Obstructive Sleep Apnea and the Subsequent Risk of Depressive Disorder: A Population-Based Follow-up Study.
417-423.
Yi-Hua Chen, Ph.D.1; Joseph K. Keller, M.S., M.P.H.1; Jiunn-Horng Kang, M.D., Ph.D.2,3,4; Heng-Ju Hsieh, M.S.5; Herng-Ching Lin, Ph.D.5,6
BRIEF SUMMARY
Current Knowledge/Study Rationale: Depression is prevalently observed in people with obstructive sleep apnea (OSA). However, although prior studies have addressed the link between OSA and depression, the results in the literature are mixed.
Study Impact: A prospective link between OSA and subsequent depressive disorder within one year was confirmed by the current study. Regular psychiatric screening among patients with OSA is suggested to prompt the timely detection of depression.
Obstructive Sleep Apnea after Weight Loss: A Clinical Trial Comparing Gastric Bypass and Intensive Lifestyle Intervention.
427-432.
Jan Magnus Fredheim, M.D.1,2,3; Jan Rollheim, M.D., Ph.D.1; Rune Sandbu, M.D., Ph.D.1; Dag Hofsø, M.D., Ph.D.1; Torbjørn Omland, M.D., Ph.D.3; Jo Røislien, M.D., M.Sc.1,5; Jøran Hjelmesæth, M.D., Ph.D.1
BRIEF SUMMARY
Current Knowledge/Study Rationale: Weight reduction reduces the severity of OSA in obese subjects, but the relative efficacy of lifestyle modifications versus bariatric surgery remains to be established. We aimed to compare the effectiveness of lifestyle modification and bariatric surgery in terms of reducing AHI and the severity of OSA.
Study Impact: Gastric bypass surgery was more effective than intensive lifestyle intervention at reducing the prevalence and severity of OSA in a population of treatment seeking morbidly obese patients, and the beneficial effect of surgery seemed to be mediated by weight loss. Weight reduction should have a high priority in the treatment of obstructive sleep apnea in morbidly obese patients.
Evaluation of Drug-Induced Sleep Endoscopy as a Patient Selection Tool for Implanted Upper Airway Stimulation for Obstructive Sleep Apnea.
433-438.
Olivier M. Vanderveken, M.D., Ph.D.1,2; Joachim T. Maurer, M.D., Ph.D.3; Winfried Hohenhorst, M.D., Ph.D.4; Evert Hamans, M.D., Ph.D.1,2; Ho-Sheng Lin, M.D., Ph.D.5,6; Anneclaire V. Vroegop, M.D.1,2; Clemens Anders, M.D.3; Nico de Vries, M.D., Ph.D.7; Paul H. Van de Heyning, M.D., Ph.D.1,2
BRIEF SUMMARY
Current Knowledge/Study Rationale: Upper airway stimulation (UAS) using respiratory-paced electrical stimulation of the hypoglossal nerve is a safe and efficacious non-CPAP therapy in a well-selected group of patients with moderate to severe obstructive sleep apnea (OSA). Patient baseline characteristics and the pattern and sites of upper airway obstruction are suggested to be predictors of UAS treatment success.
Study Impact: In this study, the predictive value of drug-induced sleep-endoscopy (DISE) was assessed towards UAS treatment success in 21 OSA patients. The results demonstrate a strong correlation between the absence of a complete circular collapse at the level of the palate as documented during DISE and a successful treatment outcome with UAS; based on these results, DISE can be recommended as a patient selection tool for implanted UAS to treat OSA.
Impact of Zaleplon on Continuous Positive Airway Pressure Therapy Compliance.
439-444.
John G. Park, M.D., F.A.A.S.M.; Eric J. Olson, M.D.; Timothy I. Morgenthaler, M.D., F.A.A.S.M.
BRIEF SUMMARY
Current Knowledge/Study Rationale: Compliance with continuous positive airway pressure (CPAP) therapy for obstructive sleep apnea remains suboptimal, and usage patterns appear heavily influenced by early CPAP experience. We hoped to improve compliance by improving the very first night's sleep on CPAP by using zaleplon during the titration study.
