Hospital Selection Factors of Sleep Disorder: Sleep Apnea Versus Other Sleep Disorders

Objectives: The hospital selection factor is the criterion based on the judgment of the patients’ decision process. We investigated the hospital selection factors of patients with sleep disorders and compared that for patients with sleep apnea and other sleep disorders. Methods: This is a questionnaire-based cross-sectional study that evaluated patients with a sleep disorder at the sleep unit of a tertiary referral center. We investigated the patients’ demographic information, occupational status, diagnosis of sleep disorders, and hospital-related and patient-related factors associated with hospital selection. Results: A total of 138 patients with a sleep disorder were analyzed. Internet information was the primary data source for sleep apnea patients to select a hospital, while it was acquaintances for patients with other sleep disorders. None with sleep apnea gathered information from broadcast or print media. Patients gave the highest score for the least waiting time and recency of the hospital’s facility. Unlike patients with other sleep disorders, those with sleep apnea valued the hospital’s popularity, accessibility, availability of appointments at desired dates, and medical expense benefits. Conclusions: This is the first study to analyze the hospital selection factors of patients with sleep disorders in South Korea. This study might improve the sleep medication as well as the medical system by revealing the medical use behavior of patients with sleep disorders.

Download Full-text

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

Sleep Disorders ◽

10.1155/2018/5987064 ◽

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.

Download Full-text

Sleep disorders in children with attention-deficit/hyperactivity disorder

Paediatrica Indonesiana ◽

10.14238/pi1.1.2018.46-50 ◽

2018 ◽

Vol 1 (1) ◽

pp. 48

Author(s):

Medina Permatawati ◽

Agung Triono ◽

Mei Neni Sitaresmi

Keyword(s):

Attention Deficit Hyperactivity Disorder ◽

Sleep Disorders ◽

Sleep Disorder ◽

Attention Deficit ◽

Sleep Disturbances ◽

Sleep Hygiene ◽

Poor Sleep ◽

Cross Sectional ◽

Children With Adhd ◽

Hyperactivity Disorder

Background Attention-deficit/hyperactivity disorder (ADHD) is a neurobehavioral abnormality that commonly occurs among children. Sleep disorders are comorbid with ADHD. Sleep disorders in Indonesian children with ADHD have not been widely studied.Objective To understand the proportion and factors that influence sleep disorders in children with ADHD. Methods This cross-sectional study involved 54 children aged 3-14 years who had been diagnosed with ADHD by a pediatric growth and development consultant using DSM-5 criteria. The subjects were consecutively selected from March to August 2017 at the Child Development Polyclinic, Dr. Sardjito Hospital, Yogyakarta. Sleep data were collected using the Sleep Disturbances Scale for Children (SDSC) and the Children’s Sleep Hygiene Scale (CSHS).Results Of the 54 children with ADHD (46 males and 8 females), 35 (64.8%) experienced sleep disorders. The majority (26 subjects, 48.1%) had the disorder of initiating and maintaining sleep. Children with the combined (inattention and hyperactive-impulsive) type of ADHD experienced significantly greater sleep disturbance compared to the inattention type or hyperactive-impulsive type (OR=3.750; 95% CI 1.133 to 12.41; P=0.027). Poor sleep hygiene was also significantly associated with more severe sleep disorders (r=-0.383, P=0.004).Conclusion The proportion of sleep disorder in children with ADHD is relatively high, with the majority having a disorder of initiating and maintaining sleep. Children with combined type ADHD experience a higher amount of sleep disorder than those with either the inattention or hyperactive-impulsive types of ADHD. Children with poor sleep hygiene have significantly more severe sleep disorders.

Download Full-text

Sleep Disorders During Pregnancy and Postpartum: A Systematic Review

Sleep Medicine Research ◽

10.17241/smr.2021.00983 ◽

2021 ◽

Vol 12 (2) ◽

pp. 81-93

Author(s):

Zahra Behboodi Moghadam ◽

Elham Rezaei ◽

Azam Rahmani

Keyword(s):

