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Effects of Exercise Training in Patients with Chronic Heart Failure and Sleep Apnea

UENO, Linda M.; DRAGER, Luciano F.; RODRIGUES, Ana C. T.; RONDON, Maria U. P. B.; BRAGA, Ana M. F. W.; MATHIAS JR., Wilson; KRIEGER, Eduardo M.; BARRETTO, Antonio C. P.; MIDDLEKAUFF, Holly R.; LORENZI-FILHO, Geraldo; NEGRAO, Carlos E.
Fonte: AMER ACAD SLEEP MEDICINE Publicador: AMER ACAD SLEEP MEDICINE
Tipo: Artigo de Revista Científica
ENG
Relevância na Pesquisa
46.79%
Study Objectives: To test the effects of exercise training on sleep and neurovascular control in patients with systolic heart failure with and without sleep disordered breathing. Design: Prospective interventional study. Setting: Cardiac rehabilitation and exercise physiology unit and sleep laboratory. Patients: Twenty-five patients with heart failure, aged 42 to 70 years, and New York Heart Association Functional Class I-III were divided into 1 of 3 groups: obstructive sleep apnea (n = 8), central sleep apnea (n 9) and no sleep apnea (n = 7). Interventions: Four months of no-training (control) followed by 4 months of an exercise training program (three 60-minute, supervised, exercise sessions per week). Measures and Results: Sleep (polysomnography), microneurography, forearm blood flow (plethysmography), peak VO(2). and quality of life were evaluated at baseline and at the end of the control and trained periods. No significant changes occurred in the control period. Exercise training reduced muscle sympathetic nerve activity (P < 0.001) and increased forearm blood flow (P < 0.01), peak VO(2) (P < 0.01), and quality of life (P < 0.01) in all groups, independent of the presence of sleep apnea. Exercise training improved the apnea-hypopnea index...

Effects of Sleep Apnea on Nocturnal Free Fatty Acids in Subjects with Heart Failure

JUN, Jonathan C.; DRAGER, Luciano F.; NAJJAR, Samer S.; GOTTLIEB, Stephen S.; BROWN, Cynthia D.; SMITH, Philip L.; SCHWARTZ, Alan R.; POLOTSKY, Vsevolod Y.
Fonte: AMER ACAD SLEEP MEDICINE Publicador: AMER ACAD SLEEP MEDICINE
Tipo: Artigo de Revista Científica
ENG
Relevância na Pesquisa
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Study Objectives: Sleep apnea is common in patients with congestive heart failure, and may contribute to the progression of underlying heart diseae. Cardiovascular and metabolic complications of sleep apnea have been attributed to intermittent hypoxia. Elevated free fatty acids (FFA) are also associated with the progression of metabolic, vascular, and cardiac dysfunction. The objective of this study was to determine the effect of intermittent hypoxia on FFA levels during sleep in patients with heart failure. Design and interventions: During sleep, frequent blood samples were examined for FFA in patients with stable heart (ejection fraction < 40%). In patients with severe sleep apnea (apnea-hypopnea index = 15.4 +/- 3.7 events/h; average low SpO(2) = 93.6%). In patients with severe sleep apnea, supplemental oxygen at 2-4 liters/min was administered on a subsequent night to eliminate hypoxemia. Measurements and Results: Prior to sleep onset, controls and patients with severe apnea exhibited a similar FFA level. After sleep onset, patients with severe sleep apnea exhibited a marked and rapid increase in FFA relative to control subjects. This increase persisted throughout NREM and REM sleep exceeding serum FFA levels in control subjects by 0.134 mmol/L (P = 0.0038) Supplemental oxygen normalized the FFA profile without affecting sleep architecture or respiratory arousal frequency. Conclusion: In patients with heart failure...

