Introduction: Sleep is a basic human need and is imperative for good health, good quality of life (QoL), and performing well during the day. Along with the physiological changes that happen with aging, changes in sleep pattern is inexorable. Considering the implications of sleep quality and its relevance amid the elderly and the paucity of data from the region, a study is being undertaken to assess the sleep quality of aging adults and its importance, to analyze the results across socio-demographic and other factors in an urban setting. Methodology: A community-based analytical study was done in an urban resettlement colony with 459 elders. Study tools include the Pittsburgh Sleep Quality Index (PSQI), Geriatric Depression Scale (GDS), and a pre-tested semi-structured questionnaire followed by a basic physical examination. Data were tabulated and analyzed with appropriate statistical measures. Results: The point prevalence of insomnia among the participants was 82% with a mean PSQI score of 7.8. Most of them reported themselves to be not active physically and preferred drinking tea before slumber. Being a female [adjusted odds ratio (AOR) 0.48], having a television in the room (AOR 2.64), having no sleeping partner (AOR 10.2), having dyspepsia or reflux (AOR 68.7), racing thoughts or stressful (AOR 5.7), habitual daytime nap (AOR 0.14), being overweight or obese (AOR 2.5), and mild depression (AOR 2.5) had a significant role with poor sleep in the elders (p-value < 0.05). Conclusion: With this study, it could be easy to infer that elderly dwelling in urban settlements abstain from habitual physical activity (PA) and tend to suffer from alarming levels of disturbed sleep. With advancing life expectancy and hence medical comorbidities, physicians may be required to include sleep health as much as any other assessment to heighten their QoL.

Background: Overlap syndrome refers to the coexistence of chronic respiratory disease and obstructive sleep apnea syndrome (OSAS) in the same patient. Untreated OSAS results in complications like cardiovascular disease, metabolic disorder, and cognitive impairment. Patients with overlap syndrome have a greater risk of morbidity and mortality compared with OSAS alone. Recognition of overlap syndrome is significant as the survival of patients with untreated overlap syndrome is significantly inferior to treated patients. Methodology: A prospective observational study of 90 patients with symptoms of OSAS was conducted in our tertiary care center with ethical approval. All patients underwent overnight polysomnography (PSG). Coexisting respiratory diseases were noted. Results: All 90 patients included in the study were diagnosed with OSAS, which was confirmed by overnight PSG. About 31% had mild, 23% had moderate, and 46% had severe OSAS. The mean age was 53.81 years, and the majority of the participants were male (64%). The majority (67%) had overlap with chronic obstructive pulmonary disease, 27% with interstitial lung disease (ILD), and 6% with bronchial asthma (BA). About 55% had hypertension, 33% had diabetes mellitus (DM), and 18.88% had hypothyroidism, 20% had hypertension and DM, 11.11% had hypertension and hypothyroidism, 4.4% had DM and hypothyroidism as non-respiratory comorbidities. Conclusion: Overlap syndrome in our tertiary center in India shows predilection toward the male sex, obesity, and frequent association with non-respiratory comorbidities such as hypertension, DM, and hypothyroidism. Chronic obstructive pulmonary disease and obstructive sleep apnea (OSA) overlap is more common than ILD and BA. Early detection and treatment of OSA among patients with respiratory disease can aid in better patient management and overall improvement in the quality of life.

The circadian rhythm mediated by the suprachiasmatic nucleus of the hypothalamus is primarily responsible for maintaining the sleep and wakefulness states. Numerous physiologic mechanisms and bodily repairs occur during the state of sleep along with functional alterations in both the autonomic and somatic nervous systems. Most individuals cycle through three stages of nonrapid eye movement sleep, accounting for about 75% of total sleep duration, followed by rapid eye movement sleep, which makes up the remaining 25%. Besides the above, endocrine factors like the release of melatonin from the pineal gland also have a significant impact on the initiation and maintenance of sleep phases. The emotional factors and the limbic system in association with a multitude of variables like stress, drugs, substance use like alcohol, appetite, and behavioral patterns are known to modulate a typical sleep cycle. Given below is a detailed review of normal sleep physiology and numerous sleep-related disorders, their risk factors along with their management, and a brief description of all factors that influence as well as alter the neuronal signaling processes of the brain.