scholarly journals Sleep Disordered Breathing Measures in Early Pregnancy Are Associated with Depressive Symptoms in Late Pregnancy

Diagnostics ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 858
Author(s):  
Margaret H. Bublitz ◽  
Meghan Sharp ◽  
Taylor Freeburg ◽  
Laura Sanapo ◽  
Nicole R. Nugent ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Early Pregnancy ◽  
Sleep Disordered Breathing ◽  
Late Pregnancy ◽  
Self Report ◽  
Apnea Hypopnea Index ◽  
Berlin Questionnaire ◽  
Sleep Study ◽  
Home Sleep Study ◽  
Disordered Breathing

Sleep disordered breathing (SDB) and depression are both common complications of pregnancy and increase risk for adverse maternal and neonatal outcomes. SDB precedes onset of depression in non-pregnant adults; however, the longitudinal relationship has not been studied in pregnancy. The present research examined temporal associations between SDB and depressive symptoms in 175 pregnant women at risk for SDB (based on frequent snoring and obesity), but without an apnea hypopnea index of ≥5 events per hour at enrollment. Women completed a self-report assessments of depressive symptoms using PHQ-9 and in-home level III sleep apnea monitoring at approximately 12- and 32-weeks’ gestation. We also assessed the risk for SDB using the Berlin Questionnaire in early pregnancy. Results revealed that measures of SDB in early pregnancy as assessed by in-home sleep study, but not by self-reported SDB, predicted elevated depressive symptoms in late pregnancy. SDB in late pregnancy was not associated with depressive symptoms. To conclude, these findings suggest that SDB may increase the risk for elevated depressive symptoms as pregnancy progresses.

scholarly journals Lack of night-to-night variability of sleep-disordered breathing measured during home monitoring

2003 ◽  
Vol 82 (2) ◽  
pp. 135-138 ◽  
Author(s):  
Terence M. Davidson ◽  
Philip Gehrman ◽  
Henry Ferreyra
Keyword(s):  
Sleep Disordered Breathing ◽  
Home Monitoring ◽  
Objective Measure ◽  
Apnea Hypopnea Index ◽  
Sleep Study ◽  
Significant Change ◽  
Home Sleep Study ◽  
Important Objective ◽  
Disordered Breathing

The apnea-hypopnea index (AHI) is an important objective measure used in the diagnosis of sleep-disordered breathing. In affected patients, the AHI has been reported to vary across successive nights. We conducted a multichannel home sleep study on 44 patients with sleep-disordered breathing to determine whether the AHI does indeed vary and, if so, to quantify the degree of night-to-night variability. Of this group, 23 patients were tested for 3 consecutive nights and 21 were tested for 2 consecutive nights. Among the group as a whole, we found no statistically significant change in AHI across nights, although we did identify variations among individual patients.

Abstract 11556: Association of Sleep Disordered Breathing and ECG R-Wave to Radial Artery Pulse Delay: The MESA Study

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Younghoon Kwon ◽  
David R Jacobs ◽  
Pamela L Lutsey ◽  
Peter Hannan ◽  
Julio A Chirinos ◽  
...  
Keyword(s):  
Arterial Stiffness ◽  
Radial Artery ◽  
Sleep Disordered Breathing ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Apnea Hypopnea Index ◽  
Sleep Study ◽  
Ventricular Ejection Fraction ◽  
Pulse Delay ◽  
Disordered Breathing

Background: Arterial stiffness is a well-recognized predictor of cardiovascular disease (CVD). ECG R-wave to Radial artery pulse delay (RRD) is a novel hemodynamic index in which arterial stiffness is an important component (shorter delay = Higher arterial stiffness) and is obtainable from a single tonometric measurement at the radial artery with simultaneous ECG. Sleep disordered breathing (SDB) has emerged as a risk factor for CVD. The aim of the study was to determine the association of SDB with RRD. Methods: Multi-Ethnic Study of Atherosclerosis participants in 2010-2012 without overt CVD who underwent a sleep study, radial artery tonometry and cardiac MRI were eligible for this cross-sectional analysis (N = 1173, Mean [SD] age: 67.8 ± 8.8, Women: 55.4%). Independent associations between SDB indices including apnea hypopnea index (AHI) and oxygen (O2) desaturation index (ODI: events with more than 4% O2 desaturation), and RRD (transit time in msec) were examined. Model was constructed to adjust for isovolumetric contraction time, another component of RRD, by including measures of contractility and preload (left ventricular ejection fraction (LVEF) and left ventricular end diastolic volume (LVEDV) respectively). Results: Median [IQR] of AHI and ODI were 7.9/hr [2.9- 18.0] and 7.5/hr [3.0- 17.5] respectively. Adjusting for transit path length, demographic factors, BMI and CVD risk factors, both AHI and ODI were inversely associated with RRD (β= -50.3 msec per SD, p = 0.09 and β= -0.60.2 msec per SD, p = 0.04 respectively). In gender stratified analyses given presence of significant interaction, measures of SDB were predictive of RRD only in men. No significant associations were found with key nocturnal hypoxemia indices including mean O2 saturation (SpO2), percent time with SpO2less than 90 % and minimum SpO2. Men, older age, Asian race, high blood pressure, LVEF and LVEDV were also inversely associated with RRD. Conclusion: SDB was associated with shorter RRD implying higher arterial stiffness in men only. These findings suggest the importance of apnea related dynamic change in SpO2 (intermittent hypoxia and reoxygenation) in its potential link to arterial stiffness and also highlights effect modification by gender in the association between the two.

