Incidence of Restless Legs Syndrome and Its Correlates.
119-124.
Pooja Budhiraja, M.D1,2; Rohit Budhiraja, M.D1,2; James L. Goodwin, Ph.D2; Richard P. Allen, Ph.D.3; Anne B. Newman, M.D.4; Brian B. Koo, M.D.5; Stuart F. Quan, M.D.2,6
BRIEF SUMMARY
Current Knowledge/Study Rationale: Restless legs syndrome is a common neurological disorder. Several studies have looked at the prevalence of RLS but the incidence and correlates of RLS still need to be elucidated. The aim of the current study was to assess the incidence of RLS and its correlates in a prospective community-based cohort.
Study Impact: The study demonstrates a relatively high annual incidence of RLS and its association with estrogen use and obstructive lung disease. An awareness of this relationship would facilitate early diagnosis and management of RLS in these patient groups, which may, in turn, lead to a decrease in insomnia and sleeping pill use.
Characteristics of REM Sleep Behavior Disorder in Childhood.
127-131.
Robin Lloyd, M.D.; Maja Tippmann-Peikert, M.D.; Nancy Slocumb; Suresh Kotagal, M.D.
BRIEF SUMMARY
Current Knowledge/Study Rationale: REM sleep behavior disorder was originally described as a parasomnia in older men. It is now recognized as a disorder of all ages and both sexes but most likely occurs more frequently in children than identified. The clinical and polysomnographic characteristics of this disorder during childhood need further characterization.
Study Impact: This study will hopefully increase the awareness of RBD in children. It describes commonly associated conditions with RBD in children including centrally mediated hypersomnia, pharmacologic agents, neurodevelopmental disorders and structural brainstem abnormalities.
Diagnostic Delay in REM Sleep Behavior Disorder (RBD).
133-136.
Caroline White1; Elizabeth A. Hill, B.Sc. (Hons)1; Ian Morrison, Ph.D.2; Renata L. Riha, M.D.1
BRIEF SUMMARY
Current Knowledge/Study Rationale: REM sleep behavior disorder (RBD) is a potentially lethal parasomnia in which normal muscle atonia during rapid eye movement (REM) sleep is lost. Although diagnostic delay is documented in other sleep disorders, such as narcolepsy, diagnostic delay in RBD has not, thus far, been investigated.
Study Impact: This is the first study to focus specifically on diagnostic delay in RBD. The study demonstrates the existence of significant diagnostic delay, highlighting the need for greater awareness of the disorder and its treatment options amongst patients and medical professionals.
Spanish Translation and Cross-Language Validation of a Sleep Habits Questionnaire for Use in Clinical and Research Settings.
137-146.
Carol M. Baldwin, Ph.D., R.N.1; Myunghan Choi, Ph.D., M.P.H.1; Darya Bonds McClain, Ph.D.1; Alma Celaya, M.S.N., M.P.H., R.N.1; Stuart F. Quan, M.D., FAASM2,3
BRIEF SUMMARY
Current Knowledge/Study Rationale: Limited knowledge of sleep and health of Hispanics of Mexican descent, the largest Hispanic group in the United States, is partly due to the need for precisely translated and validated sleep measures to assess Spanish-speaking Mexican Americans in clinical and research settings.
Study Impact: This first-of-its-kind study to rigorously translate and cross-language validate the Sleep Heart Health Study Sleep Habits Questionnaire demonstrated conceptual and content equivalency and acceptable psychometric characteristics with items loading on 4 factors that accounted for 68% and 67% of the variance on the English and Spanish versions respectively. This Spanish-language version of the Sleep Habits Questionnaire may be applied in clinical and research settings as a first step toward addressing sleep health disparities of Spanish-speaking Mexican Americans.
Spousal Involvement in CPAP: Does Pressure Help?.
147-153.
Kelly Glazer Baron, Ph.D., M.P.H1; Heather E. Gunn, M.S2; Laura A. Czajkowski, Ph.D3; Timothy W. Smith, Ph.D2; Christopher R. Jones, M.D., Ph.D4
BRIEF SUMMARY
Current Knowledge/Study Rationale: Patients often report spousal influence on treatment-seeking in OSA but few studies have systematically evaluated spousal involvement in treatment. The goal of this study was to evaluate how spouses are involved in CPAP treatment and the effects of percieved involvement on adherence to continuous positive airway pressure.
Study Impact: This study will inform sleep professionals about the ways spouses are involved in treatment and results suggest that increasing collaborative spousal involvement in CPAP use may improve adherence.
Sleep Apnea Is Related to the Atherogenic Phenotype, Lipoprotein Subclass B.
155-161.
Faith S. Luyster, Ph.D1; Kevin E. Kip, Ph.D2; Oliver J. Drumheller, Ed.D3; Thomas B. Rice, M.D., M.S3; Daniel Edmundowicz, M.D., M.S4; Karen Matthews, Ph.D5; Steven E. Reis, M.D4; Patrick J. Strollo, M.D3
BRIEF SUMMARY
Current Knowledge/Study Rationale: Sleep apnea is known to be associated with atherosclerotic risk. In order to better understand this risk in a community cohort, we examined the relationship of sleep apnea to a known risk factor for atherosclerosis – low density lipoprotein cholesterol (LDL) subclass B.
