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Obstructive sleep apnea syndrome in Parkinson’s disease: Preliminary results
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Abstracts / Sleep Medicine 14S (2013) e93–e164
duration of PD, as well as in regard to PD Sleep Scale validated for the Brazilian population (PDSS-Br), Epworth’s daytime sleepiness scale, quality of life questionnaire in PD (PDQ-39), unified PD rating scale (UPDRS), Hoehn & Yahr’s modified evaluation scale and Schwab & England’s functional evaluation scale. Conclusion: RBD is a very prevalent condition among PD patients, being associated to a lower RDI and higher risk of wounding during sleep. We found no association between RBD and reduced quality of life in PD patients. Acknowledgements: FAEPA (Fundação de Apoio ao Ensino, Pesquisa e Assistência do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo) CAPES (Coordenação de Aperfeiçoamento de Pessoal de Nível Superior). http://dx.doi.org/10.1016/j.sleep.2013.11.245
Obstructive sleep apnea syndrome in Parkinson’s disease: preliminary results M. Sobreira Neto, M. Pereira, E. Sobreira, R. França Fernandes, V. Tumas, A. Eckeli Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Brazil
Introduction: the prevalence of Obstructive Sleep Apnea Syndrome (OSAS) among patients with Parkinson’s Disease (PD) changes from 20% to 66%. OSAS also shows different characteristics in those patients as compared to general population. Objectives: to estimate the prevalence and characteristics of OSAS in patients with PD. Materials and methods: Methods and patients: Patients were consecutively evaluated at a third level Outpatient Clinics for Movement Disorders, through the following clinical scales: PD Sleep Scale validated for the Brazilian population (PDSS-Br), Epworth‘s daytime sleepiness scale, quality of life questionnaire in PD (PDQ-39), unified PD rating scale (UPDRS), Hoehn & Yahr’s modified evaluation scale and Schwab & England‘s functional evaluation scale. All patients were submitted to polysomnography and diagnose of OSAS was defined according to the 2nd International Classification of Sleep Disorders. Results: Seventy third (73) patients have been included so far, among whom we have found a prevalence of 61.6% of OSAS (45 patients), of mild or moderate severity in 86.6%. OSAS patients had higher age than those without OSAS (p = 0.004). The mean score in Epworth‘s scale was higher among OSAS patients (p = 0.05). Snore was the prevalent symptom in the group of OSAS patients (74.5%), showing a sensitivity of 80%. Apneas witnessed by partners were the most specific symptom, ranking 92%. We did not find significant differences between the groups with and without OSAS in regard to PDSS-Br, PDQ-39, UPDRS), Hoehn & Yahr’s modified evaluation scale and Schwab & England’s functional evaluation scale. Conclusion: OSAS is a prevalent sleep disorder among PD patients, in whom it is found in higher aging people and is associated to greater daytime sleepiness, in comparison to non-OSAS PD patients. Snore is the most sensitive symptom and apneas witnessed by the partner the most specific symptom in PD patients with OSAS. Acknowledgements: FAEPA (Fundação de Apoio ao Ensino, Pesquisa e Assistência do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo) CAPES (Coordenação de Aperfeiçoamento de Pessoal de Nível Superior). http://dx.doi.org/10.1016/j.sleep.2013.11.246
A collaborative care model for improving sleep disorders management in primary care J. Edinger 1, J. Grubber 2, C. Ulmer 2, J. Zervakis 2, M. Olsen 2 1 National Jewish Health, United States 2 VA Medical Center, United States
Introduction: Sleep disorders often are not adequately addressed in the primary care setting. The current study was conducted to determine the effects of a one-time consultation with a sleep specialist on sleep management patterns and outcomes in a primary care setting. Materials and methods: The study entailed a prospective, randomized, clinical intervention trial. Participants were 137 veterans (Mage = 55.4 years; 29 women) enrolled in the primary care clinics of the Durham VA Medical Center. Eligible participants had a sleep complaint > 1 month duration, P6 on the Pittsburgh Sleep Quality Index-PSQI, P24 on the Folstein exam, no unstable medical or psychiatric disorders, and no previous sleep specialist treatment. Participants were randomized to an intervention (INT; N = 68) or wait-list control (WLC; N = 69). INT