scholarly journals P015 Home (Level 2) sleep studies are feasible in children

2021 ◽  
Vol 2 (Supplement_1) ◽  
pp. A26-A26
Author(s):  
K Russo ◽  
J Greenhill ◽  
S Burgess
Keyword(s):  
Sleep Time ◽  
Young Person ◽  
Clinical Population ◽  
Limited Data ◽  
Sleep Study ◽  
Sleep Studies ◽  
Quality And Outcomes ◽  
Home Sleep Study ◽  
The Guardian ◽  
Level 2

Abstract Introduction In-hospital polysomnography (PSG or Level 1 study) is the “gold-standard” for investigating sleep disorders in children. There are long waiting lists for sleep studies in Australian tertiary centres. Level 2 home-PSG has been proposed as an alternate option. However, there are limited data regarding the feasibility in a clinical population. The aim of this study is to assess the feasibility and patient experience of home-PSG in a clinical cohort. Methods The signal quality and outcomes of a home-PSG in young people undergoing sleep investigation in a single centre were reviewed. A successful home-PSG was defined as a study with ≥ 6hrs of sleep and all channels present for ≥90% of sleep time. Feedback from the guardian/young person was collected using a questionnaire. Results Fifty-five patients (4m-18yrs) were included. Successful home-PSG, on the first attempt, was achieved for 48/55 (87%) patients. There were no differences in success when accounting for neurodevelopmental conditions, OSA severity or age. A clinical diagnosis was confidently made in 53 (96%) patients. The majority (76%) rated their sleep as the same or better than normal and only 12% found having the study conducted at home difficult. Following the study, only 8% would have preferred a hospital sleep study. Discussion Home-PSG produced technically adequate recordings for most subjects and families found the experience of having a home sleep study to be positive. These data support, in appropriate circumstances, home-PSG as a viable alternative to an in-patient sleep study.

A Sleep Laboratory Evaluation of the Long-Term Efficacy of Zopiclone

1988 ◽  
Vol 33 (2) ◽  
pp. 103-107 ◽  
Author(s):  
Jonathan A.E. Fleming ◽  
Jean Bourgouin ◽  
Peter Hamilton
Keyword(s):  
Sleep Onset ◽  
Sleep Time ◽  
Sleep Efficiency ◽  
Laboratory Evaluation ◽  
Sleep Study ◽  
Sleep Studies ◽  
Metallic Taste ◽  
Hypnotic Medication ◽  
Drug Free

Six patients between the ages of 25 and 59, with chronic, primary insomnia received the new, non-benzodiazepine, hypnotic zopiclone continuously for 17 weeks after a drug free interval of 12 nights. To qualify for the study, sleep efficiency, determined by a sleep study on two, consecutive, placebo-controlled nights, had to be less than 75%. Patients evaluated their sleep by questionnaire and had sleep studies completed throughout active treatment. Zopiclone (7.5 mg) increased sleep efficiency by decreasing sleep latency, wakefulness after sleep onset and increasing total sleep time. Sleep architecture was minimally affected by zopiclone treatment; no significant changes in delta or REM sleep were observed. The commonest side effect was a bitter or metallic taste. No significant changes in biological functioning were noted throughout the study period. These findings indicate that zopiclone is a safe and effective hypnotic medication which maintains its effectiveness with protracted use.

scholarly journals P022 Unattended home sleep studies have a high recording failure rate in a preoperative anaesthetic clinic cohort when done as a routine screening procedure for Obstructive Sleep Apnoea (OSA)

2021 ◽  
Vol 2 (Supplement_1) ◽  
pp. A28-A29
Author(s):  
B Chuong ◽  
J Cho ◽  
J Wheatley
Keyword(s):  
Failure Rate ◽  
Large Scale ◽  
Sleep Apnoea ◽  
High Failure Rate ◽  
Sleep Study ◽  
Failure Group ◽  
Sleep Studies ◽  
Obstructive Sleep ◽  
Recorded Data ◽  
Home Sleep Study

