704 The Association of Sleep Disorders in Patients with Chronic Pain Disorders

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A275-A275
Author(s):  
Marine Khachatryan ◽  
Jenna Kay ◽  
Sejal Jain
Keyword(s):  
Sleep Apnea ◽  
Sleep Quality ◽  
Regression Model ◽  
Sleep Disorders ◽  
Sleep Disorder ◽  
Pain Score ◽  
Pain Perception ◽  
Pain Clinic ◽  
Before And After ◽  
The Impact

Abstract Introduction Sleep and pain are interrelated and have a bidirectional relationship. The study was performed to identify the impact of sleep disorders on pain perception. Methods The institutional review board approved the study. Patients evaluated in the Pain Clinic between 1/1/2014 and 12/31/2017 who had polysomnography done were identified by database search. Chart review identified demographics, initial pain score, pain treatments, sleep disorder diagnosis, treatments of sleep disorder and pain scores after sleep treatments. Numerical pain score (NPS) and insomnia severity index (ISI) were used as a measure of pain and sleep quality, respectively. The descriptive statistics were presented by percentages, mean and standard deviations. Regression analysis was performed between initial NPS and ISI. T-test compared change in NPS for compliant and non-compliant subjects, before and after sleep treatments. Linear regression model identified factors associated with changes in pain perception after sleep treatments. Results Of the 320 participants identified, complete data was available for 180 subjects. The average age was 55.9±13.9; 51.41% were female; 60.2% were Caucasian and 26.64% were Hispanic. Initial NPS was 8.8±1.7, average ISI was 15.00±6.41, average BMI was 35.4±10.2. Ninety-five percent had a diagnosis of obstructive sleep apnea (OSA), 27.81% had restless leg syndrome, and 7.19% had complex sleep apnea. Since most patients had OSA, details of positive airway pressure (PAP) treatments were also investigated. Of 84% of subjects treated with PAP, compliance data were available for 53%, which showed 69% (n=55) being complaint with PAP. Initial NPS correlated positively with ISI (R2: 0.064±0.024, p<0.01). No difference in NPS was found in groups based on compliance, before and after PAP treatments. Regression model identified that BMI was the most significant factor in the change in NPS following sleep treatment (R2: 0.083±0.034, p = 0.03). Conclusion The study identified that the severity of pain is associated with poor quality of sleep. While this study failed to identify improvement in pain perception after successful OSA treatment, limited number of subjects in our study were compliant with PAP treatment which may have impacted the results. Future prospective studies are needed to understand the complex association between improvement in sleep quality and pain perception. Support (if any):

scholarly journals 1183 Board-certified Sleep Medicine Physicians See A Greater Proportion Of Complex Sleep Patients Than Non-specialist Providers

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A452-A452
Author(s):  
S L Jobe ◽  
J S Albrecht ◽  
S M Scharf ◽  
A M Johnson ◽  
S Parthasarathy ◽  
...  
Keyword(s):  
Sleep Apnea ◽  
Sleep Disorders ◽  
Sleep Disorder ◽  
Sleep Medicine ◽  
Board Certification ◽  
Administrative Claims ◽  
Medicare Beneficiaries ◽  
Sleep Complaints ◽  
Obstructive Sleep ◽  
The Impact

