Symptoms Of Daytime Sleepiness Research Articles

Orofacial dysfunction screening examinations in children with sleep-disordered breathing symptoms.

Orofacial myofunctional disorders (OMD) and sleep-disordered breathing (SDB) may present as comorbidities. Orofacial characteristics might serve as a clinical marker of SDB, allowing early identification and management of OMD and improving treatment outcomes for sleep disorders. The study aims to characterize OMD in children with SDB symptoms and to investigate possible relationships between the presence of various components of OMD and symptoms of SDB. A cross-sectional study of healthy children aged 6-8 from primary schools was conducted in central Vietnam in 2019. SDB symptoms were collected using the parental Pediatric Sleep Questionnaire, Snoring Severity Scale, Epworth Daytime Sleepiness Scale, and lip-taping nasal breathing assessment. Orofacial myofunctional evaluation included assessment of tongue mobility, as well as of lip and tongue strength using the Iowa Oral Performance Instrument, and of orofacial characteristics by the protocol of Orofacial Myofunctional Evaluation with Scores. Statistical analysis was used to investigate the relationship between OMD components and SDB symptoms. 487 healthy children were evaluated, of whom 46.2% were female. There were 7.6% of children at high risk of SDB. Children with habitual snoring (10.3%) had an increased incidence of restricted tongue mobility and decreased lip and tongue strength. Abnormal breathing patterns (22.4%) demonstrated lower posterior tongue mobility and lower muscle strength. Daytime sleepiness symptoms were associated with changes in muscle strength, facial appearance, and impaired orofacial function. Lower strengths of lip and tongue or improper nasal breathing were more likely to be present in children with reported sleep apnea (6.6%). Neurobehavioral symptoms of inattention and hyperactivity were linked to anomalous appearance/posture, increases in tongue mobility and oral strength. This study demonstrates a prevalence of orofacial myofunctional anomalies in children exhibiting SDB symptoms. Children with prominent SDB symptoms should be considered as candidates for further orofacial myofunctional assessment.

A randomized controlled trial with a combination of low frequency electroacupuncture and cognitive behavioral therapy for short-term insomnia

ObjectiveTo explore the therapeutic effects of low frequency electroacupuncture (EA) combined with cognitive behavioral therapy (CBT) for short-term insomnia. MethodsPatients with “short-term insomnia” were randomly divided into the treatment and control groups. Patients in the treatment group were treated with low-frequency EA combined with CBT, while those in the control group were only treated with low-frequency EA. The Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), Epworth Sleepiness Scale (ESS), and Dysfunctional Beliefs and Attitudes about Sleep Scale (DBAS) scores in the two groups were compared before and after treatment within the same group, as well as between the two groups. After four weeks of treatment, the comprehensive therapeutic effects of both treatment modalities and the number of people who developed chronic insomnia were compared. ResultsThe differences in PSQI score, PSQI sleep rate, ISI score, and DBAS score band after treatment, within the same group and between groups were statistically significant. There was significant difference in DBAS score between the two groups before and after treatment, and in the composition ratio of comprehensive therapeutic effects between the two groups. ConclusionLow-frequency EA combined with CBT and low-frequency EA alone can significantly improve sleep cycles in patients with insomnia, reduce the sleep severity index, prevent daytime sleepiness symptoms in patients, and improve cognition in patients. Low-frequency EA combined with CBT had better therapeutic effects and improved cognition in patients, and hence can be recommended.

Hair cortisol concentration associates with insomnia and stress symptoms in breast cancer survivors

Stress, depressive symptoms and sleep quality are important and modifiable determinant of health and their association with hair cortisol concentrations (HCC) in breast cancer survivors has not been evaluated. We selected a random sample of 65 participants (mean age 57.9 years old, range 44–75 years) recruited from local patients' associations of breast cancer survivors. Each provided a hair sample at enrollment and basic clinical data and psychological evaluation regarding self-perceived stress (PSS-scale), depressive (GDS scale) and insomnia symptoms (Athens scale). We observed a direct and significant (p = 0.001) association between HCC and stress-levels. Depressive symptoms associated significantly (p < 0.01) with stress levels but not with HCC. There were also a significant and direct correlation between hair cortisol concentration and totals core of insomnia symptoms (p = 0.002), and the subdimension of sleep difficulty symptoms (p = 0.002), and with daytime sleepiness symptoms (p = 0.016). Further investigations into the association between stress and insomnia and changes in HCC in breast cancer survivors are warranted in order to validate this biomarker for diagnosis of psychological alterations and to tailor the effects of interventions aimed to reduced stress and improve sleep quality in these women.

