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  • Asplund, Ragnar, et al. (författare)
  • Sleep complaints in women of ages 40-64 years in relation to sleep in their parents
  • 2001
  • Ingår i: Sleep Medicine. - 1389-9457 .- 1878-5506. ; 2:3, s. 233-237
  • Tidskriftsartikel (refereegranskat)abstract
    • <p>Objective: To study the occurrence of sleep complaints in women in relation to such complaints in their parents. Background: Sleep complaints are common and may be affected by many somatic, mental, and life-style and environmental factors. Methods: A cross-sectional questionnaire survey was undertaken among 3669 randomly selected women of ages 40-64 years. The women were asked about their own health and sleep and their recollection of the sleep of their parents. Results: The frequency of poor sleep was low among women reporting that neither parent had sleep disturbances. Sleep disturbances in the father, mother and both parents implied a 2.5 (95% confidence interval, 2.0-3.2), 2.5 (2.1-3.0) and 4.8-fold (3.4-6.8) increase in sleep complaints in the investigated women, respectively. The frequencies of numerous awakenings, difficulty in falling asleep again and too little sleep increased similarly. A series of logistic regression analyses revealed that all sleep characteristics were evaluated more negatively in women who reported sleep disturbances in their parents and also reported themselves to be in poor health. All sleep variables deteriorated with age. Because data regarding parent sleep was based on subjects' recall of that sleep, the results should be interpreted with some caution. Conclusions: The frequency of sleep complaints in womem aged from 40 to 64 years was increased if sleep disturbances were reported in their parents.</p>
  • Westerlund, Anna, 1980-, et al. (författare)
  • Sleep duration does not predict major adverse cardiac events in the Swedish National March cohort study
  • 2011
  • Ingår i: Sleep Medicine. - Amsterdam : Elsevier. - 1389-9457 .- 1878-5506. ; 12:Supplement 1, s. S22-S22
  • Tidskriftsartikel (refereegranskat)abstract
    • <p><strong>Introduction and Objectives:</strong> Experimental research suggests that sleep deprivation may alter physiological factors associated with an increased risk for cardiovascular diseases (CVDs). Prior observational studies examining the effects of sleep duration have focused on narrowly defined CVD outcomes, such as myocardial infarction or stroke only. A more comprehensive measure of CVDs is lacking. Therefore, we examined the relationship between sleep duration and Major Adverse Cardiac Events (MACE).</p><p><strong>Materials and Methods:</strong> In 1997, 39,047 Swedish residents (women: 64%, age: 18-94 years) were enrolled in the National March cohort study and asked to self-report their habitual sleep duration in a questionnaire. They were followed-up over approximately 7 years to study incidents of MACE. Events were defined as death from all CVDs, nonfatal myocardial infarction, stroke, or heart failure. The relationship between sleep duration and MACE was analyzed using Cox proportional hazards models.</p><p><strong>Results:</strong> A total of 1,730 events were observed during a median follow-up period of 7.25 years. We found 665 nonfatal myocardial infarctions, 641 nonfatal strokes, 212 nonfatal heart failures, and 198 deaths from all CVDs. Age- and sex-adjusted hazard ratios (95% confidence intervals) of MACE (with 7 hours of sleep/day as the reference group) for individuals reporting ≤5, 6, and ≥ 8 hours of sleep were 1.24 (1.05-1.47), 1.03 (0.91-1.16), and 1.09 (0.97-1.23), respectively. Adjusting for BMI and physical activity did not change the hazard ratios. When adjusting for additional confounders, e.g., depressive symptoms, sleep apnea, and smoking, the association between ≤5h of sleep and MACE was attenuated (HR: 1.22, 95% CI: 0.98-1.52).</p><p><strong>Conclusion:</strong> Sleep duration was not associated with the risk of Major Adverse Cardiac Events. Sleep duration, however, may not in itself explain the effects of inadequate sleep on cardiovascular diseases. Yet, it may serve as an essential component in the understanding of cardiovascular diseases. Copyright © 2011 Elsevier B.V. All rights reserved.</p>
  • Akerstedt, Torbjorn, et al. (författare)
  • Women with both sleep problems and snoring show objective impairment of sleep
  • 2018
  • Ingår i: Sleep Medicine. - 1389-9457 .- 1878-5506. ; 51, s. 80-84
