scholarly journals Pupillographic Sleepiness Test and Polysomnography in Nondemented Patients with Ischemic White Matter Lesions

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Ralf Landwehr ◽  
Robert Liszka
Keyword(s):  
Sleep Apnea ◽  
White Matter ◽  
Sleep Disorders ◽  
Daytime Sleepiness ◽  
White Matter Lesions ◽  
Primary Insomnia ◽  
Periodic Leg Movements ◽  
Nonrestorative Sleep ◽  
Pupillographic Sleepiness Test ◽  
Leg Movements

Background. Patients with ischemic white matter lesions (WML) frequently report nonrestorative sleep or daytime sleepiness. However, subjective estimations of sleep and sleepiness can differ considerably from objective measures. The pupillographic sleepiness test (PST) could identify patients with sleep disorders requiring polysomnography (PSG) and further treatment. Methods. We performed a PST and a PSG of 35 nondemented patients with WML, who reported nonrestorative sleep or daytime sleepiness, and assessed the diagnostic value of the pupillary unrest index (PUI). Sleep parameters were compared to normative data. Results. The mean PUI of WML patients was normal (5.89 mm/min) and comparable to PUIs of patients with other neurological disorders. All 9 of the 35 WML patients (25.7%) who had a PUI above normal also had clinically relevant sleep disorders (5: sleep apnea, 7: periodic leg movements, and 4: insomnia). Six patients with a normal PUI had mild to moderate primary insomnia. Conclusion. PST and PSG parameters were physiological in most patients with WML. Age-related changes and affective and neuropsychological disorders might account for their sleep-related complaints. An elevated PUI in patients with WML seems to indicate comorbid sleep disorders that require further diagnostic evaluation and treatment (sleep apnea, insomnia with periodic leg movements, but not primary insomnia).

scholarly journals The Epworth Sleepiness Scale in Service Members with Sleep Disorders

2019 ◽  
Vol 184 (11-12) ◽  
pp. e701-e707 ◽  
Author(s):  
April Hurlston ◽  
Shannon N Foster ◽  
Jennifer Creamer ◽  
Matthew S Brock ◽  
Panagiotis Matsangas ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Sleep Disorders ◽  
Military Personnel ◽  
Excessive Daytime Sleepiness ◽  
Daytime Sleepiness ◽  
Epworth Sleepiness Scale ◽  
Clinical Utility ◽  
Obstructive Sleep ◽  
The Military

ABSTRACTIntroductionExcessive daytime sleepiness affects an estimated 20% of the general population. While the prevalence of sleepiness in the military is largely unknown, it is well established that short sleep duration is endemic. The reasons for this include: the demanding nature of their duties, shift work and 24-hour duty periods, deployments and exigencies of military service as well as sleep disorders. The Epworth Sleepiness Scale (ESS) is the most widely used sleep questionnaire and provides a self-assessment of daytime sleepiness. To date the clinical utility of this questionnaire in differentiating sleep disorders in military patients with sleep disorders has never been evaluated.Materials and MethodsThe primary aim of this manuscript was to assess if Epworth Sleepiness Scale (ESS) scores differed between military personnel with insomnia, obstructive sleep apnea (OSA), comorbid insomnia/obstructive sleep apnea (COMISA), and a group with neither insomnia nor obstructive sleep apnea (NISA). This study assessed the clinical utility of the ESS in differentiating sleep disorders amongst a sample (N = 488) of U.S. military personnel with insomnia (n = 92), OSA (n = 142), COMISA (n = 221), and a NISA group (n = 33) which served as the control population.ResultsIn the present sample, 68.4% of service members reported excessive daytime sleepiness (EDS) with an ESS > 10. ESS scores differed between military personnel with COMISA (13.5 ± 4.83) and those with OSA only (11.5 ± 4.08; p < 0.001) and the NISA group (9.46 ± 4.84; p < 0.001). Also, ESS scores differed between patients with insomnia only (13.0 ± 4.84) and the NISA group (p < 0.01).ConclusionsOverall, the ESS had poor ability to differentiate sleep disorders. In military personnel, the ESS appears elevated in the most common sleep disorders, likely due to their insufficient sleep, and does not help to differentiate OSA from insomnia. Further studies are required to validate this questionnaire and determine an appropriate threshold value for abnormal sleepiness in the military population.

scholarly journals Development of Action and the Clinical Continuum

2003 ◽  
Vol 10 (1-2) ◽  
pp. 15-25 ◽  
Author(s):  
Brian Hopkins
Keyword(s):  
Early Intervention ◽  
White Matter ◽  
Early Detection ◽  
Imaging Techniques ◽  
White Matter Lesions ◽  
Reaching Movements ◽  
Qualitative And Quantitative ◽  
Leg Movements ◽  
Quantitative Assessments ◽  
Clinical Continuum