Abstract Introduction Despite a growing literature regarding the impact of board-certification in sleep medicine, little is known about the complexity of patients seen by board-certified sleep medicine physicians (BCSMPs) relative to non-specialists. To address this gap, the purpose of the current study was to evaluate the differences in sleep complaints among Medicare beneficiaries seen by BCSMPs relative to individuals seen by non-specialists. Methods Our data source was a random 5% sample of Medicare administrative claims data from 2006-2013. Sleep disorders were operationalized using International Classification of Diseases, Ninth Revision, Clinical Modification codes. Descriptive analyses were performed to estimate the number of sleep disorder diagnoses patients received by provider status. BCSMPs were identified using a cross-matching procedure based on National Provider Identifier (NPI). Results A total of 57,209 Medicare beneficiaries received a sleep disorder diagnosis between 2006-2013. Of these, only 2.2% were seen by BCSMPs. Relative to beneficiaries seen by non-specialists, those seen by BCSMPs were more likely to be diagnosed with more than one sleep disorder (p<0.001). Specifically, 91.0% of individuals seen by non-specialists received only one sleep disorder diagnosis, whereas 75.9% of individuals seen by BCSMPs received only one sleep disorder diagnosis. Among beneficiaries seen by non-specialists, the most common sleep disorders were insomnia (48.2%; n=26,967), obstructive sleep apnea (OSA; 31.4%; n=17,554), and restless legs syndrome (8.7%; n=4,871). Among those seen by BCSMPs, the most common sleep disorders were OSA, (70.4%; n=901), sleep apnea with hypersomnia (16.5%; n=211), and insomnia (11.7%; n=150). Conclusion BCSMPs see more complex sleep patients than do non-specialists. These results suggest the possibility that more complex patients are referred for sleep specialty care. Further, these results demonstrate the value of board certification in sleep medicine in caring for complex sleep patients. Support This research was supported by an AASM Strategic Research Award from the AASM Foundation to the University of Maryland, Baltimore (PI: EMW).

scholarly journals Seizures, Stimulators, and Sleep, Oh My!

2019 ◽  
pp. 629-641
Author(s):  
Thapanee Somboon ◽  
Nancy Foldvary-Schaefer
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Sleep Disorders ◽  
Sleep Disorder ◽  
Vagus Nerve Stimulation ◽  
Sleep Complaints ◽  
Obstructive Sleep ◽  
High Prevalence ◽  
The Impact

This chapter discusses the relationships between epilepsy and sleep disorders, and the impact of vagus nerve stimulation (VNS) on breathing in sleep. The prevalence of sleep disorders in people with epilepsy is twofold to threefold greater than estimates in the general population. Obstructive sleep apnea (OSA) is the most common sleep disorder investigated in epilepsy populations. Treatment of OSA has been shown to reduce seizures in some patients. In contrast, VNS therapy for epilepsy is associated with stimulation-induced respiratory changes in sleep, and in some cases it produces a clinical OSA syndrome. Given the high prevalence of sleep complaints among people with epilepsy, further research is warranted to confirm the role of sleep disorder therapies in epilepsy.

scholarly journals Evaluation of quality of sleep in women with stress urinary incontinence before and after surgical correction

2018 ◽  
Vol 16 (2) ◽  
Author(s):  
Josyandra Paula de Freitas ◽  
Mariana Pereira Inácio Silvestri ◽  
César Eduardo Fernandes ◽  
Emerson de Oliveira
Keyword(s):  
Urinary Incontinence ◽  
Stress Urinary Incontinence ◽  
Sleep Quality ◽  
Sleep Disorder ◽  
Epworth Sleepiness Scale ◽  
Quality Index ◽  
Pittsburgh Sleep Quality Index ◽  
Quality Of Sleep ◽  
Before And After

ABSTRACT Objective: To evaluate the quality of sleep in women with urinary incontinence before and after sling surgery. Methods: A prospective study of case series of women with urodynamic diagnosis of stress urinary incontinence. To evaluate the subjective quality of sleep, two specific questionnaires were used and validated for the Portuguese Language: Epworth Sleepiness Scale and Pittsburgh Sleep Quality Index. The questionnaires were applied before and 6 months after surgical repair. Results: When analyzing the Epworth Sleepiness Scale, there was an improvement in sleep quality (p=0.0401). For the Pittsburgh Sleep Quality Index, only for sleep disorder there was improvement in quality of sleep after surgery (p=0.0127). Conclusion: Women with urinary incontinence, submitted to surgery with sling, showed improvement in both quality of sleep and sleep disorder.

Impact of adenotonsillectomy on the quality of life of patients operated on at the Hospital de Clínicas, Paraguay

2021 ◽  
pp. 1-7
Author(s):  
Carlos Mena Canata ◽  
Rebeca Noemí Ruiz Vallejos
Keyword(s):  
Quality Of Life ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Rural Areas ◽  
Urban Areas ◽  
Obstructive Sleep ◽  
Significant Difference ◽  
Before And After ◽  
The Impact

