersed but never reinforced (CS-). Immediately after Conditioning, one CS+ was extinguished (CS+E) by presentation without shocks (Extinction phase). The other CS+ went unextinguished (CS+U). Twelve hours later, following continuous normal daytime waking (Wake group, N = 27) or an equal interval containing a normal night’s sleep (Sleep group, N = 26), conditioned responses (CRs) to all CSs were measured (Extinction Recall phase). It was hypothesized that the Sleep versus Wake group would show greater extinction recall and/or generalization of extinction recall from the CS+E to the CS+U. Setting: Academic medical center. Subjects: Paid normal volunteers. Measurements and Results: Square-root transformed skin conductance response (SCR) measured conditioned responding. During Extinction Recall, the Group (Wake or Sleep) x CS+ Type (CS+E or CS+U) interaction was significant (P = 0.04). SCRs to the CS+E did not differ between groups, whereas SCRs to the CS+U were significantly smaller in the Sleep group. Additionally, SCRs were significantly larger to the CS+U than CS+E in the Wake but not the Sleep group. Conclusions: After sleep, extinction memory generalized from an extinguished conditioned stimulus to a similarly conditioned but unextinguished stimulus. Clinically, adequate sleep may promote generalization of extinction memory from specific stimuli treated during exposure therapy to similar stimuli later encountered in vivo. Keywords: Fear conditioning, extinction, generalization, human, emotional memory
The Economic Burden of Insomnia: Direct and Indirect Costs for Individuals with Insomnia Syndrome, Insomnia Symptoms, and Good Sleepers
Background and Purpose: Insomnia is a highly prevalent problem that is associated with increased use of health care services and products, as well as functional impairments. This study estimated from a societal perspective the direct and indirect costs of insomnia. Participants and Methods: A randomly selected sample of 948 adults (mean age = 43.7 years old; 60% female) from the province of Québec, Canada completed questionnaires on sleep, health, use of health-care services and products, accidents, work absences, and reduced productivity. Data were also obtained from the Quebec government administered health insurance board regarding consultations and hospitalizations. Participants were categorized as having insomnia syndrome, insomnia symptoms or as being good sleepers using a standard algorithm. Frequencies of target cost variables were obtained and multiplied by unit costs to generate estimates of total costs for the adult population of the province of Quebec. Results: The total annual cost of insomnia in the province of Quebec was estimated at $6.6 billion (Cdn$). This includes direct costs associated with insomnia-motivated health-care consultations ($191.2 million) and transportation for these consultations ($36.6 million), prescription medications ($16.5 million), over the-counter products ($1.8 million) and alcohol used as a sleep aid ($339.8 million). Annual indirect costs associated with insomnia-related absenteeism were estimated at $970.6 million, with insomnia-related productivity losses estimated at $5.0 billion. The average annual per-person costs (direct and indirect combined) were $5,010 for individuals with insomnia syndrome, $1,431 for individuals presenting with symptoms, and $421 for good sleepers. Conclusions: This study suggests that the economic burden of insomnia is very high, with the largest proportion of all expenses (76%) attributable to insomnia-related work absences and reduced productivity. As the economic burden of untreated insomnia is much higher than that of treating insomnia, future clinical trials should evaluate the cost-benefits, cost-utility, and cost-effectiveness of insomnia therapies. Keywords: Insomnia, epidemiology, health economics
Race and Financial Strain are Independent Correlates of Sleep in Midlife Women: The SWAN Sleep Study
