Hypersomnia Research Articles

Changes in the functional connections of the brain in patients with hypersomnia in acute ischemic stroke

BACKGROUND: The Disorders of cerebral circulation and sleep are inextricably related, since sleep disorders, including hypersomnia, are closely intertwined with cardiovascular diseases and increase the risk of stroke. Research works on visualization of functional brain changes in patients with sleep disorders and acute ischemic stroke are very few and need more study. AIM: to determine the functional connections of the brain in hypersomnia in patients with acute ischemic stroke by performing functional magnetic resonance imaging at rest. A study of 40 patients with acute ischemic stroke and sleep disorders was performed on the basis of the Federal State Budgetary Institution Almazov Research Center of the Ministry of Health of the Russian Federation. All patients underwent neurological examination, assessment of sleepiness, worry and depression, magnetic resonance imaging was performed on tomographs with a magnetic field induction force of 1.5T, using a standard protocol and special pulse sequences of T-gradient echo 3D MPRAGE and BOLD. Functional magnetic resonance imaging of the brain at rest was used to assess functional connections. Postprocessing was performed using specialized CONN-TOOLBOX software with an appropriate graphical representation of quantitative results based on the selection of areas of interest. RESULTS: Among the examined patients, 23 had hypersomnolence; of these, 8 patients were diagnosed with secondary hypersomnia associated with sleep apnea syndrome. Thus, in the examined sample, post-stroke hypersomnolence was detected in 15 patients (34%). Patients with an unspecified subtype of stroke and right-sided lesions showed a high degree of drowsiness (p 0.05). With the help of functional magnetic resonance imaging of the brain at rest, changes in functional connections between the main nodes of the default mode network with the left temporal pole, cerebellum, central cerebral cortex on the left, angular gyrus on the left, with the dorsal attention network on the right are determined (p 0.05). CONCLUSION: The use of complex magnetic resonance imaging, which includes structural and functional magnetic resonance imaging in patients with acute ischemic stroke and sleep disorders, allows us to identify structural changes and changes in functional connectivity and identify neuroimaging markers of this pathology. Hypersomnolence is typical for patients with an unspecified subtype of ischemic stroke and damage to the right hemisphere of the brain.

Depressive symptoms in patients with hypersomnia measured with Beck Depression Inventory

BackgroundPatients with central hypersomnia (HCO) often show symptoms of depression. Despite of many studies conducted in this field, the link between these two disorders remains unclear. In order to contribute data to this research, we examined the question of which depressive symptoms characterize these patients. Furthermore, we investigated the differences between HCO who were more or less depressed regarding insomnia, sleep quality and daytime tiredness. Methods and materialThe retrospective analysis assesses the presence and kind of depressive symptoms as measured by the Beck Depression Inventory (BDI) in 168 HCO including narcolepsy type I (NAR1), narcolepsy type II (NAR2) and idiopathic hypersomnia (HYP). Sleep parameters from one night of polysomnography, scores of questionnaires for insomnia and for daytime sleepiness, and data from sustained attention tests were compared between HCO with and without depression, as determined by BDI scores (cut off >12). ResultsAccording to BDI scores 52% exhibited no depression. The BDI items pertaining to tiredness and work inhibition exhibited elevated scores, whereas those pertaining to suicidality showed low scores. No difference was found between depressed and non-depressed HCO with regard to daytime vigilance performance or daytime sleepiness. However, depression was associated with older age, higher insomnia scores, and a shorter sleep time on polysomnography. ConclusionA potential interpretation of our findings is that depressive symptoms in HCO may be a consequence of restricted life quality due to hypersomnia. Thus, therapeutical effort should focus more intensely on coping strategies.

