Characteristics of Obstructive Sleep Apnea Patients With Hypertension and Factors Associated With Autotitration Acceptance

In order to explore the characteristics and treatment status of obstructive sleep apnea (OSA) patients with hypertension, a retrospective study was conducted on 306 patients admitted from October 2018 to December 2019. According to the apnea hypopnea index (AHI), OSA patients with hypertension were divided into three groups. 69 cases were mild OSA (5 ≤ AHI < 15), 86 cases were moderate (15 ≤ AHI < 30), and 151 cases were severe (AHI ≥ 30). Compared with patients in the mild and moderate groups, the severe group had more male patients, with higher body mass index (BMI) and non-rapid eye movement stage 1 accounted for total sleep time (N1%), and lower non-rapid eye movement stage 2 accounted for total sleep time (N2%), average and minimum blood oxygen. Among all the patients, those who underwent the titration test accounted for 20.6% (63/306). Multivariate analysis showed that sleep efficiency (p < 0.001) and AHI (p < 0.001) were independent factors for patients to accept titration test. OSA patients with hypertension had a low acceptance of titration therapy. These people with higher sleep efficiency and AHI were more likely to receive autotitration.

Extreme sleep fragmentation for 11 consecutive days and nights does not significantly alter total sleep time, and sleep stage distribution, during the continuous alpine downhill skiing world record

Introduction: Extreme levels of sleep deprivation, fragmentation and management, are major problems in many sportive disciplines, ultramarathons, polar or extreme altitude expeditions, and in space operations. Material and methods: Polysomnographic (PSG) data was continuously recorded (total sleep time and sleep stage distribution) in a 34-year-old male whilst performing the new world record in long-term downhill skiing. He napped only during the short ski lift rides for 11 days and nights. Results: After an initial period of complete sleep deprivation for 24 hours, total sleep time and the total times of non-REM and REM achieved during the lift rides returned to standard values on the second day. PSG data revealed an average sleep time per 24 hours of 6 hours and 6 minutes. During daylight sleep was rarely registered. The subject experienced only two minor falls without injury and immediately resumed skiing. Conclusion: In a healthy, trained, elite male athlete, sleep fragmentation over 11 consecutive days did not significantly impair the sleep, motor or cognitive skills required to perform a continuous downhill skiing world record after an initial adaptation phase.

Epilepsy and Sleep in the ATR-X Syndrome

Background This study explores the prevalence, clinical characteristics, and treatment of epilepsy and sleep disorders in α thalassemia mental retardation (ATR-X) syndrome. Design In this cross-sectional study, 37 participants with ATR-X syndrome aged 1.8 to 44 years were studied using a customized epilepsy questionnaire, review of electroencephalography (EEG) findings, the modified Sleep Questionnaire of Simonds and Parraga and 2-week sleep diary. Results Eleven participants had a clinical diagnosis of generalized epilepsy (29.7%). Seizure types were generalized tonic-clonic seizures, absences, and myoclonia. Interictal EEG recordings in participants with GTCS showed no epileptic discharges in 78%. Similarly, EEG recordings during myoclonia and absences often demonstrated no epileptic discharges. Sleep problems (difficulty falling or maintaining sleep, and early awakening) were reported in 70%. Participants with reported sleep problems went to bed earlier (p = 0.027) and had a lower sleep efficiency (p < 0.01) than participants without sleep problems, but as a group they both had a sufficient total sleep time (9 hours and 52 minutes vs. 10 hours and 55 minutes). Sixteen participants (43.2) used medication to improve sleep (predominantly melatonin n = 10), being effective in only two. Conclusion One-third of participants with ATR-X syndrome had a clinical diagnosis of epilepsy, but the absence of EEG abnormalities in suspected epileptic seizures questions this diagnosis in these patients. EEG recording during seizure like symptoms is warranted before making an epilepsy diagnosis. Seventy percent experienced sleep problems, although total sleep time was normal in most participants. Long bedtimes might have a negative influence on sleep efficiency.

Finding a Composite Measure for Data From Wrist Actigraphy in Bipolar Disorder

Actigraphy can objectively measure sleep in studies on Bipolar Disorder (BD) where subjective sleep ratings might be influenced by affect. Actigraphy data are complex necessitating data reduction approaches. We created a composite score of actigraphy sleep metrics (total sleep time [TST], wake after sleep onset [WASO], and percent sleep [PS]) in BD. We computed z-scores of sleep measures for n=51 BD vs. n=80 healthy subjects and averaged scores. We examined associations with participant characteristics and used LASSO to identify metrics best explaining composite variability. Higher composite scores (better sleep) were seen in employed vs. unemployed (t=2.40, df=34, p=0.02), and correlated with higher medication load (r=0.41, p=0.004), lower mania symptomatology (r=-0.33, p=0.04) and lower interleukin (IL)-6 levels (r=-0.32, p=0.02). TST best explained variability in medication load and PS best explained employment, mania symptoms and IL-6. Given observed specificity of associations, selecting theory-driven sleep metrics may be more appropriate than a composite.

