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1.
Article in Chinese | WPRIM | ID: wpr-879271

ABSTRACT

Sleep stage classification is a necessary fundamental method for the diagnosis of sleep diseases, which has attracted extensive attention in recent years. Traditional methods for sleep stage classification, such as manual marking methods and machine learning algorithms, have the limitations of low efficiency and defective generalization. Recently, deep neural networks have shown improved results by the capability of learning complex pattern in the sleep data. However, these models ignore the intra-temporal sequential information and the correlation among all channels in each segment of the sleep data. To solve these problems, a hybrid attention temporal sequential network model is proposed in this paper, choosing recurrent neural network to replace traditional convolutional neural network, and extracting temporal features of polysomnography from the perspective of time. Furthermore, intra-temporal attention mechanism and channel attention mechanism are adopted to achieve the fusion of the intra-temporal representation and the fusion of channel-correlated representation. And then, based on recurrent neural network and inter-temporal attention mechanism, this model further realized the fusion of inter-temporal contextual representation. Finally, the end-to-end automatic sleep stage classification is accomplished according to the above hybrid representation. This paper evaluates the proposed model based on two public benchmark sleep datasets downloaded from open-source website, which include a number of polysomnography. Experimental results show that the proposed model could achieve better performance compared with ten state-of-the-art baselines. The overall accuracy of sleep stage classification could reach 0.801, 0.801 and 0.717, respectively. Meanwhile, the macro average F1-scores of the proposed model could reach 0.752, 0.728 and 0.700. All experimental results could demonstrate the effectiveness of the proposed model.


Subject(s)
Electroencephalography , Neural Networks, Computer , Polysomnography , Sleep , Sleep Stages
2.
Rev. bras. neurol ; 56(2): 35-44, abr.-jun. 2020. ilus
Article in English | LILACS | ID: biblio-1102915

ABSTRACT

Dreaming is the result of the mental activity of rapid eye movement (REM) sleep stage, and less commonly of non-REM sleep. Dreams offer unique insights into the patients' brains, minds, and emotions. Based on neurophysiological and neuroimaging studies, the biological core of dreaming stands on some brain areas activated or inactivated. Dream abnormalities in neurological disorders include a reduction / cessation of dreaming, an increase in dream frequency, changes in dream contents and accompaniments, and the occurrence of dreamlike experiences (hallucinations) mainly during the wake-sleep/sleep-wake transitions. Dream changes can be associated with several neurological conditions, and the unfolding of biological knowledge about dream experiences can also have significance in clinical practice. Regarding the dream importance in clinical neurological management, the aim of this paper encompasses a summary of sleep stages, dreams neurobiology including brain areas involved in the dreams, memory, and dreams, besides Dreams in the aging people and neurodegenerative disorders.


Sonhar é o resultado da atividade mental do estágio do sono de movimento rápido dos olhos (REM) e, menos comumente, do sono não-REM. Os sonhos oferecem informações únicas sobre o cérebro, a mente e as emoções dos pacientes. Com base em estudos neurofisiológicos e de neuroimagem, o núcleo biológico do sonho está em algumas áreas do cérebro ativadas ou inativadas. As anormalidades do sonho nos distúrbios neurológicos incluem uma redução / cessação do sonho, um aumento na frequência do sonho, alterações nos conteúdos e acompanhamentos do sonho e a ocorrência de experiências semelhantes ao sonho (alucinações), principalmente durante as transições de vigília-sono / sono-vigília. As mudanças do sonho podem estar associadas a várias condições neurológicas, e o desenvolvimento do conhecimento biológico sobre as experiências do sonho também pode ter significado na prática clínica. Com relação à importância do sonho no manejo neurológico clínico, o objetivo deste artigo é resumir os estágios do sono, a neurobiologia dos sonhos, incluindo as áreas do cérebro envolvidas nos sonhos, a memória e os sonhos, além dos sonhos nos idosos e nos distúrbios neurodegenerativos.


Subject(s)
Humans , Child , Adult , Sleep/physiology , Sleep, REM/physiology , Sleep Stages , Dreams/physiology , Polysomnography/methods , REM Sleep Behavior Disorder , Memory , Narcolepsy
3.
Rev. ciênc. méd., (Campinas) ; 29: 204711, jan.-dez. 2020. ilus, tab
Article in Portuguese | LILACS | ID: biblio-1118459

ABSTRACT

O estudo pretendeu avaliar a fisiopatologia correlacionada, as diferenças de sexo e as comorbidades associadas à síndrome da apneia e hipopneia obstrutiva do sono. Trata-se de uma revisão de literatura realizada a partir dos dados obtidos pesquisas com as palavras-chaves "Síndrome de Apneia e Hipopneia do Sono", "Fisiopatologia", "Fatores de Risco", "Comorbidades e Sexo" nas plataformas digitais SciELO, PubMed, DESC Bireme e Google Acadêmico no período de 2008 a 2018. O sono é dividido em sono Rapid Eye Movement e sono Non-Rapid Eye Movement. A síndrome da apneia e hipopneia do sono é observada pelo ronco e caracterizada pela obstrução total (apneia) ou parcial (hipopneia) das vias aéreas superiores, que leva ao colapso e à dessaturação da oxi-hemoglobina e, consequentemente, causa hipóxia. Os índices de apneia e hipopneia são diagnosticados pela polissonografia e classificam o distúrbio em leve, moderado ou grave. A síndrome da apneia e hipopneia do sono apresenta-se frequentemente associada à obesidade e a doenças cardiovasculares, sendo principalmente observada em homens. A síndrome é considerada um problema de saúde pública mundial e envolve uma equipe multidisciplinar para o tratamento farmacológico ou não farmacológico. Dentre as principais comorbidades verificadas estão obesidade, hipertensão, arritmias e diabetes Mellitus tipo 2.


