Browsing by Subject "APNEA"

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  • Tan, Xiao; van Egmond, Lieve; Partinen, Markku; Lange, Tanja; Benedict, Christian (2019)
    Sleep and circadian disruptions are frequently observed in patients across hospital wards. This is alarming, since impaired nocturnal sleep and disruption of a normal circadian rhythm can compromise health and disturb processes involved in recovery from illness (eg, immune functions). With this in mind, the present narrative review discusses how patient characteristics (sleep disorders, anxiety, stress, chronotype, and disease), hospital routines (pain management, timing of medication, nocturnal vital sign monitoring, and physical inactivity), and hospital environment (light and noise) may all contribute to sleep disturbances and circadian misalignment in patients. We also propose hospital-based strategies that may help reduce sleep and circadian disruptions in patients admitted to the hospital. (C) 2018 The Authors. Published by Elsevier B.V.
  • Arponen, Heidi; Waltimo-Siren, Janna; Valta, Helena; Mäkitie, Outi (2018)
    Background: Persisting fatigue has been reported to be a common complaint by individuals with connective tissue disorders, including Osteogenesis imperfecta (OI). This controlled study evaluated in an adult OI population the subjective experience of fatigue, affecting daily life. Sleep disturbances and chronic pain were examined as hypothesized underlying factors. Methods: This cross-sectional study analyzed the answers of 56 OI patients and 56 matched healthy controls to a questionnaire, designed to evaluate levels of experienced fatigue and bodily pain, as well as the presence or absence of symptoms related to sleep disturbances or sleep apnea. The relationships between fatigue, pain, and sleep disturbances were evaluated with correlation analysis and regression analysis. Results: Fatigue was reported by 96%, and daily pain by 87% of the individuals with OI. Notably, the level of fatigue was similarly experienced by patient respondents and controls. In total, 95% of the patients and 77% of the controls reported one to several sleep disturbance symptoms. These symptoms as well as previously diagnosed sleep apnea were statistically significantly more prevalent in the patient group than in the controls (p <0.05). Likewise, the experienced bodily pain was statistically highly significantly more severe among the respondents with OI (p <0.001), and correlated with the reported fatigue. Conclusions: In comparison with age-matched controls, adults with OI do not differ in experienced fatigue, unlike hypothesized. Therefore, sleep disturbances, which based on the frequency of reported related symptoms and previous sleep apnea diagnoses appear to be common in OI patients, may remain undiagnosed.
  • Wang, Heming; Lane, Jacqueline M.; Jones, Samuel E.; Dashti, Hassan S.; Ollila, Hanna M.; Wood, Andrew R.; van Hees, Vincent T.; Brumpton, Ben; Winsvold, Bendik S.; Kantojarvi, Katri; Palviainen, Teemu; Cade, Brian E.; Sofer, Tamar; Song, Yanwei; Patel, Krunal; Anderson, Simon G.; Bechtold, David A.; Bowden, Jack; Emsley, Richard; Kyle, Simon D.; Little, Max A.; Loudon, Andrew S.; Scheer, Frank A. J. L.; Purcell, Shaun M.; Richmond, Rebecca C.; Spiegelhalder, Kai; Tyrrell, Jessica; Zhu, Xiaofeng; Hublin, Christer; Kaprio, Jaakko A.; Kristiansson, Kati; Sulkava, Sonja; Paunio, Tiina; Hveem, Kristian; Nielsen, Jonas B.; Willer, Cristen J.; Zwart, John-Anker; Strand, Linn B.; Frayling, Timothy M.; Ray, David; Lawlor, Deborah A.; Rutter, Martin K.; Weedon, Michael N.; Redline, Susan; Saxena, Richa (2019)
    Excessive daytime sleepiness (EDS) affects 10-20% of the population and is associated with substantial functional deficits. Here, we identify 42 loci for self-reported daytime sleepiness in GWAS of 452,071 individuals from the UK Biobank, with enrichment for genes expressed in brain tissues and in neuronal transmission pathways. We confirm the aggregate effect of a genetic risk score of 42 SNPs on daytime sleepiness in independent Scandinavian cohorts and on other sleep disorders (restless legs syndrome, insomnia) and sleep traits (duration, chronotype, accelerometer-derived sleep efficiency and daytime naps or inactivity). However, individual daytime sleepiness signals vary in their associations with objective short vs long sleep, and with markers of sleep continuity. The 42 sleepiness variants primarily cluster into two predominant composite biological subtypes - sleep propensity and sleep fragmentation. Shared genetic links are also seen with obesity, coronary heart disease, psychiatric diseases, cognitive traits and reproductive ageing.