Abstract WP357: Prevalence of Pre- and Post-intracerebral Hemorrhage Sleep-disordered Breathing

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Richard V Scheer ◽  
Lynda D Lisabeth ◽  
Chengwei Li ◽  
Erin Case ◽  
Ronald D Chervin ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Intracerebral Hemorrhage ◽  
Mexican American ◽  
Sleep Disordered Breathing ◽  
Population Based ◽  
Apnea Hypopnea Index ◽  
Berlin Questionnaire ◽  
Portable Monitor ◽  
Before And After ◽  
Disordered Breathing

Background: Sleep-disordered breathing (SDB) is an independent risk factor for stroke. The reported prevalence of SDB after stroke ranges from 60 to >70%, while the pre-stroke prevalence of SDB is less well described. Moreover, much of these data are derived from ischemic stroke or mixed ischemic stroke and intracerebral hemorrhage (ICH) cohorts. Studies that assess the prevalence of SDB before and after ICH are lacking, with only one prior study (n=32) that reported a post-ICH SDB prevalence of 78%. We report herein the results of a second, larger, prospective study that assessed the prevalence of pre- and post-ICH. Methods: Participants enrolled in the population-based stroke surveillance study, the Brain Attack Surveillance in Corpus Christi (BASIC) project, with ICH from 2010-2015 were screened for SDB with the well validated ApneaLink Plus portable monitor (SDB defined as apnea-hypopnea index (AHI) ≥10). The Berlin questionnaire was administered, with reference to the pre-ICH state, to assess for possible pre-stroke SDB. Results: Of the 60 ICH participants screened, the median age was 63 years (interquartile range (IQR): 55.5, 74.5). Twenty-one (35%) were female, 54 (90%) were Mexican American, and 53 (88%) had a history of hypertension. The median Glasgow Coma Scale score was 15.0 (IQR: 15.0, 15.0) and the median NIHSS was 5.5 (IQR: 1.5, 8.0). Post-ICH, the median AHI was 9.5 (IQR: 5.5, 19.0); almost half (46.7%) met criteria for SDB. Thirty-four participants (56.7%) screened as high risk for SDB pre-ICH. Conclusion: Sleep-disordered breathing was highly prevalent after ICH, and also likely common before ICH, in this mostly Mexican American, community-based sample. If SDB increases risk for ICH, the findings suggest a potential new treatment target to prevent ICH and recurrent ICH.

Are questionnaires reliable in diagnosing sleep-disordered breathing in university students?

2017 ◽  
Vol 131 (11) ◽  
pp. 965-971 ◽  
Author(s):  
E Migacz ◽  
A Wichniak ◽  
W Kukwa
Keyword(s):  
Young Adults ◽  
University Students ◽  
Epworth Sleepiness Scale ◽  
Sleep Disordered Breathing ◽  
Diagnostic Tools ◽  
Berlin Questionnaire ◽  
Sleep Study ◽  
Symptom Evaluation ◽  
Respiratory Disturbance ◽  
Disordered Breathing

AbstractObjective:This study aimed to screen young adults for sleep-disordered breathing, and compare those with high and low risk for sleep-disordered breathing.Methods:A survey based on the Berlin questionnaire was completed by 330 university students, and the results were used to divide them into sleep-disordered breathing positive and sleep-disordered breathing negative groups. A representative group was selected from each cohort (positive group,n= 16; negative group,n= 21), and assessed with sleep study, ENT examination, the Nose Obstruction Symptom Evaluation scale, and the Epworth Sleepiness Scale.Results:Sleep-disordered breathing prevalence was 11.2 per cent in the questionnaire and 24 per cent according to the sleep study. The sleep-disordered breathing positive and negative groups significantly differed in terms of coexisting sleep-disordered breathing symptoms. There were no significant differences between the positive and negative groups with regard to sleep study parameters (apnoea/hypopnoea index, respiratory disturbance index, oxygen desaturation index, snoring intensity) and the Epworth Sleepiness Scale.Conclusion:Subjective and objective diagnostic tools revealed that sleep-disordered breathing is a common problem among young adults.