To evaluate correlated pathophysiologies, sex differences, and comorbidities associated with Obstructive Sleep Apnea-Hypopnea Syndrome. This is a literature review based on data obtained in SciELO, PubMed, DESC Bireme, and Google Scholar in the period between 2008 and 2018, using the following keywords: "Sleep Apnea and Hypopnea Syndrome", "Pathophysiology", "Risk Factors", "Comorbidities and Sex". Sleep is divided into Rapid Eye Movement sleep and Non- Rapid Eye Movement sleep. Obstructive Sleep Apnea-Hypopnea Syndrome is characterized by the total (apnea) or partial (hypopnea) obstruction of the upper airways, which results in snoring and leads to the collapse and desaturation of oxyhemoglobin, causing hypoxia. Apnea and hypopnea indexes are diagnosed by polysomnography and classified as mild, moderate, and severe. ApneaHypopnea Syndrome is often associated with obesity and cardiovascular diseases, and it is mainly observed in men. Apnea-Hypopnea Syndrome is a global public health problem, involving a multidisciplinary team for pharmacological or non-pharmacological treatment. Among the main comorbidities observed are: obesity, hypertension, arrhythmias, and type 2 diabetes Mellitus


Subject(s)
Sleep Stages , Cardiovascular Diseases , Comorbidity , Sleep Apnea, Obstructive , Diabetes Mellitus , Obesity
4.
Rev. bras. neurol ; 56(1): 5-10, jan.-mar. 2020. ilus
Article in English | LILACS | ID: biblio-1095921

ABSTRACT

Sleep occupies roughly one-third of human lives, yet it is still not entirely scientifically clear about its purpose or function. However, the latest research achievement concluded that sleeping has much more effect on the brain than formerly believed. Much of these studies are about the effects of sleep deprivation, and the glymphatic pathway initially identified in the rodent brain. In this paper, it is presented some of the theories about sleep functions, besides a review of some physiologic function of sleep. Now, it is accepted that sleep is involved with cleaning the brain toxins, physical restoration, information processing and recall, regulation, besides strengthening the immune system. Sleep implies in a neuronal activity markedly different along with its phases. It is regulated by two parallel mechanisms, homeostatic and circadian. Besides, the sleep-waking cycle involves diverse brain circuits and neurotransmitters and their interaction is explained using a flip-flop model. Several theories may help clarify the reasons human beings spend an important part of their lives sleeping such as those of Inactivity, Energy Conservation, Restorative, and Brain Plasticity. Recently, it was emphasized the importance of the glymphatic system that is a waste clearence system that acts mainly during sleep support efficient removal of soluble proteins and metabolites from the central nervous system. Indeed, sleep meet the needs of higher brain functions along with basic vital processes.


O sono ocupa cerca de um terço da vida humana, mas ainda não é totalmente claro cientificamente o seu propósito ou função. No entanto, a mais recente pesquisa concluiu que dormir tem muito mais efeito no cérebro do que se pensava anteriormente. Muitos desses estudos são sobre os efeitos da privação do sono e o sistema glinfático inicialmente identificada no cérebro de roedores. Neste artigo, são apresentadas algumas das teorias sobre as funções do sono, além de uma revisão de algumas funções fisiológicas do sono. Agora, aceita-se que o sono esteja envolvido com a limpeza de toxinas cerebrais, restauração física, processamento e memorização de informações, regulação do humor, além de fortalecer o sistema imunológico. O sono implica em uma atividade neuronal marcadamente diferente ao longo de suas fases. É regulado por dois mecanismos paralelos, homeostático e circadiano. Além disso, o ciclo de vigília envolve diversos circuitos cerebrais e neurotransmissores e sua interação é explicada por meio de um modelo de flip-flop. Várias teorias podem ajudar a esclarecer as razões pelas quais o ser humano passa uma parte importante de suas vidas dormindo, como as de inatividade, conservação de energia, restauração e plasticidade cerebral. Recentemente, enfatizou-se a importância do sistema glinfático agir principalmente durante o sono, que é um sistema de eliminação de resíduos para apoiar a remoção eficiente de proteínas e metabólitos solúveis do sistema nervoso central. De fato, o sono atende às necessidades de funções cerebrais superiores, juntamente com processos vitais básicos.


