Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 78
Filtrar
1.
Sleep Med ; 65: 152-158, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31706897

RESUMO

OBJECTIVE: Sleep is important for brain health. We analysed associations between usual sleep habits and magnetic resonance imaging (MRI) markers of neurodegeneration (brain atrophy), vascular damage (white matter hyperintensities, WMH) and waste clearance (perivascular spaces, PVS) in older community-dwelling adults. METHOD: We collected self-reported usual sleep duration, quality and medical histories from the Lothian Birth Cohort 1936 (LBC1936) age 76 years and performed brain MRI. We calculated sleep efficiency, measured WMH and brain volumes, quantified PVS, and assessed associations between sleep measures and brain markers in multivariate models adjusted for demographic and medical history variables. RESULTS: In 457 subjects (53% males, mean age 76 ± 0.65 years), we found: brain and white matter loss with increased weekend daytime sleep (ß = -0.114, P = 0.03; ß = -0.122, P = 0.007 respectively), white matter loss with less efficient sleep (ß = 0.132, P = 0.011) and PVS increased with interrupted sleep (OR 1.84 95% CI, P = 0.025). CONCLUSION: Cross-sectional associations of sleep parameters with brain atrophy and more PVS suggest adverse relationships between usual sleep habits and brain health in older people that should be evaluated longitudinally.

2.
Sleep Med ; 66: 165-167, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31877508

RESUMO

OBJECTIVE/BACKGROUND: The utility of the pictorial Epworth sleepiness scale (pESS) has been assessed by only a few studies in a clinical population. Some of its questions may be inappropriate in certain patient groups. The aim of this study was to assess the utility of the pESS in the adult Down syndrome (DS) population in the United Kingdom (UK). PATIENTS/METHODS: A modified sleep questionnaire including the pESS was administered to 5430 adults with DS living in the UK. Standard statistical analysis was undertaken. RESULTS: Of 1105 valid responses (20.35%), the pESS was incomplete in 129 (11.67%) cases. Of the incomplete responses, "Q1. Likelihood of dozing/falling sleep while sitting and reading?" was most frequently missed (63.6% of 129 responses). CONCLUSIONS: The pESS may not be entirely appropriate in certain populations such as those with intellectual disability where literacy levels may be low. Question modification may be necessary. CLINICAL TRIAL REGISTRATION NUMBER: ISRCTN55685305.

3.
Eur Respir Rev ; 28(154)2019 Dec 31.
Artigo em Inglês | MEDLINE | ID: mdl-31871125

RESUMO

Non-sleepy obstructive sleep apnoea (OSA) is thought to have a prevalence of around 20-25% in industrialised countries. However, the question of whether it should be routinely treated or not is controversial. This review collates the results from recent randomised controlled trials addressing OSA and examines whether treating the condition leads to improvements in quality of life and reduced cardiometabolic dysfunction, comorbidities generally attributed to untreated obstructive sleep apnoea/hypopnoea syndrome.

4.
Respirology ; 2019 Dec 24.
Artigo em Inglês | MEDLINE | ID: mdl-31872530

RESUMO

BACKGROUND AND OBJECTIVE: OSA and PLMS are known to induce acute BP swings during sleep. Our current study aimed to address the independent effect of PLMS on BP in an unselected OSA patient cohort. METHODS: This cross-sectional analysis included 1487 patients (1110 males, no previous hypertension diagnosis or treatment, mean age: 52.5 years, mean BMI: 30.5 kg/m2 ) with significant OSA (defined as AHI ≥ 10) recruited from the European Sleep Apnoea Cohort. Patients underwent overnight PSG. Patients were stratified into two groups: patients with significant PLMS (PLMSI > 25 events/hour of sleep) and patients without significant PLMS (PLMSI < 25 events/hour of sleep). SBP, DBP and PP were the variables of interest. For each of these, a multivariate regression linear model was fitted to evaluate the relationship between PLMS and outcome adjusting for sociodemographic and clinical covariates (gender, age, BMI, AHI, ESS, diabetes, smoking and sleep efficiency). RESULTS: The univariate analysis of SBP showed an increment of BP equal to 4.70 mm Hg (P < 0.001) in patients with significant PLMS compared to patients without significant PLMS. This increment remained significant after implementing a multivariate regression model (2.64 mm Hg, P = 0.044). No significant increment of BP was observed for DBP and PP. CONCLUSION: PLMS is associated with a rise in SBP regardless of AHI, independent of clinical and sociodemographic confounders. A PLMS phenotype may carry an increased risk for cardiovascular disease in OSA patients.