consisted of one meeting with a sleep specialist who administered structured interviews assessing sleep and psychiatric disorders, and then provided manualized treatment recommendations to patients and their respective healthcare providers. Providers’ referral patterns and patient outcomes (sleep diaries, PSQI, Epworth Sleepiness) were then monitored for a subsequent 10month period. Results: Provider-initiated sleep-focused interventions were significantly more frequent for the INT group than for the WLC group including PSG referrals (p < .0001), and mental health clinic referrals (p < .02). INT recipients showed greater improvements in diary total wake time (p < .05) and sleep efficiency (p < .03) than did WLC recipients at 10-month follow-up. In addition, larger proportions of the INT group showed >one standard deviation decline on the PSQI (41% vs. 21%; p = 0.02) and achieved normal (<10) Epworth Sleepiness Scale scores (69% vs. 50%; p = 0.03) by the 10-month followup than did those in the WLC group. Conclusion: A one-time sleep consultation significantly increased healthcare providers’ attention to sleep problems and resulted in benefits to patients’ sleep/wake symptoms. Acknowledgements: Funded by US Department of Veterans Affairs Health Services Research and Development Grant # IIR 05–213. http://dx.doi.org/10.1016/j.sleep.2013.11.247
Association between subjective sleepiness and severity of sleep-disordered breathing among truck drivers in Japan E. Eguchi 1, T. Tanigawa 1, M. Takahashi 2, S. Sakurai 3, K. Maruyama 4 1 Ehime University Graduate School of Medicine, Public Health, Japan 2 National Institute of Occupational Safety and Health, Japan 3 Tenri Health Care University, Japan 4 Ehime University Graduate School of Medicine, Japan
Introduction: The purpose of this study is to investigate the association of subjective sleepiness and severity of sleep-disordered breathing among truck drivers in Japan. Materials and methods: Age adjusted subjective daytime sleepiness was not significantly related to the severity of sleep-disordered breathing in this population (p = 0.36). Among the subjects who had severe sleep-disordered breathing (RDI P 20), ESS score of nonsleepiness and moderate sleepiness was 56.3% and 34.4% respectively. For the BMI stratified analysis, prevalence of non-sleepiness
Abstracts / Sleep Medicine 14S (2013) e93–e164
duration of PD, as well as in regard to PD Sleep Scale validated for the Brazilian population (PDSS-Br), Epworth’s daytime sleepiness scale, quality of life questionnaire in PD (PDQ-39), unified PD rating scale (UPDRS), Hoehn & Yahr’s modified evaluation scale and Schwab & England’s functional evaluation scale. Conclusion: RBD is a very prevalent condition among PD patients, being associated to a lower RDI and higher risk of wounding during sleep. We found no association between RBD and reduced quality of life in PD patients. Acknowledgements: FAEPA (Fundação de Apoio ao Ensino, Pesquisa e Assistência do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo) CAPES (Coordenação de Aperfeiçoamento de Pessoal de Nível Superior). http://dx.doi.org/10.1016/j.sleep.2013.11.245
Obstructive sleep apnea syndrome in Parkinson’s disease: preliminary results M. Sobreira Neto, M. Pereira, E. Sobreira, R. França Fernandes, V. Tumas, A. Eckeli Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Brazil
Introduction: the prevalence of Obstructive Sleep Apnea Syndrome (OSAS) among patients with Parkinson’s Disease (PD) changes from 20% to 66%. OSAS also shows different characteristics in those patients as compared to general population. Objectives: to estimate the prevalence and characteristics of OSAS in patients with PD. Materials and methods: Methods and patients: Patients were consecutively evaluated at a third level Outpatient Clinics for Movement Disorders, through the following clinical scales: PD Sleep Scale validated for the Brazilian population (PDSS-Br), Epworth‘s daytime sleepiness scale, quality of life questionnaire in PD (PDQ-39), unified PD rating scale (UPDRS), Hoehn & Yahr’s modified evaluation scale and Schwab & England‘s functional evaluation scale. All patients were submitted to polysomnography and diagnose of OSAS was defined according to the 2nd International Classification of Sleep Disorders. Results: Seventy third (73) patients have been included so far, among whom we have found a prevalence of 61.6% of OSAS (45 patients), of mild or moderate severity in 86.6%. OSAS