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P-wave duration and dispersion in Holter electrocardiography of patients with obstructive sleep apnea
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Abstracts / Sleep Medicine 14S (2013) e93–e164
with poor sleep quality (r = 0.503, P = 0.009) and depression (r = 0.380, P = 0.05). Both anxiety and depression were also associated with poor sleep quality (r = 0.463 and 0.478, respectively, P < 0.001). In multivariate analysis, having RLS (b = 1.334, P = 0.007), anxiety (b = 0.291, P = 0.005), and depression (b = 0.246, P = 0.020), were independently associated with poor sleep quality. No specific association between laboratory tests’ results and overall sleep quality was observed. One year new cardiovascular events (26.0% vs.12.3%, P = 0.113) and subsequent mortality (13.0% vs.7.6%, P = 0.347) were more frequent, though not statistically significant, in those with RLS than those without RLS. Conclusion: Among patients on chronic dialysis, RLS and poor sleep quality are highly frequent. Mood disorders and RLS are important independent predictors of poor sleep quality. On the other hand, RLS may be associated with increased risk of cardiovascular risk and mortality in dialysis patients. Further studies with larger sample size and longer follow-ups are required for better understanding of risk factors and also cardiovascular risk of RLS and poor sleep quality in these patients. Acknowledgements: Authors are thankful to Prof. Richard Allen from the Johns Hopkins University and Dr. Mohammad Saadatnia from the Isfahan University of Medical Sciences for helping us in designing the study. http://dx.doi.org/10.1016/j.sleep.2013.11.305
Sleep quality in women with systemic lupus erythematosus A. Gholamrezaei, N. Hosseini, Z. Sayed Bonakdar Isfahan University of Medical Sciences, Iran
Introduction: There is a lack of data on sleep quality in women with systemic lupus erythematosus (SLE). We evaluated sleep quality and its possible determinants in Iranian women with SLE. Materials and methods: Seventy-two women with SLE were investigated. Disease activity was assessed using the Systemic Lupus Erythematosus Disease Activity Index and disease damage was assessed with the SLICC/ACR Damage Index. Participants completed standardized questionnaires assessing sleep quality (Pittsburgh Sleep Quality Index (PSQI)), anxiety and depression (Hospital Anxiety and Depression Scale), and quality of life (LupusQoL). Results: Poor sleep quality (PSQI P 5) was present in 57.7% of the patients and sleep latency was the most frequent sleep problem (50% with moderate to severe score). Compared with those with good sleep quality, patients with poor sleep quality were older (p < 0.001), and had less physical activity (p = 0.01), higher BMI (p = 0.003), more frequent concurrent disease (p = 0.04), higher anti-dsDNA antibody level (p = 0.01), higher anxiety (p = 0.001) and depression (0.009) scores. They had also lower quality of life in all domains of the LupusQoL (p < 0.01). Disease activity or damage indices were not significantly associated with sleep quality. In linear regression analysis, depression was significantly associated with PSQI score (B = 0.1272, p = 0.04). Conclusion: A significant proportion of women with SLE suffer from poor sleep quality which is associated with poor quality of life. Depressed mood is an important contributor to decreased overall sleep quality. Acknowledgement: This study was supported by the Isfahan University of Medical Sciences. http://dx.doi.org/10.1016/j.sleep.2013.11.306
P-wave duration and dispersion in Holter electrocardiography of patients with obstructive sleep apnea
M. Hashemi Jazi, B. Amra, M. Yazdchi, M. Jahangiri, F. Tabesh, A. Gholamrezaei Isfahan University of Medical Sciences, Iran
Introduction: There is an association between obstructive sleep apnea (OSA) and atrial fibrillation (AF) with remained unclear underlying mechanisms. We investigated P-wave parameters as indicators of atrial conduction status among OSA patients. Materials and methods: This cross-sectional study was conducted on 42 untreated OSA patients diagnosed using polysomnography and categorized to mild (6), moderate (18), and severe (18) OSA based on the apnea/hypopnea index (AHI). The control group consisted of 18 healthy subjects without any sleep or cardiac complaints. We applied 24-h Holter electrocardiography for measurement of P-wave parameters including duration and dispersion. Results: No significant difference was observed among the groups in P-wave