Sleep Apnea

Purpose The purpose of this study was to investigate apnea–hypopnea index (AHI) across two polysomnographies (PSGs) to examine AHI variability and impact on clinical diagnosis. Materials and methods Two-night PSGs of 193 sleep clinic patients were reviewed, and the AHI variability was analyzed. Anonymized records from five patients with significant night-to-night AHI variability were used in this study: the two-night PSGs from two patients were represented as four individual PSGs; the two-night PSG for two others were represented as being obtained from two different sleep clinics; the last patient’s PSG was shown as a two-night study. Twenty-two sleep experts attending the Associated Professional Sleep Societies meeting were recruited to make diagnoses based on the PSGs. They were told that the PSGs were from seven patients: four with single-night PSG; two with two PSGs, each one from a different clinic; and one patient with a two-night PSG. Results Twenty-one percent of the 193 sle...

Our objective was to characterize sleep-disordered breathing in 88 children with achondroplasia aged 1 month to 12.6 years. At the time of their initial polysomnography, five children had previously undergone tracheostomy, and seven children required supplemental oxygen. Initial polysomnography demonstrated a median obstructive apnea index of 0 (range, 0 to 19.2 apneas/hr). The median number of central apneas with desaturation per study was 0.5 (0 to 49), the median oxygen saturation nadir was 91% (50% to 99%), and the median peak end-tidal pCO2 was 47 mm Hg (36 to 87 mm Hg). Forty-two children (47.7%) had abnormal initial study results, usually caused by hypoxemia. Two children with severe obstructive sleep apnea eventually required continuous positive airway pressure therapy, and three additional children required tracheostomies. (1) Children with achondroplasia often have sleep-related respiratory disturbances, primarily hypoxemia. (2) The majority do not have significant obstructive or central apnea; however, a substantial minority are severely affected. (3) Tonsillectomy and adenoidectomy decreases the degree of upper airway obstruction in most but not all children with achondroplasia and obstructive sleep apnea. (4) Restrictive lung disease can present at a young age in children with achondroplasia.

Purpose No studies have assessed the prevalence of fatigue, depression, sleepiness, and the risk of obstructive sleep apnea (OSA) among commercial airlines pilots in the Gulf Cooperation Council (GCC). Methods This was a quantitative crosssectional study conducted among pilots who were on active duty and had flown during the past 6 months for one of three commercial airline companies. We included participants with age between 20 and 65 years. Data were collected using a predesigned electronic questionnaire composed of questions related to demographic information in addition to the Fatigue Severity Scale (FSS), the Berlin Questionnaire, the Epworth Sleepiness Scale (ESS), and the Hospital Anxiety and Depression Scale (HADS). Results The study included 328 pilots with a mean age ± standard deviation of 41.4 ± 9.7 years. Overall, 224 (68.3%) pilots had an FSS score ≥ 36 indicating severe fatigue and 221 (67.4%) reported making mistakes in the cockpit because of fatigue. One hundred and twelve (34.1%) pilots had an ESS score ≥ 10 indicating excessive daytime sleepiness and 148 (45.1%) reported falling asleep at the controls at least once without previously agreeing with their colleagues. One hundred and thirteen (34.5%) pilots had an abnormal HADS depression score (≥ 8), and 96 (29.3%) pilots were at high risk for OSA requiring further assessment. Conclusion Fatigue, sleepiness, risk of OSA, and depression are prevalent among GCC commercial airline pilots. Regular assessment by aviation authorities is needed to detect and treat these medical problems.

Deficits in daytime performance due to sleep loss are experienced universally and associated with a significant social, financial, and human cost. Microsleeps, sleep attacks, and lapses in cognition increase with sleep loss as a function of state instability. Sleep deprivation studies repeatedly show a variable (negative) impact on mood, cognitive performance, and motor function due to an increasing sleep propensity and destabilization of the wake state. Specific neurocognitive domains including executive attention, working memory, and divergent higher cognitive functions are particularly vulnerable to sleep loss. In humans, functional metabolic and neurophysiological studies demonstrate that neural systems involved in executive function (i.e., prefrontal cortex) are more susceptible to sleep deprivation in some individuals than others. Recent chronic partial sleep deprivation experiments, which more closely replicate sleep loss in society, demonstrate that profound neurocognitive d...

