Author Interviews, NEJM, Obstructive Sleep Apnea, University of Pennsylvania, Weight Research / 13.06.2014

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 CenterMedicalResearch.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.
Author Interviews, Diabetes, JAMA, Obstructive Sleep Apnea / 11.06.2014

Tetyana Kendzerska MD, PhD Postdoctoral Fellow Institute for Clinical Evaluative Science, Sunnybrook Health Sciences Center, Toronto, ONMedicalResearch.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.
Author Interviews, Cognitive Issues, Geriatrics, Memory, Sleep Disorders / 02.05.2014

dr_elizabeth_devoreMedicalResearch.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.
Author Interviews, CHEST, Menopause, Obstructive Sleep Apnea / 20.04.2014

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.
Author Interviews, CMAJ, Pulmonary Disease, Respiratory, Sleep Disorders / 03.03.2014

Dr. Vincent Yi-Fong Su Department of Chest Medicine Taipei Veterans General Hospital Taipei, TaiwanMedicalResearch.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.
Author Interviews, Pain Research, Rheumatology, Sleep Disorders / 14.02.2014

dr_john_mcbethMedicalResearch.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.
Author Interviews, Exercise - Fitness, Sleep Disorders / 12.02.2014

MedicalResearch.com Interview with: Matthew Buman PhD School of Nutrition and Health Promotion, Arizona State University Arizona State University, School of Nutrition and Health Promotion Phoenix, AZMatthew Buman PhD 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.
Author Interviews, CHEST, Pediatrics, Sleep Disorders / 10.02.2014

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 60637MedicalResearch.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.
Antioxidants, Author Interviews, Menopause, Sleep Disorders / 06.02.2014

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.
Author Interviews, Biomarkers, Sleep Disorders / 05.01.2014

Jonathan Cedernaes PhD Department of Neuroscience Uppsala University SwedenMedicalResearch.com Interview with: Jonathan Cedernaes PhD Department of Neuroscience Uppsala University  Sweden   MedicalResearch.com: What are the main findings of this study? Dr. Cedernaes:  We found that two peripheral blood markers were modestly but significantly increased in healthy young participants after a single night of sleep deprivation, as compared with a normal night of sleep. These two markers, S-100B and NSE, are for example used as markers of acute ischemic injury in the brain, and are also increased following concussions. S-100B is produced mainly by glial cells and also increases after injury to the blood brain barrier. NSE is instead produced by neurons and is regarded as being more specific for neuronal damage, although it can also be produced by peripheral cells.
Author Interviews, CHEST, Obstructive Sleep Apnea, Respiratory / 02.01.2014

Dr. Peter Lindenauer MD MS Director, Center for Quality of Care Research Baystate Medical Center, Springfield, MA, USMedicalResearch.com Interview Invitation with: Dr. Peter Lindenauer MD MS Director, Center for Quality of Care Research Baystate Medical Center, Springfield, MA, US MedicalResearch.com: What are the main findings of the study? Answer: Among a cohort of 250,000 patients hospitalized for pneumonia at 347 US hospitals, those with a diagnosis of obstructive sleep apnea were twice as likely to be intubated at the time of hospital admission than patients without sleep apnea.  In addition, patients with sleep apnea had approximately 50% higher risk of needing to be transferred to the ICU after initial admission to a regular bed, and a 70% increased risk of requiring intubation later in the hospital stay.  Patients with sleep apnea stayed longer in the hospital and incurred higher costs than those without sleep apnea.
Blood Pressure - Hypertension, JAMA, Sleep Disorders / 16.12.2013

MedicalResearch.com Interview with: Dr. Miguel-Ángel Martínez-García Respiratory Department, Hospital Universitario y Politécnico La Fe Valencia, Spain MedicalResearch.com: What are the main findings of this study: Answer: The main findings of the study are: 1. The treatment with CPAP (continuous positive airway pressure) achieves a clinically and statistically significant reduction of blood pressure in patients with resistant hypertension (blood pressure that remains above goal in spite of the use of at least three antihypertensive drugs) and obstructive sleep apnea.
Author Interviews, Brain Injury, Nutrition, Sleep Disorders / 15.12.2013