Sleep Disorders ◽

Sleep Disorder ◽

Health Care Providers ◽

English Language ◽

Care Providers ◽

Related Factors ◽

Sleep Related Breathing Disorders ◽

Obstructive Sleep ◽

Pregnancy And Postpartum ◽

Health Related

This study aimed to asses previous research results about bio-physiological alterations during pregnancy and postpartum, and make clear outlook about prevalence and related factors of sleep disorders during pregnancy and postpartum. In this review, the articles that published from 2000 to 2019 were reviewed. Related articles were searched from databases in English language. After evaluation of inclusion and exclusion criteria, articles were chosen and reviewed based on the University of York strategies. Sleep disorders in present study were classified according to the International Classification of Sleep Disorders-3. The search revealed 4449 articles, after evaluating and assessing qualified articles, finally 56 article selected to review. According to the results of this review, The prevalence of sleep disorders was almost 76%–97% in whole pregnancy. The most common sleep disorders included central disorders of hyper somnolence (waking up in the middle of the night, daytime sleepiness, sleeplessness) or insomnia, sleep-related movement disorders (restless legs syndrome), sleep related breathing disorders (obstructive sleep apnea), and parasomnia. In addition, sleep disorder may continue 3–12 months postpartum (33.2%). Sleep disorders induced by physiological processes (fetal movement, excessive weight gain, male sex of the fetus, and multiparty), health-related risks (metabolism disorders, cardiovascular diseases, and mood disorders), and physical or sexual abuse in childhood. In addition, these disorders could have maternal outcomes that can be greatest trigger to postpartum psychiatric disorders and fetal outcomes that have harmful sequences during childhood (sexual, fertility, emotional, and cognitive problems). Health care providers should evaluate the mothers’ sleep quality because sleep disorder leads to harmful consequences in fetuses and children.

Download Full-text

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

SLEEP ◽

10.1093/sleep/zsaa056.1177 ◽

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).

Download Full-text

Association Between Hypertension, Body Mass Index, and Sleep: A Cross-Sectional Study

INDIAN JOURNAL OF MENTAL HEALTH AND NEUROSCIENCES ◽

10.32746/10.32746/ijmhns.2020.v3.i1.18 ◽

2020 ◽

Vol 3 (01) ◽

pp. 11-14

Author(s):

Aishwarya Gonzalez Cherubal ◽

S. Pooja ◽

Vijaya Raghavan

Keyword(s):

Risk Factors ◽

Body Mass Index ◽

Sleep Quality ◽

Sleep Disorders ◽

Sleep Disorder ◽

Sleep Duration ◽

Body Mass ◽

Quality Of Sleep ◽

Cross Sectional

Background: Sleep disorders can act as risk factors and even aggravate underlying conditions. With prevalence of 17% in general population, hypertension is a leading cause of morbidity and mortality in India. Though hypertension has various well established risk factors like family history, sedentary lifestyle, poor diet, smoking and age, sleep is often an understudied and overlooked factor. Body mass index is another important risk factor for various physical conditions. Associations between sleep and body mass index have been documented in many studies around the world. Although a consensus is yet to be drawn, many studies highlight that BMI related disorders could be predicted by sleep duration and quality. Materials and Methods: Two hundred consecutive hypertensive patients who were attending the OPD for follow-up were included as participants in this study after obtaining an informed consent. A semi structured proforma was designed to elicit the socio demographic profile of the participants. Each participant was assessed for the presence of sleep disorders by sleep-50 questionnaire and quality of sleep by the Pittsburgh Sleep Quality Index (PSQI). Results: Results found that BMI was significantly correlated with sleep quality, sleep duration, and sleep disorder. Hypertension was not significantly correlated to sleep quality or duration but associated to sleep disorder. Conclusion: This study found that body mass index was significantly correlated with sleep variables such as sleep duration, sleep quality, and sleep disorders. Maintaining a healthy BMI could in fact impact the amount and quality of sleep an individual receives.

Download Full-text

Insomnia – A Heterogenic Disorder Often Comorbid With Psychological and Somatic Disorders and Diseases: A Narrative Review With Focus on Diagnostic and Treatment Challenges

Frontiers in Psychology ◽

10.3389/fpsyg.2021.639198 ◽

2021 ◽

Vol 12 ◽

Author(s):

Bjørn Bjorvatn ◽

Susanna Jernelöv ◽

Ståle Pallesen

Keyword(s):

