Epworth Sleepiness Scale Questionnaire Research Articles

Risk of Obstructive Sleep Apnea in Patients With Muscle Tension Dysphonia: A Prospective Pilot Study.

To investigate the risk of obstructive sleep apnea (OSA) in patients with muscle tension dysphonia (MTD) in comparison to subjects with no dysphonia. Prospective cohort study. Patients who were diagnosed with MTD at a tertiary referral center between October 2022 and October 2023 were invited to participate in this study, alongside a healthy control group matched by age and gender, with no history of dysphonia. The risk of OSA was evaluated using the STOP-BANG and Epworth Sleepiness Scale (ESS) questionnaires. Demographic data included age, gender, history of smoking, history of allergy, and history of reflux disease. A total of 55 patients who had filled the STOP-BANG and ESS questionnaires were enrolled in this study, including 31 patients diagnosed with MTD and 24 healthy subjects. Using the STOP-BANG, two-thirds of the study group had an intermediate-to-high risk of having OSA as compared to 25% of the control group (P=0.002). The odds of having OSA was 6.3 times among patients with MTD in comparison to controls (OR=6.3; 95% CI [1.91-20.75]. When using the ESS, nine patients of the study group (29%) exhibited excessive daytime sleepiness compared to none in the control group (P=0.007). The results of this investigation indicate that the risk of OSA is significantly higher in patients with MTD vs. controls. Patients with MTD were 6.3 times more likely to have an increased risk of OSA in comparison to subjects with no dysphonia. A longitudinal study using objective tests for OSA is needed to establish a cause-effect relationship between OSA and MTD.

Sleep disturbances among combatants with mild traumatic brain injury

to evaluate the level of sleep disorders in combatants with mild traumatic brain injury (TBI), to provide a comprehensive characterization of sleep disorders using the assessment of complaints, anamnesis data, neurological status, and ESS and PSQI questionnaires with the involvement of comparison groups of patients.bMethods and subjects. The study involved 117 patients who were divided into three groups: combatant patients with mild TBI (n=30) (study group № 1), combatant patients without TBI (n=30) (study group № 2), and group relative to healthy civilian respondents (n=57) (control group). A cross-sectional research design was used. Patients were evaluated using the Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS), as well as the frequency of complaints (inability to fall asleep, night awakenings, early awakenings, and nightmares), anamnesis (age, time since injury) and neurological status data. The method of statistical hypothesis testing for multiple comparisons with appropriate post-hoc calculations was used to compare the obtained results. Results. In study group №1, complaints about the inability to fall asleep were observed in 73.3% of cases, complaints about night awakenings — 46.7%, complaints about early awakenings — 23.3%, and complaints about nightmares — 20.0%. The age was 31 (24 — 40) years, and the time since the injury — 14 (8 — 28) days. A difference from the average values in other groups was found according to the χ2 criterion with correction for continuity (p<0.05). In the process of post hoc analysis using the Bonferroni correction, a statistically significant increased frequency of complaints of inability to fall asleep, early awakenings, and nightmares were found in study group №1 compared to other groups (p<0.05). The frequency of major deviations in neurological status among combatant patients was evaluated. The score on the ESS scale in the study group №1 — 8.1±3.6 points; in the study group №2 — 6 (4 — 8) points; in the control group — 4 (3 — 6) points. The difference in medians is statistically significant according to the Kruskal-Wallis test (p<0.001). Post-hoc comparisons using the Steel-Dwass test indicate that the values of this scale differ when comparing study group №1 and the control group (p<0.001) and study group №2 and the control group (p=0.008). PSQI score in study group №1 — 11.2±4.5 points; in the study group №2 — 7.5 (5 — 11) points; in the control group — 5 (4 — 8) points. The difference in medians is statistically significant according to the Kruskal-Wallis test (p<0.001). Post-hoc comparisons using the Steel-Dwass test indicate that the values of this scale differ when comparing study group №1 and study group №2 (p=0.02) and study group №1 and the control group (p<0.001). Conclusions. Comparisons of the frequency of complaints revealed a statistically significant increase in the frequency of complaints of inability to fall asleep, early awakenings, and nightmares in combatants with TBI. A statistically significant increased level of daytime dysfunction was found in this group of patients according to the ESS scale. A statistically significant decrease in sleep quality also was found in this group of patients according to the PSQI scale. The obtained data can be interpreted as a reflection of the increased prevalence of sleep disorders in patients with traumatic brain injury.