Effects of sinoaortic Denervation on Hemodynamic parameters during natural sleep in rats

SILVEIRA, Neide P.; MOREIRA, Edson D.; DRAGER, Luciano F.; SILVA, Gustavo J. J.; KRIEGER, Eduardo M.
Fonte: AMER ACAD SLEEP MEDICINE Publicador: AMER ACAD SLEEP MEDICINE
Tipo: Artigo de Revista Científica
ENG
Relevância na Pesquisa
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Study Objectives: To analyze the role of arterial baroreflex on hemodynamic changes during synchronized and desynchronized sleep phases of natural sleep in rats. Design: Experimental study. Setting: Laboratory. Participants: Seventeen male Wistar rats. Interventions: No intervention (control, n = 8) or sinoaortic denervation (SAD, n = 9). Measurements and Results: Sleep phases were monitored by electrocorticogram, and blood pressure was measured directly by a catheter in the carotid artery. Cardiac output, as well as total and regional vascular resistances, were determined by measuring the subdiaphragmatic aorta and iliac artery flows with Doppler flow probes, respectively. In contrast to the control group, the SAD group had a strong reduction in blood pressure (-19.9% +/- 2.6% vs -0.7% +/- 2.1%) during desynchronized sleep, and cardiac output showed an exacerbated reduction (-10.4% +/- 3.5% vs 1.1% +/- 1.7%). In SAD rats, total vascular resistance decreased during desynchronized sleep (-10.1% +/- 3.5% vs -1.0% +/- 1.7%), and the increase in regional vascular resistance observed in the control group was abolished (27.5% +/- 8.3% vs -0.8% +/- 9.4%). Conclusions: SAD caused profound changes in blood pressure, cardiac output, and total vascular resistance...

Sleep deprivation of rats: The hyperphagic response is real

KOBAN, Michael; SITA, Luciane V.; LE, Wei Wei; HOFFMAN, Gloria E.
Fonte: AMER ACAD SLEEP MEDICINE Publicador: AMER ACAD SLEEP MEDICINE
Tipo: Artigo de Revista Científica
ENG
Relevância na Pesquisa
46.77%
Study Objectives: Chronic sleep deprivation of rats causes hyperphagia without body weight gain. Sleep deprivation hyperphagia is prompted by changes in pathways governing food intake; hyperphagia may be adaptive to sleep deprivation hypermetabolism. A recent paper suggested that sleep deprivation might inhibit ability of rats to increase food intake and that hyperphagia may be an artifact of uncorrected chow spillage. To resolve this, a palatable liquid diet (Ensure) was used where spillage is insignificant. Design: Sleep deprivation of male Sprague Dawley rats was enforced for 10 days by the flowerpot/platform paradigm. Daily food intake and body weight were measured. On day 10, rats were transcardially perfused for analysis of hypothalamic mRNA expression of the orexigen, neuropeptide Y (NPY). Setting: Morgan State University, sleep deprivation and transcardial perfusion; University of Maryland, NPY in situ hybridization and analysis. Measurements and Results: Using a liquid diet for accurate daily measurements, there was no change in food intake in the first 5 days of sleep deprivation. Importantly, from days 6-10 it increased significantly, peaking at 29% above baseline. Control rats steadily gained weight but sleep-deprived rats did not. Hypothalamic NPY mRNA levels were positively correlated to stimulation of food intake and negatively correlated with changes in body weight. Conclusion: Sleep deprivation hyperphagia may not be apparent over the short term (i.e....

Practice Parameters for the Clinical Evaluation and Treatment of Circadian Rhythm Sleep Disorders: An American Academy of Sleep Medicine Report

Morgenthaler, Timothy I.; Lee-Chiong, Teofilo; Alessi, Cathy; Friedman, Leah; Aurora, R. Nisha; Boehlecke, Brian; Brown, Terry; Chesson, Andrew L.; Kapur, Vishesh; Maganti, Rama; Owens, Judith; Pancer, Jeffrey; Swick, Todd J.; Zak, Rochelle
Fonte: Associated Professional Sleep Societies, LLC Publicador: Associated Professional Sleep Societies, LLC
Tipo: Artigo de Revista Científica
Publicado em 01/11/2007 EN
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The expanding science of circadian rhythm biology and a growing literature in human clinical research on circadian rhythm sleep disorders (CRSDs) prompted the American Academy of Sleep Medicine (AASM) to convene a task force of experts to write a review of this important topic. Due to the extensive nature of the disorders covered, the review was written in two sections. The first review paper, in addition to providing a general introduction to circadian biology, addresses “exogenous” circadian rhythm sleep disorders, including shift work disorder (SWD) and jet lag disorder (JLD). The second review paper addresses the “endogenous” circadian rhythm sleep disorders, including advanced sleep phase disorder (ASPD), delayed sleep phase disorder (DSPD), irregular sleep-wake rhythm (ISWR), and the non–24-hour sleep-wake syndrome (nonentrained type) or free-running disorder (FRD). These practice parameters were developed by the Standards of Practice Committee and reviewed and approved by the Board of Directors of the AASM to present recommendations for the assessment and treatment of CRSDs based on the two accompanying comprehensive reviews. The main diagnostic tools considered include sleep logs, actigraphy, the Morningness-Eveningness Questionnaire (MEQ)...