Sleep Apnea ◽

Sleep Disorders ◽

Sleep Disorder ◽

Sleep Onset ◽

Chronic Insomnia ◽

Diagnostic Challenge ◽

Insomnia Disorder ◽

Obstructive Sleep ◽

Somatic Disorders ◽

Insomnia Symptoms

Patients with insomnia complain of problems with sleep onset or sleep maintenance or early morning awakenings, or a combination of these, despite adequate opportunity and circumstances for sleep. In addition, to fulfill the diagnostic criteria for insomnia the complaints need to be associated with negative daytime consequences. For chronic insomnia, the symptoms are required to be present at least 3 days per week for a duration of at least 3 months. Lastly, for insomnia to be defined as a disorder, the sleep complaints and daytime symptoms should not be better explained by another sleep disorder. This criterion represents a diagnostic challenge, since patients suffering from other sleep disorders often complain of insomnia symptoms. For instance, insomnia symptoms are common in e.g., obstructive sleep apnea and circadian rhythm sleep-wake disorders. It may sometimes be difficult to disentangle whether the patient suffers from insomnia disorder or whether the insomnia symptoms are purely due to another sleep disorder. Furthermore, insomnia disorder may be comorbid with other sleep disorders in some patients, e.g., comorbid insomnia and sleep apnea (COMISA). In addition, insomnia disorder is often comorbid with psychological or somatic disorders and diseases. Thus, a thorough assessment is necessary for correct diagnostics. For chronic insomnia disorder, treatment-of-choice is cognitive behavioral therapy, and such treatment is also effective when the insomnia disorder appears comorbid with other diagnoses. Furthermore, studies suggest that insomnia is a heterogenic disorder with many different phenotypes or subtypes. Different insomnia subtypes may respond differently to treatment, but more research on this issue is warranted. Also, the role of comorbidity on treatment outcome is understudied. This review is part of a Research Topic on insomnia launched by Frontiers and focuses on diagnostic and treatment challenges of the disorder. The review aims to stimulate to more research into the bidirectional associations and interactions between insomnia disorder and other sleep, psychological, and somatic disorders/diseases.

Download Full-text

Relationship Between Parents’ Health Literacy and Children’s Sleep Problems: A Multicenter Cross-Sectional Study in Japan

10.21203/rs.3.rs-121155/v1 ◽

2020 ◽

Author(s):

Sae Ono ◽

Hiroto Ogi ◽

Masato Ogawa ◽

Daisuke Nakamura ◽

Teruhiko Nakamura ◽

...

Keyword(s):

Health Literacy ◽

Sleep Disorders ◽

Sleep Disorder ◽

Multiple Regression ◽

Missing Values ◽

Sleep Problems ◽

Japanese Version ◽

Sleep Habits ◽

Cross Sectional ◽

Children’S Sleep

Abstract Background: Sleep disorder in preschool children can stunt their health and growth. However, the factors that cause sleep disorders in children are not well understood. The aim of this study was to determine the relationship between parents’ health literacy (HL) and children's sleep problems. The study was conducted at two kindergartens, two nursery schools, and a center for early childhood education in Chitose-city, Hokkaido, Japan.Method: This study used a multicenter cross-sectional design. The sample comprised 354 preschoolers (aged 3–6 years) and their parents. In families with two or more children attending the same facility, only the oldest child was asked to participate in the study. Exclusion criteria included participants whose completed questionnaires had missing values. Children’s sleep disorder was assessed using the Japanese version of the Children's Sleep Habits Questionnaire (CSHQ-J). Parents’ HL was assessed using the 14-item Health Literacy Scale (HLS-14). The parents were classified into two groups (high HL group and low HL group). Multiple regression modelling was used to determine the association between HLS-14 and CSHQ-J scores.Results: Of the 354 parents, 255 (72%) were in the high HL group and 99 (28%) in the low HL group. The mean CSHQ-J score was significantly lower in the high HL group than in the low HL group (45.3 ± 6.0 points vs. 46.8 ± 5.9 points, p = 0.043). In multiple regression analyses, CSHQ-J was independently associated with parents’ HL after adjusting for all confounding factors (R² = 0.41, β = -0.11; p = 0.0043).　 Conclusions: Parents’ HL appears to affect their children's sleep disorder. This finding suggests that parents’ HL may be a target for intervention to improve children’s sleep disorders.

