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T-I-071 SHORT SLEEP AND DYSFUNCTIONAL BELIEFS AND ATTITUDES TOWARD SLEEP AMONG BLACK MEN
Abstracts of 4th International Congress of WASM & 5th Conference of CSS / Sleep Medicine 12, Suppl. 1 (2011) S1–S130
T-I-070
SEVERITY OF DEPRESSION AND ANXIETY IN OBSTRUCTIVE SLEEP APNEA SYNDROME
Fatemeh Mohammadi 1 , Alimohamad Asghari 2 , Seyed Kamran Kamrava 2 , Saman Tavakoli 3 . 1 Department & Research Center of Otolaryngology, Head and Neck Surgery, Hazrat Rasoul Akram Hospital, Tehran University of Medical Sciences, Tehran, Iran; 2 Assistant professor of otolaryngology, Department & Research Center of Otolaryngology, Head and Neck Surgery, Hazrat Rasoul Akram Hospital, Tehran University of Medical Sciences, Tehran, Iran; 3 Psychiatrist, Iran Introduction and Objectives: Obstructive sleep apnea (OSA) is a common sleep disorder which induces nocturnal hypoxemia, hypercapnia and sleep fragmentation. It subsequently results in excessive daytime sleepiness, mood problems, poor neurocognitive performance as well as serious organ system dysfunction. The aim of this study was to evaluate the severity of depression and anxiety symptoms as the most prevalent psychological disturbances present in different severity of OSA. Materials and Methods: We performed a cross-sectional study of 649 recently diagnosed sleep-disordered patients over 18 years of age, referred to Noor Sleep Lab from August 2008 to November 2010. The participants filled the Beck Depression Inventory-II (BDI-II) and the Beck Anxiety Inventory (BAI) to assess depressive and anxiety symptoms. We collected other characteristics of subjects such as age, sex, body mass index (BMI) and Epworth Sleepiness Scale (ESS). Apnea Hypopnea Index (AHI) was determined by an overnight polysomnography. Results: Mean age of the participants was 47.19 years (SD = 11.66). More than 40% of patients had normal levels of depression and anxiety. AHI showed no significant correlation with BDI or BAI (p>0.05). Obesity was not correlated with depression or anxiety (p>0.05). Nonetheless, ESS was weakly correlated with depression and anxiety scores (p=0.01, r2=0.11). BMI and ESS means were significantly higher in patients with severe OSA (p<0.05). In comparison with men, the severity of depressive and anxiety symptoms were significantly higher in women (p=0.000). Conclusion: In this cross- sectional study of patients with sleep problems, a majority of patients had normal to mild levels of depressive and anxiety symptoms and OSA was not associated with severity of these symptoms.
T-I-071
SHORT SLEEP AND DYSFUNCTIONAL BELIEFS AND ATTITUDES TOWARD SLEEP AMONG BLACK MEN
Abhishek Pandey, Dmitriy Gekhman, Prince Odigie, Girardin Jean-Louis. Brooklyn Health Disparities Center, Department of Medicine, SUNY Downstate Medical Center, Brooklyn, NY, United States, United States Introduction and Objectives: Barbershops are an ideal location for health screening and wellness promotion among black men. It is used successfully to screen for the presence of hypertension, diabetes, and prostate cancer. The present study assessed associations of short sleep with dysfunctional beliefs and attitudes toward sleep among black men in the barbershop. Materials and Methods: Respondents were black barbershop clients (n=120; mean age=42±15 years) in Brooklyn, NY. They provided sociodemographic data and estimated habitual sleep time. Apnea Risk Evaluation System (ARES) was used to identify men at high Obstructive Sleep Apnea (OSA) risk; recommended for populations with large pretest probability for OSA. Dysfunctional Beliefs & Attitudes about Sleep Scale (DBAS) was used to quantify strength of endorsed attitudes/beliefs toward sleep. DBAS is a Likert-type scale from 0 (strongly disagree) to 10 (strongly agree); higher scores indicated more dysfunctional attitudes/beliefs about sleep Results: Of the sample, 25% reported hypertension, 11%, diabetes, and 3%, heart disease; 68% were overweight/obese. They also reported caffeine intake (22%) and alcohol consumption (29%). Estimated rates of sleep-related problems were: nap=36%, DIS=23%, DMS=24%, and sleep medicine=6.2%. Rate of short sleep (≤6h) was 57%; 34% were satisfied with their sleep. ARES data showed 29% were at high OSA risk (cut-off: >5). The mean DBAS score was 4.26±1.99; log-transformed values were used in ANCOVA, adjusting for effects of age, BMI, HTN, DM, mood, and sleep variables. Short sleepers did not have greater DBAS scores than average sleepers (7-8h) [F1,92=0.89, NS]. Rather, men at high OSA risk had greater DBAS scores [F1,92=13.68, p<0.001] and tended to report greater rate of sleep dissatisfaction [36% vs. 21%, p=NS]. Conclusion: Findings suggest that ARES can be used to screen black men in the barbershop. That black men at high risk for OSA have dysfunc-
