INTRODUCTION: Obesity is a factor that is strongly related to the occurrence of obstructive sleep apnea (OSA) in adults, although this association remains controversial for children.
OBJECTIVE: The aim of this study was to compare the clinical and upper airway charactheristics, obtained by questionnaires, physical examination and laboratory tests, among obese children with and without OSA.
METHOD: This was aprospective cohort study. 44 obese children (body mass index above the 95th percentile) were included in the study. Questionnaires, physical examination of the upper airway, nasofibrolaryngoscopy, polysomnography, and laboratory allergic tests were performed.
RESULTS: There were 22 male patients (50%), and the mean age was 7.6±2.5 years. OSA was present in 19 (43%) patients. There were no statistically significant differences between the groups with and without OSA, in relation to clinical or laboratory allergic parameters. For the upper airway assessments, hypertrophy of the pharyngeal (p=0.001) and palatine (p=0.049) tonsils were the only parameters associated with OSA, and a modified Mallampati index of class III/IV also demonstrated a tendency towards being statistically associated with OSA (p=0.081). Moreover, these findings were confirmed to be factors associated with OSA in this group of children according to a logistic regression analysis.
CONCLUSIONS: The occurrence rate of OSA in this obese pediatric population was high. Adenotonsillar hypertrophy and a modified Mallampati index of class III/IV were the factors associated with OSA.
Keywords: Obstructive sleep apnea; Obesity; Physical examination; Palatine tonsil; Pharynx.
OBJECTIVE: The aim of the current study was to investigate the relationship between restless legs syndrome (RLS) and cardiorespiratory fitness, body composition and sleep quality in a sample of adolescents.
METHODS: One hundred fifty seven volunteer adolescents (16.6 ± 0.7 yrs) participated in the study. Sleep quality was assessed by the Pittsburg sleep quality index. Cardiorespiratory fitness was assessed by the 20 m shuttle run test and body composition by bioelectrical impedance analysis.
RESULTS: The prevalence of RLS was 5.1%. The adolescents with RLS were found to exhibit significantly higher body fat levels (p=0.019) and poorer sleep quality score (p=0.000) compared with their free-RLS counterparts.
CONCLUSIONS: Adolescents with RLS are subjects of higher body fat and impaired sleep quality compared with adolescents without RLS. Early diagnosis and appropriate management of RLS is essential in the adolescents.
Keywords: Sleep disorders; Body composition; Restless legs syndrome; Adolescent; Cyprus.
The pineal hormone Melatonin plays an important role in the regulation of the circadian sleep/wake cycle, mood, and perhaps immune functions, carcinogensis and reproduction. The human circadian rhythm of melatonin release from the pineal gland is tightly synchronized with the habitual hours of sleep. Peri- and postmenopausal women often complain of difficulties initiating and/or maintaining sleep, with frequent nocturnal and early morning awakenings. In this review we discuss the pathophysiology of melatonin function as it relates to sleep disorders in menopausal women, highlighting the potential use of exogenous melatonin during the menopausal transition and beyond.
Keywords: Sleep; Melatonin; Aging; Circadian rhythm; Hormones; Gender; Menopause.
Narcolepsy is a chronic neurological sleep disorder with potentially disabling symptoms ranging from occupational concerns to mental health difficulties. Recent advances related to the neurobiological basis of narcolepsy have led to newer pharmacological treatment options and adjunctive behavioral techniques that support symptom management. This article outlines evidence-based pharmacologic therapies, behavioral techniques, and psychosocial costs related to narcolepsy. Psychosocial factors, although frequently acknowledged, deserve further attention and awareness from researchers and providers. The American Academy of Sleep Medicine's (AASM) Quality Measure Drivers and potential future treatment options are also discussed.
Keywords: Narcolepsy; Therapeutics; Pharmacologic actions; Behavioral medicine; Psychosocial impact.
INTRODUCTION: Continuous positive airway pressure (CPAP) is the standard treatment for obstructive sleep apnoea (OSA), with limited data about the prevalence of respiratory infections and microbial colonization in these patients.
OBJECTIVES: The aim of this study was to determine if CPAP use is associated with respiratory infections and to identify the organisms that colonize or infect these patients.
METHOD: A retrospective, case-controlled study in patients diagnosed with OSA was carried out. 137 patients were recruited and interviewed using a questionnaire. A nasal swab was taken from each patient. Patients using CPAP machines had swabs taken from masks and humidifiers.