Sleep quality and risk of obstructive sleep apnea among breast cancer survivors with and without lymphedema.

Breast cancer survivors (BCSs) tend to have sleep disturbances such as obstructive sleep apnea (OSA). However, limited evidence exists on the role of breast cancer-related lymphedema (BCRL) in sleep disturbances and OSA. Therefore, this study aimed to investigate the quality of sleep (QoS) and OSA risk among women with and without BCRL. The quality of life (QoL) was evaluated using the SF-12 and EORTC-QLQ C-30 questionnaires, while their sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) questionnaire. The STOP-bang questionnaire (SBQ) was utilized to quantify OSA risk. Sleepiness was assessed using the Epworth Sleepiness Scale (ESS). Also, neck and waist circumference and the excessive volume in the affected limb were measured using a tape measure. The statistical analyses were performed using the SPSS 21.0 software. Seventy-one women with BCRL and 84 BCS without lymphedema were included. The comparison of PSQI, SBQ, ESS, SF-12, and EORTC QLQ-C30 questionnaires exhibited no significant difference between these two groups. The overnight snoring and average neck circumference were significantly higher in the BCRL group than in the control. The BCRL stage significantly correlated with neck circumference and SBQ total score. Additionally, the mean volume difference indicated a significant correlation with the ESS total score and both physical and mental summary components of the SF-12 questionnaire. The prevalence of sleep disturbances among BCSs with and without BCRL is high. Women with advanced stages of BCRL might be at high risk for OSA. Therefore clinical evaluation of BMI, neck circumference, and, snoring overnight should be emphasized among this population.

Longitudinal decline in DAT binding in Parkinson’s disease: connections with sleep disturbances

BackgroundThe nigrostriatal dopamine (DA) system plays a critical role in regulating the sleep–wake state. The relationship between baseline striatal DA transporter (DAT) specific binding ratios (SBR) and rapid eye movement sleep behavior disorder (RBD) has been established. This study aimed to investigate the association between the progression of striatal DA dysfunction and sleep disturbances, including excessive daytime sleepiness (EDS) and probable RBD (pRBD), in patients with Parkinson’s disease (PD).MethodsData were obtained from the Parkinson’s Progression Markers Initiative (PPMI). Six hundred twenty-one newly diagnosed PD patients and followed up for 4 years were included in this longitudinal study. EDS and pRBD were defined using the Epworth Sleepiness Scale (ESS) and RBD Screening Questionnaire (RBDSQ). Striatal DAT SBR was evaluated by [123I] FP-CIT SPECT.ResultsUsing a linear mixed-effects model across all contemporaneous data points, we found a negative correlation between striatal DAT SBR and sleep disturbances (EDS/pRBD). The interaction between striatal DAT SBR and year was specific to RBDSQ score (β = − 0.102, 95% CI: − 0.187 to − 0.017, p = 0.019), with no evidence of a similar interaction for ESS score. Additionally, the association between the alpha-synuclein gene (SNCA) and sleep disturbances was mediated by the SBR (ESS score: total effect = − 2.717, p = 0.022; direct effect = − 3.222, p = 0.007; indirect effect = 0.505, p < 0.05; RBDSQ score: total effect = 1.402, p = 0.026; direct effect = 1.209, p = 0.057; indirect effect = 0.193, p < 0.05).ConclusionsOur findings support the role of striatal DA dysfunction in sleep disturbances in early PD patients. Furthermore, we demonstrated that genetic variations in causative genes of PD contribute to the development of sleep disturbances. Striatal DAT imaging may be a useful risk indicator for sleep disturbances, providing early intervention strategies.

Impact of frenectomy on the oral exercise in patients with ankyloglossia and obstructive sleep apnea: double-blind randomized controlled clinical trials.