Study Objectives: To examine racial differences in sleep in a large cohort of midlife women and to evaluate whether indices of socioeconomic status (SES) are associated with racial differences in sleep. Design: Cross-sectional study. Setting: Participants’ homes. Participants: Caucasian (n = 171), African American (n = 138) and Chinese women (n = 59). Interventions: None. Measurements: Sleep quality was assessed with the Pittsburgh Sleep Quality Index. Polysomnographically assessed sleep duration, continuity, architecture, and NREM electroencephalograhic (EEG) power were calculated over multiple nights. Sleep disordered breathing and periodic leg movements were measured on a separate night. Linear regression analysis was used to model the independent and synergistic effects of race and SES on sleep after adjusting for other factors that impact sleep in midlife women. Indices of SES were self-reported educational attainment and financial strain. Results: Sleep was worse in African American women than Caucasian participants as measured by self-report, visual sleep stage scoring, and NREM EEG power. Slow wave sleep differences were also observed between Chinese and Caucasian participants. Racial differences persisted after adjustment for indices of SES. Although educational attainment was unrelated to sleep, financial strain was associated with decreased sleep quality and lower sleep efficiency. Financial strain-by-race interactions were not statistically significant, suggesting that financial strain has additive effects on sleep, independent of race. Conclusions: Independent relationships between race and financial strain with sleep were observed despite statistical adjustment for other factors that might account for these relationships. Results do not suggest that assessed indices of SES moderate the race-sleep relationship, perhaps due to too few women of low SES in the study. Keywords: sleep; power spectral analysis; PSQI; midlife women; menopause; race; SES
Effect of Continuous Positive Airway Pressure on Sleep Structure in Heart Failure Patients with Central Sleep Apnea
Study Objectives: At termination of obstructive apneas, arousal is a protective mechanism that facilitates restoration of upper airway patency and airflow. Treating obstructive sleep apnea (OSA) by continuous positive airway pressure (CPAP) reduces arousal frequency indicating that such arousals are caused by OSA. In heart failure (HF) patients with central sleep apnea (CSA), however, arousals frequently occur several breaths after apnea termination, and there is uncertainty as to whether arousals from sleep are a consequence of CSA. If so, they should diminish in frequency when CSA is attenuated. We therefore sought to determine whether attenuation of CSA by CPAP reduces arousal frequency. Design: Randomized controlled clinical trial. Patients and Setting: We examined data from 205 HF patients with CSA (apnea-hypopnea index [AHI] ≥ 15, > 50% were central) randomized to CPAP or control who had polysomnograms performed at baseline and 3 months later. Measurements and Results: In the control group, there was no change in AHI or frequency of arousals. In the CPAP-treated group, the AHI decreased significantly (from [mean ± SD] 38.9 ± 15.0 to 17.6 ± 16.3, P < 0.001) but neither the frequency of arousals nor sleep structure changed significantly. Conclusion: These data suggest that attenuation of CSA by CPAP does not reduce arousal frequency in HF patients. We conclude that arousals were not mainly a consequence of CSA, and may not have been acting as a defense mechanism to terminate apneas in the same way they do in OSA. Keywords:Arousal, sleep structure, central sleep apnea, sleep physiology
A Human Model That Suggests a Role for Sleep in the Cognitive Neuropsychology of PTSD and Recovery
Craniofacial Profile Assessment in Patients with Obstructive Sleep Apnea
A commentary on Lee et al. Craniofacial Phenotyping in Obstructive Sleep Apnea – A Novel Quantitative Photographic Approach. SLEEP 2008;32:37-45. and Lee et al. Prediction of Obstructive Sleep Apnea with Craniofacial Photographic Analysis. Sleep 2009;32:46-52.