The development of action is depicted as consisting of changes in the task-specific couplings between perception, movement, and posture. It is argued that this approach may provide a much needed basis from which attempts can be made at theoretically unifying the constituents of the clinical continuum (viz., early detection, diagnosis, prognosis, and intervention). Illustrative examples germane to this approach are given with regard to how posture serves as a constraint on the emergence of reaching movements and how cortical development influences the coordination of leg movements as revealed by a study involving infants with white matter lesions. Particular attention is paid to early detection and it is recommended that further improvements to this aspect of the clinical continuum can be derived from combining serial qualitative and quantitative (kinematic) assessments with brain-imaging techniques. It is emphasized that quantitative assessments should incorporate experimental manipulations of perception, movement or posture during transitional periods in development. Concluding comments include consideration of the timing of early intervention.

scholarly journals Association of Excessive Daytime Sleepiness and Obesity with Apnea-Hypopnea Index in Adult Patients Suspected of Obstructive Sleep Apnea Syndrome

2015 ◽  
Vol 30 (1) ◽  
pp. 17-23
Author(s):  
Nikki Lorraine Y. King-Chao ◽  
Michael A. Sarte
Keyword(s):  
Body Mass Index ◽  
Sleep Apnea ◽  
Sleep Disorders ◽  
Excessive Daytime Sleepiness ◽  
Daytime Sleepiness ◽  
Sleep Apnea Syndrome ◽  
Apnea Hypopnea Index ◽  
P Value ◽  
Obese Patients ◽  
Apnea Syndrome

Objective: To determine whether excessive daytime sleepiness (EDS) as assessed by the Epworth Sleepiness Scale (ESS) is significantly correlated with body mass index (BMI) and Apnea-Hypopnea Index (AHI) in patients suspected of OSAS and whether obesity as assessed by BMI is associated with AHI. Methods: Study Design:            Non-Concurrent Cohort Study Setting:                       Tertiary Private Hospital Population:                The charts of 389 patients suspected to have sleep disorders and referred for polysomnography (PSG) at the Center for Snoring and Sleep Disorders in year 2009 were reviewed. Inclusion criteria were patients aged 19 and above with complete data. A total of 238 patient charts were included in the study. Results:The study included a total of 238 patient charts. Results showed no significant association between ESS and AHI (p-value >0.05), even when correlated with the different severities of OSAS (p-value>0.05). Sensitivity and specificity of ESS was found to be 54% and 57%, respectively, indicating that ESS is not a sensitive and specific tool to predict the presence of OSAS. These findings suggest that ESS may not be able to significantly identify patients with OSAS. However, BMI showed a significant association with ESS (p-value<0.05), representing more patients with EDS belonging to the obese category. Conversely, obese patients were twice more likely to have EDS, represented by ESS scores of ³10. BMI wasalso significantly associated with AHI using one-way Anova test. Conclusion: This report concludes that the ESS alone is insufficient to identify patients with OSAS. Nevertheless, questionnaires like the ESS supplement relevant history to help diagnose patients with sleep disorders, particularly OSAS. On the other hand, the ESS showed a significant association with BMI, representing more obese patients had excessive daytime sleepiness. The likelihood ratio of having excessive daytime sleepiness is 2 times more for obese patients. BMI was also significantly associated with AHI, which confirms the well established relationship of obesity with OSAS, and shows that obese patients are at higher risk for severe OSAS. Keywords:obstructive sleep apnea syndrome, daytime sleepiness, Epworth sleepiness scale, polysomnography, apnea-hypopnea index,  body-mass index.

scholarly journals RestEaze: An Emerging Technology to Characterize Leg Movements During Sleep

2021 ◽  
Author(s):  
Justin Brooks ◽  
Cody Feltch ◽  
Janet Lam ◽  
Christopher Earley ◽  
Ryan Robucci ◽  
...  
Keyword(s):  
Sleep Disorders ◽  
Assessment Tool ◽  
Measurement Techniques ◽  
Standard Of Care ◽  
Measurement Unit ◽  
Periodic Leg Movements ◽  
Leg Muscles ◽  
Sleep Assessment ◽  
Sleep Measurement ◽  
Leg Movements

Abstract Several sleep disorders are characterized by periodic leg movements during sleep including Restless Leg Syndrome, and can indicate disrupted sleep in otherwise healthy individuals. Current technologies to measure periodic leg movements during sleep are limited. Polysomnography and some home sleep tests use surface electromyography to measure electrical activity from the anterior tibilias muscle. Actigraphy uses 3-axis accelerometers to measure movement of the ankle. Electromyography misses periodic leg movements that involve other leg muscles and is obtrusive because of the wires needed to carry the signal. Actigraphy based devices require large amplitude movements of the ankle to detect leg movements (missing the significant number of more subtle leg movements) and can be worn in multiple configurations precluding precision measurement. These limitations have contributed to their lack of adoption as a standard of care for several sleep disorders. In this study, we develop the RestEaze sleep assessment tool as an ankle-worn wearable device that combines capacitive sensors and a 6-axis inertial measurement unit to precisely measure periodic leg movements during sleep. This unique combination of sensors and the form-factor of the device addresses current limitations of periodic leg movements during sleep measurement techniques. Pilot data collected shows high correlation with polysomnography across a heterogeneous participant sample and high usability ratings. RestEaze shows promise in providing ecologically valid, longitudinal measures of leg movements that will be useful for clinicians, researchers, and patients to better understand sleep.

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