Indian Journal of Sleep Medicine

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2020 | April-June | Volume 15 | Issue 2

Original Article

Balavenkata B Chaturvedula, Ashwin M George, Naveen K Mani, Saravana Dinesh, Aravind K Subramanian

Pediatric Obstructive Sleep Apnea vs Adult Obstructive Sleep Apnea: An Orthodontic Perspective

[Year:2020] [Month:April-June] [Volume:15] [Number:2] [Pages:4] [Pages No:17 - 20]

Keywords: Maxillary constriction, Pediatric obstructive sleep apnea, Rapid maxillary expansion, Upper pharyngeal airway,Growth patterns, Lower pharyngeal airway, Mandibular protraction appliance

PDF  |  DOI: 10.5005/jp-journals-10069-0052  |  Open Access |  How to cite  | 

Abstract

Introduction: The literature evidence currently available shows a significant shift toward orthodontics and the orthodontist for management of obstructive sleep apnea (OSA). Individuals with narrow airways and/or craniofacial anomalies may have an increased risk for OSA/hypopnea syndrome, and identification of these at an early stage quite often is done by the orthodontist. The management approach to pediatric OSA is diametrically different than that of adult OSA. This study was performed to determine the upper pharyngeal airway (UPA) space and the lower pharyngeal airway (LPA) space in children of South Indian origin and establish a correlation between airway measurements and growth patterns, if any. Materials and methods: Lateral cephalometric radiographs of 100 medically fit children less than 12–13 years were assessed. The cephalograms were digitally analyzed using Facad and categorized into three growth patterns. McNamara airway analysis was used to measure the UPA and LPA space. Obtained results were subject to statistical analysis. Results: Of total 100 subjects, 33 were in group I [horizontal growth pattern (HGP)], 30 in group II [average growth pattern (AGP)], and 37 in group III [vertical growth pattern (VGP)]. There was a significant reduction in both UPA and LPA dimensions in hyperdivergent or vertical growers: 9.56 ± 0.54 mm and 9.03 ± 1.67 mm, respectively. An odd\'s ratio of 1.18 was obtained, suggestive of good correlation between Frankfurt mandibular plane angle (FMA) and airway measurements. Conclusion: The impact of OSA on the growth and development of a child may have detrimental effects on health, neuropsychological development, quality of life, and economic potential; therefore, OSA in children should be recognized as a public health problem as in the adult population. Clinical significance: Results of this study clearly indicate that there is strong correlation between the pharyngeal space and type of growth pattern in children of South Indian origin.

GUIDELINES

Jagdish C Suri, AG Ghoshal, Dipak Bhattacharya, Dipti Gothi, Dipankar Dutta, Gopal Raval, Manoj Goel, RMPL Ramanathan, Seemab Shaikh, Sushant Khurana, Tejas M Suri

A Consensus Statement on the Sleep Medicine Practice during the COVID-19 Pandemic

[Year:2020] [Month:April-June] [Volume:15] [Number:2] [Pages:5] [Pages No:21 - 25]

Keywords: Sleep studies,COVID-19, Guidelines, Obstructive sleep apnea, Sleep practice

PDF  |  DOI: 10.5005/jp-journals-10069-0051  |  Open Access |  How to cite  | 

Abstract

The coronavirus disease 2019 (COVID-19) pandemic has become a major public health concern worldwide profoundly impacting various aspects of the practice of sleep medicine. Nonetheless, new onset sleep disturbances including insomnia and circadian rhythm disorders have been reported during this period. Severe COVID-19 disease and obstructive sleep apnea (OSA) may have shared risk factors including advancing age, systemic hypertension, and cardiovascular disease. In light of the unprecedented situation and the lack of definitive evidence on ways to tackle the same, sleep physicians and surgeons from the Indian Sleep Disorders Association have prepared this consensus statement on the practice of sleep medicine in India during the COVID-19 pandemic. This document carries expert recommendations under the following categories: (i) sleep clinics and telemedicine, (ii) home sleep apnea testing (HSAT), (iii) in-laboratory polysomnography (PSG) and positive airway pressure (PAP) titration, and (iv) use of PAP devices in OSA. We hope that it will serve as a reference guide to sleep physicians to restart their practice in a safe manner during the COVID-19 pandemic.

REVIEW ARTICLE

Perugu Shyam, Momina S Mohammad

A Review Analysis of Insomnia: Age, Gender, Career, and Efficient Behavior Methods Perspectives

[Year:2020] [Month:April-June] [Volume:15] [Number:2] [Pages:4] [Pages No:26 - 29]

Keywords: Age, Gender, Sleep, Sleep quality

PDF  |  DOI: 10.5005/jp-journals-10069-0053  |  Open Access |  How to cite  | 

Abstract

Insomnia is one of the sleep disorders. Most of the people neglect the symptoms of insomnia. Our aim is to analyze an overall all together at one-step review of defining insomnia, types of insomnia, symptoms of insomnia, other diseases relating to insomnia, factors, diagnosis, and treatments of insomnia is performed for the scope of innovative method for solving the problem. Literatures were reviewed to analyze the insomnia statistically in terms of gender, age, and career. It is observed that women at their postmenopause state are the most prone to insomnia, and the rate of insomnia is high in elderly people. Working at stress, noise, nighttime, and family work imbalance was having impact. Factors indicating insomnia, effect of insomnia in other diseases as circadian rhythm disturbances, diabetes, and breast cancer were observed. The pathways involved, protein involved were analyzed, and it was observed as melatonin plays a key role in the inhibition of sleep induction. Treatments available are explored and enriched treatment with less side effects and good efficacy is needed.

REVIEW ARTICLE

Rohit Kumar, Siddharth Raj Yadav, Pranav Ish, Nitesh Gupta, Shibdas Chakrabarti

Sleep-disordered Breathing and Stroke: A Common yet Ignored Association

[Year:2020] [Month:April-June] [Volume:15] [Number:2] [Pages:5] [Pages No:30 - 34]

Keywords: Positive airway pressure, Sleep-disordered breathing, Stroke

PDF  |  DOI: 10.5005/jp-journals-10069-0054  |  Open Access |  How to cite  | 

Abstract

One of the major causes of long-term disability is stroke. It is widely accepted that the morbidity and mortality caused by stroke can be reduced by aggressively treating the risk factors. One of the modifiable and independent risk factors for stroke is Sleep-disordered breathing (SDB). Untreated SDB may be responsible for an increased risk of stroke and death. Severity of SDB could be used to predict the functional dependence of the patient and poor outcome in stroke patients. Treating SDB with positive airway pressure (PAP) therapy in stroke patients may have impact on functional and neurological outcome. This review discusses the common co-occurrence of the stroke and SDB, its pathogenesis, the effects of SDB on stroke morbidity and mortality, impact of stroke on the sleep architecture, and the possibility of improvement with CPAP therapy.

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