472 Sleep Quality in Pregnancy: An Analysis of Cardiopulmonary Coupling in the nuMoM2b Cohort

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A186-A186
Author(s):  
Francis Christian ◽  
Hugi Hilmisson ◽  
Solveig magnusdottir ◽  
Robert Thomas

Abstract Introduction The impact of pregnancy on sleep quality and sleep-breathing is of interest due to concerns of an impact on maternal, intra-uterine and neonatal health. The Sleep Disordered Breathing (SDB) sub-study of the Nulliparous Pregnancy Outcomes Study (NuMoM2b) provided a large cohort of single gestational women who underwent home sleep apnea testing (HSAT) to evaluate for SDB. To evaluate changes in sleep during pregnancy, we utilized publicly available data from http://www.sleepdata.org for cardiopulmonary coupling (CPC) analysis to evaluate SDB, as well as sleep duration and quality. No outcomes data is currently available. Methods Standardized Level 3 HSAT was performed after visit 1 (V1), (6–15 weeks’ gestation) and visit 3 (V3), (22 -31 weeks’ gestation) on 3702 women from the NuMoM2b cohort. CPC-analysis was performed using clinically validated algorithms based on CPC-method using ECG and oxygen saturation data (SpO2) as the input signals. SleepImage Apnea Hypopnea Index (sAHI) was calculated to evaluate for SDB (FDA; 182618). Additional calculations to determine sleep latency, sleep duration, wake after sleep onset, and sleep quality (SQI) were performed. The SQI-metric incorporates measures of sleep stability and instability and is then presented on a scale of 0 – 100 where a higher number is desirable. Results 3,261 & 2,511 participants had data at visits 1 & 3, respectively. A total of 3,012 and 2,332 individuals had ECG data of sufficient quality. The mean age of the analyzed cohort was 27 years old. SDB events were overall low, but significantly increased across visits, sAHI [(1.6 ± 2.5)/hour (V1) vs (2.9 ± 4.1) (V3)], p< 0.001. There was a statistically significant increase in sleep latency [7.4 ± 12.7 (V1) vs 18.7 ± 27.8 (V3)], p< 0.001 and reduction in total sleep time [401.2 ± 85.6 (V1) vs 348.5 ± 79.3 (V3)], p< 0.001. Most notably, there was a >10% reduction in the SQI, indicative of increased unstable, fragmented sleep as pregnancy progressed [72.1 ± 13.8 (V1), 60.5 ± 16.2 (V3)], p < 0.001. Conclusion Using objective measures based on CPC analysis from HSAT derived signals, sleep disordered breathing, sleep duration and sleep quality are all adversely impacted as gestation progresses. Support (if any):

2016 ◽  
Vol 54 (1) ◽  
pp. 75-79
Author(s):  
Rong-San Jiang ◽  
Kai-Li Liang ◽  
Chung-Han Hsin ◽  
Mao-Chang Sun

Background: The nose plays an important role in sleep quality. Very little is known about sleep problems in patients with chronic rhinosinusitis (CRS). The aim of this study was to investigate the impact of CRS on sleep-disordered breathing. Methodology: CRS patients who underwent functional endoscopic sinus surgery were collected between July 2010 and May 2015. Before surgery, they filled 20-item Sino-Nasal Outcome Test and Epworth Sleepiness Scale questionnaires, were asked about the severity of nasal obstruction, and received acoustic rhinometry, smell test, an endoscopic examination, sinus computed tomography, and a one-night polysomnography. Sleep quality was evaluated in these patients and was correlated with the severity of rhinosinusitis. Results: One hundred and thirty-nine CRS patients were enrolled in the study. Among them, 38.1% complained of daytime sleepiness, and this sleep problem was correlated with the symptom of nasal obstruction. Obstructive sleep apnea syndrome (OSAS) was diagnosed in 64.7% of the patients, but there was no correlation with the severity of rhinosinusitis. Nasal polyps did not worsen sleep problems in the CRS patients. Conclusions: This study showed that CRS patents had a high prevalence of OSAS, and worse OSAS in CRS patients was not correlated with the severity of rhinosinusitis.