Abstract Introduction Preoperative screening for OSA is strongly advised but attended laboratory sleep studies have limited availability. Portable unattended sleep monitors, such as ApneaLink, may provide a practical solution for large scale preoperative OSA screening. However, these unattended monitors may be prone to data recording failure. Methods We performed a prospective, uncontrolled, before-after study from March 2017 to December 2018 where patients from a pre-operative anaesthetic clinic were screened for OSA with an ApneaLink home sleep study (AHSS). 24 initial patients were provided with version 1 (v.1) recording instructions, while the next 24 patients received version 2 (v.2) which included colour, more detail and larger pictures compared to v.1. Recording failure was defined as an absence of recorded ApneaLink data. We analysed predictors of recording failure including instruction version and patient factors using logistic regression. Results Thirty-three of 48 (69%) patients successfully completed an AHSS. Failure rate was 31%. Median duration of recorded data was 480 minutes. The successful recording group was more likely to have used v.2 instructions than the failure group (61% vs. 27%; p=0.029). The odds ratio for successful recording using v.2 was 4.2 (95% CI: 1.1–16.2). Age, gender, country of birth, and number of days prior to surgery were not associated with recording failure. Discussion There was a high failure rate of AHSS for OSA screening from a preoperative anaesthetic clinic. Clear written instructions with greater use of colours and pictures may improve the recording success rate in this cohort.

scholarly journals Revisiting level II sleep studies in the era of COVID-19: a theoretical economic decision model in patients with suspected obstructive sleep apnea

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Najib T. Ayas ◽  
Rachel Jen ◽  
Brett Baumann
Keyword(s):  
British Columbia ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Decision Model ◽  
Sleep Study ◽  
Diagnostic Algorithms ◽  
Sleep Studies ◽  
Level Ii ◽  
Obstructive Sleep ◽  
Home Sleep Study

Abstract Background The recent pandemic has made it more challenging to assess patients with suspected obstructive sleep apnea (OSA) with in laboratory polysomnography (PSG) due to concerns of patient and staff safety. The purpose of this study was to assess how Level II sleep studies (LII, full PSG in the home) might be utilized in diagnostic algorithms of suspected OSA using a theoretical decision model. Methods We examined four diagnostic algorithms for suspected OSA: an initial PSG approach, an initial LII approach, an initial Level III approach (LIII, limited channel home sleep study) followed by PSG if needed, and an initial LIII approach followed by LII if needed. Costs per patient assessed was calculated as a function of pretest OSA probability and a variety of other variables (e.g. costs of tests, failure rate of LIII/LII, sensitivity/specificity of LIII). The situation in British Columbia was used as a case study. Results The variation in cost per test was calculated for each algorithm as a function of the above variables. For British Columbia, initial LII was the least costly across a broad range of pretest OSA probabilities (< 0.80) while initial LIII followed by LII as needed was least costly at very high pretest probability (> 0.8). In patients with a pretest OSA probability of 0.5, costs per patient for initial PSG, initial LII, initial LIII followed by PSG, and initial LIII followed by LII were: $588, $417, $607, and $481 respectively. Conclusions Using a theoretical decision model, we developed a preliminary cost framework to assess the potential role of LII studies in OSA assessment. Across a broad range of patient pretest probabilities, initial LII studies may provide substantial cost advantages. LII studies might be especially useful during pandemics as they combine the extensive physiologic information characteristic of PSG with the ability to avoid in-laboratory stays. More empiric studies need to be done to test these different algorithms.

scholarly journals Feasibility and parental perception of home sleep studies during COVID-19: a tertiary sleep centre experience

