Indian Journal of Sleep Medicine

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2008 | October-December | Volume 3 | Issue 4

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REVIEW ARTICLE

J M Joshi

Ambulatory Diagnostic-therapeutic Approach for Obstructive Sleep Apnoea Syndrome (OSAS)

[Year:2008] [Month:October-December] [Volume:3] [Number:4] [Pages:5] [Pages No:107 - 111]

   DOI: 10.5005/ijsm-3-4-107  |  Open Access |  How to cite  | 

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REVIEW ARTICLE

Dhrubajyoti Roy

Sleep in COPD

[Year:2008] [Month:October-December] [Volume:3] [Number:4] [Pages:5] [Pages No:112 - 116]

   DOI: 10.5005/ijsm-3-4-112  |  Open Access |  How to cite  | 

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REVIEW ARTICLE

S. Ramnathan Iyer

Sleep and Ageing – Interactions and Consequences

[Year:2008] [Month:October-December] [Volume:3] [Number:4] [Pages:5] [Pages No:117 - 121]

   DOI: 10.5005/ijsm-3-4-117  |  Open Access |  How to cite  | 

Abstract

Sleep is essential for life. Aging is a process and is a subject to semantic confusion. There are gradual changes in the various organ systems of the body and sleep is no exception. Sleep patterns change subjectively and polysomnographically with ageing. Sleep disorders are very common in the elderly population. Medical illnesses which are frequent in elderly also have adverse effect on the sleep patterns. The prevalence of sleep apnea increases with ageing. Sleep apnea itself is a risk factor for the development of hypertension, ischemic heart disease, strokes, diabetes and dementia. Recognition and treatment of sleep disorders is highly rewarding.

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REVIEW ARTICLE

Swati Dixit, Abhishek Dubey, Suneeta Tewari

Obstructive Sleep Apnea Syndrome : Genetic and Biochemical Perspective

[Year:2008] [Month:October-December] [Volume:3] [Number:4] [Pages:6] [Pages No:122 - 127]

Keywords: Obstructive sleep apnoea syndrome (OSAS), inflammation, oxidative stress.

   DOI: 10.5005/ijsm-3-4-122  |  Open Access |  How to cite  | 

Abstract

Obstructive sleep apnoea syndrome (OSAS) is a disorder characterized by repetitive complete or partial upper airway collapse occurring during sleep with daytime sleepiness. The health impact of obstructive sleep apnoea is enormous. Chronic intermittent nature of the physiologic disturbances associated with this disorder is major cause of its related morbidity e.g. the accompanying intermittent hypoxia with ventilatory overshoot hyperoxia, sympathetic nervous system surges, and enhanced state of inflammation, oxidative stress and endothelial dysfunction are potential mechanistic pathways leading to conditions including hypertension, nocturnal cardiac arrhythmias, cardiovascular disease, stroke, insulin resistance and increased mortality. Quality of life may also be affected in obstructive sleep apnoea syndrome with increased likelihood of drowsy driving/accidents, mood disorders and neurocognitive deficits. This study is an effort to identify potential perception for genetic and biochemical basis of risk factors of OSAS and related co-morbidities.

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ORIGINAL ARTICLE

Tulsi Adhikari, J. C. Suri

Epidemiology of Sleep Disorders in the Adult Population of Delhi: A Questionnaire Based Study

[Year:2008] [Month:October-December] [Volume:3] [Number:4] [Pages:10] [Pages No:128 - 137]

