MedicalResearch.com Interview with:
Dr. Swati Gulati, MD Internal Medicine
John H. Stroger Hospital of Cook County
Chicago, IL
Medical Research: What are the...
MedicalResearch.com Interview with:
Christian Benedict PhD
Associate Professor of Neuroscience
Uppsala University Dept. of Neuroscience
Medical Research: What is the background for this study? Answer:Our study involved ~1500 men who were followed from 1970 to 2010. All participants were 50 years old at the start of study.Medical Research: What are the main findings?Answer: Men with reports of sleep disturbances had a 50%-higher risk to develop Alzheimer's disease during the 40-year follow-up period, than men without reports of sleep disturbances.
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MedicalResearch.com Interview with:Chitra Lal, MD. Assistant Professor
Medical University of South Carolina
Medical Research: What are the main findings of the study?Dr. Lal:We studied the prevalence of cognitive problems in early postmenopausal women (age 45-60 years) with obstructive sleep apnea syndrome (OSAS+) and without obstructive sleep apnea syndrome (OSAS-) using a questionnaire called the Mail-In Cognitive Function Screening Instrument (MCFSI).
We found that the mean MCFSI scores after adjusting for depression were significantly higher in obstructive sleep apnea syndrome+ then the OSAS- group, indicating more self-reported cognitive difficulty in OSAS+ women
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MedicalResearch.com Interview with: Adrian Baranchuk MD FACC FRCPC
Associate Professor of Medicine
Director, EP Training Program Queen's University
Kingston, Ontario, Canada
Medical Research: What are the main findings of the study?Dr. Baranchuk: In this study, we investigated whether obstructive sleep apnea increases the risk of atrial fibrillation after coronary artery bypass surgery. We found the risk to increase by approximately two-fold for patients with obstructive sleep apnea, suggesting that this disease is a strong predictor of atrial fibrillation after coronary artery bypass surgery.
We also found that the risk increases in patients with more severe obstructive sleep apnea.
This is an important association to explore since atrial fibrillation after coronary artery bypass surgery increases patient mortality, the risk of stroke, hospital stay, healthcare costs, and has substantial burden on patients and their families. It is also a common complication of the surgery, occurring in up to half of the patients. Knowing which factors increase its risk gives us a better understanding of how to manage it and mitigate its negative consequences.
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MedicalResearch.com Interview with:Jen-Hao Chen, Ph.D.
Assistant Professor, Department of Health Sciences
University of Missouri, Columbia, MO 65211
Medical Research: What are the main findings of the study?Dr. Chen: In this study, we mapped four commonly-reported insomnia symptoms (feeling rested when waking up, having trouble falling asleep, waking up during the night, waking up too early and not being able to fall asleep again) to direct assessment of sleep characteristics in the general population of U.S. older adults. While we know older adults frequently complain about their sleep, we know little about how these complain reflect older adults’ actual sleep outcomes.
Using innovative actigraphy data of 727 older adults aged 62-91 from the National Social Life, Health and Aging Project, we found that two of these four common report of insomnia symptoms did not match specific objective sleep characteristics as these questions intends to index. The question of feeling rested was not related to any objective sleep characteristic. The question of difficulty falling asleep was not related to the objective measure of time to fall sleep but was related to other objective sleep characteristics. For waking up during the night question, high frequency was associated with more wake time after sleep onset and numbers of wake bout (but was also related to other objective sleep characteristics). For waking up too earlier question, answer of this question was related to earlier wake up time. But again, other objective sleep characteristics also predicted frequency of waking up earlier.
In sum, many of the relationships and non-relationships found in this study were unexpected. Findings suggested that these widely used questions did not related to older adults’ sleep outcomes as exactly as the wording suggested. Thus, while older adults’ report of these questions are related to objective sleep characteristics in some ways, insomnia symptoms and objective sleep characteristics did not complete match each other as expected.
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MedicalResearch.com Interview with: Steven D. Brass, M.D., M.P.H., M.B.A.