2021 ◽  
pp. archdischild-2021-322184
Author(s):  
Susan Jones ◽  
Ross Hanwell ◽  
Tharima Chowdhury ◽  
Jane Orgill ◽  
Kirandeep van den Eshof ◽  
...  
Keyword(s):  
Success Rate ◽  
Failure Rate ◽  
Home Environment ◽  
Neurodevelopmental Disorders ◽  
Parental Perception ◽  
Completion Rates ◽  
Sleep Study ◽  
Sleep Studies ◽  
Lower Success Rate ◽  
Respiratory Polygraphy

ObjectiveRapid implementation of home sleep studies during the first UK COVID-19 ‘lockdown’—completion rates, family feedback and factors that predict success.DesignWe included all patients who had a sleep study conducted at home instead of as inpatient from 30 March 2020 to 30 June 2020. Studies with less than 4 hours of data for analysis were defined ‘unsuccessful’.Results137 patients were included. 96 underwent home respiratory polygraphy (HRP), median age 5.5 years. 41 had oxycapnography (O2/CO2), median age 5 years. 56% HRP and 83% O2/CO2 were successful. A diagnosis of autism predicted a lower success rate (29%) as did age under 5 years.ConclusionSwitching studies rapidly from an inpatient to a home environment is possible, but there are several challenges that include a higher failure rate in younger children and those with neurodevelopmental disorders.

Abstract P417: Relationship Between Blood Pressure Variability and Sleep Architecture

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Xiaoyue Liu ◽  
Jeongok G Logan ◽  
Younghoon Kwon ◽  
Jennifer Lobo ◽  
Hyojung Kang ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Eye Movement ◽  
Rem Sleep ◽  
Sleep Time ◽  
Sleep Architecture ◽  
Sleep Stages ◽  
Apnea Hypopnea Index ◽  
Rapid Eye Movement ◽  
Sleep Studies ◽  
The Relationship

Introduction: Blood pressure (BP) variability (BPV) is a novel marker for cardiovascular disease (CVD) independent of high BP. Sleep architecture represents the structured pattern of sleep stages consisting of rapid eye movement (REM) and non-rapid eye movement (NREM), and it is an important element in the homeostatic regulation of sleep. Currently, little is known regarding whether BPV is linked to sleep stages. Our study aimed to examine the relationship between sleep architecture and BPV. Methods: We analyzed in-lab polysomnographic studies collected from individuals who underwent diagnostic sleep studies at a university hospital from 2010 to 2017. BP measures obtained during one year prior to the sleep studies were included. BPV was computed using the coefficient of variation for all individuals who had three or more systolic and diastolic BP data. We conducted linear regression analysis to assess the relationship of systolic BPV (SBPV) and diastolic BPV (DBPV) with the sleep stage distribution (REM and NREM sleep time), respectively. Covariates that can potentially confound the relationships were adjusted in the models, including age, sex, race/ethnicity, body mass index, total sleep time, apnea-hypopnea index, mean BP, and history of medication use (antipsychotics, antidepressants, and antihypertensives) during the past two years before the sleep studies. Results: Our sample (N=3,565; male = 1,353) was racially and ethnically diverse, with a mean age 54 ± 15 years and a mean BP of 131/76 ± 13.9/8.4 mmHg. Among the sleep architecture measures examined, SBPV showed an inverse relationship with REM sleep time after controlling for all covariates ( p = .033). We subsequently categorized SBPV into four quartiles and found that the 3 rd quartile (mean SBP SD = 14.9 ± 2.1 mmHg) had 3.3 fewer minutes in REM sleep compared to the 1 st quartile ( p = .02). However, we did not observe any relationship between DBPV and sleep architecture. Conclusion: Greater SBPV was associated with lower REM sleep time. This finding suggests a possible interplay between BPV and sleep architecture. Future investigation is warranted to clarify the directionality, mechanism, and therapeutic implications.