  • Tidskriftsartikel (refereegranskat)abstract
    • <p>Objective: Combined insomnia and obstructive sleep apnea has been the focus of considerable research with respect to its health effects. A related issue is whether sleep disturbances in combination with snoring might exert effects on objective sleep variables in the non-clinical general population. The purpose of the present study was to investigate the polysomnographical characteristics of individuals who had sought medical help for both disturbed sleep and for snoring. No previous work of this type has been carried out. Method: For this study we used a representative set of data of 384 women with one night of in-home PSG. We identified those individuals who had sought medical help for sleep problems (SL), individuals that had sought help for snoring (SN), as well as those that had sought help for either both (Combined), or for neither (Control). Results: Our results yielded an N of 46, 16, 21, and 301 individuals, respectively. A one-factor analysis of variance showed significant main effects on N1% (F = 10.2, p &lt; 0.001), N3% (F = 2.7, p &lt; 0.05), AHI/h (F = 5.5, p &lt; 0.001), and a delta power measure (F = 3.8, p &lt; 0.05). The combined group showed significantly higher levels than the other groups for N1% (29% vs &lt; 21%), AHI/h (19/h vs &lt; 10/h) and lower levels for N3%, and a measure of delta power. Reported sleep quality measures did not show the same pattern, since the highest/lowest value were found for either the group presenting snoring alone or sleep problems alone. Conclusion: We concluded that individuals who had sought help for both insomnia and snoring showed impaired sleep in terms of PSG and that this was not reflected in ratings of sleep or health. This suggests that simultaneous sleep disturbances and snoring may potentiate each other to cause impaired sleep, yet the mechanism still needs to be elucidated.</p>
  • Alonderis, A., et al. (författare)
  • Medico-legal implications of sleep apnoea syndrome : Driving license regulations in Europe
  • 2008
  • Ingår i: Sleep Medicine. - Elsevier. - 1389-9457 .- 1878-5506. ; 9:4, s. 362-375
  • Tidskriftsartikel (refereegranskat)abstract
    • <p>Background: Sleep apnoea syndrome (SAS), one of the main medical causes of excessive daytime sleepiness, has been shown to be a risk factor for traffic accidents. Treating SAS results in a normalized rate of traffic accidents. As part of the COST Action B-26, we looked at driving license regulations, and especially at its medical aspects in the European region.</p><p>Methods: We obtained data from Transport Authorities in 25 countries (Austria, AT; Belgium, BE; Czech Republic, CZ; Denmark, DK; Estonia, EE; Finland, FI; France, FR; Germany, DE; Greece, GR; Hungary, HU; Ireland, IE; Italy, IT; Lithuania, LT; Luxembourg, LU; Malta, MT; Netherlands, NL; Norway, EC; Poland, PL; Portugal, PT; Slovakia, SK; Slovenia, SI; Spain, ES; Sweden, SE; Switzerland, CH; United Kingdom, UK).</p><p>Results: Driving license regulations date from 1997 onwards. Excessive daytime sleepiness is mentioned in nine, whereas sleep apnoea syndrome is mentioned in 10 countries. A patient with untreated sleep apnoea is always considered unfit to drive. To recover the driving capacity, seven countries rely on a physician’s medical certificate based on symptom control and compliance with therapy, whereas in two countries it is up to the patient to decide (on his doctor’s advice) to drive again. Only FR requires a normalized electroencephalography (EEG)-based Maintenance of Wakefulness Test for professional drivers. Rare conditions (e.g., narcolepsy) are considered a driving safety risk more frequently than sleep apnoea syndrome.</p><p>Conclusion: Despite the available scientific evidence, most countries in Europe do not include sleep apnoea syndrome or excessive daytime sleepiness among the specific medical conditions to be considered when judging whether or not a person is fit to drive. A unified European Directive seems desirable.</p>
  • Amid Hägg, Shadi, et al. (författare)
  • Nocturnal gastroesophageal reflux increases the risk of daytime sleepiness in women
  • 2019
  • Ingår i: Sleep Medicine. - 1389-9457 .- 1878-5506. ; 53, s. 94-100
  • Tidskriftsartikel (refereegranskat)abstract
