Comparison of prevalence rates of restless legs syndrome, self-assessed risks of obstructive sleep apnea, and daytime sleepiness among patients with multiple sclerosis (MS), clinically isolated syndrome (CIS) and Neuromyelitis Optica Spectrum Disorder (NMOSD)

Prevalence rates for restless legs syndrome (RLS) and risk of Obstructive Sleep Apnea (OSA) in individuals with Neuromyelitis Optica Spectrum Disorder (NMOSD) and Clinically Isolated Syndrome (CIS) are unknown. The aims of the present study were to assess symptoms of RLS and self-assessed risks of OSA in individuals with NMOSD and CIS, to compare these prevalence rates with those of persons with multiple sclerosis (MS), and to associate RLS and OSA with expanded disability status scale (EDSS) scores, daytime sleepiness, fatigue, paresthesia, and medication.; A total of 495 individuals (mean age = 34.92 years, 84.9% females) were assessed. Of these, 24 had NMOSD, 112 had CIS and 359 had MS. Trained neurologists ascertained individuals' neurological diagnoses, assessed their EDSS scores, and conducted a clinical interview to assess RLS. Additionally, participants completed questionnaires covering sociodemographic information, risks of snoring and OSA, daytime sleepiness, fatigue, paresthesia and medication.; Prevalence rates of RLS were 45.8% in NMOSD, 41.1% in CIS, and 28.7% in MS. Prevalence rates of self-assessed risks of OSA were 8.3% in NMOSD, 7.7% in CIS, and 7.8% in MS; these rates were not significantly different. Across the entire sample and within the diagnostic groups, RLS and OSA scores were unrelated to EDSS, daytime sleepiness, fatigue or medication.; Individuals with NMOSD, CIS and MS have high prevalence rates for RLS and self-assessed risks of obstructive sleep apnea syndrome (OSAS), which are unrelated to EDSS, daytime sleepiness, fatigue, paresthesia, or medication. Sleep issues should be monitored during routine check-ups for individuals with NMOSD and CIS

Prevalence of Respiratory Disorders during Sleep among Subjects of Methadone Maintenance Therapy Program

Background: Respiratory disorders during sleep are considered a health problem affecting the life quality. There is some evidence indicating the higher prevalence of apnea in substance-dependent patients. However, there is no information on the prevalence of the disease in people under methadone maintenance therapy (MMT). Therefore, the present study was designed to estimate the disease rate in these patients and consider the relationship of the increasing risk of apnea with some psychiatric problems.Methods: Study group included 152 individuals under the MMT program. Baseline data were collected with the interview, and patients were considered using the STOP-BANG questionnaire to evaluate the risk of apnea. Furthermore, Epworth Sleepiness Scale (ESS), Fatigue Severity Scale (FSS), Hamilton Anxiety Rating Scale (HAM-A), and Hamilton Depression Rating Scale (HDRS) tests were performed for all participants. Data were analyzed using SPSS software.Findings: Based on the STOP-BANG score categories, 37.5%, 40.1%, and 22.4% of patients indicated low, intermediate, and high risk of apnea, respectively. Moreover, severe daytime sleepiness, fatigue, depression, and anxiety were observed in 5.3%, 5.5%, 6.0%, and 21.1% of participants, respectively. Sex (P = 0.007) and daytime sleepiness (P = 0.048) were significantly different between low and high-risk groups of apnea after adjustment. Besides, age (P < 0.001) and fatigue (P = 0.007) were factors predicting the STOP-BANG score.Conclusion: These findings revealed the higher prevalence of apnea in MMT patients compared to the general population of Iran and rising of the risk of apnea along with an increase in age and fatigue score. However, attention to the sleep disorders in MMT is a prominent factor that should be considered as a route of therapy

Italian Association of Sleep Medicine (AIMS) position statement and guideline on the treatment of menopausal sleep disorders

Insomnia, vasomotor symptoms (VMS) and depression often co-occur after the menopause, with consequent health problems and reductions in quality of life. The aim of this position statement is to provide evidence-based advice on the management of postmenopausal sleep disorders derived from a systematic review of the literature. The latter yielded results on VMS, insomnia, circadian rhythm disorders, obstructive sleep apnea (OSA) and restless leg syndrome (RLS). Overall, the studies show that menopausal hormone therapy (MHT) improves VMS, insomnia, and mood. Several antidepressants can improve insomnia, either on their own or in association with MHT; these include selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), and mirtazapine. Long-term benefits for postmenopausal insomnia may also be achieved with non-drug strategies such as cognitive behavioral therapy (CBT) and aerobic exercise. Continuous positive airway pressure (CPAP) and mandibular advancement devices (MADs) both reduce blood pressure and cortisol levels in postmenopausal women suffering from OSA. However, the data regarding MHT on postmenopausal restless legs syndrome are conflicting

