The effects of CPAP therapy on metabolic profile and subjective sleep parameters in patients with OSA: a prospective trial study.

Objective: Several studies confirmed a positive association between obstructive sleep apnea (OSA) and metabolic syndrome. Continuous positive airway pressure (CPAP) is the main treatment for patients with moderate and severe OSA. CPAP therapy in adults with OSA results in reduction in sleepiness, blood pressure and improvement of metabolic profile. In this study, we aimed to evaluate the effects of CPAP therapy on various components of metabolic syndrome and subjective sleep parameters in patients with OSA. Material and Methods: In this prospective trial study, 28 patients with moderate and severe OSA enrolled. Patients were asked to fill out the validated Persian version of questionnaires including Epworth sleepiness scale, insomnia severity index, STOP-BANG and Beck depression inventory - II, before and after treatment with CPAP. Weight and blood pressure were recorded before and after treatment. Only 14 patients agreed to blood sampling before and after CPAP therapy (at least 3 months of treatment). Fasting blood samples were analyzed for measuring the levels of FBS (fasting blood sugar), TG (triglyceride), total cholesterol, HDL, LDL, AST, and ALT. Results: Diastolic blood pressure, ISI and STOP-BANG score significantly decreased after treatment (p-value: 0.008, 0.022 and 0.004, respectively). FBS and TG levels decreased after treatment, but only TG levels had significant difference (p-value: 0.46 and 0.016, respectively). Discussion: CPAP therapy had positive effects on diastolic blood pressure, TG levels and ISI score. More studies with larger sample size and longer follow-up periods are warranted to investigate the effects of CPAP therapy on blood pressure, and metabolic parameters.

Sleep characteristics of Iranian people and their effects on daytime functioning: a population-based study.

Sleep characteristics vary between populations. Detrimental sleep habits have cognitive consequences leading to daytime functioning debilitation. Until now no study has been done to investigate sleep characteristics in Iran thoroughly. In this study, we aimed to evaluate Iranians' sleep characteristics and their association with daytime functioning. We conducted a population-based study from January 2017 to May 2019 on people more than 18 years old who lived in 11 urban destricts and 3 rural areas of Tehran, Iran. We randomly selected the participants using a multistage random stratified clustered sampling method. We obtained the participants' demographic and anthropometric characteristics and details of bedtime, sleep duration, sleep onset latency, wake-up time and sleep impact on daytime functioning. Logistic regression model was used to assess the relationship between sleep characteristics) and daytime functioning. In total, 1830 people with a mean age of 40.83 years participated in the study. The gender distribution of the participants was even, and 70.98% of them were married. After adjusting for age and sex, the following three factors had a significant impact on daytime functioning: bedtime, sleep onset latency, and sleep duration. (OR = 1.12, P < 0.038, OR = 1.01, P < 0.011, and OR = 0.99, P = 0.01, respectively). We also found that longer sleep onset latency (P = 0.004) and shorter sleep durations (P = 0.029) significantly interfere with daytime functioning. Iranians' sleep characteristics, especially their sleep duration and sleep onset latency, are associated with their daytime function. Interventions on people's sleep hygiene are warranted to promote healthier sleep behaviors among Iranians, considering the high impact of current sleep characteristics on their daily lives.

Shift Work Disorder, Insomnia, and Depression among Offshore Oil Rig Workers.

