This study is aimed at determining the quality of life, mental health, and adherence to continuous positive airway pressure (CPAP) therapy for obstructive sleep apnea (OSA) among Thai OSA patients during the coronavirus disease 2019 (COVID-19) pandemic as this data has been lacking. A cross-sectional study was conducted at a university hospital between September 2021 and April 2022. OSA patients aged 18 years or older who required home CPAP treatment were included. Sleep Apnea Quality of Life Index (SAQLI) and Depression Anxiety Stress Scales-21 (DASS-21) were used to assess quality of life and mental health, respectively. A total of 142 participants (62% male) were included, with a mean age of 54.4 ± 14.7 years and a body mass index of 29.9 ± 6.8 kg/m2. Polysomnographic data showed a mean apnea-hypopnea index of 48.0 ± 32.4 events/hour and a mean lowest oxygen saturation of 79.2 ± 12.2%. Severe OSA was observed in 66.9%. CPAP compliance was reported in 50.7%. The SAQLI score was 2.32 ± 1.12. Depression, anxiety, and stress scores in DASS-21 were 2.89 ± 3.31, 3.94 ± 3.67, and 4.82 ± 4.00, respectively. Compared to the CPAP compliance group, the CPAP noncompliance group had higher daily activity scores in SAQLI (2.98 ± 1.25 vs. 2.45 ± 1.33, P = 0.015). The quality of life for Thai OSA patients during the COVID-19 era was moderate degree. Poor CPAP compliance was significantly associated with limited daily activity. Enhancing CPAP compliance could improve the quality of life in these patients. This trial is registered with TCTR20211104004.

Obstructive sleep apnea (OSA) pathologically stresses the cardiovascular system. Apneic events cause significant oscillatory surges in nocturnal blood pressure (BP). Trajectories of these surges vary widely. This variability challenges the quantification, characterization, and mathematical modeling of BP surge dynamics. We present a method of aggregating trajectories of apnea-induced BP surges using a sample-by-sample averaging of continuously recorded BP. We applied the method to recordings of overnight BP (average total sleep time: 4.77 ± 1.64 h) for 10 OSA patients (mean AHI: 63.5 events/h; range: 18.3-105.4). We studied surges in blood pressure due to obstructive respiratory events separated from other such events by at least 30 s (274 total events). These events increased systolic (SBP) and diastolic (DBP) BP by 19 ± 7.1 mmHg (14.8%) and 11 ± 5.6 mmHg (15.5%), respectively, relative to mean values during wakefulness. Further, aggregated SBP and DBP peaks occurred on average 9 s and 9.5 s after apnea events, respectively. Interestingly, the amplitude of the SBP and DBP peaks varied across sleep stages, with mean peak ranging from 128.8 ± 12.4 to 166.1 ± 15.5 mmHg for SBP and from 63.1 ± 8.2 to 84.2 ± 9.4 mmHg for DBP. The aggregation method provides a high level of granularity in quantifying BP oscillations from OSA events and may be useful in modeling autonomic nervous system responses to OSA-induced stresses.

Perioperative sleep disturbances may impact healing and negatively affect the patient's perception of well-being. Therefore, accurately assessing postoperative sleep characteristics is necessary to treat sleep disturbances. This study is a secondary data analysis of research investigating the association between sleep and cognition in a perioperative setting. This study compares sleep characteristics between the St. Mary's Hospital Sleep Questionnaire and WatchPAT, a portable sleep apnea testing device. The goal of this study is to compare an objective measurement of sleep quality (WatchPAT) with a traditional questionnaire. One hundred and one patients who underwent elective, noncardiac surgical procedures wore a WatchPAT and completed the St. Mary's Hospital Sleep Questionnaire for three nights: two preoperative and one postoperative night. In the preoperative period, a Bland-Altman analysis showed an agreement Watch PAT and the St Mary's hospital sleep questionnaire except for sleep fragmentation. A good to fair correlation during the preoperative period was observed with both sleep latency and total sleep time. In the postoperative period, no correlation was observed between the St. Mary's Hospital Sleep Questionnaire data and WatchPAT data. Our study indicates that some potential factors affecting sleep and cognition such as admission type, depression, anesthesia type, and sleep apnea may limit patients' ability to report their sleep characteristics after surgery. Therefore, relying solely on one sleep assessment method is not advisable.

Aim This study aimed to determine the association between quality of sleep and metabolic syndrome (MetS) and physical activity level in young adults at the University of Ghana. Method In a cross-sectional design, 340 university students, aged between 20-30 years were recruited. Quality of sleep was assessed using the Pittsburgh Sleep Quality index (PSQI) and physical activity with the short form of the International Physical Activity Questionnaire (IPAQ-SF). Poor quality of sleep was defined as a global PSQI score>5 and low physical activity level as those not meeting the criteria for vigorous-moderate physical activity. Anthropometric features and blood pressures were measured, and fasting blood samples were collected from the participants to measure plasma levels of glucose, lipid profile, urea, and creatinine. MetS was defined using the Joint Scientific Statement criteria. Results In our study population of young adults from Ghana, the prevalence of poor quality of sleep as measured by PSQI was 54.1%, and MetS was 12.4%. MetS was associated with poor quality of sleep in females [OR (95%CI) = 2.11 (1.04–4.25), p = 0.038] and entire study participants [2.18 (1.09–4.37) p = 0.029] in both crude and adjusted models; no association was found in male participants. Low physical activity status was not associated with poor sleep status. Obesity [1.32 (1.02–3.56), p = 0.043], but not overweight [0.99 (0.58–2.34), p = 0.862], was associated with poor quality of sleep. Conclusion Young adults in a Ghanaian university have a high prevalence of poor quality of sleep and is associated with MetS and obesity. Physical activity status was not associated with poor quality of sleep.

