ISRUC-Sleep: A comprehensive public dataset for sleep researchers.

To facilitate the performance comparison of new methods for sleep patterns analysis, datasets with quality content, publicly-available, are very important and useful. We introduce an open-access comprehensive sleep dataset, called ISRUC-Sleep. The data were obtained from human adults, including healthy subjects, subjects with sleep disorders, and subjects under the effect of sleep medication. Each recording was randomly selected between PSG recordings that were acquired by the Sleep Medicine Centre of the Hospital of Coimbra University (CHUC). The dataset comprises three groups of data: (1) data concerning 100 subjects, with one recording session per subject; (2) data gathered from 8 subjects; two recording sessions were performed per subject, and (3) data collected from one recording session related to 10 healthy subjects. The polysomnography (PSG) recordings, associated with each subject, were visually scored by two human experts. Comparing the existing sleep-related public datasets, ISRUC-Sleep provides data of a reasonable number of subjects with different characteristics such as: data useful for studies involving changes in the PSG signals over time; and data of healthy subjects useful for studies involving comparison of healthy subjects with the patients, suffering from sleep disorders. This dataset was created aiming to complement existing datasets by providing easy-to-apply data collection with some characteristics not covered yet. ISRUC-Sleep can be useful for analysis of new contributions: (i) in biomedical signal processing; (ii) in development of ASSC methods; and (iii) on sleep physiology studies. To evaluate and compare new contributions, which use this dataset as a benchmark, results of applying a subject-independent automatic sleep stage classification (ASSC) method on ISRUC-Sleep dataset are presented.

Effects of Acute Sleep Deprivation Resulting from Night Shift Work on Young Doctors.

INTRODUCTION: To evaluate sleep deprivation and its effects on young physicians in relation to concentration capacity and psychomotor performance. MATERIAL AND METHODS: Eighteen physicians aged 26 - 33 years were divided into 2 groups: non-sleep deprived group (with no night work) and sleep deprived group (minimum 12 hour of night work/week). We applied Pittsburgh Sleep Quality Index to screen the presence of sleep pathology and Epworth Sleepiness Scale to evaluate subjective daytime sleepiness; we used actigraphy and sleep diary to assess sleep hygiene and standard sleep-wake cycles. To demonstrate the effects of sleep deprivation, we applied Toulouse-Piéron's test (concentration test) and a battery of three reaction time tasks after the night duty. RESULTS: Sleep deprived group had higher daytime sleepiness on Epworth Sleepiness Scale (p < 0.05) and during week sleep deprivation was higher (p < 0.010). The mean duration of sleep during the period of night duty was 184.2 minutes to sleep deprived group and 397.7 minutes to non-sleep deprived group (p < 0.001). In the Toulouse-Piéron's test, the sleep deprived group had more omissions (p < 0.05) with a poorer result in concentration (p < 0.05). Psychomotor tests that evaluated response to simple stimuli revealed longer response latency (p < 0.05) and more errors (p < 0.05) in Sleep deprived group; in reaction to instruction test the sleep deprived group showed worse perfection index (p < 0.05); in the fine movements test there was no statistically significant difference between the groups. DISCUSSION: Acute sleep deprivation resulting from nocturnal work in medical professions is associated with a reduction in attention and concentration and delayed response to stimuli. This may compromise patient care as well as the physician's health and quality of life. CONCLUSION: It is essential to study the effects of acute sleep deprivation on the cognitive abilities and performance of health professionals.

Introdução: Avaliar a privação do sono e seus efeitos sobre os jovens médicos relativamente à capacidade de concentração e desempenho psicomotor. Material e Métodos: Dezoito médicos, com idades entre 26 - 33 anos, divididos em dois grupos: grupo sem privação de sono (sem trabalho nocturno) e grupo com privação de sono (no mínimo 12 horas de trabalho nocturno / semana). Aplicámos o Índice de Qualidade de Sono de Pittsburgh para rastrear a presença de patologia do sono e a Escala de Sonolência Epworth para avaliar subjectivamente a sonolência diurna; usamos actigrafia e o diário de sono para avaliar a higiene do sono e os ciclos de sono-vigília. Para demonstrar os efeitos da privação do sono, foi aplicado o teste de Toulouse-Piéron (teste de concentração) e uma bateria de trêstestes de tempo de reação após o período de trabalho nocturno. Resultados: O grupo com privação de sono apresentou maior sonolência diurna na Escala de Sonolência Epworth (p < 0,05) e durante a semana a privação de sono foi maior (p < 0,010). A duração média do sono durante o período de trabalho nocturno foi de 184,2 minutos para o grupo com privação de sono e 397,7 minutos para grupo sem privação de sono (p < 0,001). No teste Toulouse-Piéron o grupo com privação de sono apresentou maior número de omissões (p < 0,05) com um pior resultado no índice de concentração (p < 0,05). Os testes psicomotores que avaliaram a resposta a estímulos simples revelaram maior latência na resposta (p < 0,05) e mais erros (p < 0,05) no grupo com privação de sono; no teste de reacção a instrução o e grupo com privação de sono apresentou pior índice de perfeição (p < 0,05); no teste de movimentos finos não houve diferença estatisticamente significativa entre os grupos. Discussão: A privação de sono aguda resultante do trabalho nocturno em profissões médicas está associada a uma diminuição da atenção e concentração e no atraso de resposta a estímulos. Isto pode comprometer o atendimento ao paciente, bem como a saúde e a qualidade de vida do próprio médico. Conclusão: Ã essencial estudar os efeitos da privação aguda de sono sobre a capacidade cognitiva e de desempenho dos profissionais de saúde.

