Presence Of Daytime Sleepiness Research Articles

Changes in the pattern of sleep disturbances in healthy subjects under 21-day antiorthostatic hypokinesia

Background. Antiorthostatic hypokinesia (ANOH) reproduces some of the effects of weightlessness on the human body and is used to study adaptation to space flight conditions. It is known that ANOH affects nighttime sleep, but there is no information in the literature on the sequence of occurrence of sleep disorders in ANOH.The aim of the research was to study the dynamics of subjective changes in assessing sleep quality under conditions of antiorthostatic hypokinesia.Materials and methods. Six healthy male volunteers (age from 26 to 34 years) participated in the experiment with 21-day ANOH. They were on a medical bed with a body inclination angle relative to the horizon of –6° for 21 days. To assess sleep quality, a structured questionnaire was used that assessed sleep duration, rate of falling asleep, night awakenings, the presence of daytime sleepiness, and daytime falling asleep.Results. Based on the assessment of the dynamics of the sleep efficiency index (SEI), three stages of adaptation were identified. At the stage of acute adaptation (the first 3 days), there is a decrease in SEI from 96.4 to 91.3 (p < 0.01), a statistically significant prolongation of falling asleep from 17.6 to 33.6 minutes (p < 0.01), an increase duration of night awakenings up to 17.4 minutes, increase in daytime sleepiness by 11 %. In the next 3 days (the “recovery” stage), there is a statistically significant increase in SEI compared to the 1st stage to 94.7 (p < 0.01), but it remains statistically significantly lower than the background values (p < 0.004). The number of complaints about daytime sleepiness increases (up to 42 %), evening bedtime shifts later by 26 minutes. At the 3rd stage (the remaining nights) there is a relative stabilization of the sleep-wake cycle.Conclusion. Under conditions of 21-day ANOH, a gradual change in the pattern of sleep disturbances occurs. The most negative changes in terms of subjective assessment were noted in the first three days. Then there is an improvement in falling asleep, a decrease in night awakenings, combined with an increase in daytime sleepiness and the formation of a schedule with a later bedtime.

Sleep and the Social Profiles of Individuals With Rett Syndrome

BackgroundThis study investigates the distinctive social behaviors observed in individuals with Rett syndrome (RTT), characterized by the loss of spoken language, impaired eye gaze communication, gait abnormalities, and sleep issues. The research aims to identify social profiles in RTT and explore their correlation with sleep, sleep-disordered breathing (SDB), and daytime sleepiness. MethodsStandard overnight sleep macrostructure and respiratory parameters were assessed. Extracting 25 social-related items and one for daytime sleepiness from the Rett Syndrome Behavioral Questionnaire, factor analysis was applied to establish latent social profiles. These profiles were then correlated with sleep parameters. The nonparametric Mann-Whitney U test compared social profiles based on the presence of SDB (defined by an apnea-hypopnea index greater than one per hour) and daytime sleepiness. ResultsThe study involved 12 female subjects with confirmed RTT diagnoses and MECP2 mutations, aged 8.54 ± 5.30 years. The Rett Syndrome Behavioral Questionnaire revealed a total average score of 25.83 ± 12.34, indicating varying degrees of social impairments. Comprising 25 social-related items, factor analysis yielded four social profiles: “interactive motricity,” “mood change,” “anxiety/agitation,” and “gazing.” Longer sleep onset latency correlated with increased socio-behavioral impairments, particularly in interactive motricity reduction. Conversely, higher rapid eye movement sleep was associated with fewer interactive socio-motor behaviors. No significant differences in social profiles were found concerning the presence of SDB or daytime sleepiness. ConclusionsThe findings suggest four distinct social profiles in RTT individuals, hinting at shared disrupted circuits between sensorimotor functioning and sleep-related neuronal pathways. Despite the absence of differences in SDB or daytime sleepiness, the study highlights the relationship between sleep parameters, such as sleep onset latency and rapid eye movement sleep, and socio-behavioral outcomes in RTT with MECP2 mutations.

