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At least 127 records · Page 7Linked to original sources
PubMed2006

Prevalence of symptoms and risk of sleep apnea in the US population: Results from the national sleep foundation sleep in America 2005 poll.

BACKGROUND: Obstructive sleep apnea (OSA) is a common medical condition with significant adverse consequences, but OSA remains undiagnosed in many individuals. The Berlin questionnaire is a validated instrument that is used to identify individuals who are at risk for OSA. DESIGN: We conducted an analysis of data from the Sleep in America 2005 Poll of The National Sleep Foundation (NSF). The NSF poll is an annual telephone interview of a representative sample of US adults. PARTICIPANTS: The 2005 NSF poll included 1,506 adults. The mean age of participants was 49 years (775 were women). MEASUREMENTS: The Berlin questionnaire was embedded in the NSF poll. This instrument includes questions about snoring, witnessed apneas, self-reported hypertension, and daytime sleepiness. Height and weight were included for the calculation of body mass index (BMI). The NSF poll included detailed demographic information and extensive questions related to all aspects of sleep. RESULTS: Of the 1,506 respondents, 26% (31% of men and 21% of women) met the Berlin questionnaire criteria indicating a high risk of OSA. The risk of OSA increased up to age 65 years. A significant number of obese individuals (57%) were at high risk for OSA. Those whose Berlin questionnaire scores indicated a high risk for OSA were more likely to report subjective sleep problems, a negative impact of sleep on quality of life, and a chronic medical condition than those who were at lower risk. CONCLUSIONS: As many as one in four American adults could benefit from evaluation for OSA. Considering the serious adverse health and quality-of-life consequences of OSA, efforts to expedite diagnosis and treatment are indicated.

Adolescent↗
PubMed2005

Sudden infant death syndrome risk factors with regards to sleep position, sleep surface, and co-sleeping.

We present a study of 102 Sudden Infant Death Syndrome (SIDS) deaths using a retrospective review of medical examiner autopsy reports. The prevalence of sleep related risk factors with regards to sleep surface, sleep position, and co-sleeping were determined in a population of infants less than 1-year-old. Of the 102 SIDS deaths, 67 (65.7%) were not in a crib, 63 (61.8%) were prone, and 48 (47.1%) were co-sleeping. However, 94 (92.2%) of these deaths had at least one risk factor present. Only 8 (7.8%) infants had slept alone, in a crib or bassinet, and on their back or side. Infants less than 4-months-old had a higher rate of co-sleeping (54.7%) than the older infants (25.9%), and a higher frequency of heart malformations at post-mortem examination. The older infants were more likely to exhibit pulmonary and tracheal inflammation, and neuropathology.

Age Factors↗
PubMed1991

Hypnotics and sleep physiology: a consensus report. European Sleep Research Society, Committee on Hypnotics and Sleep Physiology.

The effects of hypnotics on descriptive and functional aspects of electrophysiological sleep parameters are assessed in this report. Because of the arbitrary definition of some of the criteria underlying the conventional sleep stage scoring procedure, computer-aided methods of EEG analysis have become increasingly important for recording and interpreting pharmacological effects on sleep. Of particular interest are the changes of EEG slow-wave activity, since this parameter varies as a function of prior sleep and waking. Several types of interaction between hypnotics and sleep regulation are discussed, some recent pharmacological developments are highlighted, and some common problems in clinical trials are specified.

Anti-Anxiety Agents↗
PubMed1977

[Experimental studies of the effects of Seda-Kneipp on the sleep of sleep disturbed subjects; implications for the treatment of different sleep disturbances (author's transl)].

Seda-Kneipp a compound preparation of valerian and hops was given to sleep disturbed subjects during the second or third of three consecutive nights disturbed by heavy traffic noise. Prior drug administration reduced the noise induced disturbance of sleep stage patterns: slow-wave sleep and stage REM increased. It is recommended that the initial treatment of severe insomnia by "strong" sleeping pills should be followed by a period during which "weak" sleeping pills are given before the drug administration finally is discontinued.

