Comparative analysis of sleep physiology using qualitative and quantitative criteria for insomnia symptoms.

Despite decades of research, defining insomnia remains challenging due to its complex and variable nature. Various diagnostic systems emphasize the chronic nature of insomnia and its impact on daily functioning, relying heavily on patient self-reporting due to limitations in objective measures like polysomnography (PSG). Discrepancies between subjective experiences and objective PSG results highlight the need for more nuanced approaches, such as electroencephalogram (EEG) spectral analysis, which reveals distinct patterns of high-frequency activity in individuals with insomnia.

Identifying Risk of Postoperative Cardiorespiratory Complications in OSA.

Background: Patients with OSA are at increased risk of postoperative cardiorespiratory complications and death. Attempts to stratify this risk have been inadequate, and predictors from large, well-characterized cohort studies are needed.

Research Question: What is the relationship between OSA severity, defined by various polysomnography-derived metrics, and risk of postoperative cardiorespiratory complications or death, and which metrics best identify such risk?

Study Design And Methods: In this cohort study, 6,770 consecutive patients who underwent diagnostic polysomnography for possible OSA and a procedure involving general anesthesia within a period of 2 years before and at least 5 years after polysomnography.

Polysomnographic characteristics of excessive daytime sleepiness phenotypes in obstructive sleep apnea: results from the international sleep apnea global interdisciplinary consortium.

Study Objectives: Excessive daytime sleepiness (EDS) is a major symptom of obstructive sleep apnea (OSA). Traditional polysomnographic (PSG) measures only partially explain EDS in OSA. This study analyzed traditional and novel PSG characteristics of two different measures of EDS among patients with OSA.

The interrelationships between sleep regularity, obstructive sleep apnea, and hypertension in a middle-aged community population.

Study Objectives: Little is known about the interrelationships between sleep regularity, obstructive sleep apnea (OSA) and important health markers. This study examined whether irregular sleep is associated with OSA and hypertension, and if this modifies the known association between OSA and hypertension.

Methods: Six hundred and two adults (age mean(SD) = 56.

Sleep apnea multi-level surgery trial: long-term observational outcomes.

Study Objectives: The sleep apnea multi-level surgery (SAMS) randomized clinical trial showed surgery improved outcomes at 6 months compared to ongoing medical management in patients with moderate or severe obstructive sleep apnea (OSA) who failed continuous positive airway pressure therapy. This study reports the long-term outcomes of the multi-level surgery as a case series.

Methods: Surgical participants were reassessed >2 years postoperatively with the same outcomes reported in the main SAMS trial.

Estimating sleep duration: performance of open-source processing of actigraphy compared to in-laboratory polysomnography in the community.

Comparisons of actigraphy findings between studies are challenging given differences between brand-specific algorithms. This issue may be minimized by using open-source algorithms. However, the accuracy of actigraphy-derived sleep parameters processed in open-source software needs to be assessed against polysomnography (PSG).

Breathlessness with Pleural Effusion: What Do We Know?

Breathlessness is the most common symptom in individuals with pleural effusion and is often disabling. The pathophysiology of breathlessness associated with pleural effusion is complex. The severity of breathlessness correlates weakly with the size of the effusion.

Does OSA Increase Risk for Cancer?: A Large Historical Sleep Clinic Cohort Study.

Background: The relationship between OSA and cancer is unclear.

Research Question: What is the association between OSA and cancer prevalence and incidence in a large Western Australian sleep clinic cohort (N = 20,289)?

Study Design And Methods: OSA severity was defined by apnea-hypopnea index (AHI) and nocturnal hypoxemia (duration and percentage at oxygen saturation < 90%) measured by in-laboratory polysomnogram. Measures of potential confounding included age, sex, BMI, smoking status, socioeconomic status, and BP.

Facial and Intraoral Photographic Traits Related to Sleep Apnea in a Clinical Sample with Genetic Ancestry Analysis.

Craniofacial and pharyngeal morphology influences risk for obstructive sleep apnea (OSA). Quantitative photography provides phenotypic information about these anatomical factors and is feasible in large samples. However, whether associations between morphology and OSA severity differ among populations is unknown.