PI and Lead Author on the study
Director of Neurology Sleep Clinical Program
Co-Medical Director of Sleep Medicine Laboratory
Associate Clinical Professor in the Department of Neurology
UC Davis Health System 4860 Y Street — Suite 3700
Sacramento, CA 95817 Medical Research: What was the primary finding of your study?Dr. Brass : Among the 11,400 surveys mailed out to all members of the Northern California Chapter of the National Multiple Sclerosis Society, 2,810 (24.6%) were returned. Of these, 2,375 (84.5%) met the inclusion criteria. Among the completed surveys, 898 (37.8%) screened positive for obstructive sleep apnea, 746 (31.6%) for moderate to severe insomnia, and 866 (36.8%) for restless legs syndrome. In contrast, only 4%, 11%, and 12% of the cohort reported being diagnosed by a health care provider with obstructive sleep apnea, insomnia, and restless legs syndrome, respectively. Excessive daytime sleepiness was noted in 30% of respondents based on the Epworth Sleepiness Scale. More than 60% of the respondents reported an abnormal level of fatigue based on the Fatigue Severity Scale. There was also an increased risk between complaints of Fatigue based on screening positive for the Fatigue Severity Scale and screening positive for Obstructive Sleep Apnea (1.850, with a 95% p-value < 0.001).
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MedicalResearch.com Interview with: Paul M. Macey, Ph.D.
Assistant Professor in Residence
Associate Dean for Information Technology and Innovations,
Chief Innovation Officer UCLA School of Nursing and Brain Research Institute
Medical Research: What are the main findings of the study?Dr. Macey:People with sleep apnea are less able to control the blood flowing to their brain, in particular when they grip tightly, or have their foot put in cold water. We measured changes in blood flowing through the brain using an MRI scanner while people gripped hard, had their foot placed in cold water, and breathed out hard into a tube with a very small hole in it. These activities all lead to more blood flowing to the brain in healthy people, which probably helps protect the cells from being starved of blood and oxygen. However, people with sleep apnea send less blood that the healthy participants during the gripped and cold foot activities.
A further important finding is that women with sleep apnea are worse off than men. The female patients showed much weaker blood flow than the males, even accounting for normal differences between men and women.
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MedicalResearch.com Interview with: Marcia KleinM.D., Ph.D.
Adjunctive professor Rio de Janeiro State University
This study was conducted at the Discipline of Clinical and Experimental Pathophysiology - Rio de Janeiro State University and the financial support of FAPERJ.
Medical Research: What was the main findings of the study?Dr. Klein: The main findings were that a diet with moderate calories restriction in obese patients with obstructive sleep apnea may be able not only to reduce body fat but also to reduce obstructive sleep apnea severity and blood pressure.
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MedicalResearch.com Interview withDr. Shona E. Fang Sc.D.
New England Research Institutes, Inc
Watertown, Massachusetts
Medical Research: What are the main findings of the study?
Dr. Fang: Sleep duration varied by neighborhood in Boston, a diverse urban setting.
Individual factors, including socioeconomic status, explained some of this variation, while neighborhood socioeconomic status (SES) explained a much larger portion.
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MedicalResearch.com Interview with: Dr. Claire Sexton Ph.D.
University of Oxford
Medical Research: What are the main findings of the study?Dr. Sexton: We found that sleep difficulties (which can include trouble falling asleep, waking up during the night, or waking up too early) were associated with an increased rate of decline in brain volumes over 3-5 years.
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MedicalResearch.com Interview with: Tea Lallukka, PhD
Finnish Institute of Occupational Health &
University of Helsinki, Hjelt Institute, Department of Public Health
University of Helsinki, Finland
Medical Research: What are the main findings of the study?Dr. Lallukka: Our study used nationally representative survey data linked with
register data on medically certified sickness absence among working
-aged Finnish women and men. We showed consistent associations between
insomnia symptoms, sleep duration, and being tired and sickness
absence. The follow-up lasted around 7 years.
Sickness absence days were derived from comprehensive registers from
the Social Insurance Institution of Finland. The associations were
broadly similar among women and men. Furthermore, they remained even
after considering key correlates of sleep and sickness absence
including socioeconomic position, working conditions, health
behaviors, obesity, and mental and physical health. Health data were
derived from physical examination conducted by field physicians. These
data are more objective, and help provide more robust evidence. We
further covered all key sleep disturbances and sleep duration for more
comprehensive understanding about the contribution of sleep to
sickness absence. Finally, a novel method developed by the authors
(Härkänen & Kaikkonen) allowed us to estimate the difference in
sickness absence days per working year among those reporting and not
reporting different sleep disturbances. Using the difference in days
absent from work, we were further able to estimate the hypothetical
direct costs of sickness absence highlighting notable societal
significance of sleep. Thus, a large part of all costs of sickness
absence are attributable to poor sleep. For example, those sleeping 5
hours or less or 10 hours or more, were absent from work ca 5-9 days
more, as compared to those with optimal sleep length. The optimal
sleep length with the lowest risk of sickness absence was 7 hours 46
minutes for men and 7 hours 38 minutes for women.
