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Excessive Daytime Sleepiness

Diego Z Carvalho, Erik K St Louis, David S Knopman, Bradley F Boeve, Val J Lowe, Rosebud O Roberts, Michelle M Mielke, Scott A Przybelski, Mary M Machulda, Ronald C Petersen, Clifford R Jack, Prashanthi Vemuri
Importance: Aging is associated with excessive daytime sleepiness (EDS), which has been linked to cognitive decline in the elderly. However, whether EDS is associated with the pathologic processes of Alzheimer disease remains unclear. Objective: To investigate whether EDS at baseline is associated with a longitudinal increase in regional β-amyloid (Aβ) accumulation in a cohort of elderly individuals without dementia. Design, Setting, and Participants: This prospective analysis included participants enrolled in the Mayo Clinic Study of Aging, a longitudinal population-based study in Olmsted County, Minnesota...
March 12, 2018: JAMA Neurology
Rachel P Ogilvie, Kamakshi Lakshminarayan, Conrad Iber, Sanjay R Patel, Pamela L Lutsey
BACKGROUND: Although excessive daytime sleepiness (EDS) is a common symptom of obstructive sleep apnea (OSA), and both EDS and OSA have separately been associated with increased risk of cardiovascular disease (CVD), their joint association with CVD risk is unknown. METHODS: Among 3874 Sleep Heart Health Study (SHHS) participants without prevalent CVD, moderate to severe OSA was defined by an apnea hypopnea index (AHI) ≥ 15 on an in-home polysomnography. EDS was defined as an Epworth Sleepiness Scale score ≥11...
April 2018: Sleep Medicine
Akiyoshi Shimura, Sakai Hideo, Yoshikazu Takaesu, Ryota Nomura, Yoko Komada, Takeshi Inoue
OBJECTIVE: Sleep affects adolescents in various ways. However, the effects of multiple factors on sleep hygiene remain unclear. A comprehensive assessment of the effects of life habits on sleep in high-school students was conducted. METHODS: A cross-sectional survey of 344 high school students (age range 15-17; 171 boys, 173 girls) in Tokyo, Japan was conducted in 2015. Complete responses were provided by 294 students. Demographic variables, Pittsburgh Sleep Quality Index (PSQI), diurnal type scale, Pediatric Daytime Sleepiness Scale (PDSS), and life habits such as dinnertime, viewing electronic displays, caffeine intake, sunlight in the morning, and the brightness of the room in the night were asked...
April 2018: Sleep Medicine
Judette M Louis, Matthew A Koch, Uma M Reddy, Robert M Silver, Corette B Parker, Francesca L Facco, Susan Redline, Chia-Ling Nhan-Chang, Judith H Chung, Grace W Pien, Robert C Basner, William A Grobman, Deborah A Wing, Hyagriv N Simhan, David M Haas, Brian M Mercer, Samuel Parry, Daniel Mobley, Benjamin Carper, George R Saade, Frank P Schubert, Phyllis C Zee
BACKGROUND: Sleep-disordered breathing (SDB) is common in pregnancy, but there are limited data on predictors. OBJECTIVES: The objective of this study was to develop predictive models of sleep-disordered breathing during pregnancy. STUDY DESIGN: Nulliparous women completed validated questionnaires to assess for symptoms related to snoring, fatigue, excessive daytime sleepiness, insomnia, and restless leg syndrome. The questionnaires included questions regarding the timing of sleep and sleep duration, work schedules (eg, shift work, night work), sleep positions, and previously diagnosed sleep disorders...
February 2, 2018: American Journal of Obstetrics and Gynecology
Alexis Roman, Soraya Meftah, Sébastien Arthaud, Pierre-Hervé Luppi, Christelle Peyron
Narcolepsy type 1 is a disabling disorder with four primary symptoms: excessive-daytime-sleepiness, cataplexy, hypnagogic hallucinations and sleep paralysis. The three latter symptoms together with a short REM sleep latency have suggested impairment in REM sleep homeostatic regulation with an enhanced propensity for (i.e. tendency to enter) REM sleep. To test this hypothesis, we challenged REM sleep homeostatic regulation in a recognized model of narcolepsy, the orexin knock-out (Orex-KO) mice and their wild-type (WT) littermates...
March 7, 2018: Sleep
Monica Moresco, Fabio Pizza, Elena Antelmi, Giuseppe Plazzi
Narcolepsy type 1 (NT1) is a rare chronic neurologic disorder characterized by excessive daytime sleepiness, cataplexy, sleep paralysis, hallucinations and disrupted nocturnal sleep, usually with onset during childhood/adolescence. Pediatric NT1 is associated with limitations on children's activities and achievements, especially poor performance at school, difficulty with peers due to disease symptoms and comorbidities including depression, obesity, and precocious puberty. NT1 disease is caused by the selective loss of hypocretin-producing neurons in the lateral hypothalamus, most probably related to an autoimmune pathophysiology...