Association of sleep quality with body fat mass and metabolic factors in Iranian adults in 2020

Background: Poor sleep quality is increasingly recognized as a risk factor for poor health outcomes such as obesity, diabetes and cardiovascular diseases. This study aimed to investigate the association between sleep quality, obesity and glycemic and lipid profiles in Iranian adults in 2020.Methods: 353 adults aged 18-60 years from community centers in Tehran municipality took apart in this cross-sectional study by convenience sampling. Information on anthropometric measurements, physical activity and dietary intake were collected. Sleep quality was assessed through Pittsburgh Sleep Quality Index. Body composition was measured through BIA method. Auto analyzer was used to measure fasting blood sugar (FBS)and lipid profile and ELISA method was used to measure Insulin.Results: The mean age was 42.92±11.34 and 39.16±14.18 for women and men, respectively. Each one score increase in total sleep quality, was related to 0.1 cm increase in waist circumference and 0.3 % increase in body fat percent (P <0.05). BMI had a positive correlation with subscales of “sleep disturbances” and “use of sleep medication” (P <0.001). Physical activity had a significant negative correlation with subscales of “subjective sleep quality” and “sleep latency”. FBS and triglyceride had positive correlation with “sleep latency” and “Subjective sleep quality”, respectively (P <0.05).Conclusion: Some determinants of sleep quality are associated with obesity, disorders of glucose and triglyceride metabolism and low level of physical activity.Keywords: Sleep quality; PSQI questionnaire; Body fat mass; Fasting Blood Sugar; Lipid profil

Ethical Considerations in Research and Medical Care of Menopause

Menopause is the permanent cessation of menstruation, and among the main symptoms reported have been night sweats, heat waves, increased body fat at the central level, dyslipidemia, hypertension, osteoporosis, insulin resistance, diabetes, mild cognitive impairment, depression, periodontitis, varicose veins, apnea, urinary genital discomfort, as well as dryness in the mouth and eye. The diagnosis, study, and care of menopausal or postmenopausal women have had great advances, such as recognizing the sub-inclusion of women and female animal models in basic and clinical studies and proposing in the same design of the study the analysis by sex. Subsequently, the need for specialized ethical training was identified, beginning in undergraduate, postgraduate, and clinical practice. To achieve this, several actions were carried out, such as the foundation of Women’s Health Institutes, the implementation of the Institutional and Private Committees of Ethic, and the development of validated instruments to evaluate signs and symptoms. Currently, there is no consensus that meets the ethical requirements for care and research in these patients. Efforts have been made practically by pathology, without considering together the social and psychobiological condition. What is intended in this document is to present the ethical aspects related to the study and medical care of women in menopause

Sex Differences in the Effects of COPD on Incidence and Outcomes of Patients Hospitalized with ST and Non-ST Elevation Myocardial Infarction: A Population-Based Matched-Pair Analysis in Spain (2016–2018)

We aimed to compare the incidence, clinical characteristics, and outcomes of patients admitted with myocardial infarction (MI), whether ST elevation MI (STEMI) or non-ST elevation MI (NSTEMI), according to the presence of chronic obstructive pulmonary disease (COPD), and to identify variables associated with in-hospital mortality (IHM). We selected all patients with MI (aged ≥40 years) included in the Spanish National Hospital Discharge Database (2016–2018). We matched each patient suffering COPD with a non-COPD patient with identical age, sex, type of MI, and year of hospitalization. We identified 109,759 men and 44,589 women with MI. The MI incidence was higher in COPD patients (incident rate ratio (IRR) 1.32; 95% confidence interval (CI) 1.29–1.35). Men with COPD had higher incidence of STEMI and NSTEMI than women with COPD. After matching, COPD men had a higher IHM than non-COPD men, but no differences were found among women. The probability of dying was higher among COPD men with STEMI in comparison with NSTEMI (odds ratio (OR) 2.33; 95% CI 1.96–2.77), with this risk being higher among COPD women (OR 2.63; 95% CI 1.75–3.95). Suffering COPD increased the IHM after an MI in men (OR 1.14; 95% CI 1.03–1.27), but no differences were found in women. COPD women had a higher IHM than men (OR 1.19; 95% CI 1.01–1.39). We conclude that MI incidence was higher in COPD patients. IHM was higher in COPD men than in those without COPD, but no differences were found among women. Among COPD patients, STEMI was more lethal than NSTEMI. Suffering COPD increased the IHM after MI among men. Women with COPD had a significantly higher probability of dying in the hospital than COPD men