This study compares the efficacy of oral exercise alone to oral exercise with frenectomy in improving obstructive sleep apnea (OSA) symptoms and quality of life (QOL) in patients with ankyloglossia. A prospective, controlled, double-blind clinical study enrolled fifteen adults (20-60 years) newly diagnosed with mild to moderate OSA and ankyloglossia. Participants were randomly assigned to either oral exercise alone (control group; n = 8) or oral exercise with frenectomy (intervention group; n = 7). Outcomes were assessed after a 3-month therapy period using polysomnography, the Epworth Sleepiness Scale (ESS), tongue strength (measured in kPa), and QOL questionnaires. Both control (-2.88 ± 1.73; p = 0.02) and intervention (-4.00 ± 3.65; p = 0.03) groups showed a significant reduction in ESS scores, indicating both improved sleepiness. Although the apnea-hypopnea index (AHI) increased in both groups after treatment, these changes were not statistically significant (control 4.73 ± 15.55; p = 0.48, intervention 10.42 ± 14.66; p = 0.12). Tongue strength significantly increased in both groups: control group (p = 0.04) and intervention group (p = 0.03). Satisfaction rates with the overall treatment process were 100% in the control group and 57.1% in the intervention group. Furthermore, 75.0% and 57.1% of participants in the respective groups reported an improvement in QOL. Frenectomy improved tongue mobility and the ability to perform oral exercises in individuals with OSA and ankyloglossia. However, these exercises did not significantly improve OSA-related symptoms or QOL. While frenectomy enhances tongue mobility, thereby enabling better engagement in oral exercises. These exercises alone did not significantly improve OSA-related symptoms or QOL. This suggests that oral exercises focusing solely on tongue mobility may not be sufficient for managing OSA. The Thai Clinical Trials Registry was TCTR20220429002.

Phenotypic Characterisation of Obstructive Sleep Apnoea in Acute Coronary Syndrome

Recent neutral randomised clinical trials have created clinical equipoise for treating obstructive sleep apnoea (OSA) for managing cardiovascular risk. The importance of defining the links between OSA and cardiovascular disease is needed with the aim of advancing the robustness of future clinical trials. We aimed to define the clinical correlates and characterise surrogate cardiovascular markers in patients with acute coronary syndrome (ACS) and OSA. Overall, 66 patients diagnosed with ACS were studied. Patients underwent an unattended polysomnogram after hospital discharge (median [interquartile range] 62 [37-132] days). The Epworth Sleepiness Scale, Berlin, and STOP-BANG questionnaires were administered. Surrogate measures of vascular structure and function, and cardiovascular autonomic function were conducted. Pulse wave amplitude drop was derived from the pulse oximetry signals of the overnight polysomnogram. OSA (apnoea-hypopnea index [AHI] ≥5) was diagnosed in 94% of patients. Moderate-to-severe OSA (AHI≥15) was observed in 68% of patients. Daytime sleepiness (Epworth Sleepiness Scale ≥10) was reported in 17% of patients. OSA screening questionnaires were inadequate to identify moderate-to-severe OSA, with an area under the receiver operating characteristic curve of approximately 0.64. Arterial stiffness (carotid-femoral pulse wave velocity, 6.1 [5.2-6.8] vs 7.4 [6.6-8.6] m/s, p=0.002) and carotid intima-media thickness (0.8 [0.7-1.0] vs 0.9 [0.8-1.0] mm, p=0.027) was elevated in patients with moderate-to-severe OSA. After adjusting for age, sex and body mass index, these relationships were not statistically significant. No relationships were observed in other surrogate cardiovascular markers. A high prevalence of OSA in a mostly non-sleepy population with ACS was identified, highlighting a gross underdiagnosis of OSA among cardiovascular patients. The limitations of OSA screening questionnaires highlight the need for new models of OSA screening as part of cardiovascular risk management. A range of inconsistent abnormalities were observed in measures of vascular structure and function, and these appear to be largely explained by confounding factors. Further research is required to elucidate biomarkers for the presence and impact of OSA in ACS patients.

Questionnaire and polysomnographic evaluation of obstructive sleep apnea in a cohort of post-COVID-19 patients.

