Comorbid sleep disorders among patients presenting with insomnia who underwent polysomnography

Objective@#The aim of this study was to determine the comorbid sleep disorders on Polysomnography (PSG) of patients complaining of insomnia symptoms.@*Methodology@#This is a retrospective study among patients who underwent diagnostic and split-night polysomnography from April 2014 to February 2019. Those who had at least one of the following insomnia symptoms of difficulty initiating sleep, difficulty maintaining sleep and early morning awakening with or without a history of sleep aide use were identified as patients with insomnia. Polysomnography sleep parameters and outcome were tabulated and statistical analysis was done using SPSS v 20.0.@*Results@#Out of the 302 patients who were included in the study, 34.4% of subjects had a family history of sleep disorder and 70.4% had a history of sleep aide use. Among the medical comorbidities, 47.7% of the subjects were diagnosed with hypertension while 10.65% were diagnosed with psychiatric disorder. Most of the patients complained of both difficulty initiating sleep and early morning awakening. PSG sleep parameters showed that patients did not experience excessive daytime sleepiness or delayed sleep latency. On the other hand, poor sleep efficiency could be due to increased arousal index. Half of the patients turned out to have severe obstructive sleep apnea (52%) while 2.3% of the patients had periodic limb movement disorder. Among those diagnosed with severe OSA, 53.3% had a history of sleep aide use.@*Conclusion@#The study showed the importance of screening patients with insomnia for underlying comorbid sleep disorders. The American Academy of Sleep Medicine (AASM) treatment guidelines for chronic insomnia emphasized the need to have a high index of suspicion for this population in order to recommend diagnostic procedures such as polysomnography. Diagnosing a patient with insomnia to have an underlying sleep apnea and/or periodic limb movement disorder would change the course of management among patients with chronic insomnia and eventually avoid prescribing medications that could actually worsen the patient’s condition.

Clinical profile and outcome of admitted pediatric patients with Influenza

Background@#Influenza is one of the most common illnesses pediatricians face. Children are especially at risk for contracting influenza. Aside from fever, cough and colds, the disease may present differently in children. Complications due to influenza are varied and anti-virals may be useful if given early in the course of illness. @*Objectives@#To determine the clinical profile of admitted pediatric patients with influenza based on rapid testing and determine its prevalence, outcome and complications. @*Methods@#Cross sectional study of pediatric patients who had nasopharyngeal swab for influenza by antigen rapid detection test were included. Retrospective chart review was done on patients with influenza-like illness admitted from 2013-2019. @*Results@#There were 244 patient charts reviewed, the mean age of patients was 5 – 9 years old and majority had no influenza vaccine during the year of admission. Patients presented with fever, cough, colds and non-specific symptoms. Ear pain, difficulty of breathing and myalgia were found to be associated with a positive influenza infection. Of the 244 suspected patients, 133 (54%) were positive for influenza rapid testing, 33% were influenza B positive and 21.3 % were influenza A positive. The most common clinical complication for influenza positive patients was pneumonia. 1 patient had respiratory failure, 5 had febrile convulsions and 7 developed viral myositis. 19% of the subjects had asthma as co-morbidity. Only 11% of the population had their annual influenza vaccine. @*Conclusion@#54% of pediatric patients tested for influenza had positive tests for either Influenza A or B. Although generally a mild illness, it contributes to morbidity and mortality in children. Complications are not uncommon in the pediatric population as seen in this study. Vaccination remains an important preventive measure to curb influenza cases.