Medical factors affecting the quality of life among cardiac patients

Many factors affect the quality of life of cardiac patients. Medical factors are very important in this respect. Hence, this review aimed to systematically assess recent studies on the medical factors influencing the quality of life in cardiac patients, broadening its focus to encompass all cardiac and cardiovascular diseases. Papers relevant to the review topic were identified from Google Scholar using the review topic itself as the search term. The identified papers were screened for a set of exclusion criteria using the PRISMA process to select the targeted 25 papers. They were described and discussed to conclude. A spreadsheet with the relevant details was prepared and used to extract some quantitative trends that were useful for discussions. It was found that nearly all other chronic conditions have been linked to a diminished quality of life in these patients. However, few papers specifically addressed medical factors associated with quality of life. As a result, some studies relied on medical conditions noted in baseline data, while others referenced these conditions to elucidate findings related to quality of life. In certain instances, cardiac or cardiovascular issues were just one part of the analysis, with medical factors impacting the quality of life for all patients being analysed separately. A significant limitation identified in 11 of the studies was the deficiencies in research design, which future researchers should consider carefully. Most studies depended on self-reported data gathered through surveys. The authors could have leveraged the vast amounts of data available from healthcare facilities and analysed it using big data analytics or machine learning techniques; however, no studies utilising these methods were found. Only three of the examined papers employed randomised controlled trials, with a clear preference for surveys and qualitative reviews

Sleep-Related Problems, Sleep-Related Distress, and Sleep-Related Functional Status Among Adult Inpatients Receiving Palliative Care

Palliative care patients may be at a higher risk for sleep-related problems and their negative effects compared to the general population, yet limited sleep research has been done with this population. The purpose of this dissertation was to determine prevalence rates for excessive sleepiness, insomnia, restless legs syndrome (RLS), and high risk for sleep apnea (HRSA); examine relationships between the aforementioned sleep-related problems, sleep-related distress (SD), and sleep-related functional status (SFS); and to determine which sleep-related problem measures along with age and gender predicted SD and SFS among a sample of adult palliative care inpatients. Secondary aims were to understand causes of SD and find out participant willingness to accept inconveniences/risks to alleviate SD. Participants (N = 38) were recruited from an urban, academic medical center in Virginia and asked to participate in an interview and complete sleep-related instruments. Measures included the STOP-Bang Questionnaire (STOP-Bang) for HRSA, Epworth Sleepiness Scale (ESS), Insomnia Severity Index (ISI), 2012 International Restless Legs Syndrome Study Group (IRLSSG) revised consensus diagnostic criteria, Sleep-Related Distress Thermometer (SDT), and Functional Outcomes of Sleep Questionnaire – 10 (FOSQ-10) for SFS. Prevalence rates were 62% for insomnia (ISI score \u3e 7), 57% for HRSA (STOP-Bang score \u3e 2), 41% for excessive sleepiness (ESS score \u3e 10), and 14% for RLS (met all IRLSSG criteria). Significant relationships (p \u3c 0.05) were found between insomnia and SD (Spearman’s ρ = 0.75, p \u3c 0.0001), and excessive sleepiness and SFS (Spearman’s ρ = -0.59, p = 0.0001). Based on regression models, ISI score was found to be a predictor of SD (F = 48.14, p \u3c 0.0001); and age, ISI score, and ESS score were found to be predictors of SFS (F = 10.85, p \u3c 0.0001). The most frequently reported causes of SD were anxiety/distressing thoughts (32%) and pain/physical discomfort (19%). Most participants expressed willingness to accept minimal risk interventions (97%), prescription medication (68%) and positive airway pressure therapy (57%) to alleviate SD. In conclusion, sleep-related problems were found to be common among the study sample, frequent causes of SD included anxiety/distressing thoughts and pain/physical discomfort, and the majority of participants were willing to accept the inconvenience of standard treatment options to alleviate SD. While associations were found between variables, due to limitations of the study including small sample size and uncertainty of the reliability/validity of the measures used with this population, more research is needed to better understand these relationships. Future research is also needed to establish tolerability and efficacy of interventions for sleep-related problems among palliative care inpatients