Adult↗
PubMed2003

By the way, doctor. Three years ago, my husband went to a sleep clinic for his snoring. He was diagnosed with moderate sleep apnea and given a continuous positive airway pressure (CPAP) device. He has been sleeping like a baby ever since--and so have I. Here's my question: when he reapplied for life insurance, his rating went from super-preferred to borderline insurable. Is there that much risk, even though he faithfully wears his mask every night? I would warn anyone who has a snoring problem to get life insurance before going to the sleep clinic!

Explore the source record for details and available documents.

Fees and Charges↗
PubMed1984

Periodic movements during sleep, sleep fragmentation, and sleep-wake complaints.

To better understand the relation of sleep complaint to sleep continuity and periodic movements during sleep (PMS), two groups of patients were studied retrospectively. One group of 51 patients, 26 men and 25 women, with a mean age of 56.4 years, complained of insomnia. The other group of 29 patients, 20 men and nine women, with a mean age of 55.8 years, complained of excessive daytime sleepiness. Sleepy patients differed significantly from insomnia patients in that they fell asleep faster and slept longer. They showed more frequent arousals (shifts to stage 1 sleep and number of awakenings) than insomnia patients who had longer arousals (mean duration of awakenings). Insomnia patients had more series of PMS, but sleepy patients had more PMS bursts per series.

Arousal↗
PubMed1984

Neonatal cerebellectomy alters ethanol-induced sleep time of short sleep but not long sleep mice.

The effects of neonatal cerebellectomy on ethanol-induced sleep times in long sleep (LS) and short sleep (SS) mice were investigated. Cerebellectomy did not alter the ethanol sensitivity of LS animals for loss of righting reflex. In contrast, SS mice became more sensitive to alcohol after cerebellectomy. Even so, large differences were still observed between the alcohol-induced sleep times of cerebellectomized LS and SS mice. The data indicate that, while the cerebellum must have a prominant influence on alcohol sleep time in SS animals, this brain structure is not solely responsible for the observed differences in righting reflex sensitivity to ethanol in these two mouse lines. We postulate the existence of noncerebellar central neurons with differential sensitivities to the depressant effects of ethanol in LS and SS mice.

Animals↗
PubMed2006

Medical therapy for obstructive sleep apnea: a review by the Medical Therapy for Obstructive Sleep Apnea Task Force of the Standards of Practice Committee of the American Academy of Sleep Medicine.

A significant number of patients with obstructive sleep apnea neither tolerate positive airway pressure (PAP) therapy nor achieve successful outcomes from either upper airway surgeries or use of an oral appliance. The purpose of this paper, therefore, was to systematically evaluate available peer-reviewed data on the effectiveness of adjunctive medical therapies and summarize findings from these studies. A review from 1985 to 2005 of the English literature reveals several practical findings. Weight loss has additional health benefits and should be routinely recommended to most overweight patients. Presently, there are no widely effective pharmacotherapies for individuals with sleep apnea, with the important exceptions of individuals with hypothyroidism or with acromegaly. Treating the underlying medical condition can have pronounced effects on the apnea/hypopnea index. Stimulant therapy leads to a small but statistically significant improvement in objective sleepiness. Nonetheless, residual sleepiness remains a significant health concern. Supplemental oxygen and positional therapy may benefit subsets of patients, but whether these therapies reduce morbidities as PAP therapy does will require rigorous randomized trials. PAP therapy has set the bar high for successful treatment of sleep apnea and its associated morbidities. Nonetheless, we should strive towards the development of universally effective pharmacotherapies for sleep apnea. To accomplish this, we require a greater knowledge of the neurochemical mechanisms underlying sleep apnea, and we must use this infrastructure of knowledge to design well-controlled, adequately powered studies that examine, not only effects on the apnea/hypopnea index, but also the effects of pharmacotherapies on all health related outcomes shown beneficial with PAP therapy.

Benzhydryl Compounds↗
PubMed2000

[Disturbed sleep caused by sleep apnea. To the sleep laboratory for diagnosis?].

Since it was shown that numerous neurological, psychiatric and internal illnesses have characteristics manifested during, or influenced by sleep, somnology has been playing a clinically more and more important role. Among the 88 diagnoses listed by ICD, not only insomnia, but also sleep-related respiratory disorders, in particular the obstructive sleep apnea syndrome, are of special importance. Sleep apnea is associated with coronary heart disease, myocardial insufficiency and other pathological conditions. Already in the doctor's office, a carefully taken history (nocturnal apnea alternating with irregular snoring, and diurnal sleepiness) can arouse an appropriate suspicion. This can be confirmed by an ambulatory polygraphic exploration. The definitive diagnosis is then established with the aid of polysomnography in the sleep lab where specific treatment is also initiated.