Sleep-disordered breathing

2009 ◽  
pp. 285-296
Author(s):  
Rogan Corbridge ◽  
Nicholas Steventon
Keyword(s):  
Eye Movements ◽  
Medical Treatment ◽  
Classification System ◽  
Sleep Disordered Breathing ◽  
Sleep Time ◽  
Cpap Therapy ◽  
Eeg Activity ◽  
Sleep Studies ◽  
Sleep Physiology ◽  
Disordered Breathing

Sleep physiology 286 Assessment of sleep-disordered breathing 288 Sleep studies 290 Sleep-disordered breathing spectrum 291 Medical treatment 292 CPAP therapy 293 Surgery for sleep-disordered breathing 294 Friedman Classification System 295 —20% of sleep time (rapid eye movements seen under closed lids during sleep) —80% of sleep time. Subdivided into stages by EEG activity:...

scholarly journals 0683 CPAP Adherence Relative To Sleep Duration And Sleep Period In Different Study Populations

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A260-A261
Author(s):  
S Deering ◽  
T Shumard ◽  
T Zamora ◽  
S Martinez ◽  
C J Stepnowsky
Keyword(s):  
Pittsburgh Sleep Quality Index ◽  
Total Sleep Time ◽  
Total Sample ◽  
Sleep Time ◽  
Overlap Syndrome ◽  
Clinical Population ◽  
Sleep Period ◽  
Cpap Adherence ◽  
Combined Data ◽  
Do So

Abstract Introduction CPAP is intended for use during sleep to alleviate disordered breathing. Most patients who use CPAP do so for only a portion of their sleep period, although anecdotally it is known that some also use CPAP while awake. We compared the unusually high levels of CPAP adherence found in a recent study of patients with Overlap Syndrome to a VA clinical population and to participants from the APPLES study. Methods CPAP adherence levels were taken from three sources: (1) The O2VERLAP Study, a large comparative effectiveness trial that used two different methods of providing information and support to current CPAP users diagnosed with both OSA and COPD. (2) Combined data from the four most recent clinical CPAP trials conducted at VA San Diego Healthcare System. (3) The APPLES study. Total sample sizes were 332, 957, and 405, respectively. Total sleep time (TST) and total sleep period (TSP) were assessed via the Pittsburgh Sleep Quality Index (PSQI) for (1) and (2) and via polysomnography for (3). Results Mean CPAP use, TST, and TSP for each source were: (1) 6.7, 6.8, & 8.1; (2) 4.0, 6.1, & 7.5; (3) 4.5, 6.6, & 8.0. We examined the ratios of adherence over either TST or TSP, and the ratios for each source were: (1) 98% & 83%; (2) 66% & 55%; (3) 68% & 56%. Conclusion This comparison demonstrates that unlike many CPAP users who tend to use therapy for only a fraction of time spent asleep, patients with COPD and OSA exhibit higher levels of adherence which often exceed sleep time and may be obtaining additional benefits from CPAP use during non-sleep periods. More research is needed both to improve CPAP delivery and support for patients who are using CPAP sub optimally and to understand the factors that account for the heightened levels of CPAP adherence in COPD. Support PPRND #1507-31666; IIR 02-275; IIR 07-163; IIR 12-069; PULM-028-12F.

scholarly journals A Convolutional Network for the Classification of Sleep Stages

Proceedings ◽  
2018 ◽  
Vol 2 (18) ◽  
pp. 1174 ◽  
Author(s):  
Isaac Fernández-Varela ◽  
Elena Hernández-Pereira ◽  
Vicente Moret-Bonillo
Keyword(s):  
Sleep Medicine ◽  
Sleep Stages ◽  
Kappa Index ◽  
Night Sleep ◽  
Convolutional Network ◽  
Sleep Study ◽  
Convolutional Networks ◽  
Sleep Studies ◽  
Automatic Methods

The classification of sleep stages is a crucial task in the context of sleep medicine. It involves the analysis of multiple signals thus being tedious and complex. Even for a trained physician scoring a whole night sleep study can take several hours. Most of the automatic methods trying to solve this problem use human engineered features biased for a specific dataset. In this work we use deep learning to avoid human bias. We propose an ensemble of 5 convolutional networks achieving a kappa index of 0.83 when classifying 500 sleep studies.

