Movement Index Research Articles

Periodic limb movement index and severity of obstructive sleep apnea

BackgroundPeriodic limb movements during sleep (PLMS) and obstructive sleep apnea syndrome (OSAS) are two frequent coincident sleep disorders. The association of PLMS with OSAS severity and predictors of PLMS in OSAS patients were investigated.Material and methodThis is a retrospective study that enrolled adult patients ≥ 16 years old who visited the sleep unit at Mouwasat Hospital, Saudi Arabia, between January 2021 and October 2021. All were subjected to full medical history, clinical examination, Epworth Sleepiness (ESS), STOP-Bang questionnaires, and standard overnight polysomnography. Subjects were subdivided into two groups based on PSG findings: group I, OSA patients (153). Patients were classified into mild n = 57 (AHI ≥ 5 and < 15), moderate n = 35 (AHI ≥ 15 and < 30), and severe n = 61 (AHI ≥ 30). Group II, control group included 100 subjects.ResultThere was a higher frequency of PLMS in OSA patients vs control group (with a statistically significant value). The study showed a statistically significantly positive correlation between PLMI and each of AHI, hypopnea index, desaturation index, and PLMs with arousal index, in contrast; it had a statistically significantly negative correlation with BMI among the OSA group. By performing multivariate logistic regression to predict the possible factors associated with the existence of PLMS among the OSA group, it was showed that the apnea index and desaturation index were statistically significant predictors.ConclusionThe present study showed that OSA patients with PLM were older; had greater AHI, hypopnea index, desaturation index, and PLMs with arousal index; and had lower BMI. Further studies are needed for better understanding this complex relationship.

0308 The stability of slow wave sleep and EEG microstructure measures across two consecutive nights of laboratory polysomnography in cognitively normal older adults

Abstract Introduction Healthy and sleep disordered populations show high night-to-night variability of polysomnographic (PSG) macrostructure metrics, however there is evidence of stability in EEG microstructure. In-laboratory PSG is critical to gold standard measures of sleep physiology but multi-night investigations are resource heavy and burdensome to participants. Given the theoretical link between sleep and Alzheimer's disease (AD) pathology (tau and β-amyloid burden), we assessed the night-to-night reliability of sleep macrostructure and EEG microstructure in a group of cognitively normal elderly participating in aging and memory studies. Methods 107 participants (mean = 67±8 yrs., range [54-84 yrs.], 72% female) attended 2 consecutive nights PSG scored according to AASM guidelines for sleep staging, respiratory and leg movement events. Midline EEG (Fz, Cz and Pz referenced to average mastoid signals) were analyzed in 98 participants using an automatic algorithm (DETOKS) for detection of relative slow wave (0.5-4Hz) activity (SWA), NREM2 spindle and K-complexes (KC) densities. Differences between night 1 and 2 for total sleep time (TST), slow wave sleep (SWS), rapid eye movement (REM), stage 2 (%NREM 2), sleep efficiency (SE), apnea hypopnea (AHI) and periodic limb movement (PLM) indices, and EEG microstructure were assessed using t-tests and Wilcoxon rank sum tests where appropriate. Two-way intraclass correlations (ICC) for single unit and absolute agreement were used to determine variability between nights for all measures. Results Night 2 PSGs showed significantly greater TST (6.3 vs 6.8 hours, p&amp;lt;0.001), %REM (17.5 vs 19.7, p&amp;lt;0.001), SE (84.9 vs 87.4%, p&amp;lt;0.02) and SWA (Fz:76.8 vs 78.0%, p&amp;lt;0.01). There were no significant differences between nights for %SWS, %NREM2, AHI, PLMs, spindle and KC densities. ICC and 95% confidence interval estimates were low for TST(0.28), %REM(0.32) and SE(0.32), moderate for %SWS(0.67) and %NREM2(0.59), good for AHI(0.78), SWA(Fz:0.86) and KCs(Fz:0.85), and excellent for PLMs(0.91) and spindles (Pz:0.97). Conclusion SWS, SWA, spindles, KC’s, AHI and PLM indices show good to excellent intra-individual stability across two consecutive nights of PSG. Although there were differences in %REM, SE and SWA, these were numerically small and perhaps functionally or clinically less significant. One night of in-lab PSG is enough to provide reliable estimates of individuals’ SWS, SWA, spindles, KC’s and sleep disorders. Support (If Any) Funding NIH R21AG055002, K24HL109156, R01AG056682, R01AG056531

