Prevalence of sleep disorders in the Turkish adult population epidemiology of sleep study

Sleep disorders constitute an important public health problem. Prevalence of sleep disorders in Turkish adult population was investigated in a nationwide representative sample of 5021 Turkish adults (2598 women and 2423 men, response rate: 91%) by an interviewer‐administered questionnaire. Insomnia was defined by the DSM‐IV criteria, habitual snoring and risk for sleep‐related breathing disorders (SDB) by the Berlin questionnaire, excessive daytime sleepiness (EDS) by the Epworth sleepiness scale score, and restless legs syndrome (RLS) by the complaints according to the International Restless Legs Syndrome Study Group criteria. Mean age of the participants was 40.7 ± 15.1 (range 18 to 90) years. Prevalence rates (men/women) were insomnia 15.3% (10.5%/20.2%; P < 0.001), high probability of SDB 13.7% (11.1%/20.2%; P < 0.001), EDS 5.4% (5.0%/5.7%; P: 0.09), RLS 5.2% (3.0%/7.3%; P < 0.001). Aging and female gender were associated with higher prevalence of sleep disorders except for habitual snoring. Prevalence rates of the sleep disorders among Turkish adults based on the widely used questionnaires were close to the lower end of the previous estimates reported from different parts of the world. These findings would help for the assessment of the health burden of sleep disorders and addressing the risk groups for planning and implementation of health care

The Effect of Adding Gender Item to Berlin Questionnaire in Determining Obstructive Sleep Apnea in Sleep Clinics

BACKGROUND AND AIM: We aimed to validate the Turkish version of Berlin Questionnaire (BQ) and developped a BQ-gender (BQ-G) form by adding gender component. We aimed to compare the two forms in defining patients with moderate to severe obstructive sleep apnea (OSA) in sleep clinics. METHODS: Four hundred and eighty five consecutive patients, refered to our sleep clinic for snoring, witnessed apnea and/or excessive daytime sleepiness were enrolled to the study. All patients underwent in-laboratory polysomnography (PSG). Patients with sleep efficiency less than 40% and total sleep time less than 4 hours, chronic anxiolitic/sedative drug usage, respiratory tract infection within past two weeks were excluded from the study. All the patients fulfilled BQ. The test and retest for BQ were applied in 15-day interval in 30 patients. RESULTS: Totally 433 patients were enrolled to the study (285 male, 148 female). The mean age of the patients was 47,5 +/- 10.5 (21-79). 180 patients (41.6%) had apnea-hypopnea index (AHI) 15. The. value was 48-94 and the the truth value was 69-94% for the test-retest procedure. Sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV), and area under the curve AUC were 84.2%, 31.7%, 48.7%, 63.4%, and 0.579 in order for BQ and 79.9 %, 51.7%, 63.2%, 69.6%, and 0.652 for BQ-G. CONCLUSION: The results showed that BQ-G is relatively better than BQ in determining moderate to severe OSA in sleep clinics where most of the patients are sleep apneic but both of the tests were found to have insufficient validities in defining moderate to severe OSA in sleep clinics.Wo

Clinical, Laboratory And Computed Tomography Pulmonary Angiography Results In Pulmonary Embolism: Retrospective Evaluation Of 205 Patients

Objective: With this study, we aimed at evaluating demographic data, clinical, laboratory findings in pulmonary embolism (PE) and the relationship of these findings with the embolism location region and responses of the patients to the treatment of the embolism in order to contribute to the patient management in decreasing mortality. Methods: Clinical findings, accompanying diseases, risk factors, serum D-dimer and creatinine levels, imaging modalities and mortality rates of 205 patients (female: 98, male: 107) diagnosed with PE were examined retrospectively. The relationship between the qualifier variables was evaluated using Chi-square test. Results: Average age of the patients was 61.55 +/- 14.44 years and 86 (42%) patients were above 65 years. Most common complaint was dyspnea (85%), most frequent coexisting disease was congestive heart failure (19%). Deep vein thrombosis (DVT) (30.7%) was the most frequently seen risk factor. Pulmonary embolism was mostly in the right lobe pulmonary artery (32.1%). It was observed that the higher ages of patients the more frequency of proximal located embolism was (p<0.005), especially lobar artery involvement was observed to be high (p=0.032). An early mortality rate was 4.9% and late mortality rate was 11.2%. Conclusion: In the patients with complaint of dyspnea who are at elder ages and have accompanying diseases, PE should be considered. PE is generally localized in the main pulmonary arteries, which emphasizes crucial importance of early diagnosis and treatment in reduction of mortality. (Anadolu Kardiyol Derg 2012; 12: 142-9)WoSScopu