Sleep Health in U.S. Hispanic Population

Loredo, Jose S.; Soler, Xavier; Bardwell, Wayne; Ancoli-Israel, Sonia; Dimsdale, Joel E.; Palinkas, Lawrence A.
Fonte: Associated Professional Sleep Societies, LLC Publicador: Associated Professional Sleep Societies, LLC
Tipo: Artigo de Revista Científica
Publicado em 01/07/2010 EN
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The importance of sleep on health has only been recently recognized, and the general public and the medical community are not yet fully knowledgeable about this issue. The great majority of sleep research has been performed in whites of European descent and to a lesser extent in African Americans, making generalization of the findings to other ethnic and racial groups difficult. Very little sleep research has been done in U.S. Hispanics. However, based on the available literature and the high prevalence of risk factors in Hispanics, such as obesity, diabetes, living in the inner city, and use of alcohol, the prevalence of such important sleep disorders such as obstructive sleep apnea and sleep habits such as poor sleep hygiene are suspected to be high. There is also some evidence that acculturation to the U.S. life style may lead to worse sleep habits in Hispanics, including fewer hours of sleep. Two current large NIH sponsored studies of sleep in U.S. Hispanics promise to significantly add to the literature on various sleep disorders such as sleep disordered breathing, insomnia, restless legs syndrome, periodic limb movement disorder, and sleep habits such as short sleep duration and sleep hygiene.

Sleep Apnea Cardiovascular Clinical Trials—Current Status and Steps Forward: The International Collaboration of Sleep Apnea Cardiovascular Trialists

Gottlieb, Daniel J.; Craig, Sonya E.; Lorenzi-Filho, Geraldo; Heeley, Emma; Redline, Susan; McEvoy, R. Doug; Durán-Cantolla, Joaquín
Fonte: Associated Professional Sleep Societies, LLC Publicador: Associated Professional Sleep Societies, LLC
Tipo: Artigo de Revista Científica
Publicado em 01/07/2013 EN
Relevância na Pesquisa
46.75%
Sleep apnea is a common chronic disease that is associated with coronary heart disease, stroke, heart failure and mortality, although the ability of sleep apnea treatment to reduce cardiovascular morbidity and mortality has not been demonstrated. In contrast to patients seeking treatment in sleep disorders centers, as many as half of individuals with moderate to severe sleep apnea in the general population do not report excessive sleepiness; however, if treatment of sleep apnea were shown to reduce cardiovascular disease risk, this would provide a strong rationale for treatment of sleep apnea even in the absence of daytime sleepiness. This article summarizes the status of clinical trials evaluating the potential cardiovascular benefits of sleep apnea treatment and discusses the challenges of conducting such trials, and introduces the International Collaboration of Sleep Apnea Cardiovascular Trialists (INCOSACT), a clinical research collaboration formed to foster cardiovascular sleep research.

The economic cost of sleep disorders

Hillman, D.; Murphy, A.; Antic, R.; Pezzullo, L.
Fonte: Amer Academy Sleep Medicine Publicador: Amer Academy Sleep Medicine
Tipo: Artigo de Revista Científica
Publicado em //2006 EN
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Study Objectives: To determine the economic cost of sleep disorders in Australia and relate these to likely costs in similar economies. Design and Setting: Analysis of direct and indirect costs for 2004 of sleep disorders and the fractions of other health impacts attributable to sleep disorders, using data derived from national databases (including the Australian Institute of Health and Welfare and the Australian Bureau of Statistics). Measurements: Direct health costs of sleep disorders (principally, obstructive sleep apnea, insomnia, and periodic limb movement disorder) and of associated conditions; indirect financial costs of associated work related accidents, motor vehicle accidents, and other productivity losses; and nonfinancial costs of burden of disease. These were expressed in US dollars ($). Results: The overall cost of sleep disorders in Australia in 2004 (population: 20.1 million) was $7494 million. This comprised direct health costs of $146 million for sleep disorders and $313 million for associated conditions, $1956 million for work-related injuries associated with sleep disorders (net of health costs), $808 million for private motor vehicle accidents (net of health costs), $1201 million for other productivity losses...

