ABSTRACT
To evaluate the value of apnoea + hypopnoea index versus self-reported sleepiness at the wheel in anticipating the risk of sleepiness-related accidents in patients referred for obstructive sleep apnoea. A cross-sectional analysis of the French national obstructive sleep apnoea registry. 58,815 subjects referred for a suspicion of obstructive sleep apnoea were investigated by specific items addressing sleepiness at the wheel and sleepiness-related accidents. Apnoea + hypopnoea index was evaluated with a respiratory polygraphy or full polysomnography. Subjects had a median age of 55.6 years [45.3; 64.6], 65% were men, with a median apnoea + hypopnoea index of 22 [8; 39] events/h. Median Epworth sleepiness scale score was 9 [6; 13], 35% of the patients reported sleepiness at the wheel (n = 20,310), 8% (n = 4,588) reported a near-miss accident and 2% (n = 1,313) reported a sleepiness-related accident. Patients reporting sleepiness at the wheel whatever their obstructive sleep apnoea status and severity exhibited a tenfold higher risk of sleepiness-related accidents. In multivariate analysis, other predictors for sleepiness-related accidents were: male gender, ESS, history of previous near-miss accidents, restless leg syndrome/periodic leg movements, complaints of memory dysfunction and nocturnal sweating. Sleep apnoea per se was not an independent contributor. Self-reported sleepiness at the wheel is a better predictor of sleepiness-related traffic accidents than apnoea + hypopnoea index.
Subject(s)
Accidents, Traffic/statistics & numerical data , Sleep Apnea, Obstructive/complications , Adult , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Polysomnography , Risk Factors , Self Report , Sleep Apnea, Obstructive/diagnosis , SleepinessSubject(s)
Sleep Apnea, Obstructive/diagnosis , Accidents , Airway Obstruction/diagnosis , Arrhythmias, Cardiac/etiology , Atherosclerosis/etiology , Attention/physiology , Biomarkers/analysis , Cardiomegaly/etiology , Cognition Disorders/etiology , Endoscopy , Heart Diseases/etiology , Heart Failure/etiology , Humans , Hypertension/etiology , Insulin Resistance/physiology , Obesity Hypoventilation Syndrome/diagnosis , Otorhinolaryngologic Surgical Procedures , Pulmonary Disease, Chronic Obstructive/diagnosis , Respiration Disorders/diagnosis , Risk Factors , Sleep Apnea, Obstructive/complications , Sleep Apnea, Obstructive/physiopathology , Sleep Stages/physiology , Smoking/physiopathology , Stroke/etiology , Vascular Diseases/diagnosis , Wakefulness/physiologySubject(s)
Pulmonary Disease, Chronic Obstructive , Education, Medical , Epidemiologic Studies , France/epidemiology , Health Education , Health Services Accessibility , Humans , Patient Participation , Pulmonary Disease, Chronic Obstructive/epidemiology , Pulmonary Disease, Chronic Obstructive/prevention & control , Pulmonary Disease, Chronic Obstructive/therapy , Quality of Health Care , Research Design , Risk Factors , Smoking PreventionABSTRACT
The adsorption of argon, nitrogen, and carbon monoxide in porous Vycor glass has been studied by volumetric and microcalorimetric methods and by thermoporometry. Samples with particle sizes ranging from <50 to >200 µm have been selected and treated by sample controlled thermal analysis (SCTA). Subsequent characterization indicates that the particle size has no influence on the pore texture and nature. Thermal treatment, however, modifies the chemical nature of the surface. It would seem that nitrogen and carbon monoxide assume a distinct mean orientation leading to smaller effective cross-sectional areas than those usually accepted. Carbon monoxide clearly distinguishes two different types of adsorption site for samples treated at low temperature. Copyright 1998 Academic Press.
ABSTRACT
The campaign against smoking requires a dynamic attitude in the field. With this in mind, a study was conducted in 14 to 16 year old school-children in the Drôme region and a questionnaire was sent to all doctors in the region. The school survey confirmed the results obtained previously in similar studies, such as the high proportion of girls who smoke and the essential role of the family. There was no valorising element associated with cigarettes in young people. The aim of the questionnaire, which was sent to all doctors registered in the Drôme region (more than 800), was to encourage them to adopt a dynamic attitude towards smoking in their professional practice. The high reply rate was encouraging, even if not all of the doctors are ready for an aggressive campaign.