0817 Conquering Two Sleep Birds with One Iron stone: The Case of Resolved Restless Sleep Disorder and Parasomnia with Iron Therapy

Abstract Introduction Restless Sleep Disorder (RSD) is characterized by frequent nocturnal movements of large muscle groups or a complaint of restless sleep by observers with associated daytime dysfunction.1 RSD, like other movement disorders of sleep, is associated with low iron stores.2 Children with RSD have increased NREM sleep instability and a propensity for parasomnia.2 No reports to date have demonstrated the use of iron therapy for parasomnia in patients with RSD. Furthermore, studies are limited in very young children with this disorder as they currently fall outside proposed diagnostic criteria.1 Report of Cases: A 2 year-old male presented to the sleep clinic with parental complaints of nightly sleep initiation and maintenance difficulty, mild snoring, restless sleep, episodes of sleepwalking and night terrors multiple times per week. Symptoms worsened over 6 months and were associated with daytime irritability and behavioral problems. Sleep quality measures assessed progress between visits: the PROMIS Sleep Disturbance (PROMIS SD) and Sleep Related Impairment (PROMIS SRI). Serum ferritin was initially 20ug/L. Polysmnogram demonstrated no significant sleep related breathing disorder, a large muscle group movement index of 14, periodic limb movement index of 3. Initial treatment included oral iron therapy, scheduled awakenings, and hypnotic dose melatonin. The sleep psychologist addressed limit setting and negative sleep associations with improved insomnia symptoms but parasomnia and restless sleep continued. The parent noted reduction in both movements and parasomnia frequency after one month of iron therapy. After a 3 month period on treatment, the parent reported complete cessation of the parasomnia, drastic reduction in restlessness, and near resolution of insomnia. Sleep quality measure PROMIS SD improved by 11, demonstrating reduced sleep disturbance. PROMIS SRI did not change. Ferritin level increased to 47ug/L. Conclusion RSD in a very young child with NREM parasomnia responded to oral iron therapy improving overall sleep quality. This case demonstrates the relationship between relative iron deficiency, RSD and associated parasomnia. Support (If Any) 1. DelRosso LM, Ferri R, Allen RP, et al. Consensus diagnostic criteria for a newly defined pediatric sleep disorder: restless sleep disorder(RSD).SleepMed.2020;75:335-340. 2. Leung W, Singh I, McWilliams S, Stockler S, Ipsiroglu OS. Iron deficiency and sleep - A scoping review. SleepMedRev.2020;51:101274

The impact of COVID-19 pandemic on individuals at clinical high-risk for psychosis: Evidence from eye-tracking measures