Effects of moderate sleep deprivation and low-dose alcohol on driving simulator performance and perception in young men

Vakulin, A.; Baulk, S.; Catcheside, P.; Anderson, R.; van den Heuvel, C.; Banks, S.; McEvoy, R.
Fonte: Amer Academy Sleep Medicine Publicador: Amer Academy Sleep Medicine
Tipo: Artigo de Revista Científica
Publicado em //2007 EN
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Study Objective: To determine the combined effects of sleep restriction and low-dose alcohol on driving simulator performance, EEG, and subjective levels of sleepiness and performance in the mid-afternoon. Design: Repeated measures with 4 experimental conditions. Normal sleep without alcohol, sleep restriction alone (4 hours) and sleep restriction in combination with 2 different low blood alcohol concentrations (0.025 g/dL and 0.035 g/dL). Setting: Sleep Laboratory, Adelaide Institute for Sleep Health. Participants: Twenty-one healthy young men, aged 18-30 years, mean (±SD) = 22.5(±3.7) years, BMI = 25(±6.7) kg/m2; all had normal sleep patterns and were free of sleep disorders. Measurements: Participants completed a 70-minute simulated driving session, commencing at 14:00. Driving parameters included steering deviation, braking reaction time, and number of collisions. Alpha and theta EEG activity and subjective driving performance and sleepiness were also measured throughout the driving task. Results: All measures were significantly affected by time. Steering deviation increased significantly when sleep restriction was combined with the higher dose alcohol. This combination also resulted in a significant increase in alpha/theta EEG activity throughout the drive...

Marked reduction in obstructive sleep apnea severity in slow wave sleep

Ratnavadivel, R.; Chau, N.; Stadler, D.; Yeo, A.; McEvoy, R.; Catcheside, P.
Fonte: The American Academy of Sleep Medicine Publicador: The American Academy of Sleep Medicine
Tipo: Artigo de Revista Científica
Publicado em //2009 EN
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46.82%
Introduction: Obstructive sleep apnea (OSA) is widely accepted to improve during slow wave sleep (SWS) compared to lighter stages of NREM sleep. However, supporting data to establish the magnitude and prevalence of this effect is lacking. Consequently, we examined this phenomenon, controlling for posture, in a large group of patients investigated for OSA at an academic clinical sleep service. Methods: A detailed retrospective analysis was conducted on data obtained from each 30-sec epoch of sleep in 253 consecutive full-night diagnostic polysomnography studies performed over a 3-month period. Respiratory and arousal event rates were calculated within each stage of sleep, in the supine and lateral postures, and across the whole night, with OSA patients classified on the basis of an overall apnea-hypopnea index (AHI) ≥ 15 events/h. Central sleep apnea (CSA) patients were defined by a central apnea index ≥ 5/h. Sleep latency and time, and respiratory and arousal event rates in OSA, CSA, and non-OSA patients were compared between sleep stages and postures using linear mixed model analysis. The numbers of patients achieving reduced event rates in SWS and in the lateral posture were also examined. Results: There were 171 patients with OSA...

Sleep, Wake and Phase Dependent Changes in Neurobehavioral Function under Forced Desynchrony

Zhou, X.; Ferguson, S.; Matthews, R.; Sargent, C.; Darwent, D.; Kennaway, D.; Roach, G.
Fonte: Amer Academy Sleep Medicine Publicador: Amer Academy Sleep Medicine
Tipo: Artigo de Revista Científica
Publicado em //2011 EN
Relevância na Pesquisa
46.8%
Study Objectives: The homeostatic-circadian regulation of neurobehavioral functioning is not well understood in that the role of sleep dose in relation to prior wake and circadian phase remains largely unexplored. The aim of the present study was to examine the neurobehavioral impact of sleep dose at different combinations of prior wake and circadian phase. Design: A between-participant design involving 2 forced desynchrony protocols varying in sleep dose. Both protocols comprised 7 repetitions of a 28-h sleep/wake cycle. The sleep dose in a standard protocol was 9.33 h per 28-h day and 4.67 h in a sleep-restricted protocol. Setting: A time-isolation laboratory at the Centre for Sleep Research, the University of South Australia. Participants: A total of 27 young healthy males participated in the study with 13 in the standard protocol (age 22.5 ± 2.2 y) and 14 in the sleep-restricted protocol (age 21.8 ± 3.8 y). Interventions: Wake periods during both protocols were approximately 4 h delayed each 28-h day relative to the circadian system, allowing performance testing at different combinations of prior wake and circadian phase. The manipulation in sleep dose between the 2 protocols, therefore, allowed the impact of sleep dose on neurobehavioral performance to be examined at various combinations of prior wake and circadian phase. Measurements and Results: Neurobehavioral function was assessed using the psychomotor vigilance task (PVT). There was a sleep dose x circadian phase interaction effect on PVT performance such that sleep restriction resulted in slower and more variable response times...