2016 ◽  
Vol 2016 ◽  
pp. 1-10 ◽  
Author(s):  
Atin Supartini ◽  
Takanori Honda ◽  
Nadzirah A. Basri ◽  
Yuka Haeuchi ◽  
Sanmei Chen ◽  
...  

Aim. The aim of this study was to identify the impact of bedtime, wake time, sleep duration, sleep-onset latency, and sleep quality on depressive symptoms and suicidal ideation amongst Japanese freshmen.Methods. This cross-sectional data was derived from the baseline survey of the Enhancement of Q-University Students Intelligence (EQUSITE) study conducted from May to June, 2010. A total of 2,631 participants were recruited and completed the following self-reported questionnaires: the Pittsburgh Sleep Quality Index (PSQI), the Center for Epidemiologic Studies Depression Scale (CES-D), and the original Health Support Questionnaires developed by the EQUSITE study research team.Results. Of 1,992 participants eligible for analysis, 25.5% (n=507) reported depressive symptoms (CES-D total score ≥ 16), and 5.8% (n=115) reported suicidal ideation. The present study showed that late bedtime (later than 01:30), sleep-onset latency (≥30 minutes), and poor sleep quality showed a marginally significant association with depressive symptoms. Poor sleep quality was seen to predict suicidal ideation even after adjusting for depressive symptoms.Conclusion. The current study has important implications for the role of bedtime in the prevention of depressive symptoms. Improving sleep quality may prevent the development of depressive symptoms and reduce the likelihood of suicidal ideation.


SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A96-A98
Author(s):  
Xiaopeng Ji ◽  
Jennifer Saylor

Abstract Introduction Executive function (EF), which shows continued development into early adulthood, is essential to build resilience to cope with COVID-19-related social and environmental changes. However, how sleep interacts with the pandemic on affecting EF remains unclear, particularly among late adolescents and young adults. This study examined (1) the impact of COVID-19 pandemic on sleep and EF and (2) whether sleep moderated pandemic-related changes in EF among young people aged 18-21 years old. Methods Between April and May 2020, university students with baseline data on sleep and EF (Spring and Fall semesters in 2019) available were invited to this follow-up study. Sleep duration, mid-sleep times, social jetlag (the difference between mid-sleep times on weekdays and weekends) and sleep latency were assessed using 7-day sleep diaries. Participants also completed the Pittsburgh Sleep Quality Index (PSQI), the Morningness/Eveningness Questionnaire, and the Behavior Rating Inventory of Executive function which yielded Global Executive Composite (GEC) scores. Paired t-test and multilevel random-effects models (STATA 16.0) estimated the associations. Covariates in multilevel models included age, sex, race, family income, parental education, COVID status, and health behaviors. Results Forty participants (19.25±1.12 years old) had paired data before and during COVID-19 pandemic. Participants slept 24 min longer (t= -2.07, p=0.03) but had increased sleep latency (t=-1.83, p=0.07) during the pandemic compared to pre-COVID baseline. Mid-sleep times shifted 40 min later (t= -3.22, p=0.003) during the pandemic. In multilevel models, GEC scores increased during pandemic (b=3.15, p=0.03) versus baseline, suggesting decreased executive function. Sleep duration (β=-4.72, p=0.03) significantly interacted with assessment time (before/during COVID-19), with increasing sleep duration attenuating the decline in EF during pandemic versus baseline. Although there was no interaction with COVID-19 pandemic, poor sleep quality (PSQI>5) was independently associated with decreased EF (B=4.69, p=0.02). Other sleep variables were not associated with EF nor moderators. Conclusion Compared with pre-COVID-19 baseline, young people report longer sleep duration, later sleep phase, increased sleep latency, and worse executive function during the pandemic. Sufficient sleep represents a resilience factor against executive function decline during this unprecedented crisis. Support (if any) No


SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A308-A309
Author(s):  
Nawar Aljundi ◽  
Kelsey Arvai ◽  
Michael Mitchell ◽  
Nishtha Pandya ◽  
Salam Zeineddine ◽  
...  