Sleep and Breathing
American Academy of Dental Sleep Medicine Continuing Education Offerings
Tue, 23 Dec 2008 07:37:45 -0000
American Academy of Dental Sleep Medicine Continuing Education Offerings Content Type Journal ArticleCategory CMEDOI 10.1007/s11325-008-0238-y Journal Sleep and BreathingOnline ISSN 1522-1709Print ISSN 1520-9512 Journal Volume Volume 13 Journal Issue Volume 13, Number 1 / February, 2009
Report on the 3rd International Symposium on Dental Sleep Medicine of the European Academy of Dental Sleep Medicine (EADSM), Berlin, 3–4 October 2008
Tue, 23 Dec 2008 07:37:42 -0000
Report on the 3rd International Symposium on Dental Sleep Medicine of the European Academy of Dental Sleep Medicine (EADSM), Berlin, 3–4 October 2008 Content Type Journal ArticleCategory Society NewsDOI 10.1007/s11325-008-0239-x Journal Sleep and BreathingOnline ISSN 1522-1709Print ISSN 1520-9512 Journal Volume Volume 13 Journal Issue Volume 13, Number 1 / February, 2009
BMI is an independent risk factor for snoring in Chinese women aged over 30 years
Thu, 11 Dec 2008 12:12:47 -0000
Abstract Objective The study was designed to analyze body mass index (BMI) as one of risk factors for snoring in Chinese women. Materials and methods Totally, 2,938 women (2,423 available for evaluation of menstrual status) aged over 30 years from a population-based epidemiologic study were enrolled. Results and discussions For those with regular menstrual status, BMI was the main risk factor with OR 3.906 (BMI ≥25 kg/m2) and 8.467 (BMI ≥30 kg/m2), respectively, compared with those of BMI 20–25 kg/m2 (p < 0.001). For postmenopausal women, BMI was also indicated as a risk factor with OR 2.041 (BMI ≥25 kg/m2) and 2.884 (BMI ≥30 kg/m2) compared with those of BMI 20–25 kg/m2 (p < 0.01). As for different BMI, menopause was the only risk factor for women with BMI < 20 kg/m2 (OR = 10.568, p < 0.05). Whereas for those with BMI between 20 and 25 kg/m2, the risk factors included post-menopause, family history, drinking, etc. Conclusion In conclusion, the prevalence of snoring was correlated with BMI independent of menstrual status, and lower BMI is a protective factor against snoring in premenopausal women. Content Type Journal ArticleCategory Short CommunicationDOI 10.1007/s11325-008-0236-0Authors Qing-Yun Li, Shanghai Jiao Tong University School of Medicine Department of Respiratory Medicine, Ruijin Hospital 197 Ruijin Er Road Shanghai People’s Republic of China 200025Shao-Guang Huang, Shanghai Jiao Tong University School of Medicine Department of Respiratory Medicine, Ruijin Hospital 197 Ruijin Er Road Shanghai People’s Republic of China 200025Min Li, Shanghai Jiao Tong University School of Medicine Department of Respiratory Medicine, Ruijin Hospital 197 Ruijin Er Road Shanghai People’s Republic of China 200025Jia-Lin Liu, Shanghai Jiao Tong University School of Medicine Department of Respiratory Medicine, Ruijin Hospital 197 Ruijin Er Road Shanghai People’s Republic of China 200025Huan-Ying Wan, Shanghai Jiao Tong University School of Medicine Department of Respiratory Medicine, Ruijin Hospital 197 Ruijin Er Road Shanghai People’s Republic of China 200025 Journal Sleep and BreathingOnline ISSN 1522-1709Print ISSN 1520-9512
PubMed: 1389-9457
Predictors of restless legs syndrome in pregnancy: A hospital based cross sectional survey from Pakistan.
Sikandar R, Khealani BA, Wasay M Related Articles Predictors of restless legs syndrome in pregnancy: A hospital based cross sectional survey from Pakistan. Sleep Med. 2008 Dec 23; Authors: Sikandar R, Khealani BA, Wasay M Restless legs syndrome (RLS) is more common in pregnant women. The objective of our study was to determine frequency of RLS in pregnant women and predictors of RLS in pregnancy in Pakistan. All pregnant women admitted at The Aga Khan University Hospital for delivery from June to July 2005 were enrolled. Eighty-one of 271 (30%) interviewed women fulfilled the diagnostic criteria of RLS. One hundred seventeen (43%) of the subjects dropped their haemoglobin during the pregnancy. No significant difference in haemoglobin drop was noted between the RLS group and healthy group. On multivariate analysis family history of RLS (OR: 8.43, CI: 2.32-30.57, p value<0.001), history of RLS in prior pregnancy (OR: 53.74, CI: 6.72-429.8, p value<0. 001), history of RLS in past even when non-pregnant (OR: 12.91, CI: 3.34-49.87, p value<0.001) and haemoglobin of 11g/dL or less (OR: 2.05, CI: 1.04-4.04, p value 0.036) were found to be independent predictors of RLS during pregnancy. Subgroup analysis revealed that family history of RLS (OR: 3.06, CI: 1.2-7.83, p value 0.019) and anemia (OR: 1.89, CI: 0.96-3.71, p value 0.06) were associated with de novo RLS, and family history of RLS (OR: 12.39, CI: 4.45-35.54, p value<0.001) and multiparity (OR: 6.84, CI: 2.15-21.71, p value 0.001) were predictors of pre-existing RLS. PMID: 19110469 [PubMed - as supplied by publisher]
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Asleep at the Wheel?