The relative contributions of the homeostatic and circadian processes to sleep regulation under conditions of severe sleep restriction

Paech, G.; Ferguson, S.; Sargent, C.; Kennaway, D.; Roach, G.
Fonte: Amer Academy Sleep Medicine Publicador: Amer Academy Sleep Medicine
Tipo: Artigo de Revista Científica
Publicado em //2012 EN
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46.83%
STUDY OBJECTIVES: To investigate the relative contributions of the homeostatic and circadian processes on sleep regulation under conditions of severe sleep restriction. DESIGN: The 13-day laboratory based study consisted of 3 × 24-h baseline days (8 h sleep opportunity, 16 h wake) followed by 7 × 28-h forced desynchrony days (4.7 h sleep opportunity, 23.3 h wake). SETTING: The study was conducted in a time isolation unit at the Centre for Sleep Research, University of South Australia. PARTICIPANTS: Fourteen healthy, nonsmoking males, aged 21.8 ± 3.8 (mean ± SD) years participated in the study. INTERVENTIONS: N/A. MEASUREMENTS: Sleep was measured using standard polysomnography. Core body temperature (CBT) was recorded continuously using a rectal thermistor. Each epoch of sleep was assigned a circadian phase based on the CBT data (6 × 60-degree bins) and an elapsed time into sleep episode (2 × 140-min intervals). RESULTS: The percentage of SWS decreased with elapsed time into the sleep episode. However, no change in the percentage of REM sleep was observed with sleep progression. Whilst there was a circadian modulation of REM sleep, the amplitude of the circadian variation was smaller than expected. Sleep efficiency remained high throughout the sleep episode and across all circadian phases. CONCLUSIONS: Previous forced desynchrony studies have demonstrated a strong circadian influence on sleep...

Sleep apnea cardiovascular clinical trials-current status and steps forward: the International Collaboration of Sleep Apnea Cardiovascular Trialists

Gottlieb, D.; Craig, S.; Lorenzi-Filho, G.; Heeley, E.; Redline, S.; McEvoy, R.; Duran-Cantolla, J.
Fonte: Amer Academy Sleep Medicine Publicador: Amer Academy Sleep Medicine
Tipo: Artigo de Revista Científica
Publicado em //2013 EN
Relevância na Pesquisa
46.75%
Sleep apnea is a common chronic disease that is associated with coronary heart disease, stroke, heart failure and mortality, although the ability of sleep apnea treatment to reduce cardiovascular morbidity and mortality has not been demonstrated. In contrast to patients seeking treatment in sleep disorders centers, as many as half of individuals with moderate to severe sleep apnea in the general population do not report excessive sleepiness; however, if treatment of sleep apnea were shown to reduce cardiovascular disease risk, this would provide a strong rationale for treatment of sleep apnea even in the absence of daytime sleepiness. This article summarizes the status of clinical trials evaluating the potential cardiovascular benefits of sleep apnea treatment and discusses the challenges of conducting such trials, and introduces the International Collaboration of Sleep Apnea Cardiovascular Trialists (INCOSACT), a clinical research collaboration formed to foster cardiovascular sleep research.; Daniel J. Gottlieb, Sonya E. Craig, Geraldo Lorenzi-Filho, Emma Heeley, Susan Redline, R. Doug McEvoy and Joaquín Durán-Cantolla

Respiratory cycle-related electroencephalographic changes during sleep in healthy children and in children with sleep disordered breathing