Abstract Introduction Fatigue is a core symptom of Multiple Sclerosis (MS) and impairs function and quality of life. Studies show that sleep-disordered breathing (SDB) is also common in persons with MS and may exacerbate fatigue. Within a larger study of patients with spinal cord injuries and disorders, we evaluated the relationships among sleep-disordered breathing severity, sleep quality, and functional outcomes in patients with MS. Our objective was to examine the impact of SDB severity and sleep quality on the severity of fatigue and functional impairment in this population. Methods Twenty-five subjects (average age=57(11), min=35, max=79; 80% male; average AHI=27(20) min=3, max=70; and 67% with AHI > 15) 24 completed in-laboratory polysomnography (PSG) to measure apnea-hypopnea index (AHI) and sleep efficiency (SE) and questionnaires about sleep and function: Insomnia Severity Index (ISI), Pittsburg Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), Flinders Fatigue Scale (FFS), PHQ-9 depression scale (excluding sleep item), Brief Pain Inventory (BPI) and World Health Organization Quality of Life (WHOQOL). Relationships between sleep measures (AHI and SE from PSG, ISI and PSQI) and daytime function (ESS, FFS, PHQ-9, BPI and WHOQOL) were assessed by bivariate correlation. Results At the baseline visit, we assessed participant’s daytime sleepiness, fatigue, sleep quality, and depression. The mean scores on questionnaires: ESS was 8.0(5.6), ISI was 11.5(6.7), PSQI was 9.3(4.4), FFS was 17.3(8.7), BPI severity was 3.4 (3.13), BPI interference was 3.5 (3.5), PHQ-9 was 7.3(5.8). There were significant relationships between ISI and FFS (r=0.78, p<0.001), PSQI and FFS (r=0.68, p=0.001), ISI and WHOQOL Physical Domain (r=-0.64 p=0.001), as well as SE and FFS (r=-0.45, p=0.041). There was no significant correlation between AHI and FFS (p=0.395). Conclusion In veterans with MS, insomnia symptom severity was associated with daytime fatigue and decreased quality of life (QOL). Insomnia may represent a modifiable cause of daytime fatigue in patients with MS. Recognition and management of insomnia may improve outcomes in this population. Further research should evaluate whether insomnia interventions may benefit daytime fatigue and improve QOL. Support (if any) VA Rehabilitation Research and Development Service, (RX002116; PI Badr); VA HSR&D RCS20-191 and NIH/NHLBI K24 HL143055 (PI Martin).


Respiration ◽  
2021 ◽  
pp. 1-12
Author(s):  
Jens Spiesshoefer ◽  
Simon Herkenrath ◽  
Katharina Harre ◽  
Florian Kahles ◽  
Anca Florian ◽  
...  

<b><i>Background and objective:</i></b> The clinical relevance and interrelation of sleep-disordered breathing and nocturnal hypoxemia in patients with precapillary pulmonary hypertension (PH) is not fully understood. <b><i>Methods:</i></b> Seventy-one patients with PH (age 63 ± 15 years, 41% male) and 35 matched controls were enrolled. Patients with PH underwent clinical examination with assessment of sleep quality, daytime sleepiness, 6-minute walk distance (6MWD), overnight cardiorespiratory polygraphy, lung function, hypercapnic ventilatory response (HCVR; by rebreathing technique), amino-terminal pro-brain natriuretic peptide (NT-proBNP) levels, and cardiac MRI (<i>n</i> = 34). <b><i>Results:</i></b> Prevalence of obstructive sleep apnea (OSA) was 68% in patients with PH (34% mild, apnea-hypopnea index [AHI] ≥5 to &#x3c;15/h; 34% moderate to severe, AHI ≥15/h) versus 5% in controls (<i>p</i> &#x3c; 0.01). Only 1 patient with PH showed predominant central sleep apnea (CSA). Nocturnal hypoxemia (mean oxygen saturation [SpO<sub>2</sub>] &#x3c;90%) was present in 48% of patients with PH, independent of the presence of OSA. There were no significant differences in mean nocturnal SpO<sub>2</sub>, self-reported sleep quality, 6MWD, HCVR, and lung and cardiac function between patients with moderate to severe OSA and those with mild or no OSA (all <i>p</i> &#x3e; 0.05). Right ventricular (RV) end-diastolic (<i>r</i> = −0.39; <i>p</i> = 0.03) and end-systolic (<i>r</i> = −0.36; <i>p</i> = 0.04) volumes were inversely correlated with mean nocturnal SpO<sub>2</sub> but not with measures of OSA severity or daytime clinical variables. <b><i>Conclusion:</i></b> OSA, but not CSA, is highly prevalent in patients with PH, and OSA severity is not associated with nighttime SpO<sub>2</sub>, clinical and functional status. Nocturnal hypoxemia is a frequent finding and (in contrast to OSA) relates to structural RV remodeling in PH.