March 5, 2018: Current Drug Metabolism
Susanna Mantovani, Simon S Smith, Richard Gordon, John D O'Sullivan
Sleep and circadian alterations are amongst the very first symptoms experienced in Parkinson's disease, and sleep alterations are present in the majority of patients with overt clinical manifestation of Parkinson's disease. However, the magnitude of sleep and circadian dysfunction in Parkinson's disease, and its influence on the pathophysiology of Parkinson's disease remains often unclear and a matter of debate. In particular, the confounding influences of dopaminergic therapy on sleep and circadian dysfunction are a major challenge, and need to be more carefully addressed in clinical studies...
March 1, 2018: Journal of Sleep Research
Jun-Sang Sunwoo, Young Hwangbo, Won-Joo Kim, Min Kyung Chu, Chang-Ho Yun, Kwang Ik Yang
OBJECTIVE: To determine the prevalence, sleep characteristics, and comorbidities associated with a high risk for obstructive sleep apnea (OSA) in the Korean adult population. METHODS: We analyzed data from 2,740 subjects who responded to a nationwide questionnaire survey of sleep characteristics. Those who qualified under two or more symptom categories of the Berlin questionnaire were defined as "at high risk for OSA". We investigated their socio-demographic information, sleep habits, and medical and psychiatric comorbidities...
2018: PloS One
Winda L Ng, Jonathan E Shaw, Anna Peeters
OBJECTIVE: To assess the relationship between excessive daytime sleepiness (EDS), disability, mortality, and life expectancy (with and without disability) in a cohort of middle-aged American adults. METHODS: The Wisconsin Longitudinal Study, a life-course study on 10,317 high school graduates from Wisconsin, was used to assess the odds ratio (OR) between EDS in 2004 for prevalent and incident disability to 2011 through multiple logistic regression, and to estimate the hazard ratio (HR) of EDS in 2004 for mortality over ten years through a Cox proportional hazard model...
March 2018: Sleep Medicine
Tayyabah Yousaf, Gennaro Pagano, Flavia Niccolini, Marios Politis
OBJECTIVES/BACKGROUND: Excessive daytime sleepiness (EDS) is a common disorder, which can manifest in isolation or in combination with other neurological or psychiatric disorders. We know relatively little about the mechanisms underlying the development of EDS and the clinical management of patients with EDS remains an unmet need. In this study, we hypothesised that thalamic dopaminergic function would be altered in subjects with EDS and we sought to investigate this by assessing [123 I]FP-CIT Single Photon Emission Computed Tomography (SPECT) data, which is a molecular imaging marker of dopamine transporter (DAT)...
March 2018: Sleep Medicine
Sébastien Baillieul, Bernard Wuyam, Jean-Louis Pépin, Mathieu Marillier, Renaud Tamisier, Dominic Pérennou, Samuel Verges
STUDY AIM: Severe obstructive sleep apnoea (OSA) can lead to neurocognitive alterations, including gait impairments. The beneficial effects of continuous positive airway pressure (CPAP) on improving excessive daytime sleepiness and daily functioning have been documented. However, a demonstration of CPAP treatment efficacy on gait control is still lacking. This study aims to test the hypothesis that CPAP improves gait control in severe OSA patients. MATERIAL AND METHODS: In this prospective controlled study, twelve severe OSA patients (age = 57...
2018: PloS One
Jonathan P Zebrowski, Samantha J Pulliam, John W Denninger, Lori R Berkowitz
BACKGROUND: Sleep impairment is highly prevalent among resident physicians and is associated with both adverse patient outcomes and poor resident mental and physical health. Risk factors for sleep problems during residency are less clear, and no screening model exists to identify residents at risk for sleep impairment. OBJECTIVE: The objective of this study was to assess change in resident sleep during training and to evaluate utility of baseline sleep screening in predicting future sleep impairment...
February 20, 2018: Journal of General Internal Medicine
Sumera Shaikh Solaiman, Ritwick Agrawal
This is a rare case of non-24-hour sleep-wake rhythm disorder in a sighted male with normal functioning. The patient, a 23-year-old doctorate graduate student, presented with difficulty falling asleep and excessive daytime sleepiness. He reported variable sleep and wake times. Overnight baseline polysomnography was unremarkable and his Multiple Sleep Latency Test was significant for short mean sleep latency. Sleep diary and actigraphy were obtained, which demonstrated a pattern of delaying of sleep and wake times each day...