Purpose To determine the prevalence of central apnea (CA) events and central sleep apnea (CSA) in children with sleep-disordered breathing (SDB) and to assess the effect of tonsillectomy and adenoidectomy (TA) on CSA in children with obstructive sleep apnea (OSA). Material and Methods. The medical charts of children with SDB were reviewed to obtain information on past medical history, polysomnography (PSG) findings, and surgical management. Counts and indexes of obstructive apnea, obstructive hypopnea, and central apnea were evaluated before and after TA. The prevalence of CSA and the effect of age, gender, obesity, and comorbid conditions on CSA were assessed in children with SDB as well as in children with PSG proven OSA. Results Seven hundred twelve children with SDB (age range: 1 to 18 yrs, mean: 5.8 ± 3.4) were identified. CA events occurred in 640 of 712 (89.5%) patients. Of the 712 patients, 315 (44.2%) met the criteria for the diagnosis of CSA. CSA was more prevalent in toddlers and preschoolers (p < 0.001). Obese children had a higher prevalence of CSA compared to nonobese children (p < 0.001). The prevalence of CSA in patients with OSA was 45.4%. The number of CA events, CAI, and OAHI after TA was less than that of before TA (p < 0.001). Residual CSA after TA occurred in 20 children (26%). Conclusion Central apnea events and central sleep apnea occur in children who present to a pediatric otolaryngology clinic for evaluation of sleep disordered breathing. Central sleep apnea and obstructive sleep apnea both improve after tonsillectomy and adenoidectomy.

Materials and Methods In this quasi-experimental study with unequal control group design, 35 individuals participated in the cardiac rehabilitation program as the experimental group and 35 served as the control group. The program included 12 weeks of exercise, 3 sessions per week, 3 sessions of training programs each lasting for 45 minutes, and a special two-session sleep improvement program. Data were collected using the Pittsburgh Sleep Quality Index and analysed with descriptive and inferential statistical methods. Results There were not any significant differences between the two groups in age, sex, marital status, smoking, and indication for cardiac rehabilitation (P > 0.05). The scores of sleep quality of patients were 9.2 ± 1.58 before and 4.40 ± 1.14 after intervention in the experimental group and 9.02 ± 2.56 before and 7.48 ± 1.86 after intervention in the control group. There was no significant difference between the two groups before intervention (P = 0.73). yet there was a significant difference after intervention (P = 0.0001). In addition, scores of sleep quality of patients were significantly different in the experimental and control groups before and after intervention (P = 0.0001). Conclusion Findings indicated that the quality of sleep of cardiac patients improved after the sleep intervention program during the cardiac rehabilitation program. Therefore, it is suggested to implement sleep improvement programs for cardiac patient care as an effective, easy, and feasible technique. In addition, it is necessary to pay more attention to the sleep improvement program in cardiac rehabilitation. Trial Registration. The trial was retrospectively registered on https://en.irct.ir/trial/50799 on 14 September 2020 (14.09.2020) with registration number IRCT20140307016870N6.

Background Assessing sleep disorders and understanding their causes are essential for the proper treatment and management of the disorders. The Holland Sleep Disorders Questionnaire (HSDQ) is a self-assessment questionnaire that measures sleep problems and symptoms based on the six categories of sleep disorders described in the International Classification of Sleep Disorders-2 (ICSD-2). The aim of this study was at validating and assessing the psychometric properties of the HSDQ in Iranian adults. Method The study was carried out as a methodological and validation work. The guidelines for translation and cultural adaptation of patient-reported outcome measures were followed for the translation and the cultural validation of the tool. To examine construct validity, exploratory factor analysis (EFA) with 216 participants and confirmatory factor analysis (CFA) with 355 participants were used. As to the reliability, the test-retest method and, as to internal consistency, Cronbach's alpha were employed. Data analyses were done in SPSS-25 and LISREL-8. Results The CFA and EFA results confirmed the tool with six factors and 31 items. The R2 index of the model was 0.99, which indicated that 99% of changes in the dependent variable (adults' sleep problem) were attributed to the independent variable (the 31 items). In other words, 0.99 of the changes in the dependent variable were due to the independent variables. The main indices of CFA (χ2/DF = 2.65, CFI = 0.91NNFI/TLI = 0.92GFI = 0.81, REMSEA = 0.043, R2 = 0.99) were acceptable. In addition, a correlation coefficient below 0.05 was considered as significant. Reliability of the tool based on internal correlation (Cronbach's alpha) was in the 0.701–0.924 range for the subscales and equal to 0.789 for the whole tool. Conclusion In general, the results showed that the Farsi version of HSDQ (six factors and 31 items) had acceptable and applicable indices and it can be used as a valid tool in the Iranian society. The tool can be used as a reliable tool in different fields of medical sciences.