Screen time and its association with adolescents' lifestyles in a city in the Brazilian Northeast

Objective: To associate screen time with food, physical activity, sleep and sociodemographic variables in Brazilian adolescents, students of urban public institutions. Methods: Observational, cross-sectional, quantitative, analytical study approved by the Ethics Committee in Research on Human Beings of the Federal University of Sergipe (CAAE 38981320.2.0000.5546) with students from 10 to 18 years of age at a public school in a municipality in the Brazilian Northeast. A descriptive analysis of screen time, sociodemographic, economic variables, academic year, physical activity, sleep duration and daytime sleepiness was performed. Fisher's exact test and Pearson's chi-square test were used to analyze the independence hypothesis and the Mann-Whitney test to assess the hypothesis of equality of the median of two samples, in addition to simple and multiple logistic regression. Results: 364 students participated in the study. The eighth and ninth year of elementary school; the first and second years of high school made more excessive use of electronic devices. There is a greater chance of screen time higher than recommended in those with a higher socioeconomic level. High screen time was associated with the presence of daytime sleepiness, with a higher prevalence of excessive screen time in students who considered they rarely and often had sleepiness. Conclusions: The prevalence of excessive screen time was higher in adolescents considered older, when compared to younger ones and in those with better socioeconomic conditions. It is possible that screen time influences shorter sleep duration and the presence of daytime sleepiness.

405 The Effect of a Patient Survey in the Evaluation of Obstructive Sleep Apnea in a High Risk Cardiology Outpatient Population

Abstract Introduction Obstructive sleep apnea (OSA) is the most common sleep-related breathing disorder. The estimated prevalence is approximately 15 to 30 percent in males and 10 to 15 percent in females. Patients with OSA have an increased propensity for cardiovascular diseases and obesity. Observational studies have demonstrated a consistent association between OSA and hypertension, coronary artery disease, cardiac arrhythmias, and heart failure. The purpose of this study is to evaluate if a patient survey can improve the diagnosis of OSA in a high-risk outpatient cardiac clinic. Methods In an outpatient cardiac clinic, a retrospective analysis of OSA evaluations was done before and after the use of patient surveys in a high-risk population. The high-risk patient group was defined by the presence of two or more of the following conditions: hypertension, heart failure, cardiac arrhythmias, atrial fibrillation, obesity with a BMI of 30 or more, coronary artery disease, diabetes mellitus, chronic lung disease, history of cerebrovascular accident (CVA), hypothyroidism and chronic renal insufficiency. The patient survey included questions on the presence of daytime sleepiness, presence of snoring, ESS score, choking in sleep, witness apnea, and frequent waking in sleep. Results During the four months of patient survey use, a total of 143 patients were evaluated as compared to 86 patients in the prior four months without the use of the survey. A significant increase (66.3%) of OSA evaluations was observed during the patient survey period. Conclusion The use of patient surveys showed a significant improvement in OSA diagnoses in the defined high-risk patient group. Patient surveys might be beneficial to improve the under diagnosis of sleep apnea in high-risk patient populations. Additional research needs to be done to establish the impact of such intervention on patient outcomes. Support (if any):

Cardiovascular consequences of obstructive sleep apnea in women: a historical cohort study

Objective/BackgroundEvidence on sex differences in the association between obstructive sleep apnea (OSA) and cardiovascular outcomes is limited and controversial. We conducted a historical cohort study to investigate this relationship. Patients/methodsClinical data on adults who underwent sleep study at a large urban academic hospital (Toronto, Canada) between 1994 and 2010 were linked to provincial health administrative data from 1991 to 2015. We fit Cox regressions to investigate the association between OSA severity and a cardiovascular composite outcome (all-cause mortality or hospitalization due to myocardial infarction, stroke, heart failure or atrial fibrillation), controlling for risk factors and stratifying by sex. ResultsA total of 10,149 subjects were included: median age of 49 years, 38% women. Over a median of 9.3 years, 1782 (18%) participants developed an outcome. The association between percentage of sleep time spent with oxygen saturation <90% and outcome was stronger for women (HR for IQR, 3 vs 0% = 1.30, 1.19–1.42) than for men (HR for IQR = 1.13, 1.06–1.21) (p for interaction = 0.01) in the adjusted model. Stratifying by sex, oxygen desaturations and heart rate in sleep were significant predictors in both men and women, while presence of daytime sleepiness, sleep efficiency and periodic leg movements in sleep were predictive in women but not in men. ConclusionsIn a large clinical cohort with suspected OSA, the impact of OSA as measured by the degree of nocturnal oxygen desaturation on the composite outcome was found to be greater in women than in men. We also found a different predictive ability of OSA-related factors by sex.

