What are the important risk factors for excessive daytime sleepiness in a population-based cohort?

Excessive daytime sleepiness (EDS) is a common complaint in the general population and is associated with cardiovascular disease and increased mortality. We aimed to investigate whether sleep duration is related to excessive daytime sleepiness in the general population, both in itself and in combination with other factors. We performed a cross-sectional analysis in the population-based Swedish CArdioPulmonary bioImage Study (SCAPIS) cohort (n = 27,976; 14,436 females; aged 50-64 years) to assess how sleep-related factors along with anthropometric, lifestyle, socioeconomic factors as well as somatic disease and psychological distress, were related with EDS assessed by the Epworth sleepiness scale (ESS).

The effect of sulthiame on potential biomarkers in moderate to severe obstructive sleep apnoea.

Background: Obstructive sleep apnoea (OSA) is a common disease with breathing disturbances during sleep. Sulthiame (STM), a carbonic anhydrase (CA) inhibitor, was recently shown to reduce OSA in a significant proportion of patients. CA activity and hypoxia-inducible factor (HIF)-1α are two potential biomarkers reported in severe OSA and hypoxia.

Obstructive sleep apnoea and lung function, and their association with nocturnal hypoxemia: results from the Swedish CArdioPulmonary bioimage Study (SCAPIS) - a cross-sectional study.

Unlabelled: Obstructive sleep apnoea (OSA) and its associations with lung function.

Background: OSA is highly prevalent and characterised by abnormal respiration during sleep. This large, population-based study aimed to investigate the associations between OSA and lung function in subjects aged 50-64 years.

Temporal and sleep stage-dependent agreement in manual scoring of respiratory events.

Obstructive sleep apnea diagnosis is based on the manual scoring of respiratory events. The agreement in the manual scoring of the respiratory events lacks an in-depth investigation as most of the previous studies reported only the apnea-hypopnea index or overall agreement, and not temporal, second-by-second or event subtype agreement. We hypothesized the temporal and subtype agreement to be low because the event duration or subtypes are not generally considered in current clinical practice.

The Swedish sleep apnea registry (SESAR) cohort - "Real world data" on a national level.

Introduction: The Swedish Sleep Apnea Registry (SESAR) collects clinical data from individual obstructive sleep apnea (OSA) patients since 2010. SESAR has recently been integrated with additional national healthcare data. The current analysis presents the SESAR structure and representative clinical data of a national sleep apnea cohort.

The influence of diabetes on sleep-derived cardiorespiratory features of the finger pulse wave signal - The population-based SCAPIS study.

Study Objectives: Advanced signal processing of photoplethysmographic data enables novel analyses which may improve the understanding of the pathogenesis of dysglycemia associated with sleep disorders. We aimed to identify sleep-related pulse wave characteristics in diabetic patients compared to normoglycemic individuals, independent of cardiovascular-related comorbidities.

Methods: This cross-sectional evaluation of the population-based Swedish CArdioPulmonary bioImage Study (SCAPIS) included overnight oximetry-derived pulse wave data from 3997 subjects (45 % males, age 50-64 years).

Feasibility and usability of three consecutive nights with self-applied, home polysomnography.

In-laboratory polysomnography, the gold-standard for diagnosing sleep disorders, is resource-demanding and not conducive to multiple night evaluations. Ambulatory polysomnography, especially when self-applied, could be a viable alternative. This study aimed to assess the feasibility and reliability of self-applied polysomnography over three consecutive nights in untrained participants, assessing: technical success rate; comparing sleep diagnostic variables from single and multiple nights; and evaluating participants' subjective experience.

Dose-response of daridorexant in insomnia disorder: An analysis of Phase 2 and 3 studies.

Objective: Daridorexant is approved for the treatment of insomnia at two dose levels (25 and 50 mg). Dose-efficacy and -safety response relationships were evaluated using Phase 2 and 3 data.

Methods: Data (N = 2153) from one Phase 2 (daridorexant 5, 10, 25, 50 mg, placebo once daily for 1 month) and two Phase 3 studies (daridorexant 10 and 25 or 25 and 50 mg, placebo once daily for 3 months) were pooled.

Pulmonary function and atherosclerosis in the general population: causal associations and clinical implications.

Reduced lung function is associated with cardiovascular mortality, but the relationships with atherosclerosis are unclear. The population-based Swedish CArdioPulmonary BioImage study measured lung function, emphysema, coronary CT angiography, coronary calcium, carotid plaques and ankle-brachial index in 29,593 men and women aged 50-64 years. The results were confirmed using 2-sample Mendelian randomization.

Review and perspective on sleep-disordered breathing research and translation to clinics.

Sleep-disordered breathing, ranging from habitual snoring to severe obstructive sleep apnea, is a prevalent public health issue. Despite rising interest in sleep and awareness of sleep disorders, sleep research and diagnostic practices still rely on outdated metrics and laborious methods reducing the diagnostic capacity and preventing timely diagnosis and treatment. Consequently, a significant portion of individuals affected by sleep-disordered breathing remain undiagnosed or are misdiagnosed.