Clinical impact of adaptive servoventilation compared to other ventilatory modes in patients with treatment-emergent sleep apnea, central sleep apnea and Cheyne-Stokes respiration.

INTRODUCTION: Adaptive servoventilation is a recent ventilatory mode initially designed to treat Cheyne-Stokes respiration (CSR). Recently, the efficacy of ASV has been discussed for the treatment of central sleep apnea (CSA) and treatment-emergent central sleep apnea (treatment-emergent CSA) where other forms of traditional positive airway pressure (PAP) may be insufficient. OBJECTIVES: To compare the clinical impact of ASV with other forms of PAP in treating patients with treatment-emergent CSA, CSA and CSR. METHODS: Medical data of all the patients who underwent polysomnography (PSG) with ASV titration were evaluated. The patients were divided into two groups according to the mode of ventilation reimbursed: ASV and PAP (AutoCPAP/CPAP/BIPAP). All patients had a minimal follow-up of 6 months. Both groups were compared in terms of symptoms, apnea hypopnea index, compliance, cardiac function and cardiovascular events. RESULTS: ASV titration was performed in 33 patients (30M/3F) with a mean age of 69±8 years. The majority (58%) present a treatment-emergent SA and 42% a CSA and or CSR. The median initial diagnostic AHI was 46±22events/h. After the initial diagnosis, 28 patients were treated with PAP and 5 with servoventilation. All of the patients treated with PAP were posteriorly submitted to PSG and ASV titration because of suboptimal response to PAP. Despite a clear indication for ASV, due to differences in reimbursement, 15 patients continued treatment with PAP (12 with AutoCPAP, 1 with BIPAP and 2 with CPAP) and 16 changed to ASV. Two patients were lost in follow-up. In both groups, most of patients present a treatment-emergent SA (53% in ASV group vs. 67% in PAP group) or a CSA/CSR (29.4% in ASV group vs. 20% in PAP). After ASV titration, the mean follow-up was 25±14 months. Both groups (ASV vs. PAP) were similar in terms of compliance (77±23% vs.88±14%) and in terms of Epworth sleepiness scale score (6±5 vs. 7±5). There was a statistical difference in terms of residual AHI: mean AHI was 4±3 in ASV group and 9±3 in PAP group (P=0.005). We found no differences in terms of left ventricular fractional shortening (ASV 33±10% vs. PAP 32±10%). Although no difference was observed between the 2 groups in terms of non-fatal cardiovascular events (3 events in each group), 2 fatal cardiovascular events occurred in the PAP group (sudden death). CONCLUSIONS: These data confirm that ASV is an efficient treatment in patients with treatment-emergent CSA, CSA/CSR significantly decreasing residual AHI. In both groups, compliance rate was high and sleepiness improved. It is relevant that the 2 patients who died of sudden death were treated with PAP.

Apnea obstructiva del sueño refractaria al tratamiento por floppy epiglottis / Obstructive sleep apnea refractory to treatment due to floppy epiglottis

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Health-related quality of life in Portuguese patients with narcolepsy.

OBJECTIVE: To evaluate the perception of health-related quality of life (HRQoL) in Portuguese patients with narcolepsy, and to compare the results to normative data. METHODS: Fifty-one narcoleptic adults (26M, 25F), aged between 18 and 80 years (mean=43.35, SD=15.32), were included in the final analysis of a multicentric cross-sectional study. The Medical Outcome Study--36 Item Short-Form Survey (SF-36) was used to assess quality of life, and the Beck Depression Inventory (BDI) was used for self-assessment of depression. RESULTS: Several HRQoL domains were significantly lower than National surveys, except physical function and bodily pain (p between 0.000 and 0.006). SF-36 presented the lowest score in vitality (39.93). Deterioration was significantly higher in role physical (p=0.006), vitality (p=0.011), and mental health (p=0.008) in women, and in physical function (p=0.003) and bodily pain (p=0.045) in elderly subjects. Those with higher literacy had better physical function (p=0.046). CONCLUSION: HRQoL is significantly deteriorated in narcoleptics, affecting all dimensions (except physical function and bodily pain) when compared with the general Portuguese population. The results are consistent with studies of narcolepsy in other countries in demonstrating the profound impact of this disorder on quality of life.