Emerging evidence suggested that people with severe mental disorders were more vulnerable to the negative effects of the COVID-19 pandemic. However, few researches investigated the influence of global pandemics on people at clinical high risk (CHR) for psychosis. This study aimed to investigate the impact of the COVID-19 pandemic on clinical symptoms, psychological distress, and eye-tracking characteristics in CHR individuals and healthy participants. Forty-nine CHR individuals and 50 healthy controls (HC) were assessed by PTSD Checklist for DSM-5 (PCL-5), Perceived Stress Scale, 10-item version (PSS-10), and Coronavirus Impact Scale (CIS). Eye movement performances were measured by the tests of fixation stability, free-viewing, and anti-saccade. According to the mean score of CIS, participants were stratified into high-impact (n = 35) and low-impact (n = 64) subgroups. Compared with the HC group, CHR participants reported significantly higher levels of post-traumatic symptoms caused by the COVID-19 pandemic and showed abnormalities in most of the eye movement indexes. Among the altered indexes, the saccade amplitude of fixation stability test (far distractor), the scan path length of free-viewing test, and the accuracy of anti-saccade test were negatively affected by the severity of impact level in the CHR group. Moreover, the altered eye movement indexes were significantly associated with the total scores of CIS, PCL-5, and subscales of the Scale of Prodromal Syndromes (SOPS) among CHR individuals. Overall, our findings suggested the negative impact of the COVID-19 pandemic on the eye movement characteristics of CHR individuals. The present study provides valuable information on physiological distress related to the COVID-19 pandemic and sensitive neuropsychological biomarkers that interacted with social and environment stress in the CHR population.

Association of fetal eye movement density with sleeping and developmental problems in 1.5-year-old infants

Eye movement density (EMD) is an evaluation index of rapid eye movements observed during sleep. This study aimed to investigate the association of fetal EMD with sleeping and developmental problems in infancy. We observed 60 normal singleton pregnancies (gestational age 28–37 weeks) using ultrasonography for 1 h. Fetal eye movements were counted, and EMD was calculated. Participants answered questionnaires regarding their child’s sleep and development 1.5 years after their delivery. The outcomes of an infant’s sleep were night awakening (yes or no), bedtime (before or after 22:00), and nighttime sleep duration (< 9 or ≥ 9 h). An infant’s development was evaluated using the Child Behavior Checklist (CBCL) T-score. We found that decreased fetal EMD was associated with increased night awakening at the age of 1.5 years (odds ratio 0.84, 95% confidence interval 0.69–1.00 per unit decrease in EMD). However, fetal EMD was not associated with bedtime or nighttime sleep duration. In addition, fetal EMD was independently associated with the total problems T-score of the CBCL at the age of 1.5 years in the multivariate model (p = 0.047). In conclusion, fetal EMD may be associated with sleep and developmental problems in infants.

Effective differentiation between depressed patients and controls using discriminative eye movement features

BackgroundDepression is a common debilitating mental disorder caused by various factors. Identifying and diagnosing depression are challenging because the clinical evaluation of depression is mainly subjective, lacking objective and quantitative indicators. The present study investigated the value and significance of eye movement measurements in distinguishing depressed patients from controls. MethodsNinety-five depressed patients and sixty-nine healthy controls performed three eye movement tests, including fixation stability, free-viewing, and anti-saccade tests, and eleven eye movement indexes were obtained from these tests. The independent t-test was adopted for group comparisons, and multiple logistic regression analysis was employed to identify diagnostic biomarkers. Support vector machine (SVM), quadratic discriminant analysis (QDA), and Bayesian (BYS) algorithms were applied to build the classification models. ResultsDepressed patients exhibited eye movement anomalies, characterized by increased saccade amplitude in the fixation stability test; diminished saccade velocity in the anti-saccade test; and reduced saccade amplitude, shorter scan path length, lower saccade velocity, decreased dynamic range of pupil size, and lower pupil size ratio in the free-viewing test. Four features mentioned above entered the logistic regression equation. The classification accuracies of SVM, QDA, and BYS models reached 86.0%, 81.1%, and 83.5%, respectively. ConclusionsDepressed patients exhibited abnormalities across multiple tests of eye movements, assisting in differentiating depressed patients from healthy controls in a cost-effective and non-invasive manner.

