Sleep Characteristics Of Patients Research Articles

The effects of greater occipital nerve blockage with lidocaine on sleep characteristics in chronic migraine patients

PurposeThe aim of our study was to determine the effects of greater occipital nerve block (GONB) with lidocaine on sleep characteristics in patients with chronic migraine. Materials and methodsTwenty female patients who underwent GONB with lidocaine were included in the study. The Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), Insomnia Severity Index (ISI), Pre-Sleep Arousal Scale (PSAS), Dysfunctional Beliefs and Attitudes about Sleep Scale (DBAS), Restless Legs Syndrome Severity Scale (RLSSS), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and headache diary results before and after the treatment of the patients were compared. ResultsWe included 20 patients (all females) in our study. The mean age was 35.80 ± 8.82 years (range 24–50). After GON blockade, the number of days with pain (p < 0.001), duration of pain (p < 0.001), and Visual Analog Scale (VAS) score (p < 0.001) were significantly lower than before. After GONB, BDI (p = 0.007), BAI (p = 0.022), ISI (p = 0.009), and PSQI (p = 0.026) scores were significantly lower than before. After GONB, sleep quality was better than before (p = 0.035). ConclusionThis study showed that GONB with lidocaine can improve sleep quality, insomnia, and symptoms of depression and anxiety while reducing migraine headache.

Perceived sleep quality and objective sleep characteristics in patients with anorexia and bulimia nervosa

Perceived sleep quality and objective sleep characteristics in patients with anorexia and bulimia nervosa

Sleep Disturbances in Patients with Alcohol Dependence with and without Tobacco Use

Background: sleep disorder is one of the important factors that may lead to an increase in the risk of relapse for people in the early phases of recovery from alcohol addiction. Despite the relevance of this problem, little is known about the sleep features in people with co-occurring alcohol and nicotine use. The aim of study was to investigate the inuence of the smoking factor on the dynamics of sleep characteristics in patients with alcohol dependence . Patients and methods: the 24-week prospective cohort study in 67 smokers (mean age 41 ± 9.2; 23.9% women) and 33 non-smokers (mean age 44 ± 8.2; 21.2% women) admitted to the addiction clinics to receive alcohol withdrawal treatment (ICD-10 code F10.2, dependence syndrome; F10.30, withdrawal syndrome). Sleep characteristics were assessed by self-report (Insomnia Severity Index, Pittsburgh Questionnaire) and by actigraphy watch. Results: a group of smokers experienced greater difculty in sleep initiation compared to non-smokers (61.2% vs 39.4%) ( p ≤ 0.05). The duration and the quality of sleep increased over time of observation in both study groups ( p &lt; 0.001). Throughout the study sleep quality was poorer in smokers compared to non-smokers (17.3 vs 15.9 scores on the Insomnia Severity Index at the rst measurement and 2.6 vs 0.5 scores at the last assessment) ( p &lt; 0.001). The multivariate regression analysis revealed that the smoking was signicantly associated with poor sleep quality (F = 5.348, p = 0.021). Conclusion: smoking can predict poorer sleep quality during early remission in patients with alcohol dependence.

Sleep characteristics in patients with substance use disorder after detoxification treatment: self-report and actigraphy data