Subject(s)
Humans , Sleep/physiology , Sleep Stages , Sleep Hygiene/physiology , Sleep, REM , Executive Function/physiology , Memory
5.
Rev. bras. neurol ; 56(1): 11-18, jan.-mar. 2020. ilus, graf, tab
Article in English | LILACS | ID: biblio-1095930

ABSTRACT

The sleep-wake cycle that is circadian rhythm may have different patterns according to sex, environment and genetics determinants. This chronological cycle type, chronotype, may be populational expressed by the extremes, early or later going to bed and waking up, in a continuum. The first, the Morning-type individuals (the lark) and the later, the Evening types (the owl). Between the two extremes, there is the majority of these chronotypes ­ the intermediate ones. These patterns may be classified according to the questionnaires such as Horne and Ostberg Morningness/ Eveningness Questionnaire (MEQ) and the Munich Chrono Type Questionnaire (MCTQ). The rural population tends to be Morning-type, as well as children and younger women, more than men. The Morning person tends to be more healthy than the Evening ones who are more prone to diseases, as depression and metabolic syndrome. This basic knowledge may be helpful to patient's counseling and management: to avoid mismatch of circadian physiology and social duties / sleep. This circadian desynchrony can increase the risk of diseases, consequently there is a need to chrono-medicine into current treatment strategies.


O ciclo sono-vigília, que é um ritmo circadiano, pode ter padrões diferentes de acordo com os determinantes sexuais, ambientais e genéticos. Esse tipo de ciclo cronológico, cronótipo, pode ser expresso em termos populacionais pelos extremos, indo cedo ou mais tarde para a cama ou saindo dela, em um continuum. O primeiro, os indivíduos do tipo Manhã (a cotovia) e o posterior, os tipos da Tarde (a coruja). Entre os dois extremos, há a maioria desses cronotipos - os intermediários. Esses padrões podem ser classificados de acordo com questionários como o Horne e Ostberg Morningness/Eveningness Questionnaire (MEQ) e o Munich Chrono Type Questionnaire (MCTQ). A população rural tende a ser do tipo matutino, assim como crianças e mulheres mais jovens, mais que os homens.A pessoa da manhã tende a ser mais saudável do que as da noite, mais propensa a doenças, como depressão e síndrome metabólica. Esse conhecimento básico pode ser útil para o aconselhamento e tratamento dos pacientes: para evitar incompatibilidade entre a fisiologia circadiana e os deveres sociais / sono. Essa dessincronia circadiana pode aumentar o risco de doenças, consequentemente, é necessário a cronomedicina nas atuais estratégias de tratamento.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Sleep/physiology , Biological Clocks , Circadian Rhythm/physiology , Sleep Stages , Sex Factors , Surveys and Questionnaires , Actigraphy , Circadian Clocks/physiology
6.
Article in Korean | WPRIM | ID: wpr-811245

ABSTRACT

Narcolepsy is a chronic neurological sleep disorder caused by hypocretin neuron loss, resulting in excessive daytime sleepiness, disturbed nocturnal sleep, and intrusions of aspects of rapid eye movement sleep in wakefulness, such as cataplexy, sleep paralysis, and hypnopompic/hypnagogic hallucinations. Narcolepsy disrupts the maintenance and orderly occurrence of the wake and sleep stages. Cataplexy is a highly specific symptom of narcolepsy, but many other symptoms can be observed in a variety of sleep disorders. The diagnosis of narcolepsy type 1 requires a history of excessive daytime sleepiness and one of the following : 1) a low cerebrospinal fluid hypocretin-1 level or 2) cataplexy and a positive multiple sleep latency test result. The diagnosis of narcolepsy type 2 requires a history of excessive daytime sleepiness and a positive mean sleep-latency test result. The mean sleep-latency test must be preceded by nighttime polysomnography to exclude other sleep disorders and to document adequate sleep. The mean sleep-latency test result can be falsely positive in other sleep disorders, such as shift work, sleep apnea, or sleep deprivation, and it is influenced by age, sex, and puberty. Modafinil and armodafinil can reduce the excessive daytime sleepiness without many of the side effects associated with older stimulants. Although there is no cure for narcolepsy, the treatments are often effective and include both behavioral and pharmacologic approaches.


Subject(s)
Adolescent , Cataplexy , Cerebrospinal Fluid , Diagnosis , Disorders of Excessive Somnolence , Hallucinations , Humans , Narcolepsy , Neurons , Orexins , Polysomnography , Puberty , Sleep Apnea Syndromes , Sleep Deprivation , Sleep Paralysis , Sleep Stages , Sleep Wake Disorders , Sleep, REM , Wakefulness
8.
Arq. neuropsiquiatr ; 77(9): 609-616, Sept. 2019. tab, graf
Article in English | LILACS | ID: biblio-1038752

ABSTRACT

ABSTRACT Obstructive sleep apnea (OSA) occurs in up to 66% of Parkinson's disease (PD) patients, higher than in the general population. Although it is more prevalent, the relationship between OSA and PD remains controversial, with some studies confirming and others denying the relationship of OSA with some risk factors and symptoms in patients with PD. Objective: To determine the factors associated with OSA in PD patients com DP. Methods: A cross-sectional study was performed with 88 consecutive patients with PD from the outpatient clinic. Participants underwent clinical interviews with neurologists and a psychiatrist, assessment using standardized scales (Epworth Sleepiness Scale, Parkinson's Disease Questionnaire, Pittsburgh Sleep Quality Index and, for individuals with a diagnosis of restless legs syndrome/Willis-Ekbom disease, the International Restless Legs Syndrome Rating Scale), and video-polysomnography. Results: Individuals with PD and OSA were older and had less insomnia than those with PD without OSA. Regarding the polysomnographic variables, we observed a lower percentage of stage N3 sleep, a higher arousal index, and a higher oxygen desaturation index in those individuals with OSA, relative to those without OSA. In the multivariate analysis, only the percentage of stage N3 sleep and the oxygen desaturation index were significantly different. Besides this, most of the PD patients with OSA had a correlation with sleeping in the supine position (58% of OSA individuals). Conclusion: The PD patients showed a high prevalence of OSA, with the supine position exerting a significant influence on the OSA in these patients, and some factors that are associated with OSA in the general population did not seem to have a greater impact on PD patients.