scholarly journals The Utility of a Portable Sleep Monitor to Diagnose Sleep-Disordered Breathing in a Pediatric Population

2014 ◽  
Vol 21 (1) ◽  
pp. 31-35 ◽  
Author(s):  
Colin Massicotte ◽  
Suhail Al-Saleh ◽  
Manisha Witmans ◽  
Indra Narang
Keyword(s):  
Sleep Disordered Breathing ◽  
Pediatric Population ◽  
Apnea Hypopnea Index ◽  
Strongly Correlated ◽  
Sleep Study ◽  
Obstructive Sleep ◽  
Abnormal Breathing ◽  
Delays In Diagnosis ◽  
Pearson Correlations ◽  
Disordered Breathing

BACKGROUND: Central and/or obstructive sleep-disordered breathing (SDB) in children represents a spectrum of abnormal breathing during sleep. SDB is diagnosed using the gold standard, overnight polysomnography (PSG). The limited availability and access to PSG prevents its widespread use, resulting in significant delays in diagnosis and treatment of SDB. As such, portable sleep monitors are urgently needed.OBJECTIVE: To evaluate the utility of a commercially available portable sleep study monitor (PSS-AL) (ApneaLink, ResMed, USA) to diagnose SDB in children.METHODS: Children referred to a pediatric sleep facility were simultaneously monitored using the PSS-AL monitor and overnight PSG. The apnea-hypopnea index (AHI) was calculated using the manual and autoscoring function of the PSS-AL, and PSG. Sensitivity and specificity were compared with the manually scored PSS-AL and PSG. Pearson correlations and Bland-Altman plots were constructed.RESULTS: Thirty-five children (13 female) completed the study. The median age was 11.0 years and the median body mass index z-score was 0.67 (range −2.3 to 3.8). SDB was diagnosed in 17 of 35 (49%) subjects using PSG. The AHI obtained by manually scored PSS-AL strongly correlated with the AHI obtained using PSG (r=0.89; P<0.001). Using the manually scored PSS-AL, a cut-off of AHI of >5 events/h had a sensitivity of 94% and a specificity of 61% to detect any SDB diagnosed by PSG.CONCLUSIONS: Although PSG is still recommended for the diagnosis of SDB, the ApneaLink sleep monitor has a role for triaging children referred for evaluation of SDB, but has limited ability to determine the nature of the SDB.

scholarly journals Associations of Maternal Beliefs and Distress in Pregnancy and Postpartum With Breastfeeding Initiation and Early Cessation

2018 ◽  
Vol 35 (1) ◽  
pp. 49-58 ◽  
Author(s):  
Genevieve Ritchie-Ewing ◽  
Amanda M. Mitchell ◽  
Lisa M. Christian
Keyword(s):  
Psychological Distress ◽  
Depressive Symptoms ◽  
Early Pregnancy ◽  
Late Pregnancy ◽  
Well Being ◽  
Self Report ◽  
Breastfeeding Initiation ◽  
Postpartum Visit ◽  
General Anxiety ◽  
Pregnancy And Postpartum

Background: Breastfeeding plays an important role in both maternal and infant health and well-being. While researchers have examined the relationship between postpartum psychological distress and breastfeeding behaviors, few have investigated links between prenatal distress, postpartum distress, and breastfeeding behaviors over time. Research Aim: We aimed to determine if prenatal breastfeeding beliefs and psychological distress during and after pregnancy were associated with initiation and early cessation rates of breastfeeding. Methods: In our secondary data analysis, a nonexperimental longitudinal one-group design was used. We assessed pregnant women ( N = 70) during four perinatal visits (early, mid, and late pregnancy and 7-10 weeks postpartum). Participants completed self-report surveys about psychological distress and depressive symptoms at each visit, breastfeeding beliefs during the third visit, and breastfeeding behaviors at the postpartum visit. Results: Participants who breastfed for ⩾8 weeks had more positive beliefs about breastfeeding prior to delivery than participants with early cessation, who in turn had more positive beliefs than those who never initiated. Participants with early cessation reported heightened levels of pregnancy-specific distress in early pregnancy compared to those who continued breastfeeding or never initiated. Participants who continued breastfeeding for ⩾8 weeks reported less general anxiety and depressive symptoms in postpartum than those who discontinued or never initiated. Conclusions: Prenatal beliefs about breastfeeding, pregnancy-specific distress in early pregnancy, and general anxiety and depressive symptoms in postpartum are associated with breastfeeding initiation and continuation. Of clinical relevance, addressing prenatal and postpartum distress in the implementation of breastfeeding practice interventions could improve breastfeeding rates.

