Indian Journal of Sleep Medicine

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Volume 17, Number 2, April-June 2022

Original Article

Bassey E Edet, Emmanuel A Essien, Chidi J Okafor, Emmanuel O Olose, Ginini E Atu, Olusola R Olojo, Alexander A Audu, Anya C Okoro

Sleep Health and COVID-19-related Anxiety during the Lockdown Phase of the Pandemic in Nigeria: A Preliminary Report

[Year:2022] [Month:April-June] [Volume:17] [Number:2] [Pages:7] [Pages No:37 - 43]

Keywords: Anxiety, COVID-19, Dreams, Pandemics, Sleep

   DOI: 10.5005/jp-journals-10069-0099  |  Open Access |  How to cite  | 

Abstract

Background: During the pandemic's peak, changes in sleep and dreaming were reported around the world. Objective: The objective was to assess changes in sleep and dreaming during the lockdown phase of the coronavirus disease-2019 (COVID-19) pandemic in Nigeria. It also aimed to determine how these changes might be related to COVID-19-related fear. Methods: This was a cross-sectional study conducted during the lockdown period of the COVID-19 pandemic in Nigeria. Data were collected from 288 respondents using an online survey. Apart from sociodemographic characteristics, questions were asked about sleep and dream changes. The Pittsburgh Sleep Quality Index (PSQI) and the Fear of COVID-19 Scale (FCS) were also administered. Results: The mean age of respondents was 33 years, and 52% were females. Poor sleep quality was present in 65.1%. An increase in dream recall frequency (DRF) was reported in 20.5%, while 15.5% mainly had negatively themed dreams. Sleep latency, sleep disturbances, and daytime dysfunction were significantly associated with changes in DRF (p <0.05). Subjective sleep quality, habitual sleep efficiency, sleep disturbances, daytime dysfunction, overall sleep quality, and fear of COVID-19 were all significantly associated with the theme of dreams (p <0.05). In binary logistic regression, fear of COVID-19 [odds ratio (OR): 1.07, 95% confidence interval (CI): 1.02–1.13], negatively themed dreams (OR: 8.03, 95% CI: 1.81–35.57), and positively themed dreams (OR: 0.38 95% CI: 0.17–0.87) emerged as predictors of sleep quality. Conclusion: The COVID-19 pandemic impacted sleep quality at its peak. Clinical significance: Clinicians should pay more attention to dream changes as they could serve as indicators of sleep quality.

REVIEW ARTICLE

Mousumi Chakrabarty

Is Insufficient Sleep in Adolescents Principally Caused by Society Rather than Physiology?

[Year:2022] [Month:April-June] [Volume:17] [Number:2] [Pages:6] [Pages No:44 - 49]

Keywords: Adolescents sleep deprivation, Insufficient sleep, Sleep practice

   DOI: 10.5005/jp-journals-10069-0100  |  Open Access |  How to cite  | 

Abstract

Insufficient sleep is a major health issue in adolescents resulting in poor academic performance, mental health problems, and increased cases of automobile accidents. An intrinsic biological phase delay with the onset of puberty influences sleep timing in this population. Moreover, increased night time use of electronic gadgets, late night socializing, etc. coupled with early school start times (SST) result in sleep-deprived teenagers. Although most of them oversleep during weekends, this hardly compensates for the sleep loss on weekdays. Various studies have shown that insufficient sleep in adolescents is caused not only by the physiological change brought about by puberty but also by various social aspects which influence their sleep. Maintaining sleep hygiene practices along with a delay in SST have shown marked improvement in adolescent sleep health. Sleep medicine practitioners can play a key role in bringing about this change through sleep health education as well as administrative reforms.

CASE REPORT

S Ramnathan Iyer, S Ramchandani

Increase in the Field of Vision in a Patient with Primary Open-angle Glaucoma and Obstructive Sleep Apnea with Usage of Continuous Positive Airway Pressure

[Year:2022] [Month:April-June] [Volume:17] [Number:2] [Pages:6] [Pages No:50 - 55]

Keywords: Diabetes, Hypertension, Obstructive sleep apnea

   DOI: 10.5005/jp-journals-10069-0098  |  Open Access |  How to cite  | 

Abstract

Obstructive sleep apnea (OSA) has been reported to affect hypoxia-sensitive tissues (retina and optic tract) adversely. An 81-year-old gentleman, a known case of primary angle glaucoma, hypertension, and type 2 diabetes with visual field defects, was on established therapy, but there was no improvement in vision. He was evaluated for his sleep complaints viz. loud and habitual snoring. Polysomnography revealed obstructive sleep apnea predominantly in rapid eye movement (REM) sleep. Compared with non-rapid eye movement (NREM) sleep, REM sleep is associated with higher sympathetic activity and cardiovascular instability. Regular usage of continuous positive airway pressure during sleep was instituted. After 4 months of this mode of therapy, the perimetry showed improvement in the field of vision. The patient is being followed up regularly, and continuous positive airway pressure (CPAP) usage is being continued.

CASE REPORT

Gaurav Pratap Singh, Jayan Balakrishnan, Abhijeet Kadu

Management of a Case of Obstructive Sleep Apnea with Mandibular Advancement Surgery

[Year:2022] [Month:April-June] [Volume:17] [Number:2] [Pages:11] [Pages No:56 - 66]

Keywords: Apnea–hypopnea index, Obstructive sleep apnea, Metabolic syndrome, Syndrome Z

   DOI: 10.5005/jp-journals-10069-0101  |  Open Access |  How to cite  | 

Abstract

Aim: The aim of this case report is to highlight the use of maxillomandibular surgical advancement procedures to treat the symptoms of obstructive sleep apnea (OSA) in addition to improving esthetics, function, and stability in patients with skeletal jaw discrepancies. Background: Obstructive sleep apnea is a condition which is frequently encountered by the orthodontist both in children and adults due to the strong correlation with various craniofacial risk factors. Although “continuous positive airway pressure (CPAP) therapy” is the gold standard for management of symptoms of OSA, patients with underlying skeletal discrepancies of the jaws can benefit from maxillomandibular surgical advancement procedures which can provide long-term benefits. Case description: This case describes the interdisciplinary management of a 28-year-old man suffering from moderate OSA. The cause of OSA was determined to be multifactorial including lifestyle choices in addition to craniofacial risk factors of a skeletal class II jaw bases, retrognathic mandible, horizontal growth pattern, and increased submental fat deposition. The case was managed by orthosurgical line of treatment with mandibular advancement surgery to correct the underlying skeletal deformity. Post-orthognathic surgery, occlusion was settled and case was finished with class I skeletal and dental relationship with optimal functional occlusion and good esthetics. Posttreatment evaluation also revealed a marked improvement in sleep parameters with a downgrade from moderate-to-mild OSA. Conclusion: The result highlights how suitable and timely intervention in cases of OSA can have favorable outcomes and the value of maxillomandibular advancement techniques in amelioration of OSA. Clinical significance: Maxillomandibular surgical advancement procedures can be of great benefit to patients who suffer from symptoms of OSA owing to the underlying skeletal jaw discrepancies.

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