RESUMO A Apneia Obstrutiva do Sono (AOS) chega a acometer até 66% dos pacientes com doença de Parkinson (DP), prevalência maior, portanto, que a da população geral. Embora seja mais prevalente, a relação entre AOS e DP permanence controversa, com trabalhos confirmando e outros afastando a relação de AOS com alguns fatores de risco e sintomas em pacientes com DP. Objetivo: Determinar quais fatores estão relacionados à AOS em pacientes com DP. Métodos: Estudo transversal, observacional, realizado com 88 pacientes com DP, provenientes do ambulatório de hospital público. Os pacientes foram submetidos à entrevista clínica com neurologista e psiquiatra, à aplicação de escalas padronizadas (escala de sonolência de Epworth, questionário de qualidade de vida da DP, índice de qualidade de sono de Pittsburgh e, para os indivíduos com diagnóstico de Síndrome das Pernas Inquietas, a escala internacional de graduação da SPI), e vídeo-polissonografia. Resultados: Indivíduos com DP e AOS apresentaram maior idade e menor prevalência de insônia crônica que os indivíduos com DP, sem AOS. Em relação às variáveis polissonográficas, observamos uma baixa proporção de sono N3, elevado índice de microdespertares e maior índice de desaturações nos indivíduos com AOS, em comparação ao grupo sem AOS. Na análise multivariada, apenas a porcentagem de sono N3 e o índice de dessaturação permaneceu significativo. Além disso, a maior parte dos pacientes tem relação com a posição supina (58% dos pacientes com AOS). Conclusão: Pacientes com DP apresentaram prevalência elevada de AOS, a posição supina exerceu influência importante na AOS destes pacientes e alguns fatores que estão associados à AOS na população geral não mostraram impacto significativo nos pacientes com DP.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Parkinson Disease/complications , Parkinson Disease/epidemiology , Sleep Apnea, Obstructive/complications , Sleep Apnea, Obstructive/epidemiology , Quality of Life , Sleep Stages/physiology , Time Factors , Brazil/epidemiology , Cross-Sectional Studies , Multivariate Analysis , Surveys and Questionnaires , Risk Factors , Supine Position/physiology , Polysomnography , Statistics, Nonparametric
9.
Braz. j. med. biol. res ; 52(3): e8059, 2019. tab, graf
Article in English | LILACS | ID: biblio-984037

ABSTRACT

Cyclic alternating pattern (CAP) is a neurophysiological pattern that can be visually scored by international criteria. The aim of this study was to verify the feasibility of visual CAP scoring using only one channel of sleep electroencephalogram (EEG) to evaluate the inter-scorer agreement in a variety of recordings, and to compare agreement between visual scoring and automatic scoring systems. Sixteen hours of single-channel European data format recordings from four different sleep laboratories with either C4-A1 or C3-A2 channels and with different sampling frequencies were used in this study. Seven independent scorers applied visual scoring according to international criteria. Two automatic blind scorings were also evaluated. Event-based inter-scorer agreement analysis was performed. The pairwise inter-scorer agreement (PWISA) was between 55.5 and 84.3%. The average PWISA was above 60% for all scorers and the global average was 69.9%. Automatic scoring systems showed similar results to those of visual scoring. The study showed that CAP could be scored using only one EEG channel. Therefore, CAP scoring might also be integrated in sleep scoring features and automatic scoring systems having similar performances to visual sleep scoring systems.


Subject(s)
Humans , Male , Female , Sleep Stages/physiology , Electronic Data Processing , Polysomnography/methods , Electroencephalography/methods , Observer Variation , Reproducibility of Results , Sensitivity and Specificity , Polysomnography/instrumentation , Electroencephalography/instrumentation
10.
Article in Korean | WPRIM | ID: wpr-759852

ABSTRACT

Opioids are important drugs for the management of severe cancer pain without a ceiling effect. However, opioid administration leads to dose-limiting complications including drowsiness, hallucinations, delirium, respiratory depression, cognitive impairment, seizure, myoclonus, and hyperalgesia. Opioid-induced hyperalgesia (OIH) is a paradoxical phenomenon as opioid exposure increases pain sensitivity. Reducing or stopping opioids, opioid rotation, or co-administration of N-methyl-D-aspartate (NMDA) antagonists have been suggested for the management of OIH. In this study, we report two clinical cases of successful management of OIH in cancer pain patients that were treated with opioids.