duration (P = 0.281). P-wave dispersion and P max were significantly longer in those with moderate (P = 0.002 and 0.014, respectively) and those with severe OSA (P = 0.001 and 0.003, respectively) than controls. No correlation was found between age, gender, and BMI with P-wave parameters. AHI was significantly correlated with the P max (r = 0.407, P = 0.012) and P-wave dispersion (r = 0.431, P = 0.008). With linear regression analysis controlling for age, gender, and BMI, the AHI was independently associated with P-wave dispersion (â = 0.482, P = 0.002). Conclusion: The severity of OSA is associated with prolonged P max and P-wave dispersion, indicating that patients with severe OSA have more severe disturbance in atrial conduction. This is the first study which has used Holter monitoring for measurement of P-wave parameters and repeating this study in a larger sample of patients is warranted. Acknowledgements: This study is supported by the Isfahan University of Medical Sciences. We are thankful to Reihaneh Sadat Daneshmand who participated in designing the Holter monitoring software, and also we are thankful to Foroogh Hesabi, head of department of Holter monitoring of Noor Hospital (Isfahan). http://dx.doi.org/10.1016/j.sleep.2013.11.307
Technological insomnia and actigraphy P. Giner-Bayarri, N. Torres-Caño, T. Oviedo-Montés, K. Quintero-Hernandez, A. Mazzillo-Ricaurte Hospital Universitario Dr. Peset, Department of Clinical Neurophysiology, Spain
Introduction: Technological insomnia is a new emerging disease that is based on the difficulty of initiating and maintaining sleep due to excessive and inappropriate use of the new technologies. The increase in the use of these new technologies such as smartphones, tablets, computers, video games and television with multiple schedules have caused a difficulty in initiating and maintaining sleep in the population, which affects not only adults but especially children and adolescents. This implies a social problem with a decreased academic or work achievement, which sometimes leads to the use of medications that are not indicated in these kind of patients. Materials and methods: The actigraphy is a simple technique which consists of a wristwatch that contains an accelerometer, a memory and a light detector which is usually placed on the hand of the patient to assess sleep patterns. This technique allows us to make
Abstracts / Sleep Medicine 14S (2013) e93–e164
with poor sleep quality (r = 0.503, P = 0.009) and depression (r = 0.380, P = 0.05). Both anxiety and depression were also associated with poor sleep quality (r = 0.463 and 0.478, respectively, P < 0.001). In multivariate analysis, having RLS (b = 1.334, P = 0.007), anxiety (b = 0.291, P = 0.005), and depression (b = 0.246, P = 0.020), were independently associated with poor sleep quality. No specific association between laboratory tests’ results and overall sleep quality was observed. One year new cardiovascular events (26.0% vs.12.3%, P = 0.113) and subsequent mortality (13.0% vs.7.6%, P = 0.347) were more frequent, though not statistically significant, in those with RLS than those without RLS. Conclusion: Among patients on chronic dialysis, RLS and poor sleep quality are highly frequent. Mood disorders and RLS are important independent predictors of poor sleep quality. On the other hand, RLS may be associated with increased risk of cardiovascular risk and mortality in dialysis patients. Further studies with larger sample size and longer follow-ups are required for better understanding of risk factors and also cardiovascular risk of RLS and poor sleep quality in these patients. Acknowledgements: Authors are thankful to Prof. Richard Allen from the Johns Hopkins University and Dr. Mohammad Saadatnia from the Isfahan University of Medical Sciences for helping us in designing the study. http://dx.doi.org/10.1016/j.sleep.2013.11.305
Sleep quality in women with systemic lupus erythematosus A. Gholamrezaei, N. Hosseini, Z. Sayed Bonakdar Isfahan University of Medical Sciences, Iran