Sleep disorder syndromes of post-acute sequelae of SARS-CoV-2 (PASC) / Long Covid

IntroductionCOVID-19 infection has resulted in a high prevalence of a post-infectious syndrome, known as post-acute sequelae of SARS-CoV-2 (PASC) or “Long COVID”. PASC is a heterogeneous disease with a high prevalence of sleep disturbances, varying from an insomnia disorder to excessive daytime sleepiness. MethodsPatients seen in the Covid Survivorship Program at the Beth Israel Deaconess Medical Center Boston, USA, were screened for sleep disorders as part of a comprehensive multi-system evaluation. Those who screened positive were referred for a comprehensive sleep evaluation in a dedicated COVID-19-Sleep clinic, followed by diagnostic sleep testing and treatment. This report summarizes patients who completed an American Academy of Sleep Medicine (AASM) accredited facility-based diagnostic evaluation. International Classification of Sleep Disorders 3rd Edition-Revised criteria were met for all diagnoses. ResultsIn 42 patients with PASC, five categories of sleep disorder syndromes were observed following a sleep clinic evaluation, including obstructive sleep apnea, chronic insomnia disorder, primary hypersomnia, REM behavior disorder (RBD), and new onset circadian phase delay. Seven patients met criteria for idiopathic hypersomnia, and two had narcolepsy type 2. RBD patients were infected in three different waves; circadian disturbance patients were all infected in the winter wave of 2020/21, and the primary hypersomnolence group occurred during all waves, predominantly the initial wave of 2020. A peculiar form of insomnia was a persistent loss of sleep regularity. ConclusionsSpecific sleep symptoms/syndromes are reported in this select group of patients with PASC/Long Covid. As new onset sleep complaints are prevalent in PASC, we recommend a complete clinical and investigative sleep evaluation for persistent severe sleep symptoms following COVID-19 infection.

Behavioral and Electrophysiological Markers of Attention Fluctuations in Children with Hypersomnolence.

Background. No device is yet available to effectively capture the attentional repercussions of hypersomnolence (HYP). The present study aimed to compare attentional performance of children with HYP, attention deficit hyperactivity disorder (ADHD), and controls using behavioral and electrophysiological (EEG) markers, and to assess their relationship with conventional sleepiness measurements. Methods. Children with HYP underwent a multiple sleep latency test (MSLT) and completed the adapted Epworth sleepiness scale (AESS). Along with age-matched children with ADHD, they were submitted to a resting EEG followed by the Bron-Lyon Attention Stability Test (BLAST). The control group only performed the BLAST. Multivariate models compared reaction time (RT), error percentage, BLAST-Intensity, BLAST-Stability, theta activity, and theta/beta ratio between groups. Correlations between these measures and conventional sleepiness measurements were conducted in children with HYP. Results. Children with HYP had lower RT and BLAST-Stability than controls but showed no significant difference in BLAST/EEG markers compared to children with ADHD. The AESS was positively correlated with the percentage of errors and negatively with BLAST-Intensity. Conclusions. Children with HYP showed impulsivity and attention fluctuations, without difference from children with ADHD for BLAST/EEG markers. The BLAST-EEG protocol could be relevant for the objective assessment of attentional fluctuations related to hypersomnolence.

Scheduled hypometabolism and hypothermia at the crossroads of deep space manned mission and longevity