A persons' health subsequently depends upon the level of his body composition. Its consist percentage of fat, bone, water, and muscle. Many health consultants around the world agreed that there is a health danger if the level of fat is too high in the human body. Presently it is clear that the factors of body composition are wide and involve multiple interfaces of cultural, environmental, social and lifestyle factors. A high level of fat percentage associated with a threat for health problems for stance high blood pressure, high blood cholesterol, diabetes, and sleeping disorder. Numerous studies found that there is an effect of sleep on body composition. Sleep is a natural process that allows the body and brain to rest and recover. Irregular sleep patterns, inadequate sleep quality, and insufficient sleep play a significant role to determine the health status of individuals. Quality of Sleep is not only effective as an indicator of health but also a key component of quality of life [1]. American adults reported around 27.5% to 29, 1% short sleep duration [2]. Numerous studies have investigated the relationship between obesity and sleep. Sleep apnea has an estimated prevalence of 9% to 28% among females and 27% to 34% among males, 30 to 70 years of age [3]. Every person requires sleep; both genders experiences sleep differently throughout their lifetimes. They face different challenges to sleep. Females are more prone to insomnia, while males are more likely to suffer from a sleep disorder like sleep apnea and snoring. Galland BC et al., reported poor sleep quality by 56% of participants and were more common in girls (63.1%) than in boys (44.5%), and sleep hygiene was significantly worse in females [4]. The symptoms for insomnia prevalence increased in females from 3.4% to 12.2% and in males from 4.3% to 9.1% [5]. The studies on sleep and body composition in the Saudi region on adolescent found that there is an inverse relationship between poor sleep duration (less than seven hours per day) and obesity/ overweight [6,7]. Mahfouz MS et al., revealed that university female students have poor sleep quality (69.1%) as they slept a mean of 4.77 hours/night [8]. In particular, epidemiological studies had shown a contrary correlation between sleep duration and BMI [9]. Sleep medicine in Saudi Arabia emphasising that there are many demands for further sleep studies to discuss the issues on the prevalence of numerous sleep disorders amongst Saudi population related to lifestyle and body composition [10]. Although longitudinal research is needed to confirm study results, researchers observed a counter relationship between duration of sleep and risk towards obesity development in children. In addition, every 30 minutes of sleep disruption leads to a 3% decline in daytime activity. Overall, study results indicate that sufficient duration and quality of sleep are significant factors for childhood obesity prevention [11]. Researchers found significant prediction between sleep duration in overweight male and z-score of BMI, where the long duration of sleep was linked with risk for overweight and lower BMI. In both regression models calculated for female adolescents, the duration of sleep is not a predictor for the risk of overweight or BMI z-score, indicating a gender difference in BMI and duration of sleep [12]. Many types of research are necessary to estimate how sleep effects on body composition, Inadequate sleep may also increase the chances to eat more, particularly if time spent in an inactive way, like browsing the internet, playing video games, watching television, even taking unhealthy foods habits. Daily routine work at home that leads to reduced sleep and increased food intake. However, the latest evidence linking BMI with sleep for a different population. There is little evidence for body fat, but not for the total body water with sleep habits for male and female students. In the present study authors investigated about body composition (BMI, body fat, and body water) and sleep habits amongst male and female students which would be helpful in identifying the effect of sleep habits on the body composition and adopt the preventive strategies for obesity and abnormal sleep. ABSTRACT Introduction: Elevated body composition is associated with many health hazards and it is also strongly associated with sleep habits of individuals.

Sleep apnea syndrome is a common pathology with negative consequences on cardiovascular and metabolic diseases. The relationship between obesity and OSAS is complex, multifactorial and bidirectional; that leads to a negative mutual influence of the two pathologies. The main purpose of this study is to evaluate the risk associated with obesity and the occurrence of the apnea phenomenon, as well as, to compare the various polysomnographic parameters and to compare them with obesity. 100 patients took part to this study. 60 % of the patients were diagnosed with OSAS. 71 % of the patients had varying degrees of obesity. Significant statistic differences were revealed between: the Mean variation of the BMI in patients with and without apnea (T Test p= 0,007 < 0,05); the dorsal AHI Mean of the non-obese group as against to the dorsal AHI Mean of the obese group (T Test p= 0,002), the AHI Mean in other positions of the non-obese group as against to the AHI Mean in other positions of the...