IMPACTO DE LA CALIDAD DEL SUEÑO Y SOMNOLENCIA DIURNA EN PACIENTES CON DIABETES MELLITUS E HIPERTENSIÓN ARTERIAL

Objetivo: Evaluar la calidad del sueño nocturno y la somnolencia diurna en pacientes con diagnóstico de diabetes mellitus e hipertensión arterial. Métodos: Se realizó un estudio transversal, prospectivo, en pacientes mayores de 18 años con diagnóstico de diabetes Mellitus e hipertensión Arterial, según la ADA 2016 y ESH/ESC, que asisten a la consulta de medicina interna del Hospital “Dr. Miguel Pérez Carreño” en el periodo comprendido de enero a julio del 2017. Resultados: Se evaluó 263, con predominio femenino con 63,1 %; con un rango de edad de 19-92 años, una media de 61 años ± 13. Se aplicó el cuestionario de Berlín para estimar el riesgo de SAOS, evidenciando 56,27 % bajo riesgo y 43,7 % alto riesgo; los pacientes con sobrepeso tenían un 27 % y los obesos un 21,7 % con alto riesgo. Se observó mala calidad de sueño en el 79,8% de los pacientes hipertensos y 95,5 % en pacientes diabéticos. La somnolencia diurna en hipertensos fue de 47,2 %, y en diabéticos el 45,4 %. Se presentó Alto riesgo de SAOS en hipertensos 47,9 %, en diabéticos 40,9 %. Se determinó que no hubo relación entre HTA y DM con mala calidad de sueño (p = 0,186), somnolencia diurna (0,627) y SAOS (p = 0,208). Conclusiones: La mala calidad de sueño estuvo presente en la mayoría de la población y la presencia de somnolencia diurna fue menor. Hubo alto riesgo de SAOS en relación con el índice de masa corporal y el hábito alcohólico.

Sleep Disturbances Are Associated with Poorer Glycemia and Increased Obesity in Youth at Risk for or with Early Type 2 Diabetes (T2D)

Poor sleep may be associated with an increased risk of obesity and T2D in youth. We explored whether subjective sleep duration, sleep quality or risk factors for obstructive sleep apnea (OSA) are associated with BMI, glycemia or blood pressure (BP) in youth. Between 2013 and 2016, 236 overweight and obese youth (10-19 years old) at risk for or with recently diagnosed T2D were screened for the Restoring Insulin Secretion (RISE) Study. Data from a 2 hour OGTT and validated Sleep Disturbances Scale and Cleveland Adolescent Sleepiness questionnaires were available for 214 youth. Regression models explored the independent association between sleep variables and outcomes of fasting glucose, 2-h glucose, HbA1c, BMI and BP. The cohort consisted of 67% females, 33% males; 26% white, 26% black, 33% hispanic; age 14.1±2.1 years and BMI 35.9±6.5 kg/m2 (mean±SD). Based on the ADA criteria, 20% had normal glucose tolerance, 60% had prediabetes and 20% had T2D. Sleep duration &amp;lt;8 h and &amp;lt;7 h was reported in 74% and 43% respectively; 51% reported daytime sleepiness; 26% reported poor sleep quality, and 30% high risk for OSA. 28% of the cohort was on metformin. After adjusting for age, sex, race/ethnicity, BMI and metformin use, the presence of daytime sleepiness was associated with 0.19% higher HbA1c (p=0.018) and higher 2-h glucose (13.3 mg/dl, p=0.05), but sleep duration, quality, and OSA risk were not associated with any of the outcomes. After adjusting for age, sex, race/ethnicity and metformin use, poor sleep quality was associated with 2.95 kg/m2 higher BMI (p=0.003), and high OSA risk with 2.81 kg/m2 higher BMI (p&amp;lt;0.003). In these overweight and obese youth with or at risk for T2D, daytime sleepiness was associated with poorer glycemia, while poor sleep quality and high OSA risk were associated with higher BMI. These findings suggest that intervention studies aimed at improving sleep in youth are required to determine potential benefits on glycemia and weight. Disclosure B. Mokhlesi: None. K.A. Temple: None. A.N. Hogan: None. S. Edelstein: None. K.J. Nadeau: None. S. Sam: None. T. Hannon: Consultant; Self; Eli Lilly and Company. K. Utzschneider: Consultant; Self; Novo Nordisk Inc.. E. Barengolts: None. S. Manchanda: None. D.A. Ehrmann: None. E. Van Cauter: Research Support; Self; AstraZeneca. R. Consortium: None.