Sleep Quality in Family Caregivers and Matched Non-Caregiving Controls: The REGARDS Study

The high levels of stress experienced by family caregivers may affect their physical and psychological health, including their sleep quality. However, there are few population-based studies comparing sleep between family caregivers and carefully-matched controls. We evaluated differences in sleep and identified predictors of poorer sleep among the caregivers, in a comparison of 251 incident caregivers and carefully matched non-caregiving controls, recruited from the national REasons for Geographic and Racial Differences in Stroke (REGARDS) Study. Incident caregivers and controls were matched on up to seven demographic and health factors (age, sex, race, education level, marital status, self-rated health, and self-reported serious cardiovascular disease history). Sleep characteristics were self-reported and included total sleep time, sleep onset latency, wake after sleep onset, time in bed, and sleep efficiency. Family caregivers reported significantly longer sleep onset latency, before and after adjusting for potential confounders, compared to non-caregiving controls (ps &lt; 0.05). Depressive symptoms in caregivers predicted longer sleep onset latency, greater wake after sleep onset, and lower sleep efficiency. Longer total sleep time in caregivers was predicted by employment status, living with the care recipient, and number of caregiver hours. Employed caregivers and caregivers who did not live with the care recipient had shorter total sleep time and spent less time in bed than non-employed caregivers. Additional research is needed to evaluate whether sleep disturbances contributes to health problems among caregivers.

Prognostic Impact of Sleep Patterns and Related-Drugs in Patients with Heart Failure

Sleep disturbances are frequent among patients with heart failure (HF). We hypothesized that self-reported sleep disturbances are associated with a poor prognosis in patients with HF. A longitudinal study of 119 patients with HF was carried out to assess the association between sleep disturbances and the occurrence of major cardiovascular events (MACE). All patients with HF completed self-administered questionnaires on sleepiness, fatigue, insomnia, quality of sleep, sleep patterns, anxiety and depressive symptoms, and central nervous system (CNS) drugs intake. Patients were followed for a median of 888 days. Cox models were used to estimate the risk of MACE associated with baseline sleep characteristics. After adjustment for age, the risk of a future MACE increased with CNS drugs intake, sleep quality and insomnia scores as well with increased sleep latency, decreased sleep efficiency and total sleep time. However, after adjustment for left ventricular ejection fraction and hypercholesterolemia the HR failed to be significant except for CNS drugs and total sleep time. CNS drugs intake and decreased total sleep time were independently associated with an increased risk of MACE in patients with HF. Routine assessment of self-reported sleep disturbances should be considered to prevent the natural progression of HF.

Impact of Recent Job Loss on Sleep, Energy Consumption and Diet

To examine how sleep quality and sleep duration affect caloric intake among those experiencing involuntary job loss. Methods Adequate sleep and self-reported dietary recall data from the Assessing Daily Activity Patterns through Occupational Transitions (ADAPT) study was analyzed. Primary sleep indices used were total sleep time, time spent in bed after final awakening, and sleep quality as measured by the Daily Sleep Diary (DSD). Mean Energy consumption (MEC) was the primary nutritional index. Secondary indices included diet quality using the Health Eating Index 2015 (HEI), and self-reported intake of protein, carbohydrates and fats. Results The study participants were comprised mainly of women (61%) and non-Hispanic white. The participants had at least 2 years of college education and mean body mass index of 30.2±8.08 (kg/m 2 (). The average time in bed was 541.8 (9 hrs) ±77.55 minutes and total sleep time was 461.1 (7.7 hrs) ±56.49 minutes. Mean sleep efficiency was 91±6%, self-reported sleep quality was 2.40±0.57 (0-4 scale, 4 = very good), and minutes earlier than planned morning awakening were 14.36±24.15. Mean HEI score was 47.41±10.92. Although the MEC was below national average for both men and women, male sex was associated with higher MEC. In a fully adjusted model sleep quality was positively associated with MEC. Conclusion Daily overall assessments of sleep quality among recently unemployed persons were positively associated with mean energy consumption. Additionally, the diet quality of unemployed persons was found to unhealthier than the average American and consistent with the relationship between poor socioeconomic status and lower diet quality.