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- Akerstedt, Torbjörn, et al.
(författare)
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Sleep homeostasis during repeated sleep restriction and recovery : support from EEG dynamics.
- 2009
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Ingår i: Sleep. - : Oxford University Press (OUP). - 0161-8105 .- 1550-9109. ; 32:2, s. 217-22
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Tidskriftsartikel (refereegranskat)abstract
- STUDY OBJECTIVES: Sleep reduction normally causes a homeostatic response during subsequent recovery sleep, but this does not seem to be true for repeated partial sleep loss. The aim of the present study was to test the response to repeated partial sleep loss through detailed focus on spectral data and parts of sleep. DESIGN: The experiment involved 4 h of sleep across 5 days in the laboratory (partial sleep deprivation [PSD]), followed by 3 days of recovery sleep. PSD was achieved through a delayed bedtime. Nine individuals participated. To avoid "laboratory monotony," subjects were permitted to leave the lab for a few hours each day. MEASUREMENTS AND RESULTS: All sleep stages and the latencies to sleep and slow wave sleep (SWS) showed a significant reduction during PSD. However, SWS and TST (total sleep time) during the first half of sleep increased gradually across days with PSD. During the first recovery sleep, SWS was significantly increased, while stage 1 and latency to stage 3 were reduced. All were back to baseline on the second night of recovery sleep. Summed spectral power during the first 3.8 h of sleep showed a gradual and robust increase (50% above baseline) in the range 1.25-7.25 Hz across days with PSD up to first recovery sleep and then returned to baseline. CONCLUSIONS: SWS and summed power density in a broad low-frequency band respond to repeated partial sleep deprivation in a dose-response fashion during the first 4 h sleep, apparently reflecting a robust and stable homeostatic response to sleep loss.
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| 5. |
- Franklin, Karl A, et al.
(författare)
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Effects and side-effects of surgery for snoring and obstructive sleep apnea--a systematic review
- 2009
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Ingår i: Sleep. - : The Associated Professional Sleep Societies, LLC. - 0161-8105 .- 1550-9109. ; 32:1, s. 27-36
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Tidskriftsartikel (refereegranskat)abstract
- Only a small number of randomized controlled trials with a limited number of patients assessing some surgical modalities for snoring or sleep apnea are available. These studies do not provide any evidence of effect from laser-assisted uvulopalatoplasty or radiofrequency ablation on daytime sleepiness, apnea reduction, quality of life or snoring. We call for research of randomized, controlled trials of surgery other than uvulopalatopharyngoplasty and uvulopalatoplasty, as they are related to a high risk of long-term side-effects, especially difficulty swallowing.
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| 6. |
- Friberg, Danielle, et al.
(författare)
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Sibling risk of pediatric obstructive sleep apnea syndrome and adenotonsillar hypertrophy.
- 2009
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Ingår i: Sleep. - : Oxford University Press (OUP). - 0161-8105 .- 1550-9109. ; 32:8, s. 1077-1083
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Tidskriftsartikel (refereegranskat)abstract
- Objectives:To estimate sibling risk of hospitalization for children with sleep disordered breathing (SDB), diagnosed with (1) obstructive sleep apnea syndrome (OSAS), or (2) adenotonsillar hypertrophy in the total Swedish population.Design, Setting, and Participants:Using the MigMed database at the Karolinska Institute, we divided the population of Sweden aged 0–18 years into sibling groups based on a shared mother and father and presence of a primary hospital diagnosis of OSAS or adenotonsillar hypertrophy for each individual born between 1978 and 1986, during the follow-up period 1997–2004. Individuals with at least one affected sibling were identified and the incidence rates were computed, using standardized incidence ratios (SIRs) with 95% confidence intervals (CIs). Reference groups were boys and girls with unaffected siblings of 2 or more.Results:After accounting for socioeconomic status, age, and geographic region, boys with at least one sibling with OSAS had an increased risk of having OSAS (SIR, 33.2; 95% CI, 16.5–64.8), and in girls the SIR was 40.5 (19.4–81.4). For hypertrophy of the tonsils or hypertrophy of the adenoids and tonsils the corresponding SIRs were 4.53 (3.0–6.8) for boys and 4.94 (3.3–7.4) for girls.Conclusions:The study indicate an increased sibling risk of sleep disordered breathing in children, which may be due to heritable genes and/or shared environment such as increased awareness among family members or referring doctors. Caregivers should ask parents if siblings have similar symptoms, and thus offer them early treatment.
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| 7. |
- J, Sundquist, et al.
(författare)
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Obstructive sleep apnea syndrome in siblings : an 8-year Swedish follow-up study.