To evaluate the efficiency of 5 screening questionnaires for obstructive sleep apnea (OSA), OSA frequency, and the association between OSA and COVID-19 severity in recent COVID-19 cases, and to compare the use of the oxygen desaturation index (ODI) as an alternative measure for the respiratory disturbance index (RDI). This open cohort study recruited patients with recent COVID-19 (within 30-180 days) diagnosed using reverse transcription polymerase chain reaction. Participants were screened for OSA using the following 5 sleep disorder questionnaires prior to undergoing type I polysomnography: the Sleep Apnea Clinical Score (SACS), Epworth Sleepiness Scale (ESS), STOP-Bang score, No-Apnea score, and Berlin questionnaire. Polysomnography revealed that 77.5% of the participants had OSA and that these patients exhibited higher COVID-19-related hospitalization (58%) than those exhibited by non-apneic patients. The Kappa coefficient showed reasonable agreement between RDI > 5/h and No-Apnea score, RDI > 15/h and Berlin questionnaire score, and Epworth Sleepiness Scale and STOP-Bang score, but only moderate agreement between RDI > 15/h and No-Apnea score. An OSA-positive No-Apnea score increased the specificity of the SACS to 100% when RDI > 5/h. The intraclass correlation coefficient showed 95.2% agreement between RDI > 5/h and ODI > 10/h. The sequential application of the No-Apnea score and SACS was the most efficient screening method for OSA, which had a moderately high incidence among the post-COVID-19 group. We demonstrated an association between OSA and COVID-19 related hospitalization and that ODI could be a simple method with good performance for diagnosing OSA in this population.

Relationship between sleep bruxism and obstructive sleep apnoea: A population-based survey.

Sleep bruxism (SB) and obstructive sleep apnoea (OSA) seem to be mutually associated. This study investigates the relationship between current SB and OSA-related symptoms and the difference in OSA-related symptoms between groups based on a history of SB. An online survey was drafted to report the presence of SB and OSA in sample of 243 individuals (M = 129;F = 114;mean(SD)age = 42.4 ± 14.4 years). The Subject-Based Assessment strategy recommended in the 'Standardized Tool for the Assessment of Bruxism' (STAB) was adopted to assess SB. To evaluate OSA-related symptoms, Epworth Sleepiness Scale (ESS) and STOP-BANG questionnaires were adopted. Correlations between current SB and OSA-related symptoms were evaluated by Spearman test. ESS and STOP-BANG scores were compared by Mann-Whitney U test in individuals with and a without positive SB history. Current SB and SB history were reported by 45.7% and 39.1% of the sample, respectively. 73.7%, 21% and 5.3% of the responders showed a low, intermediate and high risk of OSA, respectively. Neither significant correlations between current SB and OSA nor significant differences between SB groups emerged. This study did neither find any significant correlation between self-report of current SB and OSA nor significant differences in ESS and STOP-BANG scores between groups based on SB history.

P115 CLINICAL PROFILE AND PREVALENCE OF OBSTRUCTIVE SLEEP APNEA IN A POPULATION OF YOUNG ADULTS REGISTERED IN A PRIMARY CARE UNIT IN RIO DE JANEIRO

Background: Obstructive Sleep Apnea (OSA) is strongly associated with high blood pressure (BP) and cardiovascular risk (CVR). There is a lack of studies and specific screening for younger populations, which could allow for early intervention and potentially reduce CVR. Objective: Analyze the prevalence and clinical profile of OSA, identifying the best screening method in a young population attended by a Family Health Strategy Unit in Rio de Janeiro. Methods: Cross-sectional population study of adults between 20 and 65 years old. Sociodemographic characteristics, anthropometric measures and CVR were obtained. Office BP was calculated using two measurements. The risk of OSA was assessed using STOP-BANG (SB) and Epworth Sleepiness Scale (ESS) questionnaires. All underwent home polysomnography. Result: 67 individuals included [38.9% men; average age of 38.9 ± 8 years]: 35 without OSA, 20 with mild OSA, 9 with moderate OSA and 3 with severe OSA. The prevalence of moderate/severe OSA was 18%. Individuals with moderate/severe OSA were older, more obese, had higher prevalence of increased neck circumference, dyslipidemia and heart rate. High risk for OSA in screening by SB, ESS and both questionnaires was respectively 55.2%, 44.8% and 19.4%. SB confirmed moderate/severe OSA in 30% in high-risk individuals, and excluded in 97% of low risk, with 60% accuracy. The sensitivity, specificity, PPV and NPV of SB to identify moderate/severe OSA were respectively 92%, 53%, 36% and 97%. In those with high risk according to the ESS, moderate/severe OSA was confirmed in 13%, while in those with low risk it was excluded in 78%. The accuracy of the ESS was 49%. The sensitivity, specificity, PPV and NPV of the ESS to identify moderate/severe OSA were respectively 33%, 53%, 13% and 78%. Conclusion: Moderate/severe OSA was more associated with an adverse metabolic profile than with high BP. The best screening questionnaire for this population is the STOP-BANG.