Truck drivers who routinely get too little sleep or suffer from sleep apnea show signs of fatigue and impaired performance that can make them a hazard on the road, according to a major new study by Penn Sleep Centers researchers. The study results, entitled “Impaired Performance in Commercial Drivers: Role of Sleep Apnea and Short Sleep Duration,” were published in the August 15th issue of the American Journal of Respiratory and Critical Care Medicine.
Sleep Apnea and Heart Disease
Along with the epidemic of obesity, the incidence of sleep apnea has risen at an alarming rate. The most common form, known as obstructive sleep apnea (OSA), is caused by extra tissue in the upper airway that collapses and literally blocks the airflow to the lungs. The risk factors for OSA include male sex (women’s risk increases after menopause), obesity, and neck size greater than 17 inches. The symptoms of sleep apnea include fatigue, early morning headaches, snoring, falling asleep during the daytime, depression and witnessed episodes of irregular breathing while sleeping.
Cognitive-Behavioral Treatment of Insomnia
Insomnia is the most prevalent sleep disorder, representing one of the most common complaints reported to doctors by their patients. In an effort to provide non-pharmacologic treatment options for insomnia, research and clinical practice have focused on developing cognitive- behavior treatments as an alternative.
Do Flies and Worms Sleep?
Can you tell if a fly is asleep? This is precisely the question asked seven years ago by Dr. Joan Hendricks, who is now the Dean of the School of Veterinary Medicine at the University of Pennsylvania. In collaboration with Dr. Amita Sehgal and Dr. Allan Pack of the Penn Center for Sleep and Respiratory Neurobiology (CSRN), Dr. Hendricks wanted to determine if the fruit fly Drosophila melanogaster, an animal used since the early 1900s for genetic studies in biology, has a sleeplike state much as we do. But unlike human studies, where one can measure brain electrical activity to distinguish sleep from the waking state, one cannot easily measure fly brain waves. Instead, Dr. Hendricks used behavioral measures.
Advice for Sleepy Students
Each fall, Grace Pien, MD in the University of Pennsylvania Division of Sleep Medicine sees teenagers being brought into her office by parents. The teens complain about difficulty falling asleep at night. After several follow-up questions, Pien often determines that these patients suffer from a sleep disorder called delayed sleep phase syndrome (DSPS) - when the body's circadian rhythm delays the urge to sleep until much later than what is considered to be a normal bedtime.
New Headquarters for Penn Sleep
In April of this year, the practices and sleep laboratory facilities of the Penn Sleep Centers at the Hospital of the University of Pennsylvania and Penn Presbyterian Medical Center were merged into a single new site at 3624 Market St. which serves as headquarters for the Penn Sleep Centers. This newly renovated facility provides pleasant and spacious areas for both patients and staff.