S77
tional beliefs about sleep might explain low adherence rates to physicianrecommended sleep assessment in that population. Acknowledgements: Brooklyn Health Disparities Center, Department of Medicine, SUNY Downstate Medical Center, Brooklyn, NY, United States
T-I-072
SLEEP APNEA ANIMAL MODEL ELEVATES BRAIN WATER CONTENT AND DECREASES AQP 1 IN MOUSE CEREBELLUM
Diego Baronio. UFRGS, Brazil Introduction and Objectives: Patients with sleep apnea syndrome exhibit cerebral morphological changes. Aquaporins are membrane proteins responsible for the transport and the balance of water content in the brain. Changes in aquaporin 1 expression in the cerebellum have been reported in pregnancy. Little attention has been dedicated to the role of aquaporins in sleep apnea-related brain alterations. The present study aims to quantify aquaporin 1 levels in mouse hippocampus and cerebellum as well as to determine the brain water content. Materials and Methods: We exposed C57BL/6 mice to 35 days of intermittent hypoxia (IH; n=17) or sham intermittent hypoxia (SIH; n=18), alternating 30 seconds of progressive hypoxia to a nadir of 6% FIO2 with 30 seconds of room air insuflation. During 8 hours of the light period, the rodents underwent a total of 480 cycles of hypoxia/reoxygenation, equivalent to an apnea index of 60/hour. Brains of 6 HI and 6 SHI animals were dissected, weighted while wet and placed in an oven at 95°C during 48 hours. Percent brain water content was calculated. Levels of aquaporin 1 were measured using an ELISA test. Results: The mean brain wet weight and brain water content were higher in the IH group (respectively 0.48±0.004 g and 79.7±0.11%) than the SIH group (respectively 0.46±0.008 g and 76.8±0.52%; p<0.01). The average aquaporin 1 level in the cerebellum was higher in the SIH group (4.5±0.79 ng/mL) than in the IH group (3.9±0.48 ng/m; p=0.01). No significant difference was found between the two groups for the aquaporin 1 in the hippocampus. Conclusion: Exposure to intermittent hypoxia during 35 days in a mice model of sleep apnea increases wet weight and water content of the brain while reducing cerebellar aquaporin 1 levels. The relationship between sleep apnea and central nervous system structural alterations may involve downregulation of aquaporin 1 activity. Acknowledgements: Medical Sciences Graduated Program - UFRGS and research incentive fund (FIPE- Hospital de Clínicas de Porto Alegre).
T-I-073
SLEEP DISORDERED BREATHING AND SHIFT WORK: ASSOCIATION WITH IMPAIRED GLUCOSE METABOLISM
Juan Carrillo, Gisella Arellano, Jacqueline Peters, Mariana Dastres, Claudio Morales, Jecar Neghme. Felix Bulnes Clinical Hospital, Chile Introduction and Objectives: Obesity and diabetes are epidemic diseases with increasing rates around the world. Sleep disordered breathing (SDB) are also a public health problem due to its high prevalence and association with obesity, metabolic and cardiovascular diseases. The severity of obstructive sleep apnea has been associated with the degree of insulin resistance. Shift work (SW) has been also related with alterations in lipid and glucose metabolism. Our aim was to assess the effects of the combination of SDB and SW on glucose metabolism. Materials and Methods: We conducted a cross sectional study as part of a program of occupational health in workers of a public hospital in the city of Santiago, Chile. The Berlin Questionnaire was utilized, as measurement of height and weight to calculate BMI. A battery of tests including fasting glucose and insulin to calculate HOMA-IR were also performed. Results: We studied 102 workers with an age average of 45.5 (± 12.3) years, in which 75 (73.5%) were women. 47 (46.1%) were working in rotating night shifts, and 47 (46.1%) were scored at high risk for OSAS in Berlin Questionnaire. The workers were classified into four groups: Under normal schedule and low risk (NS/LR) (n = 35), normal schedule and high risk (NS/HR) (n = 20), rotating shifts and low risk (RS/LR) (n = 20), and rotating shifts and high risk (RS/HR) (n = 27). Results were analyzed by ANOVA for HOMA-IR, resulting in higher values for groups with high risk for OSA: NS/LR = 2.55 (±2.05), NS/HR = 5.8 (±5.33), RS/LR = 3.53 (±2.39), and RS/HR = 7.67 (±6.52); (p<0.000).
