scholarly journals Increased Serum Prolactin and Excessive Daytime Sleepiness: An Attempt of Proof-of-Concept Study

2021 ◽  
Vol 11 (12) ◽  
pp. 1574
Author(s):  
Maria P. Mogavero ◽  
Filomena I. I. Cosentino ◽  
Bartolo Lanuzza ◽  
Mariangela Tripodi ◽  
Giuseppe Lanza ◽  
...  
Keyword(s):  
Sleep Disorder ◽  
Excessive Daytime Sleepiness ◽  
Daytime Sleepiness ◽  
Clinical Sample ◽  
Retrospective Chart Review ◽  
Serum Levels ◽  
Sleep Time ◽  
Serum Prolactin ◽  
Time In Bed ◽  
Obstructive Sleep

The objectives of this study were: (1) to identify subjects with hyperprolactinemia in a clinical sample of patients; (2) to compare the neurologic, psychiatric, and sleep conditions found in patients subgrouped by excessive daytime sleepiness (EDS) and hyperprolactinemia; and (3) to identify patients with hyperprolactinemia and EDS not supported by the presence of any other neurologic, psychiatric, or sleep disorder, or substance/medication use. A retrospective chart review of inpatients was carried out in order to identify all patients in whom the prolactin (PRL) serum levels were determined. A total of 130 subjects were retrieved: 55 had increased levels of PRL, while the remaining 75 participants had normal PRL levels. EDS was reported by 32 (58.2%) participants with increased PRL and 34 (45.3%) with normal PRL. Obstructive sleep apnea or other sleep or neurologic/psychiatric conditions could explain EDS in all participants with normal PRL. Among subjects with increased PRL, eight had no other neurologic/psychiatric or sleep disorder (or drug) potentially causing EDS; these participants, at polysomnography, had time in bed, sleep period time, and total sleep time longer than those with EDS associated to another condition. These findings can be considered as a preliminary indication of a role of hyperprolactinemia in EDS and represent a basis for future controlled studies able to test this hypothesis in a reliable, objective, and methodologically more appropriate way.

scholarly journals P020 Reduced duration and continuity of N3 sleep is associated with excessive daytime sleepiness in suspected obstructive sleep apnea patients

2021 ◽  
Vol 2 (Supplement_1) ◽  
pp. A28-A28
Author(s):  
X Chen ◽  
H Korkalainen ◽  
T Leppänen ◽  
A Oksenberg ◽  
J Töyräs ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Excessive Daytime Sleepiness ◽  
Daytime Sleepiness ◽  
Nrem Sleep ◽  
Sleep Time ◽  
Sleep State ◽  
Sleep Continuity ◽  
State Duration ◽  
Obstructive Sleep

Abstract Introduction Excessive daytime sleepiness (EDS) is a common but not universal-accompanying symptom of obstructive sleep apnea (OSA). The mechanisms explaining the presence of EDS in OSA subjects are not fully understood. We hypothesised that characteristic differences in sleep architecture can be quantified with more comprehensive descriptors of sleep continuity in those with and without severe-EDS according to the Multiple Sleep Latency Test (MSLT). Methods 2111 participants with suspected OSA and complaints of daytime sleepiness underwent in-lab diagnostic polysomnography (PSG) and next-day MSLT. Sleep continuity was quantified by calculating the cumulative-frequency relationship of continuous sleep-state duration against proportion of sleep time; and continuous sleep-state duration against absolute sleep time. Results Study contained 368 severe-EDS participants (MSLT≤5min) and 385 non-EDS participants (MSLT>15min). Severe-EDS participants had less Wake After Sleep Onset (48.1±37.7 vs. 68.1±44.2-minutes, p<0.05 [mean±SD]), and greater Total Sleep Time (366.5±50.3 vs. 336.2±58.2-minutes, p<0.05). While total NREM sleep time was similar between groups, severe-EDS participants had less N3 sleep (67.7±38.0 vs. 78.6±32.0-minutes, p<0.05) and more N2 sleep (230.7±59.3 vs. 178.4±45.9-minutes, p<0.05). Moreover, severe-EDS participants had both less cumulative N3 sleep (36.9±2.9 vs. 60.0±3.3-minutes, p<0.05) and a lower proportion of N3 sleep (66.8±5.3% vs. 77.2±4.2%, p<0.05) occurring in periods ≥10mins duration. Discussion Whilst OSA participants with severe EDS have similar NREM sleep time to non-EDS participants; they have less N3 sleep, and N3 sleep periods are less consolidated. These preliminary results suggest that individuals with OSA which disturbs both the quantity and consolidation of N3 sleep are at greater risk of severe EDS.