F94. A PREVALENCE PILOT STUDY FOR OBSTRUCTIVE SLEEP APNEA SYNDROME IN CLOZAPINE USERS

BackgroundObstructive Sleep Apnea Syndrome (OSAS) is a frequent and common disorder. Estimated 50.000 persons in the Netherlands suffer from this disorder. Clozapine is known for its efficacy in treatment resistant schizophrenia. Frequent side effects of clozapine are weight gain, fatigue, sleepiness and metabolic syndrome. Similar symptoms occur in the course a OSAS. The Dutch pharmacovigilance centre LAREB (LAREB 2012) proposed an association between OSAS and clozapine usage, independent of confounding factors as obesity, smoking and glucose intolerance. Although clozapine is much used in the treatment of schizophrenia, OSAS prevalence studies in the clozapine treatment group are scarce. Research is needed to elucidate the relationship between clozapine use and OSAS. Identifying OSAS and treatment with continuous positive airway pressure (CPAP) could possibly (Galletly te al, 2016), through reduction in cardiovascular risk factors, have a favorable effect on mortality and possibly have a positive effect on daytime sleepiness, fatigue and daytime functioning.Primary goal of this study is discovering the prevalence of OSAS in clozapine using schizophrenic spectrum disorder patients. The secondary goal is discovering how willing schizophrenic spectrum disorder patient are in undergoing a polysomnography.HypothesisMany patients with schizophrenia spectrum disorder have multiple OSAS risk factors: obesity, presence of metabolic syndrome, frequent usage of benzodiazepines, male sex, older age. OSAS prevalence is estimated to be much higher than in the general population because of these risk factors. Atypical antipsychotics are an independent risk factor for the development of OSAS. Polysomnographically diagnosed OSAS will even be higher in the clozapine treatment group estimated to be present in 30% percent of the patients.MethodsResearch design: prospective observational and cross-sectional study in a group of stable adult patients with DSM IV schizophrenia spectrum disorder treated with clozapine in an outpatient community mental health service. Estimated study group consists of 30–50 patients. Exclusion criteria: unwillingness to undergo a polysomnography, inability to give informed consent, insufficient understanding of the Dutch language, severe cardiac failure, a history a cerebrovascular accidents and alcohol abuse.Methodscreening on the presence of OSAS symptoms and risk factors associated with OSAS through: Epworth Sleepiness Scale for daytime sleepiness (Johns, 1991), STOP-BANG Questionaire ((SBQ: Chung 2012) when there is a high risk for OSAS followed by an ambulatory polysomnography including heart rate/ECG, respiratory measures with nasal flow canule and thermistor flow inductive respiratory movements, oximetry, and snoaring noises through sensory measurements (AASAM, 2009). OSAS is considered to be present in the presence of daytime sleepiness and if the Apnea Hypopnea Index (AHI) is larger than 5.0 obstructive or mixed type respiratory events per hour (AASM, 2009: Berry et. al, 2015: NVALT & CBO, 2009).Statistical analysis: polysomnography: descriptive and univariate analysis. Presence of OSAS will be dichomotized (1 =OSAS present; 0 = OSAS absent) Summation of the amount of positive results will be presented as percentage of the total study population. Chi- squared test for considering of the height of the results on the ESS test and the STOP-Bang test and the prevalence of OSAS. Statistical significance: p < 0.05.Prevalence: percentage of patients in the clozapine treatment group with OSAS.ResultsNo results at the moment of poster submission. In April 2018 results will be presented.DiscussionWill be presented in April 2018.