SLEEP Articles
Sleep Promotes Generalization of Extinction of Conditioned Fear
Study Objective: To examine the effects of sleep on fear conditioning, extinction, extinction recall, and generalization of extinction recall in healthy humans. Design: During the Conditioning phase, a mild, 0.5-sec shock followed conditioned stimuli (CS+s), which consisted of 2 differently colored lamps. A third lamp color was interspersed but never reinforced (CS-). Immediately after Conditioning, one CS+ was extinguished (CS+E) by presentation without shocks (Extinction phase). The other CS+ went unextinguished (CS+U). Twelve hours later, following continuous normal daytime waking (Wake group, N = 27) or an equal interval containing a normal night’s sleep (Sleep group, N = 26), conditioned responses (CRs) to all CSs were measured (Extinction Recall phase). It was hypothesized that the Sleep versus Wake group would show greater extinction recall and/or generalization of extinction recall from the CS+E to the CS+U. Setting: Academic medical center. Subjects: Paid normal volunteers. Measurements and Results: Square-root transformed skin conductance response (SCR) measured conditioned responding. During Extinction Recall, the Group (Wake or Sleep) x CS+ Type (CS+E or CS+U) interaction was significant (P = 0.04). SCRs to the CS+E did not differ between groups, whereas SCRs to the CS+U were significantly smaller in the Sleep group. Additionally, SCRs were significantly larger to the CS+U than CS+E in the Wake but not the Sleep group. Conclusions: After sleep, extinction memory generalized from an extinguished conditioned stimulus to a similarly conditioned but unextinguished stimulus. Clinically, adequate sleep may promote generalization of extinction memory from specific stimuli treated during exposure therapy to similar stimuli later encountered in vivo. Keywords: Fear conditioning, extinction, generalization, human, emotional memory
The Economic Burden of Insomnia: Direct and Indirect Costs for Individuals with Insomnia Syndrome, Insomnia Symptoms, and Good Sleepers
Background and Purpose: Insomnia is a highly prevalent problem that is associated with increased use of health care services and products, as well as functional impairments. This study estimated from a societal perspective the direct and indirect costs of insomnia. Participants and Methods: A randomly selected sample of 948 adults (mean age = 43.7 years old; 60% female) from the province of Québec, Canada completed questionnaires on sleep, health, use of health-care services and products, accidents, work absences, and reduced productivity. Data were also obtained from the Quebec government administered health insurance board regarding consultations and hospitalizations. Participants were categorized as having insomnia syndrome, insomnia symptoms or as being good sleepers using a standard algorithm. Frequencies of target cost variables were obtained and multiplied by unit costs to generate estimates of total costs for the adult population of the province of Quebec. Results: The total annual cost of insomnia in the province of Quebec was estimated at $6.6 billion (Cdn$). This includes direct costs associated with insomnia-motivated health-care consultations ($191.2 million) and transportation for these consultations ($36.6 million), prescription medications ($16.5 million), over the-counter products ($1.8 million) and alcohol used as a sleep aid ($339.8 million). Annual indirect costs associated with insomnia-related absenteeism were estimated at $970.6 million, with insomnia-related productivity losses estimated at $5.0 billion. The average annual per-person costs (direct and indirect combined) were $5,010 for individuals with insomnia syndrome, $1,431 for individuals presenting with symptoms, and $421 for good sleepers. Conclusions: This study suggests that the economic burden of insomnia is very high, with the largest proportion of all expenses (76%) attributable to insomnia-related work absences and reduced productivity. As the economic burden of untreated insomnia is much higher than that of treating insomnia, future clinical trials should evaluate the cost-benefits, cost-utility, and cost-effectiveness of insomnia therapies. Keywords: Insomnia, epidemiology, health economics
Race and Financial Strain are Independent Correlates of Sleep in Midlife Women: The SWAN Sleep Study