Characterization of sleep in emerging adults with cystic fibrosis on elexacaftor/tezacaftor/ivacaftor

Characterization of sleep in emerging adults with cystic fibrosis on elexacaftor/tezacaftor/ivacaftor

Whole-food plant-based diet reduces daytime sleepiness in patients with OSA

Consumption of a diet high in saturated fat has been associated with daytime sleepiness. A whole-food plant-based (WFPB) dietary pattern, which is low in saturated fat, has been shown to be beneficial in a variety of health conditions. We assessed the effect of a short-term (21 days) WFPB diet intervention on daytime sleepiness in 14 patients with obstructive sleep apnea (OSA). We found a mean decrease of 3.8 points (SD = 3.3, p = 0.003) on the Epworth Sleepiness Scale (ESS) after switching from a standard Western diet to a WFPB diet. Our results suggest that a WFPB diet could be a viable dietary intervention to reduce symptom of daytime sleepiness.

Orofacial dysfunction screening examinations in children with sleep-disordered breathing symptoms

Orofacial myofunctional disorders (OMD) and sleep-disordered breathing (SDB) may present as comorbidities. Orofacial characteristics might serve as a clinical marker of SDB, allowing early identification and management of OMD and improving treatment outcomes for sleep disorders. The study aims to characterize OMD in children with SDB symptoms and to investigate possible relationships between the presence of various components of OMD and symptoms of SDB. A cross-sectional study of healthy children aged 6–8 from primary schools was conducted in central Vietnam in 2019. SDB symptoms were collected using the parental Pediatric Sleep Questionnaire, Snoring Severity Scale, Epworth Daytime Sleepiness Scale, and lip-taping nasal breathing assessment. Orofacial myofunctional evaluation included assessment of tongue mobility, as well as of lip and tongue strength using the Iowa Oral Performance Instrument, and of orofacial characteristics by the protocol of Orofacial Myofunctional Evaluation with Scores. Statistical analysis was used to investigate the relationship between OMD components and SDB symptoms. 487 healthy children were evaluated, of whom 46.2% were female. There were 7.6% of children at high risk of SDB. Children with habitual snoring (10.3%) had an increased incidence of restricted tongue mobility and decreased lip and tongue strength. Abnormal breathing patterns (22.4%) demonstrated lower posterior tongue mobility and lower muscle strength. Daytime sleepiness symptoms were associated with changes in muscle strength, facial appearance, and impaired orofacial function. Lower strengths of lip and tongue or improper nasal breathing were more likely to be present in children with reported sleep apnea (6.6%). Neurobehavioral symptoms of inattention and hyperactivity were linked to anomalous appearance/posture, increases in tongue mobility and oral strength. This study demonstrates a prevalence of orofacial myofunctional anomalies in children exhibiting SDB symptoms. Children with prominent SDB symptoms should be considered as candidates for further orofacial myofunctional assessment.

Low levels of awareness of obstructive sleep apnoea amongst the Australian general public

Abstract Introduction: Despite the serious health implications associated with obstructive sleep apnoea, the condition remains under-diagnosed. This study aims to evaluate the awareness of the condition amongst the Australian community. Methods: A total of 2016 respondents recruited from a web-based panel completed an online questionnaire which assessed awareness and experience of obstructive sleep apnoea and sleep-disordered breathing. The association between the level of awareness and various socio-demographic variables was analysed using uni- and multivariate analyses. Results: The results of the questionnaire indicated that 50% and 70% of participants were unaware of adult and paediatric obstructive sleep apnoea. Socio-demographic variables including age, annual household income and education level significantly influenced a participant’s level of awareness. Approximately 8.3% of the participants had previously been diagnosed with obstructive sleep apnoea. However, 65% of participants exhibiting symptoms of daytime sleepiness had not sought health care. Paediatric sleep apnoea had been previously diagnosed in 7.1% of children residing in participant’s households but 49% of children with regular snoring had not been medically evaluated. Conclusion: A deficiency exists in the awareness of sleep apnoea amongst the Australian general public. This is reflected in the discrepancy between the number of participants exhibiting potential symptoms and those who sought medical advice.

