Time Sleepiness Research Articles

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.

Narcolepsy: A case with polysomnographic findings

Narcolepsy is a sleep disorder presented with excessive sleepiness. Excessive sleepiness is key symptom of Narcolepsy. In obstructive sleep apnea excessive daytime sleepiness is also a remarkable symptom. Here we presented a 67-year-old female with uncontrollable sleep attacks and hypnagogic hallucination. She was previously diagnosed as obstructive sleep apnea and under BiPAP therapy for last few years. Her multiple sleep latency test become positive to meet diagnostic criteria for Narcolepsy. Clinicians should be cautious about possibilities of coexisting sleep disorders like Narcolepsy and obstructive sleep apnea in excessive day time sleepiness complaining patients. Bangladesh Crit Care J September 2022; 10(2): 161-162

Sleep Patterns among the Pre-clinical Medical Students of a Selected Medical College in Bangladesh

Introduction: Sleep is a complex biological pattern consisting of period of temporary unconsciousness. Sleep deprivation often leads to serious physical and mental health consequences. Medical college students often sacrifice sleep to comply with their demanding academic schedule which may influence their health and academic performance. Objective: To observe sleep patterns in pre-clinical (first and second year) students of MBBS course of Armed Forces Medical College, Dhaka, Bangladesh. Materials and Methods: This cross-sectional study was conducted during the period of March 2021 to July 2021 among 233 respondents. Two validated scales were used to assess quality of sleep and daytime sleepiness: 1) Pittsburgh Sleep Quality Index (PSQI) and 2) Epworth Sleepiness Scale (ESS). Results: Sleep patterns observed in the study-group revealed that more than quarter of the medical students of pre-clinical MBBS course are having insufficient sleep, delayed sleep onset with excessive day time sleepiness. Conclusion: The students should be made aware of the undesirable consequences of improper sleep habits so that they may inculcate healthy sleep practices in their day-to-day life and thus enjoy natural human circadian rhythm and cope up with their busy academic schedule with sound physical and mental health. JAFMC Bangladesh. Vol 18, No 1 (June) 2022: 61-66

Sleep duration and level of salivary C-reactive protein in adolescent students studying in different school start timing

The purpose of this study is to investigate the association of adolescent sleep duration and day time sleepiness with salivary CRP level among school students studying in different school start timings. A total 488 healthy school students of adolescent age (12-14yrs), participated in the present study. Both boys and girls of 7th and 8th class having 3 different school start timings (7:30 am, 8:30 am and 10:00 am), not taking any type of medication previously were included. After taking consent from respective schools and parents, Epworth sleepiness scale and Munich chronotype questionnaires was asked to fill by them to get information about their sleep habitats, sleep duration during weekdays and weekends. Saliva sample of same students was taken in small vials of 1.5 ml at morning 9:00 am only. Sample was stored at 2-80C for further quantitative analysis. The test was performed using RHELAX CRP KIT. Present study reveals a significant negative correlation of C- reactive protein level with sleep duration (p<0.01). 7:30 am school students get less sleep duration (6.8 h) than 8:30 am (8.5 h) and 10:00 am (8.7 h) in weekdays. Also, the average ESS score of 7:30 am school timing students was more than other 2 delayed school start timing students. The percentage of sleep dissatisfaction was also higher in early school students (46%) than other 2 later school timings (28%, 20.09%) with almost 50% students having EDS. Statistical analysis of data revealed a significant positive correlation between CRP level with daytime sleepiness (ESS score) and sleep debt (p<0.01). In conclusion, earlier school start timing students are more sleep deprived with higher ESS score than delayed school start timing students. This chronic sleep deprivation is leading to increase in the level of CRP in saliva indicating CRP as a potent indicator of sleep deprivation. The findings of the present study suggest that delaying of school start timing will not only increase the sleep duration of students but also decrease the level of CRP with improvement of sleep quality and health of these adolescents.

A study on the effect of mobile phone use on sleep.

