Indian Journal of Sleep Medicine

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2009 | October-December | Volume 4 | Issue 4

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REVIEW ARTICLE

D Sahu, B Jayan, RS Vats, UR Kamat

Cranio-facial morphology, upper airway and orthodontics – the crucial connection

[Year:2009] [Month:October-December] [Volume:4] [Number:4] [Pages:6] [Pages No:119 - 124]

Keywords: Craniofacial morphology, upper airway, orthodontics.

   DOI: 10.5005/ijsm-4-4-119  |  Open Access |  How to cite  | 

Abstract

Narrowing and collapse of upper airway particularly in sleep has been observed in individuals with retrognathic maxilla, retrognathic mandible, narrow maxillary and mandibular arches, long face syndrome, inferiorly and posteriorly placed hyoid bone, retrogenia and increased over jet. Therefore the above observations can be summed up as risk factor for upper airway narrowing that would lead to potential health risks like obstructive sleep apnea, hypopnea syndrome, upper airway resistance syndrome, intractable snoring, mouth breathing and nasal allergies. In children it is likely to affect academic performance, memory, growth and development per se. Extraction orthodontic treatment used as a of camouflage sometimes could be detrimental by altering the tongue posture and thus compromising the airway. Functional considerations should outweigh purely aesthetic ones. It is important when making an orthodontic surgical or combined diagnosis for a patient, to bear in mind the impact that the treatment would have on the upper airways. Good aesthetics should never be achieved at the expense of diminishing the capacity of their upper airway. The speciality of orthodontics has a crucial role to play in terms of prevention, interception and correction of the potential health risks by accurate diagnosis, dento-facial orthopedic treatment and surgical orthodontics. This presentation would be focusing on the crucial connection between the three and the urgent need to change the existing mind set among orthodontic community in the country in order to redefine and optimize our treatment goals so that we contribute significantly to the general health and well being of our patients.

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REVIEW ARTICLE

Manvir Bhatia, M Sharma

Insomnia and its management

[Year:2009] [Month:October-December] [Volume:4] [Number:4] [Pages:7] [Pages No:125 - 131]

Keywords: Insomnia

   DOI: 10.5005/ijsm-4-4-125  |  Open Access |  How to cite  | 

Abstract

Insomnia is a perceived disturbance in the quality or quantity of sleep, which, depending on the specific condition may be associated with disturbances in objectively measured sleep. Insomnia is a common subjective complaint of inadequate sleep that affects 15% to 40% of the general population, with 10% to 15% of individuals reporting chronic insomnia of 6 month's duration.

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REVIEW ARTICLE

Arvind Tripathi, Pooran Chand, Suryakant

Role of oral appliances in treatment of obstructive sleep apnea patient: a review

[Year:2009] [Month:October-December] [Volume:4] [Number:4] [Pages:4] [Pages No:132 - 135]

Keywords: OSA, oral appliances, continuous positive airway pressure (CPAP), snoring

   DOI: 10.5005/ijsm-4-4-132  |  Open Access |  How to cite  | 

Abstract

Human beings spend approximately one third of their lives sleeping. Sleep disruption caused by breathing disorders is recognized as an important global health issue because of its prevalence and association with disease development and death. Sleep apneas are classified into three types; obstructive, central, and mixed. Obstructive apneas are the most common type, and result from the collapse or obstruction of the oropharyngeal region of the upper airway. The most common symptoms associated with obstructive sleep apnea are loud snoring, disrupted sleep, and excessive daytime sleepiness. The treatment modalities consist of both surgical and nonsurgical methods. The nonsurgical approaches to treatment include weight loss,, continuous positive airway pressure (CPAP) and oral appliances which include tongue retainer appliance and mandibular advancement appliance.. Oral appliances have become increasingly popular for treatment of the obstructive sleep apnea syndrome, because of being a valuable alternative for treatment of patients who are not able to tolerate CPAP, due to its side effects.