IntroductionSleep problems are common in patients with substance use disorders (SUD) and have been related to poor treatment outcomes. Little is known about the sleep characteristics in patients with opioid and alcohol use disorders after detoxification program.ObjectivesTo compare sleep quantitative and qualitative characteristics between patients with opioid and alcohol use disorders.MethodsThis is a secondary data analysis of the longitudinal data from the observational study in St. Petersburg, Russia. The sample included 75 patients (22.7% female) who received detoxification treatment for alcohol (n=49) or opioid (n=26) withdrawal. Participants completed the Pittsburgh Sleep Quality Index (PSQI) and underwent daily wrist actigrahy.Results Good internal consistency was demonstrated for self-report and actigraphy data (r =-0,405, p&lt;0,01). Sleep duration and sleep onset latency were not different between alcohol and opioid groups (5.7 vs. 6.1 hours; 74 vs. 65 minutes, respectively) based on self-report data. The majority of the patients (57-100%) had sleep complaints and low quality of sleep after detoxification completion (at baseline). In both groups, the mean PSQI score had a tendency to decrease, representing better sleep quality, over the 1-week following detoxification program completion (from 12 at baseline to 10 at 1-week in alcohol group; from 13 to 12 in opioid group, p&lt;0,001).ConclusionsThe findings show that sleep characteristics are similar in patients with different SUD and insomnia symptoms are prevalent after detoxification, suggesting the rationale for sleep assessment before hospital discharge. Despite the positive changes in sleep quality over 1-week abstinence, patients might benefit from the therapeutic sleep interventions.DisclosureThis work was financially supported by a research grant from Russian Foundation for Basic Research, 18-013-00481.

Sleep characteristics in patients with tramadol dependence

Introduction: Despite the fact that tramadol is commonly assumed as a therapeutic medication, it has the potential to create addiction, especially when taken for extended durations and in high dosages. In Egypt, tramadol misuse has recently get to be a severe health issue. Tramadol and other opioids, have a clinically known influence on sleep. However, just a few studies have evaluated the influence of tramadol addiction on sleep. Objectives: 1). Tcomparing the sleep architecture of Tramadol-dependent patients to that of normal controls; 2).To find out what variables are connected with Tramadol misuse and alterations in sleep architecture. Methodology: The research was a case-control, comparison study that was conducted on a convenient sample of male Egyptian Tramadol addicts. The study includes 40 patients who met the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) criteria for tramadol addiction and were recruited from the inpatient addiction department at Cairo University's Psychiatry and Addiction Medicine Hospital, that were evaluated by comparing to a control group of 20 matched controls. The Addiction Severity Index (ASI), the Sleep Disorder Questionnaire (SDQ), and an overnight attended polysomnographic study (PSG) were administered to the participants.

The quality and quantity of sleep on dexmedetomidine during high-flow nasal cannula oxygen therapy in critically ill patients.

Purpose : High-flow nasal cannula oxygen therapy (HFNC) is a new type of non-invasive respiratory support for acute respiratory failure patients. However, patients receiving HFNC often develop sleep disturbances. We therefore examined whether dexmedetomidine could preserve the sleep characteristics in patients who underwent HFNC. Patients and Methods : This was a pilot, randomized controlled study. We assigned critically ill patients treated with HFNC to receive dexmedetomidine (0.2 to 0.7 µg / kg / h, DEX group) or not (non-DEX group) at night (9:00 p.m. to 6:00 a.m.). Polysomnograms were monitored during the study period. The primary outcomes were total sleep time (TST), sleep efficiency and duration of stage 2 non-rapid eye movement (stage N2) sleep. Results : Of the 28 patients who underwent randomization, 24 were included in the final analysis (12 patients per group). Dexmedetomidine increased the TST (369 min vs. 119 min, p = 0.024) and sleep efficiency (68% vs. 22%, P = 0.024). The duration of stage N2 was increased in the DEX group compared with the non-DEX group, but this finding did not reach statistical significance. The incidences of respiratory depression and hemodynamic instability were similar between the two groups. Conclusions : In critically ill patients who underwent HFNC, dexmedetomidine may optimize the sleep quantity without any adverse events. J. Med. Invest. 69 : 266-272, August, 2022.

Analysis of the characteristics of sleep in patients with patent foramen ovale complicated with obstructive sleep apnea.