Several studies have been conducted globally to assess the impact of usage of mobile phones on quality and duration of sleep as also on day time sleepiness. The objective of the present study was to assess the effect of mobile phone usage on the quality and composition of sleep in a sample from Indian population. The study was conducted at two tertiary care hospitals in north India from July 2014 to September 2019. A total of 566 participants were recruited in this study from both the centres. Sleep quality was assessed with the help of the Pittsburgh Sleep Quality Index (PSQI) questionnaire. Subsequently, actigraphy was done in 96 participants and polysomnography in 95 participants. Of the 566 participants, 128 (22.61%) had PSQI ≥5, reflecting poor sleep quality. A higher use of mobile phone was significantly associated with a poor sleep quality as a component of PSQI questionnaire (P=0.01) and higher overall PSQI score (P=0.01). The latency from sleep onset to N2 and N3 sleep stages was significantly shorter in participants having a higher mobile phone usage as compared to those with a lower usage [Median (range): 13.5 min (1.5-109) vs. 6.5 min (0-89); P=0.02] and [Median (range): 49 min (8.5-220.5) vs. 28.75 min (0-141); P=0.03], respectively. This study focused on the maladaptive changes brought on by mobile phone usage on sleep. More studies with larger sample sizes need to be done that may serve to confirm the hypothesis generating findings of our study.

Palatal Implantation Using Platelet Rich Plasma and Radio Frequency Palatal Surgery for Management of Obstructive Sleep Apnea

Background: Obstructive Sleep Apnea (OSA) is a common health problem affecting large number of people all over the world with great psychological and physiological burdens. The aim of this study is to investigate the effect of radio frequency palatal Surgery and platelet rich plasma in the soft palate as a new technique in treatment of obstructive sleep apnea OSA. Patients and Methods: This study included 30 patients with mild to moderate OSA Group A: n=15 (Tonsillectomy and palatal radio frequency surgery) and Group B n=15 (Tonsillectomy and Platelet Rich Plasma (PRP) palatal injection, this study investigate the effect of body mass index, retropalatal anteroposterior diameter, Epworth Steepness Scale Apnea Hypopnia Index in treatment of OSA in both groups. This study found that both techniques improved day time sleepiness with reduction of Apnea-Hypopnea Index (AHI), also there was marked improvement in radiological parameters in the form of increase of the anteroposterior diameter and retro-palatal cross section area, there was reduction of Body Mass Index BMI in postoperative in both groups but there was superiority of group A over group B in improvement of this parameters, group A success rate was 86.6% and Group B was 80%. Conclusion: Radio frequency palatal surgery and platelet rich plasma, both are effective as a treatment of obstructive sleep apnea due to retro-palatal collapse.

Shift-work sleep disorder among health care workers at public hospitals, the case of Sidama national regional state, Ethiopia: A multicenter cross-sectional study.

Shift-work disrupts circadian rhythm, resulting in disturbed sleep time and excessive sleepiness during the work shift. Little is known about shift-work sleep disorder among health care workers in Ethiopia. This study examined the magnitude and associated factors of shift-work sleep disorder among health care workers in Public Hospitals in Sidama National Regional State, Southern Ethiopia. An institution-based cross-sectional study was carried out on 398 health care workers selected using a systematic random sampling technique. A self-administered structured questionnaire consisting of insomnia, sleepiness scales and international classification of sleep disorder criteria items was employed. Epi data version 4.6 and Stata 14 were used for data entry and statistical analysis respectively. Binary logistic regression was fitted to determine associated factors and decision for the statistical significance was made at p<0.05 in the multivariable binary logistic regression. Three hundred and ninety-eight health care workers (female = 53%) were included in the analysis with a response rate of 94.8%. The prevalence of shift-work sleep disorder was 33.67% (95% CI: 29.17%-38.45%). Being married (AOR = 1.88 (1.01-3.28)), three-shift (AOR = 1.078 (1.00-3.16)), ≥11 night shifts per month (AOR = 2.44 (1.36-4.38)), missing nap (AOR = 1.85 (1.04-3.30)), daily sleep time < 7hours (AOR = 1.88 (1.05-3.38)), khat chewing (AOR = 2.98 (1.27-8.09)), alcohol drinking (AOR = 2.6(1.45-4.92)), and cigarette smoking (AOR = 3.32 (1.35-8.14)) were significantly associated with shift-work sleep disorder. This study showed a high prevalence of shift-work sleep disorder. Two shift schedule, napping, and reduction of substance use might reduce shift-work sleep disorder.