Research on sleep disorders and related risk factors among healthcare workers from Fujian province supporting Hubei province during the COVID-19 pandemic.

To explore the impact of COVID-19 on the sleep of healthcare workers from Fujian Province supporting Hubei Province and its related risk factors. A cross-sectional, anonymous, self-reported online questionnaire survey was conducted among all participants. The questionnaire consisted of five parts: sociodemographic characteristics and COVID-19 epidemic-related factors, Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), Morningness-Eveningness Questionnaire-5 (MEQ-5), and 12-item General Health Questionnaire (GHQ-12). Among 552 participants, 203 (36.8%) had a PSQI score > 7, indicating the presence of sleep disorders. Logistic regression analysis revealed that sleep disorders were independently associated with a history of previously diagnosed sleep disorders (OR 6.074, 95% CI 2.626-14.049, P < 0.001), rotating night shifts > 3 times per week (OR 3.089, 95% CI 1.650-5.781, P < 0.001), using electronic devices before sleep >1 h (OR 1.685, 95% CI 1.131-2.511, P = 0.010), concern about contracting COVID-19 (OR 1.116, 95% CI 1.034-1.204, P = 0.005), perception of societal support for supporting healthcare workers in Hubei (OR 0.861,95% CI 0.744-0.998, P = 0.047) (OR 0.861, 95% CI 0.744-0.998, P = 0.047), non-medical staff (OR 0.257, 95% CI 0.067-0.987, P = 0.048), ESS score (OR 1.068, 95% CI 1.018-1.121, P = 0.007), and GHQ-12 score (OR 1.511, 95% CI 1.281-1.782, P < 0.001). Sleep disorders were highly prevalent among healthcare workers from Fujian Province supporting Hubei Province during the COVID-19 pandemic. Risk factors for sleep disorders included a history of previously diagnosed sleep disorders, rotating night shifts > 3 times per week, using electronic devices before sleep >1 h, excessive concern about contracting COVID-19, and poorer psychological health. Higher perceived societal support and understanding of support for healthcare workers supporting Hubei were associated with a reduced risk of sleep disorders, as was being non-medical staff. Providing more sleep hygiene education and psychological health services for frontline healthcare workers is necessary.

Interaction Between Physical Performance and Health Metrics in Patients with Obstructive Sleep Apnea Syndrome

Purpose: The study aimed to explore the potential correlation between physical performance and health metrics in patients with obstructive sleep apnea (OSA). Furthermore, it sought to compare the variations in health metrics and physical performance across different severities of OSA. Material and Methods: Eighty-four participants undergoing polysomnography with the suspected presence of OSAS were included. Participants completed the 36-Item Short Form (SF-36), Hospital Anxiety-Depression Scale (HADS), and Epworth Sleepiness Scale (ESS) questionnaires. Physical performance was assessed using the 30-second Sit-To-Stand Test (30CST). Participants were categorized into two groups to compare health metrics based on the severity of OSA. Results: Body mass index, neck circumference, ESS scores, hypoxia levels, emotional well-being, and energy levels of quality of life (QoL), differed statistically according to the severity of OSA. While there was no correlation between 30CST scores and social functioning (r=.125, p=.290), all other QoL subheadings and 30CST were significantly correlated (p

Barbed Expansion Sphincter Pharyngoplasty (BESP) for the Treatment of OSA. “A Step Ahead”

