Indian Journal of Sleep Medicine

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2022 | October-December | Volume 17 | Issue 4

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Original Article

Amina Mobashir, Vivek Nangia, Shriram Sudhakar Shenoy, Navin Dalal, Rohit R Chandran

Insomnia: An Under-recognized Mental Health Catastrophe during the COVID-19 Era

[Year:2022] [Month:October-December] [Volume:17] [Number:4] [Pages:6] [Pages No:93 - 98]

Keywords: Cognition, Coronavirus pandemic, Insomnia, Sleep

   DOI: 10.5005/jp-journals-10069-0107  |  Open Access |  How to cite  | 

Abstract

Introduction: The coronavirus pandemic (COVID-19) has affected individuals globally in varied manners. It has also affected the psychosocial well-being, particularly of persons residing in the countries that were worst affected. In India, complete lockdown, social distancing, working from home, and fear of getting infected have caused a vast majority to develop problems related to sleep. We studied the prevalence of insomnia and also identified the potential modifiable risk factors that can address the coronavirus-related sleep pandemic. Materials and methods: We conducted a survey using a questionnaire delivered through the internet. A total of 645 individuals were enrolled in the study. Insomnia severity index was used to calculate the prevalence of clinically significant insomnia. Data were coded and recorded in MS Excel spreadsheet program. SPSS v23 was used for data analysis. Results: We found that 51.3% (n = 331) of our study population had clinically significant insomnia out of which 137 (21.2%) reported new onset symptoms during the lockdown. Statistically significant association were found between insomnia and female gender, age, anxiety, caffeine consumption, alcohol consumption, and sleep–wake patterns. Conclusions: In conclusion, the burden of insomnia is more than those that seek treatment. It has tremendous negative consequences on patient's well-being. During the pandemic, given the current social and economic doldrums, insomnia may very well be the last nail in the coffin for those with pre-existing mental illnesses just trying to stay afloat.

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REVIEW ARTICLE

J. C. Suri, Jagdish Chander Suri, Tejas Menon Suri

A Review of the Current Status of Home Sleep Apnea Testing vis-à-vis In-lab Polysomnography: Is Old Still Gold?

[Year:2022] [Month:October-December] [Volume:17] [Number:4] [Pages:4] [Pages No:99 - 102]

Keywords: Home sleep apnea testing, Obstructive sleep apnea, Polysomnography, Portable sleep study, Sleep-disordered breathing

   DOI: 10.5005/jp-journals-10069-0106  |  Open Access |  How to cite  | 

Abstract

Obstructive sleep apnea (OSA) affects almost one billion people worldwide and is a major cause of morbidity and mortality. However, most patients with OSA remain undiagnosed and untreated. In-lab polysomnography attended by a sleep technologist is the gold standard intervention for the diagnosis of OSA and titration of positive airway pressure (PAP) therapy. However, in-lab polysomnography is expensive, labor-intensive, and associated with long wait times. Further, patients are observed for only one night outside their normal sleep environment which may adversely affect the quality of sleep and not capture night-to-night variability. Hence, various portable devices have been developed to perform home sleep apnea testing (HSAT) at lower costs than in-lab polysomnography. In this review article, we compare the relative merits and demerits of HSAT vis-à-vis in-lab polysomnography. We delve into the current evidence for the efficacy, shortcomings, and costs of the different types of sleep studies. We summarize the current guidelines for sleep apnea testing. We conclude with the Indian perspective on the various types of sleep studies available.

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REVIEW ARTICLE

Kamaldeep Singh, Arpit Jain, Ishita Panchal, Hritik Madan, Salil Chaturvedi, Anastas Kostojchin, Ambreen Shahzadi, Muzammil M Khan, Shobhit Piplani

Smartphones and Consumer Devices in Management of Obstructive Sleep Apnea

[Year:2022] [Month:October-December] [Volume:17] [Number:4] [Pages:5] [Pages No:103 - 107]

Keywords: Obstructive sleep apnea, Review, Sleep medicine, Smartphone, Telemonitoring, Wearable sleep technology

   DOI: 10.5005/jp-journals-10069-0108  |  Open Access |  How to cite  | 

Abstract

Aim: To review various consumer-level technologies for management and continuing case of obstructive sleep apnea (OSA) patients. Background: Recent advancements in wearable and smartphone technology have created new ways to assess sleep health, including OSA. Obstructive sleep apnea leads to continuous upper airway obstruction during sleep, producing episodes of apnea–hypopnea, sleep fragmentation, nonrestorative sleep, and excessive daytime somnolence, leading to long-term cardiopulmonary complications. This review sheds light on the use of modern smartphone-based sleep-tracking applications and consumer devices in the management of OSA. Results: Rapid advancements in mHealth technologies have enabled users to self-monitor and visualize their sleeping patterns, symptoms, and behavioral data, enabling them to take everyday precautions. Various available options include plethysmography, actigraphy, pulse-oximetry, ambulatory ECG recorders, body temperature sensors, sound analysis, and cardiorespiratory coupling. Conclusion: Due to limitations in precision and standards, such tools may not be recommended for clinical populations or as diagnostic tools. Future research should focus on analyzing the effect of these interventions on persons who already have good sleep quality or who use the applications but skip days. In addition, comprehensive studies measuring behavioral changes in various age, gender, and comorbidity groups are warranted. Clinical significance: While technological aids help in better management, it is vital to develop efficient methods for integrating wearables’ data into patient-care pathways. Restrictive IT infrastructures, privacy, data protection, and data ownership arguments prevent widespread integration of consumer wearables into clinical workflows.

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CASE REPORT

Mahendran Arul Janakiammal

An Uncommon Cause of Hypersomnolence

[Year:2022] [Month:October-December] [Volume:17] [Number:4] [Pages:2] [Pages No:108 - 109]

Keywords: Excessive daytime sleepiness, Multiple sleep latency test, Narcolepsy

   DOI: 10.5005/jp-journals-10069-0109  |  Open Access |  How to cite  | 

Abstract

Excessive daytime sleepiness (EDS) is a frequent complaint of patients presenting to a pulmonologist, neurologist, psychiatrist, and a physician. We present a case of a 21-year-old medical student who had complaints of EDS and was eventually diagnosed as narcolepsy and treated effectively for the same.

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