Analyzing sleep quality and sleep structure in patients with patent foramen ovale (PFO) complicated with obstructive sleep apnea (OSA) and the interaction between OSA and PFO in sleep. We compared patients with PFO complicated with OSA, patients with simple PFO, and controls. Pittsburgh Sleep Quality Index was used to compare sleep quality and polysomnography was used to compare sleep structure of the three groups. Compared with the control group(n = 62), PFO with OSA (n = 48) and simple PFO (n = 61) groups had more frequent occurrence of poor sleep quality (χ2 = 89.901; p < 0.001). These two groups also showed decreased sleep efficiency (p < 0.010),lower percentages of REM sleep, and reducedN3 sleep (p < 0.050). The N2 sleep was prolonged (p < 0.010). The nocturnal lowest SpO2 was lower and the oxygen desaturation index was higher (p < 0.50). Compared with the simple PFO group, the poor sleep quality was more frequent in the PFO with OSA group; sleep latency (p < 0.001) was prolonged; wake after sleep onset (p < 0.001) and arousal times (p = 0.031) were increased; and sleep micro-arousal index (p = 0.037), periodic leg movement index (p = 0.024), and apnea hypopnea index (p < 0.001) were higher in the PFO with OSA group. Patients withPFO and OSA have poor sleep quality with changes in sleep stage and high occurrence rate of sleep disorders. OSA further deteriorates sleep quality and alters sleep structure in patients with PFO.

Comparisons Of Demographical And Sleep Architecture Between OSA Patients With Various Severities And Developing A Simple Prediction Model

Due to changes in dietary habits and demographic structure, obstructive sleep apnea with obesity and aging as risk factors has become an important public health issue. The aim of this study is to investigate the relationships between demographics features as well as sleep characteristics of patients and severity of OSA and using easily available measurements to develop a simple model for rapidly identify OSA patients.

Sleep Disturbances Are Commonly Reported Among Patients Presenting to a Gastroenterology Clinic.

Poor sleep quality is common among patients with gastrointestinal (GI) disorders. However, few studies have assessed the presence of insomnia or reported circadian preferences and none have directly compared sleep between common GI conditions. To compare clinical sleep characteristics in patients presenting to a tertiary care GI clinic for irritable bowel syndrome (IBS), functional dyspepsia (FD), inflammatory bowel disease (IBD), gastroesophageal reflux disease (GERD), and celiac disease (CD). Validated sleep measures were administered to consecutive patients if they were diagnosed with IBS, IBD in clinical remission, CD, FD, or GERD. Healthy Controls (HCs) with no reported GI diagnoses or symptoms were also recruited. A total of 212 eligible respondents completed this survey, 161 GI clinic patients (IBS (n = 48), GERD (n = 29), IBD in clinical remission (n = 44), CD (n = 40)), and 41 HCs. Only, 10 respondents had a diagnosis of FD, and these were excluded. The IBS group had the highest frequency of poor sleep (72%) followed by CD (61%), GERD (60%), IBD (54%), and HC (39%). IBS patients also had the highest frequency of clinical insomnia (51%), followed by GERD (37%), CD (35%), IBD (27%), and HC (18%). 40% of IBS patients reported taking sleep medications at least once per week, compared to 32% of GERD, 23% IBD, 13% CD, and 15% HC. Patients presenting to a tertiary care GI clinic report poorer sleep than healthy controls. In general, patients with IBS report the highest rates of sleep difficulties compared to patients with other diagnoses.

AB053. Sleep characteristics of patients weaning from invasive mechanical ventilation

Background Quality of sleep in mechanically ventilated patients is influenced by several factors, such as patients’ overall condition, medication, environmental conditions and ventilation mode. Aim of the study was to evaluate patients’ sleep characteristics during weaning from mechanical ventilation (MV) in 2 consecutive nights: with the patient under MV followed by a sleep study with spontaneous respiration (SR).

