Sleep assessment in cystic fibrosis patients using a minimal-impact biomotion system.

PURPOSE: In our study we aimed to analyze sleep variability and activity in patients with cystic fibrosis (CF) during their hospital stay. METHODS: Forty-three CF patients were recruited and have been divided into two subgroups: exacerbated (n = 18) and non-exacerbated (n = 25). During the course of their hospital stay we used VitaLog, a minimal-impact biomotion device, in order to determine total sleep time (TST), time in bed (TIB), sleep efficiency (SE) and intra patient standard deviation (IPSD) of TST. RESULTS: TST was 5.1 h ± 1.5 h and ranged from 0.6h to 7.9 h.TIB was 17.7 h ± 3.8 h and ranged from 5.6h to 23.9 h. SE was 70.0% ± 17.0% and ranged from 13.6% to 98.5%. TST was higher in non-exacerbated patients (5.3 h ± 1.4 h vs. 4.8 h ± 1.6 h, p = 0.008) whereas TIB was lower in non-exacerbated patients (17.0 h ± 3.7 h vs. 18.5 h ± 3.8 h, p = 0.002). We also found that SE was better in non-exacerbated patients (73.1% ± 14.6% vs. 66.6% ± 18.8%, p = 0.002). Furthermore, we observed that IPSD of TST was higher in exacerbated patients (1.3 h ± 0.5 h vs. 0.9 h ± 0.4 h, p = 0.004). CONCLUSION: In general, in CF patients TST was short and SE poor during the night. Furthermore, in the course of their hospital stay patients showed low activity. In exacerbated patients sleep quality was lower compared to non-exacerbated patients.

A novel minimal-contact biomotion method for long-term respiratory rate monitoring.

PURPOSE: In this study, we assessed the diagnostic accuracy of the device VitaLog (SWG Sportwerk GmbH & Co. KG, Dortmund, Germany) for estimation of respiratory rate (RR) variability. METHODS: VitaLog is a minimal-contact biomotion device that is placed under the mattress topper. It senses respiratory effort and body movement using a piezoelectric sensor. Diagnostic accuracy was determined in 103 patients referred to our sleep laboratory for suspected sleep-disordered breathing (SDB). SDB was defined by AHI ≥ 15/h. Results provided by VitaLog were compared with nasal flow measurement obtained by polysomnography (PSG). RESULTS: Diagnostic accuracy of VitaLog was excellent. We obtained a correlation of r = 0.99 and a bias of 0.2 cycles per minute (cpm) between VitaLog and PSG-provided nasal flow. Detection RR variability worked nearly identically in patients with and without SDB. CONCLUSION: VitaLog is an appropriate method for determination of RR variability based on a minimal-contact biomotion sensor. This device is easy to handle, available at low cost, and suitable for long-term monitoring in the hospital or at home.

Epidemiology and societal costs of gastroesophageal reflux disease and Barrett's syndrome in Germany, Italy and Spain.

AIM: To estimate the economic consequences for society arising from populations with poorly treated gastroesophageal reflux disease (GERD) and Barrett's esophagus in Germany, Italy and Spain. METHODS: The following epidemiologic data were used: total population figures, the prevalence and incidence of GERD and its complications, and data on patients with poorly treated GERD, as well as data on treatment costs and active workers' presenteeism and absenteeism. These data were used to calculate the economic consequences arising from the population with poorly treated GERD and Barrett's esophagus for the healthcare system and employers in each country. RESULTS: The size of the population with poorly treated GERD with Barrett's esophagus was estimated to be 29,678 in Spain, 19,327 in Germany and 10,079 in Italy. Costs for the healthcare systems in Spain, Germany and Italy for the population with poorly treated GERD with Barrett's esophagus were estimated to be €18, 12 and 7 million, respectively, for each country. Total costs for absenteeism and presenteeism for employers due to poorly treated GERD with Barrett's esophagus were €10 million for Germany, €1 million for Italy and none for Spain. CONCLUSION: Costs due to poorly treated GERD with Barrett's esophagus represent a substantial burden for the healthcare systems of all three studied countries. Costs for employers owing to absenteeism or presenteeism of employees were low or no costs were found.