Subject(s)
Analgesics, Opioid , Cognition Disorders , Delirium , Hallucinations , Humans , Hyperalgesia , Myoclonus , N-Methylaspartate , Pain Management , Respiratory Insufficiency , Seizures , Sleep Stages
11.
Article in English | WPRIM | ID: wpr-763300

ABSTRACT

OBJECTIVES.: To investigate the apnea-hypopnea index (AHI) according to the sleep stage in more detail after control of posture. METHODS.: Patients who underwent nocturnal polysomnography between December 2007 and July 2018 were retrospectively evaluated. Inclusion criteria were as follows: age >18 years, sleep efficacy >80%, and patients who underwent polysomnography only in the supine position (100% of the time). Patients were classified into different groups according to the methods: the first, rapid eye movement (REM)-dominant group (AHIREM/AHINREM >2), non-rapid eye movement (NREM)-dominant group (AHINREM/AHIREM >2), and non-dominant group; and the second, light sleep group (AHIN1N2>AHISWS) and slow wave sleep (SWS) group (AHISWS>AHIN1N2). RESULTS.: A total of 234 patients (mean age, 47.4±13.9 years) were included in the study. There were 108 patients (46.2%) in the REM-dominant group, 88 (37.6%) in the non-dominant group, and 38 (16.2%) in the NREM-dominant group. The AHI was significantly higher in the NREM-dominant group than in the REM-dominant group (32.9±22.9 events/hr vs. 18.3±9.5 events/hr, respectively). There were improvements in the AHI from stage 1 to SWS in NREM sleep with the highest level in REM sleep. A higher AHISWS than AHIN1N2 was found in 16 of 234 patients (6.8%); however, there were no significant predictors of these unexpected results except AHI. CONCLUSION.: Our results demonstrated the highest AHI during REM sleep stage in total participants after control of posture. However, there were 16.2% of patients showed NREM-dominant pattern (AHINREM/AHIREM >2) and 6.8% of patients showed higher AHISWS than AHIN1N2. Therefore, each group might have a different pathophysiology of obstructive sleep apnea (OSA), and we need to consider this point when we treat the patients with OSA.


Subject(s)
Eye Movements , Humans , Polysomnography , Posture , Retrospective Studies , Sleep Apnea, Obstructive , Sleep Stages , Sleep, REM , Supine Position
12.
Article in English | WPRIM | ID: wpr-763004

ABSTRACT

With progress in sensors and communication technologies, the range of sleep monitoring is extending from professional clinics into our usual home environments. Information from conventional overnight polysomnographic recordings can be derived from much simpler devices and methods. The gold standard of sleep monitoring is laboratory polysomnography, which classifi es brain states based mainly on EEGs. Single-channel EEGs have been used for sleep stage scoring with accuracies of 84.9%. Actigraphy can estimate sleep effi ciency with an accuracy of 86.0%. Sleep scoring based on respiratory dynamics provides accuracies of 89.2% and 70.9% for identifying sleep stages and sleep effi ciency, respectively, and a correlation coeffi cient of 0.94 for apnea–hypopnea detection. Modulation of autonomic balance during the sleep stages are well recognized and widely used for simpler sleep scoring and sleep parameter estimation. This modulation can be recorded by several types of cardiovascular measurements, including ECG, PPG, BCG, and PAT, and the results showed accuracies up to 96.5% and 92.5% for sleep effi ciency and OSA severity detection, respectively. Instead of using recordings for the entire night, less than 5 min ECG recordings have used for sleep effi ciency and AHI estimation and resulted in high correlations of 0.94 and 0.99, respectively. These methods are based on their own models that relate sleep dynamics with a limited number of biological signals. Parameters representing sleep quality and disturbed breathing are estimated with high accuracies that are close to the results obtained by polysomnography. These unconstrained technologies, making sleep monitoring easier and simpler, will enhance qualities of life by expanding the range of ubiquitous healthcare.


Subject(s)
Actigraphy , Brain , Delivery of Health Care , Electrocardiography , Electroencephalography , Mycobacterium bovis , Polysomnography , Respiration , Sleep Stages
13.
Article in English | WPRIM | ID: wpr-764118

ABSTRACT

PURPOSE: To determine if self-administered transcutaneous tibial nerve stimulation (TTNS) is a feasible treatment option for neurogenic bladder among people with spinal cord injury (SCI) who utilize intermittent catheterization for bladder management. METHODS: Four-week observational trial in chronic SCI subjects performing intermittent catheterization with incontinence episodes using TTNS at home daily for 30 minutes. Those using anticholinergic bladder medications were given a weaning schedule to begin at week 2. Primary outcomes were compliance and satisfaction. Secondary outcomes included change in bladder medications, efficacy based on bladder diary, adverse events, and incontinence quality of life (I-QoL) survey.


Subject(s)
Appointments and Schedules , Catheterization , Catheters , Compliance , Humans , Mouth , Quality of Life , Sleep Stages , Spinal Cord Injuries , Spinal Cord , Tibial Nerve , Transcutaneous Electric Nerve Stimulation , Urinary Bladder , Urinary Bladder, Neurogenic , Urodynamics , Weaning
14.
Article in English | WPRIM | ID: wpr-766231

ABSTRACT

A close relationship has emerged between obstructive sleep apnea (OSA) and cardiac arrhythmia. However, transient sinus arrest or atrioventricular (AV) conduction disturbance during rapid eye movement (REM) sleep was rarely reported. This sleep stage specific arrhythmia has been referred to as REM sleep-related bradyarrhythmia syndrome. The differential diagnosis between OSA-related arrhythmia and REM sleep-related bradyarrhythmia syndrome is important in determining the treatment strategy for the underlying disease and its complication, especially in patient with a history of OSA. Here, we report a case with both REM sleep-related AV block and severe OSA, whose REM sleep-related AV block was not improved with continuous positive airway pressure treatment.