patients had higher age than those without OSAS (p = 0.004). The mean score in Epworth‘s scale was higher among OSAS patients (p = 0.05). Snore was the prevalent symptom in the group of OSAS patients (74.5%), showing a sensitivity of 80%. Apneas witnessed by partners were the most specific symptom, ranking 92%. We did not find significant differences between the groups with and without OSAS in regard to PDSS-Br, PDQ-39, UPDRS), Hoehn & Yahr’s modified evaluation scale and Schwab & England’s functional evaluation scale. Conclusion: OSAS is a prevalent sleep disorder among PD patients, in whom it is found in higher aging people and is associated to greater daytime sleepiness, in comparison to non-OSAS PD patients. Snore is the most sensitive symptom and apneas witnessed by the partner the most specific symptom in PD patients with OSAS. Acknowledgements: FAEPA (Fundação de Apoio ao Ensino, Pesquisa e Assistência do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo) CAPES (Coordenação de Aperfeiçoamento de Pessoal de Nível Superior). http://dx.doi.org/10.1016/j.sleep.2013.11.246
A collaborative care model for improving sleep disorders management in primary care J. Edinger 1, J. Grubber 2, C. Ulmer 2, J. Zervakis 2, M. Olsen 2 1 National Jewish Health, United States 2 VA Medical Center, United States
Introduction: Sleep disorders often are not adequately addressed in the primary care setting. The current study was conducted to determine the effects of a one-time consultation with a sleep specialist on sleep management patterns and outcomes in a primary care setting. Materials and methods: The study entailed a prospective, randomized, clinical intervention trial. Participants were 137 veterans (Mage = 55.4 years; 29 women) enrolled in the primary care clinics of the Durham VA Medical Center. Eligible participants had a sleep complaint > 1 month duration, P6 on the Pittsburgh Sleep Quality Index-PSQI, P24 on the Folstein exam, no unstable medical or psychiatric disorders, and no previous sleep specialist treatment. Participants were randomized to an intervention (INT; N = 68) or wait-list control (WLC; N = 69). INT consisted of one meeting with a sleep specialist who administered structured interviews assessing sleep and psychiatric disorders, and then provided manualized treatment recommendations to patients and their respective healthcare providers. Providers’ referral patterns and patient outcomes (sleep diaries, PSQI, Epworth Sleepiness) were then monitored for a subsequent 10month period. Results: Provider-initiated sleep-focused interventions were significantly more frequent for the INT group than for the WLC group including PSG referrals (p < .0001), and mental health clinic referrals (p < .02). INT recipients showed greater improvements in diary total wake time (p < .05) and sleep efficiency (p < .03) than did WLC recipients at 10-month follow-up. In addition, larger proportions of the INT group showed >one standard deviation decline on the PSQI (41% vs. 21%; p = 0.02) and achieved normal (<10) Epworth Sleepiness Scale scores (69% vs. 50%; p = 0.03) by the 10-month followup than did those in the WLC group. Conclusion: A one-time sleep consultation significantly increased healthcare providers’ attention to sleep problems and resulted in benefits to patients’ sleep/wake symptoms. Acknowledgements: Funded by US Department of Veterans Affairs Health Services Research and Development Grant # IIR 05–213. http://dx.doi.org/10.1016/j.sleep.2013.11.247
Association between subjective sleepiness and severity of sleep-disordered breathing among truck drivers in Japan E. Eguchi 1, T. Tanigawa 1, M. Takahashi 2, S. Sakurai 3, K. Maruyama 4 1 Ehime University Graduate School of Medicine, Public Health, Japan 2 National Institute of Occupational Safety and Health, Japan 3 Tenri Health Care University, Japan 4 Ehime University Graduate School of Medicine, Japan
Introduction: The purpose of this study is to investigate the association of subjective sleepiness and severity of sleep-disordered breathing among truck drivers in Japan. Materials and methods: Age adjusted subjective daytime sleepiness was not significantly related to the severity of sleep-disordered breathing in this population (p = 0.36). Among the subjects who had severe sleep-disordered breathing (RDI P 20), ESS score of nonsleepiness and moderate sleepiness was 56.3% and 34.4% respectively. For the BMI stratified analysis, prevalence of non-sleepiness