TESTING A DYADIC SLEEP INTERVENTION FOR PERSONS LIVING WITH COGNITIVE IMPAIRMENT AND THEIR CARE PARTNERS

Abstract Sleep disturbance is prevalent among persons living with cognitive impairment (PLWCI) and their care partners, suggesting that dyadic sleep disturbance is an interdependent phenomenon. There is also interdependence in the dyadic sleep disturbance. Despite the pervasiveness of shared sleep disturbance among these dyads and its negative impact on dyadic health outcomes, there are remarkably few interventions for sleep disturbance in which both members of the dyad participate. This study examines sleep outcomes of PLWCI-care partner dyads with insomnia symptoms. Dyads were simultaneously participating in a cognitive behavioral therapy for insomnia intervention. The Epworth Sleepiness Scale and the Insomnia Severity Index assessed daytime sleepiness and insomnia, respectively, at baseline and immediately post-intervention. We compared pre- and post-intervention ESS and ISI scores. For the 14 participants (n=7 dyads), care partners were spouses, on average 71.6 years, female (100%) and highly educated (18.85 years). The PLWCI were on average 73.85 years with 18.28 years of education. Daytime sleepiness improved for four and worsened for two care partners. It improved for three and worsened for three PLwCI. Insomnia improved for five care partners and four PLwCI. Two dyads experienced congruent improvement of daytime sleepiness. Four dyads reported congruent improvement of insomnia symptoms. A behavioral sleep intervention simultaneously engaging both the PLWCI and the care partners resulted in a reduction in insomnia and daytime sleepiness symptoms for most of the participants. This study provides preliminary evidence that PLwCI-care partner dyads with sleep disturbance can work together to improve their sleep outcomes.

Investigation of the Effectiveness of Traditional Breathing Therapy on Pulmonary Function in College Students with Obstructive Sleep Apnea.

Background Obstructive sleep apnea (OSA) is a problem that involves many body systems, but its impact on the respiratory system deserves special attention. While there are many studies investigating the use of continuous positive airway pressure (CPAP) to treat lung function in patients with sleep apnea, the lack of studies in the literature on the effects of traditional breathing therapy on lung function in patients with OSA prompted us to conduct such a study. Objective The present randomized trial aims to assess the effect of traditional breathing therapy on daytime sleepiness and pulmonary function in college students with OSA. Methods Forty college students (male) with OSA were randomly divided into two groups: the control group (CG) and the traditional breathing therapy group (TG). Daytime sleepiness symptoms in OSA are measured primarily by the Epworth Sleepiness Scale (ESS). Pulmonary function measurements included FVC, FEV1, PEE, and MEF50%. The changes in morning blood pressure (BP), including diastolic BP and systolic BP, were also recorded. Data were recorded before and after the experiment. Results A decrease in ESS at 12 weeks after intervention had statistical significance compared with values recorded before intervention (P < 0.05). A decrease in systolic and diastolic BP at 12 weeks after intervention had statistical significance compared with values recorded before intervention (P < 0.05). Comparisons made in terms of pulmonary functions demonstrated a statistically significant increase in 12-week postintervention values of FVC, FEV1, PEF, and MEF50% (P < 0.05). Conclusion Our study shows the positive effects of traditional breathing therapy on pulmonary function parameters. This suggests that traditional breathing therapy treatment in OSA patients is as effective as CPAP on pulmonary function, while there is an improvement in daytime sleepiness and a modest decline in the mean daytime systolic and diastolic BP.