Subject(s)
Arrhythmias, Cardiac , Atrioventricular Block , Bradycardia , Continuous Positive Airway Pressure , Diagnosis, Differential , Humans , Sleep Apnea, Obstructive , Sleep Stages , Sleep, REM
15.
Article in English | WPRIM | ID: wpr-739228

ABSTRACT

OBJECTIVES: To develop a simple algorithm for prescreening of obstructive sleep apnea (OSA) on the basis of respiratorysounds recorded during polysomnography during all sleep stages between sleep onset and offset. METHODS: Patients who underwent attended, in-laboratory, full-night polysomnography were included. For all patients, audiorecordings were performed with an air-conduction microphone during polysomnography. Analyses included allsleep stages (i.e., N1, N2, N3, rapid eye movement, and waking). After noise reduction preprocessing, data were segmentedinto 5-s windows and sound features were extracted. Prediction models were established and validated with10-fold cross-validation by using simple logistic regression. Binary classifications were separately conducted for threedifferent threshold criteria at apnea hypopnea index (AHI) of 5, 15, or 30. Prediction model characteristics, includingaccuracy, sensitivity, specificity, positive predictive value (precision), negative predictive value, and area under thecurve (AUC) of the receiver operating characteristic were computed. RESULTS: A total of 116 subjects were included; their mean age, body mass index, and AHI were 50.4 years, 25.5 kg/m2, and23.0/hr, respectively. A total of 508 sound features were extracted from respiratory sounds recorded throughoutsleep. Accuracies of binary classifiers at AHIs of 5, 15, and 30 were 82.7%, 84.4%, and 85.3%, respectively. Predictionperformances for the classifiers at AHIs of 5, 15, and 30 were AUC, 0.83, 0.901, and 0.91; sensitivity, 87.5%,81.6%, and 60%; and specificity, 67.8%, 87.5%, and 94.1%. Respective precision values of the classifiers were89.5%, 87.5%, and 78.2% for AHIs of 5, 15, and 30. CONCLUSION: This study showed that our binary classifier predicted patients with AHI of ≥15 with sensitivity and specificityof >80% by using respiratory sounds during sleep. Since our prediction model included all sleep stage data, algorithmsbased on respiratory sounds may have a high value for prescreening OSA with mobile devices.


Subject(s)
Apnea , Area Under Curve , Body Mass Index , Classification , Humans , Logistic Models , Machine Learning , Noise , Polysomnography , Respiratory Sounds , ROC Curve , Sensitivity and Specificity , Sleep Apnea, Obstructive , Sleep Stages , Sleep, REM
16.
Article in Korean | WPRIM | ID: wpr-739087

ABSTRACT

PURPOSE: The purpose of this paper is to determine effects of auricular acupressure on knee pain, range of motion, and sleep in the elderly with knee osteoarthritis. METHODS: This is an experimental study designed with randomization and single-blind in a placebo-control approach. The subjects included the elderly with knee osteoarthritis who were using an elderly welfare facility. In each of the groups, 28 subjects were assigned. For the experimental group, auricular acupressure was applied to five pressure points related to the pain caused by osteoarthritis and sleep. In the case of the placebo-control group, auricular acupressure was applied to other five points than the former. The intervention lasted eight weeks. In order to examine intervention effects of auricular acupressure, joint pain, Pressure Pain Thresholds (PPTs), and extension and flexion range of motion (ROM) were measured weekly. As for the pre- and post-examinations, pain, sleep quality, and the time-by-sleep stage of the patients with knee osteoarthritis were measured. RESULTS: The VAS scores in the experimental group with auricular acupressure significantly decreased through time (p<.001) and WOMAC also significantly decreased (p<.01) compared with the placebo-control group. However, there were no significant differences in PPTs. The flexion (p<.01) and extension (p<.001) ROMs measured for eight weeks improved over time. Meanwhile, sleep quality improved significantly after the intervention termination (p<.01), but there was no significant difference found in the time-by-sleep stage. CONCLUSION: Auricular acupressure applied for eight weeks was found to be effective in reducing joint pain, improving knee ROM, and improving sleep quality in patients with degenerative knee arthritis.


Subject(s)
Acupressure , Aged , Arthralgia , Arthritis , Humans , Joints , Knee , Osteoarthritis , Osteoarthritis, Knee , Pain Threshold , Random Allocation , Range of Motion, Articular , Sleep Stages
17.
Biomedical Engineering Letters ; (4): 257-265, 2019.
Article in English | WPRIM | ID: wpr-785502

ABSTRACT

Recent studies have developed simple techniques for monitoring and assessing sleep. However, several issues remain to be solved for example high-cost sensor and algorithm as a home-use device. In this study, we aimed to develop an inexpensive and simple sleep monitoring system using a camera and video processing. Polysomnography (PSG) recordings were performed in six subjects for four consecutive nights. Subjects' body movements were simultaneously recorded by the web camera. Body movement was extracted by video processing from the video data and fi ve parameters were calculated for machine learning. Four sleep stages (WAKE, LIGHT, DEEP and REM) were estimated by applying these fi ve parameters to a support vector machine. The overall estimation accuracy was 70.3 ± 11.3% with the highest accuracy for DEEP (82.8 ± 4.7%) and the lowest for LIGHT (53.0 ± 4.0%) compared with correct sleep stages manually scored on PSG data by a sleep technician. Estimation accuracy for REM sleep was 68.0 ± 6.8%. The kappa was 0.19 ± 0.04 for all subjects. The present non-contact sleep monitoring system showed suffi cient accuracy in sleep stage estimation with REM sleep detection being accomplished. Low-cost computing power of this system can be advantageous for mobile application and modularization into home-device.


