Monitoring sleep-wake rhythm with actigraphy in patients on continuous positive airway pressure therapy.

BACKGROUND: Continuous positive airway pressure (CPAP) therapy has been shown to be effective in alleviating the underlying obstruction as well as reducing patients' excessive sleepiness and improving their functioning and health-related quality of life. However, residual excessive sleepiness is observed in some patients even though CPAP therapy eliminates sleep apnea and desaturation. OBJECTIVES: The aim of this study was to determine the prognostic effect of actigraphic sleep-wake rhythm evaluation in the management of patients with obstructive sleep apnea syndrome (OSAS) treated with CPAP. METHODS: Eighteen patients with OSAS diagnosed by standard polysomnography (PSG; 48.1 ± 12.5 years) were enrolled in this study. The sleep-wake parameters were determined by actigraphy before and after 1 month of CPAP treatment, and results were compared with PSG data. In addition, data obtained before CPAP were compared with those measured after 1 month of CPAP treatment. RESULTS: The total sleep time (TST) and sleep efficiency using PSG were significantly correlated with those using actigraphy. Bland-Altman plots of TST and sleep efficiency confirmed good agreement between PSG and actigraphy data. Sleep efficiency significantly improved following CPAP compared to baseline, and sleep fragmentation and sleep fragmentation >5 min determined by actigraphy were significantly lower during CPAP therapy than at baseline. Movement was significantly lower on CPAP therapy than at baseline. CONCLUSIONS: Actigraphy provides a valuable sleep-wake rhythm assessment in outpatients with OSAS where PSG is difficult to perform.

Effects of aged garlic extract on left ventricular diastolic function and fibrosis in a rat hypertension model.

Daily consumption of garlic is known to lower the risk of hypertension and ischemic heart disease. In this study, we examined whether aged garlic extract (AGE) prevents hypertension and the progression of compensated left ventricular (LV) hypertrophy in Dahl salt-sensitive (DS) rats. DS rats were randomly divided into three groups: those fed an 8% NaCl diet until 18 weeks of age (8% NaCl group), those additionally treated with AGE (8% NaCl + AGE group), and control rats maintained on a diet containing 0.3% NaCl until 18 weeks of age (0.3% NaCl group). AGE was administered orally by gastric gavage once a day until 18 weeks of age. LV mass was significantly higher in the 8% NaCl + AGE group than in the 0.3% NaCl group at 18 weeks of age, but significantly lower in the 8% NaCl + AGE group than in the 8% NaCl group. No significant differences were observed in systolic blood pressure (SBP) between the 8% NaCl and 8% NaCl + AGE groups at 12 and 18 weeks of age. LV end-diastolic pressure and pressure half-time at 12 and 18 weeks of age were significantly lower in the 8% NaCl + AGE group compared with the 8% NaCl group. AGE significantly reduced LV interstitial fibrosis at 12 and 18 weeks of age. Chronic AGE intake attenuated LV diastolic dysfunction and fibrosis without significantly decreasing SBP in hypertensive DS rats.