Spaceflight is a mysterious ageing/rejuvenation transition. It is associated with factors of evolutionary unfamiliar to the earth's inhabitants — microgravity, cosmic rays and solar wind irradiation, failure of circadian rhythms and numerous other singularities. For still unknown reasons, spaceflight provokes quick acceleration of almost all hallmarks of ageing and age-related diseases. The alterations have a transitory character and disappear in the post-landing adaptation period. The posited ageing/rejuvenation transition could be repeated over multiple flights. This should be confirmed by epigenetic or other types of ageing clocks. Hypometabolism and hypothermia are considered efficient protectors from the hazards of space missions while saving energy and food intake. The two most discussed approaches are based on the idea of dormancy (synthetic torpor) or excessive sleeping (shallow metabolic depression). We suggest another model of metabolic depression induced by a rebreathing hypoxic-hypercapnic environment (HHE), which is accompanied by ‘voluntary’ calorie restriction. Crewmembers' work schedules can be designed to allow crewmembers to maintain normoxic levels during energy-demanding activities and transition to HHE during rest periods. A computerized tracking system can harmonize daily schedules with personalized HHE. The resulting scheduled hypometabolothermia (SHMT) could optimise energy expenditure without compromising productivity and be applicable during spaceflight and upon arrival at a destination and subsequent planetary exploration. We envision SHMT as a major human lifestyle on Earth as well. Of course, only further thorough explorations will reveal all the advantages and pitfalls of HHE and SHMT on Earth and in space. ________________________________________________________________________________________Keywords: hypoxia and hypercapnia; metabolic suppression; food consumption; space mission; longevity

Association of hypocretin dosage, HLADQB1*06:02 status, clinical and neurophysiological features of 37 patients with primary hypersomnia, and evaluation of a novel ELISA kit for hypocretin measurement

Association of hypocretin dosage, HLADQB1*06:02 status, clinical and neurophysiological features of 37 patients with primary hypersomnia, and evaluation of a novel ELISA kit for hypocretin measurement

The nightmare severity index (NSI): A short new multidimensional tool for assessing nightmares.

This psychometric pilot study aims to evaluate a new multidimensional simple scale, named the nightmare severity index (NSI) - close to the existing insomnia (ISI) and hypersomnia (HSI) severity indexes. The NSI encompasses all main dimensions of nightmare disorder, evaluating four subdimensions: frequency, emotional impact, diurnal impact, and nocturnal impact of nightmares. The NSI was completed by a total of 102 patients. The majority of the population consisted of women (64%) and outpatient individuals (76%) diagnosed with mood disorders such as depression (31%) and bipolar disorder (41%). Comorbidity with post-traumatic stress disorder (PTSD) was prevalent (44%), and psychotropic medications were commonly used (47%). Internal validity analyses indicated that the NSI was well suited for exploratory factor analysis. All items demonstrated satisfactory correlations with the factors, and the questionnaire exhibited good internal consistency (Cronbach's alpha >0.7). Higher NSI scores were observed among individuals experiencing nightmare symptoms considering the DSM-5/ICSD-3 criteria. In summary, the NSI proves to be a promising and valuable tool for clinical practice, demonstrating good acceptability, internal validity, and the ability to assess nightmare severity.

Mercury Exposure among Artisanal and Small-Scale Gold Miners in Four Gold Mining Districts in the East Region of Cameroon

Artisanal and small-scale gold mining (ASGM) is the single largest intentional-release of mercury (Hg) in the world. In Cameroon, there is paucity of data concerning the contribution of ASGM to human mercury contamination. This study aimed at providing new data for a region in Cameroon where ASGM is practiced, through an assessment of the concentration of total mercury (T-Hg) in hair as a function of occupational exposure, and investigating symptoms related to Hg toxicity. A quantitative cross-sectional survey design was employed involving 60 gold miners from four gold mining districts: Batouri, Kette, Ngoura and Bétaré-Oya. Questionnaire was used to collect sociodemographic data, nature of work processes and symptoms of Hg toxicity. Scalp hair samples were drawn from all 60 respondents and analysis for total mercury (T-Hg) in hair was done via a milestone DMA-80 Mercury Analyzer. The results show that males (86.7%) were generally represented than females (13.3%). The minimum, maximum and mean concentrations of Hg in hair of miners across the four districts was 0 μg/g, 8.97 μg/g and 2.09±1.84 μg/g respectively. Over three-quarters (71.7%) of the miners had T-Hg in hair above the occupational toxic threshold of 1 μg/g set by the United States Environmental Protection Agency (USEPA), also identified as 66.7% in the “alert level” and 5% as “high” according the German Human Biomonitoring (HBM) Commission. The factors affecting the concentration of mercury in hair according to a multiple linear regression model (R2 = 0.400 and p = 0.03) were living in Bétaré-Oya, younger age, male sex, burning of amalgam, and increased number of working days per week. According to the same model (R2 = 0.076 and p = 0.940), the symptoms associated with mercury exposure were unusual tiredness, excessive sleeping, dizziness and visual difficulties. ASGM in the east region of Cameroon, therefore, is significantly contributing to Hg contamination in humans as a result of occupational exposures to Hg, and there is urgent need for interventions to mitigate human exposure, especially as adverse health effects cannot be excluded following long-term exposures.