Pulmonary rehabilitation: A novel adjunct in management of obstructive sleep apnea.

Pulmonary rehabilitation (PR) is being used in the routine management of patients of obstructive sleep apnea (OSA) at some centers. However, the studies documenting benefits of PR in OSA lack standardization in terms of outcome measures. A study was hence planned to determine the efficacy of PR on exercise capacity, health related quality of life (HRQOL), day time sleepiness and sleep-quality of life (QOL) in patients of OSA. As a part of comprehensive therapy, patients diagnosed with OSA are managed with continuous positive airway pressure (CPAP), 8 weeks thrice weekly outpatient hospital-based PR and medical treatment at the Pulmonary Medicine Department, Government Medical College and Hospital, Chandigarh. However, some patients refuse for PR because of time constraints and travel issues. Patients with newly diagnosed OSA without co-existing respiratory disease, who agreed for the CPAP, PR and medical management were enrolled in group A. The patients who refused for PR but were ready for CPAP and medical management were enrolled in Group B; 30 patients were taken in each group. Exercise capacity, HRQOL, day time sleepiness and sleep-QOL were determined at baseline and at 8-weeks follow-up by 6-minute walk distance (6MWD), St. George's Respiratory Questionnaire (SGRQ), Epworth Sleepiness Scale (ESS) and Functional Outcomes of Sleep Questionnaire (FOSQ) and compared amongst the two groups. Four patients from group A were excluded as they did not complete PR; 26 patients from group A and 30 patients from group B were finally analyzed. At baseline, both groups were matched with respect to age, gender, apnea-hypopnea index (AHI), body mass index (BMI), FEV1%predicted, 6MWD, SGRQ, ESS and FOSQ. At follow up at 8 weeks, BMI, 6MWD, SGRQ, ESS and FOSQ improved significantly from baseline in group A (p<0.001). FEV1%predicted also improved but non significantly. In group B, FEV1%predicted, BMI, 6MWD, SGRQ, ESS and FOSQ score did not improve significantly from baseline. Mean improvement from baseline in BMI, 6MWD, SGRQ, ESS and FOSQ was significantly more in group A than group B (p<0.001, p<0.001, p=0.041, p<0.001 and p<0.001, respectively). PR, being beneficial, should be incorporated in standard management of OSA.

0020 Investigation of Seasonal Changes in Self-Reported Sleep Quality and Psychomotor Vigilance Task Outcomes: Results From the Ultra Long-Term Sleep (ULTS) Study

Abstract Introduction Although sleep is fundamental for human well-being, factors that contribute to an individual’s experience and report of sleep quality remain poorly understood. Utilizing that sleepiness is known to impact vigilance performance, this study sets out to explore how self-reported sleep quality changes with behavioral performance and how this variation is affected by seasonal changes. Methods This work is an interim analysis of self-reported sleep quality and behavioral performance data collected in the Ultra Long-term Sleep (ULTS) study (ClinicalTrials.gov Identifier: NCT04513743). In the study 20 healthy participants (average 33±13 years of age) were enrolled for 365 continuous days to observe the seasonal variation in sleep and cognitive performance. The outcome from the daily psychomotor vigilance task (PVT) and sleep questionnaire is analyzed and reported. The sleep questionnaire is a composite of questions from the Sleep Satisfaction Tool, the Karolinska Sleep Diary, questions regarding feelings of pain and outside disturbances, easiness of waking up, and the Karolinska Sleepiness Scale (KSS). The PVT was designed for self-administered high-frequency testing and has a short 3-minute test period. Monthly changes were examined from June to November. This period was chosen since all subjects were active. Results The first eight participants have now completed the study. Repeated measures correlations between KSS and mean PVT reaction time showed moderate but highly robust associations between the two measures over time (r=0.2; 95% CI 0.18-0.23). From the data collected thus far from the entire population, fastest PVT mean reaction times were found on Saturdays and slowest on Tuesdays. Similarly, KSS had best scores in weekends. There was an overall increase in mean PVT reaction time during the investigated period from June to November. This was also observed in KSS. Conclusion Our findings show a moderate correlation between the mean PVT reaction time and Karolinska Sleepiness Scale with up to 365 datapoints per subject with weekly and seasonal trends observed. Support (If Any) This research is supported by Innovation Fund Denmark.