Miranda M. Lim, MD, PhD Assistant Professor, Sleep Medicine Division of Pulmonary and Critical Care Portland VA Medical Center and Oregon Health & Science UniversityMedicalResearch.com Interview with: Miranda M. Lim, MD, PhD Assistant Professor, Sleep Medicine Division of Pulmonary and Critical Care Portland VA Medical Center and Oregon Health & Science University MedicalResearch.com: What are the main findings of the study? Dr. Lim: People with traumatic brain injury (TBI) often have persistent sleep-wake disturbances including excessive daytime sleepiness and nighttime insomnia, yet the link between a hard blow to the head and drowsiness remains a mystery. We report that a dietary supplement containing branched chain amino acids helps keep mice with TBI awake and alert. The findings suggest that branched chain amino acids, something all humans produce from foods in their normal diets, could potentially alleviate sleep problems associated with TBI. In experiments with brain-injured mice that had trouble staying awake, we found that feeding the animals a dietary supplement enriched with branched chain amino acids improved wakefulness. Treated mice not only stayed continuously awake for longer periods of time, they also showed more orexin neuron activation, neurons known to be involved in maintaining wakefulness. (Previous studies have shown that people with narcolepsy lose significant amounts of orexins.) Branched chain amino acids are the building blocks of neurotransmitters, the chemicals released by neurons in the brain, including glutamate and GABA. We believe that branched chain amino acids act to restore the excitability of orexin neurons after brain injury, which could potentially promote wakefulness. Further studies are needed to pinpoint the exact mechanism of branched chain amino acids effect on sleep pathways in the brain, and to determine any side effects.
Author Interviews, Sleep Disorders, University of Pittsburgh, Weight Research / 06.12.2013

Dr G. Neil Thomas, 
Regional Director, NIHR Research Design Service West Midlands 
 Deputy Director, Master of Public Heath Programme 
Reader in Epidemiology Department of Public Health, Epidemiology and Biostatistics
 School of Health and Population Sciences
 College of Medical and Dental Sciences The University of Birmingham
 Edgbaston, Birmingham, B15 2TTMedicalResearch.com Interview with: Dr G. Neil Thomas, 
Regional Director, NIHR Research Design Service West Midlands Deputy Director, Master of Public Heath Programme 
Reader in Epidemiology Department of Public Health, Epidemiology and Biostatistics
 School of Health and Population Sciences
 College of Medical and Dental Sciences The University of Birmingham
 Edgbaston, Birmingham, B15 2TT MedicalResearch.com: What are the main findings of the study? Dr. Thomas: This population of severely obese individuals (mean BMI 47kg/m2) from a regional specialist weight management service poor sleep quality (Pittsburgh Sleep Quality Index, PSQI) and daytime sleepiness (Epworth Sleepiness Scale) were strongly associated with poorer quality of life (Impact of Quality of Life-Lite (IWQOL-Lite)
Author Interviews, General Medicine, Hospital Readmissions, Sleep Disorders / 06.12.2013

Dr. Takatoshi Kasai, MD, PhD Department of Cardiology and Cardio-Respiratory Sleep Medicine, Juntendo University School of Medicine, Tokyo, JapaMedicalResearch.com Interview with: Dr. Takatoshi Kasai, MD, PhD Department of Cardiology and Cardio-Respiratory Sleep Medicine, Juntendo University School of Medicine, Tokyo, Japan MedicalResearch.com: What are the main findings of the study? Dr. Kasai: Sleep disordered breathing, determined using predischarge nocturnal pulse oximetry, is prevalent and is an independent predictor of the combined end point of readmission and mortality in hospitalized patients with left ventricular systolic dysfunction after acute decompensated heart failure.
Author Interviews, Pediatrics, Sleep Disorders / 19.11.2013

Dr. Kathryn Orzech PhD Postdoctoral fellow,Charting the Digital Lifespan University of Dundee, Scotland, UKMedicalResearch.com Interview with: Dr. Kathryn Orzech  PhD Postdoctoral fellow,Charting the Digital Lifespan University of Dundee, Scotland, UK   MedicalResesarch.com: What are the main findings of the study? Dr. Orzech: We found that acute illnesses, such as colds, flu, and gastroenteritis were more common among healthy adolescents with shorter sleep.  Specifically, our main analysis found that reported bouts of illness (analyzed on a bouts-of-illness-per-interview basis) declined with longer sleep for both male and female high school students.  Longer sleep was also generally protective against school absences that students attributed to illness. There were sex differences, with males reporting fewer illness bouts than females, even with similar sleep durations.  This is consistent with another recent study that showed a lower impact of shorter sleep on male adolescents (in that case the outcome was male adiposity), but more research is needed. We also conducted a secondary analysis to examine total sleep time in matched 6-day windows before illness and before wellness in the same adolescents. Although the number of participants who met our strict criteria for a healthy 6-day window before illness or wellness was only 18 (I was amazed at how difficult it was to find adolescents who reported being completely well for 6 consecutive days), we were able to see a trend in the data toward shorter sleep before illness vs. wellness. Because of the difficulty in comparing sleep before illness vs. wellness, we conducted a qualitative analysis as well, choosing two 17 year old males who were both shorter sleepers, but who reported very different illness profiles - 0 days of illness vs. 35 days of illness across the school term. An in-depth look at notes made by interviewers allowed us to create brief case studies to illustrate that not all shorter sleepers are alike.  More irregular sleep timing across weeknights and weekends (much shorter sleep during the week and longer sleep times on the weekend), and a preference for scheduling work and social time later in the evening hours may both contribute to differences in illness outcomes.
Author Interviews, CMAJ, Sleep Disorders / 18.11.2013

