Evaluation of sleep medicine fellowship program websites.

STUDY OBJECTIVES: Sleep fellowship program websites likely serve as a preliminary source of information for prospective fellows. Arguably, applicants have likely become even more reliant on program websites during the COVID-19 pandemic due to travel restrictions and social-distancing measures limiting in-person interviews. In this study, we evaluated the content and comprehensiveness of sleep medicine fellowship websites to identify areas of improvement. METHODS: A list of sleep medicine fellowship programs in the United States participating in the 2021 match cycle was compiled using the Electronic Residency Application Service (ERAS) and Fellowship and Residency Electronic Interactive database (FREIDA) websites. Twenty-two prespecified content criteria related to education, recruitment, and compensation were used to evaluate each program website. Sleep programs' website comprehensiveness were compared based on US location, type, matching status, core specialty, and size of programs. RESULTS: Seventy-eight US sleep fellowship program websites were evaluated. Most program websites had a working hyperlink on ERAS or FREIDA. There was considerable variability in content reported across program websites, with a mean of 56.8% of content items reported per program. There was a greater educational website content comprehensiveness for internal medicine compared with other specialty-based sleep programs. There was no difference in sleep programs' website comprehensiveness based on US location, type, matching status, or size of programs. CONCLUSIONS: Website content comprehensiveness among sleep fellowship programs is variable. There is opportunity for all sleep fellowship programs to improve their websites to better inform prospective trainees. CITATION: Shenoy S, Akberzie W, Landeo-Gutierrez JS, Leon Guerrero CR, Karroum EG. Evaluation of sleep medicine fellowship program websites. J Clin Sleep Med. 2023;19(6):1083-1088.

Sleep Disorders and Aging in Women.

Women of advancing age can suffer from an array of sleep disorders. We review the changes in sleep architecture, the impact of hormonal changes on sleep, and the various sleep disorders in women of advancing age. A focused history in this population should include the temporal relation to menopause and comorbid conditions. Treatment options should involve patient preference and review of current medications and comorbid conditions to optimize sleep in this population.

Sleep Disorders and Aging in Women.

What are the effects of sleep disturbance and changes of sleep on aging women in the short and long term? Most research that has been done in recent years evaluates how sleep disorders and sleep disturbance may change mortality and outcomes of this population. Many confounding factors may be playing a role, including comorbid conditions. This article reviews sleep disorders including insomnia, circadian sleep-wake rhythm disorders, restless legs syndrome, disorders of hypersomnia, and sleep-disordered breathing in women aged 65 and older; prevalence of these disorders; and recommended treatment options.

The Prevalence of Anxiety and Depression Symptoms in Obstructive Sleep Apnea.

Objectives Mood disorders are common in obstructive sleep apnea (OSA), though the interactions are not well-understood. The objective of this study was to evaluate the relationship between anxiety and depression with OSA.  Methods Patients who presented to the sleep center underwent polysomnography (PSG). Records were included if the sleep study showed OSA (Apnea-Hypopnea Index (AHI) ≥5 events/hour). All patients completed an Epworth Sleepiness Scale (ESS) and Hospital Anxiety and Depression Scale (HADS). A score of 8 or higher on the respective portion of the HADS was abnormal. Results A total of 45 records were included, with 28 scoring positive for anxiety and 29 positive for depression. Patients with anxiety had lower AHI (median (interquartile ratio)) than those without (21.4 (9.6-41.3) vs. 50.5 (25.1-94.3); p=0.0076). The peripheral oxygen saturation (SpO2) nadir (80 (74-84)% vs. 65 (57-76)%; p=0.0007) and time with SpO2 <90% (11 (6-12) minutes vs. 36 (13-68) minutes; p=0.0002) were less abnormal in patients with anxiety. The anxiety score on the HADS weakly correlated with AHI (r = -0.29). Patients with depression were not significantly different than those without depression in AHI, SpO2 nadir, and time with SpO2 <90%. Conclusions Symptoms of anxiety and depression are both prevalent in patients with OSA. There is an inverse relationship between OSA severity and the presence of anxiety, suggesting that comorbid anxiety may prompt sleep evaluation in less severe disease. Depression symptoms did not demonstrate a similar relationship with OSA severity.