Differences in psychosocial factors and sleep study findings between delayed sleep-wake phase disorder and hypersomnia in teenagers.

Central hypersomnia (HS) and delayed sleep-wake phase disorder (DSWPD) appear commonly in adolescents, and they severely reduce quality of life and have an enormous impact on academic performance and other aspects of development. Although these disorders are thought to be considerably different in etiology, it is sometimes difficult to distinguish them because of their similar clinical features. This study aimed to compare psychosocial factors and sleep study findings between HS and DSWPD in teenagers. The clinical data of 89 teenagers who visited the psychiatric section of the Sleep Medicine Center of Nihon University Itabashi Hospital from January 2013 to December 2019 were analyzed. Psychosocial factors were evaluated at the first visit, and polysomnography (PSG) and the multiple sleep latency test (MSLT) were performed for patients deemed to require definitive diagnosis. Compared with patients with HS, those with DSWPD had a higher rate of mother's employment, introversion, adjustment problems, events that triggered the disorder, concurrent mental disorders, habitual lateness, and difficulty attending school or work. PSG did not show any differences in sleep parameters between the two disorders, except for sleep latency. On the MSLT, sleep latency was shorter in those with HS on the second, third, and fourth tests. The present results suggest that focusing on psychosocial factors could be useful for differential diagnosis of the two disorders that appear commonly in adolescents.

Pet Owner Perception of Ferret Boredom and Consequences for Housing, Husbandry, and Environmental Enrichment.

Boredom is a potential chronic but overlooked animal welfare problem. Caused by monotony, sub-optimal stimulation, and restrictive housing, boredom can therefore affect companion animals, particularly those traditionally caged, such as ferrets. We surveyed owners' (n = 621) perceptions of ferrets' capacity to experience boredom, behaviours they associate with it, and whether their perception of their ferrets' capacity for boredom influenced training techniques, housing, and environmental enrichment (EE). Most (93.0%) owners believed that ferrets could experience boredom, but owners who doubted that ferrets experience boredom (7.0%) provided slightly but significantly fewer EE types to their ferrets. Heat map and classification tree analysis showed that owners identified scratching at enclosure walls (n = 420) and excessive sleeping (n = 312) as distinctive behavioural indicators of ferret boredom. Repetitive pacing (n = 381), yawning (n = 191), and resting with eyes open (n = 171) were also suggested to indicate ferret boredom, but these overlapped with other states. Finally, ferret owners suggested social housing, tactile interaction with humans, and exploration as most important for preventing boredom. These results suggest that pet ferrets are at risk of reduced welfare from owners who doubt they can experience boredom, highlighting an opportunity to improve welfare through information dissemination. We recommend further investigation into ferret boredom capacity, behavioural indicators, and mitigation strategies.

Cognitive, emotional, physical, and behavioral stress-related symptoms and coping strategies among university students during the third wave of COVID-19 pandemic.