scholarly journals 0458 Does Simulated Limited-Channel Home Sleep Study Testing Accurately Predict The Diagnosis Of Sleep-disordered Breathing In Patients With Spinal Cord Injury, Or Disease?

SLEEP ◽  
2019 ◽  
Vol 42 (Supplement_1) ◽  
pp. A184-A184
Author(s):  
Salam Zeineddine ◽  
Kelsey Arvai ◽  
Sarah E Vaughan ◽  
Anan Salloum ◽  
Jennifer L Martin ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Sleep Disordered Breathing ◽  
Sleep Study ◽  
Cord Injury ◽  
Home Sleep Study ◽  
Disordered Breathing

Abstract 11254: Association of Sleep Disordered Breathing and Sleep Architecture With Atrial Fibrillation: The MESA Study

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Younghoon Kwon ◽  
Sina A Gharib ◽  
Mary Lou Biggs ◽  
David R Jacobs ◽  
Alvaro Alonso ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Sleep Disordered Breathing ◽  
Slow Wave Sleep ◽  
Cross Sectional Study ◽  
Sleep Architecture ◽  
Apnea Hypopnea Index ◽  
Cvd Risk ◽  
Cross Sectional ◽  
Sleep Study ◽  
Disordered Breathing

Background: Sleep disordered breathing (SDB) has been associated with nocturnal atrial fibrillation (AF). However, the association of SDB and other important sleep characteristics with prevalent AF (beyond nocturnal AF) is unclear. We explored the cross-sectional association of SDB and other objectively measured sleep characteristics with AF. Methods: Prevalence of AF was examined among MESA (Multi-Ethnic Study of Atherosclerosis) study participants who underwent polysomnography (PSG) (n=2048) (MESA Sleep Study). Presence or a history of AF was determined if AF or atrial flutter was identified by at least one of the following measures: (i) 12-lead ECG during study examination; (ii) PSG; (iii) ICD-9 codes from hospital discharge diagnosis; (IV) inpatient and outpatient Medicare claims data. Results: Overall prevalence of AF was 4.9 % (n=100). Prevalence of AF was significantly higher at 6.7% in subjects with moderate to severe SDB (n = 691, apnea hypopnea index (AHI) ≥15/h) compared with a prevalence of 4.0% in participants without SDB (n = 707, AHI < 5/h) (p=0.02). After accounting for demographics, body habitus, cardiovascular disease (CVD) risk factors and prevalent CVD, participants with higher values of AHI were more likely to have AF, although the result was not statistically significant (OR: 1.22 [0.99-1.49] per SD [17/hr], p = 0.06). Exploratory analyses of the association of sleep architecture with AF using the same model found significantly lower odds of AF associated with longer duration of slow wave sleep (SWS) (OR: 0.66 [0.5-0.89] per SD [34 min], p = 0.01). Results from a multivariable model that included 3 key sleep characteristics (AHI, SWS time and arousal index (AI)) suggested that all were independently associated with AF (AHI: OR 1.45 [1.13-1.87] per SD, p = 0.004; SWS time: OR 0.65 [0.49-0.87] per SD, p = 0.004; AI: OR 0.65 [0.50-0.86] per SD (12/hr), p = 0.002). Conclusion: In a cross-sectional study of a large multi-ethnic population, the prevalence of AF was associated with more severe SDB, shorter SWS time, and lower AI. This finding highlights sleep architecture’s implication, potentially via autonomic balance, in the association between sleep and AF.

scholarly journals Questionnaire and Portable Sleep Test Screening of Sleep Disordered Breathing in Acute Stroke and TIA

2021 ◽  
Vol 10 (16) ◽  
pp. 3568
Author(s):  
Benjamin K. Petrie ◽  
Tudor Sturzoiu ◽  
Julie Shulman ◽  
Saleh Abbas ◽  
Hesham Masoud ◽  
...  
Keyword(s):  
Acute Stroke ◽  
Sleep Disordered Breathing ◽  
Secondary Analysis ◽  
Apnea Hypopnea Index ◽  
Berlin Questionnaire ◽  
Acute Setting ◽  
C Statistic ◽  
Ischemic Attack ◽  
Stop Questionnaire ◽  
Disordered Breathing

