Indian Journal of Sleep Medicine

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2021 | January-March | Volume 16 | Issue 1

Original Article

Chithra Ramachandran, Janhvi J Bhate, Unnikrishnan K Menon, Siddharth Panikkar

Prevalence of Sleep Disorders in Moderate to Severe Type of Allergic Rhinitis

[Year:2021] [Month:January-March] [Volume:16] [Number:1] [Pages:4] [Pages No:1 - 4]

Keywords: Quality of life, Sleep disorders,Allergic rhinitis, Cross-sectional study, Prevalence

PDF  |  DOI: 10.5005/jp-journals-10069-0063  |  Open Access |  How to cite  | 

Abstract

Aim and objective: To study the prevalence of sleep disorders in patients with moderate and severe types of allergic rhinitis (AR). Materials and methods: Patients presenting to the ENT OPD of a tertiary care hospital were evaluated using validated tools. Those with symptoms of allergic rhinitis and having a score of >7 using the score for allergic rhinitis (SFAR) questionnaire, were assessed for severity of allergic rhinitis using allergic rhinitis and its impact on asthma (ARIA) classification. A total of 210 patients with moderate to severe AR were included. Associated sleep disorders were assessed using self-administered questionnaires—French version (HD 42) and Epworth sleepiness scale score (ESS). The data was compiled into IBM SPSS statistics 2.0 windows and correlated. Results: Among 210 patients included in this study, the sleep disorders reported were insomnia in 59%, hypersomnia in 38.6%, and obstructive sleep apnea (OSA) in 2.4% with no gender or age significance (p = 0.153 and 0.173, respectively). A total of 83.3% of patients complained of tiredness on waking up in the morning and 54.3% of patients reported daytime somnolence. Snoring was correlated with OSA and was seen to be higher in males (45%, p = 0.001) and middle aged (42.96 years, p = 0.002). Conclusion: There is a significant prevalence of sleep disorders in patients with moderate to severe allergic rhinitis. Early detection and treatment of these will improve their quality of life. Clinical significance: Patients presenting with AR symptoms should be routinely questioned about their sleep quality and daytime somnolence so that early detection and aggressive treatment of AR can help in controlling the resultant sleep disturbances and thereby significantly improve the quality of life in these individuals.

Original Article

Uma Devaraj, Uma Maheswari Krishnaswamy, Sujana Balla, Ashna M Pinto, Kavitha Venkatnarayan, Priya Ramachandran, Chitra Veluthat, George D Souza

Prevalence and Risk Factors for OSA among Urban and Rural Subjects in Bengaluru District, South India: A Cross-sectional Study

[Year:2021] [Month:January-March] [Volume:16] [Number:1] [Pages:5] [Pages No:5 - 9]

Keywords: Berlin questionnaire, Epworth sleepiness scale, Level III sleep study, Obstructive sleep apnea, Rural and urban setting

PDF  |  DOI: 10.5005/jp-journals-10069-0064  |  Open Access |  How to cite  | 

Abstract

Introduction: Prevalence rates of obstructive sleep apnea (OSA) in India vary widely due to diverse study settings. Besides, the literature comparing the prevalence of OSA between urban and rural settings is sparse. Aims and objectives: To determine prevalence and risk factors for OSA among urban and rural South Indian subjects. Materials and methods: This prospective study was carried out in seven census blocks in Bengaluru and seven villages in Anekal taluk. Clinical data were collected; Epworth sleepiness scale and Berlin questionnaire were used to screen for sleepiness and OSA, respectively. Subjects deemed high risk for OSA during screening underwent level III sleep study. Results: A total of 709 subjects (388 urban and 321 rural) were included. The mean age was 35.5 ± 10.6 years (urban subjects) and 39.4 ± 15.6 years (rural subjects). Those at risk of OSA after screening were 36 (6.7%) and 28 (8.7%) among urban and rural participants, respectively. The prevalence of OSA was 18 (4.6%) in urban and 12 (3.7%) in rural subjects. Discussion: The urban OSA group had significantly higher body mass index (27.6 vs 24.2 kg/m2; p = 0.05) and neck circumference (38.9 vs 34.4 cm; p = 0.0001). Although the overall prevalence of OSA was similar in both groups, urban subjects had a significantly higher prevalence of severe OSA (44 vs 8.4%). Conclusion: Prevalence of OSA was similar in urban and rural subjects but risk factors and OSA severity showed variation between the two groups, with urban subjects having unfavorable anthropometry and a higher proportion of severe OSA.