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MedicalResearch.com Interview with: Prof. Mary J MorrellFaculty of Medicine, National Heart & Lung InstituteProfessor of Sleep & Respiratory Physiology
Imperial College, London
Medical Research: What are the main findings of the study?Prof. Morrell:Our results showed that when older patients with obstructive sleep apnea were treated with continuous positive airway pressure (CPAP) they had significantly less daytime sleepiness than those not treated with CPAP. A comparison of the costs and benefits of treatment suggested that CPAP would meet the usual criteria for being funded by the NHS.
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MedicalResearch.com Interview with: Pasquale K Alvaro
School of Psychology
University of Adelaide
South Australia, Australia
Medical Research: What are the main findings of the study?Answer: In adolescents, insomnia is related to depression beyond chronotype (a classification system for circadian rhythms or body clock), anxiety and age. Insomnia is also related to Generalised Anxiety Disorder (GAD) beyond chronotype, depression and age. Depression accounts for the relationship between insomnia and Obsessive Compulsive Disorder (OCD), Separation Anxiety Disorder (SAD) and Social Phobia (SP). Furthermore, an evening chronotype (delayed sleep phase, that is, preferring to go to bed in the early morning) predicts insomnia beyond depression, anxiety and age. Moreover, an evening chronotype predicts depression beyond insomnia, anxiety and age. Finally, insomnia and depression account for the relationships between an evening chronotype and panic disorder, OCD, SAD and SP.
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MedicalResearch.com Interview with: Prof. Dr. Ulrich Ettinger
Departments of Psychology
University of Bonn
Bonn, Germany
Medical Research: What are the main findings of the study?Prof. Ettinger:We found that 24-hour sleep deprivation induced subjective cognitive, perceptual and emotional alterations resembling the symptoms of schizophrenia. We also observed that sleep deprivation led to a deficit in a sensorimotor filter mechanism called prepulse inhibition (PPI), similar to the disturbance seen in schizophrenia.
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MedicalResearch.com Interview with:
Vincenza Spallone MD PhD
Endocrinology and Neurology
Department of Systems Medicine
Tor Vergata University, Rome, Italy
Medical Research: What are the main findings of the study?Dr. Spallone:To investigate a possible relationship between painful diabetic polyneuropathy (PDPN) and the circadian pattern of blood pressure (BP), we performed ambulatory blood pressure monitoring in 113 diabetic patients with PDPN, with painless diabetic polyneuropathy (DPN) and without DPN. In addition, we evaluated neuropathic pain, sleep, risk for obstructive sleep apnoea (OSA), autonomic function, and in a subgroup of patients, depressive symptoms.
The main finding was that patients with painful diabetic polyneuropathy displayed impaired nocturnal fall in BP compared to those without neuropathy, and higher nocturnal systolic blood pressure than the other two groups. Although the day-night change (∆) in blood pressure failed to reach a significant difference between painful diabetic polyneuropathy and DPN groups, nondipping (the loss of nocturnal fall in systolic BP) was more strictly associated with painful diabetic polyneuropathy than DPN and in multivariate analysis, including comorbidities and most potential confounders, neuropathic pain was an independent determinant of ∆ BP and nocturnal systolic blood pressure.
In summary, we showed a novel association of peripheral diabetic neuropathic pain with nondipping and higher systolic nocturnal blood pressure, which was not entirely explained through pain dependent sleep problems or other pain- or diabetes-related comorbidities, like CAN, OSA and depression.
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MedicalResearch.com Interview with:Nathaniel F. Watson, MD, MSc
Professor of Neurology, University of Washington
Co-director, University of Washington Medicine Sleep Center
Director, Harborview Medical Center Sleep Clinic
Seattle, Washington
MedicalResearch: What are the main findings of the study?
Dr. Watson: The Singh Index is a composite measure of socioeconomically deprived neighborhoods. We found that as Singh Index increased, sleep duration reduced. This was true in the total sample of twins, and within twin pairs. The fact that we saw this within twin pairs means the association is present after controlling for genetics and shared environment, which substantially strengthens the association.
