Indian Journal of Sleep Medicine

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2024 | April-June | Volume 19 | Issue 2

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Original Article

Amit Antil, Saugat Ray, Amrit Thapa, Baljinder Singh Walia, Prasanna Kumar

Does Reduced Hypopharyngeal Space Affects Respiratory Function and Pharyngeal Volume?

[Year:2024] [Month:April-June] [Volume:19] [Number:2] [Pages:5] [Pages No:13 - 17]

Keywords: Acoustic pharyngometry, Forced expiratory volume in one second, Hypopharyngeal airway space, Oropharyngeal volume

   DOI: 10.5005/jp-journals-10069-0135  |  Open Access |  How to cite  | 

Abstract

Background/objective: Reduced dimensions of the upper airway tract may affect the functionality to the extent of distorting the vertical growth of the face. However, human adaptability also tries to compensate for the anatomic alterations so that vital functions of the body like respiration are not grossly hampered. The present study aims to determine the correlation of forced expiratory volume in one second (FEV1) with oropharyngeal volume (OPV) in individuals exhibiting reduced hypopharyngeal space. Materials and methods: About 36 patients with reduced hypopharyngeal airway space (HAS), as measured on lateral cephalograms from a tertiary care government hospital, were included in this cross-sectional study. Forced expiratory volume in one second and OPV were measured using spirometry and acoustic pharyngometry (AP) respectively. Results: The study population, comprised 15 males and 21 females with a mean age of 17.6 ± 4.7 years. A statistically significant positive correlation was observed between age with BMI and FEV1 (p = 0.001, < 0.000 respectively) and BMI with FEV1 (p = 0.004). No statistically significant correlation was found between mean HAS with OPV (p = 0.140) and with FEV1 (p = 0.503). Further, no significant correlation was also observed between OPV and FEV1 (p = 0.958) also. One sample t-test showed a statistically significant difference between the mean HAS and predicted normative with a mean difference of –3.52 mm (p = 0.000). Limitations: The present study, being cross-sectional, had the limitation of choosing a homogenous group of participants with reduced HAS. However, the authors suggest a comparative study including patients with various growth patterns and occurrence of obstructive sleep apnea. Conclusion/Implications: The authors conclude that reduced hypopharyngeal space alone does not affect the respiratory function and overall volume of the oropharyngeal region.

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REVIEW ARTICLE

Athul Francis

Insomnia: An Update on Epidemiology, Diagnosis and Non-pharmacological Management

[Year:2024] [Month:April-June] [Volume:19] [Number:2] [Pages:5] [Pages No:18 - 22]

Keywords: Adolescents, Cognitive behavior therapy in insomnia-I, Functional outcomes of sleep, Insomnia, Insufficient sleep, Sleep medicine, Sleep quality

   DOI: 10.5005/jp-journals-10069-0131  |  Open Access |  How to cite  | 

Abstract

Insomnia is defined as a condition in which a person finds it difficult to fall or stay asleep. It is usually associated with significant impairment in daytime function and adversely affects the quality of life of the individual. Insomnia is often found in individuals with psychiatric illness and it has been reported that insomnia may be a risk factor for hypertension, diabetes, depression, anxiety, substance use disorders, and suicidal tendencies. As insomnia is associated with poor quality of life, increased rates of road traffic accidents, and adverse health consequences, early detection and treatment of this condition is warranted. It is recommended that treatment be targeted specifically to address insomnia whenever it is present, including when it occurs along with physical or psychiatric conditions. Several treatment options are available for Insomnia. This paper reviews the various studies on insomnia with special emphasis on diagnosis and various non-pharmacological treatments like cognitive behavior therapy in insomnia (CBT-I).

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REVIEW ARTICLE

Tejas Menon Suri, Harshini Errabelli

Recent Technological Advancements in Sleep Medicine: A Narrative Review

[Year:2024] [Month:April-June] [Volume:19] [Number:2] [Pages:3] [Pages No:23 - 25]

Keywords: Artificial intelligence, Consumer technology, Peripheral arterial tonometry, Photoplethysmography, Sleep medicine

   DOI: 10.5005/jp-journals-10069-0130  |  Open Access |  How to cite  | 

Abstract

Sleep medicine is a specialty historically rooted in the rapid adoption of technological advancements. Recently, there has been an acceleration in the development of newer technologies related to sleep health. While most of these technologies are meant for consumer use, a few have been found robust enough for clinical applications. The artificial intelligence revolution and the COVID-19 pandemic have been two significant drivers for technological innovation that can simplify sleep disorders management and permit remote healthcare delivery. This review discusses the issues related to artificial intelligence, newer consumer and clinical sleep technologies, and their applications in sleep medicine.

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REVIEW ARTICLE

Sanchit Mohan, Pranav Ish, Rohit Kumar, Nitesh Gupta, Vidushi Rathi, Nupoor Vaghasia

Beyond the Breath: Exploring the Complex Nexus of Obstructive Sleep Apnea and Comorbid Conditions

[Year:2024] [Month:April-June] [Volume:19] [Number:2] [Pages:5] [Pages No:26 - 30]

Keywords: Chronic respiratory failure, Metabolic syndrome, Obstructive sleep apnea, Overlap syndrome, Syndrome-Z

   DOI: 10.5005/jp-journals-10069-0133  |  Open Access |  How to cite  | 

Abstract

Obstructive sleep apnea (OSA) can have multi-system involvement, including cardiac, renal, pulmonary, neuropsychiatric, and endocrine complications. Several complications have shown a bidirectional relationship with OSA, and multiple mechanisms of bidirectional relationship have been studied in the literature, like fluid retention and redistribution in heart failure and renal and neural mechanisms in stroke and diabetes. The current review aims to explore comorbidities associated with OSA, look for bidirectional relationships, and the impact of therapy.

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CASE REPORT

Ajay Godse, Sunil Jaisingh, Prachi Shah, Shivanjali Gore

Sleep-disordered Breathing in an Adult with Mucopolysaccharidosis Type I (Hurler–Scheie Syndrome): A Case Report

[Year:2024] [Month:April-June] [Volume:19] [Number:2] [Pages:3] [Pages No:31 - 33]

Keywords: Case report, Mucopolysaccharidosis, Obstructive sleep apnea, Polysomnography, Sleep-disordered breathing

   DOI: 10.5005/jp-journals-10069-0132  |  Open Access |  How to cite  | 

Abstract

Aim and background: Hurler–Scheie syndrome, also known as mucopolysaccharidosis (MPS) type I, is one of the lysosomal storage diseases, resulting in the accumulation of glycosaminoglycans in various organs. The patient presents with coarse facial features, musculoskeletal deformities, and umbilical hernia with no signs of intellectual disability or corneal involvement in childhood. This case report aims to create awareness among the clinicians to identify, diagnose, and treat the sleep-disordered breathing (SDB) in adult patients of MPS. Case description: This case report highlights the incidence of a 33-year-old adult, who was diagnosed with MPS type I in childhood, and later presented with SDB in his adulthood. The patient was diagnosed with obstructive sleep apnea (OSA) with polysomnography. He was treated with bilevel PAP support in which post-treatment his apnea–hypopnea index (AHI) showed drastic improvement from AHI of 99.2 to AHI of 2. Conclusion: The SDB and OSA are few of the respiratory complications seen in MPS type I. With the advent of new therapies, these pediatric disorders have better survival rates than the past few years. Adult survivors of MPS, thus pose as a novel challenge to physicians in their management. Clinical significance: This case report highlights a new challenge that physicians face with the treatment of adults’ survivors of MPS, who present with SDB.

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