Immanuel, S.A.; Pamula, Y.; Kohler, M.; Martin, J.; Kennedy, D.; Saint, D.A.; Baumert, M.
Fonte: Associated Professional Sleep Societies Publicador: Associated Professional Sleep Societies
Tipo: Artigo de Revista Científica
Publicado em //2014 EN
Relevância na Pesquisa
46.8%
STUDY OBJECTIVE: To investigate respiratory cycle-related electroencephalographic changes (RCREC) in healthy children and in children with sleep disordered breathing (SDB) during scored event-free (SEF) breathing periods of sleep. DESIGN: Interventional case-control repeated measurements design. SETTING: Paediatric sleep laboratory in a hospital setting. PARTICIPANTS: Forty children with SDB and 40 healthy, age- and sex-matched children. INTERVENTIONS: Adenotonsillectomy in children with SDB and no intervention in controls. MEASUREMENTS AND RESULTS: Overnight polysomnography; electroencephalography (EEG) power variations within SEF respiratory cycles in the overall and frequency band-specific EEG within stage 2 nonrapid eye movement (NREM) sleep, slow wave sleep (SWS), and rapid eye movement (REM) sleep. Within both groups there was a decrease in EEG power during inspiration compared to expiration across all sleep stages. Compared to controls, RCREC in children with SDB in the overall EEG were significantly higher during REM and frequency band specific RCRECs were higher in the theta band of stage 2 and REM sleep, alpha band of SWS and REM sleep, and sigma band of REM sleep. This between-group difference was not significant postadenotonsillectomy. CONCLUSION: The presence of nonrandom respiratory cycle-related electroencephalographic changes (RCREC) in both healthy children and in children with sleep disordered breathing (SDB) during NREM and REM sleep has been demonstrated. The RCREC values were higher in children with SDB...

Movement distribution: a new measure of sleep fragmentation in children with upper airway obstruction

Coussens, S.; Baumert, M.; Kohler, M.; Martin, J.; Kennedy, D.; Lushington, K.; Saint, D.; Pamula, Y.
Fonte: American Academy of Sleep Medicine Publicador: American Academy of Sleep Medicine
Tipo: Artigo de Revista Científica
Publicado em //2014 EN
Relevância na Pesquisa
46.79%
STUDY OBJECTIVES: To develop a measure of sleep fragmentation in children with upper airway obstruction based on survival curve analysis of sleep continuity. DESIGN: Prospective repeated measures. SETTING: Hospital sleep laboratory. PARTICIPANTS: 92 children aged 3.0 to 12.9 years undergoing 2 overnight polysomnographic (PSG) sleep studies, 6 months apart. Subjects were divided into 3 groups based on their obstructive apnea and hypopnea index (OAHI) and other upper airway obstruction (UAO) symptoms: primary snorers (PS; n = 24, OAHI <1), those with obstructive sleep apnea syndrome (OSAS; n = 20, OAHI ≥1) and non-snoring controls (C; n = 48, OAHI <1). INTERVENTIONS: Subjects in the PS and OSAS groups underwent tonsillectomy and adenoidectomy between PSG assessments. MEASUREMENTS AND RESULTS: Post hoc measures of movement and contiguous sleep epochs were exported and analyzed using Kaplan-Meier estimates of survival to generate survival curves for the 3 groups. Statistically significant differences were found between these group curves for sleep continuity (P < 0.05) when using movement events as the sleep fragmenting event, but not if stage 1 NREM sleep or awakenings were used. CONCLUSION: Using conventional indices of sleep fragmentation in survival curve analysis of sleep continuity does not provide a useful measure of sleep fragmentation in children with upper airway obstruction. However...

Effects of Acute Sleep Deprivation Resulting from Night Shift Work on Young Doctors; Efeitos Agudos da Privação de Sono Decorrente do Trabalho Nocturno em Jovens Médicos