Effect of empagliflozin in patients with type 2 diabetes during Ramadan on volume status, ketonaemia, and hypoglycaemia.

Background And Aims: Patients with type 2 diabetes (T2D) carry higher risk of glycaemic variability during Ramadan. Glucose-lowering medications such as SGLT2 inhibitors are also associated with genitourinary infection, acute kidney injury, and euglycaemic diabetic ketoacidosis. Limited data is available on the effects of SGLT2 inhibitors on T2D patients during Ramadan.

Estimating the mineral density of trabecular bone using Compton scattering.

This study proposes a technique based on Compton scattering to estimate trabecular bone mineral density (TBMD), which is important for understanding bone strength, and hence, is pivotal for estimating the condition of the bone. Bone phantoms (a mixture of paraffin wax and bone powder) with various concentrations of bone ash were prepared to simulate the trabecular bone. These samples were exposed to primary gamma photon flux from aCs (222 GBq) radioisotope source one after the other, and the scattered photon flux was detected using an NaI(Tl) detector.

Cross-sectional interrelationships between chronotype, obstructive sleep apnea and blood pressure in a middle-aged community cohort.

Chronotype is linked to adverse health measures and may have important associations with obstructive sleep apnea and blood pressure, but data are limited. This study aimed to determine the separate and combined associations of chronotype with obstructive sleep apnea and blood pressure in a middle-aged community population. Adults (n = 811) from the Raine Study (female = 59.

Telemedicine compared to standard face-to-face care for continuous positive airway pressure treatment: real-world Australian experience.

Study Objectives: We tested a telemedicine model of care to initiate continuous positive airway pressure (CPAP) for patients with obstructive sleep apnea (OSA) living in remote Western Australia.

Methods: A prospective study comparing telemedicine for CPAP initiation in a remote population versus standard face-to-face CPAP initiation in a metropolitan population. The primary outcome was average nightly CPAP use in the final week of a CPAP trial.

Ipsilateral and contralateral hemidiaphragm dynamics in symptomatic pleural effusion: The 2nd PLeural Effusion And Symptom Evaluation (PLEASE-2) Study.

Background And Objective: The pathophysiology of breathlessness in pleural effusion is unclear. In the PLEASE-1 study, abnormal ipsilateral hemidiaphragm shape and movement, assessed qualitatively, were independently associated with breathlessness relief after pleural drainage. Effects of pleural effusion on contralateral hemidiaphragm function are unknown.

Isolated diaphragm weakness and the diagnostic value of phrenic nerve stimulation.

Acute onset, atraumatic, bilateral diaphragm paralysis due to isolated bilateral phrenic neuropathy is uncommon. Respiratory physicians should be alert to this disorder because it is associated with considerable morbidity and diagnosis is often delayed. These case reports highlight important aspects of the presentation, investigations and management of this disorder.

The changing profile of obstructive sleep apnea: long term trends in characteristics of patients presenting for diagnostic polysomnography.

Introduction: We aimed to analyze long-term trends in characteristics of patients undergoing diagnostic polysomnography (PSG) and subsequently diagnosed with obstructive sleep apnea (OSA) to inform delivery of sleep services.

Material And Methods: We studied 24,510 consecutive patients undergoing PSG at a tertiary-care sleep service between 1989 and 2013. OSA was defined by an apnea hypopnea index (AHI)≥ 5 events/hour.

Circulating C-reactive protein levels in patients with suspected obstructive sleep apnea.

Study Objectives: To assess determinants of C-reactive protein (CRP) in a cohort of patients referred for investigation of obstructive sleep apnea (OSA) and to determine whether the overlap of OSA and chronic obstructive pulmonary disease (overlap syndrome) is associated with higher levels of CRP.

Methods: This was a cross-sectional study that included 2,352 patients seen at the West Australian Sleep Disorders Research Institute between 2006 and 2010. All patients had circulating CRP levels measured and spirometry performed.