Blood pressure control in hypertensive sleep apnoea patients of the European Sleep Apnea Database cohort - effects of positive airway pressure and antihypertensive medication.

Aims: We analysed longitudinal blood pressure (BP) data from hypertensive obstructive sleep apnoea (OSA) patients in the European Sleep Apnea Database cohort. The study investigated the interaction between positive airway pressure (PAP)-induced BP change and antihypertensive treatment (AHT).

Methods And Results: Hypertensive patients with AHT [monotherapy/dual therapy = 1283/652, mean age 59.

Long-Term Efficacy and Safety of Pitolisant for Residual Sleepiness Due to OSA.

Background: In people with OSA, excessive daytime sleepiness is a prominent symptom and can persist despite adherence to CPAP, the first-line therapy for OSA. Pitolisant was effective in reducing daytime sleepiness in two 12-week randomized controlled trials (RCTs), one in patients adherent to CPAP (BF2.649 in Patients With OSA and Treated by CPAP But Still Complaining of EDS [HAROSA 1]) and the other in patients refusing or not tolerating CPAP (BF2.

Modification of Endotypic Traits in OSA by the Carbonic Anhydrase Inhibitor Sulthiame.

Background: The carbonic anhydrase inhibitor sulthiame reduces OSA severity, increases overnight oxygenation, and improves sleep quality. Insights into how sulthiame modulates OSA pathophysiologic features (endotypic traits) adds to our understanding of the breathing disorder itself, as well as the effects of carbonic anhydrases in respiratory regulation.

Research Question: How does sulthiame treatment modify endotypic traits in OSA?

Study Design And Methods: Per-protocol tertiary analysis of a randomized controlled trial with the inclusion criteria as follow: BMI, ≥ 20 to ≤ 35 kg/m; age, 18-75 years; apnea-hypopnea index (AHI) ≥ 15 events/h; Epworth sleepiness scale score, ≥ 6; as well as nonacceptance or nontolerance of positive airway pressure treatment.

Beneficial Effects of Early Intervention Telemedicine-based Follow-Up in Sleep Apnea: A Randomized Controlled Multicenter Trial.

Positive airway pressure (PAP) is standard treatment for obstructive sleep apnea. Telemedicine has been introduced for improved PAP follow-up. Our study aim was to evaluate the clinical utility of and patient satisfaction with PAP follow-up with an early intervention telemedical protocol.

Changes in cognitive function and daytime sleepiness in patients with chronic heart failure and Cheyne-Stokes respiration with adaptive servo ventilation treatment.

Study Objectives: Cheyne - Stokes respiration (CSR) is prevalent in patients with chronic heart failure (CHF). Adaptive Servo Ventilation (ASV) alleviates CSR and improves objective sleep quality. We investigated the effects of ASV on neurocognitive function in the symptomatic phenotype of patients with CSR and CHF.

Clinical characteristics and positive airway pressure adherence among elderly European sleep apnoea patients from the ESADA cohort.

Background: The prevalence of obstructive sleep apnoea (OSA) is growing as the population is ageing. However, data on the clinical characteristics of elderly patients with OSA and their adherence to positive airway pressure (PAP) treatment are scarce.

Methods: Data from 23 418 30-79-year-old OSA patients prospectively collected into the ESADA database during 2007-2019 were analysed.

The placebo effect in pharmacological treatment of obstructive sleep apnea, a systematic review and meta-analysis.

Objective: New drug treatments are under development in obstructive sleep apnea (OSA). The placebo effect is well recognized in various conditions, but its relevance in OSA is debated. In the current study we determined the influence of a placebo effect in studies of drug therapy in OSA.

National Knowledge-Driven Management of Obstructive Sleep Apnea-The Swedish Approach.

Introduction: This paper describes the development of "Swedish Guidelines for OSA treatment" and the underlying managed care process. The Apnea Hypopnea Index (AHI) is traditionally used as a single parameter for obstructive sleep apnea (OSA) severity classification, although poorly associated with symptomatology and outcome. We instead implement a novel matrix for shared treatment decisions based on available evidence.

Night-to-Night Variability of Polysomnography-Derived Physiologic Endotypic Traits in Patients With Moderate to Severe OSA.

Background: Emerging data suggest that determination of physiologic endotypic traits (eg, loop gain) may enable precision medicine in OSA.

Research Question: Does a single-night assessment of polysomnography-derived endotypic traits provide reliable estimates in moderate to severe OSA?

Study Design And Methods: Two consecutive in-lab polysomnography tests from a clinical trial (n = 67; male, 69%; mean ± SD age, 61 ± 10 years; apnea-hypopnea index [AHI] 53 ± 22 events/h) were used for the reliability analysis. Endotypic traits, reflecting upper airway collapsibility (ventilation at eupneic drive [V]), upper airway dilator muscle tone (ventilation at the arousal threshold [V]), loop gain (stability of ventilatory control, LG1), and arousal threshold (ArTh) were determined.