Objective: To determine the reliability and validity of Persian version of “BEARS” (B=Bedtime Issues, E= Excessive Daytime Sleepiness, A=Night Awakenings, R=Regularity and Duration of Sleep, S=Snoring) pediatric sleep questionnaire. Setting: Two primary care pediatric clinics in Tehran, IRAN Methods: In the first step BEARS sleep questionnaire filled and in a 2 to 4 week period BEARS completed again (by another questioner) and all of the subjects visited by sleep specialists for diagnosis of sleep problem. To determine test-retest reliability findings of BEARS compared during the time and between different questioners. To determine criteria validity, findings of BEARS compared with experts’ diagnosis. Results: A total of 215 children (2-12 years old) were studied. From these 101 were in preschool age group (2-6 years old) and 114 in primary school age group (7-12 years old). All of the BEARS items in preschool age group and most of the items in school aged group had good to excellent test-retest reliability (P<0.05). Approximate to half of items in both age groups were valid (P<0.05). Conclusion: This study suggests that the use of BEARS (a simple brief screening tool for pediatric sleep problems) is a reliable and relatively valid sleep screening tool in children especially in Persian language.

Aim: To assess and compare efficacy and safety of Eszopiclone in patients suffering from insomnia. Design: Randomized, multicentric, comparative clinical trial. Materials and Methods: Adult patients suffering from short-term/transient/chronic insomnia were enrolled after obtaining written informed consent and subjected to a washout (no drug) period for first 4 days followed by 7 days treatment with Eszopiclone 3 mg OD. After eszopiclone treatment, patients were randomly allocated to any one of the four drugs viz. zopiclone 7.5 mg OD, zolpidem 10 mg OD, zaleplon 10 mg OD and nitrazepam 5 mg OD for next 7 days. Patients were given patient diary cards for recording sleep parameters and were followed-up thrice, on day 5, day 12 and day 19 when assessment of improvement in sleep parameters and side-effect profile was done. Results: A total of 100 patients completed the study. Baseline total sleep time (minutes, mean ± SD) in the Eszopiclone 3 mg (n=100), Zopiclone 7.5 mg (n=27), Zaleplon 10 mg (n=24), Zolpidem 10 mg (n=23) and Nitrazepam 5 mg (n=26) treated groups increased significantly (P<0.001) from 327.5 ± 105.3 to 438.34 ± 105.3; 345.7 ± 98.03 to 454.71 ± 122.3; 291 ± 89.73 to 430.39 ± 76.73; 311 ± 125.8 to 441.12 ± 107.65 and 356.8 ± 99.21 to 456.68 ± 67.41 respectively. Baseline sleep latency time (minutes, mean ± SD) and number of awakenings (mean ± SD) in the Eszopiclone, Zopiclone, Zaleplon, Zolpidem and Nitrazepam treated groups decreased (P<0.001) from 117.15 ± 72.38 and 1.91 ± 1.1 to 36.89 ± 20 and 0.78 ± 0.65; 127.73 ± 59.03 and 1.61 ± 0.92 to 45.14 ± 24.86 and 0.77 ± 0.75; 108.13 ± 78.7 and 1.9 ± 1.04 to 40.95 ± 18.01 and 0.9 ± 0.56; 131.52 ± 95.18 and 2.25 ± 1.58 to 38.93 ± 26.43 and 0.89 ± 0.57; 101.78 ± 53.09 and 1.93 ± 0.7 to 34.12 ± 11.8 and 0.69 ± 0.64 respectively. There was no statistically significant (P>0.05) difference between-groups in improving total sleep time and sleep latency. The overall incidence of side-effects was: Eszopiclone (39%), Zopiclone (51.85%), Zolpidem (52.17%), Zaleplon (33.33%) and Nitrazepam (50%). Conclusion: Eszopiclone was effective and comparable to other treatments in improving the sleep parameters in patients suffering from insomnia with better safety profile than Zopiclone, Zolpidem and Nitrazepam.

Fifty pregnant female subjects aged 20-35 yrs in the third trimester of their pregnancy and reportedly snoring during sleep who were attending the ante-natal out patients department (ANC OPD) of Safdarjang Hospital were recruited into the study (study group). An equal number of non-snoring pregnant females of the same age group who were attending the same OPD were taken as controls. They were asked to respond to a standard sleep questionnaire that was based on sleep apnea scale (SAS)³ and Epworth sleepiness scale (ESS). All the subjects in the study group underwent a sleep study (polysomnography) after evaluation of questionnaire. Respiratory distress index (RDI) was calculated as a sum of apnea, hypopnea and flow limitations. The study and control groups were followed during pregnancy and labour. Comparison of complications and outcomes of pregnancy in mother and fetus was done among the study and control groups. Parameters specifically looked for were development of preeclampsia and eclampsia, IUGR, and lower Apgar score Incidence of bad obstetric history, pre-term delivery and post-term delivery were not statistically different among snorers and non snorers. Incidence of pre-eclampsia was 30.3% in snorers as compared to 9.1% in non snorers (p = 0.004). Incidence of meconium-stained liquor was 27.2% in snorers and 6.8% in non snorers (p =0.005) Incidence of Apgar score < 7 was high in babies born to snorers as compared to non snorers. 36.3% babies born to snorers had Apgar score < 7 in comparison to only 14.94% born to non snorers (p = 0.025). Incidence of low birth weight was also more in babies born to snorers (30%) as compared to non-snorers (13.79%) (p = 0.037). Incidence of pre-eclampsia increased with increase in RDI values. 9.09% of snorers had non-progression of labour (NPOL) as opposed to 4.9% in non-snorers. Among snorers 24.2% landed up into Caesarian delivery in comparison to 11.8% of non-snorers (p=0.076). Mean birth weight of babies born to snorers and non-snorers were 2660+443.2 gm and 2801+378.3 gm respectively (p=0.086, 95% CI=-301.4 – 20.02). Mean Ponderal index was 3.04+0.4 in babies of snorers as compared to 2.97+0.4 in non-snorers (p=0.491, 955 CI= -0.126 –0.261). Snoring and sleep disordered breathing (SDB) are extremely common conditions that compromise the vital functions of respiration and circulation. SDB has widespread systemic effects that include adverse impact on maternal and fetal outcomes of pregnancy.