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MedicalResearch.com: Interview with:Dr. June Chi-Yan Lo Research Fellow
Cognitive Neuroscience Laboratory
Duke-NUS Graduate Medical School
Singapore
MedicalResearch: What are the main findings of the study?Dr. Lo:The Duke-NUS study examined the data of 66 older Chinese adults, from the
Singapore-Longitudinal Aging Brain Study. Participants underwent
structural MRI brain scans measuring brain volume and neuropsychological
assessments testing cognitive function every two years. Additionally,
their sleep duration was recorded through a questionnaire. Those who slept
fewer hours showed evidence of faster brain aging and decline in cognitive performance.
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MedicalResearch.com Interview with: Ronnie Fass, M.D., FACG, Professor of Medicine
Case Western Reserve University
Director, Division of Gastroenterology and Hepatology, Head, Esophageal and Swallowing Center, Metro Health Medical Center
Cleveland, OH
MedicalResearch: What are the main findings of the study?Dr. Fass: This is the first study to compare the extent of acid reflux between nighttime sleep and daytime naps in patients with Gastroesophageal reflux disease. The results of our study show that naps are associated with significantly greater esophageal acid exposure compared to sleep. Acid reflux events were more frequent and their total duration was longer during naps when compared with acid reflux events during nighttime sleep. Additionally, the fraction of time that the subjects were experiencing acid reflux with pH < 4 was significantly higher during naps than nighttime sleep and subjects experienced more symptoms due to acid reflux during their nap than their sleep.
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MedicalResearch.com Interview with:Julio A. Chirinos, MD, PhD
Assistant Professor of Medicine
Director, CTRC Cardiovascular Phenotyping Unit
Perelman School of Medicine, University of Pennsylvania
Director of Non-Invasive Imaging
Philadelphia VA Medical Center
MedicalResearch: What are the main findings of the study?Dr. Chirinos: The main findings of the study is that, among patients with obesity and moderate to severe obstructive sleep apnea, obesity, rather than OSA, appears to be the primary cause of inflammation, insulin resistance and dyslipidemia. However, both obesity and obstructive sleep apnea appear to be causally related to hypertension. In this population, weight loss, but not CPAP, can be expected to reduce the burden of inflammation, insulin resistance and dyslipidemia. However, CPAP, among patients who comply with therapy, can be expected to provide a significant incremental benefit on blood pressure. The latter is an important potential benefit of CPAP and should not be disregarded.
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MedicalResearch.com Interview with: Tetyana Kendzerska MD, PhD
Postdoctoral Fellow
Institute for Clinical Evaluative Science,
Sunnybrook Health Sciences Center, Toronto, ON
MedicalResearch: What are the main findings of the study?Dr. Kendzerska: Based on a large sample of more than 8,500 participants with suspected sleep apnea, our study shows that among people with obstructive sleep apnea (OSA), and controlling for risk factors for diabetes development, initial OSA severity predicted risk for incident diabetes. Measures of the physiologic consequences of OSA (e.g., low level of oxygen, sleep deprivation) were also risk factors for diabetes in this population.
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MedicalResearch.com Interview with:
Lois E. Krahn, M.D.
Sleep Disorders Center
Mayo Clinic, Arizona
MedicalResearch: What are the main findings of the study?
Dr. Krahn: Patients...
MedicalResearch.com Interview with: Elizabeth Devore, ScD
Associate Epidemiologist
Brigham and Women’s Hospital
Instructor in Medicine, Harvard Medical School
MedicalResearch.com: What are the main findings of the study?Dr. Devore: In this study, we examined sleep duration and memory performance in a group of ~15,000 women participating in the Nurses’ Health Study. We found that women with sleep durations of 5 or fewer hours/day or 9 or more hours/day, either in midlife or later life, had worse memory at older ages than those sleeping 7 hours/day. In addition, women with sleep durations that changed by two or more hours/day from midlife to later life performed worse on memory tests compared to those whose sleep duration did not change during that time period.The magnitude of these memory differences was approximately equivalent to being 1-2 years older in age.