Prevalance of Insomnia Among Elderly Patients Attending Teritiary Care Hospital

BACKGROUND: Sleep disorders among elderly society constitute a substantial public health problem. It is estimated that nearly 50% of people aged 55years and older have trouble sleeping, including initiating and maintaining sleep. The aim of this study was to determine the prevalence of sleep disorders among elderly patients attending tertiary care hospital.&#x0D; METHODS: The study included a total of 60 people – aged 60 or older 27 women (45%) and 33 men (55%). Data was collected from elderly patients attending tertiary care hospital and were screened for cognitive impairment by using mini mental state examination (MMSE). Patients who had MMSE score more than 24 were studied.&#x0D; The study used two standardized psychometric scales: The Epworth Sleepiness Scale (ESS) and The Insomnia Severity Index (ISI).&#x0D; RESULTS: As per insomnia severity index scale (ISI) out of 60 patients ,n=18(30%) had mild insomnia n=13(21.67) had moderate insomnia and n=1(1.67%) severe insomnia ,where as n=28(46.67%) had no insomnia.&#x0D; As per Epworth sleepiness scale (ESS) out of 60 patients ,n=3(05%) had mild day time sleepiness and n=57(95%) had no sleepiness. As per the study there is significant correlation between ISI and ESS .There was a statistically significant association between increasing age and insomnia in elderly patients. The incidence of comorbidities in the patients complaining of insomnia was analyzed. Cardiovascular disorders were the most common followed by Diabetes mellites and chronic obstructive pulmonary disease.&#x0D; CONCLUSION: Sleep conditions, particularly insomnia, constitute an important social and health problem among elderly people visiting tertiary care hospital. In light of the obtained study results, it is suggested to conduct and improve existing health education plans aimed at the elderly regarding sleep disorders to improve the quality of their sleep, and thus quality of life, and raise the alertness of the elderly about the importance of sleep in everyday life. There is a need for further research in the field of sleep disorders in the elderly to determine the prevalence of these disorders on a nationwide scale.

Study of Insomnia in Chronic Obstructive Pulmonary Disease Patients at a Tertiary Care Centre

