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Association between Poor Quality of Sleep and Metabolic Syndrome in Ghanaian University Students: A Cross-Sectional StudyRead the full article
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Assessment of Central Sleep Apnea Events in Children with Sleep-Disordered Breathing
Purpose. To determine the prevalence of central apnea (CA) events and central sleep apnea (CSA) in children with sleep-disordered breathing (SDB) and to assess the effect of tonsillectomy and adenoidectomy (TA) on CSA in children with obstructive sleep apnea (OSA). Material and Methods. The medical charts of children with SDB were reviewed to obtain information on past medical history, polysomnography (PSG) findings, and surgical management. Counts and indexes of obstructive apnea, obstructive hypopnea, and central apnea were evaluated before and after TA. The prevalence of CSA and the effect of age, gender, obesity, and comorbid conditions on CSA were assessed in children with SDB as well as in children with PSG proven OSA. Results. Seven hundred twelve children with SDB (age range: 1 to 18 yrs, mean: ) were identified. CA events occurred in 640 of 712 (89.5%) patients. Of the 712 patients, 315 (44.2%) met the criteria for the diagnosis of CSA. CSA was more prevalent in toddlers and preschoolers (). Obese children had a higher prevalence of CSA compared to nonobese children (). The prevalence of CSA in patients with OSA was 45.4%. The number of CA events, CAI, and OAHI after TA was less than that of before TA (). Residual CSA after TA occurred in 20 children (26%). Conclusion. Central apnea events and central sleep apnea occur in children who present to a pediatric otolaryngology clinic for evaluation of sleep disordered breathing. Central sleep apnea and obstructive sleep apnea both improve after tonsillectomy and adenoidectomy.
Effect of Sleep Intervention Programs during Cardiac Rehabilitation on the Sleep Quality of Heart Patients
Background and Objective. Patients with cardiovascular problems experience sleep disorders. Due to the importance of adequate sleep and rest for the growth and repair of damaged cells, it is necessary to use appropriate interventions to improve it. This study determined the effect of sleep intervention programs during cardiac rehabilitation on patients’ sleep quality. Materials and Methods. In this quasi-experimental study with unequal control group design, 35 individuals participated in the cardiac rehabilitation program as the experimental group and 35 served as the control group. The program included 12 weeks of exercise, 3 sessions per week, 3 sessions of training programs each lasting for 45 minutes, and a special two-session sleep improvement program. Data were collected using the Pittsburgh Sleep Quality Index and analysed with descriptive and inferential statistical methods. Results. There were not any significant differences between the two groups in age, sex, marital status, smoking, and indication for cardiac rehabilitation (). The scores of sleep quality of patients were before and after intervention in the experimental group and before and after intervention in the control group. There was no significant difference between the two groups before intervention (). yet there was a significant difference after intervention (). In addition, scores of sleep quality of patients were significantly different in the experimental and control groups before and after intervention (). Conclusion. Findings indicated that the quality of sleep of cardiac patients improved after the sleep intervention program during the cardiac rehabilitation program. Therefore, it is suggested to implement sleep improvement programs for cardiac patient care as an effective, easy, and feasible technique. In addition, it is necessary to pay more attention to the sleep improvement program in cardiac rehabilitation. Trial Registration. The trial was retrospectively registered on https://en.irct.ir/trial/50799 on 14 September 2020 (14.09.2020) with registration number IRCT20140307016870N6.
Assessment of the Psychometric Properties of the Holland Sleep Disorders Questionnaire in the Iranian Population
Background. Assessing sleep disorders and understanding their causes are essential for the proper treatment and management of the disorders. The Holland Sleep Disorders Questionnaire (HSDQ) is a self-assessment questionnaire that measures sleep problems and symptoms based on the six categories of sleep disorders described in the International Classification of Sleep Disorders-2 (ICSD-2). The aim of this study was at validating and assessing the psychometric properties of the HSDQ in Iranian adults. Method. The study was carried out as a methodological and validation work. The guidelines for translation and cultural adaptation of patient-reported outcome measures were followed for the translation and the cultural validation of the tool. To examine construct validity, exploratory factor analysis (EFA) with 216 participants and confirmatory factor analysis (CFA) with 355 participants were used. As to the reliability, the test-retest method and, as to internal consistency, Cronbach’s alpha were employed. Data analyses were done in SPSS-25 and LISREL-8. Results. The CFA and EFA results confirmed the tool with six factors and 31 items. The index of the model was 0.99, which indicated that 99% of changes in the dependent variable (adults’ sleep problem) were attributed to the independent variable (the 31 items). In other words, 0.99 of the changes in the dependent variable were due to the independent variables. The main indices of CFA (, , , ) were acceptable. In addition, a correlation coefficient below 0.05 was considered as significant. Reliability of the tool based on internal correlation (Cronbach’s alpha) was in the 0.701–0.924 range for the subscales and equal to 0.789 for the whole tool. Conclusion. In general, the results showed that the Farsi version of HSDQ (six factors and 31 items) had acceptable and applicable indices and it can be used as a valid tool in the Iranian society. The tool can be used as a reliable tool in different fields of medical sciences.