People suffering from migraines, sleep apnea, glaucoma, memory loss, stroke, ADHD, and even impotence may benefit from new sleep research, which has discovered how sleep position impacts brain and head circulation, and can create many problems whose cause is considered unknown by medicine, which has been ignoring sleep position in brain disease research and treatment.

The issue has to do with the effect of gravity on the body, which is different when standing versus lying down. Medicine has ignored this effect, which is essential for understanding diseases of the brain.

The answer to many health problems may all be in our bed.

There's one big problem with sleeping that most people never think about. This is an important issue, since we spend on average one third of our lives in bed. It has to do with gravity, and the pull it has on your body when it is lying flat in bed. Let's say you weight 150 pounds. When you are standing, gravity pulls your 150-pound body weight down towards your feet, which must support that weight. When standing, gravity also pulls your blood down towards your feet, and resisted the return of blood from your feet back to your heart. As a result, some people feel extra fluid pressure in their lower legs and feet by the end of the day from this pull of gravity. But the feet are designed to withstand this pressure and weight, especially since we take breaks from this pressure and weight when we lie down to rest. What happens then? Does the effect of gravity disappear when we lie down? Of course, not. Instead, when you lie your 150-pound body down, the first thing that happens is that gravity pulls your body into the mattress. This means that the weight of your body presses on the lower edge of your body that is touching the mattress. Essentially, you are compressing your body into the bed. This means that it is very important to consider your body position while sleeping. Depending on how you sleep, there will be compression of parts of your body from the weight of your body pressing you into the mattress. This can lead to compression injuries, which involve reduced blood and lymph circulation, nerve injuries, joint injuries, and problems with your brain, eyes, ears, face, and sinuses, depending on your sleep position. This is one reason why people toss and turn while sleeping. Circulation is impaired from the pressure of sleeping on your body, so you unconsciously move to restore circulation. Leaning on anything for 8-hours straight, day after day, can cause compression injuries. But there are certain sleep positions which are worse than others when it comes to these injuries.

Purpose: No study has assessed the titration success of CPAP therapy in patients with obesity hypoventilation syndrome (OHS) and an apnea-hypopnea index (AHI) <30 event/h. This study aimed to assess the titration success of CPAP therapy under polysomnography and subsequent short-term adherence (1 month) in patients with OHS and an AHI <30 event/h.
Methods: Consecutive OHS patients with an AHI <30 events/h between 2010 and 2019 were included (n=54). All OHS patients were first started on CPAP during the therapeutic sleep-study. If the therapeutic-study showed that the SpO2 remained < 90% for 20% of the total sleep time, a second therapeutic study was arranged with bi-level PAP (BPAP). Thirty patients agreed to participate in the 1-month follow-up adherence study. We applied the American-Thoracic-Society criteria for PAP adherence.
Results: The mean age was 54.8±14.6 years, and the mean BMI was 45.9±12.2 kg/m2. Successful titration on CPAP was attained in 36 (66.7%) patients, and 18 (33.3%) required BPAP. Patients who failed the CPAP trial had a significantly higher PaCO2 and bicarbonate, a more restrictive respiratory pattern on spirometry,  and a significantly higher time with SpO2<90 % (mins) during sleep. The only independent correlate of CPAP-titration success on the multivariable regression analysis was the desaturation index (OR: 1.33 [1.033-1.712]). More than 80% of the participants were using CPAP therapy after one-month with no differences in adherence between the CPAP and BPAP groups.
Conclusions: The current results suggest that CPAP therapy could be an acceptable alternative therapy to BPAP in patients with OHS without severe OSA.

What does lying down in bed for about 1/3 of your life do to your body and brain?  Are your sleep habits making you sick?  We show how common sleep positions can cause migraines, glaucoma, stroke, sleep apnea, sinus congestion, ear infections, facial distortion, and many other problems, which are reversible by changing the way you sleep.