Background: Chronic Obstructive Pulmonary Disease (COPD) is a common, preventable and treatable disease that is characterized by persistent respiratory symptoms and airflow limitation that is due to airway and/or alveolar abnormalities caused by significant exposure to noxious particles or gases. Aims and Objectives: 1. To estimate the proportion of insomnia in Chronic Obstructive Pulmonary Diseases patients, 2. To study the association of insomnia with severity of Chronic Obstructive Pulmonary Diseases among study participants and 3. Assessment of Quality of Life among study participants. Materials and Methods: This prospective observational study was conducted in Department of Respiratory Medicine in a tertiary care center and medical college. Written informed consent was taken from all the study participants and those who give consent were enrolled in the present study. Total 159 COPD patients were included in the study, after satisfying the eligibility criteria. The COPD patients were enrolled after satisfying the eligibility criteria given GSAQ Questionnaire to find the presence of insomnia, PSQI for quality of sleep and then SF-36 score questionnaire to assess Quality of Life. Study was conducted for duration of 2 years (August 2018 to December 2020). Observation and Results: The most common age group amongst study population was 51 to 60 years (42%) followed by 40 to 50 years (29%) and more than 60 years (29%). There was male predominance (54.5%) in the study population as compared to females (45.5%). The most common occupation amongst study population was farmer (28%) followed by Shopkeeper (23%) and Driver (19%) and most of the study population were obese (65.2%) followed by normal BMI (28.8%) and underweight (6.1%). Most of the study population were Grade 2 dyspnea (36%) followed by Grade 3 (34%) and Grade 4 (16%). Most of the study population were Moderate COPD (45.5%) followed by severe COPD (27.3%) and very severe (21.2%). Comorbidities like Diabetes and Hypertension was observed in 11% and 28% of study population. 29% of study population was ex smokers. 69.57% of ex smokers had more than 20 pack years while 30.43% had less than 20 pack years. The prevalence of insomnia in our study population was 43%. The prevalence of insomnia was most commonly observed in severe COPD (40%) followed by Very severe COPD (35%), Moderate COPD (19%) and mild COPD (6%) and the difference was statistically significant. Mean Physical health score and Mental health score was significantly lower in insomnia patients as compared to non insomnia patients. Mean PSQI was significantly higher in insomniac patients as compared to non insomnia patients. Conclusion: 40% of our patients with COPD experienced poor sleep quality. Presence of insomnia in patients with COPD is also associated with increased day time sleepiness and worse QOL.

Analysis of Excessive Day Time Sleepiness in Adolescent Girls Pursuing Professional Courses

Analysis of Excessive Day Time Sleepiness in Adolescent Girls Pursuing Professional Courses

Is Posterior Nasal Nerve Neurectomy Really a Ray of Hope for the Patients of Allergic Rhinitis.

Allergic rhinitis significantly affects the quality of life, it contributes to missed or unproductive time at school or work, disturbed sleep pattern and day time somnolence. Rhinitis is defined clinically as having two or more symptoms of anterior or posterior rhinorrhoea, sneezing, nasal blockage and/or itching of the nose during two or more consecutive days for more than 1 h on most days (International rhinitis management working group, 1994). Allergic rhinitis is diagnosed when these symptoms are caused by allergen exposure leading to an IgE mediated reaction. Nerve irritation causes sneezing and itching, the loss of mucosal integrity causes causes rhinorrhoea and the vascular engrogment leads to nasal blockage. Medical modalities are symptomatically effective in mild cases, with temporary relief and addressable adverse effects. Prolonged treatment with allergy immunotherapy causes a sustainable financial burden while remaining inaccessible at smaller towns. Posterior nasal nerve neurectomy is short, easy and effective alternative. The basic procedure is to selectively cut nerve bundles at the level of the sphenopalatine foramen (SPF) with a trans nasal approach. By denervating the nasal mucosa one renders it unresponsive to any sorts of allergen or allergic reaction. The aim of the study was to evaluate the outcome of posterior nasal nerve neurectomy in cases of severe allergic rhinitis by assessing its impact on the total nasal symptom score. The study is a hospital based prospective study, conducted on 15 patients who presented to the ENT department of Mahatma Gandhi Hospital from march 2021 to October 2021 (6months) suffering from allergic rhinitis and did not show any satisfactory improvement even after 1year of medical treatment. Adult patients in the age group of 20-45 yrs. diagnosed with allergic rhinitis were enrolled into the study after obtaining a due written consent. These included patients having 2 or more symptoms of allergic rhinitis and refractoriness to medical therapy for > 1year along with significantly affected quality of life and elevated IgE level. Patients with drug induced & hormonal causes of rhinitis, chronic rhinosinusitis and any anatomical feature which precipitates to rhinitis such as deviated nasal septum, hypertrophied turbinates, blocked osteomeatal unit, polypoidal nasal mucosa and sinonasal polyposis were excluded from the study. During our study period from march 2021-September 2021, 15 patients were enrolled in the study. All the patients were followed up at 2nd and 6th month postoperatively. Amongst these patients, there were 11 females (73.34%) and 4 were male (26.67%)The mean age of patients was 35.2years. Subjective nasal symptoms of all 15 patients improved over the period of 6months. The mean TNSS improved from 12.067 preoperatively to 8.66 at the end of 2nd month, i.e., 23.1% improvement. By the end of the 6th postoperative month there was a consistent reduction in the tnss, which further reduced to a mean of 3.4 (70.2% reduction) indicating a further improvement in symptoms with time. With the advancement & popularity of endoscopic sinus surgery in the past decade, endoscopic resection of the posterior nasal nerve is emerging as a safe and less invasive technique with long standing results. Medical treatment usually provides mild and symptomatic relief with long duration of treatment period. Thus, PNN is safer, economical & easier alternative to current trend of treatment of allergic rhinitis, proving to be highly efficient in cases of intractable allergic rhinitis.