T-I-070
SEVERITY OF DEPRESSION AND ANXIETY IN OBSTRUCTIVE SLEEP APNEA SYNDROME
Fatemeh Mohammadi 1 , Alimohamad Asghari 2 , Seyed Kamran Kamrava 2 , Saman Tavakoli 3 . 1 Department & Research Center of Otolaryngology, Head and Neck Surgery, Hazrat Rasoul Akram Hospital, Tehran University of Medical Sciences, Tehran, Iran; 2 Assistant professor of otolaryngology, Department & Research Center of Otolaryngology, Head and Neck Surgery, Hazrat Rasoul Akram Hospital, Tehran University of Medical Sciences, Tehran, Iran; 3 Psychiatrist, Iran Introduction and Objectives: Obstructive sleep apnea (OSA) is a common sleep disorder which induces nocturnal hypoxemia, hypercapnia and sleep fragmentation. It subsequently results in excessive daytime sleepiness, mood problems, poor neurocognitive performance as well as serious organ system dysfunction. The aim of this study was to evaluate the severity of depression and anxiety symptoms as the most prevalent psychological disturbances present in different severity of OSA. Materials and Methods: We performed a cross-sectional study of 649 recently diagnosed sleep-disordered patients over 18 years of age, referred to Noor Sleep Lab from August 2008 to November 2010. The participants filled the Beck Depression Inventory-II (BDI-II) and the Beck Anxiety Inventory (BAI) to assess depressive and anxiety symptoms. We collected other characteristics of subjects such as age, sex, body mass index (BMI) and Epworth Sleepiness Scale (ESS). Apnea Hypopnea Index (AHI) was determined by an overnight polysomnography. Results: Mean age of the participants was 47.19 years (SD = 11.66). More than 40% of patients had normal levels of depression and anxiety. AHI showed no significant correlation with BDI or BAI (p>0.05). Obesity was not correlated with depression or anxiety (p>0.05). Nonetheless, ESS was weakly correlated with depression and anxiety scores (p=0.01, r2=0.11). BMI and ESS means were significantly higher in patients with severe OSA (p<0.05). In comparison with men, the severity of depressive and anxiety symptoms were significantly higher in women (p=0.000). Conclusion: In this cross- sectional study of patients with sleep problems, a majority of patients had normal to mild levels of depressive and anxiety symptoms and OSA was not associated with severity of these symptoms.
T-I-071
SHORT SLEEP AND DYSFUNCTIONAL BELIEFS AND ATTITUDES TOWARD SLEEP AMONG BLACK MEN
Abhishek Pandey, Dmitriy Gekhman, Prince Odigie, Girardin Jean-Louis. Brooklyn Health Disparities Center, Department of Medicine, SUNY Downstate Medical Center, Brooklyn, NY, United States, United States Introduction and Objectives: Barbershops are an ideal location for health screening and wellness promotion among black men. It is used successfully to screen for the presence of hypertension, diabetes, and prostate cancer. The present study assessed associations of short sleep with dysfunctional beliefs and attitudes toward sleep among black men in the barbershop. Materials and Methods: Respondents were black barbershop clients (n=120; mean age=42±15 years) in Brooklyn, NY. They provided sociodemographic data and estimated habitual sleep time. Apnea Risk Evaluation System (ARES) was used to identify men at high Obstructive Sleep Apnea (OSA) risk; recommended for populations with large pretest probability for OSA. Dysfunctional Beliefs & Attitudes about Sleep Scale (DBAS) was used to quantify strength of endorsed attitudes/beliefs toward sleep. DBAS is a Likert-type scale from 0 (strongly disagree) to 10 (strongly agree); higher scores indicated more dysfunctional attitudes/beliefs about sleep Results: Of the sample, 25% reported hypertension, 11%, diabetes, and 3%, heart disease; 68% were overweight/obese. They also reported caffeine intake (22%) and alcohol consumption (29%). Estimated rates of sleep-related problems were: nap=36%, DIS=23%, DMS=24%, and sleep medicine=6.2%. Rate of short sleep (≤6h) was 57%; 34% were satisfied with their sleep. ARES data showed 29% were at high OSA risk (cut-off: >5). The mean DBAS score was 4.26±1.99; log-transformed values were used in ANCOVA, adjusting for effects of age, BMI, HTN, DM, mood, and sleep variables. Short sleepers did not have greater DBAS scores than average sleepers (7-8h) [F1,92=0.89, NS]. Rather, men at high OSA risk had greater DBAS scores [F1,92=13.68, p<0.001] and tended to report greater rate of sleep dissatisfaction [36% vs. 21%, p=NS]. Conclusion: Findings suggest that ARES can be used to screen black men in the barbershop. That black men at high risk for OSA have dysfunc-