Measurements of American lobster heart rate and movements in the wild using a low-cost open source datalogger

To better understand the behavior of the American lobster (Homarus americanus) in the wild, we developed the C-HAT (Crustacean Heart and Activity Tracker): a datalogger capable of continuously recording the triaxial acceleration, compass heading, and heart rate of lobsters that are freely moving in their natural habitat. C-HATs and acoustic transmitters were affixed to six lobsters that were released within an acoustic positioning array off the coast of New Hampshire (USA) and recaptured by divers after 15–47 h at large. Lobster heart rates tended to be ~ 60 beats per minute (bpm) at rest, but increased to ~ 80 bpm during periods of activity. The presence of brief cardiac startle responses during the beginning of some periods of activity suggested that at least a third of their movement bouts occurred in response to external stimuli, such as interactions with other species. The combination of acoustic positioning data and datalogging allowed us to determine if various indices of acceleration could be used to estimate distance traveled. We found a significant correlation between a Movement Index (MI), based on differentiation of the three axes of acceleration, and the distance lobsters traveled in 10 min based on telemetry data. This enabled us to use the MI in concert with compass headings to reconstruct lobster movement paths via dead reckoning. This study demonstrates the potential for low-cost, open-source, dataloggers to provide detailed information on the daily behavior and physiology of marine invertebrates in the wild.

The impact of different AR-HUD virtual warning interfaces on the takeover performance and visual characteristics of autonomous vehicles

Objective The objective of this study was to determine the different effects of the arrow-pointing augmented reality head-up display (AR-HUD) interface, virtual shadow AR-HUD interface, and non-AR-HUD interface on autonomous vehicle takeover efficiency and driver eye movement characteristics in different driving scenarios. Methods Thirty-six participants were selected to carry out a simulated driving experiment, and the eye movement index and takeover time were analyzed. Results The arrow pointing AR-HUD interface and the virtual shadow AR-HUD interface could effectively reduce the driver's visual distraction, improve the efficiency of obtaining visual information, reduce the number of times the driver's eyes leave the road, and improve the efficiency of the takeover compared with the non-AR-HUD interface, but there was no significant difference in eye movement indexes between the arrow pointing AR-HUD interface and the more eye-catching virtual shadow AR-HUD interface. When specific scenarios were considered, it was found that in the scenario of emergency braking of the vehicle in front, the arrow pointing AR-HUD interface and the virtual shadow AR-HUD interface had more advantages in takeover efficiency than the non-AR-HUD interface. However, in the scenarios of a rear vehicle overtaking the vehicle ahead and non-motor vehicles running red lights, there was no significant difference in takeover efficiency. For the non-motor vehicle invading the line, emergency U-turn of the vehicle in front, and pedestrian crossing scenarios, the virtual shadow AR-HUD interface had the highest takeover efficiency. Conclusions These research results can help improve the active safety of autonomous vehicle AR-HUD interfaces.

Mid-air gestures for in-vehicle media player: elicitation, segmentation, recognition, and eye-tracking testing

There was a problem of great distraction in traditional touch interactive operation of in-vehicle information interface, but the application of gesture recognition technology on in-vehicle system improved this problem. However, users had less experience in this new interactive mode, and the cognitive deviation of the agreement between gestures and commands could directly affect the safety of drivers. The main purpose of this paper was to obtain the user's preference mid-air gestures for the in-vehicle information interface by using the user-elicitation method. In addition, the optimized gesture recognition network structure was applied to the prototype system of in-vehicle information interaction with user-defined mid-air gestures developed by us, and the effectiveness of the system was evaluated by collecting eye movement indicators of users through the simulation of driving eye movement experiments. In the process of user elicitation, the principle of command prompt and agreement rate was introduced. According to the agreement rate elicited by users (AR = .397), we got the gesture consensus set design direction of in-vehicle information control. The experimental results of the eye movement index showed that the method of user-defined mid-air gestures can effectively improve driving safety on in-vehicle media control, and reduced the distraction of users when driving compared with the traditional touch-based method.Article highlightsThe user's preferred in-vehicle media control task gestures were obtained through the user elicitation method.Constructed an in-vehicle secondary task control prototype system based on gesture recognition.The eye movement experiment proved that the prototype system can reduce the user's distraction when operating the in-vehicle's secondary tasks.