Study Objectives: To examine racial differences in sleep in a large cohort of midlife women and to evaluate whether indices of socioeconomic status (SES) are associated with racial differences in sleep. Design: Cross-sectional study. Setting: Participants’ homes. Participants: Caucasian (n = 171), African American (n = 138) and Chinese women (n = 59). Interventions: None. Measurements: Sleep quality was assessed with the Pittsburgh Sleep Quality Index. Polysomnographically assessed sleep duration, continuity, architecture, and NREM electroencephalograhic (EEG) power were calculated over multiple nights. Sleep disordered breathing and periodic leg movements were measured on a separate night. Linear regression analysis was used to model the independent and synergistic effects of race and SES on sleep after adjusting for other factors that impact sleep in midlife women. Indices of SES were self-reported educational attainment and financial strain. Results: Sleep was worse in African American women than Caucasian participants as measured by self-report, visual sleep stage scoring, and NREM EEG power. Slow wave sleep differences were also observed between Chinese and Caucasian participants. Racial differences persisted after adjustment for indices of SES. Although educational attainment was unrelated to sleep, financial strain was associated with decreased sleep quality and lower sleep efficiency. Financial strain-by-race interactions were not statistically significant, suggesting that financial strain has additive effects on sleep, independent of race. Conclusions: Independent relationships between race and financial strain with sleep were observed despite statistical adjustment for other factors that might account for these relationships. Results do not suggest that assessed indices of SES moderate the race-sleep relationship, perhaps due to too few women of low SES in the study. Keywords: sleep; power spectral analysis; PSQI; midlife women; menopause; race; SES
Effect of Continuous Positive Airway Pressure on Sleep Structure in Heart Failure Patients with Central Sleep Apnea
Study Objectives: At termination of obstructive apneas, arousal is a protective mechanism that facilitates restoration of upper airway patency and airflow. Treating obstructive sleep apnea (OSA) by continuous positive airway pressure (CPAP) reduces arousal frequency indicating that such arousals are caused by OSA. In heart failure (HF) patients with central sleep apnea (CSA), however, arousals frequently occur several breaths after apnea termination, and there is uncertainty as to whether arousals from sleep are a consequence of CSA. If so, they should diminish in frequency when CSA is attenuated. We therefore sought to determine whether attenuation of CSA by CPAP reduces arousal frequency. Design: Randomized controlled clinical trial. Patients and Setting: We examined data from 205 HF patients with CSA (apnea-hypopnea index [AHI] ≥ 15, > 50% were central) randomized to CPAP or control who had polysomnograms performed at baseline and 3 months later. Measurements and Results: In the control group, there was no change in AHI or frequency of arousals. In the CPAP-treated group, the AHI decreased significantly (from [mean ± SD] 38.9 ± 15.0 to 17.6 ± 16.3, P < 0.001) but neither the frequency of arousals nor sleep structure changed significantly. Conclusion: These data suggest that attenuation of CSA by CPAP does not reduce arousal frequency in HF patients. We conclude that arousals were not mainly a consequence of CSA, and may not have been acting as a defense mechanism to terminate apneas in the same way they do in OSA. Keywords:Arousal, sleep structure, central sleep apnea, sleep physiology
A Human Model That Suggests a Role for Sleep in the Cognitive Neuropsychology of PTSD and Recovery
Craniofacial Profile Assessment in Patients with Obstructive Sleep Apnea
A commentary on Lee et al. Craniofacial Phenotyping in Obstructive Sleep Apnea – A Novel Quantitative Photographic Approach. SLEEP 2008;32:37-45. and Lee et al. Prediction of Obstructive Sleep Apnea with Craniofacial Photographic Analysis. Sleep 2009;32:46-52.
Sleep and Breathing
American Academy of Dental Sleep Medicine Continuing Education Offerings
Tue, 23 Dec 2008 07:37:45 -0000
American Academy of Dental Sleep Medicine Continuing Education Offerings Content Type Journal ArticleCategory CMEDOI 10.1007/s11325-008-0238-y Journal Sleep and BreathingOnline ISSN 1522-1709Print ISSN 1520-9512 Journal Volume Volume 13 Journal Issue Volume 13, Number 1 / February, 2009
Report on the 3rd International Symposium on Dental Sleep Medicine of the European Academy of Dental Sleep Medicine (EADSM), Berlin, 3–4 October 2008
Tue, 23 Dec 2008 07:37:42 -0000
Report on the 3rd International Symposium on Dental Sleep Medicine of the European Academy of Dental Sleep Medicine (EADSM), Berlin, 3–4 October 2008 Content Type Journal ArticleCategory Society NewsDOI 10.1007/s11325-008-0239-x Journal Sleep and BreathingOnline ISSN 1522-1709Print ISSN 1520-9512 Journal Volume Volume 13 Journal Issue Volume 13, Number 1 / February, 2009
