Sleep-disordered breathing was associated with lower health-related quality of life and cognitive function in a cross-sectional study of older adults

BACKGROUND AND OBJECTIVE: The clinical significance of sleep‐disordered breathing (SDB) in older age is uncertain. This study determined the prevalence and associations of SDB with mood, daytime sleepiness, quality of life (QOL) and cognition in a relatively healthy older Australian cohort. METHODS: A cross‐sectional analysis was conducted from the Study of Neurocognitive Outcomes, Radiological and retinal Effects of Aspirin in Sleep Apnoea. Participants completed an unattended limited channel sleep study to measure the oxygen desaturation index (ODI) to define mild (ODI 5–15) and moderate/severe (ODI ≥ 15) SDB, the Centre for Epidemiological Studies Scale, the Epworth Sleepiness Scale, the 12‐item Short‐Form for QOL and neuropsychological tests. RESULTS: Of the 1399 participants (mean age 74.0 years), 36% (273 of 753) of men and 25% (164 of 646) of women had moderate/severe SDB. SDB was associated with lower physical health‐related QOL (mild SDB: beta coefficient [β] −2.5, 95% CI −3.6 to −1.3, p < 0.001; moderate/severe SDB: β −1.8, 95% CI −3.0 to −0.6, p = 0.005) and with lower global composite cognition (mild SDB: β −0.1, 95% CI −0.2 to 0.0, p = 0.022; moderate/severe SDB: β −0.1, 95% CI −0.2 to 0.0, p = 0.032) compared to no SDB. SDB was not associated with daytime sleepiness nor depression. CONCLUSION: SDB was associated with lower physical health‐related quality of life and cognitive function. Given the high prevalence of SDB in older age, assessing QOL and cognition may better delineate subgroups requiring further management, and provide useful treatment target measures for this age group

Constraining the Evolution of Zz Ceti

We report our analysis of the stability of pulsation periods in the DAV star (pulsating hydrogen atmosphere white dwarf) ZZ Ceti, also called R548. On the basis of observations that span 31 years, we conclude that the period 213.13 s observed in ZZ Ceti drifts at a rate dP/dt ≤ (5:5 ± 1:9) x 10-15 s s-1, after correcting for proper motion. Our results are consistent with previous Ṗ values for this mode and an improvement over them because of the larger time base. The characteristic stability timescale implied for the pulsation period is ⎸P / Ṗ ⎸=⎹≥ 1:2 Gyr, comparable to the theoretical cooling timescale for the star. Our current stability limit for the period 213.13 s is only slightly less than the present measurement for another DAV, G117-B15A, for the period 215.2 s, establishing this mode in ZZ Ceti as the second most stable optical clock known, comparable to atomic clocks and more stable than most pulsars. Constraining the cooling rate of ZZ Ceti aids theoretical evolutionary models and white dwarf cosmochronology. The drift rate of this clock is small enough that we can set interesting limits on reflex motion due to planetary companions

Effects of 1-month withdrawal of ventilatory support in hypercapnic myotonic dystrophy type 1

International audienceThe benefits of domiciliary non-invasive ventilation (NIV) in myotonic dystrophy type 1 (DM1) are unclear. We sought to determine the effects of elective discontinuation of ventilatory support for 1 month in DM1 patients receiving NIV for chronic hypercapnic respiratory failure. METHODS: At baseline, 12 patients underwent polysomnography, and assessment of subjective (Epworth Sleepiness Scale) and objective (Oxford Sleep Resistance Test) sleepiness, fatigue (Fatigue Severity Scale), respiratory function including muscle strength, arterial blood gas (ABG), hypercapnic ventilatory response (HCVR), Blood Pressure, peripheral arterial tonometry (PAT) and pulse wave velocity (PWV). They also completed the SF36. Testing was repeated (Visit 2) 1 month after elective cessation of NIV and again (Visit 3) 1 month after NIV reintroduction. RESULTS: No changes were seen in SF36, sleepiness or fatigue, respiratory function, muscle strength nor HCVR. Likewise, there were no changes in Blood Pressure, PAT or PWV. Mean nocturnal SpO2deteriorated off NIV and improved on resumption (mean \textpm SD = 95.02 \textpm 1.90%, 92.23 \textpm 3.61% and 95.08 \textpm 2.28%, P = 0.006 change Visit 1 to Visit 2, 0.009 Visit 2 to Visit 3). Daytime PaCO2(arterial partial pressure of carbon dioxide) was 43.13 \textpm 4.20 mm Hg, 46.28 \textpm 2.25 mm Hg and 43.87 \textpm 2.85 mm Hg, P = 0.056 and 0.017 over the same intervals. DM1 patients derive little benefit in symptoms or quality of life from NIV. Nocturnal and diurnal ventilatory functions deteriorate slightly off NIV for 1 month, but this does not appear to be due to changes in HCVR or respiratory function. HCVR changes may be of primary CNS origin given stability on or off NIV