BackgroundStress is manifested by different physical, cognitive, emotional, and behavioral stress-related symptoms, and everyone experiences it uniquely. The COVID-19 Pandemic has tremendously affected university students' lives. So, we conducted this study to determine the stress frequency, causes, determinants, and related symptoms involving physical, cognitive, emotional, and behavioral traits and coping strategies among university students in Egypt during the third wave of the COVID-19 pandemic, 2021.MethodsCross-sectional study targeted 1,467 randomly selected undergraduate university students, representing all colleges from 30 universities in Egypt, through a validated self-administrated questionnaire.ResultsThe total stress-related symptom score was statistically significant (p < 0.05), higher among females, married, living on campus, with a (B) GPA, and those who had both organic and psychological disorders. The top 10 prevalent physical symptoms were headaches, chronic fatigue, hair loss, low back pain, neck pain, shoulders and arm pain, ophthalmological symptoms, acne, shakiness of extremities, and palpitations, respectively. The most reported symptoms regarding the cognitive, emotional, and behavioral aspects were anxiety and racing thoughts, moodiness and irritability, and excessive sleeping, respectively. Nine hundred and thirty-seven (63.9%) reported that the COVID-19 pandemic badly affected their lives, either directly or indirectly. The study showed that the prevalence of stress among university students is more than 97%. One thousand and five (68.5%) preferred isolation as a relieving technique.ConclusionStress and its related physical, cognitive, emotional, and behavioral symptoms are prevalent among university students. Most of the university students who were recruited reported that the COVID-19 pandemic badly affected their lives and used negative ways to deal with stress, like staying alone and sleeping too much. Positive ways to deal with stress, like seeing a therapist or meditating, were less common.

0819 Restless Sleep, Snoring, Excessive Daytime Sleepiness, And Ataxia: A Pediatric Quandary

Abstract Introduction Central sleep apnea in pediatrics is inherently complex, often going undiagnosed and untreated. Signs and symptoms of central nervous system dysfunction may be attributed to more common childhood conditions. We aim to educate on the diagnosis and treatment of central sleep apnea in this vulnerable patient population. Report of Cases: A 12-year-old girl presents for initial sleep visit with global developmental delay, borderline obesity, chronic headaches, early morning tremors, and insulin resistance. She has history of snoring and restless sleep for years with severe daytime sleepiness for the past three months with worsening over two to four weeks. She is unable to stay awake in school. Epworth sleepiness scale (ESS) score is twenty-one. There is history of recurrent Strep but no history of infectious mononucleosis or influenza infection. Primary sleep disorders or CNS hypersomnia are suspected, and polysomnogram with MSLT is ordered. MRI of the brain is pending. The patient presents to the emergency department ten days later with frontal headaches, ataxia, altered speech, and oral aversion. CT head is normal. Hematology, neurology, and neurosurgery are consulted. MRI of the brain shows thrombosis of the superior sagittal sinus, the right transverse sinus, the right sigmoid sinus, the right jugular bulb, as well as cortical veins overlying both cerebral hemispheres, and she is started on anticoagulation for suspected stroke. A polysomnogram shows a severe degree of central sleep apnea with a central apnea index of 49.9 events per hour. There is significant periodic breathing present. There is no nonapneic hypoxemia or sleep hypoventilation present, and the patient is scheduled for an oxygen titration study. Conclusion Central sleep apnea is more prevalent in older male individuals and may affect patients with heart failure1.Pediatricians and subspecialists must remain vigilant as children are also susceptible to medical conditions which result in central nervous system dysfunction. Support (If Any) 1.) Donovan LM, Kapur VK. Prevalence and Characteristics of Central Compared to Obstructive Sleep Apnea: Analyses from the Sleep Heart Health Study Cohort. Sleep. 2016;39(7):1353-1359. Published 2016 Jul 1.doi:10.5665/sleep.5962

