Journal of sleep research
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Journal of sleep research · Apr 2018
Comparative StudyComparison of sleep structure and psychometric profiles in patients with fibromyalgia, osteoarthritis and healthy controls.
While research indicates that both the macro- and microstructure of sleep may be altered in fibromyalgia syndrome, few studies have controlled for symptom duration or included pain-control participants (i.e. patients with chronic pain and sleep disturbance not associated with fibromyalgia syndrome). A frequently reported alteration found in the sleep microstructure of patients with fibromyalgia syndrome is the alpha-delta sleep anomaly. Although alpha waves have been observed during N3 sleep in healthy individuals, it has been proposed that there is an increase in alpha wave activity during slow-wave sleep in fibromyalgia syndrome. ⋯ However, the groups showed no significant differences in polysomnographic measures of total sleep time, sleep latency and total wake after sleep onset. Levels of alpha-delta sleep were statistically similar in both clinical (fibromyalgia syndrome and osteoarthritis) groups, indicating that it is not a specific abnormality of fibromyalgia syndrome. Overall, subjective measurements of anxiety, depression, fatigue and sleep quality better discriminated between the three groups than did objective measurements of sleep variables.
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Journal of sleep research · Feb 2018
Do physical activity and body mass index modify the association between chronic musculoskeletal pain and insomnia? Longitudinal data from the HUNT study, Norway.
We investigated the prospective association between chronic musculoskeletal pain and risk of insomnia, and if leisure-time physical activity and body mass index modify this association. The study comprised historical data on 11 909 women and 9938 men in the Norwegian HUNT study without sleep problems at baseline in 1995-97 and followed-up for insomnia in 2006-08. Poisson regression was used to estimate adjusted risk ratios (RRs) with 95% confidence intervals (CIs). ⋯ Analysis of joint effects showed that: (i) compared to pain-free physically active people, RRs in people with ≥5 chronic pain sites were 3.77 (95% CI: 2.42-5.85) if they were inactive and 2.76 (95% CI: 2.29, 3.31) if they were active; and (ii) compared to pain-free people with normal weight, RRs in people with ≥5 chronic pain sites were 3.52 (95% CI: 2.81, 4.40) if they were obese and 2.93 (95% CI: 2.24, 3.84) if they had normal weight. In conclusion, chronic musculoskeletal pain increases the risk of insomnia, particularly among those who report several pain sites. Although there was no clear evidence of modifying effects, our results suggest that a healthy active lifestyle reduces the risk of insomnia in people with chronic musculoskeletal pain.
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Journal of sleep research · Dec 2017
Randomized Controlled TrialEffects of a lifestyle intervention on REM sleep-related OSA severity in obese individuals with type 2 diabetes.
The aim of this study was to determine if an intensive lifestyle intervention (ILI) reduces the severity of obstructive sleep apnea (OSA) in rapid-eye movement (REM) sleep, and to determine if longitudinal changes in glycaemic control are related to changes in OSA severity during REM sleep over a 4-year follow-up. This was a randomized controlled trial including 264 overweight/obese adults with type 2 diabetes (T2D) and OSA. Participants were randomized to an ILI targeted to weight loss or a diabetes support and education (DSE) control group. ⋯ Compared to control, the ILI reduced REM-AHI and NREM-AHI during the 4-year follow-up. Weight, as opposed to REM-AHI and NREM-AHI, was related to changes in HbA1c. The findings imply that weight loss from a lifestyle intervention is more important than reductions in AHI for improving glycaemic control in T2D patients with OSA.
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Journal of sleep research · Dec 2017
Comparative StudyA comparison of pulse oximetry and cerebral oxygenation in children with severe sleep apnea-hypopnea syndrome: a pilot study.
Near infrared spectroscopy (NIRS) has been used to assess the impact of obstructive sleep apnea-hypopnea syndrome (OSAHS) on cerebral oxygenation. However, the relationship between the variations in the cerebral tissue oxygen saturation (ΔTOI) and pulse oximetry (ΔSpO2 ) has not been assessed in children with OSAHS. Consecutive clinically stable children with severe OSAHS [apnea-hypopnea index (AHI) >15 events h-1 ] diagnosed during a night-time polygraphy with simultaneous recording of cerebral oxygenation with NIRS (NIRO-200NX, Hamamatsu Photonics KK) were included between September 2015 and June 2016. ⋯ Maximal ΔSpO2 of approximately 70% were coupled with ΔTOI of no more than 35%. ΔPtcCO2 correlated only weakly with the cerebral oxygenation indexes. This pilot study shows a strong relationship between pulse oximetry and cerebral oxygenation in children with OSAHS, with lower changes in TOI compared to SpO2. Future studies should address the clinical impact of respiratory events on cerebral oxygenation and its consequences.
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Journal of sleep research · Dec 2017
Randomized Controlled TrialNight-to-night variability of obstructive sleep apnea.
One night of a sleep study is the standard for diagnosis and exclusion of obstructive sleep apnea. Single testing requires high sensitivity of the test method and a stable disease of interest to warrant a low rate of false-negative tests. Obstructive sleep apnea is diagnosed and graded by conventional thresholds of apneas and hypopneas per hour of sleep, and treatment is usually initiated in the presence of symptoms. ⋯ Obstructive sleep apnea shows a considerable night-to-night variability. Single-night diagnostic sleep studies are prone to miscategorise obstructive sleep apnea if arbitrary thresholds are used. Thus, treatment decisions should be based less on the conventional derivatives from sleep studies, especially in patients with less severe obstructive sleep apnea.