5.
Eur Respir Rev ; 28(154)2019 Dec 31.
Artigo em Inglês | MEDLINE | ID: mdl-31694839

RESUMO

Obstructive sleep apnoea (OSA) and obstructive sleep apnoea/hypopnoea syndrome (OSAHS) have long been considered predominantly male-related conditions. The clinical presentation of sleep disordered breathing in females differs from males and can vary with age and physiological status, e.g. menopause and pregnancy. Overall, females appear to be more symptomatic, with lower apnoea-hypopnoea index scores compared to males. Furthermore, they appear to have more prolonged partial upper airway obstruction, and may report insomnia as a symptom of OSAHS more frequently. As a consequence of these differences in clinical presentation, females with sleep disordered breathing are often underdiagnosed and undertreated compared to males. This review is aimed at discussing the epidemiology, clinical presentation, pathophysiology and hormonal and metabolic differences in females who present with OSA/OSAHS in comparison to males.

6.
Breathe (Sheff) ; 15(3): e104-e107, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31777572

RESUMO

Nocturnal oxygen therapy cannot currently be recommended as a sole treatment for obstructive sleep apnoea http://bit.ly/2kuAsPU.

9.
Sleep ; 42(4)2019 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-30668819

RESUMO

We examined associations between self-reported sleep measures and cognitive level and change (age 70-76 years) in a longitudinal, same-year-of-birth cohort study (baseline N = 1091; longitudinal N = 664). We also leveraged GWAS summary data to ascertain whether polygenic scores (PGS) of chronotype and sleep duration related to self-reported sleep, and to cognitive level and change. Shorter sleep latency was associated with significantly higher levels of visuospatial ability, processing speed, and verbal memory (ß ≥ |0.184|, SE ≤ 0.075, p ≤ 0.003). Longer daytime sleep duration was significantly associated slower processing speed (ß = -0.085, SE = 0.027, p = 0.001), and with steeper 6-year decline in visuospatial reasoning (ß = -0.009, SE = 0.003, p = 0.008), and processing speed (ß = -0.009, SE = 0.002, p < 0.001). Only longitudinal associations between longer daytime sleeping and steeper cognitive declines survived correction for important health covariates and false discovery rate (FDR). PGS of chronotype and sleep duration were nominally associated with specific self-reported sleep characteristics for most SNP thresholds (standardized ß range = |0.123 to 0.082|, p range = 0.003 to 0.046), but neither PGS predicted cognitive level or change following FDR. Daytime sleep duration is a potentially important correlate of cognitive decline in visuospatial reasoning and processing speed in older age, whereas cross-sectional associations are partially confounded by important health factors. A genetic propensity toward morningness and sleep duration were weakly, but consistently, related to self-reported sleep characteristics, and did not relate to cognitive level or change.

10.
11.
Breathe (Sheff) ; 14(3): 174-175, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30186512

RESUMO

The September issue of Breathe focuses on facets of respiratory care and compromise in the context of lifestyle http://ow.ly/nBkc30lb0S6.

12.
Curr Opin Pulm Med ; 24(6): 543-548, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30148726

RESUMO

PURPOSE OF REVIEW: To explore the evidence for using exogenous melatonin in the treatment of sleep disorders, both primary and secondary, in children and adults. RECENT FINDINGS: A number of recently published meta-analyses have shown that there is evidence for the efficacy of exogenously administered melatonin in a number of sleep disorders. However, melatonin is likely to be prescribed largely for reasons of perceived minimal side-effect profile and very low cost in situations in which high-quality evidence for its usefulness is not forthcoming. SUMMARY: There is evidence for the efficacy of melatonin in the management of insomnia and some intrinsic disorders of circadian rhythm in adults and children as well as in reducing sleep onset latency in jet-lag and shift work disorder in adults. Melatonin is used routinely in the treatment of rapid-eye movement sleep-behaviour disorder despite limited trial evidence. Increasingly, dual melatonin receptor agonists are being trialled in a variety of sleep disorders. Long-term adverse effects are currently not fully identified.


Assuntos
Depressores do Sistema Nervoso Central/uso terapêutico , Melatonina/uso terapêutico , Parassonias/tratamento farmacológico , Transtornos do Sono do Ritmo Circadiano/tratamento farmacológico , Distúrbios do Início e da Manutenção do Sono/tratamento farmacológico , Humanos , Sono/efeitos dos fármacos
13.
Breathe (Sheff) ; 14(2): 85-86, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29875826

RESUMO

The June issue of Breathe focuses on gender and/or sex differences in the evolution of respiratory conditions that commence in childhood and persist into adulthood http://ow.ly/nABf30jGO6N.