Objective: Numerous offshore jobs require 24-hour tasks, such as in industrial workplaces (eg, oil rigs). The purpose of this study was to assess shift work disorder (SWD), insomnia, daytime sleepiness, and depression among Iranian offshore oil rig workers in different shift schedules. Method : This cross-sectional study was conducted on Iranian offshore oil workers at the Persian Gulf. A questionnaire package consisted of Epworth Sleepiness Scale (ESS), Insomnia Severity Index (ISI), Beck Depression Inventory (BDI- II), and SWD filled. The scores were calculated among different groups of shift schedules (fixed-day, fixed-night, swing and standby shift workers). ISI, BDI-II, and ESS scores were also compared between individuals with or without SWD. Results: A total of 188 participants were recruited in the study, and all were male. The mean age was 37.06 ± 9.2 years. Among different shift schedules, the highest and lowest ISI and ESS scores were related to fixed-night shifts workers and fixed-day shift workers, respectively. ISI, ESS, and BDI mean scores in different shift schedules were not significantly different (p values = 0.14, 0.57, and 0.93, respectively). SWD was diagnosed in 57 (30.3%) of studied shift workers. The difference between SWD prevalence was not significant between different shift schedules (P value =0.13). Workers with SWD had higher ISI, ESS, and BDI-II score (P values <0.0001, <0.0001, and <0.0001, respectively) and workers without SWD had higher job satisfaction (p value = 0.04). Conclusion: SWD is considered as a serious health-related issue in Persian Gulf oil rig shift workers. Insomnia, daytime sleepiness, and depression are associated with SWD.

The association between sleep quality, health status and disability due to breathlessness in chronic obstructive pulmonary disease patients.

BACKGROUND: Chronic obstructive pulmonary disease (COPD) increases susceptibility to sleep disturbances. This study aimed to evaluate the association between COPD severity criteria with sleep quality. METHODS: One hundred fifty-eight patients in Rasul Akram Hospital of Iran University of Medical Sciences, Tehran, Iran, from April 2019 to March 2021 diagnosed with COPD were examined using the Pittsburgh Sleep Quality Index (PSQI), COPD Assessment Test (CAT), modified Medical Research Council (mMRC) dyspnoea scale, spirometry and pulse oximetry. RESULTS: Of 158 subjects, 125 patients were male (79%), and 33 were female (21%). The mean subject's age and FEV1/FVC ratio were 62.6 ± 11.5 and 65.6 ± 14.9%, respectively. The mean CAT scoring and Spo2 saturation reported 16.2 ± 7 and 91.5 ± 10.8%, respectively. The mean PSQI score was 8.2 ± 3.8. The association between PSQI score with FEV1 and FEV1/FVC ratio was not statistically significant (p = 0.64 and 0.58, respectively), whereas the association between PSQI scores with CAT score (p Ë‚ 0.0001, r2  = 0.51) and dyspnoea severity (p Ë‚ 0.0001, r2  = 0.29) were statistically significant. The patients with higher CAT score demonstrated poor sleep quality, particularly in longer sleep latency (p = 0.001, r2  = 0.056), bad subjective sleep quality (p Ë‚ 0.0001, r2  = 0.286), lower sleep efficiency (p = 0.002, r2  = 0.077), higher sleep disturbance (p Ë‚ 0.0001, r2  = 0.225), daytime dysfunction (p Ë‚ 0.0001, r2  = 0.259) and sleep medication intake times a week (p = 0.01, r2  = 0.069). Dyspnoea severity was attributed to bad subjective sleep quality (p Ë‚ 0.0001, r2  = 0.069), higher sleep disturbances (p = 0.005, r2  = 0.08), and daytime dysfunction (p Ë‚ 0.0001, r2  = 0.108). CONCLUSION: The PSQI has a significant association with the CAT and mMRC for COPD patients and is linked to the disease's severity.

Evaluating the quality and duration of sleep using actigraphy in petroleum industry shift workers.