IMPACT OF COVID-19 LOCKDOWN ON INTERNATIONAL STUDENTS IN MELBOURNE AUSTRALIA

The study aimed to explore impact of COVID-19 related extended lockdown in Melbourne Australia on international student’s daily lives. Data was collected from 61 international students residing in Melbourne during lockdown and impact was found on their mental, physical, social health, learning (social and peer), and academic performance along with coping strategies used, and any support students received from the Victorian government. A data was collected through using purposive sampling and students from 10 countries participated in this study (51 percent male and 49 percent female). Study findings show that regardless of age, gender, nationality, and mode of study finance (scholarships or self-finance) majority of the students mentioned severe impact of COVID-19 related restrictions particularly lockdown on all dimensions of their lives mentioned above. The highest impact has been found on the academic performance (98 percent) following the mental health (94 percent), physical health (87 percent), social lives (84 percent). Study inquired about the coping strategies students used and results show that studies and use of social media was among the highly used coping methods (70 percent) following face time with family (32 percent) and excessive sleeping (39 percent). While responding to the support received from Victorian government 74 percent students mentioned no support and flagged the assistance required from Australian government in sectors like finances (43 percent), repatriation flights, visa issues (21 percent) and lease agreements (28 percent). Keywords: COVID-19, Lockdown, International Students, Covid-19 Impact, Australia

Sleep Disorders During Pregnancy and Postpartum: A Systematic Review

This study aimed to asses previous research results about bio-physiological alterations during pregnancy and postpartum, and make clear outlook about prevalence and related factors of sleep disorders during pregnancy and postpartum. In this review, the articles that published from 2000 to 2019 were reviewed. Related articles were searched from databases in English language. After evaluation of inclusion and exclusion criteria, articles were chosen and reviewed based on the University of York strategies. Sleep disorders in present study were classified according to the International Classification of Sleep Disorders-3. The search revealed 4449 articles, after evaluating and assessing qualified articles, finally 56 article selected to review. According to the results of this review, The prevalence of sleep disorders was almost 76%–97% in whole pregnancy. The most common sleep disorders included central disorders of hyper somnolence (waking up in the middle of the night, daytime sleepiness, sleeplessness) or insomnia, sleep-related movement disorders (restless legs syndrome), sleep related breathing disorders (obstructive sleep apnea), and parasomnia. In addition, sleep disorder may continue 3–12 months postpartum (33.2%). Sleep disorders induced by physiological processes (fetal movement, excessive weight gain, male sex of the fetus, and multiparty), health-related risks (metabolism disorders, cardiovascular diseases, and mood disorders), and physical or sexual abuse in childhood. In addition, these disorders could have maternal outcomes that can be greatest trigger to postpartum psychiatric disorders and fetal outcomes that have harmful sequences during childhood (sexual, fertility, emotional, and cognitive problems). Health care providers should evaluate the mothers’ sleep quality because sleep disorder leads to harmful consequences in fetuses and children.

Knowledge about Complication of Congenital Hypothyroidism among Parents in Aseer Region, Saudi Arabia

Background: A lack of thyroid hormone present at birth is described as Congenital Hypothyroidism (CH). A difficulty with thyroid development or thyroid hormone production (dysgenesis) is most frequent in thyroid birth hormone insufficiency. It is one of the main causes of avoidable mental delay in infants This study aims to assess knowledge and awareness of Saudi parents towards complication of congenital hypothyroidism in Aseer region, KSA.&#x0D; Methods: A cross sectional study was conducted of general population of Aseer region. Data was collected by means of online questionnaire distributed online to be self-filled by parents. The study included 1086 participants. The collected data was entered and analyzed using the Statistical Package for the Social Science (SPSS Inc. Chicago, IL, USA) version 23. Descriptive statistics was performed.&#x0D; Results: All participants were from Aseer region, 39.5% of participants reported consanguinity between parents, 34.5% of all participants had heard of CH. 18.2% identified iodine deficiency during pregnancy as risk factor for CH. 22.6% identified excessive sleeping, 15.2% jaundice and 16% facial swelling. 60.2% did not know CH complications while 22.1% reported poor growth, resulting in short stature as a complication, followed by 14.4% Goiter, 14.1% delayed puberty, 13.5% mental retardation, 12.9% osteoporosis, 9.9% heart defects, and 4.6% bone fractures. 11.9% of all participants identified optimal time to start treatment to prevent complications as the first two weeks of the baby's life&#x0D; Conclusion: Parental knowledge of congenital hypothyroidism in Aseer is relatively unsatisfactory. Health campaigns and conferences to raise awareness is necessary looking to catastrophic complications caused by delayed diagnosis and management of the disease.