RESULTS: 66 (48.2%) patients received CPAP treatment with 60.6% of them having a heated humidifier. 78.8% were male, with the majority using a full face mask (63.6%). No significant difference was seen in the prevalence of rhinosinusitis, lower respiratory tract infections and hospital admissions for pneumonia between CPAP and non-CPAP treated patients. The presence of a humidifier did not influence the prevalence of infections. Commensal flora was predominantly cultured from nasal swabs from both patient groups. Coagulase Negative Staphylococci and Diphtheroids were the main organisms cultured from masks and humidifiers respectively.
CONCLUSIONS: This study shows that the use of CPAP, choice of mask and humidifier have no significant impact on the prevalence of infections and micro-organisms isolated. This is very reassuring to the physician prescribing CPAP therapy and users.
Keywords: Respiratory tract infections; Obstructive sleep apnea; Continuous positive airway pressure; Drug-related side effects and adverse reactions.
INTRODUCTION: Patients that started on Non-Invasive Ventilation (NIV) need to define several parameters selected on the basis of diurnal arterial blood gas and underlying disease. We hypothesize that respiratory polygraphy (RP) could be useful to monitor NIV. This retrospective work describes RP findings and their impact on the setting of continuous flow ventilators from patients on NIV of Intensive Care Unit (ICU).
MATERIAL AND METHODS: Patient's data on NIV from at the ICU of Hospital Británico were included in this study. RP recordings were performed in all of them. Respiratory events, such as ventilatory pattern changes, impact on oximetry or tidal volume, were observed to modify the ventilatory mode after RP.
RESULTS: The RP findings have contributes to change the ventilatory mode for one third of the patients. The mean values of expiratory positive airway pressure (EPAP) and inspiratory positive airway pressure (IPAP) were not significantly different across all the population before or after RP: 8.7±0.3 vs. 8.6±0.4; p<0.88 and 18.6±0.6 vs. 17.7±0.7; p<0.26 respectively, however, half the patients presented > 2 cmH2O pressure value changes after RP.
CONCLUSIONS: RP recordings could contribute to broad range of data useful to make decisions about changes in programming and allowed to identify adverse events related to positive pressure.
Keywords: Oximetry; Noninvasive ventilation; Intensive care units; Blood gas analysis.
INTRODUCTION: Sleep and lifestyles interact to allow the appropriate development of cerebral structures, and prevention of mood disorders. But just a hand of articles identified a precise relationship between these two above, and the probability to develop a suicidal behaviour.
OBJECTIVE: The aim of this study is to explore how the suicidal behaviour is associated in simultaneous with sleep components, psychological stress, depression, anxiety, well-being, addiction, and global health of participants; and if it is also influenced by the sociodemographic profile of each subject.
METHODS: The present study was led by a questionnaire incorporating McNair test, and an incorporated score to evaluate suicide tendencies. The questionnaire also included socio-demographic items and other questions to exhibit a profile of suicide tendency for each individual.
RESULTS: Our results showed that the stress levels and well-being are comparable according to gender. Specifically the results showed that lack of sleep combined with a low score to McNair test strongly affects the suicidal tendency, while score of memory and attention decreased.
CONCLUSIONS: The suicidal behaviour is closely linked with sleep parameters which decreased accordingly, and the family's history of medication and suicidal behaviour.
Keywords: young adult; suicide; sleep; mood disorders; sleep disorders.
INTRODUCTION: Olfactory dysfunction affects about 85-90% of Parkinson's disease (PD) patients with severe deterioration in the ability of discriminate several types of odors. In addition, studies reported declines in olfactory performances during a short period of sleep deprivation. Besides, PD is also known to strongly affect the occurrence and maintenance of rapid eye movement (REM) sleep.
METHODS: Therefore, we investigated the mechanisms involved on discrimination of a social odor (dependent on the vomeronasal system) and a non-social odor (related to the main olfactory pathway) in the rotenone model of PD. Also, a concomitant impairment in REM sleep was inflicted with the introduction of two periods (24 or 48 h) of REM sleep deprivation (REMSD). Rotenone promoted a remarkable olfactory impairment in both social and non-social odors, with a notable modulation induced by 24 h of REMSD for the non-social odor.
RESULTS: Our findings demonstrated the occurrence of a strong association between the density of nigral TH-ir neurons and the olfactory discrimination capacity for both odorant stimuli. Specifically, the rotenone-induced decrease of these neurons tends to elicit reductions in the olfactory discrimination ability.
CONCLUSIONS: These results are consistent with the participation of the nigrostriatal dopaminergic system mainly in the olfactory discrimination of a non-social odor, probably through the main olfactory pathway. Such involvement may have produce relevant impact in the preclinical abnormalities found in PD patients.
Keywords: Olfactory discrimination; Dopamine; Rotenone; REM sleep deprivation; Parkinson disease.