Clinical Assessment and Comorbidities of Sleep Disorders最新文献

Diagnosis and illness burden of excessive daytime sleepiness with obstructive sleep apnea in the United States 美国白天过度嗜睡伴阻塞性睡眠呼吸暂停的诊断和疾病负担

Clinical Assessment and Comorbidities of Sleep Disorders Pub Date : 2019-04-11 DOI: 10.1183/23120541.sleepandbreathing-2019.p41

L. Waldman, S. Parthasarathy, K. Villa, M. Bron, S. Bujanover, M. Brod

{"title":"Diagnosis and illness burden of excessive daytime sleepiness with obstructive sleep apnea in the United States","authors":"L. Waldman, S. Parthasarathy, K. Villa, M. Bron, S. Bujanover, M. Brod","doi":"10.1183/23120541.sleepandbreathing-2019.p41","DOIUrl":"https://doi.org/10.1183/23120541.sleepandbreathing-2019.p41","url":null,"abstract":"Background: Obstructive sleep apnea (OSA) with excessive daytime sleepiness (EDS) can impair quality of life (QOL) and may go undiagnosed. Objectives: To examine the diagnosis experience and impacts of EDS with OSA on QOL in the US. Methods: Focus groups in 3 US cities with 42 patients experiencing EDS with OSA; coded transcripts qualitatively analysed using adapted grounded theory approach. Results: Prior to diagnosis, 40% (n=17) of patients were aware of their EDS and 74% (n=31) were informed of their other OSA symptoms by a spouse/partner, family or friends. About half (n=22, 52%) waited an average of 11.4 (range 1-37) years to seek medical care for OSA; 32% (n=7/22) had thought their symptoms were normal rather than a sign of OSA. Reasons for seeking care were: input from a loved one (n=21, 50%); self-concern about symptoms (n=7, 17%); and impaired driving (n=5, 12%). Twenty-seven patients discussed referral pathways: 15/27 (56%) first saw a primary care physician and 12/27 (44%) a specialist. Although 74% (n=31) were currently on OSA treatment, the majority reported EDS impacts on physical functioning (n=40, 95%); daily life (n=39, 93%); cognition (n=38, 90%); social life (n=37, 88%); and work (n=29, 69%). Conclusions: In the US, OSA diagnosis is often delayed, with many patients unaware of the need to seek medical care. Following OSA diagnosis, EDS may continue to impair QOL. Future research should address diagnostic delays and unmet treatment needs for this population.","PeriodicalId":250960,"journal":{"name":"Clinical Assessment and Comorbidities of Sleep Disorders","volume":"59 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130419762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Adropin protein concentration level among obstructive sleep apnea patients – pilot study 阻塞性睡眠呼吸暂停患者的阿托品蛋白浓度水平--试点研究

Clinical Assessment and Comorbidities of Sleep Disorders Pub Date : 2019-04-11 DOI: 10.1183/23120541.SLEEPANDBREATHING-2019.P44

A. Gabryelska, M. Panek, J. Szemraj, P. Białasiewicz

{"title":"Adropin protein concentration level among obstructive sleep apnea patients – pilot study","authors":"A. Gabryelska, M. Panek, J. Szemraj, P. Białasiewicz","doi":"10.1183/23120541.SLEEPANDBREATHING-2019.P44","DOIUrl":"https://doi.org/10.1183/23120541.SLEEPANDBREATHING-2019.P44","url":null,"abstract":"Introduction: Obstructive sleep apnea (OSA) is a chronic condition that is characterised by recurrent pauses in breathing during sleep. Adropin is a short peptide, mainly expressed in liver and brain. It plays a key role in energy homeostasis, lipid and glucose metabolism. Aim: To investigate the relationship between the adropin protein concertation in blood serum and severity of the disorder among OSA patients. Methods: 36 patients (83% male) referred to Sleep Disorders Centre were included in the study. Patients underwent polysomnography (PSG) examination. Peripheral blood was collected in the morning (6:00-7:00 am) after the PSG. Based on PSG results patients were divided into 2 groups: severe OSA (AHI>30) and control group (AHI Results: Higher adropin protein concentration level was observed in group with severe OSA (p=0.022) compared to controls. There has been difference between the groups regarding BMI (p Conclusion: Patients suffering from severe OSA have higher concentration level adropin than controls. There is a need to further investigate adropin, in larger cohort and in context of OSA comorbidities as it could be a relevant factor in their etiopathogenesis.","PeriodicalId":250960,"journal":{"name":"Clinical Assessment and Comorbidities of Sleep Disorders","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128127965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Impact of severe OSA during REM sleep on cardiac and inflammatory protein levels REM睡眠期间严重OSA对心脏和炎症蛋白水平的影响

