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Snoring is related to the elevation of morning blood pressure
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Abstracts / Sleep Medicine 14S (2013) e93–e164
LMA was increased in the middle of respiratory events. Increased LMA before the beginning of the respiratory event consisted mainly of the longer tail of LMA after the end of the previous respiratory event. Importantly, LMA increased shortly before the end of the respiratory events, with peak onset of LMA 2.5 s after the end of the respiratory event. Conclusion: Our results showed that leg movements are not augmented at the beginning or middle of respiratory events but are increased around the end of respiratory events over a period significantly longer than specified in the AASM and the WASM/IRLSSG rules. Both rules therefore underestimate the number of respiratory leg movements in patients with obstructive sleep apnea. http://dx.doi.org/10.1016/j.sleep.2013.11.290
Nocturnal intermittent hypoxia as an associated risk factor for microalbuminuria in women with type 2 diabetes mellitus S. Furukawa, E. Eguchi, K. Maruyama, T. Tanigawa Ehime University Graduate School of Medicine, Department of Public Health, Japan
Introduction: The International Diabetes Federation has expressed the need for further research into the links between sleep-disordered breathing (SDB) and type 2 diabetes mellitus. However studies on the association between SDB and microvascular complications among type 2 diabetes (T2DM) mellitus patients are limited. Materials and methods: We recruited 513 Japanese patients with T2DM. Nocturnal intermittent hypoxia was diagnosed using the 3% oxygen desaturation index (ODI), with <5 events/h corresponding to normal, and 5 events or more/h corresponding to nocturnal intermittent hypoxia. Nephropathy was defined using the urinary albumin–creatinine ratio to classify the participants as follows: normoalbuminuria, <30 mg/mmol creatinine; microalbuminuria, 30 mg and over/mg creatinine; and nephropathy, 300 mg and over /mg creatinine. Results: The prevalence of nocturnal intermittent hypoxia was 45.4% among T2DM patients. The nocturnal intermittent hypoxia group was older (P = 0.007), had a higher BMI (P = 0.001), greater weight change since the age of 20 years (P = 0.001), higher smoking rate (P = 0.005), and increased prevalence of hypertension (P = 0.001), hyperlipidaemia (P = 0.001), microalbuminuria (P = 0.001), and nephropathy (P = 0.001). Microalbuminuria (model 1: OR, 3.41; 95% CI, 1.85–6.40; P = 0.001; model 2: OR, 3.69, 95% CI, 1.85–7.59, P = 0.001; model 3: OR, 3.12; 95% CI, 1.45–6.95; P = 0.001) and nephropathy (model 1: OR, 3.12; 95% CI, 1.45–6.95; P = 0.001; model 2: OR, 7.31; 95% CI, 2.11–31.6; P = 0.001; model 3: OR, 5.23; 95% CI, 1.45–23.8; P = 0.001) were derived as factors from all 3 statistical models and constantly associated with nocturnal intermittent hypoxia only in women. Conclusion: Nocturnal intermittent hypoxia was highly prevalent among T2DM patients, and may be an independent associated risk factor for microalbuminuria in Japanese women with T2DM. Acknowledgements: We thank Isao Saito, Shin Yamamoto, Teruki Miyake, Teruhisa Ueda, Tetsuji Niiya, Masamoto Torisu, Teru Kumagi, Takenori Sakai, Hisaka Minami, Hiroaki Miyaoka, Susumu Sakurai, Bunzo Matsuura, and Morikazu Onji. This study was supported in part by Grants-in-Aid for Young Scientists (B) (grant number 217090583, 2008–2010) provided to SF from the Japanese Society for the Promotion of Science. http://dx.doi.org/10.1016/j.sleep.2013.11.291
Snoring is related to the elevation of morning blood pressure T. Furukawa 1, H. Nakano 2, T. Tanahashi 1, K. Yoshihara 1, N. Sudo 1 1 Kyushu University, Department of Psychosomatic Medicine Graduate School of Medical Sciences, Japan 2 National Hospital Organization, Fukuoka National Hospital, Sleep Disorders Center, Japan