0104 Acoustic enhancement of slow-wave sleep in healthy adolescents

Abstract Introduction Adolescents have a stable sleep-need of between 9-10 hours a night, yet a pattern of markedly restricted sleep duration, particularly on school nights, has given rise to an epidemic of sleep deprivation in this population. As demonstrated by large numbers of studies, insufficient, irregular, and/or poor-quality sleep is a risk factor for both mental health problems and learning difficulties. Enhancing slow-wave sleep through non-pharmacological means may be a mechanism for alleviating daytime functional deficits in youth. In this study, we tested the feasibility of enhancing slow-wave sleep in healthy adolescents using a closed-loop, sleep-wearable device (SmartSleep, Phillips-Respironics) which monitors the EEG signal to automatically detect sleep stages, slow-waves, and micro-arousals to deliver acoustic stimulation to enhance SWA. Methods Seventeen healthy adolescents (15.5±1.8 years; 11 female) who endorsed sleep restriction and symptoms of daytime sleepiness participated in a randomized, cross-over study. Participation included wearing SmartSleep for two consecutive 4-night periods at home—one period with acoustic stimulation (STIM) and one without (SHAM). During STIM, SmartSleep monitors the EEG in real-time and delivers acoustic tones (50 ms, 1 second interval between) through embedded headphones at an intensity dynamically modulated by sleep depth. Stimulation is stopped when an arousal or sleep stage-shift is detected. During SHAM recording, the same stimulation protocol is applied with tones played at zero volume. Results No differences were observed in any measure of sleep architecture. A mixed effects linear regression model was used to analyze the impact of condition (STIM vs SHAM) on both cumulative and average SWA during N2N3 and N3 sleep. At the group level, cumulative SWA during N2N3 and average SWA during N3 were significantly increased in STIM relative to SHAM (p=0.01; p=0.02, respectively), while age (p=0.67) and sex (p=0.71) had no effect. Despite the significant group effects, not all youth were responders; an average increase in cumulative SWA (11.5 ± 7.1%) in the STIM condition was observed in 12/17 participants. Conclusion Consecutive nights of acoustic stimulation enhanced SWA in otherwise healthy, sleep-restricted adolescents. These data suggest that acoustic stimulation during sleep may be a viable method for optimizing slow-wave activity and minimizing the emotional and cognitive consequences of sleep restriction during this sensitive developmental period. Support (If Any)

Associations of sleep and circadian phenotypes with COVID-19 susceptibility and hospitalization: an observational cohort study based on the UK Biobank and a two-sample Mendelian randomization study.

Study ObjectivesSleep and circadian phenotypes are associated with several diseases. The present study aimed to investigate whether sleep and circadian phenotypes were causally linked with coronavirus disease 2019 (COVID-19)-related outcomes.MethodsHabitual sleep duration, insomnia, excessive daytime sleepiness, daytime napping, and chronotype were selected as exposures. Key outcomes included positivity and hospitalization for COVID-19. In the observation cohort study, multivariable risk ratios (RRs) and their 95% confidence intervals (CIs) were calculated. Two-sample Mendelian randomization (MR) analyses were conducted to estimate the causal effects of the significant findings in the observation analyses. Beta values and the corresponding 95% CIs were calculated and compared using the inverse variance weighting, weighted median, and MR-Egger methods.ResultsIn the UK Biobank cohort study, both often excessive daytime sleepiness and sometimes daytime napping were associated with hospitalized COVID-19 (excessive daytime sleepiness [often vs. never]: RR=1.24, 95% CI=1.02-1.5; daytime napping [sometimes vs. never]: RR=1.12, 95% CI=1.02-1.22). In addition, sometimes daytime napping was also associated with an increased risk of COVID-19 susceptibility (sometimes vs. never: RR= 1.04, 95% CI=1.01-1.28). In the MR analyses, excessive daytime sleepiness was found to increase the risk of hospitalized COVID-19 (MR IVW method: OR = 4.53, 95% CI = 1.04-19.82), whereas little evidence supported a causal link between daytime napping and COVID-19 outcomes.ConclusionsObservational and genetic evidence supports a potential causal link between excessive daytime sleepiness and an increased risk of COVID-19 hospitalization, suggesting that interventions targeting excessive daytime sleepiness symptoms might decrease severe COVID-19 rate.

Screening for Adult Attention-Deficit Hyperactivity Disorder in the Korean Community Sample: Prevalence and Association with Mood and Sleep Symptoms.