Introduction: There is a lack of data on sleep quality in women with systemic lupus erythematosus (SLE). We evaluated sleep quality and its possible determinants in Iranian women with SLE. Materials and methods: Seventy-two women with SLE were investigated. Disease activity was assessed using the Systemic Lupus Erythematosus Disease Activity Index and disease damage was assessed with the SLICC/ACR Damage Index. Participants completed standardized questionnaires assessing sleep quality (Pittsburgh Sleep Quality Index (PSQI)), anxiety and depression (Hospital Anxiety and Depression Scale), and quality of life (LupusQoL). Results: Poor sleep quality (PSQI P 5) was present in 57.7% of the patients and sleep latency was the most frequent sleep problem (50% with moderate to severe score). Compared with those with good sleep quality, patients with poor sleep quality were older (p < 0.001), and had less physical activity (p = 0.01), higher BMI (p = 0.003), more frequent concurrent disease (p = 0.04), higher anti-dsDNA antibody level (p = 0.01), higher anxiety (p = 0.001) and depression (0.009) scores. They had also lower quality of life in all domains of the LupusQoL (p < 0.01). Disease activity or damage indices were not significantly associated with sleep quality. In linear regression analysis, depression was significantly associated with PSQI score (B = 0.1272, p = 0.04). Conclusion: A significant proportion of women with SLE suffer from poor sleep quality which is associated with poor quality of life. Depressed mood is an important contributor to decreased overall sleep quality. Acknowledgement: This study was supported by the Isfahan University of Medical Sciences. http://dx.doi.org/10.1016/j.sleep.2013.11.306
P-wave duration and dispersion in Holter electrocardiography of patients with obstructive sleep apnea
M. Hashemi Jazi, B. Amra, M. Yazdchi, M. Jahangiri, F. Tabesh, A. Gholamrezaei Isfahan University of Medical Sciences, Iran
Introduction: There is an association between obstructive sleep apnea (OSA) and atrial fibrillation (AF) with remained unclear underlying mechanisms. We investigated P-wave parameters as indicators of atrial conduction status among OSA patients. Materials and methods: This cross-sectional study was conducted on 42 untreated OSA patients diagnosed using polysomnography and categorized to mild (6), moderate (18), and severe (18) OSA based on the apnea/hypopnea index (AHI). The control group consisted of 18 healthy subjects without any sleep or cardiac complaints. We applied 24-h Holter electrocardiography for measurement of P-wave parameters including duration and dispersion. Results: No significant difference was observed among the groups in P-wave duration (P = 0.281). P-wave dispersion and P max were significantly longer in those with moderate (P = 0.002 and 0.014, respectively) and those with severe OSA (P = 0.001 and 0.003, respectively) than controls. No correlation was found between age, gender, and BMI with P-wave parameters. AHI was significantly correlated with the P max (r = 0.407, P = 0.012) and P-wave dispersion (r = 0.431, P = 0.008). With linear regression analysis controlling for age, gender, and BMI, the AHI was independently associated with P-wave dispersion (â = 0.482, P = 0.002). Conclusion: The severity of OSA is associated with prolonged P max and P-wave dispersion, indicating that patients with severe OSA have more severe disturbance in atrial conduction. This is the first study which has used Holter monitoring for measurement of P-wave parameters and repeating this study in a larger sample of patients is warranted. Acknowledgements: This study is supported by the Isfahan University of Medical Sciences. We are thankful to Reihaneh Sadat Daneshmand who participated in designing the Holter monitoring software, and also we are thankful to Foroogh Hesabi, head of department of Holter monitoring of Noor Hospital (Isfahan). http://dx.doi.org/10.1016/j.sleep.2013.11.307
Technological insomnia and actigraphy P. Giner-Bayarri, N. Torres-Caño, T. Oviedo-Montés, K. Quintero-Hernandez, A. Mazzillo-Ricaurte Hospital Universitario Dr. Peset, Department of Clinical Neurophysiology, Spain
Introduction: Technological insomnia is a new emerging disease that is based on the difficulty of initiating and maintaining sleep due to excessive and inappropriate use of the new technologies. The increase in the use of these new technologies such as smartphones, tablets, computers, video games and television with multiple schedules have caused a difficulty in initiating and maintaining sleep in the population, which affects not only adults but especially children and adolescents. This implies a social problem with a decreased academic or work achievement, which sometimes leads to the use of medications that are not indicated in these kind of patients. Materials and methods: The actigraphy is a simple technique which consists of a wristwatch that contains an accelerometer, a memory and a light detector which is usually placed on the hand of the patient to assess sleep patterns. This technique allows us to make