Clinical Assessment and Comorbidities of Sleep Disorders Pub Date : 2019-04-11 DOI: 10.1183/23120541.SLEEPANDBREATHING-2019.P45

M. Ljunggren, J. Theorell-Haglöw, E. Freyhult, A. Malinovschi, C. Janson, E. Lindberg

{"title":"Impact of severe OSA during REM sleep on cardiac and inflammatory protein levels","authors":"M. Ljunggren, J. Theorell-Haglöw, E. Freyhult, A. Malinovschi, C. Janson, E. Lindberg","doi":"10.1183/23120541.SLEEPANDBREATHING-2019.P45","DOIUrl":"https://doi.org/10.1183/23120541.SLEEPANDBREATHING-2019.P45","url":null,"abstract":"Background: Proteomic-based technologies offer new possibilities to identify altered levels of cardiac and inflammatory proteins that might reflect the cardiometabolic stress caused by different measures of OSA. Aim: To investigate the effects of OSA on the cardiovascular system by analysing a broad panel of cardiac and inflammatory proteins in relationship to different measures of OSA in a population based cohort of women. Method: In the “Sleep and Health in Women” (SHE) cohort study, 400 women underwent polysomnography, anthropometric measurements and blood sampling. Two proteomic assays (Olink Proseek® Inflammation panel and Cardiovascular II panel), each measuring 92 proteins, were analysed in a subsample of 253 women. Results: In unadjusted models, with false discovery rate set to 10%, 57 proteins were associated with AHI, 56 proteins with ODI and 64 proteins with REM AHI. After adjustment for age, BMI and plate there were no significant associations between AHI or ODI and any of the proteins. REM AHI>30 was associated with decreased levels of two proteins involved in anti-inflammatory processes; Sirt2 (q-value 0.016) and LAP-TGFs1 (q-value 0.016). There was further a negative association between REM AHI>30 and Axin1 (q-value 0.095), a protein known to facilitate TGFs signalling. Conclusion: Severe OSA during REM sleep affected the plasma levels of Sirt2, LAP-TGFs1 and Axin1. For overall AHI and ODI the associations with cardiac and inflammatory proteins were weaker and to a large extent explained by age and BMI.","PeriodicalId":250960,"journal":{"name":"Clinical Assessment and Comorbidities of Sleep Disorders","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132039836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The role of PSGL-1 and P-selectin in OSA PSGL-1和p -选择素在OSA中的作用

Clinical Assessment and Comorbidities of Sleep Disorders Pub Date : 2019-04-11 DOI: 10.1183/23120541.sleepandbreathing-2019.p46

M. Mészáros, P. Horváth, Z. Lázár, L. Kunos, A. Bikov

{"title":"The role of PSGL-1 and P-selectin in OSA","authors":"M. Mészáros, P. Horváth, Z. Lázár, L. Kunos, A. Bikov","doi":"10.1183/23120541.sleepandbreathing-2019.p46","DOIUrl":"https://doi.org/10.1183/23120541.sleepandbreathing-2019.p46","url":null,"abstract":"Background: Obstructive sleep apnoea (OSA) is characterised by chronic intermittent hypoxia (CIH), which can induce expression of adhesion molecules, such as P-selectin. P-selectin interacts with its major ligand, the P-selectin glycoprotein ligand-1 (PSGL-1). PSGL-1 expressed on leukocytes and its interaction with P-selectin plays important role in rolling and migration of leukocytes trough the endothelium. The aim of this study to evaluate circulating P-selectin and PSGL-1 concentrations and to understand their role in the pathogenesis of OSA. Methods: 51 patients with OSA and 42 healthy volunteers were recruited. Blood samples were taken before and after a diagnostic polysomnography (PSG). The concentration of plasma PSGL-1 and P-selectin was measured using ELISA. Results: There was no difference between circulating PSGL-1 levels of OSA patients and control subjects, either in the evening or in the morning (478.06 ± 170.43 U/ml vs. 497.95 ± 236.09 U/ml p = 0.67 in the morning and 476.20 ± 217.24 U/ml vs. 495.72 ± 230.81 U/ml p = 0.70 in the evening). P-selectin levels were significantly higher in OSA patients compared to the control group (18.43 ± 7.40 vs. 22.85 ± 11.90 ng/ml in controls and OSAS respectively, p = 0.03). There was no correlation between OSA severity and circulating PSGL-1, but P-selectin correlated significantly with AHI (r = 0.45, p Conclusion: Our results suggest that endothelial activation plays a role in OSA without altering adhesion molecules on leukocytes.","PeriodicalId":250960,"journal":{"name":"Clinical Assessment and Comorbidities of Sleep Disorders","volume":"56 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114157624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Association between obstructive sleep apnea and liver steatosis investigated by magnetic resonance imaging 磁共振成像研究阻塞性睡眠呼吸暂停与肝脏脂肪变性的关系