   DOI: 10.5005/ijsm-3-4-128  |  Open Access |  How to cite  | 

Abstract

A questionnaire based survey was conducted to determine the prevalence of common sleeprelated disorders in the adult population of Delhi. The questionnaire used for the purposes of this study was adapted from those by Chervin and the Stanford Sleep Clinic questionnaire. A total of 4000 questionnaires were distributed of which 2774 were received back. And finally 2475 questionnaires were selected for analysis as they satisfied all criteria for acceptance. A subgroup of 200 (a number that was considered to be statistically significant) adults were randomly selected from the total pool of adults that reported snoring and were then subjected to whole night in-lab supervised polysomnography. The overall prevalence of snoring was found to be 39.5% (Males = 49.5%, Females = 29%). The overall prevalence of Sleep disordered breathing (SDB) was 4.3%. Approximately 48.6% of the adult population was seen to suffer from excessive daytime sleepiness. The prevalence of symptoms suggestive of restless leg syndrome was 8.2% and was found to correlate significantly with BMI, rising age and female gender. The overall prevalence of sleepwalking in the adult population studied was 6%. The prevalence of nightmares in the adult population studied was 30.6% while bruxism was observed to be present in 9.2% of the adult population studied. Approximately 2.3% of the entire study population admitted that they consumed sleeping pills. Its use correlated significantly with rising socio-economic strata and symptoms suggestive of disorders of initiation and maintenance of sleep (DIMS). Approximately 10.7% of the study population responded affirmatively to have met with road traffic accident in the past few years and 28.1% of the adult population was observed to have complaints suggestive of disorders of initiation and maintenance of sleep. More than half the population under study was observed to be sleep-deprived (sleep time <8 hours per day); and 29.3% of them slept for less than seven hours. In this questionnaire-based survey, approximately 55% of the study population was observed to have some type of sleep-related disorder. This indicates that the impact of sleep disorders on the morbidity profile of this segment of urban society is of a gigantic proportion. It also reflects the phenomenal burden of undiagnosed sleep disorders in this segment of the general population as well as its impact on social, mental, physical and economic health of the society.

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ORIGINAL ARTICLE

Kavita R. Mody, Amita U. Athavale, Maheema A. Bhaskar, R. Mohan, Kapil Salgia

Association of Sleep Disordered Breathing with Systemic hypertension – The Indian perspective

[Year:2008] [Month:October-December] [Volume:3] [Number:4] [Pages:6] [Pages No:138 - 143]

Keywords: hypertension, sleep disordered breathing, sleep study

   DOI: 10.5005/ijsm-3-4-138  |  Open Access |  How to cite  | 

Abstract

Introduction : Economic growth, better per capita income and a westernized lifestyle has increased the prevalence of metabolic disorders like hypertension, diabetes, dyslipidemia and obesity in developing countries including India. Sleep Disordered Breathing has been found to be increasingly associated with obesity and hypertension. The incidence and prevalence of SDB in India remains to be fully investigated. In the study an attempt was made to elucidate the true extent and magnitude of association between sleep disordered breathing and hypertension in Indian context. Materials and Methods : 80 patients were enrolled from the Chest Clinic of a tertiary hospital from 2003 till 2005. Patients underwent clinical interview (questionnaire), physical examination, blood pressure measurement and routine investigations. Overnight sleep study was carried out using E series EEG/PSG Compumedics machine (Compumedics, Australia) at the sleep lab. Results : Mean systolic and diastolic blood pressure as well as prevalence of hypertension increased significantly with increasing SDB. High body mass index may be a confounding factor in the analysis. OSAHS has been identified as an independent risk factor for hypertension, with a linear relationship between hypertension and OSAHS. AHI was strongly associated with self reported history of snoring (p=0.007). Conclusion : Our findings suggest that sleep disordered breathing is associated with systemic hypertension in middle and older individuals.

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CASE REPORT

R. U. Thombare, A. J. Pakhan, B. K. Motwani, S. R. Godbole, S. K. Diwan, Prachi Gupta, Pallavi Thombare

A Simple Removable Custom Made Mandibular Advancement Device Fabricated for an Elderly Lady Suffering from Obstructive Sleep Apnea – A Case Report

[Year:2008] [Month:October-December] [Volume:3] [Number:4] [Pages:4] [Pages No:144 - 147]

Keywords: Obstructive sleep apnea, oral appliance, polysomnography.

   DOI: 10.5005/ijsm-3-4-144  |  Open Access |  How to cite  | 

Abstract

Nearly every practitioner in dentistry, no matter what his or her specialty or special interest, may have a potential role in the management of patients with a sleep disorder, particularly snoring and sleep apnoea. Every dentist as a practitioner in the healthcare field should be able to assist the patient identified with a potential sleep disorder by making recommendations, referrals or participating in overall management. Many dentists are not familiar with sleep medicine, its magnitude, and prevalence of sleep disorders. This case report reflects how a low cost custom made mandibular repositioning appliance has helped an obese severe obstructive sleep apnea patient, non-affordable for continuous positive pressure device in getting relieved of her symptoms and improved her quality of life by a better night's rest.

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