2021 ◽  
Vol 10 (15) ◽  
pp. 3332
Author(s):  
Ayham Daher ◽  
Tobias Müller ◽  
Nikolaus Marx ◽  
Jörg Schröder ◽  
Mohammad Almalla ◽  
...  

Sleep disordered breathing (SDB) is common among patients with valvular heart disease, and successful valve surgery could reduce SDB severity. However, data about the effects of transcatheter mitral valve repair on SDB are scarce. Therefore, mitral regurgitation (MR) patients undergoing MitraClip-placement were prospectively enrolled. Before MitraClip-placement, daytime sleepiness and sleep quality were assessed using the Epworth Sleepiness Scale (ESS) and Pittsburgh Sleep Quality Index (PSQI), respectively; and all patients underwent SDB screening using five-channel respiratory polygraphy. After 3–6 months, patients had a similar reassessment including: ESS, PSQI, and respiratory polygraphy. 67 patients were included (77 ± 8years). Despite normal sleepiness scores, 41 patients (61%) had SDB with apnea-hypopnea-index (AHI) ≥ 15 h before MitraClip-placement, of whom only three patients had known SDB previously. Compared to patients without SDB, patients with SDB had similar sleepiness scores but higher NT-proBNP values at baseline (4325 vs. 1520 pg/mL, p < 0.001). At follow-up, there were significant AHI improvements among patients with SDB (p = 0.013). However, there were no significant sleepiness score changes. In conclusion, the prevalence of SDB among MitraClip candidates is very high even in those without daytime sleepiness. MR patients with SDB have higher NT-proBNP values, which may reflect a worse prognosis. MitraClip-placement may improve the underlying SDB, which could be an additional benefit of the procedure.


2020 ◽  
Vol 15 (8) ◽  
pp. 1117-1124
Author(s):  
Jordan L. Fox ◽  
Aaron T. Scanlan ◽  
Robert Stanton ◽  
Cody J. O’Grady ◽  
Charli Sargent

Purpose: To examine the impact of workload volume during training sessions and games on subsequent sleep duration and sleep quality in basketball players. Methods: Seven semiprofessional male basketball players were monitored across preseason and in-season phases to determine training session and game workloads, sleep duration, and sleep quality. Training and game data were collected via accelerometers, heart-rate monitors, and rating of perceived exertion (RPE) and reported as PlayerLoad™ (PL), summated heart-rate zones, and session RPE (sRPE). Sleep duration and sleep quality were measured using wrist-worn activity monitors in conjunction with self-report sleep diaries. For daily training sessions and games, all workload data were independently sorted into tertiles representing low, medium, and high workload volumes. Sleep measures following low, medium, and high workloads and control nights (no training/games) were compared using linear mixed models. Results: Sleep onset time was significantly later following medium and high PL and sRPE game workloads compared with control nights (P < .05). Sleep onset time was significantly later following low, medium, and high summated heart-rate-zones game workloads, compared with control nights (P < .05). Time in bed and sleep duration were significantly shorter following high PL and sRPE game workloads compared with control nights (P < .05). Following low, medium, and high training workloads, sleep duration and quality were similar to control nights (P > .05). Conclusions: Following high PL and sRPE game workloads, basketball practitioners should consider strategies that facilitate longer time in bed, such as napping and/or adjusting travel or training schedules the following day.


SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A89-A89
Author(s):  
Caroline Tse ◽  
Alicia Stewart ◽  
Omar Ordaz-Johnson ◽  
Maya Herzig ◽  
Jacqueline Gagnon ◽  
...  

Abstract Introduction Cannabis use is on the rise in the United States, with 10% of adults reporting cannabis use in the past 30 days. Users commonly report consuming cannabis to improve sleep despite the lack of research that supports an association between cannabis use and sleep. In this pilot study we sought to examine objective measures of sleep duration and sleep quality among non- and chronic-cannabis users, and any patterns in relation to the time since consumption of cannabis. Methods Chronic cannabis users (cannabis used 2 or more times/week) and non-users provided up to 2-weeks of actigraphy (ActiGraph wGT3X-BT), worn on the wrist and verified by sleep diary. Chronic cannabis users also reported the date, time, amount, and route of their cannabis use. Mixed-effects models with participant as a random factor were used to examine: 1) the relationship between daily sleep parameters in cannabis non-users vs. users; and 2) the elapsed time between cannabis use and time in bed in chronic cannabis users. Results Chronic cannabis users (n=6) and non-users (n=7) collectively provided 151 nights of sleep. Participant characteristics (38.5% female; age, 25.8 years ± 4 years; BMI, 23.4 kg/m2 ± 3.4 kg/m2) did not significantly differ between groups. Cannabis use was associated with decreased total sleep time (measured in hours, ß=-0.58, p&lt;0.001) and increased wake after sleep onset (WASO, ß=32.79, p=0.005), but not with the number of awakenings (ß=6.02, p=0.068). Among chronic cannabis users, cannabis use within two hours of bed was associated with increased sleep latency compared to use greater than two hours (ß=6.66, p=0.026). There was no association between time of cannabis use and WASO (p=0.621) or the number of awakenings (p=0.617). Conclusion In this pilot study of objectively measured sleep, we found that chronic cannabis use compared to non-use is associated with decreased sleep duration of otherwise healthy adults. Cannabis used closer to bedtime is associated with increased sleep latency. Additional studies that are able to assess the mode and dosage of use are needed to further understand the effects of cannabis and its components on sleep. Support (if any) KL2TR002370, AASM, Oregon Institute of Occupational Health Sciences


SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A366-A367
Author(s):  
P Raine ◽  
J Wang ◽  
S Pitt

Abstract Introduction Liquid consumption is essential for daily function and may also play a role in sleep regulation. The aim of this study was to assess 1) the association between the frequency of liquid consumption and sleep patterns; and 2) the different types of liquids on the association between liquid consumption and sleep. Methods Participants included 597 children ages 9-13 years old from the China Jintan Child Cohort Study. To assess child liquid intake, children self-reported the types of liquids consumed and the frequency these liquids were consumed. To assess sleep patterns, both parents and children reported sleep patterns using the parent-reported Child Sleep Habit Questionnaire (CSHQ) and a child self-reported questionnaire. Descriptive statistics and independent sample t-tests analyses were performed to examine the differential effects of liquid consumption frequency and sleeping habits. Results Overall, a slight dose-dependent relationship between liquid consumption and sleep quality was observed. Less sleep problems and improved sleep quality were observed for water (bedtime resistance, sleep anxiety, night awakenings, parasomnias, sleep-disordered breathing, daytime sleepiness; p&lt;0.05) and milk (parasomnias, sleep-disordered breathing, p&lt;0.05) consumption. Caffeinated soda tended to increase sleep problems (sleep-disordered breathing, p&lt;0.05). Sleep onset delay had a different pattern from that of other subscales, in which water increased sleep problems and caffeinated soda decreased sleep problems. There was some discrepancy between parent- and self-reported parasomnias, but sleep disordered breathing showed consistent patterns. Conclusion Children who consumed more liquid, especially water and milk, were more likely to experience less sleep problems. However, caffeinated soda consumption may be linked to increased sleep problems. Findings suggest that school children may need consume more healthy liquids for better sleep patterns. Future randomized-controlled trial studies are needed to verify these findings. Support This study was funded by the National Institutes of Environmental Health Sciences and the National Institutes of Health (R01-ES-018858, K02-ES-019878, and K01-ES015877).


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