A Study on Ideals of Kabir Das and His Contribution in Human Unity

Famous as a pioneer of the liberal social system, Saint Kabir Das was one of the major indices of the medieval Bhakti movement. Although permanent evidence is not available, according to most beliefs, the poet Kabir Das was born in Kashi (Varanasi, Uttar Pradesh) in the mid-15th century. The details of Kabir's life is still unknown till date. As far as recorded, there are stories of Kabir's birth mystery has a similar trail found in Biblical texts. Among his most famous writings are his Doha or couplets and poems that sometimes refer the Sikh scripture Guru Granth Sahib. Kabir was deeply focused on his spiritual knowledge. In Davistan in Mosinfani and Aineakbari in Abu'l-Fazur, he is called "Muwahid" or "Believer of God." He criticized both Hinduism and Islam, the former as per him being misinterpretation of the Vedas. He frequently questioned meaningless rituals such as sacred threads and circumcision. Kabir is a brave pioneer, a great pioneer in the unification of the Hindu and Muslim communities of India, an apostle of human faith, and taught that God has been revealed to all of humanity. Although his life is a mystery and lesser known, his contribution as a social and religious reformer has become a promoter of social progress and laid a solid foundation for modern society. However, the implementation of Kabir's philosophy is still incomplete and uninterpreted. With the inspiration of this gap, the current review of Kabir Das's ideals and contributions to human unity takes into account the legendary saint's theory and view of human unity as an important element of a stable and constructive society.

Development and Utilization of an Isolation Box Test to Characterize Personality Traits of Dairy Calves

The use of an isolation box test (IBT) to characterize personality traits has been used in non-bovine species with success. We aimed to develop an IBT for dairy calves and determine if the behavioral responses to an IBT were associated with personality traits found from traditional tests (novel person, novel object, and a startle tests) and average daily gain (ADG; Kg/d) through weaning. Calf movement while in the IBT was measured via accelerometers attached to 5 locations on the exterior of the box. A total movement index (TMI) was calculated based on accelerometer readings during the IBT. We performed a principal component analysis on the traditional tests and identified 3 influential factors that we labeled as “fearful,” “bold,” and “active.” Calves were weighed biweekly to track liveweight ADG. Factor scores and ADG were regressed against TMI. A significant negative association was found between the TMI and the factor “active,” indicating the validity of IBT as a tool for assessing some personality traits of dairy calves. Furthermore, TMI had a positive association with ADG through the entire experimental period and thus has potential to help predict performance through weaning. IBT has potential to be used as a personality test in research scenarios. Further development is needed to produce an IBT that would be appropriate to measure animals' responses reliably in production settings. An automated test that can accommodate a wide range of ages and developing a computer learning model to interpret output from the IBT would be a possible option to do so.

Association of Periodic Limb Movements With Medication Classes: A Retrospective Cohort Study.

To investigate the association between various medication classes and the periodic limb movement index (PLMI) in a clinical cohort of adults who completed in-laboratory polysomnography. A single, diagnostic, overnight, in-laboratory polysomnogram was completed for 3,488 patients consecutively referred from 2010 to 2015 to determine PLMI. Medication use and medical comorbidities were collected through patient questionnaires. Associations between medication classes and PLMI were ascertained using multivariable ordinal logistic regression models. The median age of the cohort was 56.0 years (48.2% male). After adjusting for age, sex, body mass index, relevant comorbidities, and sleep measures, the use of selective serotonin reuptake inhibitors (SSRIs) (odds ratio [OR] 1.52) and serotonin-norepinephrine reuptake inhibitors (SNRIs) (OR 1.99) was associated with increased PLMI. Conversely, gabapentinoids (OR 0.71), stimulants (OR 0.52), benzodiazepines (OR 0.79), and dopamine agonists (OR 0.38) were associated with decreased PLMI. A non-statistically significant trend for decreased PLMI with neuroleptic use was observed. No significant associations were found between PLMI and the use of antihypertensives, statins, tricyclic antidepressants, bupropion, anticoagulants, antiplatelets, modafinil, and antihistamines. The use of SSRIs and SNRIs was associated with elevated PLMI while the use of gabapentinoids, stimulants, benzodiazepines, and dopamine agonists was associated with decreased PLMI. These results can assist physicians in managing periodic limb movements in sleep (PLMS) and invite further research into the relationship between PLMS and medications with the modulating effects of dose, formulation type, and time of administration. This study provides Class II evidence that SSRIs and SNRIs are associated with elevated PLMI while gabapentinoids, stimulants, benzodiazepines, and dopamine agonists are associated with decreased PLMI.