BMI is an independent risk factor for snoring in Chinese women aged over 30 years
Thu, 11 Dec 2008 12:12:47 -0000
Abstract Objective The study was designed to analyze body mass index (BMI) as one of risk factors for snoring in Chinese women. Materials and methods Totally, 2,938 women (2,423 available for evaluation of menstrual status) aged over 30 years from a population-based epidemiologic study were enrolled. Results and discussions For those with regular menstrual status, BMI was the main risk factor with OR 3.906 (BMI ≥25 kg/m2) and 8.467 (BMI ≥30 kg/m2), respectively, compared with those of BMI 20–25 kg/m2 (p < 0.001). For postmenopausal women, BMI was also indicated as a risk factor with OR 2.041 (BMI ≥25 kg/m2) and 2.884 (BMI ≥30 kg/m2) compared with those of BMI 20–25 kg/m2 (p < 0.01). As for different BMI, menopause was the only risk factor for women with BMI < 20 kg/m2 (OR = 10.568, p < 0.05). Whereas for those with BMI between 20 and 25 kg/m2, the risk factors included post-menopause, family history, drinking, etc. Conclusion In conclusion, the prevalence of snoring was correlated with BMI independent of menstrual status, and lower BMI is a protective factor against snoring in premenopausal women. Content Type Journal ArticleCategory Short CommunicationDOI 10.1007/s11325-008-0236-0Authors Qing-Yun Li, Shanghai Jiao Tong University School of Medicine Department of Respiratory Medicine, Ruijin Hospital 197 Ruijin Er Road Shanghai People’s Republic of China 200025Shao-Guang Huang, Shanghai Jiao Tong University School of Medicine Department of Respiratory Medicine, Ruijin Hospital 197 Ruijin Er Road Shanghai People’s Republic of China 200025Min Li, Shanghai Jiao Tong University School of Medicine Department of Respiratory Medicine, Ruijin Hospital 197 Ruijin Er Road Shanghai People’s Republic of China 200025Jia-Lin Liu, Shanghai Jiao Tong University School of Medicine Department of Respiratory Medicine, Ruijin Hospital 197 Ruijin Er Road Shanghai People’s Republic of China 200025Huan-Ying Wan, Shanghai Jiao Tong University School of Medicine Department of Respiratory Medicine, Ruijin Hospital 197 Ruijin Er Road Shanghai People’s Republic of China 200025 Journal Sleep and BreathingOnline ISSN 1522-1709Print ISSN 1520-9512
PubMed: 1389-9457
Predictors of restless legs syndrome in pregnancy: A hospital based cross sectional survey from Pakistan.
Sikandar R, Khealani BA, Wasay M Related Articles Predictors of restless legs syndrome in pregnancy: A hospital based cross sectional survey from Pakistan. Sleep Med. 2008 Dec 23; Authors: Sikandar R, Khealani BA, Wasay M Restless legs syndrome (RLS) is more common in pregnant women. The objective of our study was to determine frequency of RLS in pregnant women and predictors of RLS in pregnancy in Pakistan. All pregnant women admitted at The Aga Khan University Hospital for delivery from June to July 2005 were enrolled. Eighty-one of 271 (30%) interviewed women fulfilled the diagnostic criteria of RLS. One hundred seventeen (43%) of the subjects dropped their haemoglobin during the pregnancy. No significant difference in haemoglobin drop was noted between the RLS group and healthy group. On multivariate analysis family history of RLS (OR: 8.43, CI: 2.32-30.57, p value<0.001), history of RLS in prior pregnancy (OR: 53.74, CI: 6.72-429.8, p value<0. 001), history of RLS in past even when non-pregnant (OR: 12.91, CI: 3.34-49.87, p value<0.001) and haemoglobin of 11g/dL or less (OR: 2.05, CI: 1.04-4.04, p value 0.036) were found to be independent predictors of RLS during pregnancy. Subgroup analysis revealed that family history of RLS (OR: 3.06, CI: 1.2-7.83, p value 0.019) and anemia (OR: 1.89, CI: 0.96-3.71, p value 0.06) were associated with de novo RLS, and family history of RLS (OR: 12.39, CI: 4.45-35.54, p value<0.001) and multiparity (OR: 6.84, CI: 2.15-21.71, p value 0.001) were predictors of pre-existing RLS. PMID: 19110469 [PubMed - as supplied by publisher]
Sites:
BabyCenter - Sleep During Pregnancy: Describes how pregnancy will affect sleep and what to do about it (also has useful links).Children Who Sleep With Light on May Damage Their Sight: News item from British Medical Journal (1999).
Sleepwalking in Children: Definition, symptoms, and what a parent should do. American Academy of Family Physicians (AAFP).
Sudden Infant Death Syndrome (SIDS) in the Child Care Setting: U.S. National Center for Infectious Diseases Centers for Disease Control and Prevention information sheet.
The Treatment of Sleep Disorders in Older People: National Institutes of Health Consensus Development Conference Statement, March 26-28, 1990. Comprehensive.
This directory is based on the Open Directory and may have been modified