The Effect of Sleeping Environment and Sleeping Location Change on Positive Airway Pressure Adherence.

STUDY OBJECTIVES: Poor adherence undermines the effectiveness of positive airway pressure (PAP) therapy for sleep apnea. Disparities exist in PAP adherence by race/ethnicity and neighborhood socioeconomic status (SES), but the etiology of these differences is poorly understood. We investigated whether home environmental factors contribute to PAP adherence and whether identified factors explain disparities in adherence by SES. METHODS: Adult patients with sleep apnea were surveyed at clinic visits about their sleep environment. Medical records were abstracted for demographic data, sleep apnea severity, comorbidities, and objective PAP adherence. We evaluated the association between aspects of home sleep environment with PAP adherence using multivariate linear and logistic regression, and assessed effect modification by SES factors. RESULTS: Participants (n = 119) were diverse, with 44% nonwhite and 35% uninsured/Medicaid. After adjusting for age, sex, race/ethnicity, insurance, neighborhood SES, education, and marital status, participants who endorsed changing sleeping location once per month or more (18%, n = 21) had 77% lower odds of meeting PAP adherence criteria (> 4 h/night for 70% of nights) and less PAP use (median -11 d/mo, 95% confidence intervals -15.3, -6.5). Frequency of sleeping location change was the only environmental factor surveyed associated with PAP adherence. CONCLUSIONS: Frequent change in sleeping location is associated with reduced PAP adherence, independent of sociodemographic factors. This novel finding has implications for physician-patient dialogue. PAP portability considerations in device selection and design may modify adherence and potentially improve treatment outcomes. Prospective investigation is needed to confirm this finding and inform design of possible interventions.

Influence of simulated microgravity on rat islets morphology in culture / 中国普通外科杂志

Objective To observe the influence of simulated microgravity on rat islet. Methods Isolated islet were assigned to flask-culture or bioreactor-culture. Gross structure and ultrastructure of islet were observed by transmission electron microscopy (TEM) and scanning electron microscopy (SEM). Results Islets ultrastructure on 7th day in bioreactor closely resembled fresh islets,with well-formed secretory granules and abundant mitochondria. SEM showed under microgravity islets communicating each other with cavity-like areas. Conclusions The ultrastructure of islets cultured under microgravity closely resembled fresh islets.