scholarly journals 0767 Analysis Of The Effect On Blood Pressure And Heart Rate When Adding Solriamfetol (Sunosi) To Stimulant Therapy

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A291-A291
Author(s):  
G J Meskill ◽  
S D Meskill
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Excessive Daytime Sleepiness ◽  
Daytime Sleepiness ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Stimulant Therapy ◽  
Obstructive Sleep ◽  
Paired T Test

Abstract Introduction Solriamfetol is a non-stimulant wakefulness-promoting agent (WPA) indicated for the treatment of excessive daytime sleepiness in adult patients with obstructive sleep apnea or narcolepsy. It acts by inhibiting reuptake of dopamine and norepinephrine. Since many patients with excessive daytime sleepiness take stimulants, clinicians commonly ponder the safety of adding solriamfetol in this population due to concern of increased blood pressure and/or heart rate (HR). Methods We conducted a retrospective chart review and identified 18 patients who had solriamfetol added to their stimulant therapy. Of those, 7 to date have had a follow-up appointment after the addition of solriamfetol (6 on 150mg, 1 on 75mg). We collected the blood pressure and HR readings at the appointment immediately prior to and following the addition of solriamfetol and conducted a paired t-test. Results The systolic blood pressure (SBP) had a mean difference of -0.57 (95% CI -9.6 to 8.5, p=0.88), diastolic blood pressure (DBP) 1.7 (95% CI -4.4 to 7.9, p=0.52), mean arterial pressure (MAP) 0.95 (95% CI -5.6 to 7.5, p=0.73), and HR 6.6 (95% CI -0.07 to 13.2, p=0.052). Conclusion The addition of solriamfetol to stimulant therapy did not lead to a significant increase in SBP, DBP, MAP, or HR. Support none

scholarly journals A novel parameter is better than the AHI to assess nocturnal hypoxaemia and excessive daytime sleepiness in obstructive sleep apnoea

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Changxiu Ma ◽  
Ying Zhang ◽  
Jiuyu Liu ◽  
Gengyun Sun
Keyword(s):  
Obstructive Sleep Apnoea ◽  
Excessive Daytime Sleepiness ◽  
Daytime Sleepiness ◽  
Total Sleep Time ◽  
Sleep Time ◽  
Sleep Apnoea ◽  
Anthropometric Measures ◽  
Obstructive Sleep ◽  
Nocturnal Hypoxaemia ◽  
Better Than

AbstractTo evaluate whether the percentage of total sleep time spent with apnoea and hypopnoea duration time (AHT%) is better than the apnoea-hypopnoea index (AHI) for the assessment of nocturnal hypoxaemia and excessive daytime sleepiness (EDS) in patients with obstructive sleep apnoea (OSA). Patients with suspected OSA were enrolled. Polysomnography, Epworth Sleepiness Scale, self-administered surveys and anthropometric measures were performed. The efficiency of AHT% and the AHI was evaluated for nocturnal hypoxaemia and EDS. A total of 160 eligible participants were analysed. The median AHT% in normal, mild, moderate and severe OSA patients was significantly different in the four-group patients with OSA. Spearman rank correlations analysis found that the associations were stronger between AHT% with percentage of total sleep time and O2 saturation of < 90% and minimum nocturnal oxygen saturation than these parameters with the AHI. AHT% had a greater area under the curve than the AHI for predicting EDS in patients with OSA. AHT% was significantly higher in the EDS group. We present a novel parameter, AHT%, to evaluate nocturnal hypoxaemia and EDS in OSA patients. AHT% partially compensates for the shortcomings of the AHI. AHT% is better than the AHI for assessing nocturnal hypoxaemia and EDS. AHT% reflects different clinical characteristics associated with OSA from a new perspective.

scholarly journals Risk of obstructive sleep apnea, excessive daytime sleepiness and depressive symptoms in a Nigerian elderly population

Sleep Science ◽  
2016 ◽  
Vol 9 (2) ◽  
pp. 106-111 ◽  
Author(s):  
Michael B. Fawale ◽  
Olanrewaju Ibigbami ◽  
Ishaq Ismail ◽  
Adekunle F. Mustapha ◽  
Morenikeji A. Komolafe ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Depressive Symptoms ◽  
Sleep Apnea ◽  
Excessive Daytime Sleepiness ◽  
Daytime Sleepiness ◽  
Elderly Population ◽  
Obstructive Sleep

scholarly journals The association between beta-blocker therapy and daytime sleepiness in obstructive sleep apnoea