Study Impact: Our study did not show improvement in CPAP compliance with the use of zaleplon during CPAP titration. A very high level of compliance in our control group and similar quality of sleep during CPAP titration between the zaleplon and control group suggests that other factors are more important in determining CPAP compliance.
Effects of Armodafinil on Simulated Driving and Self-Report Measures in Obstructive Sleep Apnea Patients prior to Treatment with Continuous Positive Airway Pressure.
445-454.
Gary G. Kay, Ph.D.1; Neil Feldman, M.D., F.A.A.S.M.2
BRIEF SUMMARY
Current knowledge/Study Rationale: This study investigated a strategy for improving driving safety in OSA patients during the interval between the first contact of the clinician with the patient and the initiation of CPAP. The study was designed to assess the effect of armodafinil on simulated driving performance prior to the initiation of CPAP treatment and to determine the impact of this treatment on subsequent CPAP compliance.
Study Impact: Results demonstrate that 2 weeks of treatment with armodafinil improved simulated driving performance prior to the initiation of CPAP therapy and had no impact on subsequent CPAP compliance. The study also provided evidence of the marked improvement in driving performance following 6 weeks of treatment with CPAP (after discontinuation of the drug treatment phase of the study).
The Prevalence of Restless Legs Syndrome across the Full Spectrum of Kidney Disease.
455-459.
Jonathan Lee, B.H.Sc.1; David D. M. Nicholl, B.H.Sc.1; Sofia B. Ahmed, M.D., M.M.Sc.1,2; Andrea H. S. Loewen, M.D.1,3; Brenda R. Hemmelgarn, M.D., Ph.D.1,2; Jaime M. Beecroft, M.Sc.3; Tanvir C. Turin, M.B.B.S., Ph.D.1; Patrick J. Hanly, M.D., F.A.A.S.M.1,3
BRIEF SUMMARY
Current Knowledge/Study Rationale: Previous studies of Restless Legs Syndrome (RLS) in patients with kidney disease have focused on those with end-stage renal disease (ESRD). The objective of this study was to determine the prevalence of RLS and its impact of sleep quality and daytime function across the full spectrum of kidney disease.
Study Impact: Restless Legs Syndrome (RLS) is common in patients with non-dialysis-dependent chronic kidney disease (CKD) as well as those with ESRD. Furthermore, RLS is a significant source of sleep disruption in both of these patient populations and should be considered in any patient with kidney disease who reports poor sleep quality.
Is Nocturnal Panic a Distinct Disease Category? Comparison of Clinical Characteristics among Patients with Primary Nocturnal Panic, Daytime Panic, and Coexistence of Nocturnal and Daytime Panic.
461-467.
Masaki Nakamura, M.D., Ph.D.; Tatsuki Sugiura, M.D., Ph.D.; Shingo Nishida, M.D., Ph.D.; Yoko Komada, Ph.D.; Yuichi Inoue, M.D., Ph.D.
BRIEF SUMMARY
Current Knowledge/Study Rationale: Many patients with panic disorder experience nocturnal panic attack during sleep time (coexistence of day panic and nocturnal panic attacks: DP/NP), and some patients have panic attacks mainly during the nocturnal sleep period (primary nocturnal panic: NP). The aim of this study was to discuss whether NP is a distinct disease category from DP/NP.
Study Impact: NP was differ from DP/NP in demographic and clinical characteristics. Our findings suggest that DP/NP could be a severe form of panic disorder, while NP could be a relatively mild subcategory partially sharing common pathophysiology with adult type night terror.
A Multi-Step Pathway Connecting Short Sleep Duration to Daytime Somnolence, Reduced Attention, and Poor Academic Performance: An Exploratory Cross-Sectional Study in Teenagers.
469-473.