Mohamed El Shayeb MD, MSc Health Technology and Policy Unit University of Alberta 3025 Research Transition Facility Edmonton, Alberta, Canada T6G2V2MedicalResearch.com Interview with: Mohamed El Shayeb MD, MSc Health Technology and Policy Unit University of Alberta 3025 Research Transition Facility Edmonton, Alberta, Canada T6G2V2 MedicalResearch.com: What are the main findings of the study? Dr. El Shayeb: Our study shows that limited channel level-3 portable devices, used at home, are of good diagnostic value compared to the comprehensive reference-standard level-1 sleep tests conducted in lab in the diagnosis of obstructive sleep apnea (the most common subtype of sleep disordered breathing.)

Were any of the findings unexpected? None of the findings were unexpected. Level-3 portable devices are commonly used in clinical practice; however, this technology has been widely disseminated, without solid evidence about their diagnostic performance or the subpopulation of sleep disordered breathing patients who are most appropriately diagnosed with them. Our research provides a high level of evidence on the diagnostic performance of these devices, and most importantly, defines the subgroup of patients who are eligible for this test (patients with simple obstructive sleep apnea, and without significant comorbidities.)
Allergies, Author Interviews, Heart Disease, Metabolic Syndrome, Pediatrics, Sleep Disorders, Surgical Research / 16.11.2013

MedicalResearch.com Interview with: Nina Berentzen Centre for Nutrition, Prevention and Health Services National Institute for Public Health and the Environment Bilthoven The Netherlands MedicalResearch.com: What are the main findings of the study? Answer: This study in 11-12 year old children shows that self-reported characteristics of sleep quality were not associated with blood pressure and HbA1c; and that in girls, but not in boys, some sleep characteristics were associated with anthropometric outcomes (BMI, waist circumference) and cholesterol levels. More specifically, in girls, longer time in bed was associated with lower BMI and waist circumference; having night-time awakenings with higher total cholesterol, going late to bed while rising early with higher total and HDL cholesterol; and feeling sleepy/tired during daytime with lower HDL cholesterol and with higher total-to-HDL cholesterol ratio. We report new findings for daytime outcomes of sleep quality that were not studied before in relation to cardiometabolic risk; e.g. difficulty with getting up in the morning, feeling rested after waking, and feeling sleepy or tired during the day. Our study therefore offers insight not only in characteristics of sleep at night, but also in consequences of sleep during the day.
Author Interviews, Metabolic Syndrome, Obstructive Sleep Apnea, Weight Research / 15.11.2013

MedicalResearch.com Interview with: MedicalResearch.com Interview with: Dr. Emilia Mazzuca Biomedical Department of Internal and Specialistic Medicine (DIBIMIS) Section of Pneumology and Dr. Maria R Bonsignore, MD Associate Professor in Respiratory Medicine University of Palermo, Palermo, Italy MedicalResearch.com: What are the main findings of the study? Answer: Our main goal was to investigate gender-related interactions between obstructive sleep apnea (OSA) and obesity while taking associated metabolic abnormalities into account. We analyzed 423 men and 105 women previously studied for the association of OSA and the Metabolic Syndrome (MetS) (Bonsignore et al, Eur Respir J, 2012), to assess whether markers of general and visceral obesity were differently associated with OSA in men and women. Multivariate analysis showed that in men the apnea-hypopnea index (AHI), an indicator of OSA severity, was associated with waist circumference, a marker of visceral obesity, and body mass index (BMI); conversely, in women AHI was associated with hip circumference, a marker of subcutaneous fat deposition, and neck size.  The results were similar when patients without a diagnosis of MetS were analyzed; conversely, in patients with MetS, waist circumference was the only significant marker of OSA in both genders.
Author Interviews, Pediatrics, Sleep Disorders, Weight Research / 05.11.2013

Chantelle Hart, Ph.D. Associate Professor of Public Health Center for Obesity Research & Education Department of Public Health 3223 N. Broad Street Philadelphia, PA 19140MedicalResearch.com Interview with: Chantelle Hart, Ph.D. Associate Professor of Public Health Center for Obesity Research & Education Department of Public Health Philadelphia, PA 19140   MedicalResearch.com: What are the main findings of the study? Dr. Hart: Following one week of sleeping their typical amount, children 8-11 years old were asked to decrease and increase their time in bed by 1.5 hours/night for one week each in random order.  Compared to when children decreased their sleep, when they increased their sleep, they reported consuming 134 kcal/day fewer, had lower fasting levels of leptin, a hunger-regulating hormone that is also highly correlated with the amount of adipose tissue, and weighed approximately 0.5 lbs less.  Reported decreases in food intake were most pronounced later in the day.
Author Interviews, Johns Hopkins, Sleep Disorders / 22.10.2013