S77
tional beliefs about sleep might explain low adherence rates to physicianrecommended sleep assessment in that population. Acknowledgements: Brooklyn Health Disparities Center, Department of Medicine, SUNY Downstate Medical Center, Brooklyn, NY, United States
T-I-072
SLEEP APNEA ANIMAL MODEL ELEVATES BRAIN WATER CONTENT AND DECREASES AQP 1 IN MOUSE CEREBELLUM
Diego Baronio. UFRGS, Brazil Introduction and Objectives: Patients with sleep apnea syndrome exhibit cerebral morphological changes. Aquaporins are membrane proteins responsible for the transport and the balance of water content in the brain. Changes in aquaporin 1 expression in the cerebellum have been reported in pregnancy. Little attention has been dedicated to the role of aquaporins in sleep apnea-related brain alterations. The present study aims to quantify aquaporin 1 levels in mouse hippocampus and cerebellum as well as to determine the brain water content. Materials and Methods: We exposed C57BL/6 mice to 35 days of intermittent hypoxia (IH; n=17) or sham intermittent hypoxia (SIH; n=18), alternating 30 seconds of progressive hypoxia to a nadir of 6% FIO2 with 30 seconds of room air insuflation. During 8 hours of the light period, the rodents underwent a total of 480 cycles of hypoxia/reoxygenation, equivalent to an apnea index of 60/hour. Brains of 6 HI and 6 SHI animals were dissected, weighted while wet and placed in an oven at 95°C during 48 hours. Percent brain water content was calculated. Levels of aquaporin 1 were measured using an ELISA test. Results: The mean brain wet weight and brain water content were higher in the IH group (respectively 0.48±0.004 g and 79.7±0.11%) than the SIH group (respectively 0.46±0.008 g and 76.8±0.52%; p<0.01). The average aquaporin 1 level in the cerebellum was higher in the SIH group (4.5±0.79 ng/mL) than in the IH group (3.9±0.48 ng/m; p=0.01). No significant difference was found between the two groups for the aquaporin 1 in the hippocampus. Conclusion: Exposure to intermittent hypoxia during 35 days in a mice model of sleep apnea increases wet weight and water content of the brain while reducing cerebellar aquaporin 1 levels. The relationship between sleep apnea and central nervous system structural alterations may involve downregulation of aquaporin 1 activity. Acknowledgements: Medical Sciences Graduated Program - UFRGS and research incentive fund (FIPE- Hospital de Clínicas de Porto Alegre).
T-I-073
SLEEP DISORDERED BREATHING AND SHIFT WORK: ASSOCIATION WITH IMPAIRED GLUCOSE METABOLISM
Juan Carrillo, Gisella Arellano, Jacqueline Peters, Mariana Dastres, Claudio Morales, Jecar Neghme. Felix Bulnes Clinical Hospital, Chile Introduction and Objectives: Obesity and diabetes are epidemic diseases with increasing rates around the world. Sleep disordered breathing (SDB) are also a public health problem due to its high prevalence and association with obesity, metabolic and cardiovascular diseases. The severity of obstructive sleep apnea has been associated with the degree of insulin resistance. Shift work (SW) has been also related with alterations in lipid and glucose metabolism. Our aim was to assess the effects of the combination of SDB and SW on glucose metabolism. Materials and Methods: We conducted a cross sectional study as part of a program of occupational health in workers of a public hospital in the city of Santiago, Chile. The Berlin Questionnaire was utilized, as measurement of height and weight to calculate BMI. A battery of tests including fasting glucose and insulin to calculate HOMA-IR were also performed. Results: We studied 102 workers with an age average of 45.5 (± 12.3) years, in which 75 (73.5%) were women. 47 (46.1%) were working in rotating night shifts, and 47 (46.1%) were scored at high risk for OSAS in Berlin Questionnaire. The workers were classified into four groups: Under normal schedule and low risk (NS/LR) (n = 35), normal schedule and high risk (NS/HR) (n = 20), rotating shifts and low risk (RS/LR) (n = 20), and rotating shifts and high risk (RS/HR) (n = 27). Results were analyzed by ANOVA for HOMA-IR, resulting in higher values for groups with high risk for OSA: NS/LR = 2.55 (±2.05), NS/HR = 5.8 (±5.33), RS/LR = 3.53 (±2.39), and RS/HR = 7.67 (±6.52); (p<0.000).