Quality of life in obstructive sleep apnea is related to female gender and comorbid insomnia.

Obstructive sleep apnea (OSA) is a common sleep disorder affecting health-related quality of life (QoL), and OSA severity is not a reliable indicator for QoL. The aim of this study was (1) to evaluate the impact of gender on QoL and (2) to identify the predictors of QoL in OSA patients. World Health Organization Quality of Life Scale short form (WHOQOL-Bref) was used for evaluating QoL in OSA patients undergoing polysomnography in sleep laboratory of a university hospital. Out of 197 patients (age 50.4 ± 12.1years, AHI 38.5 ± 28.4/h), 139 (70.6%) were men and 79.2% had moderate-to-severe OSA. Female gender, increased BMI, higher Epworth sleepiness score (ESS), and lower oxygen saturations were associated significantly with poor QoL in terms of all domains (physical, psychological, social relationship, and environmental) of WHOQOL-Bref questionnaire. The indicators of OSA severity (AHI and ODI) correlated negatively only with the physical domain. The subjects with comorbid insomnia and OSA had lower physical and social scores than subjects with no insomnia, and women with insomnia had significantly worse QoL scores in all domains than the others. In the multivariate linear regression analysis, female gender, comorbid insomnia, increased sleepiness, and higher BMI were significantly associated with poor QoL. Female gender, comorbid insomnia, and daytime sleepiness were the outstanding factors affecting health-related QoL negatively in OSA. Besides, the impact of OSA on QoL may be explained by the presence of daytime sleepiness rather than OSA severity.

The Influence of Sleep Disorders on Voice Quality

To verify the influence of sleep quality on the voice. Descriptive and analytical cross-sectional study. Data were collected by an online or printed survey divided in three parts: (1) demographic data and vocal health aspects; (2) self-assessment of sleep and vocal quality, and the influence that sleep has on voice; and (3) sleep and voice self-assessment inventories-the Epworth Sleepiness Scale (ESS), the Pittsburgh Sleep Quality Index (PSQI), and the Voice Handicap Index reduced version (VHI-10). A total of 862 people were included (493 women, 369 men), with a mean age of 32 years old (maximum age of 79 and minimum age of 18 years old). The perception of the influence that sleep has on voice showed a difference (P < 0.050) between measures of sleep quality and vocal self-assessment. There were higher scores on the ESS, PSQI, and VHI-10 protocols if sleep and vocal self-assessment were poor. The results indicate that the greater the effect that sleep has on voice, the greater the perceived voice handicap. The aspects that influence a voice handicap are vocal self-assessment, ESS total score, and self-assessment of the influence that sleep has on voice. The absence of daytime sleepiness is a protective factor (odds ratio [OR] > 1) against perceived voice handicap; the presence of daytime sleepiness is a damaging factor (OR < 1). Sleep quality influences voice. Perceived poor sleep quality is related to perceived poor vocal quality. Individuals with a voice handicap observe a greater influence of sleep on voice than those without.

SLEEP DISORDERS IN EPILEPTIC PATIENTS

Objective. To investigate the main features of sleep disorders in patients with three main forms of epilepsy and its impact on the quality of life. Materials and methods . One hundred and fifty patients with different forms of epilepsy (including idiopathic, cryptogenic, and symptomatic) aged 17-64 years were enrolled. The following parameters were evaluated: presence of sleep disorders (estimated using special questionnaires developed by the Somnological Center of the Ministry of Health of the Russian Federation), presence of daytime sleepiness according to the Epworth scale, level of anxiety and depression according to the hospital scale (HADS), quality of life (analyzed using the QOLIE-89 questionnaire). Results. Patients in all three groups experienced daytime sleepiness, difficulty falling asleep and maintaining sleep at night, problems with final awakening. We found a reliable correlation between the daytime sleepiness at rest or during activities with the subjective sleep characteristics, difficulty falling asleep and maintaining sleep, level of anxiety, and the values from QOLIE-89 questionnaire (quality of life). Conclusion . Our findings demonstrate the obligatory nature of the circadian rhythm sleep disorders in all three groups of epileptic patients. The differences in the subjective sleep characteristics between the groups (depending on the form of epilepsy: symptomatic/cryptogenic and idiopathic) can be compared with the psychological characteristics of the patients with these forms of epilepsy.