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ORIGINAL ARTICLE

Ruchi Singh, J. C. Suri, Renuka Sharma, Shobha Das

Is daytime napping a healthy habit in adolescents?

[Year:2009] [Month:October-December] [Volume:4] [Number:4] [Pages:7] [Pages No:136 - 142]

Keywords: napping, sleep fragmentation, mood, performance

   DOI: 10.5005/ijsm-4-4-136  |  Open Access |  How to cite  | 

Abstract

Introduction: Napping is a commonly observed phenomenon, seen due to increase in daytime drowsiness and is usually perceived as a part of circadian rhythm dip in level of alertness. Whether such brief periods of sleep are just a habit, a sign of sleep deprivation or underlying mood disorder is a matter of debate. This study was conducted to see the relationship of napping with various aspects of mood & performance Material & Method: One hundred first year medical students were assessed for sleep habits by means of a validated questionnaire. Mood disorders were scored using the depression, anxiety, stress scales (DASS). Performance was calculated based on their overall grades during the academic session. Result: We found that non-nappers were significantly (59.3%) more regular in their sleep routines, followed early to bed and early to rise routines and had e” 7Hrs of sleep at night on weekdays compared to nappers. Nappers reported significant sleep disturbances and mood changes though there was no significant difference in the academic performance of the two groups. We also found that with increasing length of nap there was significant increase in various sleep disturbances and mood changes though these changes were minimal in those napping either for 30mins or 90mins. Conclusion: From this study it appears that napping may not always be a healthy habit and in fact could be a marker of an underlying sleep deprivation, a psychiatric or psychological disturbance in some individuals. Further studies with larger sample size are needed to confirm these observations.

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ORIGINAL ARTICLE

David Cunnington, Himanshu Garg, Harry Teichtahl

Accuracy of an ambulatory device for the diagnosis of sleep disordered breathing

[Year:2009] [Month:October-December] [Volume:4] [Number:4] [Pages:6] [Pages No:143 - 148]

Keywords: obstructive sleep apnea, polysomnography, diagnosis, ambulatory monitoring, physiologic monitoring

   DOI: 10.5005/ijsm-4-4-143  |  Open Access |  How to cite  | 

Abstract

Objective: This study aimed to evaluate the accuracy of the portable SomtéTM (Compumedics Limited, Melbourne, Australia) sleep data acquisition device against the current gold-standard of technician-attended, laboratory-based polysomnography (PSG) for the diagnosis of sleep disordered breathing (SDB). Methods: Patients attending the sleep disorders laboratory for overnight PSG for the evaluation of suspected SDB were fitted with both the Somté device and a PSG system (Compumedics ESeries). An apnea-hypopnea index (AHI) was calculated after manual scoring of respiratory events recorded using the Somté and PSG systems. Results: 37 patients (29 male, 8 female) participated in the study. The mean difference between the AHI estimated by the two devices showed good agreement, with the Somté device AHI being similar to that obtained by PSG. Mean difference (PSG – Somté AHI), -0.5 events per hour (95% CI -4.4 to 5.4, p=0.83). The Somté device was able to correctly classify the presence or absence of SDB (defined as PSG AHI e”15) with a sensitivity of 96%, specificity of 83%, positive predictive value of 92% and a negative predictive value of 91%. Conclusion: The Somté device accurately detects respiratory events during sleep and can be used to diagnose SDB in patients referred for the evaluation of sleep disordered breathing.

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COMMENTARY

M. S. Kanwar

The past, present and future of sleep medicine

[Year:2009] [Month:October-December] [Volume:4] [Number:4] [Pages:5] [Pages No:149 - 153]

   DOI: 10.5005/ijsm-4-4-149  |  Open Access |  How to cite  | 

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JOURNAL SCAN

U. C. Ojha

Journal Scan

[Year:2009] [Month:October-December] [Volume:4] [Number:4] [Pages:9] [Pages No:154 - 162]

   DOI: 10.5005/ijsm-4-4-154  |  Open Access |  How to cite  | 

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