Santiago Perez-Lloret, M.D., Ph.D.1,2; Alejandro J. Videla, M.D.3; Alba Richaudeau, M.D.3; Daniel Vigo, M.D.1; Malco Rossi, M.D.4; Daniel P. Cardinali, M.D., Ph.D.1; Daniel Perez-Chada, M.D.3
BRIEF SUMMARY
Current Knowledge/Study Rationale: Academic performance is known to be strongly affected by insufficient sleep. The path connecting reduced sleep to impaired academic performance has been insufficiently explored.
Study Impact: It was observed that diurnal somnolence and reduced attention were in the middle of the pathway connecting insufficient sleep to poor academic outcomes. Therefore, short sleep duration should be discouraged in teenagers as it significantly impacts cognitive performance.
Validation of the Mayo Sleep Questionnaire to Screen for REM Sleep Behavior Disorder in a Community-Based Sample.
475-480.
Bradley F. Boeve, M.D., F.A.A.S.M.1,3; Jennifer R. Molano, M.D.1; Tanis J. Ferman, Ph.D.2; Siong-Chi Lin, M.D., F.A.A.S.M.3; Kevin Bieniek, B.S.1; Maja Tippmann-Peikert, M.D., F.A.A.S.M.1,3; Brendon Boot, M.B.B.S.1; Erik K. St. Louis, M.D., F.A.A.S.M.1,3; David S. Knopman, M.D.1; Ronald C. Petersen, Ph.D., M.D.1; Michael H. Silber, M.B.Ch.B., F.A.A.S.M.1,3
BRIEF SUMMARY
Current Knowledge/Study Rationale: While confirmation of REM sleep behavior disorder (RBD) requires the presence of REM sleep without atonia on polysomnography (PSG), a screening measure for RBD validated in older adults would be desirable for clinical and research purposes. We assessed the validity of the Mayo Sleep Questionnaire (MSQ) by comparing the responses of subjects' bed partners with the findings on PSG in a community-based sample (n = 128).
Study Impact: The core question on recurrent dream enactment behavior yielded sensitivity (SN) of 100% and specificity (SP) of 95% for the diagnosis of RBD. These data suggest that the MSQ has adequate SN and SP for the diagnosis of RBD among elderly subjects in a community-based sample.
Sensitivity and Specificity of Polysomnographic Criteria for Defining Insomnia.
481-491.
Jack D. Edinger, Ph.D.; Christi S. Ulmer, Ph.D.; Melanie K. Means, Ph.D.
BRIEF SUMMARY
Current Knowledge/Study Rationale: In recent years, polysomnography-based eligibility criteria have been increasingly used to identify candidates for insomnia research. The current study was conducted to evaluate the accuracy of this approach for identifying individuals with insomnia.
Study Impact: We found that none of the PSG-based criteria accurately discriminated those with primary insomnia from normal sleepers, and none of the criteria sets used in recent trials demonstrated acceptable sensitivity and specificity for identifying primary insomnia. Thus, our findings suggest that the use of quantitative PSG-based selection criteria in insomnia research may exclude many who meet current diagnostic criteria for an insomnia disorder.
C-Reactive Protein and Carotid Intima-Media Thickness in Children with Sleep Disordered Breathing.
493-498.
Arcangelo Iannuzzi, M.D.1; Maria Rosaria Licenziati, M.D.2; Fausto De Michele, M.D.3; Maria Carmela Verga, M.D.4; Carlo Santoriello, M.D.5; Luigi Di Buono, M.D.5; Maurizio Renis, M.D.5; Loredana Lembo, M.D.3; Bruno D'Agostino, M.D.6; Donato Cappetta, Ph.D.7; Mario Polverino, M.D.5; Francesca Polverino, M.D.7
BRIEF SUMMARY
Current Knowledge/Study Rationale: Sleep apnea is often associated with cardiovascular disease and atherogenesis. This study was done to evaluate the association between sleep apnea and low-grade inflammation in a pediatric population without confounding influence of risk factors, as in adults.
Study Impact: The study demonstrated that obstructive sleep apnea in children is not associated with subclinical atherosclerosis. The major clinical implication of our study is that there is scope for prevention in childhood before sleep apnea syndrome causes the irreversible damage to arteries observed in adult patients.