Sanches, Inês; Pneumology Department. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal.; Teixeira, Fátima; Pneumology Department. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal. Sleep Medicine Center. Centro Hospitalar
Fonte: Ordem dos Médicos Publicador: Ordem dos Médicos
Tipo: info:eu-repo/semantics/article; article; info:eu-repo/semantics/publishedVersion Formato: application/pdf
Publicado em 31/08/2015 ENG
Relevância na Pesquisa
46.81%
Introduction: To evaluate sleep deprivation and its effects on young physicians in relation to concentration capacity and psychomotor performance.Material and Methods: Eighteen physicians aged 26 - 33 years were divided into 2 groups: non-sleep deprived group (with no night work) and sleep deprived group (minimum 12 hour of night work/week). We applied Pittsburgh Sleep Quality Index to screen the presence of sleep pathology and Epworth Sleepiness Scale to evaluate subjective daytime sleepiness; we used actigraphy and sleep diary to assess sleep hygiene and standard sleep-wake cycles. To demonstrate the effects of sleep deprivation, we applied Toulouse-Piéron’s test (concentration test) and a battery of three reaction time tasks after the night duty.Results: Sleep deprived group had higher daytime sleepiness on Epworth Sleepiness Scale (p < 0.05) and during week sleepdeprivation was higher (p < 0.010). The mean duration of sleep during the period of night duty was 184.2 minutes to sleep deprived group and 397.7 minutes to non-sleep deprived group (p < 0.001). In the Toulouse-Piéron´s test, the sleep deprived group had more omissions (p < 0.05) with a poorer result in concentration (p < 0.05). Psychomotor tests that evaluated response to simple stimuli revealed longer response latency (p < 0.05) and more errors (p < 0.05) in Sleep deprived group; in reaction to instruction test the sleepdeprived group showed worse perfection index (p < 0.05); in the fine movements test there was no statistically significant difference between the groups.Discussion: Acute sleep deprivation resulting from nocturnal work in medical professions is associated with a reduction in attention and concentration and delayed response to stimuli. This may compromise patient care as well as the physician’s health and quality of life.Conclusion: It is essential to study the effects of acute sleep deprivation on the cognitive abilities and performance of healthprofessionals.; Introdução: Avaliar a privação do sono e seus efeitos sobre os jovens médicos relativamente à capacidade de concentração edesempenho psicomotor.Material e Métodos: Dezoito médicos...

Respiratory-related leg movements and their relationship with periodic leg movements during sleep

Manconi, M.; Zavalko, I.; Bassetti, C.L.; Colamartino, E.; Pons, M.; Ferri, R.
Fonte: Associated Professional Sleep Societies Publicador: Associated Professional Sleep Societies
Tipo: Artigo de Revista Científica
Publicado em //2014 EN
Relevância na Pesquisa
46.75%
STUDY OBJECTIVES: To describe the time structure of leg movements (LM) in obstructive sleep apnea (OSA) syndrome, in order to advance understanding of their clinical significance. LOCATION: Sleep Research Centre, Oasi Institute (IRCCS), Troina, Italy. SETTING: Sleep laboratory. PATIENTS: Eighty-four patients (16 females, 68 males, mean age 55.1 y, range 29-74 y). METHODS: Respiratory-related leg movements (RRLM) and those unrelated to respiratory events (NRLM) were examined within diagnostic polysomnograms alone and together for their distributions within the sleep period and for their periodicity. MEASUREMENTS AND RESULTS: Patients with OSA and RRLM exhibited more periodic leg movements in sleep (PLMS), particularly in NREM sleep. A gradual decrease in number of NRLM across the sleep period was observed in patients with RRLM. This pattern was less clear for RRLM. Frequency histograms of intermovement intervals of all LMs in patients with RRLM showed a prominent first peak at 4 sec, and a second peak at approximately 24 sec coincident with that of PLMS occurring in the absence of OSA. A third peak of lowest amplitude was the broadest with a maximum at approximately 42 sec. In patients lacking RRLM, NRLM were evident with a single peak at 2-4 sec. A stepwise linear regression analysis showed that...

Disturbed dreaming and the instability of sleep: altered nonrapid eye movement sleep microstructure in individuals with frequent nightmares as revealed by the cyclic alternating pattern