Original Article

Raj Vardhan, Archana Ghidiyal, Sunita Tiwari, Shweta Kanchan

Association between Sleep Spindles and IQ of College Students

[Year:2021] [Month:January-March] [Volume:16] [Number:1] [Pages:4] [Pages No:10 - 13]

Keywords: Intelligence quotient, Polysomnography, Sleep spindle,Electroencephalogram

PDF  |  DOI: 10.5005/jp-journals-10069-0065  |  Open Access |  How to cite  | 

Abstract

Introduction: Sleep spindles are short burst-like waveform of signals generated in the electroencephalogram (EEG) recorded during sleep, and these are the electrical representation of an oscillatory neuronal activity of thalamic neurons. Some studies have linked different sleep spindle parameters with intelligence quotient (IQ). But there is a lack of uniformity in different studies, as spindle parameters may be positively associated with cognition variables in one study, but those same parameters might be negatively associated or even unrelated in other studies. The present study was conducted to further throw light on the correlation of sleep spindle activity with IQ. Objective: To find the association between different sleep spindle parameters and IQ. Method: The sleep spindle data of 50 healthy young medical students aged between 18 and 23 years were taken from previously conducted sleep studies (polysomnography), which were available in the sleep lab in the department of physiology (King George\'s Medical University). The participating students underwent a Wechsler IQ test. The result of the test was correlated with sleep spindle parameters available with us to see any correlation. Results and conclusion: Sleep spindle frequency was negatively correlated with the IQ, and the number of spindles in deep sleep (N3) was positively associated with the IQ of an individual.

Original Article

Ilin Kinimi, Neha Mohan Rao

Review of Pediatric Polysomnographic Studies over a 2-year Period in a Tertiary Care Hospital in Bengaluru, India

[Year:2021] [Month:January-March] [Volume:16] [Number:1] [Pages:4] [Pages No:14 - 17]

Keywords: Polysomnograph, Sleep disorders, Sleep study

PDF  |  DOI: 10.5005/jp-journals-10069-0066  |  Open Access |  How to cite  | 

Abstract

Introduction: Pediatric polysomnography is the gold standard in diagnosing sleep-related breathing disorders, the most common cause of this being obstructive sleep apnea (OSA). Instituting good sleep hygiene measures, early recognition of symptoms and signs of sleep-disordered breathing, and timely referral for polysomnography play a vital role in improving a child\'s quality of life. We report our experience with sleep disorders in children and the challenges faced during diagnosis. Aims: To review indications for pediatric sleep studies done over 2 years and their outcomes in a tertiary care center in Bengaluru, India. Methods: Retrospective descriptive analysis of 65 pediatric sleep studies done between 2018 and 2020 (2-year period) for various indications. Results: The total numbers of studies included in the analysis were 65, of which complete studies were done in 58 children and portable studies in 7 children. The most common indication for performing a sleep study was suspected OSA, followed by referrals for children with spinal muscular atrophy and Duchenne muscular dystrophy, respectively. Average age of the patient was 93.56 months (range 3–216 months). The number of boys and girls included in the study was 45 and 20, respectively. The average duration of sleep was 375.35 minutes, of which rapid eye movement (REM) sleep contributed to 45.33 minutes (12.13%) (range, 0–90 minutes). The average sleep latency time was 21.36 minutes (range, 0.5–138 minutes). The total apnea–hypopnea index (AHI) was 12.64/hour with 26 (40%) children having mild OSA, defined as an AHI of less than 5/hour; 17 (26.1%) having moderate OSA, defined as an AHI of 5 to 10/hour; 22 (33.8%) having severe OSA defined as an AHI of 15 to 30/hour. The mean REM AHI was 29.67/hour. Thirty-four children were started on bilevel positive airway pressure (BiPAP) following the study and four children had their BiPAP setting titrated following the study with one child whose high flow oxygen was continued. Conclusion: Of the 65 pediatric sleep studies included, 39 children (60%) underwent some form of intervention following the study, indicating the clear benefit of performing polysomnography and indicating a high prevalence of sleep disorders in children. Mouth breathing was the most common symptom and OSA was the most common diagnosis.

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