Young Scientist Symposium. Preliminary investigations of the use of aromatherapy for treating mild to moderate insomnia

A sleep apnoea episode prediction system is presented that is based exclusively on the airflow signal. Detection of obstructive sleep apnoea (OSA) is generally carried out using polysomnography, with the data being analysed and a diagnosis formed. Being able to predict when a sleep apnoea episode is going to occur will allow for treatment to be applied before the episode becomes detrimental to the patient

The 2007 AASM Recommendations for EEG Electrode Placement in Polysomnography: Impact on Sleep and Cortical Arousal Scoring

STUDY OBJECTIVE: To examine the impact of using American Academy of Sleep Medicine (AASM) recommended EEG derivations (F4/M1, C4/M1, O2/M1) vs. a single derivation (C4/M1) in polysomnography (PSG) on the measurement of sleep and cortical arousals, including inter- and intra-observer variability. DESIGN: Prospective, non-blinded, randomized comparison. SETTING: Three Australian tertiary-care hospital clinical sleep laboratories. PATIENTS OR PARTICIPANTS: 30 PSGs from consecutive patients investigated for obstructive sleep apnea (OSA) during December 2007 and January 2008. INTERVENTIONS: N/A. MEASUREMENTS AND RESULTS: To examine the impact of EEG derivations on PSG summary statistics, 3 scorers from different Australian clinical sleep laboratories each scored separate sets of 10 PSGs twice, once using 3 EEG derivations and once using 1 EEG derivation. To examine the impact on inter- and intra-scorer reliability, all 3 scorers scored a subset of 10 PSGs 4 times, twice using each method. All PSGs were de-identified and scored in random order according to the 2007 AASM Manual for the Scoring of Sleep and Associated Events. Using 3 referential EEG derivations during PSG, as recommended in the AASM manual, instead of a single central EEG derivation, as originally suggested by Rechtschaffen and Kales (1968), resulted in a mean ± SE decrease in N1 sleep of 9.6 ± 3.9 min (P = 0.018) and an increase in N3 sleep of 10.6 ± 2.8 min (P = 0.001). No significant differences were observed for any other sleep or arousal scoring summary statistics; nor were any differences observed in inter-scorer or intra-scorer reliability for scoring sleep or cortical arousals. CONCLUSION: This study provides information for those changing practice to comply with the 2007 AASM recommendations for EEG placement in PSG, for those using portable devices that are unable to comply with the recommendations due to limited channel options, and for the development of future standards for PSG scoring and recording. As the use of multiple EEG derivations only led to small changes in the distribution of derived sleep stages and no significant differences in scoring reliability, this study calls into question the need to use multiple EEG derivations in clinical PSG as suggested in the AASM manual.Warren R. Ruehland, Fergal J. O’Donoghue, Robert J. Pierce, Andrew T. Thornton, Parmjit Singh, Janet M. Copland, Bronwyn Stevens, Peter D. Rochfor

Sleep hypoventilation in hypercapnic chronic obstructive pulmonary disease: prevalence and associated factors

146 WEST ST,STE 2.4, HUTTONS BLDG, SHEFFIELD, ENGLAND, S1 4E