Introduction: Consequences of snoring independent of obstructive sleep apnea remains controversial. We hypothesized that snoring sound intensity, as assessed by mean tracheal sound energy (Leq) during sleep, is related to morning blood pressure. Materials and methods: Subjects were 191 government workers. Overnight tracheal sound recording at home was performed using an IC-recorder. The data were analyzed using a PC-based compressed sound spectrograph system, which yielded the respiratory disturbance index (RDI) and the equivalent tracheal sound pressure level (Leq). Blood pressure was measured in the morning following the overnight monitoring. We stratified the subjects into four groups: lean or normal-weight nonapneics (LNA; RDI < 5/h, BMI < 25, n = 110), overweight nonapneics (ONA; RDI < 5/h, BMI < 25, n = 20), lean or normal-weight apneics (LA; RDI < 5/h, BMI < 25, n = 27), and overweight apneics (OA; RDI < 15/h, BMI < 25, n = 16). Pearson’s correlation analysis and multiple regression analysis were employed to elucidate the association between snoring and morning blood pressure. Results: Both systolic and diastolic blood pressure values (SBP and DBP) in the morning in LNA were lower than those in ONA, LA and OA (116/73 vs. 127/80, 128/82, 133/84 mmHg). Leq was correlated to both SBP and DBP in the morning (r = 0.38, p < 0.0001; r = 0.33, p = 0.0004, respectively) only in LNA, not in other groups. In LNA, multiple regression analysis showed that Leq was significantly associated with morning SBP after adjustment for the RDI, BMI and other confounding factors (p = 0.022), but not with morning DBP. Conclusion: Snoring is independently related to the elevation of morning blood pressure in lean or normal-weight workers. Acknowledgements: The authors thank Kenji Hirayama for useful suggestion. http://dx.doi.org/10.1016/j.sleep.2013.11.292
The impact of hypnotics usage on daytime function and associated factor for the usage in shiftwork nurses K. Futemma 1, A. Murakoshi 1, Y. Takaesu 1, S. Asaoka 2, Y. Komada 3, Y. Inoue 4 1 Department of Psychiatry, Tokyo Medical University, Tokyo, Japan 2 Sleep Research Institute, Edogawa University, Tokyo, Japan 3 Department of Somnology, Tokyo Medical University, Tokyo, Japan 4 Japan Somnology Center, Neuropsychiatric Research Institute, Tokyo, Japan
Introduction: It has been known that a certain number of shiftwork nurses have shift work disorder (SWD) and regularly take hypnotics@However, impact of hypnotics usage on health-related quality of life (QOL) and daytime function in shiftwork nurses remain unclear. Especially, condition of usage of high dose or multiple kinds of hypnotics, which is likely to cause dependency of hypnotics, has not been investigated in this population. To clarify this issue, we investigated QOL and work performance status of hypnotic user and explored the factors associated with multiple hypnotics usage in shiftwork nurses.
Abstracts / Sleep Medicine 14S (2013) e93–e164
LMA was increased in the middle of respiratory events. Increased LMA before the beginning of the respiratory event consisted mainly of the longer tail of LMA after the end of the previous respiratory event. Importantly, LMA increased shortly before the end of the respiratory events, with peak onset of LMA 2.5 s after the end of the respiratory event. Conclusion: Our results showed that leg movements are not augmented at the beginning or middle of respiratory events but are increased around the end of respiratory events over a period significantly longer than specified in the AASM and the WASM/IRLSSG rules. Both rules therefore underestimate the number of respiratory leg movements in patients with obstructive sleep apnea. http://dx.doi.org/10.1016/j.sleep.2013.11.290
Nocturnal intermittent hypoxia as an associated risk factor for microalbuminuria in women with type 2 diabetes mellitus S. Furukawa, E. Eguchi, K. Maruyama, T. Tanigawa Ehime University Graduate School of Medicine, Department of Public Health, Japan
Introduction: The International Diabetes Federation has expressed the need for further research into the links between sleep-disordered breathing (SDB) and type 2 diabetes mellitus. However studies on the association between SDB and microvascular complications among type 2 diabetes (T2DM) mellitus patients are limited. Materials and methods: We recruited 513 Japanese patients with T2DM. Nocturnal intermittent hypoxia was diagnosed using the 3% oxygen desaturation index (ODI), with <5 events/h corresponding to normal, and 5 events or more/h corresponding to nocturnal intermittent hypoxia. Nephropathy was defined using the urinary albumin–creatinine ratio to classify the participants as follows: normoalbuminuria, <30 mg/mmol creatinine; microalbuminuria, 30 mg and over/mg creatinine; and nephropathy, 300 mg and over /mg creatinine. Results: The prevalence of nocturnal intermittent hypoxia was 45.4% among T2DM patients. The nocturnal intermittent hypoxia group was older (P = 0.007), had a higher BMI (P = 0.001), greater weight change since the age of 20 years (P = 0.001), higher smoking