Simor, P.; Bódizs, R.; Horváth, K.; Ferri, R.
Fonte: Associated Professional Sleep Societies, LLC Publicador: Associated Professional Sleep Societies, LLC
Tipo: Artigo de Revista Científica
Publicado em //2013 EN
Relevância na Pesquisa
46.8%
STUDY OBJECTIVES: Nightmares are disturbing mental experiences during sleep that usually result in abrupt awakenings. Frequent nightmares are associated with poor subjective sleep quality, and recent polysomnographic data suggest that nightmare sufferers exhibit impaired sleep continuity during nonrapid eye movement (NREM) sleep. Because disrupted sleep might be related to abnormal arousal processes, the goal of this study was to examine polysomnographic arousal-related activities in a group of nightmare sufferers and a healthy control group. DESIGN: Sleep microstructure analysis was carried out by scoring the cyclic alternating pattern (CAP) in NREM sleep and the arousal index in rapid eye movement (REM) sleep on the second night of the polysomnographic examination. SETTING: Hospital-based sleep research laboratory. PARTICIPANTS: There were 17 in the nightmare (NMs) group and 23 in the healthy control (CTLs) group. INTERVENTIONS: N/A. MEASUREMENTS AND RESULTS: The NMs group exhibited reduced amounts of CAP A1 subtype and increased CAP A2 and A3 subtypes, as well as longer duration of CAP A phases in comparison with CTLs. Moreover, these differences remained significant after controlling for the confounding factors of anxious and depressive symptoms. The absolute number and frequency of REM arousals did not differ significantly between the two groups. CONCLUSIONS: The results of our study indicate that NREM sleep microstructure is altered during nonsymptomatic nights of nightmares. Disrupted sleep in the NMs group seems to be related to abnormal arousal processes...

Longitudinal study of sleep behavior in normal infants during the first year of life

Bruni, O.; Baumgartner, E.; Sette, S.; Ancona, M.; Caso, G.; Di Cosimo, M.E.; Mannini, A.; Ometto, M.; Pasquini, A.; Ulliana, A.; Ferri, R.
Fonte: American Academy of Sleep Medicine Publicador: American Academy of Sleep Medicine
Tipo: Artigo de Revista Científica
Publicado em //2014 EN
Relevância na Pesquisa
46.77%
STUDY OBJECTIVES: To longitudinally examine sleep patterns, habits, and parent-reported sleep problems during the first year of life. METHODS: Seven hundred four parent/child pairs participated in a longitudinal cohort study. Structured interview recording general demographic data, feeding habits, intercurrent diseases, family history, sleep habits, and parental evaluation of the infant's sleep carried out at 1, 3, 6, 9, and 12 months. RESULTS: Nocturnal, daytime, and total sleep duration showed a high inter-individual variability in the first year of life associated with changes in the first 6 months and stability from 6 to 12 months. Bedtime was at around 22:00 and remained stable at 6, 9, and 12 months of age. Approximately 20% of the infants had more than 2 awakenings and slept more often in the parent bed. Nearly 10% of the infants were considered as having a problematic sleep by parents and this significantly correlated with nocturnal awakenings and difficulties falling asleep. CONCLUSIONS: Sleep patterns change during the first year of life but most sleep variables (i.e., sleep latency and duration) show little variation from 6 to 12 months. Our data provide a context for clinicians to discuss sleep issues with parents and suggest that prevention efforts should focus to the first 3-6 months...

Psychometric properties of a subjective sleep quality index to be used with the elderly: an exploratory study

Marques, Mariana; Espirito-Santo, Helena; Matreno, Joana; Fermino, Simon; Alves, Vítor; Vigário, Vanessa; Nascimento, Tirsa; Moitinho, Sara; Almeida, Rute; Costa, André; Tomaz, Marisa; Caldas, Luísa; Testas, Lília; Ferreira, Libânia
Fonte: Journal of Sleep Research Publicador: Journal of Sleep Research
Tipo: Artigo de Revista Científica
ENG
Relevância na Pesquisa
46.75%
Este trabalho inseriu-se no projeto de investigação: Trajetórias do Envelhecimento: estudo dos fatores preditores da demência e do envelhecimento saudável; Objectives: Explore the psychometric properties of a sleep quality index to be used with the elderly population. Methods: 99 elderly (mean age, M=78.65; SD= 6.92; range=60-95) under social responses in institutions from Coimbra Council were assessed through a sleep questionnaire, composed of a sleep quality index and questions assessing sleep correlates. The sleep index is composed by seven items assessing sleep latency, difficulty in falling asleep, number of night awakenings, waking up spontaneously too early, subjective perception that waking up too early constitutes a problem for the person and two items that evaluate general subjective sleep quality and sleep depth. Results: KMO = .830; Bartlett’s Test of Sphericity ≤.001. A principal components analysis and the scree plot inspection revealed a one-factor solution, explaining 48.8% of the total variance. Very good internal consistency (Cronbach alpha coefficient; α=.812). Conclusion: This sleep quality index presents good psychometric properties. Since, in terms of assessment, it is important not to overload the elderly population...