Betamethasone versus dexamethasone on the fetal movement index in the women with preterm labor: A cross-sectional study

Background and aims: Biophysical evaluation of fetal profile and movements is a useful tool for assessing fetal health, which even has significant effects on neonatal health. This study aimed to compare the biophysical parameters of the profile – fetal movement index, in particular – before and after corticosteroid administration in two groups receiving dexamethasone and betamethasone. Methods: In this descriptive/analytical study, 200 patients diagnosed with preterm delivery and admitted to the gynecology section of Hajar Hospital in Shahrekord in 2016 were investigated. Their demographic findings and medical histories were collected using a checklist form. Then their biophysical profiles 24 to 48 hours after corticosteroid administration were assessed. Finally, the data were analyzed by SPSS v. 18 software using t test, chi-square and Fisher exact test. Results: According to our study results, there was a significant difference in fetal movements before and after receiving corticosteroids, and the decrease in the percentage of movements was greater in the betamethasone group (P&lt;0.001). Also, the biophysical profile was significantly different in the dexamethasone group compared to the betamethasone group (P&lt;0.001). No significant difference was found between two groups in terms of fetal respiration and non-stress test (NST) before and after receiving corticosteroids (P=0.47 and P=0.65, respectively). Conclusion: Dexamethasone administration had less effect on reducing fetal movement index than betamethasone administration. As the result, the biophysical profile was significantly different in the dexamethasone group compared to the betamethasone one.

Suprascapular Nerve Block (SSNB) improves the outcome in exercise based management of Primary Adhesive Capsulitis (PAC): A prospective randomized comparative study.

Increased pain and associated stiffness hinders the advantages of exercise and process of recovery in primary adhesive capsulitis. We hypothesized that suprascapular nerve block may positively affect the outcome due to its role in pain relief of acute or chronic shoulder pain. We compared the effect of suprascapular nerve block and exercise with only exercise on the recovery of primary adhesive capsulitis. A total of 96 patients of both sexes presenting with primary adhesive capsulitis were divided by computer randomization in two equal groups (n = 48). Group A received exercise only and Group B received suprascapular nerve block followed by exercise. Oral paracetamol was given for analgesia as desired. Patients were followed up at 4, 8, 16, and 24 weeks. Pain was assessed by visual analog scale; functional outcome by Shoulder Pain and Disability Index and range of movement by goniometer. The pain scores and Shoulder Pain and Disability Index scores were significantly lower at all observation points of 4, 8,16, and 24 weeks in Group B than Group A (P < 0.05). The range of movement in all the ranges of forward flexion, extension, internal and external rotation, and abduction at all observation points was significantly higher in Group-B (P < 0.05) compared to Group A. The consumption of analgesics was significantly more in Group A than Group B at 4 and 8 weeks (P = 0.020 and P = 0.044) but comparable at 12 and 24 weeks (P = 0.145 and P = 0.237 respectively). Combining SSNB with exercise is more effective in treatment of primary adhesive capsulitis than exercise alone and reduces the use of analgesics. SSNB it is effective and safe to use in primary adhesive capsulitis.