Attention-deficit hyperactivity disorder (ADHD) symptoms start in early childhood and continue into adulthood, and are frequently associated with comorbid symptoms of depression, bipolar, insomnia, and daytime sleepiness. The aim of this study was to screen adult ADHD symptoms in a community sample and investigate the association of adult ADHD symptoms with mood and sleep symptoms. Respondents (n = 1500) from the general adult population, aged between 19 and 49 years, were recruited. The sample consisted of a population in Busan, Korea that was representative in terms of sex, age, and residential area. ADHD symptoms and mood/sleep symptoms were assessed using validated questionnaires with cut-off threshold. The screening for adult ADHD documented ADHD symptoms in 3% (45 out of 1500) of the participants. The ADHD screen-positive group was more likely to have depression symptoms (OR = 14.97, 95% CI: 7.94-28.25, P < .001) and daytime sleepiness symptoms (OR = 3.18, 95% CI: 1.55-6.52, P < .001). Present result indicates high prevalence of adult ADHD symptoms in a community sample in Korea. The findings of this study also suggest significant association between adult ADHD symptoms and depression symptoms and daytime sleepiness. Optimal management of adult ADHD requires the consideration of not only ADHD symptoms but also the assessment and treatment of symptoms associated with comorbid conditions.

Establishing the content validity of the Epworth Sleepiness Scale for Children and Adolescents in Prader-Willi syndrome.

Excessive daytime sleepiness is common in Prader-Willi syndrome (PWS), with prevalence ranging from 52% to 100%. The goal of this study was to establish the content validity (ie, evidence that an instrument measures an intended concept of interest) of the parent/caregiver version of the Epworth Sleepiness Scale for Children and Adolescents (ESS-CHAD), a measure of daytime sleepiness, in PWS. Qualitative, dyadic semistructured video interviews were conducted with 18 caregivers and their children with PWS from April to June 2020. Concept elicitation and cognitive interview techniques were implemented. Thematic analyses allowed for examination of themes and data patterns. All caregivers (mean age 49 years) were mothers of individuals with PWS who experienced troublesome daytime sleepiness (mean age 14 years). The most prevalent observable signs/symptoms of daytime sleepiness were sleepy/sleepiness (n = 17; 94.4%), tired/tiredness (n = 16; 88.9%), exhaustion/exhausted (n = 5; 27.8%), anxious/stressed (n = 5; 27.8%), irritable/frustrated (n = 5; 27.8%), having tantrums/outbursts (n = 5; 27.8%), and lethargy (n = 4; 22.2%). Daytime sleepiness impacted various aspects of health including mental, emotional, physical, and social well-being. When caregivers were asked about the activities associated with daytime sleepiness, all salient concepts elicited mapped to the ESS-CHAD; saturation was met after the first 4 interviews. Only 2 concepts, after physical exertion and while inactive/bored, did not map. Caregiver statements indicated that these concepts, although related to daytime activities, were atypical of daily routines. The ESS-CHAD was well understood and relevant to caregivers. This study supports the content validity of the ESS-CHAD and its appropriateness for evaluating treatment efficacy of daytime sleepiness in PWS. Patel VP, Patroneva A, Glaze DG, Davis K, Merikle E, Revana A. Establishing the content validity of the Epworth Sleepiness Scale for Children and Adolescents in Prader-Willi syndrome. J Clin Sleep Med. 2022;18(2):485-496.

P-SP002. Prevalence of daytime sleepiness among emergency medical service ambulance driver in kuala lumpur hospital

Introduction . The Emergency Medical Service (EMS) ambulance driver's prevalence of daytime sleepiness is the most important field of study because it concerns the health and well-being of a rescue team member, a survivor or patient and the public. Objective of the study was to measure the self-reported level of daytime sleepiness among EMS ambulance drivers at Kuala Lumpur Hospital, Malaysia. Methods . Cross-section and descriptive analysis using a self-filled questionnaire for the target population sample of 31 EMS ambulance drivers was conducted in Asia's largest public hospital, HKL, Malaysia, using the Epworth Sleepiness Scale (ESS). Results . Measures for the prevalence of daytime sleepiness among 31 respondents. The ESS shows that 20 (65%) respondents have excessive daytime sleepiness while 11 (35%) were free of daytime sleepiness. In comparison, the frequency of a near-miss crash was relatively high (74%) and also significant (52%) slept while driving. Conclusion . Ambulance driver at HKL working as an EMS is at risk symptoms of daytime sleepiness. This result highlights the importance of sleepiness screening, providing adequate instruction, support and providing the necessary facilities to prevent adverse health effects among EMS ambulance drivers from developing.