Reliability and Validity of Gujarati Version of Epworth Sleepiness Scale: A Cross-sectional Study

Introduction: Daytime sleepiness is a common symptom of many sleep disorders. Epworth Sleepiness Scale (ESS) measures average sleep propensity of an individual for wide range of daily living activities. As it is a self-administered questionnaire, the Gujarati translation of ESS can be helpful for the evaluation of daytime sleepiness in clinical population. Aim: To find reliability and validity of Gujarati version of ESS. Materials and Methods: This cross-sectional study was conducted during August, 2020 to February, 2021. ESS is available in Gujarati language. Permission was taken to use and to find reliability and validity of Gujarati ESS from the Mapi Research Trust. This study was carried out in two phases: 1) Face and content validation by expert clinical review; 2) Test-retest reliability. The consensus method was used to find face and content validity of Gujarati ESS. The group of experts having mean experience of 10.5 years in different fields examined each item of Gujarati ESS. Each item of Gujarati ESS was scored either as rejected, accepted or accepted with modification. Procedure was continued till 80% of consensus for all items was achieved. Total 80 participants aged between 18-60 years were included in this study. To find reliability of Gujarati ESS, internal consistency and test-retest reliability was determined. The Statistical Package for Social Sciences (SPSS) version 24.0 was used to analyse the data. Test-retest reliability was determined by Intraclass Correlation Coefficient (ICC) and internal consistency was calculated by chronbach’s alpha. Results: Total of 80 participants (mean age 42.68±13.37 years; 34 males and 46 females) were studied. Normal BMI was observed for 20 participants, overweight were 26 and obese were 34. Gujarati version of ESS showed excellent test-retest reliability as evidenced by high ICC (ICC=0.94) and high Internal consistency (α=0.97). Mean score of Gujarati ESS at baseline 13±6.72 and after one week 12.98±5.65. Values for Content Validation Ratio (CVR), Item level Content Validation Index (I-CVI), Modified Kappa (K), and Proportion of agreement were 1. The content of translated items was understandable and were related to quality of sleep and its evaluation. Conclusion: Gujarati version of the ESS has excellent reliability and good face and content validity. It is adequate and useful for evaluation of day time sleepiness in Gujarati speaking population.

Effect of Sleep Deprivation on Mood States of Junior Residents in Obstetrics and Gynaecology Department: A Prospective Observational Study

Introduction: Junior residents of highly demanding clinical specialties, like, Obstetrics and Gynaecology, are an integral part in the functioning of hospitals. They work round the clock donning the role of caregiver as well as learner and are in a constant state of stress. Any alteration in mood while working in intensive set ups like labor room and operation theatre can adversely affect not only the physician’s performance but also patient safety. Aim: To evaluate the effect of sleep deprivation on mood states of junior residents in Obstetrics and Gynaecology Department during call duty. Materials and Methods: This prospective observational study was conducted in Department of Obstetrics and Gynaecology at Armed Forces Medical College (tertiary care hospital), Pune, Maharashtra, India, from march 2019 to august 2019. The study included 37 junior residents of Obstetrics and Gynaecology Department, between age range of 25-40 years. Sleep diary was used to record resident’s sleep patterns, Karolinska Sleepiness Scale (KSS) was used to assess the day time sleepiness. Profile of Mood States (POMS) score was calculated during pre-call and post-call duty. This data was used to ascertain any changes in mood post-call due to sleep deprivation. Statistical analysis was done using paired Student’s t-test and Wilcoxon Signed Rank test and p-value &lt;0.05 was considered as significant. Results: Out of 37 participants, 21 were males and 16 females. There was a significant worsening of post-call POMS score (5.24±27.82) from pre-call score (-6.86±23.70) following call duty associated with a decrease in mean night time sleep (p-value&lt;0.001). Likewise increased KSS score was also noted after call duty (pre-call score was 3.03±1.65 vs post-call score was 5.73±2.05; p-value&lt;0.001). This signifies that mood states are adversely affected by sleep deprivation in these residents. Conclusion: The study showed that there was a significant worsening of mood states due to sleep deprivation during call duties. This also mandates review of efficacy and feasibility of current policy regulating work hour schedule of junior residents in India.