The natality and mortality of population in various social economic regions of the Far North

The issues of improving demographic situation in Russia at large and in its particular subjects are of special actuality. Therefore, the study was carried out concerning actual characteristics of population natural movement with consideration of regional specifics of the northern and eastern territories of the country. Nowadays, in Far North regions, Arctic and Sub-Arctic territories, Far East territories that occupy almost 2/3 of the area of the Russian Federation reside less than 10% of total population. By virtue of immense industrial and resource potential of these regions, the issue of natural population increase in the northern and arctic territories is of strategic importance for the Russian Federation. The entire territory of the Republic of Sakha (Yakutia) is included in the Far North regions. The demographic situation in this territory is determined both by processes of national level and specific climatic, economic and other conditions specific for northern and arctic territories. The study was carried out to comparatively analyze indices of population natural movement in various social economic regions of the Republic of Sakha (Yakutia) such as arctic, agricultural and industrial, including Yakutsk. It was established that most unfavorable demographic situation from point of view of processes of population natural reproduction is observed in industrial regions, where lowest natality indices are observed at high mortality rates. The highest natality indices were noted in agricultural regions. The highest mortality indices were specific for Arctic and industrial regions and the lowest ones for Yakutsk. Since 2014, occurs slowdown of natural population increase in all groups of regions, while in industrial areas in 2006 and 2020, natural population loss was recorded. The revealed differences in medical and demographic indices are a basis of implementation of regional programs targeted to development of social economic living conditions and improvement of demographic policy in regions of the Far North.

Multiple levels of mental attentional demand modulate peak saccade velocity and blink rate

Every day we mentally process new information that needs to be attended, encoded and retrieved. Processing demands depend on the amount of information and the mental attentional capacity of the individual. Research shows that eye movement indices such as peak saccade velocity and blink rate are related to processes of attentional control, however it is still unclear how eye movements are affected by graded changes in task demand. We examine for the first time relations of eye movements to mental attentional tasks with six levels of task demand and two interference conditions. We report data on 57 adults who completed two versions of the color matching task and provided subjective self rating for each mental attentional demand level. Results show that peak saccade velocity and blink rate decrease as a function of mental attentional demand and correlate negatively with self rating of mental effort. Theoretically, new findings related to mental attentional demand and eye movements inform models of visual processing and cognition. Practically, results point to directions for further research to better understand complex relations among eye movements and mental attentional demand in pediatric populations and individuals with cognitive deficits.

Sex Differences in Excessive Daytime Sleepiness Among Patients With Obstructive Sleep Apnea.

Background and PurposeTo identify sex differences in daytime sleepiness associated with apnea severity and periodic limb movements during sleep (PLMS) in subjects with obstructive sleep apnea (OSA).MethodsThis study used the Epworth Sleepiness Scale (ESS), Beck Depression Inventory (BDI), and Sleep Hygiene Index (SHI) in logistic regression analyses with interaction terms. Severe OSA, excessive daytime sleepiness (EDS), and PLMS were defined as an apnea-hypopnea index of ≥30, an ESS score of ≥11, and a periodic limb movements index of >15, respectively.ResultsThe 1,624 subjects with OSA (males, 79.1%) comprised 45.3%, 38.2%, and 16.4% with severe OSA, EDS, and PLMS, respectively. Multiple logistic regression without interaction terms showed that sex, severe OSA, and PLMS were not significantly associated with EDS. However, significant interactions were noted between sex and severe OSA and PLMS in EDS in both crude and adjusted models (all p values<0.05). In the adjusted model, severe OSA was associated with EDS in males (p=0.009) but not in females. PLMS were more likely to be associated with EDS in females (p=0.013), whereas PLMS were less likely to be associated with EDS in males (p=0.041). The models were adjusted by the BDI score, SHI, and presence of medical comorbidities.ConclusionsThere are significant sex differences in subjective daytime sleepiness in subjects with severe OSA and PLMS. Severe OSA and PLMS may influence daytime sleepiness more in males and females, respectively.