    • <p><strong>OBJECTIVE:</strong> Daytime sleepiness is common in women and has negative health effects. Nocturnal gastroesophageal reflux (nGER) and snoring are risk factors for daytime sleepiness, but the effect of their interaction remains unknown. The aim of this study was to examine how nGER and snoring combined affected daytime sleepiness and involuntary falling asleep in women.</p><p><strong>METHODS:</strong> A questionnaire was sent to randomly selected women in 2000 and 2010. Participants who answered questions regarding both nGER and snoring in both questionnaires were included (N = 4882). Daytime sleepiness was defined as severe or very severe problems with daytime sleepiness. Involuntary falling asleep was defined as sometimes, often or very often falling asleep involuntarily during the day. Respondents snoring loudly and disturbingly sometimes, often or very often were defined as snorers. Having nocturnal heartburn or acid reflux sometimes, often or very often was defined as having nGER.</p><p><strong>RESULTS:</strong> Daytime sleepiness was reported by 14% of the participants, involuntary falling asleep by 11%. After adjustment for age, smoking, physical activity, caffeine intake and alcohol dependency, increased odd ratios (ORs) for both daytime sleepiness (adjusted OR 4.2, 95% confidence interval (CI): 1.9-9.2) and involuntary falling asleep (adjusted OR 3.1, 95% CI: 1.5-6.4) were seen in women with the combination of nGER and snoring at both baseline and follow-up. The association with daytime sleepiness was also strong for those with only persistent nGER but not for those with only persistent snoring.</p><p><strong>CONCLUSION:</strong> Women with nGER were at increased risk of developing daytime sleepiness and snoring augmented this association. In addition, women with both nGER and snoring were also at increased risk of developing involuntary falling asleep.</p>
  • Benediktsdottir, Bryndis, et al. (författare)
  • Prevalence of restless legs syndrome among adults in Iceland and Sweden : Lung function, comorbidity, ferritin, biomarkers and quality of life
  • 2010
  • Ingår i: Sleep Medicine. - 1389-9457 .- 1878-5506. ; 11:10, s. 1043-1048
  • Tidskriftsartikel (refereegranskat)abstract
    • <p>Objective: This study investigates the prevalence and the association between restless legs syndrome (RLS) and a large variety of health variables in two well-characterized random samples from the general population in Reykjavik, Iceland, and Uppsala, Sweden. Methods: Using the national registries of inhabitants, a random sample from adults aged 40 and over living in Reykjavík, Iceland (n= 939), and Uppsala, Sweden (n= 998), were invited to participate in a study on the prevalence of COPD (response rate 81.1% and 62.2%). In addition, the participants were asked to answer the following questionnaires: International RLS Rating Scale, Short Form-12, the Epworth Sleepiness Scale, and questions about sleep, gastroeosophageal reflux, diabetes and hypertension, as well as pharmacological treatment. Interleukin-6 (IL-6), C-reactive protein (CRP) and ferritin were measured in serum. Results: RLS was more commonly reported in Reykjavik (18.3%) than in Uppsala (11.5%). Icelandic women reported RLS almost twice as often as Swedish women (24.4 vs. 13.9% p= 0.001), but there was no difference in prevalence of RLS between Icelandic and Swedish men. RLS was strongly associated with sleep disturbances and excessive daytime sleepiness. Subjects with RLS were more likely to be ex- and current smokers than subjects without RLS (p&lt; 0.001). Respiratory symptoms and airway obstruction were more prevalent among those reporting RLS and they also estimated their physical quality of life lower than those without RLS (p&lt; 0.001). RLS was not associated with symptoms of the metabolic syndrome like hypertension, obesity, markers of systemic inflammation (IL-6 and CRP) or cardiovascular diseases. Ferritin levels were significantly lower in RLS participants (p= 0.0002), but not (p= 0.07) after adjustment for center, age, sex and smoking history. Conclusion: Restless legs syndrome was twice as common among Icelandic women compared to Swedish women. No such difference was seen for men. RLS was strongly associated with smoking and respiratory symptoms, decreased lung function, sleep disturbances, excessive daytime sleepiness, and physical aspects of life quality. RLS was not associated with markers of the metabolic syndrome like hypertension, obesity, cardiovascular diseases or biomarkers of systemic inflammation.</p>
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