Indian Journal of Sleep Medicine

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2020 | July-September | Volume 15 | Issue 3

RESEARCH ARTICLE

Shweta Kanchan, Krishna Kant Bhardwaj, Sunita Tiwari, Siddhant Bakshi, Prashant Vajpei

Effect of Coronavirus Disease-2019 Pandemic on the Sleep Quality of Indian Population

[Year:2020] [Month:July-September] [Volume:15] [Number:3] [Pages:4] [Pages No:35 - 38]

Keywords: Pandemic, Pittsburgh sleep quality index, Sleep quality

PDF  |  DOI: 10.5005/jp-journals-10069-0055  |  Open Access |  How to cite  | 

Abstract

Aim and objective: This survey was conducted to compare the sleep quality of the general Indian population before the coronavirus disease-2019 (COVID-19) pandemic and during the pandemic using Pittsburgh Sleep Quality Index (PSQI). Materials and methods: It is a cross-sectional online survey-based study conducted on 1,000 consenting Indian adult citizens. The survey was circulated by the investigators through an online link on various social media platforms. It had questions based on PSQI to access the sleep quality. Results: The mean PSQI before the pandemic was found to be 4.37 and during the pandemic to be 5.00. Results showed that the pandemic had deteriorated the sleep quality of general population of India. All the sleep parameters in the PSQI scale showed deterioration in sleep quality due to the pandemic. Significant change was seen in the level of enthusiasm—34.3% people lacked the enthusiasm to get the things performed before the pandemic while 48.4% people lacked the enthusiasm to get the things performed during the pandemic. Conclusion: The study indicated a marked decrease in the sleep quality during the pandemic as compared to before the pandemic. Clinical significance: This survey informs about the change in sleep quality parameters due to COVID-19 pandemic.

RESEARCH ARTICLE

Kartik Deshmukh, Arjun Khanna

Seasonality of Obstructive Sleep Apnea in Asia: Insights from Google Trends

[Year:2020] [Month:July-September] [Volume:15] [Number:3] [Pages:7] [Pages No:39 - 45]

Keywords: Obstructive sleep apnea, Sleep apnea, Sleep-related breathing disorders

PDF  |  DOI: 10.5005/jp-journals-10069-0056  |  Open Access |  How to cite  | 

Abstract

Background and objectives: Obstructive sleep apnea (OSA) is the most common type of sleep-disordered breathing encountered in clinical practice and has considerable medical and psychosocial consequences. Snoring is the most common sign of OSA, yet it is most often ignored. Seasonal changes may lead to changes in body weight, pharyngeal flow, and frequency of allergies, which in turn leads to changes in the severity of OSA. The seasonal pattern of worsening of OSA can be demonstrated by the analysis of information-seeking behavior on the internet from a specific region. Google, the most popular search engine, indexes the queries with every search performed and makes this information available to the public through Google trends. Materials and methods: In the current study, we used Google trends data to investigate the seasonal variation in sleep-disordered breathing in eight countries in the Asia-Pacific region (India, Hong Kong, Thailand, Singapore, Malaysia, Taiwan, Japan, and South Korea) from 2015 to 2020. The seasonality of queries for the term “snoring” was analyzed using the cosinor model. Results: Peaks and troughs in trends of search volume index (SVI) or normalized search volume during the specific period for the term “snoring” were evident. There were significant differences in mean SVI values across the seasons. Cosinor models confirmed the seasonality for “snoring” in all countries in the study. The peak season for queries corresponded to the cold climate in the respective countries, with maximum amplitude seen in India. Conclusion: Obstructive sleep apnea exhibits seasonality with increased severity in winter. The results of this study can guide targeted implementation of sleep awareness program in winters to increase the awareness and the management of OSA across the Asian countries.

RESEARCH ARTICLE

Ilin Kinimi, Supriya S Shinde, Neha M Rao

Home Mechanical Ventilation in Children: A 7-year Experience

[Year:2020] [Month:July-September] [Volume:15] [Number:3] [Pages:5] [Pages No:46 - 50]

Keywords: Bilevel positive airway pressure, Continuous positive airway pressure, Chronic respiratory failure, Home mechanical ventilation

PDF  |  DOI: 10.5005/jp-journals-10069-0058  |  Open Access |  How to cite  | 

Abstract

Aims and objectives: To review the profile of children requiring home mechanical ventilation (HMV), the diagnoses, modes of presentation, age at initiating HMV, and outcome of these children on follow-up. Materials and methods: This is a retrospective observational study. We included all children up to 18 years of age who were started on HMV between May 2013 to April 2020 at our hospital. Source of data was the hospital records of children receiving HMV. Clinical data were captured on Excel sheet and analyzed. Results: Fifty-seven children were started on HMV with a mean age of 6.43 years (range of 3 months to 17 years 8 months) at start of HMV; 35 (61.4%) were male and 22 (38.6%) were female. Fifteen (17.5%) of 57 presented with acute respiratory failure, and 42 (73.6%) of 57 with chronic respiratory failure. Thirty-nine (68.4%) of 57 had an established diagnosis of a neuromuscular disease (NMD) of 22 (56.41%) of 39 had an underlying diagnosis of spinal muscular atrophy 2 (SMA type II) which was also the most common diagnosis in this study. Average age at initiating ventilation in the neuromuscular group was 7.92 years (range: 4 months–17 years 8 months) and the other non-NMD group was 2.91years (range: 3 months–15 years). Seven children were on invasive tracheostomy and 50 on noninvasive ventilation (NIV). Fifty-six children were started on BiPAP, and one child is on CPAP. Two children have been weaned of HMV and are doing well. There were three episodes of life-threatening complications in three different children, and the annual rate of hospitalization with respiratory morbidity was 0.36 per child. There has been no mortality in this study period. Conclusion: Home mechanical ventilation improves the life expectancy and enhances the quality of care and survival. Under the appropriate clinical scenarios, HMV significantly reduces the economic, psychosocial burden on the family and improves quality of life for the child. Transition to home care is challenging, especially in developing countries with lack of nursing care/home care support, but is feasible with meticulous planning wherein parents or caregivers are the key partners. To the authors knowledge, this is the largest case series of children on HMV from India.

REVIEW ARTICLE

S Ramnathan Iyer, Revati R Iyer

Obstructive Sleep Apnea and Venous Thrombosis: Clinical Implications

[Year:2020] [Month:July-September] [Volume:15] [Number:3] [Pages:3] [Pages No:51 - 53]

Keywords: Venous return, Venous thromboembolism,Obstructive sleep apnea

PDF  |  DOI: 10.5005/jp-journals-10069-0057  |  Open Access |  How to cite  | 

Abstract

Obstructive sleep apnea (OSA), although a disease of upper respiratory airway, has profound effects on body systems. The breathing abnormalities have effects on venous return. Pooling of blood in legs during apnea–hypopnea, coupled with hemodynamic changes and pathological cascades, favors thrombosis in legs and subsequent thromboembolism. An OSA has possible implications in vascular endothelial injury, stagnant blood flow, increased coagulability (Virchow\'s triad), and Trousseau\'s syndrome. An OSA suspicion must be high in all patients with venous thrombosis, particularly in those who have recurrent episodes of this disorder.

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