Kleine - Levine Syndrome (A Rare Case Report)

Kleine–Levin syndrome (KLS) also called sleeping beauty syndrome, is a rare sleep disorder with onset in early adolescence. Common symptoms are episodes of hyper somnolence, behavioral and cognitive disturbances (including specific feelings of derealization), hyperphagia and hypersexuality.The cause is not known and neither there are any definitive management guidelines. It remains a diagnosis of exclusion after ruling out other psychiatric and neurological disorders. Our case,a 15 year old boy with duration of illness of 3 years, episodic presented with hypersomnia,increased appetite, irritability, hyper sexuality and behavior abnormality mainly fearfulness and suspiciousness. Patient responded well to lithium therapy. The priority of this report is to add the existing clinical knowledge of psychiatrists, neurologists and physicians. Keywords : Hyper phagia, Kleine–Levin syndrome, hyper somnolence, Lithium

Neurotransmitter Related Idiopathic Hypersomnia

Idiopathic hypersomnia affects 5% of the adult population, and both men and women are equally susceptible. Excessive sleep, sleep attacks, or wake-time delays are all examples of primary hypersomnia. Hypersomnia can be caused by a mental disorder, an organic condition (such as medications), or it might be idiopathic. This condition is the polar opposite of insomnia. Patients are frequently misdiagnosed as having mental illnesses or being sluggish. Hypersomnia patients require more sleep than the average person. The patient will generally sleep 1-2 times each day, with each nap lasting more than an hour. Despite the fact that they sleep a lot, they are usually weary and sluggish during the day. The causes of hypersomnia can be diverse, including neurological, medical, or psychological disorders. Neurotransmitters can also play a role in regulating a person's sleep patterns and alertness. This review aimed to describe neurotransmitters related to idiopathic hypersomnia.

Influence of excessive daily sleeping and sleep quality on BDNF and NGF serum levels in adolescents

IntroductionThe brain-derived neurotrophic factor (BDNF) and neural growth factor (NGF) are widely expressed in the brain and play an important role in neuroplasticity, neurogenesis, and increased neuronal connections. Previous studies have shown that reduced serum levels of these proteins are associated with disorders in human sleep. ObjectiveCurrent study evaluates the prevalence in adolescents of excessive daytime sleepiness (EDS) and sleep quality, and analyzes the influence of these factors on BDNF and NGF serum levels. MethodsA cross-section population-based study was conducted with data from a Brazilian birth cohort, with a sample of five hundred and thirteen 18–19-year-old adolescents. Sleep quality was assessed by the Pittsburgh Sleep Quality Index and EDS by Epworth Sleepiness Scale. Neurotrophins serum levels were measured by Luminex™ technology kits. Analysis consisted of marginal structural models which compared people who were exposed and not exposed to sleep quality and EDS. ResultsPoor sleep quality and EDS were detected in 62.57% and 36.35% of the sample. Adolescents with poor sleep quality and EDS had −0.39 (p-value = 0.049) and −0.51 pg/ml in NGF (p-value = 0.009). Individuals with self-reported sleep disorder had lower serum levels of NGF (Coef. −0.41, p-value = 0.045). ConclusionHigh prevalence of EDS and low sleep quality in a population of adolescents were evidenced. Poor sleep quality and EDS were associated with lower NGF levels, whilst adolescents with self-reported sleep disorder had lower serum levels of NGF.