The Quantitative Analysis of Uvulopalatal Flap Surgery

Objective: In this work, a new methodology based on signal processing techniques for the quantitative analysis of uvulopalatal flap surgery is proposed. Clinical assessment studies of uvulopalatal flap surgery are based on not only the physician's examination, but also the patient's subjective feedback. Quantitative and objective evaluation studies are still lacking in the literature. Materials and Methods: Full night sleep records were analyzed for 21 patients before and after the surgery. The proposed algorithm consists of two independent parts. In the first part, the heart rate variability and complexity of the electrocardiogram were calculated. The second part includes calculating the electroencephalogram sub-band energy. Afterwards, the statistical methods were applied in order to determine the correlation of clinical and experimental parameters. Results: The low frequency/high frequency ratio and the sub-band energy of beta wave were significant for the patients having low postoperative delta sleep duration. Moreover, the sub-band energies of both alpha and beta waves, and theta wave were significant for the patients who had high post-operative delta sleep duration and blood oxygen saturation (SaO(2))-parameter. Complexity was significant for the patients with low postoperative respiratory disturbance index and SaO(2) parameter, and respiratory disturbance is correlated with snoring index. Conclusion: Respiratory disturbance index, which is not significant according to the pre- and post-operative clinical findings, was found to be directly related to the complexity feature. The most important result of this work is that the pre-operative complexity feature is correlated with respiratory disturbance and snoring index. This means that complexity feature can be a predictor prior to surgery

Prevalence of insomnia and its clinical correlates in a general population in Turkey

AimThe prevalence of insomnia is influenced by environmental factors. This study aimed to investigate the prevalence of insomnia and its sociodemographic and clinical correlates in a general population-based survey in Turkey

Prevalence and associated factors of sleep-disordered breathing in the Turkish adult population

Sleep disordered breathing (SDB) represents a major public health problem. We investigated the risk of SDB and associated factors in the Turkish adult population. We collected data by an interviewer-administered questionnaire in a nationwide representative sample of 5021 adults (2598 women, 2423 men) with a mean age of 40.7 years (SD:15.1) in 2010. High risk of SDB was defined as the positive response to at least two of the three categories in the Berlin questionnaire (BQ). High risk of SDB was found in 13.7% (men: 11.1%, women: 20.2%). High risk of SDB prevalence was not significantly different between the genders in the analysis stratified for BMI categories. Female gender, older age, lower level of education and smoking in the past were associated with high risk of SDB in the logistic regression analysis models adjusting for age and gender. After the adjustment for age, gender, smoking, BMI and educational status, high risk of SDB, and BQ Category 2 score were associated with previous hospitalization and cardiovascular diseases. Risk due to BQ Category 1 and BQ Category 2 was more than additive in the models for hypertension and heart disease for the age groups 4565 years and 65 years and over. Higher prevalence of SDB and obesity among women in our population should be addressed in further studies. Association between high risk of SDB and cardiovascular diseases, if confirmed, indicates the public health importance of screening for SDB symptoms

The Relationship Between The Physical Activity Level And Fatigue Perception, Quality Of Life And Psychological Status In Patients With Obstructive Sleep Apnea Syndrome

Objective: Currently, there is a need for research that examines factors which affect physical activity (PA) participation in Obstructive Sleep Apnea syndrome (OSAS) patients. The purpose of this study was to investigate the relationship between the PA level and daytime sleepiness, fatigue perception, quality of life, and psychological status in patients with OSAS. Materials and Methods: This cross-sectional study involved 38 patients with OSAS between the ages of 30-60 years. The PA level was determined using the Turkish version of the International Physical Activity Questionnaire (IPAQ). Quality of life was evaluated by the Functional Outcomes of Sleep Questionnaire and Nottingham Health Profile (NHP). The Epworth Sleepiness Scale (ESS) was used for evaluation of the sleepiness status. The fatigue perception of the patients was evaluated by the Fatigue Impact Scale (FIS) and the Fatigue Severity Scale (FSS). Results: According to IPAQ classification, 44.7% of patients were inactive. A marked correlation was observed between IPAQ-total score with ESS score (r =-0.493, p=0.002), Hospital Anxiety and Depression Scale-Anxiety score (r=-0.338, p=0.041), NHP-social isolation score (r=-0.406, p=0.013), FIS-physical score (r=-0.404, p=0.013), and FIS-psychosocial score (r=-0.411, p=0.01 2). Conclusion: This study showed that the total amount of PA in patients with OSAS is closely related to excessive daytime sleepiness, anxiety level, social isolation and effects of fatigue on physical and psychosocial functions.Wo

Absenteeism And Delay To Work Due To Sleep Disorders In The Turkish Adult Population: A Questionnaire-Based National Survey

Sleep problems may have negative effects on work-life balance, overall health, and safety. We aimed to investigate the association between sleep disorders and absenteeism and delay to work (being late or tardy) among the working adult population. The study was conducted by using data from a large survey of working adults who participated in the Turkish Adult Population Epidemiology of Sleep Study (TAPES) managed by Turkish Sleep Medicine Society (TSMS). Secondary analyses was employed to examine absenteeism and delay to work and their associations with sleep problems, including sleepiness by Epworth Sleepiness Scale (ESS), parasomnias, sleep apnea (by Berlin Questionnaire), sleep quality (by Pittsburgh Sleep Quality Index), and restless leg. History of any absenteeism and delay to work was observed in 276 (18%) and 443 (29%) out of 1,533 working adults, respectively. In the multivariate analyses, absenteeism was associated with younger age, female gender and poor sleep quality, while delay to work was associated with younger age, poor sleep quality, parasomnia, and sleepiness. In the presence of absenteeism and delay to work, sleep disorders including sleepiness, poor sleep quality, and parasomnia should be considered. Such evaluation may improve worker well-being and provide some additional benefits in terms of increasing productivity and lowering work-related costs.WoSScopu