Real-time assessment of daytime sleepiness in drivers with multiple sclerosis

BackgroundDaytime sleepiness is a common symptom of multiple sclerosis (MS) that may jeopardize safe driving. Our aim was to compare daytime sleepiness, recorded in real-time through eyelid tracking, in a simulated drive between individuals with MS (iwMS) and healthy controls. MethodsFifteen iwMS (age = median (Q1 – Q3), 55 (50 – 55); EDSS = 2.5 (2 – 3.5); 12 (80%) female) were matched for age, sex, education, and cognitive status with 15 controls. Participants completed self-reported fatigue and sleepiness scales including the Modified Fatigue Impact Scale (MFIS), Pittsburg Sleep Quality Inventory (PSQI), and Epworth Sleepiness Scale (ESS). Percentage of eyelid closure (PERCLOS) was extracted from a remote eye tracker while completing a simulated drive of 25 min. ResultsAlthough iwMS reported more symptoms of fatigue (MFIS, p = 0.003) and poorer sleep quality (PSQI, p = 0.008), they did not report more daytime sleepiness (ESS, p = 0.45). Likewise, there were no differences between groups in real-time daytime sleepiness, indexed by PERCLOS (p = 0.82). Both groups exhibited more real-time daytime sleepiness as they progressed through the drive (time effect, p < 0.0001). The interaction effect of group*time (p = 0.05) demonstrated increased symptoms of daytime sleepiness towards the end of the drive in iwMS compared to controls. PERCLOS correlated strongly (Spearman ρ = 0.76, p = 0.001) with distance out of lane in iwMS. ConclusionIwMS show exacerbated symptoms of daytime sleepiness during a monotonous, simulate drive. Future studies should investigate the effect of MS on daytime sleepiness during real-world driving.

Geriatrik Hastalarda Obstruktif Uyku Apne Sendromu Ve Sistemik Hastalık Birlikteliği

Aim: To evaluate the coincidence of obstructive sleep apnea syndrome (OSAS) and systemic diseases in elderly patients presenting to our sleep disorders center. Patients and Methods: Ninety-seven patients with ages older than 65 years, who had at least one of snoring, witnessed apnea, and excessive daytime sleepiness symptoms, and whose systemic diseases were under evaluation, were included in the study. The patients were divided into 4 groups according to their apnea-hypopnea indexes (AHI) and body mass index (BMI) values. The association of BMI and the polysomnography parameters such as AHI, arousal index, lowest oxygen saturation and mean oxygen desaturation in patients with and without systemic illnesses ,were evaluated. Results: Seventy-one (73.2%) of the patients comprised the group with systemic illnesses, and 26 (26.80%) patients comprised the group without systemic illnesses. AHI value was found to be higher in patients with systemic diseases compared to patients without systemic illnesses, and this was statistically significant (p&amp;lt;0.05). A statistically significant association was found between the presence of systemic diseases and OSAS and increased BMI (BMI&amp;gt;25) (p&amp;lt;0.05). A statistically significant association was not detected between the arousal index, lowest oxygen saturation, mean oxygen saturation, and presence of systemic illness. No difference in the rates of presence of systemic illnesses was found among male and female patients. Conclusion: Patients in the geriatric age group with increased BMI and OSAS should be evaluated for the presence of systemic illnesses.

Parkinson’s Disease Motor and Non-Motor Features Accompanying Insomnia and Excessive Daytime Sleepiness Symptoms, a Large Population-Based Study

Insomnia and excessive daytime sleepiness are the most common sleep disturbances in Parkinson’s disease. This study aims at better understanding how severity of PD motor and non-motor features and dopaminergic treatments contribute to these sleep symptoms in the first decade of PD. Data from a community-based cohort of PD patients was used to model cross-sectional PD-related risk factors for insomnia and EDS sleep scores using linear regression models adjusted for age, gender, and PD duration. Longitudinal changes in sleep scores were assessed with paired t-tests. For 481 patients who completed the MOS-Sleep questionnaire at least once, high levodopa daily doses (500mg+) and severe autonomic and complex non-motor symptoms (depression, anxiety, apathy, hallucinations and dopamine dysregulation syndrome) were associated with both EDS and insomnia symptoms. Higher total motor UPDRS and especially tremor sub-scores and motor complications were associated only with insomnia, while axial/posture/gait and body bradykinesia UPDRS sub-scores were associated only with EDS. In 156 patients, with a second sleep measure on average after 2.2 years of follow-up, only EDS scores increased over time. Groups defined by worse PD features severity at first follow-up (UPDRS 35+, PD duration 6.5+ years, or LED 500mg+) had larger average increases in EDS score over time. These findings provide evidence that motor and non-motor dysfunction in PD are associated with insomnia and EDS symptoms, but specific features and level of severity affect sleep symptoms differently. Motor manifestations related to tremor and dyskinesia are associated with sleep quantity and quality, measured by insomnia symptoms, while axial motor features are related to EDS symptoms.