Impact of lockdown on musculoskeletal health due to COVID-19 outbreak in Bangladesh: A cross sectional survey study

BackgroundDuring the nationwide lockdown implemented by the government of Bangladesh due to the coronavirus, has led to the various changes in the overall activities and lifestyle. Most of the people began living a sedentary lifestyle, spending more time on their phone, watching television and excessive sleeping. Reduction of physical activity level had profoundly negative impact on musculoskeletal health. AimThis study aims to investigate the impact of lockdown on musculoskeletal health, association between leisure and musculoskeletal pain during this period. MethodsA cross sectional study was conducted among general populations living in a specific area of Bangladesh by simple random sampling methods. A total of 230 participants both male (182) and female (48) age group between 18-60 years have participated. The study was carried out by sending the Google Form link containing demographic questionnaire, numeric pain rating scale and Nordic musculoskeletal Questionnaire. Wilcoxon sign rank t and Chi squire test was used to analyze the data. ResultsThe mean height, weight and BMI of the participants were 164.17 ± 8.40 cm, 63.82 ± 10.70 kg and 23.74 ± 3.97 kg/m2 respectively. There was significant increase in time spent in watching television (p= < 0.0001), using smartphone (p= < 0.0001) and sleeping (p= < 0.0001) during the lockdown period. 33.9% participants had pain before the lockdown which increased by 57% during the lockdown periods. There was a significant association between pain intensity and sleeping time (X2 = 54.84; p= < 0.0001), time spent watching television (X2 = 83.70; <0.0001), time spent on smartphone (X2 = 58.39; <0.0001) during the lockdown period. ConclusionThe result of this study concluded that the lockdown has negatively impacted the musculoskeletal health of the participants. The musculoskeletal pain might be short term initially, but can develop to be a long-term problem and burden if proper measures are not taken.

502 Idiopathic hypersomnia and co-occurring psychopathology among veterans

Abstract Introduction Idiopathic hypersomnia (IH) is relatively rare and characterized by excessive daytime sleepiness despite prolonged and undisturbed sleep as well as the absence of cataplexy and other causes of hypersomnolence. The etiology of IH is largely unknown. The present study capitalized on electronic medical record (EMR) data from the Veterans Health Administration (VHA) to create a cohort of veterans diagnosed with IH in order to: 1) estimate the prevalence of IH diagnosis in the VHA, and 2) identify co-occurring physical and behavioral health conditions to characterize IH in the sample. Methods Using 2009–19 VHA EMR data, we created two cohorts: those with an IH diagnosis (N = 3,674) or a hypersomnia diagnosis (e.g., primary hypersomnia) other than IH (N = 110,530). Diagnostic data (i.e., ICD 9 and 10 codes) were extracted for the 6-months prior to index diagnosis to examine group differences in the prevalence of physical and behavioral health conditions. Results Veterans diagnosed with IH, as compared to veterans with another hypersomnia disorder, were more likely to be female (30.1% vs 12.3%) and less likely to be obese (16% vs 28.3%; chi-squared = 79.27, p &amp;lt;.001), or carry diagnoses of diabetes (type 1 or 2; 9.7% vs 24.4%; chi-squared = 123.02, p &amp;lt;.001), or anxiety disorders (5.8% vs 9.5%; chi-squared = 16.83, p &amp;lt;.001). Individuals with IH were more likely to carry diagnoses of chronic fatigue syndrome (4.2% vs 1.6%; chi-squared = 45.91, p &amp;lt;.001), depression (31.3% vs 23.4%; chi-squared = 36.04, p &amp;lt;.001), and posttraumatic stress disorder (29.5% vs 26.5%; chi-squared = 5.79, p = .02). Conclusion Data suggest that veterans diagnosed with idiopathic hypersomnia may present with different diagnostic profiles than veterans with other hypersomnia disorders. Far more basic and clinical research is needed in IH. Support (if any) This work was supported by the Hypersomnia Foundation and in part by the VA Center of Excellence for Suicide Prevention in the Finger Lakes Healthcare System.