Palatoplasty versus radiofrequncy palatal surgery for management of obstructive sleep apnea

Background: Obstructive sleep apnea (OSA) is a huge problem affecting large sector of people all over the world with great social and physiological effects. The aim of this study is to investigate the effect of radio frequency palatal. Surgery and palatoplasty in treatment of obstructive sleep apnea OSA. Patients and Methods: This study included 70 patients with mild to moderate OSA Group A: n=35 (Tonsillectomy and palatal radio frequency surgery) and Group B n=35 (Tonsillectomy and palatoplasty), this study investigate the effect of radio frequncy technique and palatoplasty on retropalatal anteroposterior diameter, Epworth Steepness Scale, apnea Hypopnia Index in Treatment of OSA. Results: This study found that both techniques improved day time sleepiness with reduction of apnea- hypopnea index (AHI), also there was marked improvement in radiological parameters in the form of increase of the anteroposterior diameter and retro-palatal cross section area, in postoperative in both groups but there was superiority of group A over group B in improvement of this parameters, group A success rate was 81.3% and Group B was 78.6% Conclusion: radio frequency palatal surgery and palatoplasty both are effective as a treatment of obstructive sleep apnea due to retro-palatal collapse.

Study of sleep disorders in the elderly visiting geriatrics department.

Context:Sparse published data are available from India regarding sleep disorders in elderly, sleep quality, and daytime sleepiness.Aims:To study sleep disturbances in the elderly (>60 years) subjects.Settings and Design:Hospital-based cross-sectional study.Methods and Material:All the subjects underwent a thorough clinical evaluation which included detailed history and a thorough physical examination. The daytime sleepiness was assessed using the Epworth Sleepiness Scale (ESS). The sleep quality (SQ) was evaluated with the Pittsburgh Sleep Quality Index (PSQI).Statistical Analysis Used:Association between categorical variables was studied by Chi-square (χ2) test with continuity correction. All tests were two-tailed; a P value <0.05 was considered as significant.Results:During the period November 2019 to July 2020, 122 elderly subjects were studied; women (n = 70; 57.4%) outnumbered men. Only six (4.9%) patients presented with sleep-related complaints. Seven (5.7%) patients had an ESS score >10 suggestive of increased day time sleepiness. Sixty-four (52.5%) were labelled “bad sleepers” (PSQI >5). Compared with those with ≤3 comorbid conditions, a higher proportion of elderly with >3 comorbid conditions had significantly higher occurrence of poor sleep quality (PSQI >5) and daytime sleepiness (ESS >10). Increased daytime sleepiness (ESS >10) was significantly high in patients with osteoarthritis and cerebrovascular disease.Conclusions:Our observations suggest that a high proportion of elderly subjects who did not complain of sleep-related symptoms were found to have poor sleep quality. Therefore, incorporating SQ assessment as a part of routine geriatric assessment screening would be beneficial in early detection of this condition.

Total sleep time, sleep efficiency, and next day subjective sleepiness in a large group of women.