Loss of REM sleep features across nighttime in REM sleep behavior disorder

ObjectivesMelatonin is a chronobiotic treatment which also alleviates rapid eye movement (REM) sleep behavior disorder (RBD). Because the mechanisms of this benefit are unclear, we evaluated the clock-dependent REM sleep characteristics in patients with RBD, whether idiopathic (iRBD) or associated with Parkinson's Disease (PD), and we compared findings with PD patients without RBD and with healthy subjects. MethodsAn overnight videopolysomnography was performed in ten iRBD patients, ten PD patients with RBD (PD + RBD+), ten PD patients without RBD (PD + RBD−), and ten controls. The rapid eye movement frequency per minute (REMs index), the tonic and phasic electromyographic (EMG) activity of the levator menti muscle, and the duration of each REM sleep episode were evaluated. A generalized linear model was applied in each group, with the REM sleep cycle (four ordinal levels) as the dependent variable, as a function of REMs index, REM sleep duration, and tonic and phasic EMG activity. ResultsFrom the first to the fourth sleep cycle, REM sleep duration progressively increased in controls only, REMs index increased in subjects without RBD but not in patients with RBD, whether idiopathic or associated with PD, whereas tonic and phasic EMG activity did not change. ConclusionsPatients with PD or iRBD lost the physiologic nocturnal increase in REM sleep duration, and patients with RBD (either with or without PD) lost the increase of REMs frequency across the night, suggesting an alteration in the circadian system in RBD. This supports the hypothesis of a direct effect of melatonin on RBD symptoms by its chronobiotic activity.

Correlation of melatonin and TNF-α levels with characteristics of sleep in patients with rheumatoid arthritis

Specific immune and neuroendocrine factors are considered in the pathogenic mechanisms of sleep disorders in RA. The aim was to investigate the nature of the correlation between sleep disorders and levels of serum melatonin and TNF-α in RA patients. Methods and results. 105 patients and 30 healthy control subjects were examined in the study. Investigation of sleep disorders was conducted by semi-structured clinical interview using the Insomnia severity index (ISI) and with the visual analogue scale (VAS) of sleep disorders. It was found significant differences in the metabolism of melatonin and TNF-α in healthy and RA patients with different variants of insomnia (p <0.01). Differences between the levels of TNF-α and all variants of insomnia (p <0.05) were identified. Conclusion. The lack of a direct relations between melatonin and insomnia in patients with RA indicates complex multifactorial nature of sleep disorders in this pathology.

Clinical factors associated with extreme sleep apnoea [AHI>100 events per hour] in Peruvian patients: A case-control study–A preliminary report

PurposeThe severity of obstructive sleep apnoea (OSA) ranges from mild or moderate to severe sleep apnoea. However, there is no information available on the clinical characteristics associated with cases involving more than 100 events per hour. This is a preliminary report and our goal was to characterise the demographics and sleep characteristics of patients with Extreme OSA and compare with patients with sleep apnoea of lesser severity. We hypothesised that patients with Extreme OSA (AHI>100) is associated with an increased comorbidities and/or risk factors. MethodsWe carried out a case-control study on male patients with OSA who were seen in a private hospital in Lima, Peru between 2006 and 2012. Cases were identified if their apnoea/hypopnea index (AHI) was higher than 100 (Extreme OSA), and four controls were selected per case: two with 15–29 AHI and two with 30–50 AHI, matched according to case diagnosis dates. We evaluated demographic, past medical history, and oxygen saturation variables ResultsWe identified 19 cases that were matched with 54 controls. In the multivariate model, only arterial hypertension, neck circumference, age, and over 10% in SatO2Hb≤90% in total sleep time (T90) were associated with Extreme OSA. Arterial hypertension had an OR=6.31 (CI95%: 1.71–23.23) of Extreme OSA. Each 5-cm increment in neck circumference was associated with an increase of OR=4.34 (CI95%: 1.32–14.33), while T90>10% had an OR=19.68 (CI95%: 4.33–89.49). Age had a marginal relevance (OR=0.95; CI95%: 0.92–0.99) ConclusionOur results suggest that arterial hypertension, neck circumference, and over 10% SatO2Hb≤90% in total sleep time were associated with a higher probability of Extreme OSA. We recommend investigators to study this population of Extreme OSA looking for an early diagnosis and the identification of prognostic factors in comparison with moderate to severe levels.

