Indian Journal of Sleep Medicine

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2017 | July-September | Volume 12 | Issue 3

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Abhijeet Kadu, Balakrishnan Jayan, Reena R Kumar, Oommen Nainan, Probod K Chattopadhyay

Strategies for integrating Sleep Medicine in Dental Practice and Postgraduate Training

[Year:2017] [Month:July-September] [Volume:12] [Number:3] [Pages:6] [Pages No:33 - 38]

Keywords: Dental practice, Postgraduate training, Sleep medicine

   DOI: 10.5005/jp-journals-10069-0007  |  Open Access |  How to cite  | 


Dentistry's entry into the management of upper airway sleep disorders has led to the development of a new specialty, i.e., dental sleep medicine. This specialty involves oral appliance therapy (OAT) for obstructive sleep apnea (OSA) and snoring, maxillomandibular advancement surgeries to increase upper airway volume, assessment of craniofacial risk factors, cephalometric studies for craniofacial and airway evaluation, and prevention of sleep-disordered breathing (SDB) in children. Dentists trained in dental sleep medicine, orthodontists, and maxillofacial surgeons are recognized members of interdisciplinary team to manage upper airway sleep disorders. So it is of paramount importance for dental students and orthodontists to familiarize with the basic knowledge of upper airway sleep disorders and its management in order to contribute effectively in managing those affected patients. There is need to integrate dental sleep medicine in postgraduate orthodontic curriculum. The current status of this new and challenging discipline in India, the Armed Forces Medical College and Army Dental Centre (Research and Referral) experience, and strategies to build capacity are discussed in this article.



Ashalatha Radhakrishnan, Sapna E Sreedharan, Pragati Agrawal, Chembakode A Anees, MJ Pradeep, P Sankara Sharma

Diabetics with Obstructive Sleep Apnea need Higher Positive Airway Pressures

[Year:2017] [Month:July-September] [Volume:12] [Number:3] [Pages:5] [Pages No:39 - 43]

Keywords: Diabetes mellitus, Neck circumference, Obstructive sleep apnea, Positive airway pressure therapy.

   DOI: 10.5005/jp-journals-10069-0008  |  Open Access |  How to cite  | 


Introduction: Continuous positive airway pressure (CPAP) is the only proven therapy for moderate to severe obstructive sleep apnea syndrome (OSAS). The CPAP requirements can widely vary among individuals. We studied the demographic, clinical, and polysomnographic (PSG) predictors of high CPAP requirement (pressures >10 cm H2O) in a cohort of patients with OSAS. Materials and methods: Consecutive patients with PSG-proven moderate to severe OSAS attending the Sleep Clinic, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, India, were prospectively recruited for the study from November 2014 till October 2015. After informed consent, demographic data, risk factor profile, and PSG data were extracted using a structured pro forma. All the patients underwent overnight CPAP titration in the sleep laboratory as per guidelines. The patients were grouped into two, those requiring CPAP ≤ 10 and >10 cm H2O. Pearson correlation and chi square tests were used to study the association between variables. Results: A total of 64 patients (55 male, 9 female) with OSAS underwent CPAP titration during the study period. Mean age of the study group was 53.81 ± 12.01 (26–85 years) and majority were overweight by Asian standards [mean body mass index (BMI) 29.31 ± 5.01]. Mean apnea-hypopnea index (AHI) of the cohort was 62.28. Average CPAP requirement was 11.82 cm H2O. We found that neck circumference, presence of diabetes mellitus (DM), and AHI severity were independent predictors for higher PAP requirements, while gender, BMI, and other vascular risk factors were not predictive of high PAP requirements. Conclusion: Diabetes mellitus and neck circumference are better predictors of higher CPAP requirements in Indian population than BMI. Those with higher AHI required more pressures while apnea duration failed to show an association with higher PAP.



A Elavarsi, Garima Shukla

Sleep Disorders in Parkinson's Disease

[Year:2017] [Month:July-September] [Volume:12] [Number:3] [Pages:5] [Pages No:44 - 48]

Keywords: Excessive daytime sleepiness, Insomnia, Parkinson disease, Rapid eye movement sleep behavior disorder, Sleep

   DOI: 10.5005/jp-journals-10069-0009  |  Open Access |  How to cite  | 


Sleep disorders in Parkinson's disease (PD) have been recognized as one of the nonmotor symptoms of PD and is the common cause of poor quality of life in these patients, as motor symptoms are very well controlled by drugs as well as deep brain stimulation. Assessment and treatment of these disorders are essential for optimal management of the disease. This article presents a brief overview of various disorders and how to approach them.



Garima Shukla, Anupama Gupta, Alok Nath, Ravi Mishra

Hypersomnolence among Adolescents: Narcolepsy an Often Misdiagnosed Condition

[Year:2017] [Month:July-September] [Volume:12] [Number:3] [Pages:4] [Pages No:49 - 52]

Keywords: Adolescent, Hypersomnolence, Multiple sleep latency test, Sleep, Type II narcolepsy

   DOI: 10.5005/jp-journals-10069-00010  |  Open Access |  How to cite  | 


Hypersomnolence is becoming an important problem in adolescents because of the change of lifestyle. Narcolepsy is a chronic and incurable sleep disorder, classically presenting with excessive daytime sleepiness associated with cataplexy, hypnagogic hallucinations, sleep paralysis and nocturnal sleep fragmentation. It's most common presenting symptom and essential feature is excessive daytime sleepiness. Diagnosis is often missed in India because of lack of proper sleep labs and training to diagnose this disorder This case highlights the need to keep Narcolepsy among the common differentials for adolescents presenting with excessive daytime sleepiness, while also looking for other common causes of the same. A detailed approach to the same is also discussed.


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