INTRODUCTION: Increased use of shift work has led to more and more people working outside a traditional daytime schedule. Currently, approximately 20% of the labor force in developed countries is shift workers. Shift work can have devastating effects on employees' quality of life and sleep, leading to negative consequences for individuals and their families. This study evaluates the effect of different shift schedules (seven days/seven nights, fixed-day or fixed-night, and stand-by shift) on the sleep of oil rig shift workers. PARTICIPANTS AND METHODS: In this cross-sectional study, 43 offshore workers from the National Iranian Drilling Company were enrolled. Subjects were asked to complete a questionnaire package consisting of the Epworth Sleepiness scale and Pittsburgh Sleep Quality Index (PSQI). Changes in sleep patterns were measured using actigraphy for different shift schedules. RESULTS: The mean age of the participants was 35.9 ± 7.9 years and the mean tenure with the drilling company was 10 ± 6.8 years. The mean total sleep time was 353 ± 58 min. The seven day/seven night shift workers had less total sleep time than the other three groups of shift workers. The mean PSQI and Epworth Sleepiness scale scores were 6.77 ± 3.1 and 7.49 ± 4.3, respectively. Twelve shift workers (27%) were diagnosed with shift work disorder in the current study and 31 participants had poor sleep quality according to PSQI score (≥5). CONCLUSION: Poor sleep quality is common in oil rig shift workers. Further research is needed to evaluate sleep problems in oil rig shift workers.

Association Study of HLA-DQB1*0602 Allele in Iranian Patients with Narcolepsy.

Narcolepsy is a rare, disabling disorder characterized by excessive daytime sleepiness, cataplexy, hypnagogic hallucinations and sleep paralysis. Several studies demonstrated its association with HLA-DQB1*0602 in various ethnic groups. Our study aimed to determine the prevalence of HLA-DQB1*0602 allele in Iranian patients with narcolepsy and assess its predictive parameters for diagnosing narcolepsy. In addition, car accidents and job problems were assessed among narcoleptic patients. We studied 44 narcoleptic patients, 30 patients with other types of excessive daytime sleepiness (EDS)  and 50 healthy age and sex matched individuals in this case-control study. Patients and controls filled out a questionnaire including items about car accidents due to sleepiness and job problems. International classification of sleep disorders-2 criteria was used as the gold standard for diagnosis of narcolepsy. The DNAs isolated from whole blood samples were collected from the patients and controls to assess the presence of HLA-DQB1*0602. The results showed that HLA DQB1*0602 was present in 4 (8%) individual of controls and 20 (45.5%) patients with higher prevalence in patients with cataplexy (78.9%) than patients without cataplexy (p<0.001). The sensitivities of the DQB1*0602 for diagnosing narcolepsy with cataplexy and narcolepsy without cataplexy were 78.9 and 20; specificities were 88 and 72.4, respectively. 18.2% of patients had car accidents due to sleepiness and 68.2% suffered from job problems. Our study shows that evaluation of DQB1*0602 in patients suspected to narcolepsy could be helpful especially in complex cases with atypical cataplexy and indistinguishable multiple sleep latency test MSLT results. Moreover, high rates of car accidents and job problems are found among narcoleptic patients.

The Epworth Sleepiness Scale: translation and validation study of the Iranian version.

PURPOSE: The main purpose of this study was to assess the reliability and validity of the Iranian version of the Epworth Sleepiness Scale (ESS-IR). METHODS: This was a cross-sectional study of 507 suspicious patients either to obstructive sleep apnea (n = 466) or narcolepsy (n = 41) in order to carry out a psychometric evaluation of the ESS-IR by performing reliability, validity, and responsiveness analyses. Reliability of the ESS-IR was assessed by internal consistency and test-retest reliability. Validity of the instrument was assessed using several statistical approaches including construct validity (exploratory factor analysis), discriminant validity, and criterion validity. Responsiveness of the ESS-IR was assessed by comparing the ESS-IR total score before and after 6-9 months of continues positive airway pressure (CPAP) treatment in 16 patients with obstructive sleep apnea (OSA). RESULTS: The ESS-IR had an acceptable internal consistency and test-retest reliability. Factor analysis in both groups showed a two-factor solution for the ESS-IR, but the first factor showed statistically significant loads in all items. In addition, the ESS-IR discriminated well between patients with and without OSA. There is a fair correlation between the ESS-IR total score and multiple sleep latency test results that is not significant at all. Finally, the ESS-IR was found to be responsive to change where the total score was significantly decreased after CPAP treatment (P < 0.001). CONCLUSION: The findings suggest that the ESS-IR is a reliable and valid measure for evaluating daytime sleepiness and now can be used in research and clinical settings in Iran.