Exploration of the Relationships between Hazard Perception and Eye Movement for Young Drivers

Aiming at young drivers’ hazard perception (HP) and eye movement, a cross-sectional study was conducted in the city of Xi’an, China. 46 participants were recruited, and 35 traffic scenes were used to test drivers’ hazard perception and eye movement. The difference analysis and correlation analysis were carried out for the acquired data. The results suggest that some indices of hazard perception and eye movement are significantly correlated. A higher saccade speed is in the direction of higher hazardous scenes. Higher complex scenes result in smaller saccade angle. The number of hazards unidentified is negatively influenced by complexity degree and hazardous degree of traffic scenes, and similar associations are found between hazard identification time, complexity degree, and hazardous degree. The hazard identification time and the number of hazards slowly identified are positively affected by the number of fixations and the number of saccades. Meanwhile, differences in the hazardous degree evaluation, hazard identification time, number of hazards unidentified, number of fixations, and number of saccades are found in different types of traffic scenes. The results help us to improve the design of road and vehicle devices, as well as the assessment and enhancement of young drivers’ hazard perception skills.

A meta-analysis of the first-night effect in healthy individuals for the full age spectrum

ObjectivesThe first-night effect (FNE) affects the accuracy of polysomnography (PSG) findings. However, the levels of FNE in different ages are unclear. MethodsWe searched PubMed, Cochrane Library, Embase and Web of Science. The studies that reported sleep parameters by PSG for at least 2 consecutive nights from healthy individuals were included. The weighted mean differences were used to assess the effect size of differences in each sleep parameters between the first and second nights, as well as between the second and the third. ResultsA total of 53 studies from 1422 subjects with mean age of 9.2–85.5 years were included. Meta-analyses showed that prolonged sleep onset latency, wake time after sleep onset and rapid eye movement sleep (REM) latency, accompanied by decreased total sleep time, sleep efficiency, and REM and increased non-rapid eye movement sleep stage 1 (N1) during the first night compared to the second (all P-value ≤ 0.001). No significant differences were observed in N2 and slow wave sleep, apnea–hypopnea index or periodic limb movement index (all P-value > 0.5). A non-linear association between FNE and age was observed: young adults (age 20–29 years) had the lowest level of FNE compared to other age ranges. Moreover, no significant differences were observed in most sleep parameters between the second and third night except more N2 and less REM in the second night (both P-value < 0.05). ConclusionsThe FNE exists in most cases but only in the first night of PSG recording and is less pronounced among young adults.

Individuals progressive tension protocol in the application of elastic bandage in nonspecific chronic low back pain: a case study

Introduction: Low back pain is a disorder of musculoskeletal origin of multifactorial character, which can become chronic when it persists for more than 3 months. It is expected that 80% of the world's population will present with low back pain at some stage of life, characterizing it as a serious public health condition that requires specific interventions for treatment. Given the context, elastic banding arises, a resource that can be useful to these patients, however, its effectiveness requires that the bandage be of quality that the therapist has experience and that its application is standardized, the latter being scarce in the current literature. Thus, the present study sought to observe what would be the application of a progressive tension protocol with elastic bandage in an individual with nonspecific chronic low back pain. Methods: A 47-year-old female, caregiver of the elderly and diagnosed with nonspecific chronic low back pain participated in the study. The treatment protocol lasted 10 weeks, where the elastic bandage was applied to the participant and in the first and last session, in addition to the report of the level of pain obtained through the Numerical Pain Scale (END), the following questionnaires were used to evaluate: Oswestry Disability Index (ODI), Survey of Pain Attitude (SOPA-B) and Fear Avoidance Beliefs Questionnaire (FABQ). Conclusion: The findings suggest that the application of elastic bandage following the progressive tension protocol promoted a reduction in disability index, pain and fear of movement, such outcomes can be considered clinically relevant, given the constant search for therapeutic techniques that provide improvement in the quality of life of patients with chronic low back pain.&#x0D;