Diagnosis, Differential↗
PubMed1998

[Comparative study for assessing quality of life of patients with exogenous sleep disorders (temporary sleep onset and sleep interruption disorders) treated with a hops-valarian preparation and a benzodiazepine drug].

This randomized, double-blind, controlled clinical trial in parallel group design demonstrated equivalent efficacy and tolerability of a hop-valerian preparation compared with a benzodiazepine preparation in patients suffering from sleep disorders according to DSM-IV criteria. Sleep quality, fitness and quality of life were determined by psychometric tests, psychopathologic scales and sleep-questionnaires at the beginning of the therapy, end of therapy (duration 2 weeks) and then 1 week after cessation of therapy. Patients' state of health (4-point scale) and medication tolerability (occurrence of adverse events) were documented. Using the following as parameters "Alphabetischer Durchstreichtest, Feinmotoriktest, Befindlichkeitsskala, Beschwerdeliste, Schlaffragebögen A and B" the differences between beginning and the end of the therapy were analyzed by simultaneous testing of the equality or superiority of the test preparation. The equivalence of both therapies according to sleep quality, fitness and quality of life was proven by a Mann-Whitney-Statistic of 0.50 with a lower boundary of the 95% confidence interval of 0.46. The patients' state of health improved during therapy while showing a deterioration after cessation with both preparations. Withdrawal symptoms, however, were documented with benzodiazepine. Only one adverse drug reaction was reported during this study, namely stomach complaints from both the test and reference medication. This study shows that the investigated hop-valerian preparation in the appropriate dose is a sensible alternative to benzodiazepine for the treatment of nonchronic and non-psychiatric sleep disorders.

Adult↗
PubMedDate not supplied

Sleep-wake cycle, sleep-related disturbances, and sleep disorders: a chronobiological approach.

There is convincing evidence that the functions of sleep include restoration of brain energy storage and memory consolidation. The circadian timing system (CTS) is involved in the daily variation of almost any physiological and psychological variable evaluated thus far. Disturbances of the CTS can be clinically observed by their influence on the sleep-wake cycle, hormones, body temperature, and locomotor activity. This article reviews the basic mechanisms of circadian rhythm sleep disturbances, names the applicable diagnostic tools and specific therapeutic strategies, and thereby hints at the impact of circadian rhythm sleep disturbance on psychiatric disorders, especially disorders of affect and cognition. In light of the preventive, diagnostic, and therapeutic tools now available, a new round of chronobiological studies in psychiatry seems justified, promising, and necessary.

Brain↗
PubMed2000

Should children with suspected obstructive sleep apnea syndrome and normal nap sleep studies have overnight sleep studies?

STUDY OBJECTIVES: Overnight polysomnography (ONP) is the "gold standard" for the diagnosis of sleep-disordered breathing, but it is expensive and time-consuming. Thus, daytime nap studies have been used as screening tests. If the findings of a nap study are normal or mildly abnormal, should ONP be performed? Do specific abnormalities in nap studies predict abnormal findings in ONP? To answer these questions, we conducted this study. DESIGN: Retrospective chart review. SETTING: Children's hospital. PARTICIPANTS: One hundred forty-three children with suspected obstructive sleep apnea syndrome secondary to isolated adenotonsillar hypertrophy, who had normal or mildly abnormal nap studies, and underwent ONP. MEASUREMENTS AND RESULTS: We compared daytime nap and overnight polysomnograms in 143 children (52 girls; mean [+/- SD] age, 5.6 +/- 3.1 years). Total sleep time was 1 h in daytime nap, and 5.1 +/- 1.3 h in ONP. The interval between the two studies was 5.9 +/- 4.8 months. The findings of 59% of the nap studies were mildly abnormal, while 66% of overnight studies were abnormal. No individual nap study parameter (including short obstructive apneas, hypopneas, hypoxemia, hypoventilation, snoring, paradoxical breathing, gasping, retractions) had good sensitivity at predicting abnormal overnight polysomnograms, but most had good specificity and positive predictive value. CONCLUSIONS: We conclude that individual nap study parameters are not very sensitive in predicting abnormal ONP findings. However, when nap study parameters are abnormal, the chance of obstructive sleep apnea syndrome is high.