Introduction Sleep disorders are extremely prevalent in the general population. College students are more susceptible to sleep problems. This is due to the increased competition in getting a job position and the current alterations in the labor market. Poor sleep is prevalent and has deleterious effects on college students, but its frequency among college students has not been documented in Jordan. So, the aims of this study are to assess the prevalence of daytime sleepiness among medical college students in Jordan and to look for any links between daytime sleepiness and academic performance. Methods A cross-sectional study performed on medical and paramedical specialties students and Epworth sleepiness Sscale (ESS) was used. To assess the students' academic performance, the cumulative grade point average was utilized. Results 977 students from five medical colleges participated in the study. ESS scores were abnormal in 34.4% of students and were considered to have daytime sleepiness. Significant lower ESS scores were associated with students who reported good sleep quality than students who reported poor sleep quality. Significant lower ESS scores were reported by students who slept more than 7 hours compared with students who slept less than 6 hours. The ESS scores were not significantly associated with students' CPGA. Conclusion Daytime sleepiness is highly prevalent among medical students in Jordan. The data of this study might be very helpful to assess the academic policy makers to develop intervention strategies that resolve the sleep disturbances in college students and reduce its impact on the academic achievements.

Background Acute hypercapnic respiratory failure (AHRF) is a common life-threatening event in patients with obesity hypoventilation syndrome (OHS). Objectives To study the clinical pattern, noninvasive ventilatory support, as well as the short- and long-term outcomes of patients with OHS admitted in a ward because of AHRF. Methods We conducted a retrospective cohort study including all adults with OHS aged ≥ 18 − year − old, admitted in a 90-bed-ward for AHRF. Results A total of 44 patients were included. Fifteen (34.1%) and 29 (65.9%) patients were diagnosed with malignant OHS (mOHS) and nonmalignant OHS (non-mOHS), respectively, while 36 (81.8%) had coexisting obstructive sleep apnea hypopnea syndrome (OSAHS). Patients with mOHS had a significantly higher rate of heart failure (100% vs. 31%; p < 0.001), chronic renal insufficiency (CRI) (73.3% vs. 41.4%; p = 0.04), and dyslipidemia (66.7% vs. 34.5%; p = 0.04) than those with non-mOHS. The mean forced vital capacity (FVC) in our patients was of 59.5% ± 18.5 of the predicted value, lower than what is usually reported in stable patients with OHS. At hospital admission, more than two-thirds (n = 34, 77.3%) were misdiagnosed as having asthma exacerbation (n = 4, 4.9.1%), chronic obstructive pulmonary disease (COPD) exacerbation (n = 12, 27.3%) and/or heart failure (n = 29, 65.9%). Acute pulmonary oedema (ACPE) (n = 16, 36.4%) and acute viral bronchitis (n = 12, 27.3%) were the main identified causal factors, while no cause could be determined in 5 (11.4%) patients. Noninvasive positive pressure ventilation (NIPPV) using bilevel positive airway pressure (BIPAP) was very highly effective to treat AHRF, with only 2.27% of patients failing the modality. Median overall duration of ventilation was 9 hours per day (1.3–20) and was significantly longer in patients with mOHS than in those with non-mOHS (10 [6–18] vs. 8 [1.3–20], respectively; p = 0.01). Forty two of the forty-three patients discharged alive were treated with BIPAP or continuous positive airway pressure (CPAP) in 26 and 16 patients, respectively. The probability of survival was 90% at 12 months, while the probability of readmission for a new episode of AHRF was 56% at 6 months and 22% at 12 months, respectively. Conclusion AHRF in OHS patients is a life-threatening event which can be successfully and safely treated with BIPAP, with a low long-term mortality even in patients with mOHS.

Poor sleep quality has been reported to be common amongst medical students and healthcare professionals worldwide. Sleep disturbance has been associated with increased rates of burnout and depression. As a result, this has been negatively impacting performance and functioning. Research on this topic is limited in the United Arab Emirates (UAE). This study is aimed at exploring sleep pattern and the emotional state of medical and dental students in Dubai, UAE. This cross-sectional study was based on an electronic survey sent to 181 medical and dental students. Of the 181 invitations, 96 individuals agreed to participate and complete the rating scales. The Pittsburgh Sleep Quality Index was utilized to explore sleep duration, quality, and daytime functioning. The Positive and Negative Affect Scale was used to assess the emotional states of the participants. Overall, the findings revealed diminished sleep duration. The average duration of sleep amongst the study participants was 5 hours and 24 minutes, which is significantly below the recommended duration as per sleep guidelines. Results also showed a significant positive correlation between total sleep duration and overall sleep quality with enthusiasm during the day. Future research designed to explore factors contributing to sleep efficiency, in more depth, as well as strategies to enhance sleep quality is highly warranted.