Indian Journal of Sleep Medicine

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2021 | October-December | Volume 16 | Issue 4

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Rohit Kumar, Siddharth R Yadav

Continuous Positive Airway Pressure Compliance: Addressing the Elephant in the Room

[Year:2021] [Month:October-December] [Volume:16] [Number:4] [Pages:2] [Pages No:95 - 96]

   DOI: 10.5005/jp-journals-10069-0084  |  Open Access |  How to cite  | 



Dimple Rawat, Anshu Sharma, Arti Gulati, Ram Sagar

To Determine the Predictors for Sleep Quality in Young Adults Using Modifiable Lifestyle Factors for Noncommunicable Diseases: A Cross-sectional Study

[Year:2021] [Month:October-December] [Volume:16] [Number:4] [Pages:5] [Pages No:97 - 101]

Keywords: Anthropometry, Body composition, Noncommunicable disease, Sleep quality

   DOI: 10.5005/jp-journals-10069-0086  |  Open Access |  How to cite  | 


Aims: To determine the predictors for sleep quality in young adults using modifiable lifestyle markers for noncommunicable diseases (NCDs) among adults aged 20–40 years. Materials and methods: An exploratory study was conducted in New Delhi among 100 young adults aged 20–40 years in the year 2018, using a convenience sampling method. Body composition was assessed using Tanita UM-075. The relationship between the variables was measured with Spearman correlation analysis. Multivariable logistic regression analysis was conducted to determine the predictors for poor sleep quality. The receiver operating characteristics (ROC) curve was used to determine the predictive accuracy of the model. Results: Among all, 57% had sound quality sleep followed by 43% with disturbed; 23% were highly stressed, 71% moderately, and 6% low stressed. Significant correlation between sleep quality and risk factors for NCDs like body mass index (BMI) (r = 0.8111, p <0.001), waist circumference (r = 0.6661, p <0.001), body fat percentage (r = 0.3692, p = 0.002), visceral fat (r = 0.68, p <0.001), stress score (r = 0.092, p = 0.36), muscle mass (MM) (r = 0.36, p = 0.0002). High BMI was observed to be an independent predictor for disturbed sleep quality (odds ratio 4.31, 95% CI 1.98–9.38). The area under the curve for the prediction of sleep quality was observed 0.97% using a combination of BMI, MM, duration of sleep. Conclusion: High BMI was observed to be an independent predictor (4.31 times higher) for the disturbed sleep quality. Clinical significance: Lifestyle modifiable factors should be looked upon when dealing with patients with disturbed sleep quality.



Aritrik Das

Sleep Quality during COVID-19 Lockdown among Young Indian Adults: A Cross-sectional Study

[Year:2021] [Month:October-December] [Volume:16] [Number:4] [Pages:6] [Pages No:102 - 107]

Keywords: Containment zone, COVID-19, Lockdown, PSQI, Sleep quality

   DOI: 10.5005/jp-journals-10069-0087  |  Open Access |  How to cite  | 


Background: COVID-19 disrupted lives globally, and to combat it, various countries including India imposed lockdown and other restrictions. This study was conducted to estimate the prevalence of poor sleep quality among Indian adults in 18–30-year age-group and factors associated with it during lockdown. Methods: This was an online survey-based cross-sectional study conducted in May 2020 after 6 weeks of lockdown in India. Information regarding sociodemographic profile, screen time, physical activity, substance use, caffeine intake, and sleep habits during lockdown was collected. Pittsburgh sleep quality index was used to assess the sleep quality. Descriptive analysis was performed. Results: A total of 244 study participants were included in the study, out of which 59% (144) were males and mean age was 24.1 years. Physical activity was decreased among 138 (56.6%) and screen time of more than 4 hours among 152 (62.3%) study participants. Poor sleep quality was reported by 47.1% (115) and sleep duration was decreased among 24.6% (60) study participants. Younger age, living in a containment zone, optimal use of available time, and decreased sleep duration were found to be associated with poor sleep quality. Conclusion: Lockdown affected sleep quality of the study participants adversely, delaying sleeping and waking times. It is important to ensure minimum disruption of day-to-day schedule of people even during such restrictions. Living in a containment zone was found to be significantly associated with poor sleep quality. Authorities should see to it that people living in such zones should be given priority and counseled appropriately.



Caroline Gouder, Stephen Montefort, Joan Bartra

Usefulness of Checking Sensitization Status in Adult Patients with Suspected Sleep Apnea

[Year:2021] [Month:October-December] [Volume:16] [Number:4] [Pages:8] [Pages No:108 - 115]