  • Takala, Mari; Puustinen, Juha; Rauhala, Esa; Holm, Anu (2018)
    Objectives Sleep-Disordered Breathing (SDB) is frequent in stroke patients. Polysomnography (PSG) and cardiorespiratory polygraphy are used to confirm SDB, but the need for PSG exceeds the available resources for systematic testing. Therefore, a simple and robust pre-screening instrument is necessary to identify the patients with an urgent need for a targeted PSG. The aim of this systematic review was to identify and evaluate the available methods to pre-screen stroke patients possibly suffering from SDB. Materials and Methods Eleven studies out of 3,561 studies met the inclusion criteria. The selected studies assessed the efficiency of seven instruments based on the data acquired clinically or by inquiries (Berlin Questionnaire, Epworth Sleepiness Scale, SOS, Modified Sleep Apnea Scale of the Sleep Disorders Questionnaire, STOP-BANG, Four-variable Screening Tool and Multivariate Apnea Index) and three physiological measures (capnography, nocturia, nocturnal oximetry). The instruments were used to predict SDB in patients after acute or subacute stroke. Either PSG or cardiorespiratory polygraphy was used as a standard to measure SDB. Results No independent studies using the same questionnaires, methods or criteria were published reducing generalizability. Overall, the questionnaires were quite sensitive in finding SDB but not highly specific in identifying the non-affected. The physiological measures (capnography) indicated promising results in predicting SDB, but capnography is not an ideal pre-screening instrument as it requires a specialist to interpret the results. Conclusions The results of pre-screening of SDB in acute and subacute stroke patients are promising but inconsistent. The current pre-screening methods cannot readily be referred to clinicians in neurologic departments. Thus, it is necessary to conduct more research on developing novel pre-screening methods for detecting SDB after stroke.
  • Kalsi, Juhani; Tervo, Timo; Bachour, Adel; Partinen, Markku (2018)
    Objective: To study different factors that are associated with fatal sleepiness-related motor vehicle accidents (FSMVA) and in other types of fatal motor vehicle accidents (FMVA) in Finland. Methods: All FMVA that were caused by falling asleep at the wheel (FSMVA) during the years 2005-2014 were investigated using OTI (Finnish Crash Data Institute) data. The control group consisted of 136 drivers who died in other types of FMVA in 2013. A total of 258 accidents were investigated. Results: The mean age of the 122 drivers in the FSMVA group was 44 (standard deviation 19) years; there were 100 men (82%) and 22 women. The mean age of the 136 control drivers was 45 (standard deviation 19) years; there were 116 men (85%) and 20 women. Short sleep time ( Conclusion: Short sleep is a major cause of fatal sleepiness-related motor vehicle accidents. Driver health factors such as sleep apnea or acute/chronic diseases as well as use of sedative medications and drugs are known risk factors for FSMVA, but these factors are associated also with other types of accidents. Healthy individuals are at risk for falling asleep while driving if they are sleep deprived. All drivers should be aware of the importance of adequate sleep. (C) 2018 Elsevier B.V. All rights reserved.
  • Aledavood, Talayeh; Torous, John; Hoyos, Ana Maria Triana; Naslund, John A.; Onnela, Jukka-Pekka; Keshavan, Matcheri (2019)
    Purpose of ReviewSleep is an important feature in mental illness. Smartphones can be used to assess and monitor sleep, yet there is little prior application of this approach in depressive, anxiety, or psychotic disorders. We review uses of smartphones and wearable devices for sleep research in patients with these conditions.Recent FindingsTo date, most studies consist of pilot evaluations demonstrating feasibility and acceptability of monitoring sleep using smartphones and wearable devices among individuals with psychiatric disorders. Promising findings show early associations between behaviors and sleep parameters and agreement between clinic-based assessments, active smartphone data capture, and passively collected data. Few studies report improvement in sleep or mental health outcomes.SummarySuccess of smartphone-based sleep assessments and interventions requires emphasis on promoting long-term adherence, exploring possibilities of adaptive and personalized systems to predict risk/relapse, and determining impact of sleep monitoring on improving patients' quality of life and clinically meaningful outcomes.