2021 ◽  
Author(s):  
Martina Meszaros ◽  
Alexander G. Mathioudakis ◽  
Maria Xanthoudaki ◽  
Victoria Sircu ◽  
Evangelia Nena ◽  
...  
Keyword(s):  
Obstructive Sleep Apnoea ◽  
Beta Blocker ◽  
Daytime Sleepiness ◽  
Beta Blockers ◽  
Multivariate Logistic Regression Analysis ◽  
Sleep Time ◽  
Sleep Apnoea ◽  
Sensitivity Analyses ◽  
Obstructive Sleep ◽  
Cardinal Symptom

AbstractDaytime sleepiness is a cardinal symptom of obstructive sleep apnoea (OSA) and a well-recognised side effect of beta-blockers, therefore patients with OSA under this treatment may have worse sleepiness. However, the interaction between daytime sleepiness and beta-blockers use has not been thoroughly investigated in patients with OSA before. We analysed the data of 2183 individuals (1852 patients with OSA and 331 snorer controls) from 3 countries (Greece, Hungary and Moldova). Medical history, including medication usage and the Epworth Sleepiness Scale (ESS) were recorded. Patients and controls were divided into somnolent (ESS ≥ 11) and non-somnolent (ESS < 11) groups, and the association between-blocker use with the somnolent group was investigated with multivariate logistic regression analysis adjusted for confounders. Sensitivity analyses were performed in each cohort, in the severity subgroups, in patients who did not take statins and in those who had polysomnography as a diagnostic test. There was no relationship between beta-blocker usage and the somnolent OSA (p = 0.24) or control (p = 0.64) groups. These results were similar in sensitivity analyses (all p > 0.05). ESS was related to BMI (ρ = 0.25), total sleep time (ρ = 0.07), AHI (ρ = 0.32), oxygen desaturation index (ρ = 0.33) and minimum oxygen saturation (ρ =  – 0.32, all p < 0.05) in OSA, and was higher in patients with hypertension, diabetes and cerebro/cardiovascular disease and those who took statins (all p < 0.05). In general, beta-blockers are not associated with increased daytime sleepiness in OSA. Thus, the diagnosis of OSA should not discourage initiation of beta-blocker treatment, if it is clinically indicated.

scholarly journals 1253 Multiple sleep onset REM episodes in middle age woman with excessive daytime sleepiness – Is this automatically assumed narcolepsy?

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A477-A477
Author(s):  
Kamal Patel ◽  
Bianca J Lang
Keyword(s):  
Daytime Sleepiness ◽  
Sleep Latency ◽  
Sleep Onset ◽  
Sleep Time ◽  
Multiple Sleep Latency Test ◽  
Sleep Onset Latency ◽  
Onset Latency ◽  
Obstructive Sleep ◽  
Falling Asleep ◽  
Multiple Sleep Latency

Abstract Introduction Presence of sleep onset REM episodes often raises concerns of narcolepsy. However other conditions have shown to have presence of sleep on REM episodes which include but not limited to obstructive sleep apnea, sleep wake schedule disturbance, alcoholism, neurodegenerative disorders, depression and anxiety Report of Case Here we present a case of 30 year old female with history of asthma, patent foraman ovale, migraine headache, and anxiety who presented with daytime sleepiness, falling asleep while at work, occasional scheduled naps, non-restorative sleep, sleep paralysis, and hypnopompic hallucination. Pertinent physical exam included; mallampati score of 4/4, retrognathia, high arched hard palate, crowded posterior oropharynx. She had a score of 16 on Epworth sleepiness scale. Patient previously had multiple sleep latency test at outside facility which revealed 4/5 SOREM, with mean sleep onset latency of 11.5 minutes. She however was diagnosed with narcolepsy and tried on modafinil which she failed to tolerate. She was tried on sertraline as well which was discontinued due to lack of benefit. She had repeat multiple sleep latency test work up which revealed 2/5 SOREM, with mean sleep onset latency was 13.1 minutes. Her overnight polysomnogram prior to repeat MSLT showed SOREM with sleep onset latency of 10 minutes. Actigraphy showed consistent sleep pattern overall with sufficient sleep time but was taking hydroxyzine and herbal medication. Patient did not meet criteria for hypersomnolence disorder and sleep disordered breathing. Conclusion There is possibility her medication may have played pivotal role with her daytime symptoms. We also emphasize SOREMs can be present in other disorders such as anxiety in this case and not solely in narcolepsy

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