Clinical Assessment and Comorbidities of Sleep Disorders Pub Date : 2019-04-11 DOI: 10.1183/23120541.SLEEPANDBREATHING-2019.P42

W. Trzepizur, J. Boursier, A. Berréhare, M. Vaillant, P. Ducluzeau, S. Dubois, S. Henni, P. Abraham, P. Calès, C. Aubé, F. Gagnadoux

{"title":"Association between obstructive sleep apnea and liver steatosis investigated by magnetic resonance imaging","authors":"W. Trzepizur, J. Boursier, A. Berréhare, M. Vaillant, P. Ducluzeau, S. Dubois, S. Henni, P. Abraham, P. Calès, C. Aubé, F. Gagnadoux","doi":"10.1183/23120541.SLEEPANDBREATHING-2019.P42","DOIUrl":"https://doi.org/10.1183/23120541.SLEEPANDBREATHING-2019.P42","url":null,"abstract":"Background and Aims: Obstructive sleep apnea (OSA) and nonalcoholic fatty liver disease (NAFLD) are frequently encountered in overweight and obese patients. Whether OSA is associated with liver steatosis investigated by magnetic resonance imagery (MRI), a robust and non-invasive physical marker of liver steatosis in a large cohort of patients suspected for OSA is unknown. Methods: 167 nondrinking patients with nocturnal polysomnographic recording for clinical suspicion of OSA were included in the study. Liver steatosis evaluation was performed by measuring the proton density fat fraction (PDFF) which is the fraction of MRI visible protons bound to fat divided by all protons in the liver. Significant liver steatosis was defined as a PDFF ?6.5%. Results: 11(6.5%) patients had no OSA, 31 (18.6%) had mild OSA, 56 (33.5%) had moderate OSA and 69 (41.3%) had severe OSA. 79 (47.3%) patients had a PDFF values ?6.5%. On univariate analysis, severe OSA (AHI ?30 events/h) was associated with a significantly increased risk of a PDFF ?6.5% (OR 2.04, 95% CI 1.09–3.80) but the association was not maintained after adjusting for confounders including age, gender, triglycerides level and body mass index (OR 1.27, 95%CI 0.63–2.56). Conclusions: Severe OSA is associated with increased liver steatosis but the association is not maintained after adjusting for confounders including BMI.","PeriodicalId":250960,"journal":{"name":"Clinical Assessment and Comorbidities of Sleep Disorders","volume":"77 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124472226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Feature selection for sleep staging using cardiorespiratory and movement signals 基于心肺和运动信号的睡眠分期特征选择

Clinical Assessment and Comorbidities of Sleep Disorders Pub Date : 2019-04-11 DOI: 10.1183/23120541.sleepandbreathing-2019.p40

M. Zimmermann, M. Maathuis, Sunil Kumar

{"title":"Feature selection for sleep staging using cardiorespiratory and movement signals","authors":"M. Zimmermann, M. Maathuis, Sunil Kumar","doi":"10.1183/23120541.sleepandbreathing-2019.p40","DOIUrl":"https://doi.org/10.1183/23120541.sleepandbreathing-2019.p40","url":null,"abstract":"EEG based sleep staging is commonly conducted at clinical setting, which may disturb patients’ sleep habits and thus impair study results. A non-invasive method of sleep staging through cardiorespiratory signals and body movement allow us to classify the stages awake, light, deep and REM sleep using random forest (RF) with good clinical accuracy. The aim is to improve the latter by tuning the RF hyperparameters. Statistical features of size p=63 extracted from vital signals from 13 nights of healthy subjects were used as inputs to the classifiers and classified using 30s epochs. The hyperparameters were tuned over the splitting criteria Gini and entropy, maximal tree depth (up to fully grown), number of trees (up to 1000) and maximal number of features considered at each split (p, vp or log p). Classification accuracies when employing a 10-fold cross-validation were highest with the hyperparameters Gini, vp used features, tree depth of 30 and 1000 trees, yielding an accuracy of (72.8±1.3)%. The feature importance ranking was consistent between the different classifiers, where respiration variability standard deviation always came first with (5.3±2.3)%, ahead of the second by (1.9±1.1)%. Selecting only the most important features may allow to increase the accuracy further by reducing noisy inputs while decreasing computation time. Cardiorespiratory features came out as much more relevant than movement, which indicates that the latter may be omitted without risking a meaningful decrease in scoring accuracy.","PeriodicalId":250960,"journal":{"name":"Clinical Assessment and Comorbidities of Sleep Disorders","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115324804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Sleep disorders in patients affected by Lymphangioleiomiomatosis (LAM) 淋巴管油瘤病(LAM)患者的睡眠障碍