14.
Eur Respir J ; 52(3)2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-29853491

RESUMO

Obstructive sleep apnoea (OSA) is a major challenge for physicians and healthcare systems throughout the world. The high prevalence and the impact on daily life of OSA oblige clinicians to offer effective and acceptable treatment options. However, recent evidence has raised questions about the benefits of positive airway pressure therapy in ameliorating comorbidities.An international expert group considered the current state of knowledge based on the most relevant publications in the previous 5 years, discussed the current challenges in the field, and proposed topics for future research on epidemiology, phenotyping, underlying mechanisms, prognostic implications and optimal treatment of patients with OSA.The group concluded that a revision to the diagnostic criteria for OSA is required to include factors that reflect different clinical and pathophysiological phenotypes and relevant comorbidities (e.g. nondipping nocturnal blood pressure). Furthermore, current severity thresholds require revision to reflect factors such as the disparity in the apnoea-hypopnoea index (AHI) between polysomnography and sleep studies that do not include sleep stage measurements, in addition to the poor correlation between AHI and daytime symptoms such as sleepiness. Management decisions should be linked to the underlying phenotype and consider outcomes beyond AHI.


Assuntos
Apneia Obstrutiva do Sono/diagnóstico , Apneia Obstrutiva do Sono/terapia , Comorbidade , Europa (Continente) , Humanos , Polissonografia , Sociedades Médicas
15.
ERJ Open Res ; 4(2)2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29670891

RESUMO

Sleep medicine: a new approach http://ow.ly/qzVh30iVkWL.

16.
Breathe (Sheff) ; 14(1): 3-4, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29515660

RESUMO

The March issue of Breathe focuses on ERS activities to further education in respiratory medicine http://ow.ly/CLoR30hWJZy.

17.
Sleep Breath ; 22(3): 825-830, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-28951996

RESUMO

OBJECTIVES: Rapid eye movement behaviour disorder (RBD) is a parasomnia in which there is loss of muscle atonia during rapid eye movement (REM) sleep, resulting in dream enactment. The aims of this study were to determine the prevalence of obstructive sleep apnoea (OSA) in RBD patients and determine whether continuous positive airway pressure (CPAP) therapy improved RBD symptoms in patients with concomitant RBD and OSA. METHODS: A questionnaire was mailed to 120 patients identified from a tertiary sleep centre with RBD meeting full International Classification for Sleep Disorders-3 (ICSD-3) criteria. Patients were diagnosed as having OSA if they had an apnoea-hypopnea index (AHI) ≥ 5. The questionnaire focused on CPAP-use, compliance and complications. Standard statistical analysis was undertaken using SPSS (v.21, IBM). RESULTS: One hundred and seven of the potential participants (89.2%) had an OSA diagnosis. Out of 72 who responded to the questionnaire, (60%) 27 patients were using CPAP therapy. CPAP therapy improved RBD symptoms in 45.8% of this group. Despite this positive response to treatment in nearly half of CPAP-users, there was no significant difference in subjective or objective CPAP compliance between those who reported RBD improvement and those who did not. Subjective compliance with CPAP was over-reported, with mean usage being 7.17 ± 1.7 h per night compared to objective mean compliance of 5.71 ± 1.7. CONCLUSIONS: OSA is a very common co-morbidity of RBD. CPAP therapy might improve self-reported RBD symptoms further, in addition to standard RBD treatment. However, further research into its topic is necessary.


Assuntos
Pressão Positiva Contínua nas Vias Aéreas , Transtorno do Comportamento do Sono REM/epidemiologia , Apneia Obstrutiva do Sono/epidemiologia , Apneia Obstrutiva do Sono/terapia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Cooperação do Paciente , Polissonografia , Prevalência , Transtorno do Comportamento do Sono REM/terapia , Autorrelato , Inquéritos e Questionários , Resultado do Tratamento
18.
Breathe (Sheff) ; 13(4): 267-268, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29209419

RESUMO

The December issue of Breathe focuses on palliative care in respiratory disease http://ow.ly/LN5130fTQus.

19.
Breathe (Sheff) ; 13(3): 161-162, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28894476

RESUMO

The September issue of Breathe looks at global networks in respiratory disease http://ow.ly/QkT830e4HvE.

SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA