Population-based analysis of sociodemographic predictors, health-related quality of life and health service use associated with obstructive sleep apnoea and insomnia in Australia.

Although there is growing recognition of the effects of living with sleep disorders and the important role of primary care in their identification and management, studies indicate that the detection of sleep apnoea (OSA) and insomnia may still be low. This large representative community-based study (n=2977 adults) used logistic regression models to examine predictors of self-reported OSA and current insomnia and linear regression models to examine the association of these sleep conditions with both mental and physical components of health-related quality of life (HRQoL) and health service use. Overall, 5.6% (95% confidence interval (CI) 4.6-6.7) and 6.8% (95% CI 5.7-7.9) of subjects self-reported OSA (using a single-item question) and current insomnia (using two single-item questions) respectively. Many sociodemographic and lifestyle predictors for OSA and insomnia acted in different directions or showed different magnitudes of association. Both disorders had a similar adverse relationship with physical HRQoL, whereas mental HRQoL was more impaired among those with insomnia. Frequent consultations with a doctor were associated with a lower physical HRQoL across these sleep conditions; however, lower mental HRQoL among those frequently visiting a doctor was observed only among individuals with insomnia. The adverse relationship between sleep disorders and physical and mental HRQoL was substantial and should not be underestimated.

Pilot cohort study of obstructive sleep apnoea in community-dwelling people with schizophrenia.

OBJECTIVES: We aimed to assess the incidence of obstructive sleep apnoea (OSA) in people with schizophrenia, to explore clinical associates with OSA and how well OSA screening tools perform in this population. METHODS: All patients registered in a community outpatient Clozapine clinic, between January 2014 and March 2016, were consecutively approached to participate. Participants were screened for OSA using at home multichannel polysomnography (PSG) and were diagnosed with OSA if the apnoea-hypopnoea index (AHI) was >10 events/hr. Univariate comparison of participants to determine whether AHI > 10 events/hr was associated with demographic factors, anthropometric measures and psychiatric symptoms and cognition was performed. The sensitivity, specificity, positive predictive value and negative predictive value of the commonly used sleep symptoms scales and OSA screening tools were also determined. RESULTS: Thirty participants were recruited, 24 men and 6 women. Mean age was 38.8 (range: 25-60), and mean body mass index (BMI) was 35.7 (range 19.9-62.1). The proportion of participants with OSA (AHI > 10 events/hr) was 40%, 18 (60%) had no OSA, 4 (13%) had mild OSA (AHI 10.1-20), zero participants had moderate OSA (AHI 20.1-30) and 8 (27%) had severe OSA (AHI > 30). Diagnosis of OSA was significantly associated with increased weight, BMI, neck circumference and systolic blood pressure. Diagnosis of OSA was not significantly associated with Positive and Negative Symptoms Scale, Montgomery Asperger's Depression Rating Scale, Personal and Social Performance scale or Brief Assessment of Cognition for Schizophrenia scores. All OSA screening tools demonstrated poor sensitivity and specificity for a diagnosis of OSA. CONCLUSION: OSA was highly prevalent in this cohort of people with schizophrenia and was associated with traditional anthropometric OSA risk factors.

Perception versus Reality: The Relationship between Subjective and Objective Measures of Sleep When On-call under Simulated Laboratory Conditions.

BACKGROUND: On-call working arrangements have been shown to negatively impact sleep. However, workers may perceive their sleep to be worse than it actually is. The aim of this study was to compare participants' pre- and post-sleep estimates of sleep duration and sleep quality with objectively measured sleep when on-call under laboratory conditions. PARTICIPANTS: 72 healthy, adult males. METHODS: Analyses were performed on three interrelated studies, all of which consisted of four nights in a sleep laboratory. Following adaptation and baseline nights were two on-call nights (sleep opportunity 23:00 h - 07:00 h). Before and after each sleep opportunity, participants provided subjective estimates of sleep. Sleep was objectively measured using polysomnography. RESULTS: Estimated sleep duration (6.74 ± 1.13 h) and sleep onset latency (20.55 ± 14.85 min) were significantly poorer than objectively measured sleep outcomes (sleep duration 7.21 ± 1.25 h; sleep latency 13.20 ± 10.06 min). Of the variance in post-sleep estimated sleep duration, 14% was associated with objectively measured minutes of N3 (R2Δ = 0.55) and REM (R2Δ = 0.75). Additionally, 14% of post-sleep sleep quality estimation variance was associated with minutes of N2 (R2Δ = 0.60) and N3 (R2Δ = 0.79), measured by polysomnography. CONCLUSIONS: Some objective measures of sleep were associated with subjective estimates of sleep duration and sleep quality. However, individuals may overestimate sleep onset latency and underestimate sleep duration during on-call periods. It may be beneficial for on-call workers to actively reflect on feelings of fatigue/alertness for workplace fatigue management, rather than relying solely on estimates of sleep.

Waking qEEG to assess psychophysiological stress and alertness during simulated on-call conditions.

INTRODUCTION: On-call schedules are associated with stress and disrupted sleep. In a recent study, under non-sleep deprived conditions, low and high-stress on-call conditions did not significantly impact sleep quality but did impact next day performance. Our aim was to determine whether quantitative electroencephalography (qEEG) would reflect changes in cortical activity in on-call conditions, predicting that the high-stress condition would display faster qEEG frequencies compared with the control and low-stress condition. METHODS: Twenty-four healthy male participants (age: 26.5 ±â€¯4.0 yrs) spent four nights in a time-isolated sleep laboratory. The within-subjects, repeated measures experimental design assessed waking EEG, via the Karolinska Drowsiness Test (KDT) during four time-points across a control day and two experimental (on-call) days. Experimental days comprised a low-stress (LS - reading task) and high-stress (HS - speech task) condition and were counterbalanced. Mixed-models analysis was used to assess condition and time by EEG biomarkers: Alpha Attenuation Coefficient (AAC), Slowing Ratio (SR) and Scaling Exponent (SE). RESULTS: Main effects were found for all three biomarkers by condition, with pairwise analysis reported. There was a significant difference in AAC between the LS condition (M = 1.26 ±â€¯=1.24) and HS condition (M = 1.01 ±â€¯0.76 p = .02) indicating decreased alertness between LS and HS. A significant increase in SR between control (M = 7.1 ±â€¯4.3) and LS (M = 10.1 ±â€¯8.5 p = .0001), and a significant increase between the LS and HS (M = 7.8 ±â€¯6.8 p = .018) showing greatest EEG slowing in the LS condition, reflecting of a passive, sleepier brain state. The SE was significantly higher in the LS (M = 1.09, ±0.17) condition compared with control (M = 1.0, ±0.11 p = .001) indicating decreased alertness in the LS task. DISCUSSION: Using qEEG biomarkers, in contrast with our initial hypothesis, the current study found that compared with control, the LS condition resulted in greater EEG slowing. These findings have implications for on-call workers who engage in periods of passive attention and highlight a protective role task stress may play in maintaining alertness levels during on-call conditions.

Effects of moderate sleep deprivation and low-dose alcohol on driving simulator performance and perception in young men.

STUDY OBJECTIVE: To determine the combined effects of sleep restriction and low-dose alcohol on driving simulator performance, EEG, and subjective levels of sleepiness and performance in the mid-afternoon. DESIGN: Repeated measures with 4 experimental conditions. Normal sleep without alcohol, sleep restriction alone (4 hours) and sleep restriction in combination with 2 different low blood alcohol concentrations (0.025 g/dL and 0.035 g/dL). SETTING: Sleep Laboratory, Adelaide Institute for Sleep Health. PARTICIPANTS: Twenty-one healthy young men, aged 18-30 years, mean (+/-SD) = 22.5(+/-3.7) years, BMI = 25(+/-6.7) kg/m2; all had normal sleep patterns and were free of sleep disorders. MEASUREMENTS: Participants completed a 70-minute simulated driving session, commencing at 14:00. Driving parameters included steering deviation, braking reaction time, and number of collisions. Alpha and theta EEG activity and subjective driving performance and sleepiness were also measured throughout the driving task. RESULTS: All measures were significantly affected by time. Steering deviation increased significantly when sleep restriction was combined with the higher dose alcohol. This combination also resulted in a significant increase in alpha/theta EEG activity throughout the drive, as well as greater subjective sleepiness and negative driving performance ratings compared to control or sleep restriction alone. DISCUSSION: These data indicate that combining low-dose alcohol with moderate sleep restriction results in significant decrements to subjective alertness and performance as well as to some driving performance and EEG parameters. This highlights the potential risks of driving after consumption of low and legal doses of alcohol when also sleep restricted.

[Influence of vitamins-antioxidants on antiaggregative effect of acetylsalicylic acid]. / Vliianie vitaminov na antiagregatnyl 'effekt atsetilsalitsilovol kisloty.

Antiaggregative effect of aspirin has been studied in white rats that were given vitamins A, E, C and P in balanced diet in doses adequate to therapeutic ones. Aspirin (15 mg/100 g of body weight) without additional vitamin dose inhibits spontaneous and ADP-induced aggregation to 50% within 3 days following its administration restricting release of thrombocytic factors 3 and 4 into plasma, maximal aggregation, maximal reaction time and aggregation rate decreasing. Antiaggregative effect of aspirin is intensified with additional vitamins administration since the 4th day: aggregation inhibition lasting 5 days is noted in a dose of 5 mg/100 g of weight; antiaggregative effect of 10 mg dose of aspirin in combination with vitamin is higher than that of aspirin in a dose of 15 mg/100 g in animals without additional vitamin administration. Vitamins intensify antiaggregative effect of aspirin, prolongate its activity, increase hypocoaguloemia due to reduced releasing of thrombocytic factors 3 and 4 into plasma. Anticoagulative effect of vitamin combination examined is insufficient, however it potentiates aspirin antiaggregative effect. It is expedient to study vitamin combination influence on treating the diseases when thrombocyte aggregative activity increase does not take effect on pathologic process. So, administration of vitamin combination studied is likely to diminish thrombocyte aggregative activity to a level needed using lower aspirin doses.