rate (P = 0.005), and increased prevalence of hypertension (P = 0.001), hyperlipidaemia (P = 0.001), microalbuminuria (P = 0.001), and nephropathy (P = 0.001). Microalbuminuria (model 1: OR, 3.41; 95% CI, 1.85–6.40; P = 0.001; model 2: OR, 3.69, 95% CI, 1.85–7.59, P = 0.001; model 3: OR, 3.12; 95% CI, 1.45–6.95; P = 0.001) and nephropathy (model 1: OR, 3.12; 95% CI, 1.45–6.95; P = 0.001; model 2: OR, 7.31; 95% CI, 2.11–31.6; P = 0.001; model 3: OR, 5.23; 95% CI, 1.45–23.8; P = 0.001) were derived as factors from all 3 statistical models and constantly associated with nocturnal intermittent hypoxia only in women. Conclusion: Nocturnal intermittent hypoxia was highly prevalent among T2DM patients, and may be an independent associated risk factor for microalbuminuria in Japanese women with T2DM. Acknowledgements: We thank Isao Saito, Shin Yamamoto, Teruki Miyake, Teruhisa Ueda, Tetsuji Niiya, Masamoto Torisu, Teru Kumagi, Takenori Sakai, Hisaka Minami, Hiroaki Miyaoka, Susumu Sakurai, Bunzo Matsuura, and Morikazu Onji. This study was supported in part by Grants-in-Aid for Young Scientists (B) (grant number 217090583, 2008–2010) provided to SF from the Japanese Society for the Promotion of Science. http://dx.doi.org/10.1016/j.sleep.2013.11.291
Snoring is related to the elevation of morning blood pressure T. Furukawa 1, H. Nakano 2, T. Tanahashi 1, K. Yoshihara 1, N. Sudo 1 1 Kyushu University, Department of Psychosomatic Medicine Graduate School of Medical Sciences, Japan 2 National Hospital Organization, Fukuoka National Hospital, Sleep Disorders Center, Japan
Introduction: Consequences of snoring independent of obstructive sleep apnea remains controversial. We hypothesized that snoring sound intensity, as assessed by mean tracheal sound energy (Leq) during sleep, is related to morning blood pressure. Materials and methods: Subjects were 191 government workers. Overnight tracheal sound recording at home was performed using an IC-recorder. The data were analyzed using a PC-based compressed sound spectrograph system, which yielded the respiratory disturbance index (RDI) and the equivalent tracheal sound pressure level (Leq). Blood pressure was measured in the morning following the overnight monitoring. We stratified the subjects into four groups: lean or normal-weight nonapneics (LNA; RDI < 5/h, BMI < 25, n = 110), overweight nonapneics (ONA; RDI < 5/h, BMI < 25, n = 20), lean or normal-weight apneics (LA; RDI < 5/h, BMI < 25, n = 27), and overweight apneics (OA; RDI < 15/h, BMI < 25, n = 16). Pearson’s correlation analysis and multiple regression analysis were employed to elucidate the association between snoring and morning blood pressure. Results: Both systolic and diastolic blood pressure values (SBP and DBP) in the morning in LNA were lower than those in ONA, LA and OA (116/73 vs. 127/80, 128/82, 133/84 mmHg). Leq was correlated to both SBP and DBP in the morning (r = 0.38, p < 0.0001; r = 0.33, p = 0.0004, respectively) only in LNA, not in other groups. In LNA, multiple regression analysis showed that Leq was significantly associated with morning SBP after adjustment for the RDI, BMI and other confounding factors (p = 0.022), but not with morning DBP. Conclusion: Snoring is independently related to the elevation of morning blood pressure in lean or normal-weight workers. Acknowledgements: The authors thank Kenji Hirayama for useful suggestion. http://dx.doi.org/10.1016/j.sleep.2013.11.292
The impact of hypnotics usage on daytime function and associated factor for the usage in shiftwork nurses K. Futemma 1, A. Murakoshi 1, Y. Takaesu 1, S. Asaoka 2, Y. Komada 3, Y. Inoue 4 1 Department of Psychiatry, Tokyo Medical University, Tokyo, Japan 2 Sleep Research Institute, Edogawa University, Tokyo, Japan 3 Department of Somnology, Tokyo Medical University, Tokyo, Japan 4 Japan Somnology Center, Neuropsychiatric Research Institute, Tokyo, Japan
Introduction: It has been known that a certain number of shiftwork nurses have shift work disorder (SWD) and regularly take hypnotics@However, impact of hypnotics usage on health-related quality of life (QOL) and daytime function in shiftwork nurses remain unclear. Especially, condition of usage of high dose or multiple kinds of hypnotics, which is likely to cause dependency of hypnotics, has not been investigated in this population. To clarify this issue, we investigated QOL and work performance status of hypnotic user and explored the factors associated with multiple hypnotics usage in shiftwork nurses.