MedicalResearch.com Interview with: Ruth Tamrat, Minh-Phuong Huynh-Le, and Madhav Goyal Johns Hopkins University School of Medicine, MSIV MedicalResearch.com: What are the main findings of the study? Answer: Despite the known adverse effects of sleep deprivation on recovery from illness, studies have shown that sleep deprivation remains an incompletely addressed problem among inpatients.  Behavioral interventions are recommended as first line therapy prior to using pharmacologic therapy due to the adverse side effects of sedative hypnotics. This systematic review sought to identify the efficacy of non-pharmacologic interventions that have been used to improve the sleep of general inpatients.  The results of this review demonstrate a lack of high quality evidence regarding the efficacy of these non-pharmacologic interventions in improving the sleep quality or quantity of patients in the hospital.
Author Interviews, Obstructive Sleep Apnea, Sleep Disorders / 21.09.2013

MedicalResearch.com Interview with: Marc L. Benton, MD, FCCP, FAASM Morristown Medical Center and Atlantic Sleep & Pulmonary Associates, 300 Madison Ave. Third Floor Madison, NJ 07940 MedicalResearch.com: What are the main findings of the study? Dr. Benton:  When compared to a group of matched controls, 12 male golfers who had moderate-severe obstructive sleep apnea syndrome (OSAS) demonstrated statistically significant improvement in their ability to play golf (as measured by changes in the Handicap Index, the standardized indicator of golfing performance) after undergoing CPAP treatment for their condition.  Treatment adherence among the group placed on CPAP was unusually high.
Author Interviews, McGill, Sleep Disorders / 22.08.2013

MedicalResearch.com Interview with: Ruifeng Cao, MD,PhD Postdoctoral Fellow Laboratory of Nahum Sonenberg McGill University Department of Biochemistry Montreal, QC H3A 1A3, Canada MedicalResearch.com: What are the main findings of the study? Answer: Circadian (~24h) timing is a fundamental biological process, underlying cellular physiology in animals, plants, fungi, and cyanobacteria.  In mammals, including humans, a circadian clock in the brain drives daily rhythms in sleep and wakefulness, feeding and metabolism, and many other essential processes. We studied how protein synthesis, which is a fundamental process underlying many biological activities, is controlled in the brain clock in mice and identified a protein that functions as a clock repressor. By removing the repressor protein, the clock function is improved.
Author Interviews, Diabetes, JCEM, OBGYNE, Obstructive Sleep Apnea, Sleep Disorders / 22.08.2013

Sirimon Reutrakul MD Section of Endocrinology Department of Medicine Rush University Medical Center Chicago, Illinois 60612MedicalResearch.com: Interview with Sirimon Reutrakul MD Section of Endocrinology Department of Medicine Rush University Medical Center Chicago, Illinois 60612   MedicalResearch.com: What are the main findings of the study? Answer: We found a strong association between obstructive sleep apnea and gestational diabetes mellitus. In pregnant women diagnosed with gestational diabetes, the risk of obstructive sleep apnea is increased nearly 7-fold compared to those without gestational diabetes.  In addition, we found that in non-diabetic women, pregnancy is associated with more disrupted sleep.
Author Interviews, Gastrointestinal Disease, PLoS, Sleep Disorders / 04.07.2013

Keith Summa MD/PhD Student Northwestern University Feinberg School of Medicine Chicago, Illinois, United States of AmericaMedicalResearch.com Interview with: Keith Summa MD/PhD Student Northwestern University Feinberg School of Medicine Chicago, Illinois, United States of America   Disruption of the Circadian Clock in Mice Increases Intestinal Permeability and Promotes Alcohol-Induced Pathology and Inflammation MedicalResearch.com: What are the main findings of the study? Answer: The main findings of the study were that disruption of circadian rhythms, which we achieved using independent genetic and environmental strategies in mice, leads to impaired function of the intestinal epithelial barrier. This loss of epithelial barrier integrity, which has been associated with numerous diseases, results in "gut leakiness," a phenomenon in which endotoxin from gut bacteria can cross the intestinal wall and enter circulation, promoting inflammation. In particular, using in a disease model of gut-derived endotoxemia and inflammation, alcoholic liver disease, we found the circadian disruption interacted with alcohol, leading to increased gut leakiness, inflammation and liver damage.
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