Purpose: This article focuses on recent evidence linking Rapid eye movement (REM) obstructive sleep apnea (OSA) (REM-OSA) to neurocognitive dysfunction and mood changes, the proposed mechanisms for increased risk of neurocognitive dysfunction in REM-OSA, and future research prospects.

Methods: PubMed and Google Scholar records were examined for articles utilizing predefined keywords. In this work, we mainly included studies published after 2017; nevertheless, critical studies published prior to 2017 were considered.

Results: REM-OSA is an under-recognized stage-related sleep-disordered breathing in which obstructive respiratory events happen chiefly in stage REM. The disorder is commonly seen amongst younger patients and females and has recently been linked to cardiometabolic complications. Although less symptomatic than non-REM-OSA and non-stage-specific OSA, current findings indicate that REM-OSA may have neurocognitive repercussions and mood changes and could be linked to insomnia, increased dreams, and nightmares.

Conclusion: Currently available evidence indicates that REM-OSA may present with insomnia and nightmares and could affect cognitive function and mood.

The nose and pharynx begin the upper airway system and represent a continuum. This is the biologic basis for the mutual influences of rhinitis and obstructive sleep apnea (OSA). Sleep-disordered breathing has a large differential diagnosis that includes snoring, upper airway resistance syndrome, and severe OSA. Nasal obstruction is an independent risk factor for OSA, but there is no correlation of daytime nasal resistance with the severity of OSA. However, nasal resistance was an independent predictor of apnea-hypopnea index in a recent study of nonobese OSA patients. Rhinitis alone is associated with mild OSA, but commonly causes microarousals and sleep fragmentation. Reduction of nasal inflammation with topical treatment improves sleep quality and subsequent daytime sleepiness and fatigue. Patient compliance with the nasal continuous positive airway pressure (nCPAP) device is relatively low, in part due to adverse nasal effects.

Force Sensing Resistors (FSR) are ultra-thin, low-cost, pressure sensors, which exhibit change in their electrical resistance when force is applied on their surface. The FSR has been used in wide ranging applications in the automotive industry, musical instruments, touch-buttons, portable electronic devices, etc. The FSR is also proving to be promising device for developing applications in healthcare. The present work reviews the reported work on developing novel applications of FSR in non-invasive diagnosis, and monitoring of patients undergoing treatment. The techniques used in biosignal acquisition and its subsequent processing after using FSR, as reported in the literature are briefly reviewed. This is followed by review of the recently reported innovations in diagnostic technology using FSR. The applications of the FSR for diagnosis and monitoring of several major medical disorders are described. The merits and of using FSR are highlighted. The limitations of the technology using FSR are also noted for future advancement. It is observed that application of FSR, despite its present limitations of the technology, opens new opportunities for developing novel applications in bio-medical instrumentation and healthcare.

Majority of the physiological processes in the human organism are rhythmic. The most common are the diurnal changes that repeat roughly every 24 hours, called circadian rhythms. Circadian rhythms disorders have negative influence on human functioning. The aim of this article is to present the current understanding of the circadian rhythms physiological role, with particular emphasis on the circadian rhythm sleep-wake disorders (CRSWD), principles of their diagnosis and chronobiological therapy. The guidelines are based on the review of
recommendations from the scientific societies involved in sleep medicine and the clinical experiences of the authors. Researchers participating in the preparation of guidelines were invited by the Polish Sleep Research Society and the Section of Biological Psychiatry of the
Polish Psychiatric Association, based on their significant contributions in circadian rhythm research and/or clinical experience in the treatment of such disorders. Finally, the guidelines were adjusted to the questions and comments given by the members of both Societies. CRSWD have a significant negative impact on human health and functioning. Standard methods used to assess CRSWD are sleep diaries and sleep logs, while the actigraphy, when available, should be also used. The most effective methods of CRSWD treatment are melatonin administration and light therapy. Behavioral interventions are also recommended. A fourteen-day period of sleep-wake rhythm assessment in CRSWD enables accurate diagnosis, adequate selection of chronobiological interventions, and planning adequate diurnal timing of their application. This type of assessment is quite easy, low-cost, and provides valuable indications how to adjust the therapeutic approach to the circadian phase of the particular patient.