The objective of this study is to determine the impact of adenotonsillectomy on the quality of life of postoperative patients.The study is observational, cross-sectional, and retrospective. The files of all postoperative adenotonsillectomy patients in Otorhinolaryngology Service, Hospital de Clínicas, San Lorenzo Paraguay. The Obstructive sleep apnea – 18 questionnaire (OSA 18) was applied, asking patients about symptoms before and after surgery. An effective sample of 143 postoperative patients was obtained. The average age was 6.05 ± 2.08 years, 55.10% (81) were male and 44.89% (66) were female, 65.30% (96) were from urban areas and 34.69% (51) from the rural areas. The t test was performed for means of two paired samples, comparing the results of the Obstructive sleep apnea – 18 questionnaire surveys before and after surgery which presented a significant difference (p <0.05) with a tendency to improve the quality of life after surgery. It has been shown that there is a significant difference, a considerable improvement in the quality of life of patients after adenotonsillectomy.

scholarly journals The Association of Unreported Sleep Disturbances and Systemic Inflammation: Findings from the 2005-2008 NHANES

2018 ◽  
Vol 2018 ◽  
pp. 1-8
Author(s):  
Jeff A. Dennis ◽  
Ahmad Alazzeh ◽  
Ann Marie Kumfer ◽  
Rebecca McDonald-Thomas ◽  
Alan N. Peiris
Keyword(s):  
Sleep Apnea ◽  
Sleep Disturbance ◽  
Sleep Disorders ◽  
Sleep Disorder ◽  
Inflammatory Markers ◽  
Sleep Disturbances ◽  
Laboratory Data ◽  
Poor Sleep ◽  
Distribution Width ◽  
Inflammatory Status

Background/Objective. Sleep apnea is associated with elevated inflammatory markers. A subgroup of patients never report sleep disturbances to their physician. The inflammatory status of this subgroup is not known. The present study aims to evaluate two inflammatory markers, C-reactive protein (CRP) and red cell distribution width (RDW), in those with unreported sleep disturbances and compares these findings to those with and without reported sleep disorders. We also investigate the utility of RDW as an inflammatory marker in sleep disorders. Methods. Sample includes 9,901 noninstitutionalized, civilian, nonpregnant adults from the 2005-2008 National Health and Nutrition Examination Survey, a nationally representative, cross-sectional U.S. study. Sleep questionnaire and laboratory data were used to compare inflammatory markers (CRP and RDW) in five subgroups of individuals: reporting physician-diagnosed sleep apnea, reporting another physician-diagnosed sleep disorder, reported sleep disturbance to physician with no resulting diagnosis, unreported sleep disturbance (poor sleep quality not reported to physician), and no diagnosed sleep disorder or sleep disturbance. Results. Individuals with unreported sleep disturbance had significantly higher odds of elevated RDW (>13.6%) when compared to those without a sleep disturbance in adjusted models (OR=1.33). Those with unreported sleep disturbance had significantly higher odds of elevated CRP levels (>1 mg/L) than those without sleep disturbances (OR 1.34), although the association was not significant when adjusted for obesity and other controls. Conclusion. Self-identified unreported sleep disturbances are associated with significantly higher odds of elevated RDW than those without sleep disturbances. RDW may serve as a valuable indicator in identifying individuals at higher risk for sleep apnea and other sleep disorders.

Changes in Sleep Quality Following Treatment for Chronic Rhinosinusitis: A Systematic Review and Meta-Analysis

2021 ◽  
pp. 194589242110614
Author(s):  
Jacob Fried ◽  
Erick Yuen ◽  
David A. Gudis ◽  
Rodney J. Schlosser ◽  
Shaun A. Nguyen ◽  
...  
Keyword(s):  
Sleep Apnea ◽  
Sleep Quality ◽  
Chronic Rhinosinusitis ◽  
Meta Analysis ◽  
Patient Reported Outcome Measures ◽  
Cochrane Library ◽  
Patient Reported ◽  
Sleep Parameters ◽  
The Impact ◽  
Snot 22