Keywords: Adult, Obstructive sleep apnea, Prevalence

   DOI: 10.5005/jp-journals-10069-0085  |  Open Access |  How to cite  | 


Aim: An association between obstructive sleep apnea (OSA) and allergic rhinitis (AR), both common with increasing prevalence worldwide, has frequently been reported. The objective of this study was to assess acceptability, feasibility, and usefulness of routinely checking sensitization status in suspected sleep apnea. Materials and methods: All consecutive adult patients referred to an adult sleep clinic in Malta over a 10-week period were included. A medical history, physical examination, and skin testing for common aeroallergens were performed for all and rhinoconjunctivitis quality of life questionnaire (RQLQ), Total-4-nasal symptom score (T4NSS), and visual analogue scale (VAS) for AR patients. Uncontrolled AR was treated. The polysomnography report was reviewed. Results: Our cohort included 95 patients—34.7% were sensitized and diagnosed with AR. The most common perennial aeroallergens were Dermatophagoides pteronyssinus (86.1%), farina (75%), seasonal aeroallergens, tree (19%), and grass pollen (19%). When comparing allergic and nonallergic groups, the former were younger (p = 0.002), more likely female (p = 0.06) and asthmatic (p = 0.014), suffered rhinorrhea (p = 0.02), or other rhinoconjunctivitis symptoms (p <0.001). Patients with AR were less likely diagnosed with sleep apnea (60.6%) compared to those without (81.3%) (p = 0.014). A total of 54.2% of patients with normal polysomnography were diagnosed with AR compared to 30% of sleep apnea patients (p = 0.26). Conclusion: Skin prick testing (SPT) in this context is acceptable, safe, and feasible, mainly useful in younger females, asthmatics, and those with AR symptoms. Diagnosing AR in patients whose symptoms have been mistaken for sleep apnea and in patients with coexisting sleep apnea will improve morbidity and quality of life. Clinical significance: Checking sensitization status in patients with suspected sleep apnea will improve clinical outcomes.



Shubhajeet Roy, Archna Ghildiyal

Effects of Diet Components on the Sleep Quality of First-year Medical Students of a Medical University of Northern India

[Year:2021] [Month:October-December] [Volume:16] [Number:4] [Pages:9] [Pages No:116 - 124]

Keywords: Calories, Diet components, Medical students, Pittsburgh sleep quality index, Sleep quality

   DOI: 10.5005/jp-journals-10069-0089  |  Open Access |  How to cite  | 


Aim: The primary aim was to find out the effect of diet components: protein-rich food (represented by the non-vegetarians) or carbohydrate-rich food (represented by the vegetarians) on the sleep quality of first-year medical students. The secondary aim was to find whether the total calorie intake and the sleep quality of the subjects had any relation. Materials and methods: Students were divided into four groups according to gender and whether they are vegetarians or non-vegetarians. All of them were required to fill their daily food consumption questionnaire, at the end of each day, for 28 days. At the end of this period, they had to fill the Pittsburgh Sleep Quality Index (PSQI) questionnaire. The total calorie intake and PSQI scores were calculated and analyzed. Results: The average calorie intake and PSQI score of non-vegetarians are ± SD = 50747.78 ± 15068.05 kcal and 5.76 ± 2.57, respectively. The average calorie intake and PSQI score of vegetarians are ± SD = 60342.63 ± 18309.56 kcal and 6.02 ± 2.66, respectively. No significant correlation was found to exist between calorie intake and sleep quality, in any of the individual groups nor overall. Conclusion: The average calorie intake of vegetarians was higher, but their sleep quality was worse, due to more carbohydrate consumption and less protein consumption as compared to the non-vegetarians. More of carbohydrate and less of protein had resulted into their poorer sleep quality. Boys had overall better sleep quality than girls. Excess intake of snacks and fast food and consuming less variety of foods, as mostly seen in girls, were also found to be the dietary reasons behind their poorer sleep quality. Clinical significance: This study will help hostellers in finding the balanced combination of food components that are best for them to lead a healthy life and get the very needed sound sleep and can be beneficial for different institutions in designing their balanced hostel mess menu.



Nisha Kalonia, Pradeep Raghav, Kumar Amit, Prashant Sharma

Effect of Mandibular Advancement through Oral Appliance Therapy on Quality of Life in Obstructive Sleep Apnea: A Scoping Review

[Year:2021] [Month:October-December] [Volume:16] [Number:4] [Pages:6] [Pages No:125 - 130]

Keywords: Health status, MAD, Obstructive sleep apnea, Oral appliance, Quality of life, Scoping review

   DOI: 10.5005/jp-journals-10069-0088  |  Open Access |  How to cite  | 


Purpose: The scoping review was conducted for the evaluation of effect of mandibular advancement through oral appliance therapy on quality of life in obstructive sleep apnea (OSA). Methods: Strategic and thorough literature search using free text and MESH terms in three major database systems PubMed, SCOPUS, and Web of Science was undertaken till October 30, 2020, followed by PRISMA for the identification of studies for data extraction. Results and conclusions: Summarization of evidence was done for study characteristics, and diagnostic methods for the evaluation of effect of mandibular advancement through oral appliance therapy on quality of life in OSA. The literature supports that patients using mandibular advancement appliances (MADs) showed better adherence and compliance in comparison with those using continuous positive airway pressure (CPAP); along with the patients’ compliance, the daytime sleepiness, state on waking, morning headache, oxygen saturation, frequency and intensity of snoring, and quality of sleep for both patients and their bed partners showed a marked improvement with MAD.



Harsha Jain, Neeraj K Gupta

Laurence–Moon–Bardet–Biedl Syndrome and Obstructive Sleep Apnea

[Year:2021] [Month:October-December] [Volume:16] [Number:4] [Pages:4] [Pages No:131 - 134]

Keywords: Laurence–Moon–Bardet–Biedl syndrome, Obstructive sleep apnea, Polysomnography, Positive airway pressure

   DOI: 10.5005/jp-journals-10069-0090  |  Open Access |  How to cite  | 


Pediatric obstructive sleep apnea (OSA) often is underdiagnosed, particularly when associated with a syndrome when there are numerous and varied manifestations. However, a high index of suspicion and screening can help in early diagnosis and treatment for the same. We present a case of Laurence–Moon–Bardet–Biedl syndrome diagnosed since the age of 8 years presenting at the age of 16 years with severe OSA with good clinical recovery on therapeutic use of continuous positive airway pressure (CPAP).


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