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MedicalResearch.com Interview with: Rodrigo Pinto Pedrosa, MD, PhD
Sleep and Heart Laboratory,
Pronto Socorro Cardiológico de Pernambuco
Pernambuclo, Brazil
MedicalResearch.com: What are the main findings of the study?Dr. Pedrosa: Perimenopause is associated with increased cardiovascular risk. This study evaluated the association between obstructive sleep apnea (OSA) and arterial stiffness and hypertension in perimenopausal women. OSA (apnea-hypopnea index: ≥5 events/hour) and moderate/severe OSA (apnea-hypopnea index: ≥15 events/h) were diagnosed in 111 (40.1%) and 31 (11.1%) of women, respectively. Women with moderate/severe obstructive sleep apnea had a higher prevalence of hypertension, were prescribed more medications for hypertension, had higher awake blood pressure, nocturnal blood pressure, diastolic blood pressure, as well as higher arterial stiffness (pulse wave velocity: 11.5 [10.1 to 12.3] vs 9.5 [8.6 to 10.8] m/s, p<0.001) than women without obstructive sleep apnea, respectively. Oxygen desaturation index during the night was independently associated with 24h arterial blood pressure and with arterial stiffness.
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MedicalResearch.com Interview with:
Prof. Dr. Bernd Schultes
Endocrinology and Diabetes Internal Medicine
eSwiss Medical & Surgical Center
Brauerstrasse 97
9016 St. Gallen Schweiz
MedicalResearch.com: What...
MedicalResearch.com Interview with:Dr. Vincent Yi-Fong Su
Department of Chest Medicine
Taipei Veterans General Hospital
Taipei, Taiwan
MedicalResearch.com: What are the main findings of the study?Answer: We found interestingly that patients with sleep apnea experienced a 1.20-fold (95% CI, 1.10-1.31; p <0.001) increase in incident pneumonia compared to patients without sleep apnea. We also demonstrated an “exposure-response relationship,” in that the patients with more severe sleep apnea might have a higher risk for pneumonia than did those of milder severity.
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MedicalResearch.com Interview with:Dr Abi Fisher PhD
Senior Researcher, Cancer Research UK
Health Behaviour Research Centre
University College London
MedicalResearch.com: What are the main findings of the study? (more…)
MedicalResearch.com Interview:Dr. John McBeth
Arthritis Research UK Primary Care Centre
Keele University in Staffordshire
MedicalResearch.com: What are the main findings of the study?Dr. McBeth: In this study, reporting musculoskeletal pain was common with just under half of participants reporting some pain and one quarter reporting widespread pain. Of those who were free of WP at baseline, 19% reported new onset widespread pain at three year follow up.
In addition to osteoarthritis, sleep, cognitive impairment, anxiety and physical health independently predicted the onset of widespread pain and are important treatment targets. In this study non-restorative sleep was the strongest predictor of new onset widespread pain. Sleep is a modifiable target that could improve outcome in this patient group.
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MedicalResearch.com Interview with:Matthew BumanPhD
School of Nutrition and Health Promotion, Arizona State University
Arizona State University, School of Nutrition and Health Promotion
Phoenix, AZ
MedicalResearch.com: What are the main findings of the study?Dr. Buman: We found that that exercise at night (within 4 hours of bedtime) was not associated with poor sleep compared with individuals that did not exercise before bed. However, we also found that morning exercise appears to be associated with optimal sleep quality.
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MedicalResearch.com Interview with:David Gozal, MD
The Herbert T. Abelson Professor and Chair
Department of Pediatrics
Physician-in-Chief, Comer Children's Hospital
The University of Chicago Chicago, IL 60637
MedicalResearch.com: What are the main findings of the study?Dr. Gozal: Our study shows that in children with mild obstructive apnea, treatment with an anti-inflammatory combination of 2 medications, namely nasal corticosteroid and oral montelukast is associated with favorable outcomes in the vast majority of the children. Thus, rather than pursue treatment with adenotonsillectomy as is currently the case in most places, this study paves the way for non-surgical alternative therapies in pediatric OSA.
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MedicalResearch.com Interview with: Chih-Jen Chang, MD
Department of Family Medicine
National Cheng Kung University Hospital, Tainan, Taiwan
MedicalResearch.com: What are the main findings of the study?Dr. Chang: Postmenopausal women without vasomotor symptoms (hot flushes and night sweats) have poorer sleep quality than premenopausal women. In addition, menopause and snoring are associated with an increased risk of poor sleep quality independently of cardiometabolic factors and lifestyle.
(more…)
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