Comparison of Pre- and Postoperative Sleep Studies in Patients Undergoing Sphincter Pharyngoplasty

2018 ◽  
Vol 55 (10) ◽  
pp. 1447-1449 ◽  
Author(s):  
Christina M. Busuito ◽  
Nathan Vandjelovic ◽  
Diana M. Flis ◽  
Arlene Rozzelle
Keyword(s):  
Chart Review ◽  
Outcome Measure ◽  
Retrospective Chart Review ◽  
Velopharyngeal Insufficiency ◽  
Apnea Hypopnea Index ◽  
Pediatric Hospital ◽  
Sleep Study ◽  
Sleep Studies ◽  
Sphincter Pharyngoplasty ◽  
Central Apneas

Objective: To determine if sphincter pharyngoplasty changes sleep study parameters on patients undergoing surgery for velopharyngeal insufficiency (VPI). Design: Retrospective chart review on patients undergoing sphincter pharyngoplasty for VPI with pre- and postoperative polysomnography completed. Setting: Institutional study at a tertiary pediatric hospital. Patients: All patients who underwent sphincter pharyngoplasty over a 20-year period were reviewed; all patients with both pre- and postoperative sleep studies were collected for evaluation. Interventions: Sphincter pharyngoplasty for patients with VPI. Main Outcome Measure: Sleep study parameters collected include apnea–hypopnea index (AHI), obstructive and central apneas, hypopneas, and mixed events. The preoperative values were compared to postoperative values. Results: There were 98 patients collected with sleep studies for review. Of these, 32 patients had both pre- and postoperative sleep studies. The AHI increased from 1.8 preoperatively to a postoperative value of 4.8 ( P = .004). The number of obstructive events per night went from 4.6 to 17.6 postoperatively ( P = .04). The number of hypopneas increased from 4.0 to 13.6 ( P = .003). The other parameters were not statistically different, central events decreased from 4.8 to 2.1 ( P = .086), and mixed events were essentially unchanged from 0.2 to 0.5 ( P = .17) events per night. Conclusions: Patients undergoing sphincter pharyngoplasty for VPI may experience an increase in their postoperative AHI, obstructive events per night, and hypopneas. Sleep studies should be performed both pre- and postoperatively to assess the need for intervention or change in management.

scholarly journals Sleep deprivation undermines the link between identity and intergroup bias

SLEEP ◽  
2019 ◽  
Author(s):  
Jinxiao Zhang ◽  
Yang Yang ◽  
Ying-Yi Hong
Keyword(s):  
Sleep Deprivation ◽  
Sleep Time ◽  
Intergroup Bias ◽  
Sleep Study ◽  
Global Context ◽  
Low Levels ◽  
Common Identity ◽  
Common Ingroup Identity ◽  
The One ◽  
Ingroup Identity

Abstract This research seeks to bridge two findings—on the one hand, top-down controlled processes inhibit display of intergroup bias; on the other one hand, sleep deprivation impairs cognitive control processes. Connecting these two proven statements, begs the question: would sleep deprivation also influence intergroup bias? This intriguing link has hardly been explored in extant literature. To fill this gap, we theorize through the lens of social identity. Previous research has shown that individuals who share a common identity with an outgroup are more motivated to inhibit biases toward the outgroup than do their counterparts who do not endorse such common identity. We predicted that this motivated inhibition would be compromised by sleep deprivation. Across two studies, as predicted, we found that only when an individual has adequate sleep did common ingroup identity attenuate the display of intergroup bias, whereas individuals with short habitual sleep (study 1) or after one-night sleep deprivation (study 2) displayed equally high levels of intergroup bias regardless of their high or low levels of common ingroup identity. In the global context of incessant intergroup bias and diminishing sleep time, our findings offer new insights for understanding and handling intergroup bias.

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