Wake-up stroke: Clinical characteristics, sedentary lifestyle, and daytime sleepiness.

Wake-up stroke (WUS) is defined when the exact time of the beginning of the symptoms cannot be determined, for the deficits are perceived upon awakening. Sleep alterations are important risk factors for stroke and cardiovascular diseases. This study evaluates the characteristics of patients with and without WUS, the presence of daytime sleepiness, and associated risk factors. Patients with ischemic stroke were investigated about the presence of WUS. Clinical and demographic characteristics were evaluated. Stroke severity was studied by the National Institutes of Health Stroke Scale (NIHSS) and the Modified Rankin Scale (MRS), and daytime sleepiness severity was studied by the Epworth Sleepiness Scale (ESS). Seventy patients (57.1% men) aged from 32 to 80 years (58.5±13.3) were studied. WUS was observed in 24.3%. Arterial hypertension (67.1%), type 2 diabetes (27.1%), and hyperlipidemia (22.8%) were frequent. Type 2 diabetes and sedentary lifestyle were more common in patients with WUS (p<0.05). Overall, mild, moderate or very few symptoms of stroke (NIHSS<5) were predominant (62.3%). Among all cases, 20% had excessive daytime sleepiness (ESS>10). No differences were found between patients with and without WUS as regards stroke severity or excessive daytime sleepiness. Patients with excessive daytime sleepiness were younger and had more sedentary lifestyle (p<0.05). Individuals with previous history of heavy drinking had more daytime sleepiness (p=0.03). Wake-up stroke occurs in approximately 25% of stroke cases. In this study, patients with WUS had more diabetes and sedentary lifestyle. Daytime sleepiness is frequent and is associated with sedentary lifestyle and heavy drinking.

Obstructive Sleep Apnea and Quality of Life: Comparison of the SAQLI, FOSQ, and SF-36 Questionnaires.

The impact of sleep on quality of life (QoL) has been well documented; however, there is a great need for reliable QoL measures for persons with obstructive sleep apnea (OSA). We compared the QoL scores between the 36-Item Short Form of the Medical Outcomes Survey (SF-36), Calgary Sleep Apnea Quality of Life Index (SAQLI), and Functional Outcomes Sleep Questionnaire (FOSQ) in persons with OSA. A total of 884 participants from the Sleep Heart Health Study second examination, who completed the SF-36, FOSQ, and SAQLI, and in-home polysomnograms, were included. The apnea hypopnea index (AHI) at 4% desaturation was categorized as no OSA (<5 /hour), mild to moderate OSA (5-30 /hour) and severe OSA (>30 /hour). QoL scores for each questionnaire were determined and compared by OSA severity category and by gender. Participants were 47.6% male, 49.2% (n=435) had no OSA, 43.2% (n=382) had mild to moderate OSA, and 7.6% (n=67) had severe OSA. Participants with severe OSA were significantly older (mean age = 63.7 years, p <.0001), had higher BMI (mean = 34.3 kg/m2, p <.0001) and had lower SF-36 Physical Component scores (PCS) (45.1) than participants with no OSA (48.5) or those with mild to moderate OSA (46.5, p= .006). When analyzed according to gender, no significant differences were found in males for QoL by OSA severity categories. However, females with severe OSA had significantly lower mean scores for the SAQLI (5.4, p= .006), FOSQ (10.9, p= .02), and SF-36 PCS (37.7, p<.0001) compared to females with no OSA (6.0, 11.5, 44.6) and those with mild to moderate OSA (5.9, 11.4, 48, respectively). Females with severe OSA also had significantly higher mean BMI (41.8 kg/m2,) than females with no OSA (26.5 kg/m2) or females with mild to moderate OSA (30.6 kg/m2, p<.0001). The SF-36 PCS and Mental Component Scores (MCS) were correlated with the FOSQ and SAQLI (r=.37 PCS vs FOSQ; r=.31 MCS vs FOSQ; r=.42 PCS vs SAQLI; r=.52 MCS vs SAQLI; and r=.66 FOSQ vs SAQLI, p<.001 for all correlations). Linear regression analyses, adjusting for potential confounders, indicated that the impact of OSA severity on QoL is largely explained by the presence of daytime sleepiness. The impact of OSA on QoL differs between genders with a larger effect on females and is largely explained by the presence of daytime sleepiness. Correlations among QoL instruments are not high and various instruments may assess different aspects of QoL.