Breath Tests↗
PubMed1999

Sleep and Breathing in Recreational Climbers at an Altitude of 4200 and 6400 Meters: Observational Study of Sleep and Patterning of Respiration During Sleep in a Group of Recreational Climbers.

Background: The increasing popularity of mountain climbing will result in greater numbers of the general population being at risk for the disturbances known to occur with altitude exposure. Methods: Observations of sleep and breathing were made in 6 healthy travellers (5 males and 1 female, 38 to 62 years of age) before, during, and after a recreational climb. We modified a portable seven channel polygraph to record sleep state, oxygen saturation, respiratory movements, body position, and oronasal airflow 4 weeks prior to the expedition at home (500m), at base camp (4200m) and in 3 climbers at 6400m. All had a repeat study at 500m altitude 4 weeks after the expedition. Results: For the group, the total number of obstructive apneas and hypopneas (OA/H) at night increased from 36 at home to 68 at base camp over a one night recording. Separately counted central apneas and hypopneas (CA/CS) increased from 6.7 to 45. In one climber, who had a history of recurrent snoring and observed apneas at home, the number of apneas increased from 201 at 4200m to 322 at 6400m, whereas in 2 climbers measured at 6400m, all apneas decreased. The total sleep time (TST) increased in all 6 climbers by 10% at base camp in comparison to home records. In the 3 climbers attaining an altitude of 6400m, the REM (rapid eye movement) sleep declined by 10% compared to the record at 4200m. Conclusion: Respiratory disturbances at low altitude are amplified by exposure to high and extreme altitude. In those without symptoms of sleep apnea, significant physiologic alterations will occur at high altitude but at extreme altitude regular ventilation is re-established.

Journal Article↗
PubMed1995

Changes of sleep EEG slow-wave activity in response to sleep manipulations: to what extent are they related to changes in REM sleep latency?

Sleep interventions may have direct effects on slow-wave activity (SWA, i.e. power of the sleep EEG signal in the 0.75-4.5 Hz range) as well as indirect ones caused by changes in REM sleep (REMS) latency. The effects of changes in REMS latency on SWA were investigated by analysing simulations with a mathematical model. Mean SWA in the first non-REMS episode shows an initial increase and a later decline as a function of REMS latency. In the second non-REMS episode, mean SWA decreases with increasing REMS latency. These results of the simulations were validated with experimental data. In the evaluation of the effects of sleep interventions on SWA the effects of the timing of REMS have to be accounted for. The analysis of SWA over a sufficiently long constant amount of time spent in non-REMS proves to be relatively independent of REMS latency, which allows conclusions about the effects of sleep interventions on SWA per se.

Journal Article↗
PubMed1987

Sleep movements and poor sleep in patients with non-specific somatic complaints--II. Affective disorders and sleep quality.

Nocturnal motor activity of 67 poor sleepers referred to the Rehabilitation Research Centre (RRC) and of 16 healthy subjects were recorded to distinguish poor sleepers without affective disorders from those with affective disorders. All subjects slept on the static charge sensitive bed (SCSB) in a single room of the patient dormitory. All subjects filled out a sleep questionnaire about their subjective sleep quality. After comprehensive rehabilitation consultations the poor sleepers were divided into two subgroups: those with and those without affective disorders. Complaints about insomnia and sleep disorders distinguished poor sleepers from healthy controls but the subgroups of poor sleepers did not differ in the estimation of the quality of sleep. However, when the distribution of body movements through the night was considered, the dynamic of nocturnal motor activity typified poor sleepers with affective symptoms.

Adult↗
PubMed1990

Sleep stability with home sleep recording and automatic sleep stage analysis.

Three home sleep recordings were conducted in 12 normal subjects using the Oxford Medilog 9000 system with automatic sleep stage analysis (SS90III). Each night was separated by 1 week. No significant differences were noted for any sleep parameter, with the mean intraindividual variation less than 20% for most parameters. This indicates that sleep patterns are stable over time.

Adult↗