February 13, 2018: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
Dushyanth Babu Jasti, Sarat Mallipeddi, A Apparao, B Vengamma, Satyarao Kolli, A Mohan
Objective: The objective of this study is to study the quality of sleep, sleep disorders, and polysomnographic profile in Parkinsonism patients from rural areas and to correlate polysomnographic profile with the staging of disease and with sleep questionnaire. Materials and Methods: Between May 2014 and December 2015, 168 Parkinsonism patients were prospectively screened using sleep questionnaire; Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI), Parkinson Disease Sleep Score-2 (PDSS-2)...
January 2018: Journal of Neurosciences in Rural Practice
L Lerousseau
Excessive daytime sleepiness is a major symptom in cases of the obstructive sleep apnea-hypopnea syndrome. Most often, it is vastly improved by treatment with continuous positive airway pressure (CPAP). The most effective way to confirm its disappearance is through wakefulness maintenance testing. If residual sleepiness remains, despite CPAP, further diagnostic investigation must be carried out. Firstly, it must be assessed whether the treatment is fully effective (apnea hypopnea index<10/h) by examining flow limitations under treatment (polysomnography) and whether it is sufficiently used (>6h/night)...
February 14, 2018: Revue des Maladies Respiratoires
Isao Muraki, Hiroo Wada, Takeshi Tanigawa
The aim of this review is to clarify the association between obstructive sleep apnea (OSA) and type 2 diabetes, and discuss the therapeutic role of continuous positive airway pressure (CPAP) in type 2 diabetes. OSA patients are more likely than non-OSA populations to develop type 2 diabetes while more than half of patients with type 2 diabetes suffer from OSA. Similarly to the Western countries, in the East Asian population, the association between these two disorders has also been reported. CPAP is the primary treatment for OSA, but the effect of CPAP on comorbid diabetes has not been established...
February 17, 2018: Journal of Diabetes Investigation
Renata Pecotic, Ivana Pavlinac Dodig, Maja Valic, Tea Galic, Linda Lusic Kalcina, Natalija Ivkovic, Zoran Dogas
STUDY OBJECTIVES: We prospectively investigated the effects of continuous positive airway pressure (CPAP) on long-term cognitive and psychomotor performances, and excessive daytime sleepiness in severe obstructive sleep apnea (OSA) patients. METHODS: A total of 40 patients were recruited and 23 patients with severe OSA fully completed the study protocol to investigate the effects of CPAP therapy on psychomotor performance at 1, 3, and 6 months and 1 year following initiation of the therapy...
February 16, 2018: Sleep & Breathing, Schlaf & Atmung
G Dave Singh, Mark Kraver, Oleg Chernyshev
Background A sleep study of a 56-year old male with excessive daytime sleepiness demonstrated an AHI of 16.4hr -1 with 13% of total sleep time in REM sleep and a mean oxygen desaturation (SpO 2 ) of 86%. Clinical presentation On intra-oral examination, it was found that the patient had maxillary hypoplasia and bilateral torus mandibularis. A 3D cone-beam CT (CBCT) scan was taken, and 28 craniofacial parameters were measured. Surgical reduction of the mandibular tori followed by biomimetic oral appliance therapy (BOAT) was initiated...
February 15, 2018: Cranio: the Journal of Craniomandibular Practice
Geoffrey Lawrence, Rexford Muza
Background: Excessive daytime sleepiness (EDS) is a complaint common to many aspects of medicine. There are primary and secondary causes for EDS, with secondary causes including a large number of common conditions. Primary causes, such as narcolepsy, are much rarer. When assessing for primary hypersomnia, restricted or fragmented sleep must be ruled out. This process involves assessment of sleeping habits using a sleep diary and/or actigraphy. Clinicians are suspicious of the accuracy with which patients use the former...
January 2018: Journal of Thoracic Disease
Sasha Smith, Jennifer Rossdale, Yaseen Serry, Anisha Sekaran, Panagis Drakatos, Joerg Steier
Background: In this study we investigated subjective measures of sleepiness and related our findings to dimensions of affect, fatigue, emotion, mood and quality of life based on a hypothetical multidimensional model of sleepiness. Methods: Patients referred to a sleep clinic were assessed regarding their excessive daytime sleepiness (EDS), sleep complaints, routine and symptoms. Age, gender and body mass index (BMI), the Epworth Sleepiness Scale (ESS), the Stanford Sleepiness Scale (SSS), the Samn-Perelli fatigue Scale (SPS), the Global Vigor and Affect Scale (GVS and GAS, respectively), the Hospital Anxiety and Depression Scale (HADS-A and HADS-D, respectively), and the Positive and Negative Affect Schedule (PAS and NAS, respectively) scores were recorded...
January 2018: Journal of Thoracic Disease
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