Download Full-text

Gambaran Gangguan Tidur pada Pasien Pasca Stroke Iskemik

Jurnal Ilmu Kesehatan Indonesia ◽

10.25077/jikesi.v1i3.75 ◽

2021 ◽

Vol 1 (3) ◽

pp. 336-342

Author(s):

Alya Ramadhini ◽

Yuliarni Syafrita ◽

Russilawati Russilawati

Keyword(s):

Risk Factors ◽

Ischemic Stroke ◽

Sleep Disorders ◽

Sleep Disorder ◽

Restless Legs Syndrome ◽

Stroke Risk ◽

Stroke Patients ◽

Cross Sectional ◽

Restless Legs ◽

Stroke Risk Factors

Background : Sleep disorder is common to be the complication in stroke patients and can be a risk factor for stroke. Sleep disorder in stroke patients decrease the quality of life. Objective : The purpose of this study was to find out the prevalence of sleep disorders in a post-ischemic stroke patient and the association between sleep disorders and stroke risk factors. Methods: A cross-sectional study was conducted on post-ischemic stroke at the neurology outpatient clinic of Ibnu Sina Islamic Hospital Padang. Information about stroke risk factors is obtained through patient data and guided questionnaires. Types of sleep disorders were assessed through the 2005 Specialized Center of Research Sleep Questionnaire. Results: We found out there were 57 post-ischemic stroke patients, in which 37 post-ischemic stroke patients (64.9%) had sleep disorder incidences, such as apnea, restless legs syndrome, insomnia, and narcolepsy (38.6%, 36.8%, 35.1%, and 15.8%; respectively). There was an association between age and insomnia (p = 0.034,CI = 95%). On the other hand, there was no association between other risk factors (gender, diabetes mellitus, dyslipidemia, heart disease, obesity, smoking, and alcohol consumption) and insomnia, apnea, narcolepsy, and restless legs syndrome. Conclusions : The conclusion of this study was more than half post-ischemic stroke patients have sleep disorder with the most common were apnea. There was an association between age and insomnia. Keywords: sleep disorder, apnea, ischemic stroke

Download Full-text

Cross-Sectional Survey on the Relationship Between Occupational Stress, Hormone Levels, and the Sleep Quality of Oilfield Workers in Xinjiang, China

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16183316 ◽

2019 ◽

Vol 16 (18) ◽

pp. 3316 ◽

Cited By ~ 3

Author(s):

Xue Li ◽

Xiaoyan Gao ◽

Jiwen Liu

Keyword(s):

Sleep Quality ◽

Sleep Disorders ◽

Sleep Disorder ◽

Occupational Stress ◽

Protective Factor ◽

High Stress ◽

Cross Sectional Survey ◽

Subjective Sleep Quality ◽

Cross Sectional ◽

Quality Sleep

The impact of psychosocial factors on health has received increased attention. This study employed a multi-stage hierarchical cluster sampling method and a cross-sectional survey was conducted from March to August 2017. By studying 2116 oilfield workers based in Karamay, Xinjiang, the relationship between occupational stress, blood hormone levels, and sleep was analyzed. Occupational stress was measured using the internationally accepted Occupational Stress Inventory Revised Edition (OSI-R) questionnaire and sleep disorders were measured using the Pittsburgh Sleep Quality Index (PSQI) questionnaire. The study found that the sleep quality of respondents was not high and the incidence of sleep disorders was 36.67%. The higher the level of occupational stress, the higher the incidence of sleep disorders. Irregular shifts can affect sleep quality and individuals with high-level professional titles experience a higher incidence of sleep disorders than those with low-level titles. The total score of the PSQI was different among the low, medium, and high stress groups. The higher the level of stress, the higher the scores of subjective sleep quality, sleep disorder, and daytime dysfunction. The scores of the PSQI, subjective sleep quality, sleep time, sleep disturbance, and daytime dysfunction in the high-stress group were higher than those in the low stress group. A case-control study found that the concentration of glucocorticoids in the sleep disorder positive group was lower than that in the sleep disorder negative group. The results of the regression analysis showed that glucocorticoid is a protective factor for sleep disorders (OR = 0.989, 95% CI: 0.983–0.995), suggesting that the higher the level of glycosaminoglycan, the less likely the subject is to have sleep disorders. For example, in the case of high occupational stress, the interaction between low and moderate occupational stress levels and glucocorticoids is a protective factor for sleep disorders.

Download Full-text