Sleep disordered breathing (SDB) is highly prevalent, but frequently unrecognized among stroke patients. Polysomnography (PSG) is difficult to perform soon after a stroke. We evaluated the use of screening questionnaires and portable sleep testing (PST) for patients with acute stroke, subarachnoid hemorrhage, or transient ischemic attack to expedite SDB diagnosis and management. We performed a single-center retrospective analysis of a quality improvement study on SDB screening of consecutive daytime, weekday, adult admissions to a stroke unit. We excluded patients who were unable to communicate and lacked available family members. Patients were screened with the Epworth Sleepiness Scale, Berlin Questionnaire, and STOP-BANG Questionnaire and underwent overnight PST and/or outpatient PSG. The 4-item STOP Questionnaire was derived from STOP-BANG for a secondary analysis. We compared the sensitivity and specificity of the questionnaires for the diagnosis of at least mild SDB (apnea hypopnea index (AHI) ≥5) on PST and correlated AHI measurements between PST and PSG using the Spearman correlation. Out of sixty-eight patients included in the study, 54 (80%) were diagnosed with SDB. Only one (1.5%) had a previous SDB diagnosis. Thirty-three patients completed all questionnaires and a PST. The STOP-BANG questionnaire had the highest sensitivity for at least mild SDB (0.81, 95% CI (confidence interval): 0.65–0.92) but a low specificity (0.33, 95% CI 0.10, 0.65). The discrimination of all questionnaires was overall poor (C statistic range 0.502–0.640). There was a strong correlation (r = 0.71) between the AHI results estimated using PST and outpatient PSG among 28 patients. The 4-item STOP Questionnaire was the easiest to administer and had a comparable or better sensitivity than the other questionnaires. Inpatient PSTs were useful for screening in the acute setting to facilitate an early diagnosis of SDB and to establish further outpatient evaluations with sleep medicine.

scholarly journals 0968 Sleep-disordered Breathing In Schaaf-yang Syndrome

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A367-A368
Author(s):  
W Powell ◽  
M Rech ◽  
C Schaaf ◽  
J Wrede
Keyword(s):  
Sleep Apnea ◽  
Sleep Disordered Breathing ◽  
Central Sleep Apnea ◽  
Sleep Time ◽  
Sleep Stages ◽  
Apnea Hypopnea Index ◽  
Sleep Study ◽  
Central Index ◽  
Obstructive Sleep ◽  
Disordered Breathing

Abstract Introduction Schaaf-Yang Syndrome (SYS) is a genetic disorder caused by truncating variants in the MAGEL2 gene located in the maternally imprinted, paternally expressed Prader-Willi syndrome (PWS) region at 15q11-13. The SYS phenotype shares features with PWS, a disorder with known high incidence of central and obstructive sleep apnea (OSA). However the spectrum of sleep-disordered breathing in SYS has not been described. Methods We performed a retrospective analysis of polysomnograms from 22 of the known 115 patients with molecular diagnosis of SYS. Sleep characteristics including total sleep time, latency, efficiency, % sleep stages, apnea-hypopnea index (AHI), obstructive index, central index, and oxygenation were analyzed for the whole group and by truncation location (c.1996dupC variants [n=11] or other locations [n=11]). Only the initial diagnostic study or initial diagnostic portion of a split-night study was used in analysis (analytic n=21). Results We collected 33 sleep study reports from 22 patients, ages 2 months - 18.5 years. Mean analyzed sleep time was 357 minutes (129-589 min) with mean sleep efficiency of 71.45% (45-94%) and sleep latency of 24.8 minutes (0-146 min). The mean apnea-hypopnea index (AHI) was 19.1/hr (0.9 -49/hr) with mean obstructive AHI of 16.3 (0.6-49/hr). Mean central index was 2.8/hr (0-14/hr). 18/21 (86%) were diagnosed with OSA, and 13/21 (62%) with moderate or severe OSA (oAHI &gt;5/hr). Central sleep apnea was diagnosed in 2/21 (9.5%). 15 studies reported periodic limb movement index (PLMI) with mean of 7.8 (0-67/hr) and 4/15 (26%) with PLMI &gt;5. Comparison of genotype groups did not reveal any difference in presence of OSA or severity of OSA. Conclusion OSA is frequently identified on polysomnography in patients with SYS. Central sleep apnea is less common, which is in contrast to PWS. The majority of patients with OSA had moderate or severe OSA, and 47% had severe OSA. Support N/A

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