Subject(s)
Machine Learning , Methods , Mobile Applications , Polysomnography , Sleep Stages , Sleep, REM , Support Vector Machine
18.
Gac. méd. boliv ; 41(2): 14-17, Dec. 2018. ilus.
Article in Spanish | LILACS, LIBOCS | ID: biblio-988163

ABSTRACT

OBJETIVO: el objetivo primario es determinar si los estudiantes de medicina de la Universidad Mayor de San Simón (UMSS) sufren de somnolencia diurna excesiva mediante el uso de la Escala de somnolencia de Epworth (ESE). MÉTODOS: Se trata de un estudio transversal, descriptivo. Estudiantes de medicina de la UMSS completaron una encuesta la cual incluía datos demográficos, escala del sueño de Epworth traducida al español, número de horas nocturnas de sueño, siestas y uso de estimulantes del SNC durante el mes anterior a la realización de la encuesta. RESULTADOS: el universo consistió en 1923 estudiantes y la muestra en 324 estudiantes del primer al quinto curso de carrera de medicina (5% margen de error, 95% nivel de confianza); 57% del sexo femenino, media de edad de 21 años (±2,1), la media de la escala de Epworth fue de 9 (±3,3) (95% IC 8,46-9,54); 23,6% presentó algún grado de somnolencia diurna excesiva; 67% de los estudiantes indican dormir 4-6 hrs diarias; 79% goza entre 5 ­ 90 minutos de siesta cada día durante el mes anterior a la encuesta; 76% reporta usar algún tipo de estimulante del sistema nervioso central. CONCLUSIONES: un porcentaje menor pero relevante de estudiantes de medicina de la UMSS tiene algún grado de somnolencia diurna excesiva. Este menor porcentaje puede deberse al uso de siestas; habito comúnmente practicado en nuestro país.


OBJECTIVES: the primary objective is to determine if medical students of San Simon University (UMSS) suffer from excessive daytime sleepiness using the Epworth Sleeping Scale (ESS). METHODS: It was a cross-sectional, descriptive study. Medical students of San Simon University responded to a survey which included demographics, Epworth Sleepiness Scale translated to Spanish, number of nighttime hours of sleep, presence of naps and use of any stimulant of the central nervous system during the month prior to the survey. RESULTS: The universe consisted of 1923 students and the sample was 324 students from the first to the fifth course of the medical school of University of San Simon (5% margin of error, 95% level of confidence); 57% female, mean age was 21 years (±2.1), the average Epworth Sleepiness scale was 9 (±3.3) (95% CI 8.46-9.54); 23.6% presented some degree of excessive daytime sleepiness; 67% of students indicated sleep 4-6 hours daily; 79% enjoy 5 - 90 minute daily naps during the month prior to survey; 76% reported using some type of stimulant of the central nervous system. CONCLUSIONS: A small but relevant number of medical students have some degree of excessive daytime sleepiness. This is maybe due to use of naps; a habit commonly used in our country.


Subject(s)
Humans , Female , Adult , Sleep Deprivation/diagnosis , Sleep Stages , Sleep
19.
Rev. ADM ; 75(4): 187-195, jul.-ago. 2018. ilus
Article in Spanish | LILACS | ID: biblio-914912

ABSTRACT

El sueño es un requerimiento biológico para la vida, sus alteraciones o su ausencia pueden disminuir la calidad de vida, el estado anímico y funcional, afectando seriamente la salud. Un sueño placentero y reparador implica cursar por facetas de profundidad diversa y actividad neuronal compleja. En este artículo se intentan explicar las generalidades del proceso del sueño y algunos de sus trastornos que lo relacionan con aumento de la actividad de los músculos masticatorios (bruxismo). Son presentados aspectos clínicos y neuronales que inducen a un incremento de microdespertares como alteración del sueño, estimulando bruxismo nocturno y bruxismo asociado a apnea nocturna. Son discutidas las posibles relaciones bidireccionales entre bruxismo diurno y nocturno secundarias a modifi caciones en la cantidad y calidad del proceso del sueño. De la misma manera, son sugeridas algunas consideraciones semiológicas y nosológicas para el mejor manejo y control del bruxismo asociado a las alteraciones del sueño, bajo el diagnóstico, atención y supervisión de equipos de atención multi- e interdisciplinarios (AU)