Abstract Background expansion sphincter pharyngoplasty is one of the newly introduced techniques for treating OSA in the last 20 years that showed promising results by increasing the lateral dimensions of the oropharynx by pulling the lateral pharyngeal wall and anchoring it to the pterygomandibular raphe, the paper study the efficacy of performing the procedure using the barbed suture on moderate to severe OSA. Methods Twelve patients with moderate to severe OSA due to oropharyngeal collapse according to VOTE classification after DISE were assigned to the study. Pre- and post-operative Epworth sleepiness scale questionnaire was completed, Pre- and post-operative polysomnography was performed as an objective measurement, all patients underwent BESP and the duration, post- operative complications, and pain records were plotted. Results The technique was confirmed to be feasible with a success rate of 91.7%, with reduction of median AHI from (38.75 to 8.7 event/hour) and reduction of the mean ESS from (20.83 to 5.67) and mean ODI (37.62 to 9.38). Conclusion The barbed expansion sphincter pharyngoplasty is an effective technique for treating obstructive sleep apnea in patients with retropalatal and oropharyngeal collapse.

Effect of a Whole-Food Plant-Based Diet on Postprandial Sleepiness: A Pilot Study.

Postprandial sleepiness refers to the state of excessive drowsiness that occurs after consuming a meal. This transient phenomenon is experienced by many individuals, often leading to decreased productivity and impaired cognitive performance. This study examined the effect of a whole-food plant-based (WFPB) diet on postprandial sleepiness. Ten participants who had postprandial sleepiness who were on a typical American diet transitioned to a WFPB dietary pattern for 21days. Postprandial sleepiness was assessed using the Epworth Sleepiness Scale (ESS) questionnaire, focusing on Q7 "sitting quietly after lunch without alcohol" as well as Q5 "lying down to rest in the afternoon when circumstances permit." The participants had a mean age of 44 +/- 15years, with 30% being male. There was a statistically significant reduction in sleepiness measured by ESS Q7 (median change = -1, P = .012) and ESS Q5 (median change = -1.5, P = .008). Moreover, there was a statistically significant decrease in overall ESS scores (median change = -8.0, P = .006), and weight (median change = -2.9kg, P = .006). Participants demonstrated significant improvement in postprandial sleepiness-related situations. Our findings showed that the WFPB diet may have potential benefits for reducing postprandial and overall daytime sleepiness.

Screening Tools for Obstructive Sleep Apnea in Pregnant Women: An Extended and Updated Systematic Review and Meta-analysis.

The prevalence of obstructive sleep apnea syndrome (OSA) increases in women during pregnancy and negatively affects maternal and fetal outcomes. The updated systematic review and meta-analysis aimed to evaluate the validity of the Berlin, STOP-Bang, and Epworth sleepiness scale (ESS) questionnaires in detecting OSA in pregnant women. PubMed, Embase, and Web of Science were searched systematically up to March 2022. After eligible studies inclusion, two independent reviewers extracted demographic and clinical data. Bivariate random effects models were used to estimate the pooled accuracy measures including sensitivity and specificity, positive (PPV) and negative predictive values (NPVs), diagnostic odds ratio (DOR), and receiver operating characteristic curve (ROC) curve. We included 8 studies including 710 pregnant women with suspected OSA. The performance values of Berlin, STOP-Bang, and ESS questionnaires were as follows: the pooled sensitivity were 61% (95% confidence interval (CI): 40%-80%), 59% (95% CI: 49%-69%), and 29%, (95% CI: 10%-60%); pooled specificity were 61% (95% CI: 42%-78%), 80% (95% CI: 55%-93%), and 80% (95% CI: 50%-94%); pooled PPVs were 60% (95% CI: 0.49-0.72), 73% (95% CI: 61%-85%), and 59% (95% CI: 31%-87%); pooled NPVs were 60% (95% CI: 0.49-0.71), 65% (95% CI: 54%-76%), and 53% (95% CI: 41%-64%); and pooled DORs were 3 (95% CI: 1-5), 6 (95% CI: 2-19), and 2 (95% CI: 1-3), respectively. It seems that the Berlin, STOP-Bang, and ESS questionnaires had poor to moderate sensitivity and specificity in pregnancy, with the ESS showing the worst characteristics. Further studies are required to evaluate the performance of alternative screening methods for OSA in pregnancy.