Sleep characteristics in Goldenhar Syndrome

ObjectiveTo examine the characteristics of sleep in patients with Goldenhar Syndrome. DesignRetrospective review of all polysomnography studies conducted at the University of North Carolina Hospitals between 2003 and 2013 on patients carrying the diagnosis of Goldenhar's Syndrome. ResultsA preponderance of patients demonstrated severe obstructive sleep apnea and hypercapnia. ConclusionsPatients with Goldenhar Syndrome should be screened for sleep apnea and hypercapnia.

Depressive feelings in children with narcolepsy

ObjectivesWe aimed to evaluate depressive feelings and their correlations in children and adolescents with narcolepsy collected in national reference centers for narcolepsy. MethodsWe compared clinical and sleep characteristics of patients with and without depressive symptoms evaluated on the Children’s Depression Inventory (CDI). ResultsOur study sample included 88 children (44 boys; 44 de novo patients) with a mean age of 11.9±3.1years at diagnosis (37.5% were aged ⩽10years). Obesity was found in 59% of the sample and cataplexy was present in 80.7%. The DQB1*0602 allele was positive in 93.5% of our sample. There were 25% of children who had clinically depressive feelings (CDI>16), especially girls older than the age of 10years. Bivariate associations indicated that depressive feelings were associated with fatigue (48%), hyperactivity (31%), insomnia (16%), and excessive daytime sleepiness (EDS) (14–24%). In the multivariate model adjusted for gender and age, only fatigue explained the variability of the depression score. ConclusionIn our large cohort, high levels of depressive symptoms essentially expressed by fatigue affected 25% of children with narcolepsy. The girls older than 10years of age were especially vulnerable. The similar prevalence of depressive feelings in treated vs never-treated patients suggests a specific need for diagnosing and managing this symptom in young patients with narcolepsy.

A New Category: Very Severe Obstructive Sleep Apnea Has Worse Outcomes on Morbidity and Mortality

PURPOSE: Obstructive sleep apnea severity is a known to cause increased mortality. However there is only one other known study to demonstrate that very severe sleep apnea (AHI > 60) has a worse outcome. Our goal is to characterize the demographics and sleep characteristics of patients with very severe OSA, and to determine whether this additional class of OSA severity predicts worse outcomes.METHODS: Retrospective analysis with patients > 18 years who underwent diagnostic polysomnography between January and December 2010. Data were collected using the clinical sleep database at our facility and electronic medical record queries for number of demographics, insurance status, hospitalizations, and mortality up until October 2011. Categories of OSA severity were defined by AHI 5-= 60 (OSA, very severe OSA (VSOSA)). Primary outcome was mortality. Secondary outcomes were hospitalization and number of hospitalizations. Data were analyzed by Student's t-tests and Pearson's chi-squared tests, as appropriate.RESULTS: 1464 patients were included, of which 1305 had OSA at baseline, 14 patients died and 725 patients were hospitalized during the study period. As compared to patients with lower severity OSA, patients with VSOSA were more likely to be older (53 vs. 49, p=0.01), male (61% vs. 36%, p= 60 have an even greater risk of mortality than other patients with OSA. This being said, we may need to re-evaluate the way sleep apnea severity is categorized to include a Very Severe OSA group.CLINICAL IMPLICATIONS: Patients with higher AHI >= 60 have increased mortality that is statistically significant. These patients need to be identified and have more aggressive interventions and earlier institution of therapy.DISCLOSURE: The following authors have nothing to disclose: Dennis Jurcevic, Ziad Shaman, Vidya KrishnanNo Product/Research Disclosure InformationMetroHealth Medical Center, Cleveland, OH. Language: en

The characteristics of sleep in patients with manifest bipolar disorder, subjects at high risk of developing the disease and healthy controls