Background Chronic rhinosinusitis (CRS) presents with broad and systemic manifestations, including impaired sleep; however, the impact of CRS treatments upon sleep is unknown. Objective To establish the effect of medical or surgical CRS treatment on subjective and objective sleep metrics for patients not previously diagnosed with sleep apnea. Methods Review of PubMed, Scopus, Web of Science, and the Cochrane Library was performed from the databases’ date of inception through August 13, 2020, for studies evaluating the effect of CRS treatment on sleep quality. All studies reporting on subjective and objective sleep parameters for patients with CRS, with completed pre- and posttreatment data were included. Studies composed of patients with diagnosed sleep apnea were excluded. Results Sixteen unique studies reporting data on a total of 1770 patients (mean age, 50.6 ± 15.6 (n = 1675) years) following treatment for CRS were included. Patient-reported outcome measures, Epworth Sleepiness Scale, Pittsburgh Sleep Quality Index, and Fatigue Severity Scale, demonstrated mean posttreatment differences of −2.8 (95% CI: −4.9 to −0.7), −2.4 (95% CI: −3.7 to −1.2), and −1.2 (95% CI: −1.6 to −0.7), respectively. The SNOT-22 and its sleep domain demonstrated a mean posttreatment difference of −23.5 (95% CI: −31.7 to −15.3) and −5.4 (95% CI: −6.8 to −4.0), respectively. EpSS, FSS and SNOT-22 exceeded their respective reported MCID values. Objective findings did not significantly change with treatment; mean difference: AHI: 0.7 (95% CI: −1.5 to 2.9), oxygen nadir: 0.3 (95% CI: −0.4 to 0.9). Conclusions Treatment of CRS may lead to clinically meaningful reduction in disease burden and improvements in both overall sleep quality and patient-reported fatigue. Despite clinically meaningful quality of life improvements, objective sleep parameters did not demonstrate corresponding posttreatment improvements.

430 Outcome of Sleep-Wake Pattern in Obstructive Sleep Apnea Patients after Positive Airway Pressure Therapy using Actigraphy

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A170-A170
Author(s):  
Narumol Luekitinun ◽  
Kanlaya Panjapornpon ◽  
Pattharaphong Plurksathaporn ◽  
Rungaroon Tangsrikertikul ◽  
Wanlana Tongkien ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Sleep Quality ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Matched Pair ◽  
Cpap Therapy ◽  
Obstructive Sleep ◽  
Before And After ◽  
Sleep Parameters

Abstract Introduction The initial phase of continuous positive airway pressure (CPAP) therapy in patients with obstructive sleep apnea (OSA) may affect sleep parameters and PAP compliance. Actigraphy is a validated method using accelerometer to objectively measure sleep parameters in patients with a range of sleep disorders, including OSA, particularly to follow-up after treatment. We compare sleep parameters from actigraphy, sleep log, sleep diary, Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI), heart rate and blood pressure in OSA patients before and after CPAP therapy for 1 week. Methods This pilot study have been prospectively performed at Central Chest Institute of Thailand (CCIT) since June to November 2020. Adult OSA patients, diagnosed by ICSD-3 criteria and achieved optimal or good CPAP pressure titration from split-night polysomnography (PSG), were informed and consent to wear actigraphy before and after CPAP therapy each for 1 week. Clinical and sleep parameters were recorded and analyzed using Wilcoxon matched-pair signed-rank and Mann Whitney U test. P-value &lt; 0.05 was considered to have statistical significance. Results All 11 OSA patients participated in this study. Most patients were male (63.6%), hypertension (54.5%) and dyslipidemia (45.4%). Means of age, body mass index (BMI), ESS, PSQI, apnea hypopnea index (AHI), nadir SpO2, and CPAP usage were 45.5 ± 15.9 years, 29.1 ± 5.2 kg/m2, 10.8 ± 3.9, 7.7 ± 2.9, 65.2 ± 37.7 events/h, 82.3 ± 10.8 % and 9.5 ± 3.1 cmH2O, respectively. Comparing before and after 1-week CPAP therapy, an average number of wake bouts ((NWB), 48.4 vs 38 events, p=0.010), ESS (11 vs 9, p=0.035) and PSQI (8 vs 4, p=0.005) were significantly decrease. Additionally, when comparing between poor and good CPAP compliance group, NWB (55.1 vs 36.3 events, p=0.036) and the difference of wake after sleep onset (WASO, 10.5 vs -0.11 min, p=0.035) were significantly decrease. Conclusion OSA patients treated with CPAP for 1-week experienced marked improvement in sleepiness, sleep quality and nighttime awakening. Support (if any):

scholarly journals The impact of changes in serum levels of metalloproteinase-2 and metalloproteinase-9 on pain perception in patients with disc herniation before and after surgery