Olfactory Dysfunction and Long-Term Trajectories of Sleep Disorders among early Parkinson’s Disease: Findings from a Longitudinal Cohort

Background: Previous studies have suggested a connection between impaired olfactory function and an increased risk of rapid eye movement sleep behavior disorder (RBD) in individuals diagnosed with Parkinson’s disease (PD). However, there is a gap in knowledge regarding the potential impact of olfactory dysfunction on the long-term patterns of sleep disorders among early PD patients. Methods: Data from the Parkinson’s Progression Markers Initiative program included 589 participants with assessments of sleep disorders using the Epworth Sleepiness Scale (ESS) and RBD Screening Questionnaire (RBDSQ). Olfactory dysfunction at baseline was measured using the University of Pennsylvania Smell Identification Test. Trajectories of sleep disorders over a 5-year follow-up were identified using group-based trajectory modeling, and the relationship between olfactory dysfunction and sleep disorder trajectories was examined through binomial logistic regression. Results: Two distinct trajectories of sleep disorders over the 5-year follow-up period were identified, characterized by maintaining a low or high ESS score and a low or high RBDSQ score. An inversion association was observed between olfactory function measures and trajectories of excessive daytime sleepiness (odds ratio [OR] = 0.97, 95% confidence interval [CI] 0.95, 1.00, p = 0.038), after controlling for potential covariates. Similarly, olfactory function showed a significant association with lower trajectories of probable RBD (OR = 0.96, 95% CI 0.94, 0.98, p = 0.001) among early PD individuals. Consistent findings were replicated across alternative analytical models. Conclusions: Our findings indicated that olfactory dysfunction was associated with unfavorable long-term trajectories of sleep disorders among early PD.

Assessing sleep-related breathing disorders among newly diagnosed rheumatoid and psoriatic arthritis patients: a cross-sectional study.

This cross-sectional study aimed to determine the prevalence and risk factors for sleep-related breathing disorders (SRBD) in newly diagnosed, untreated rheumatoid arthritis (RA) and psoriatic arthritis (PsA) patients, and to develop a screening algorithm for early detection. We evaluated newly diagnosed RA or PsA patients using the Epworth Sleepiness Scale (ESS) questionnaire, cardiorespiratory polygraphy (RPG), and clinical and laboratory assessments. Sleep apnea syndrome (SAS) was diagnosed based on pathological RPG findings excessive daytime sleepiness, defined as ESS score above 10. The study included 39 patients (22 RA, 17 PsA) and 23 controls. In RPG, SRBD was identified in 38.5% of arthritis patients compared to 39.1% of controls (p = 1.00), with male gender (p = .004) and age (p < .001) identified as risk factors. Excessive daytime sleepiness was noted in 36.4% of RA patients, 17.6% of PsA patients, and 21.7% of controls. Of the 24 patients diagnosed with SRBD, 41.6% met the criteria for SAS. SAS prevalence was 31.8% among RA patients, 0% in PsA patients, and 13% in controls. A significant association was observed between excessive daytime sleepiness and SRBD (p = .036). Our findings reveal a high prevalence of SRBD in newly diagnosed, untreated RA and PsA patients in ESS and RPG, with excessive daytime sleepiness being a reliable predictor of SRBD. Patients with RA exhibited a higher predisposition to SAS. We therefore suggest incorporating ESS and RPG as screening tools in RA or PsA for early detection and management of SRBD.

Sleep disorders and other medical and socio-demographic factors in systemic scleroderma.