Daytime Sleepiness among Medical Colleges’ Students in Jordan: Impact on Academic Performance
Introduction. Sleep disorders are extremely prevalent in the general population. College students are more susceptible to sleep problems. This is due to the increased competition in getting a job position and the current alterations in the labor market. Poor sleep is prevalent and has deleterious effects on college students, but its frequency among college students has not been documented in Jordan. So, the aims of this study are to assess the prevalence of daytime sleepiness among medical college students in Jordan and to look for any links between daytime sleepiness and academic performance. Methods. A cross-sectional study performed on medical and paramedical specialties students and Epworth sleepiness Sscale (ESS) was used. To assess the students’ academic performance, the cumulative grade point average was utilized. Results. 977 students from five medical colleges participated in the study. ESS scores were abnormal in 34.4% of students and were considered to have daytime sleepiness. Significant lower ESS scores were associated with students who reported good sleep quality than students who reported poor sleep quality. Significant lower ESS scores were reported by students who slept more than 7 hours compared with students who slept less than 6 hours. The ESS scores were not significantly associated with students’ CPGA. Conclusion. Daytime sleepiness is highly prevalent among medical students in Jordan. The data of this study might be very helpful to assess the academic policy makers to develop intervention strategies that resolve the sleep disturbances in college students and reduce its impact on the academic achievements.
Characteristics of Obese Patients with Acute Hypercapnia Respiratory Failure Admitted in the Department of Pneumology: An Observational Study of a North African Population
Background. Acute hypercapnic respiratory failure (AHRF) is a common life-threatening event in patients with obesity hypoventilation syndrome (OHS). Objectives. To study the clinical pattern, noninvasive ventilatory support, as well as the short- and long-term outcomes of patients with OHS admitted in a ward because of AHRF. Methods. We conducted a retrospective cohort study including all adults with OHS , admitted in a 90-bed-ward for AHRF. Results. A total of 44 patients were included. Fifteen (34.1%) and 29 (65.9%) patients were diagnosed with malignant OHS (mOHS) and nonmalignant OHS (non-mOHS), respectively, while 36 (81.8%) had coexisting obstructive sleep apnea hypopnea syndrome (OSAHS). Patients with mOHS had a significantly higher rate of heart failure (100% vs. 31%; ), chronic renal insufficiency (CRI) (73.3% vs. 41.4%; ), and dyslipidemia (66.7% vs. 34.5%; ) than those with non-mOHS. The mean forced vital capacity (FVC) in our patients was of of the predicted value, lower than what is usually reported in stable patients with OHS. At hospital admission, more than two-thirds (, 77.3%) were misdiagnosed as having asthma exacerbation (, 4.9.1%), chronic obstructive pulmonary disease (COPD) exacerbation (, 27.3%) and/or heart failure (, 65.9%). Acute pulmonary oedema (ACPE) (, 36.4%) and acute viral bronchitis (, 27.3%) were the main identified causal factors, while no cause could be determined in 5 (11.4%) patients. Noninvasive positive pressure ventilation (NIPPV) using bilevel positive airway pressure (BIPAP) was very highly effective to treat AHRF, with only 2.27% of patients failing the modality. Median overall duration of ventilation was 9 hours per day (1.3–20) and was significantly longer in patients with mOHS than in those with non-mOHS (10 [6–18] vs. 8 [1.3–20], respectively; ). Forty two of the forty-three patients discharged alive were treated with BIPAP or continuous positive airway pressure (CPAP) in 26 and 16 patients, respectively. The probability of survival was 90% at 12 months, while the probability of readmission for a new episode of AHRF was 56% at 6 months and 22% at 12 months, respectively. Conclusion. AHRF in OHS patients is a life-threatening event which can be successfully and safely treated with BIPAP, with a low long-term mortality even in patients with mOHS.
Sleep Quality and Emotional State of Medical Students in Dubai
Poor sleep quality has been reported to be common amongst medical students and healthcare professionals worldwide. Sleep disturbance has been associated with increased rates of burnout and depression. As a result, this has been negatively impacting performance and functioning. Research on this topic is limited in the United Arab Emirates (UAE). This study is aimed at exploring sleep pattern and the emotional state of medical and dental students in Dubai, UAE. This cross-sectional study was based on an electronic survey sent to 181 medical and dental students. Of the 181 invitations, 96 individuals agreed to participate and complete the rating scales. The Pittsburgh Sleep Quality Index was utilized to explore sleep duration, quality, and daytime functioning. The Positive and Negative Affect Scale was used to assess the emotional states of the participants. Overall, the findings revealed diminished sleep duration. The average duration of sleep amongst the study participants was 5 hours and 24 minutes, which is significantly below the recommended duration as per sleep guidelines. Results also showed a significant positive correlation between total sleep duration and overall sleep quality with enthusiasm during the day. Future research designed to explore factors contributing to sleep efficiency, in more depth, as well as strategies to enhance sleep quality is highly warranted.
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