Sleep is a biological requirement for life, its alterations or privation thereof may reduce a person's quality of life, his or her state of mind and physical functions, which signifi cantly aff ects their health. Pleasant and repairing sleep implies going through variable deepness sleep stages, and a complex neuronal activity. This article intends to explain the generalities of the sleep process and certain disorders, particularly those in connection with the activity of the mastication muscles (bruxism). Clinical and neuronal aspects are presented inducing an increase in micro-awakenings such as sleep alterations stimulating nocturnal and bruxism associated with sleep apnea. Bidirectional connections between diurnal and nocturnal bruxism are argued as secondary to changes in the amount and quality of the sleep process. In the same manner, certain considerations associated to semiology and nosology of the diverse bruxism manifestations are considered for the better handling and control of the bruxism associated with sleep alterations under the diagnosis attention and supervision of multi- and interdisciplinary teams (AU)


Subject(s)
Humans , Sleep Arousal Disorders , Sleep Bruxism , Sleep Stages , Dyssomnias , Neurotransmitter Agents , Parasomnias , Patient Care Team , Sleep Apnea Syndromes , Sleep, REM , Stress, Psychological
20.
Rev. latinoam. enferm. (Online) ; 26: e3105, 2018. graf
Article in English | LILACS, BDENF | ID: biblio-978608

ABSTRACT

Objective to present the knowledge produced about sleep and Acute Coronary Syndrome in order to assist in the elaboration of the operational and conceptual definitions of the defining characteristics of the nursing diagnosis Disturbed Sleep Pattern (00198). Method integrative review in the following databases: COCHRANE; SCOPUS; MEDLINE (Medical Literature Analysis and Retrieval System Online) via Pubmed; LILACS (Latin American and Caribbean Health Science Literature Database); CINAHL (Cumulative Index to Nursing and Allied Health Literature) and EMBASE (The Excerpta Medical Database). At the end of the search, 2827 studies were found, 43 were selected for reading, and 10 were included in the review. The gray literature was also included. Results important findings related to clinical evidence and contributing factors of sleep were found in the review. However, in order to build definitions of the defining characteristics, it was necessary to use gray literature, such as a Portuguese dictionary and two textbooks about sleep. Conclusion the definitions will help nurses in their practice in the collection of information, in the determination of the nursing diagnosis studied here, and in directing care measures with respect to quantity and quality of sleep of Acute Coronary Syndrome inpatients. They will also assist in the next steps of the validation of this diagnosis to the referred population.


Objetivo apresentar o conhecimento produzido sobre sono e Síndrome Coronariana Aguda a fim de auxiliar na elaboração das definições operacionais e conceituais das características definidoras do diagnóstico de enfermagem Padrão de Sono Prejudicado (00198). Método revisão integrativa nas bases de dados COCHRANE; SCOPUS; MEDLINE (Medical Literature Analysis and Retrieval System Online) via Pubmed; LILACS (Latin American and Caribean Health Science Literature Database); CINAHL (Cumulative Index to Nursing and Allied Health Literature) e EMBASE (The Excerpta Medica Database). Ao final das buscas, 2827 estudos identificados, 43 selecionados para leitura e 10 incluídos. A literatura cinzenta também foi incluída. Resultados importantes achados relacionados a evidências clínicas e fatores contribuintes do sono foram encontrados na revisão realizada. Porém, para a construção das definições das características definidoras, fez-se necessário lançar mão de literatura cinzenta, como um dicionário da Língua Portuguesa e dois livros-texto sobre o sono. Conclusão tais definições poderão auxiliar os enfermeiros da prática na coleta de informações, na determinação do referido diagnóstico de enfermagem e, assim, no direcionamento de cuidados ao que tange à quantidade e qualidade do sono de pacientes internados com Síndrome Coronariana Aguda. Também auxiliarão nas próximas etapas do processo de validação desse diagnóstico à população referida.


Objetivo presentar el conocimiento producido sobre sueño y Síndrome Coronario Agudo a fin de auxiliar en la elaboración de las definiciones operacionales y conceptuales de las características definidoras del diagnóstico de enfermería Estándar de Sueño Perjudicado (00198). Método revisión integradora en las bases de datos COCHRANE; SCOPUS; MEDLINE (Medical Literature Analysis and Retrieval System Online) via Pubmed; LILACS (Latin American and Caribean Health Science Literature Database); CINAHL (Cumulative Index to Nursing and Allied Health Literature) e EMBASE (The Excerpta Medica Database). Al final de las búsquedas, 2827 estudios identificados, 43 seleccionados para lectura y 10 incluidos. La literatura gris también fue incluida. Resultados importantes hallados relacionados a las evidencias clínicas y factores contribuyentes del sueño fueron encontrados en la revisión realizada. Sin embargo, para la construcción de las definiciones de las características definidoras es necesario usar la literatura gris, como un diccionario de la Lengua Portuguesa y dos libros texto sobre el sueño. Conclusión tales definiciones podrán auxiliar a los enfermeros de la práctica en la recolección de informaciones, en la determinación del referido diagnóstico de enfermería y así, en el direccionamiento de cuidados sobre la cantidad y calidad del sueño de pacientes internados con Síndrome Coronario Agudo. También auxiliarán en las próximas etapas del proceso de validez de ese diagnóstico a la población referida.


Subject(s)
Humans , Sleep/physiology , Sleep Wake Disorders/etiology , Sleep Stages/physiology , Nursing Diagnosis/standards , Acute Coronary Syndrome/complications , Coronary Care Units , Validation Studies as Topic
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