Study Impact: The atherogenic phenotype LDL subclass B may be an important modifiable therapeutic target in sleep apnea patients. Further research is needed to assess the impact of sleep apnea treatment on LDL subclass B and subsequent atherosclerosis.
Neurophysiological Two-Channel Polysomnographic Device in the Diagnosis of Sleep Apnea.
163-168.
Álex Ferré, M.D.1,2; Gabriel Sampol, Ph.D.1,3,4; Maria José Jurado, M.D.1,2; Roser Cambrodi, M.D.1,2; Patricia Lloberes, Ph.D.1,3,4; Odile Romero, M.D.1,2,4
BRIEF SUMMARY
Current Knowledge/Study Rationale: Portable monitoring testing is increasingly being used to evaluate patients with suspected sleep apnea (OSA). The most widely used approach are type 3 studies or respiratory polygraphy, but the obtained Apnea-Hypopnea Index with this technique could be affected by its lack of sleep variables.
Study Impact: The addition of two neurophysiological channels, EEG and EOG, to respiratory polygraphy showed high diagnostic accuracy for OSA. This approach could be a complementary diagnostic alternative to full polysomnography and respiratory polygraphy.
Refill Rates of Accessories for Positive Airway Pressure Therapy as a Surrogate Measure of Long-Term Adherence.
169-175.
Nimesh Patel, D.O.1,2; Afshin Sam, M.D.1,2; Alexandra Valentin, RRT1,3; Stuart F. Quan, M.D.2,3,4; Sairam Parthasarathy, M.D.1,2,3
BRIEF SUMMARY
Current Knowledge/Study Rationale: Adherence to medications assessed by medication refill rate is a pragmatic real-world bioinformatics aided tool that has been associated with patient outcomes in many disease conditions. To our knowledge, a systematic assessment of whether refills of PAP accessories can parallel objectively measured device-downloaded adherence data has not been performed.
Study Impact: Refill rates of PAP device accessories exhibited good test characteristics for predicting long-term adherence to PAP therapy. Such a surrogate measure of long-term PAP adherence - based upon insurance claims data - can be a powerful epidemiological tool to assess quality of healthcare delivery in the management of patients with sleep-disordered breathing.
Relative Prolongation of Inspiratory Time Predicts High versus Low Resistance Categorization of Hypopneas.
177-185.
Anne M. Mooney, M.D.; Khader K. Abounasr, M.D.; David M. Rapoport, M.D.; Indu Ayappa, Ph.D.
BRIEF SUMMARY
Current Knowledge/Study Rationale: On polysomnography it is difficult to separate central from obstructive hypopneas without invasive monitoring. The purpose of the current project was to separate hypopneas into central (low resistance) and obstructive (high resistance) using non-invasive criteria derived from the flow signal alone.
Study Impact: An algorithm based on the inspiratory time and presence of inspiratory flow limitation on the airflow signal was useful in separating obstructive from central hypopneas. This non-invasive technique has the potential to improve clinical decision making and influence research design.
Nighttime Awakenings Responding to Gabapentin Therapy in Late Premenopausal Women: A Case Series.
187-189.
Thomas Guttuso, M.D.
BRIEF SUMMARY
Current Knowledge/Study Rationale: It is known that women experience insomnia at significantly higher rates than men and that this disparity may be related to cycling hormones, however, the sleep-related physiology of this association is unknown. Three cases are presented here suggesting that insomnia due to nighttime awakenings in some cycling premenopausal women may be physiologically related to menopausal night sweats and may also improve with bedtime gabapentin, a treatment known to be effective for hot flashes and night sweats.
Study Impact: These cases may represent the first description of a novel sleep disorder unique to women found to have low serum estradiol and nighttime awakenings. This proposed sleep disorder has been coined LUNAs and may help to explain the higher prevalence of insomnia in women.
Dissemination of CBTI to the Non-Sleep Specialist: Protocol Development and Training Issues.
209-218.
Rachel Manber, Ph.D1; Colleen Carney, Ph.D2; Jack Edinger, Ph.D3,4; Dana Epstein, R.N., Ph.D5; Leah Friedman, Ph.D1,6; Patricia L. Haynes, Ph.D7,8; Bradley E. Karlin, Ph.D9; Wilfred Pigeon, Ph.D10,11,12; Allison T. Siebern, Ph.D1; Mickey Trockel, M.D., Ph.D1
Development and Growth of a Large Multispecialty Certification Examination: Sleep Medicine Certification—Results of the First Three Examinations.
221-224.
Stuart F. Quan, M.D.1,2; Daniel J. Buysse, M.D.3; Sally L. Davidson Ward, M.D.4; Susan M. Harding, M.D.5; Conrad Iber, M.D.6; Vishesh K. Kapur, M.D., M.P.H.7; James A. Rowley, M.D.8; Michael J. Sateia, M.D.9; Michael H. Silber, MB.Ch.B.10; Adam J. Sorscher, M.D.11; Bradley V. Vaughn, M.D.12; Manisha Witmans, M.D.13; B. Tucker Woodson, M.D.14; Phyllis Zee, M.D., Ph.D.15; Linda E. Mills, M.A.16; Brian J. Hess, Ph.D.16