Sleep medicine catalogue of knowledge and skills – Revision

The 'catalogue of knowledge and skills' for sleep medicine presents the blueprint for a curriculum, a textbook, and an examination on sleep medicine. The first catalogue of knowledge and skills was presented by the European Sleep Research Society in 2014. It was developed following a formal Delphi procedure. A revised version was needed in order to incorporate changes that have occurred in the meantime in the International Classification of Sleep Disorders, updates in the manual for scoring sleep and associated events, and, most important, new knowledge in sleep physiology and pathophysiology. In addition, another major change can be observed in sleep medicine: a paradigm shift in sleep medicine has taken place. Sleep medicine is no longer a small interdisciplinary field in medicine. Sleep medicine has increased in terms of recognition and importance in medical care. Consequently, major medical fields (e.g. pneumology, cardiology, neurology, psychiatry, otorhinolaryngology, paediatrics) recognise that sleep disorders become a necessity for education and for diagnostic assessment in their discipline. This paradigm change is considered in the catalogue of knowledge and skills revision by the addition of new chapters

L’introduction des objets connectés en médecine

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Severe Central Sleep Apnea Associated With Chronic Baclofen Therapy

International audienc

ASSOCIATION BETWEEN OBSTRUCTIVE SLEEP APNEA SYMPTOMS AND INCIDENCE OF DE NOVO HYPERTENSION IN A LARGE FRENCH POPULATION-BASED EPIDEMIOLOGICAL COHORT

International audienceObjective: There is a strong association between Obstructive Sleep Apnea (OSA) and hypertension but the effects of OSA symptoms on the risk of incident hypertension in previously normotensive individuals are not well documented. The aim of this prospective cohort study was to examine whether OSA symptoms (snoring and sleepiness) are associated with the incidence of hypertension independently of confounding factors including body mass index. Design and method: Data from the French population-based CONSTANCES cohort were analyzed. Participants, aged 18 to 69 years, were included between 2012 and 2016, and screened for OSA in 2017 using the Berlin Questionnaire. Snoring and sleepiness were assessed from the questionnaire, and considered as severe when they were declared to occur at least three times a week. Individuals who had a history of treated OSA, cardiovascular diseases or hypertension (defined either by blood pressure of 140/90 mmHg or more at the inclusion visit, or by self-reported hypertension or antihypertensive drugs delivering until 2017) were excluded from these analyses. We used Cox models, adjusted for age, gender, smoking, alcohol consumption, physical activity, education level, household income and body mass index, to compute hazards ratios (HR) of incident treated hypertension (defined by antihypertensive drugs delivering through linkage to the National Health Data System (SNDS)) until December 2020. Results: Among 36,798 normotensive subjects, the prevalence of high risk of OSA according to Berlin questionnaire was 7.6% and the incidence of treated hypertension was 4.2%. Risk of de novo treated hypertension increased significantly in participants who declared symptoms of severe snoring (adjusted HR [95% CI] = 1.17 [1.04-1.31]), severe sleepiness after sleep (adjusted HR [95% CI] = 1.18 [1.03-1.36]) and severe sleepiness during waking time (adjusted HR [95% CI] = 1.40 [1.23-1.64]), and increased with the weekly frequency of these symptoms with a dose-dependent relationship (p for trend <0.005). Conclusions: Self-declared snoring and sleepiness are associated with an increased risk of developing de novo hypertension. Our results suggest that primary care patients should be routinely screened for these symptoms, not only to identify possible OSA, but also to encourage preventive measures and regular blood pressure monitoring

Effects of smoking on sleep architecture and ventilatory parameters including apneas: Results of the Tab-OSA study

Background: The interaction between smoking and sleep seems appears to be bidirectional, but few studies evaluated the impact of smoking and its cessation on objective sleep parameters. In this context, this new study aimed to assess the impact of smoking and its cessation on sleep architecture and on ventilatory sleep parameters, particularly the presence of sleep apnea syndrome (apnea-hypopnea index (AHI)≥15). Methods: Patients hospitalized for polysomnographic sleep exploration were compared according to their smoking status: active smokers (AS), former smokers (FS), non-smokers (NoNi). Psychiatric and non-psychiatric co-morbidities and treatment or substance use were taken into account in the analyses. Results: A total of 170 participants were included (N = 37 FS, 39 AS, 86 NoNi). A significant decrease in the mean nocturnal O2 saturation was observed for FS and AS compared to NoNi. No differences were found regarding AHI. Regarding sleep architecture, we observed a significant decrease in the slow wave sleep duration for AS compared to NoNi, and interestingly not between FS and NoNi. Conclusion: This study suggests that current smokers suffer from alterations in both sleep architecture and ventilatory parameters, the later appears to persist even after smoking cessation