The relationship between sleep duration and sleepiness has seen much research, but no data are available on the association between polysomnographically (PSG) determined total sleep time (TST) (or other PSG variables) and subjective sleepiness during the subsequent day in individuals in their habitual life situation. The purpose of the present study was to study the association between TST and sleep efficiency (SE) (and other PSG variables) and next-day sleepiness at 7 times of the day. A large population-based group of women (N = 400) participated. Daytime sleepiness was measured with the Karolinska Sleepiness Scale (KSS). The association was studied through analysis of variance (ANOVA), as well as regression analyses. For SE there was a significant difference in sleepiness across groups with >90%, 80%-89.99%, and <80% SE (F = 7.2, p < .001, eta2 = 0.04), with lowest sleepiness in the first group. In contrast, TST groups of <6 h, 6-6.99 h, and ≥7 h did not differ significantly. In addition, a pronounced U-shape (eta2 > 0.45) was seen for both analyses, with maximum sleepiness at bedtime (≈ 7.5 KSS units). A multiple regression analysis, including all PSG variables (adjusted for age and BMI), showed that SE was a significant predictor (β = 0.16, p < .05) of mean sleepiness, even after depression, anxiety, and subjective sleep duration were entered, but this was eliminated by subjective sleep quality. It was concluded that high SE is modestly associated with lower next-day sleepiness in women in a real-life context, but that TST is not.

The Association of Serum 25(OH) Vitamin D Level with Severity of Obstructive Sleep Apnea Syndrome in Patients with Syndrome Z (the Interaction of Obstructive Sleep Apnea with Metabolic Syndrome).

Background: The interaction of obstructive sleep apnea syndrome (OSAS) with metabolic syndrome (MetS) is known as syndrome Z. The aim of this study was to investigate the association of serum vitamin D levels with severity of OSAS in patients with Syndrome Z. Methods: In this retrospective study, 270 patients with MetS and OSAS were included. Demographic data, lifestyle habits, anthropometric measurements, sleep characteristics, polysomnographic indices, and laboratory results were recorded from the patient files. Multivariable logistic regression analyses were performed to determine the associations of serum 25(OH)D3 levels with OSAS. Results: Of the 270 patients, 71.9% were female. The mean age was 46.86 ± 8.46 (33-72) years. Of the participants, 8.2% did not have OSAS (control group), while 30.4% had mild, 28.1% had moderate, and 33.3% had severe OSAS. There were significant differences in gender, waist circumference, hip circumference, waist/hip ratio, neck circumference, body mass index, apnea-hypopnea index, total sleep time, average SpO2 and Epworth sleepiness scale score, oxygen desaturation index, blood glucose, total cholesterol, triglycerides, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and 25(OH)D3 levels. There was a significant difference in serum 25(OH)D3 level with increasing severities of OSAS (none+mild to moderate+severe OSAS). After adjusting for potential confounding factors in multivariable logistic regression analyses, we found that serum 25(OH)D3 level was significantly associated with the severity of OSAS. Conclusions: Serum 25(OH)D3 level was significantly associated with the severity of OSAS in patients with Syndrome Z. Therefore, patients with MetS and OSAS should be investigated for the presence of vitamin D insufficiency and, if observed, referred for vitamin D treatment.

Biomedical Sleep Inducer System

Sleeping difficulty called insomnia, can involve difficulty in falling asleep one who has first go to bed at night, waking up too early in the morning and waking up often during night. The lack of restful sleep can affect your ability to hold out daily responsibilities. All types of insomnia can cause day time drowsiness, poor concentration, and therefore the inability to feel refreshed and rested in the morning. Magnetic flux related to the plannet is termed geo-magnetic fields. It is essentially dipolar on the earth’s surface. Many of us experience sleeping well within the natural surroundings into a tent or a wooden hut. This fact is because of not only to the healthy atmosphere but also from our unconscious ability to perceive natural earth’s magnetic fields. Our paper is about this sort of geo-magnetic –fields. This has been designed a circuit, which radiates an electromagnetic field which is low frequency through a radiator coil and our aim is to perceive them, in this manner our brain is surrounded by a perfect&nbsp; environment for a sound sleep.