- 2008
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Ingår i: Sleep. - : Oxford University Press (OUP). - 0161-8105 .- 1550-9109. ; 31:6, s. 817-823
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Tidskriftsartikel (refereegranskat)abstract
- Background:Understanding the genetic transmission of obstructive sleep apnea syndrome (OSAS) will help clinicians identify patients at risk and offer opportunities for intervention and treatment at specialist clinics.Objective:To estimate familial risk of hospitalization for OSAS in the adult population of Sweden, and to determine if there are any differences by age and sex.Design, setting, and participants:Using the MigMed database at the Karolinska Institute, we divided the population of Sweden into sibling groups based on a shared mother and father and ascertained the presence or absence of a primary hospital diagnosis of OSAS in each individual during the follow-up period, 1997 to 2004. Individuals were categorized as having or not having a sibling with OSAS, based on the presence or absence of the disorder in at least 1 of their siblings. Standardized incidence ratios (SIRs) with 95% confidence intervals (CIs) were estimated for men and women with a sibling with OSAS, compared with men and women in the reference group (SIR = 1).Results:After accounting for socioeconomic status, age, geographic region, and period of diagnosis, men with at least 1 sibling who had OSAS had a SIR of 3.42 (95% CI, 2.18–5.36); the corresponding SIR in women was 3.25 (95% CI, 1.84–5.65).Conclusions:Our results indicate that physicians should consider family history of OSAS when deciding whether to refer a patient for further sleep examinations.
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| 8. |
- Jansson-Fröjmark, Markus, et al.
(författare)
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The course of insomnia over one year : A longitudinal study in the general population in Sweden
- 2008
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Ingår i: Sleep. - : Oxford University Press (OUP). - 0161-8105 .- 1550-9109. ; 31:6, s. 881-886
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Tidskriftsartikel (refereegranskat)abstract
- Study Objectives: The purpose of this study was to examine the course of insomnia in the general population over one year with an emphasis on prevalence, consequences, persistence, remission, and incidence of insomnia.Design: This study employed a longitudinal design with a 1-year follow-up. Insomnia was defined as reporting problems sleeping for three nights or more per week during the past three months, problems with daytime symptoms or daytime functioning, and difficulties with sleep onset, sleep maintenance, or early morning awakening.Participants: From a randomly selected sample of the adult general population (N = 3,000; 20-60 year), 1,746 individuals filled out a baseline and 1-year follow-up survey.Results: The prevalence rates of insomnia were 6.8-9.7% at the two assessment points. The longitudinal analyses suggested that for 44.4% of the individuals with insomnia at baseline, insomnia was characterized by persistence (4.3% of the general population). For 56.6% of the individuals with insomnia at baseline, the condition remitted over one year (5.4% of the general population). The cumulative incidence of insomnia was 2.8% over the course of a year.Conclusions: In summary, the results showed that insomnia is a prevalent condition in the general population associated with negative consequences and is characterized not only by persistence but also by relatively high remission and incidence.
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| 9. |
- Janszky, Imre, et al.
(författare)
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Heavy snoring is a risk factor for case fatality and poor short-term prognosis after a first acute myocardial infarction
- 2008
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Ingår i: Sleep. - : Oxford University Press (OUP). - 0161-8105 .- 1550-9109. ; 31:6, s. 801-807
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Tidskriftsartikel (refereegranskat)abstract
- STUDY OBJECTIVESSleep disordered breathing has been associated with an increased risk for developing coronary heart disease. Data on the effects of sleep disordered breathing on case fatality and prognosis of a myocardial infarction are sparse. The present study aimed to investigate a possible relationship of snoring and case fatality and mortality after an acute myocardial infarction.DESIGN, SETTINGS, PATIENTS, AND MEASUREMENTSIn this study, we enrolled 1660 first acute myocardial infarction cases and examined the effects of self- or relative-reported heavy snoring on case fatality and prognosis. The average follow-up time was 8 years, SD = 262 days.RESULTSThere was a variation in the association between snoring and mortality with time, with a strong association in the first 28 days after infarction but not later during the follow-up. Occasional and regular heavy snorers, when compared to those never having heavy snoring, had a 2.04 (95% confidence interval, 1.50 to 2.79) and 3.30 (95% confidence interval, 2.37 to 4.58) hazard ratio for mortality within the first 28 days after controlling for age, gender, obesity, history of diabetes and hypertension, physical activity, smoking, and education, respectively. There was no association between snoring and new myocardial infarction, stroke, or hospitalization for heart failure during the follow-up.CONCLUSIONSHeavy snoring is associated with case fatality and short-term mortality in patients with a first acute myocardial infarction.
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