| 1. |
- Fietze, I, et al.
(författare)
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Management of obstructive sleep apnea in Europe
- 2011
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Ingår i: Sleep Medicine. - : Elsevier. - 1389-9457 .- 1878-5506. ; 12:2, s. 190-197
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: In Europe, the services provided for the investigation and management of obstructive sleep apnoea (OSA) varies from country to country. The aim of this questionnaire-based study was to investigate the current status of diagnostic pathways and therapeutic approaches applied in the treatment of OSA in Europe, qualification requirements of physicians involved in diagnosis and treatment of OSA, and reimbursement of these services. Methods: Two questionnaires were sent to 39 physicians in 22 countries in Europe. In order to standardize the responses, the questionnaire was accompanied by an example. Results: Sleep centers from 21 countries (38 physicians) participated. A broad consistency among countries with respect to the following was found: pathways included referral to sleep physicians/sleep laboratories, necessity for objective diagnosis (primarily by polysomnography), use of polygraphic methods, analysis of polysomnography (PSG), indications for positive airway pressure (PAP) therapy, application of standard continuous PAP (CPAP) therapy (100% with an CPAP/APAP ratio of 2.24:1), and the need (90.5%) and management of follow-up. Differences were apparent in reimbursement of the diagnostic procedures and follow-up, in the procedures for PAP titration from home APAP titration with portable sleep apnea monitoring (38.1%) up to hospital monitoring with PSG and APAP (85.7%), and in the qualification requirements of sleep physicians. Conclusions: Management of OSA in different European countries is similar except for reimbursement rules, qualification of sleep specialists and procedures for titration of the CPAP treatment. A European network (such as the one accomplished by the European Cooperation in Science and Technology [COST] B26 Action) could be helpful for implementing these findings into health-service research in order to standardize management in a cost effective perspective.
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| 2. |
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| 3. |
- Lissek, T, et al.
(författare)
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Building Bridges through Science
- 2017
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Ingår i: Neuron. - : Elsevier BV. - 1097-4199 .- 0896-6273. ; 96:4, s. 730-735
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Tidskriftsartikel (refereegranskat)
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| 4. |
- Alonderis, A, et al.
(författare)
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Medico-legal implications of sleep apnoea syndrome: Driving license regulations in Europe.
- 2008
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Ingår i: Sleep medicine. - : Elsevier BV. - 1389-9457 .- 1878-5506. ; 9:4, s. 362-75
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Tidskriftsartikel (refereegranskat)abstract
- 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. 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). 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. 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.
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| 5. |
- Hedin, G., et al.
(författare)
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Measuring insomnia among adolescents : Analysis of the Minimal Insomnia Symptom Scale (MISS) with the Rasch measurement model
- 2022
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Ingår i: Sleep Medicine. - : Elsevier. - 1389-9457 .- 1878-5506. ; 100:Suppl. 1, s. S130-S131
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- The Minimal Insomnia Symptom Scale (MISS) is a three-item screening instrument that has been found to be psychometrically sound and capable of screening for insomnia among adults and older people. This study aimed to test the measurement properties of the MISS together with an additional item focusing on daytime functioning among adolescents using the Rasch measurement model.
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| 6. |
- Hedin, G, et al.
(författare)
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Measuring Insomnia Among Adolescents : Analysis of the Minimal Insomnia Symptom Scale (miss) with the Rasch Measurement Model
- 2022
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Ingår i: Sleep Medicine. - : Elsevier BV. - 1389-9457.
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Konferensbidrag (refereegranskat)abstract
- Introduction : The Minimal Insomnia Symptom Scale (MISS) is a three-item screening instrument that has been found to be psychometrically sound and capable of screening for insomnia among adults and older people. This study aimed to test the measurement properties of the MISS together with an additional item focusing on daytime functioning among adolescents using the Rasch measurement model. Materials and Methods : A cross-sectional design were used, and data from adolescents (age 13-17 years, n=3022) was analyzed using the Rasch measurement model. Results : The MISS had good measurement properties. When replacing the original MISS item “not rested by sleep” with the item “daytime disturbance”, the measurement properties slightly improved. We label this new scale the MISS-Revised (MISS-R). The reliability was significantly better for the MISS-R (0.55) compared to the MISS (0.50). The optimal cut-off was found to be >6 points, both for the MISS and the MISS-R. Conclusions : This study provides general support that both the MISS as well as the MISS-R have good fit to the Rasch model. At this stage, neither the MISS nor the MISS-R can be advocated over the other for use among adolescents, although the MISS-R had slightly better reliability than the MISS. Additional studies are needed to determine the clinically optimal cut-off score for identification of insomnia.
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| 8. |
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| 9. |
- Hedin, G, et al.
(författare)
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Predictors of Insomnia Among Adolescents a Longitudinal Study
- 2022
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Konferensbidrag (refereegranskat)abstract
- Introduction : Insufficient sleep is a public health problem that can impact children’s’ and adolescents’ mental and physical health. This longitudinal study aimed to investigate whether sleep habits, sleep duration and family financial situation among school-aged girls and boys (age 6-10 years) can predict insomnia among female and male adolescents (age 14-16 years). Materials and Methods : School-aged children (n = 522, 49.8% girls) in southern Sweden answered a questionnaire at baseline (age 9.4, SD 1.28 years) and at follow-up (age 14.3, SD 0.69). The survey consisted of questions about tiredness in school, problems waking up, sleep duration, sex, family financial situation and questions from the Minimal Insomnia Symptom Scale - Revised (MISS-R). Multivariate binary logistic regression analyses were used to examine whether tiredness at school, problems waking up, short sleep duration, gender, and family financial situation at baseline predicted insomnia at follow-up. Results : Poor family financial situation (OR: 3.3) and short sleep duration (<10 hours, OR: 2.3) among girls at baseline was associated with insomnia at follow-up. Problems waking up among boys at baseline was associated with insomnia at follow-up (OR: 3.6). Conclusions : Short sleep duration, problems waking up and poor family financial situation in childhood are linked with adolescent insomnia. However, these associations differ between girls and boys, and therefore need to be further investigated to understand adolescent insomnia.
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