Health impacts of Facebook usage and mobile texting among undergraduate dental students: it's time to understand the difference between usage and an excessive use.

Facebook and mobile texting are prevalent in the lives of almost every student. However, little is known about the relationship between Facebook usage or mobile texting and their impacts on health amongst undergraduate dental students. In this study, excessive Facebook use and excessive mobile texting were studied as they relate to impacts on health. A cross-sectional study was conducted at a private university in Malaysia. A total of 188 undergraduate dental students were interviewed using a pre-tested and self-rated questionnaire. Data collected from participants were analysed using SPSS version 18.0. Chi-square test, Fisher's exact test and multiple logistic regression analyses were applied to study the relationship between explanatory variables and excessive Facebook use and excessive mobile texting. The prevalence of excessive Facebook use and excessive mobile texting amongst undergraduate dental students was found to be 33.2% and 33.0%, respectively. According to a multivariate analysis, texting habits, such as the presence of daytime sleepiness after texting late at night (aOR=2.682, 95% CI=1.142-6.301) and the presence of anxious feelings if students failed to receive a timely response (aOR=3.819, 95% CI=1.580-9.230), were determined to be significant predictors of excessive mobile texting. Excessive Facebook use was found to be significantly related to three variables as follows: fewer numbers of close friends (aOR=2.275, 95% CI=1.057-4.898), the checking of updates on the Facebook walls of their friends (aOR=2.582, 95% CI=1.189-5.605) and the absence of active and vigorous feelings during Facebook use (aOR=3.401, 95% CI=1.233-9.434). Approximately one-third of undergraduate dental students in this study experienced excessive Facebook use and/or excessive mobile texting. Health education and promotion should be instituted to create awareness, whilst students should be advised to practise self-control with respect to both mobile texting and Facebook usage.

Factores asociados a la somnolencia diurna en adultos mayores chilenos

AimTo determine the prevalence of mild and excessive somnolence and the associated factors with the presence of daytime sleepiness in the elderly. MethodsA total of 1780 independent individuals 60 years and olderof both sexes (70.9±7.9 years old; females 62%), were included, of which 1704 of them completed all the information. All of them were assessed using an Epworth sleepiness scale (ESE), an Pittsburgh sleep quality index, plus information of cigarettes smoking, dinner time, and an anthropometric evaluation. An ESE score>10 was considered drowsiness and scores>15 excessive or severe drowsiness. ResultsAmong the population under 80 years, 5.3% showed ESE score>15 and 26.2% an ESE score>10. For over 80 years, the prevalence of sleepiness was 6.3% for an ESE score>15 and 32.5% for an ESE score>10. In the adjusted model, the factors associated with increased risk of sleepiness (ESE>10) were age older than 80 years (OR=1.58; 95% CI=1.14 to 2.19) and dinner after 21hours (OR=1.3; 95% CI=1.01 to 1.68). By contrast, only age older than 80 years was independently associated with severe sleepiness (OR=1.81; 95% CI=1.01 to 3.29). ConclusionsMeals after 21hours and age above 80 years are associated with increased likelihood of daytime sleepiness. Instead, only older than 80 years is associated with severe daytime sleepiness.