Sleep is highly altered during affective episodes in patients with bipolar disorder. There is accumulating evidence that sleep is also altered in euthymic states. A deficit in sleep regulation may be a vulnerability factor with aetiological relevance in the development of the disease. This study aims to explore the objective, subjective and lifetime sleep characteristics of patients with manifest bipolar disorder and persons with an elevated risk of developing the disease. Twenty-two patients with bipolar I and II disorder, nine persons with an elevated risk of developing the disorder and 28 healthy controls were evaluated with a structured interview to characterize subjective and lifetime sleeping habits. In addition, participants wore an actimeter for six nights. Patients with bipolar disorder had longer sleep latency and duration compared with healthy controls as determined by actigraphy. The subjective and lifetime sleep characteristics of bipolar patients differed significantly from healthy controls. The results of participants with an elevated risk of developing the disorder had subjective and lifetime characteristics that were largely analogous to those of patients with manifest bipolar disorder. In particular, both groups described recurring insomnia and hypersomnia, sensitivity to shifts in circadian rhythm, difficulties awakening and prolonged sleep latency. This study provides further evidence that sleep and circadian timing are profoundly altered in patients with bipolar disorder. It may also tentatively suggest that sleep may be altered prior to the first manic episode in subjects at high risk.

Sleep duration is associated with dyslipidemia in patients with bipolar disorder in clinical remission

The pathways to increased cardiovascular risk in bipolar disorder include health behaviors, psychosocial stress and long-term medication exposure. However, the evidence that the association between cardiovascular risk factors and bipolar disorder remains significant after controlling for these co-factors suggests that additional important risk factors have yet to be identified. Our hypothesis is that disturbances in the sleep-wake cycle are an important and under-recognized pathway through which affective disorders lead to increased cardiovascular risk. In patients with bipolar disorder type 1 in clinical remission, we: 1) explored whether sleep disturbance predicted the endorsement of NCEP ATP-III criteria for dyslipidemia, independent of other lifestyle factors and 2) tested the association between low HDL (NCEP-ATP III) and sleep duration measured with actigraphy over an eight-day period. Median sleep duration is significantly associated with low HDL. The risk of having low HDL increases by 1.23 with every 30 minutes of reduced sleep time. Since sleep patterns in patients with bipolar disorder are variable and irregular, it is possible that other sleep characteristics, not present during the span of our study, or the variability itself may be what drives the increased cardiovascular risk. Sleep characteristics of patients with bipolar disorder in clinical remission are associated with cardiovascular risk. More specifically, sleep duration was associated with low HDL. Clinicians should pay special attention to sleep hygiene in treating individuals with bipolar disorder, even when they are in clinical remission.

Melatonin dysregulation, sleep disturbances and fatigue in multiple sclerosis

BackgroundSleep disruption and fatigue are common in Multiple Sclerosis (MS). Melatonin is one of the major regulators of sleep–wake cycle. The role of melatonin in MS-related sleep disturbances and fatigue as well as the interaction between melatonin and Interferon beta (IFN-β) treatment were the subject of this study. ObjectiveTo assess the influence of IFN-β treatment on melatonin secretion, fatigue and sleep characteristics in patients with MS. Methods13 MS patients and 12 healthy controls participated. Fatigue was evaluated using the Fatigue Impact Scale (FIS), sleep was assessed by actigraphy and day/night levels of 6-sulphatoxy-melatonin (6-SMT) in urine were determined using a highly specific ELISA assay. ResultsNaïve MS patients demonstrated significantly decreased levels of 6-SMT and disrupted circadian regulation of its secretion, which were increased with IFN-β treatment, in association with improved fatigue. Sleep Efficiency was significantly lower in the MS group compared to controls. ConclusionOur findings suggest dysregulation of Melatonin secretion in MS, which may be influenced by IFN-β treatment. The results call for further characterization of the role of neuro-hormones such as melatonin in MS, and their cross-regulation with immune-mediators.

P.7.a.004 Assessment of sleep characteristics of patients with attention deficit hyperactivity disorder by actigraphy

P.7.a.004 Assessment of sleep characteristics of patients with attention deficit hyperactivity disorder by actigraphy