Clinical Assessment and Comorbidities of Sleep Disorders Pub Date : 2019-04-11 DOI: 10.1183/23120541.sleepandbreathing-2019.p48

I. Prediletto, F. Tavalazzi, A. Fabiani, S. Nava

{"title":"Sleep disorders in patients affected by Lymphangioleiomiomatosis (LAM)","authors":"I. Prediletto, F. Tavalazzi, A. Fabiani, S. Nava","doi":"10.1183/23120541.sleepandbreathing-2019.p48","DOIUrl":"https://doi.org/10.1183/23120541.sleepandbreathing-2019.p48","url":null,"abstract":"LAM is a rare and progressive pulmonary disease characterized by cystic radiological pattern and by the possible presence of angiomyolipomas in other organs. Functionally LAM consists in airway obstruction and progressive hypoxemia leading to respiratory failure. No studies, so far, investigated whether during sleep LAM patients show changes in the sleep profile. Aim of our study was to evaluate if, during sleep, the physiological modification of respiration is associated with polysomnographic (PSG) alterations. 8 patients affected by LAM underwent a whole-night polysomnography. Either respiratory failure or use of long-term oxygen therapy were exclusion criteria. All patients were female and had a normal BMI. 3 out of 8 patients (37.5%) had alterations to the PSG pattern: 1 patient showed obstructive sleep apnea (AHI 8.6), 1 patient had nocturnal desaturation (SatO2 time below 90% \"T90\" equal to 17.2%), while 1 patient had nocturnal desaturation (T90 = 27%) and obstructive sleep apnea (AHI 7.5). No arrhythmias were reported. Median sleep efficiency was 91% and median REM latency was 49 minutes. The two patients (25%) with nocturnal desaturation were treated with nocturnal oxygen therapy solving sleep desaturations, showing clinical improvement. This pilot study underlines the importance of assessing respiration during sleep in patients affected by LAM: these patients have a fragile respiratory balance and the normal physiological sleep modifications could translate in pathological desaturations, worsening the damage.","PeriodicalId":250960,"journal":{"name":"Clinical Assessment and Comorbidities of Sleep Disorders","volume":"227 7","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"120840305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Night sleep disruption related to delirium incidence in critically ill patients 危重症患者夜间睡眠中断与谵妄发生率的关系

Clinical Assessment and Comorbidities of Sleep Disorders Pub Date : 2019-04-11 DOI: 10.1183/23120541.SLEEPANDBREATHING-2019.P39

Sejoong Kim, Y. Lee, Jong-Sun Park, Y. Cho, H. Yoon, C. Lee, Jae Ho Lee

{"title":"Night sleep disruption related to delirium incidence in critically ill patients","authors":"Sejoong Kim, Y. Lee, Jong-Sun Park, Y. Cho, H. Yoon, C. Lee, Jae Ho Lee","doi":"10.1183/23120541.SLEEPANDBREATHING-2019.P39","DOIUrl":"https://doi.org/10.1183/23120541.SLEEPANDBREATHING-2019.P39","url":null,"abstract":"Background: Delirium is common in the intensive care unit (ICU). Many critically ill patients treated in the ICU experience sleep disruption. Disrupted sleep in the ICU has been proposed as a potential risk factor for delirium, but the evidence is sparse. This study was undertaken to identify the sleep status for the development of delirium in non-sedated critically ill patients Methods: This prospective study was conducted in medical ICU of a tertiary referral hospital. Polysomnography recording was performed over 24 hour to assess the quantity and quality of sleep. Delirium was measured daily using the Confusion Assessment Method for the ICU. Results: Total 20 patients were enrolled. Median total sleep time was 03:43 (hh:mm, IQR: 00:49 - 06:10). The majority of sleep was stage 1 (median 03:02 [00:47 - 04:34]) with scant stage 2 (median 00:00 [00:00 - 00:46]), REM (median 00:00 [00:00 - 00:15]) and absent stage 3. Delirium was developed in 4 patients (20%). In multivariable analysis, the duration of ICU stay more than 5 days was independently associated with delirium incidence (P=0.042). We also found that patients who stayed more than 5 days in ICU showed significant reduction in night sleep time compared to patients who stayed less than 5 days (00:42 ± 0:46 vs 2:04 ± 1:25, P=0.012), despite of similar total sleep time. Conclusions: The long duration of ICU stay disrupted night sleep which might contribute to the development of delirium in critically ill patients.","PeriodicalId":250960,"journal":{"name":"Clinical Assessment and Comorbidities of Sleep Disorders","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129446825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0