Risk of obstructive sleep apnea among Saudis with chronic renal failure on hemodialysis.

AIM:The prevalence of obstructive sleep apnea (OSA) in end-stage renal disease (ESRD) patients was reported to be 10-fold that in the general population. OSA can worsen the clinical symptoms and cardiovascular complications of ESRD. We aimed to investigate the prevalence of symptoms and risk of OSA among Saudi patients with ESRD.SETTINGS AND DESIGN:This multi-center, cross-sectional study was conducted in Jeddah, Saudi Arabia, between June 2012 and September 2013.METHODS:The prevalence of OSA was assessed using the Berlin questionnaire. The presence of daytime sleepiness was evaluated using the Epworth sleepiness scale. Data were also collected on the medical history, clinical, and laboratory findings of participants.RESULTS:In all, 355 patients (61% male) were enrolled (mean age: 45.5 ± 15.4 years). The overall prevalence of high-risk of OSA was 44.2% (males, 47.3%; females, 44.8%; P = 0.65). The prevalence of excessive daytime sleepiness (EDS) was 74%. Controlling for age, gender and body mass index, multivariate analysis revealed that hypertension and hepatitis C infection were the only comorbidities significantly associated with OSA (odds ratio [OR]: 3.827 and 0.559; confidence interval [CI]: 2.120-6.906 and 0.324-0.964; P < 0.0001 and 0.036, respectively). OSA was also strongly associated with EDS (OR: 3.054; CI: 1.676-5.565; P < 0.0001).CONCLUSIONS:In Saudi Arabia, the risk of OSA is more common in ESRD patients than in the general population. OSA is strongly associated with EDS. Interestingly, a significant negative correlation between OSA and hepatitis C infection was noted, which warrants further investigation.

Excessive daytime sleepiness in patients with chronic kidney disease undergone hemodialysis

Introduction Approximately 80% of patients with chronic kidney disease complain about sleep disorders, which is a much higher percentage than in the general population. Excessive daytime sleepiness is the third most frequent complaint in these patients, and it is significantly associated with a higher risk of sleep apnea. The aim of this study was to assess the presence of daytime sleepiness in patients with end stage renal disease (ESRD) who were undergoing diurnal hemodialysis. Materials and methods The Epworth Sleepiness Scale (ESS) was applied to patients with ESRD who underwent diurnal hemodialysis in the Centro de Nefrologia da Zona Norte in Sao Paulo, Brazil. Results A total of 168 patients were included in the study. According to the ESS, 31% presented with a mild propensity to sleep, 22% with a moderate propensity, and 17% with a severe propensity. Conclusion Our study concluded that 70% of the sample of patients with ESRD who were undergoing hemodialysis presented with a propensity to sleep in inappropriate circumstances on the ESS. When excessive daytime sleepiness is associated with sleep apnea and other comorbidities, it is essential to carefully assess patients’ complaints.

CPAP Adherence during the Perioperative Period

CPAP Adherence during the Perioperative Period

Quality of Sleep and Daytime Sleepiness among University Students

Quality of Sleep and Daytime Sleepiness among University Students Background: During university life, students are exposed to a variety of stressful factors that can culminate with daytime sleepiness. The objective of the present study was to assess the quality of sleep and the presence of daytime sleepiness among university students. Method: The sample comprised 502 university students, randomly taken from the 2,619 students at Universidade Metropolitana de Santos. Data collection was performed using the Pittsburgh Sleep Quality Index (PSQI) and the Epworth sleepiness scale (ESE), with self-applied questionnaires. Results: The results showed that the students took, on average, over 20 minutes to fall asleep. There was, in general, bad quality of sleep in this population. Bad quality of sleep was significantly associated to higher degrees of daytime sleepiness. When the sixth-year medical students were assessed as a subgroup and compared with the first-year medical students, significantly worse quality of sleep and daytime sleepiness were observed among students in the last year of medical school. Conclusion: The poor sleep quality in this population suggests that universities should have specific guidance on sleep hygiene and should provide support for students presenting disturbances in this field.

Analysis of Recent Papers in Hypertension

Analysis of Recent Papers in Hypertension