Energy drink intake is associated with insomnia and decreased daytime functioning in young adult females.

To investigate the association between energy drink (ED) use and sleep-related disturbances in a population-based sample of young adults from the Raine Study. Analysis of cross-sectional data obtained from self-administered questionnaires to assess ED use and sleep disturbance (Epworth Sleepiness Scale, Functional Outcomes of Sleep Questionnaire (FOSQ-10) and the Pittsburgh Sleep Symptoms Questionnaire-Insomnia (PSSQ-I)). Regression modelling was used to estimate the effect of ED use on sleep disturbances. All models adjusted for various potential confounders. Western Australia. Males and females, aged 22 years, from Raine Study Gen2-22 year follow-up. Of the 1115 participants, 66 % were never/rare users (i.e. <once/month) of ED, 17·0 % were occasional users (i.e. >once/month to <once/week) and 17 % were frequent users (≥once/week). Compared with females, a greater proportion of males used ED occasionally (19 % v. 15 %) or frequently (24 % v. 11 %). Among females, frequent ED users experienced significantly higher symptoms of daytime sleepiness (FOSQ-10: β = 0·93, 95 % CI 0·32, 1·54, P = 0·003) and were five times more likely to experience insomnia (PSSQ-I: OR = 5·10, 95 % CI 1·81, 14·35, P = 0·002) compared with never/rare users. No significant associations were observed in males for any sleep outcomes. We found a positive association between ED use and sleep disturbances in young adult females. Given the importance of sleep for overall health, and ever-increasing ED use, intervention strategies are needed to curb ED use in young adults, particularly females. Further research is needed to determine causation and elucidate reasons for gender-specific findings.

A need for comprehensive care planning for excessive daytime sleepiness symptoms in older adults who receive long-term services and support.

A need for comprehensive care planning for excessive daytime sleepiness symptoms in older adults who receive long-term services and support.

Symptoms of Daytime Sleepiness and Sleep Apnea among Pregnant Women.

ObjectivesDespite the fact that sleep disturbances have been associated with poor maternal and neonatal health outcomes in pregnancy, no studies have assessed excessive daytime sleepiness or the risk for sleep apnea among pregnant Saudi Arabian women. We sought to estimate the prevalence of excessive daytime sleepiness (EDS) and the high risk for sleep apnea (OSA) in a sample of pregnant Saudi women.MethodsAn anonymous self-report questionnaire was completed by 517 pregnant women who attended obstetric outpatient clinics at King Abdulaziz Medical City, Riyadh, Saudi Arabia, for a routine pregnancy check. We collected demographic and clinical data for all patients and used the Berlin Questionnaire and the Epworth Sleepiness Scale to determine the primary outcomes.ResultsA high risk of OSA was found in 37.1% of women (95% confidence interval (CI): 33.00%–41.50%), and EDS was found in 32.1% (95% CI: 28.10%–36.30%). The presence of both (EDS and a high risk of OSA) was found in 14.9% of women (95% CI: 11.90%–18.30%). We found increased odds of EDS in women who reported pain three times or more per week (adjusted odds ratio (aOR) = 2.59) and insomnia (aOR = 1.65). Older women (≥ 37 years) (aOR = 3.00), those who reported pain once a week (aOR = 1.99), pain twice a week (aOR = 2.75), three times or more a week (aOR = 2.57), and insomnia (aOR = 1.95) increased the odds of high risk for OSA.ConclusionsEDS and a high risk for OSA affected a large portion of the pregnant women included in the study, primarily those who reported pain and insomnia. Our study provides important information for gynecologists to help promote healthy sleep and manage the issues arising from sleep disturbances among pregnant women as part of their daily practice.