2019 ◽  
Vol Volume 12 ◽  
pp. 1457-1464
Author(s):  
Piotr Kamieniak ◽  
Joanna Bielewicz ◽  
Jacek Kurzepa ◽  
Beata Daniluk ◽  
Joanna Kocot ◽  
...  
Keyword(s):  
Disc Herniation ◽  
Pain Perception ◽  
Serum Levels ◽  
Before And After ◽  
The Impact ◽  
Metalloproteinase 9

scholarly journals Automatic Sleep Disorders Classification Using Ensemble of Bagged Tree Based on Sleep Quality Features

Electronics ◽  
2020 ◽  
Vol 9 (3) ◽  
pp. 512 ◽  
Author(s):  
Edita Rosana Widasari ◽  
Koichi Tanno ◽  
Hiroki Tamura
Keyword(s):  
Sleep Quality ◽  
Sleep Disorders ◽  
Sleep Disorder ◽  
Sleep Stage ◽  
Computational Cost ◽  
Behavior Disorder ◽  
The Elderly ◽  
Support Vector ◽  
Ecg Signal ◽  
Quality Features

Sleep disorder is a medical disease of the sleep patterns, which commonly suffered by the elderly. Sleep disorders diagnosis and treatment are considered to be challenging due to a time-consuming and inconvenient process for the patient. Moreover, the use of Polysomnography (PSG) in sleep disorder diagnosis is a high-cost process. Therefore, we propose an efficient classification method of sleep disorder by merely using electrocardiography (ECG) signals to simplify the sleep disorders diagnosis process. Different from many current related studies that applied a five-minute epoch to observe the main frequency band of the ECG signal, we perform a pre-processing technique that suitable for the 30-seconds epoch of the ECG signal. By this simplification, the proposed method has a low computational cost so that suitable to be implemented in an embedded hardware device. Structurally, the proposed method consists of five stages: (1) pre-processing, (2) spectral features extraction, (3) sleep stage detection using the Decision-Tree-Based Support Vector Machine (DTB-SVM), (4) assess the sleep quality features, and (5) sleep disorders classification using ensemble of bagged tree classifiers. We evaluate the effectiveness of the proposed method in the task of classifying the sleep disorders into four classes (insomnia, Sleep-Disordered Breathing (SDB), REM Behavior Disorder (RBD), and healthy subjects) from the 51 patients of the Cyclic Alternating Pattern (CAP) sleep data. Based on experimental results, the proposed method presents 84.01% of sensitivity, 94.17% of specificity, 86.27% of overall accuracy, and 0.70 of Cohen’s kappa. This result indicates that the proposed method able to reliably classify the sleep disorders merely using the 30-seconds epoch ECG in order to address the issue of a multichannel signal such as the PSG.

Autonomic dysfunction and sleep disorders

2017 ◽  
Author(s):  
Giovanna Calandra-Buonaura ◽  
Pietro Cortelli
Keyword(s):  
Sleep Disorders ◽  
Sleep Disorder ◽  
Autonomic Dysfunction ◽  
Sleep Apnea Syndrome ◽  
Rem Sleep Behavior Disorder ◽  
Causal Mechanism ◽  
Sleep Behavior ◽  
Obstructive Sleep ◽  
Autonomic Dysfunctions ◽  
The Impact

Autonomic dysfunctions are frequently associated with sleep disorders, as the autonomic nervous system and sleep are closely related from anatomical, physiological, and neurochemical points of view. The autonomic dysfunctions described in this chapter may result from a common pathogenetic mechanism that affects both the autonomic and the sleep functions, as in fatal familial insomnia, or from a prevalent expression of a primary disorder of autonomic regulation during sleep, as in congenital central hypoventilation syndrome. Alternatively, the autonomic dysfunction may be mainly caused by the sleep disorder, as observed in obstructive sleep apnea syndrome, or the causal mechanism resulting in the association between the autonomic dysfunction and the sleep disorder has yet to be identified with certainty, as in narcolepsy with cataplexy and in REM sleep behavior disorder. The impact of the autonomic dysfunction on health and on patients’ quality of life is also reviewed.

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