We aimed to investigate sleep disorders in patients with systemic scleroderma (SSc) and its relationship with socio-demographic and medical factors and to provide a suitable solution to better control the disease and improve the quality of life in these patients. This cross-sectional study evaluated SSc patients seen at a rheumatology clinic from September 1, 2022, through April 1, 2023.The patients were examined by the main investigator of the project and entered the study after taking the medical history and meeting the criteria of ACR 2013 Classification Criteria. Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), Epworth Sleepiness Scale (ESS) and STOP-Bang Questionnaire were employed to investigate sleep disorders. A total of 103 patients were included in the study. The average age of the patients was 48.42 ± 12.4 years. PSQI showed lower quality of sleep scores among SSc (68% of patients), which was significantly related to the degree of skin stiffness in patients, telangiectasia, interstitial lung disease (ILD) in computed tomography (CT) scan, patient age, duration of the disease, and pulmonary artery pressure (PAP). STOP-Bang Questionnaire revealed that obstructive sleep apnea (OSA) was significantly associated with telangiectasia, ILD, patient age, disease onset age, disease duration, body mass index and PAP. Insomnia had a statistically significant relationship with telangiectasia, ILD and patient age. Drowsiness during daily activities was not significantly related to any of the individual variables and disease-related variables. Sleep disorders are common in patients with systemic scleroderma. Telangiectasia, ILD and patient age were related to all sleep quality disorders and respiratory apnea and insomnia. Furthermore, the amount of skin involvement significantly causes disturbances in the quality of sleep of patients, where in the group with diffuse skin stiffness, 80% of patients exhibited disturbances in the quality of sleep. Therefore, paying attention to sleep health can be an effective factor in improving the quality of life of patients with SSc.

Excessive daytime sleepiness is associated with increased residual cardiovascular risks among coronary artery disease patients with obstructive sleep apnea

ObjectiveExcessive daytime sleepiness (EDS) frequently accompanies obstructive sleep apnea (OSA) and may increase cardiovascular risks. The majority of coronary artery disease (CAD) patients receive understandard treatments, it is not clear whether EDS is associated with increased residual cardiovascular risks in CAD patients with OSA. MethodThis study is a prospective cohort study that included 1215 consecutive CAD patients underwent overnight sleep study with a 3.7 year follow-up. Sleepiness was is determined by the Epworth Sleepiness Scale questionnaire. The primary endpoint was major adverse cardiovascular and cerebrovascular events (MACCE), including cardiovascular death, myocardial infarction, stroke, and heart failure. Kaplan-Meier model and Cox proportional hazards models were used to explore the relationship between residual cardiovascular risks and EDS. Result1027 cases were eventually enrolled, and a total of 129 patients experienced cardiovascular and cerebrovascular events. Participants with EDS had a higher risk of MACCE compared to those without EDS (17.02% vs. 9.58%, P = 0.005). The presence of EDS is associated with higher incidence of MACCE compared to non-EDS patients (HR 2.833; 95%CI:1.394–5.762; P < 0.001). EDS was significantly associated with increased incidence of MACCE in OSA patients (HR 1.765; 95%CI:1.276–2.543; P = 0.193), while there was no significant association between EDS and cardiovascular risks in non-OSA patients (HR 1.233; 95%CI: 0.893–2.755; P = 0.127). ConclusionsThe existence of EDS may lead to increased cardiovascular risks, EDS is associated with increased cardiovascular risks in CAD patients, especially in patients with OSA.

Utilizing epworth sleepiness scale and sleep questionnaires to understand sleep in pediatric residents

Utilizing epworth sleepiness scale and sleep questionnaires to understand sleep in pediatric residents

Daytime sleepiness in health-care employees: A cross-sectional study between shift duty and day duty

Background: Shift duty disrupts the sleep-wake cycle, leading to shift work disorder, which is characterized by daytime sleepiness and insomnia. Excessive daytime sleepiness decreases work performance, increases workplace accidents, and impairs neurocognitive function. Sleep disturbance also impacts the employee-patient relationship; thereby, it is necessary to assess the prevalence of daytime sleepiness. Aim and Objective: The aim of the study is to compare the prevalence of daytime sleepiness in healthcare employees working in the daytime versus shift duty. Materials and Methods: Subjects were chosen from the Parent Institute between the ages of 24 and 38. A total of 260 health-care employees were included in the study and were divided into two equal groups, with one working on day duty and the other working on shift duty. To evaluate subjective and objective daytime sleepiness, the Epworth sleepiness scale questionnaire was given to both groups. Results: The parameters were analyzed statistically. There was a significant difference in daytime sleepiness between the two groups. There was increased daytime sleepiness in health-care employees working on shift duty as compared to those working on day duty. Conclusion: Sleep deprivation due to disruption of internal sleep regulation leading to shift work disorder is thought to be an important cause of increased daytime sleepiness in health-care employees working on shift duty.