Indian Journal of Sleep Medicine

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2011 | July-September | Volume 6 | Issue 3

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Krishnan A. Subramanian

Dental Sleep Medicine: Treatment of snoring and obstructive sleep apnea with oral appliances

[Year:2011] [Month:July-September] [Volume:6] [Number:3] [Pages:4] [Pages No:79 - 82]

Keywords: Standards of practice, snoring, obstructive sleep apnea syndrome, oral appliances, dental devices

   DOI: 10.5005/ijsm-6-3-79  |  Open Access |  How to cite  | 


Oral appliances (OAs) are indicated for use in patients with mild to moderate OSA who prefer them to continuous positive airway pressure (CPAP) therapy, or who do not respond to, are not appropriate candidates for, or who fail treatment attempts with CPAP. For patients with severe OSA, CPAP is indicated whenever possible before considering OAs. Oral appliances should be fitted by qualified dental personnel who are trained and experienced in dental sleep medicine. Follow-up polysomnography or home sleep study is needed to verify efficacy. Patients with OSA who are treated with oral appliances should return for follow-up office visits with the dental specialist at regular intervals to monitor patient adherence, evaluate device deterioration or maladjustment, and to evaluate the health of the oral structures and integrity of the occlusion. Regular follow up is also needed to assess the patient for signs and symptoms of worsening OSA. Research to define patient characteristics more clearly for OA acceptance, success, and adherence is needed.



J M Joshi

Home sleep testing (HST)

[Year:2011] [Month:July-September] [Volume:6] [Number:3] [Pages:7] [Pages No:83 - 89]

Keywords: Home sleep testing (HST), Polysomnography (PSG), Unattended limited channel testing (ULCT), Obstructive sleep apnea syndrome (OSAS)

   DOI: 10.5005/ijsm-6-3-83  |  Open Access |  How to cite  | 


Obstructive sleep apnea (OSA) is the commonest variety of sleep apnea syndromes having a significant prevalence amongst the Indian population. But despite being a common disease, a large number of cases remain undiagnosed due to lack of diagnostic facilities. Though full polysomnography (PSG) is considered as the “gold standard” for the diagnosis of OSA, it is expensive, labour-intensive and has limited availability. Hence, the need for a strategy like Home sleep testing (HST), which is substantially less expensive and more readily available, thereby helping the physician in achieving a higher rate of diagnosis and treatment of OSA. HST may be used for diagnosis of OSA in patients with a high pretest probability of moderate to severe OSA, when PSG is not possible by virtue of immobility, safety or critical illness and for monitoring of non-continuous positive airway pressure (CPAP) based therapy. Various studies have shown that HST have a high degree of accuracy and is comparable to inlaboratory PSG with respect to improvement in sleep apnea-specific quality of life (SAQLI) and compliance to CPAP therapy. Though HST may not be as accurate as PSG, the modest reduction in its accuracy is counterbalanced by its timeliness, the greater patient access afforded and the substantially lower cost.



Deepak Shrivastava

The physiology of sleep for clinicians

[Year:2011] [Month:July-September] [Volume:6] [Number:3] [Pages:4] [Pages No:90 - 93]

   DOI: 10.5005/ijsm-6-3-90  |  Open Access |  How to cite  | 


The quest to learn about the need, organization and the functions of sleep has led to basic understanding of physiology of human sleep. Just like wakefulness, different stages of sleep exert unique influence on organ systems of the body. The amount and quality of sleep seems to be in part, controlled by the competing endogenous rhythms. The autonomic system demonstrates characteristic changes with each sleep cycle of non rapid eye movement and rapid eye movement sleep. Cardiovascular physiology provides evidence of “rest and relaxation” during most of the sleep. While behavioral and wakefulness drive to breathe ceases during sleep, respiratory mechanics and ventilatory responses change predictably. Sleep influences most hormone secretion and their actions. Thermoregulation is linked to the sleep wake cycle. Thorough understanding of sleep physiology not only facilitates the approach to diagnosis and management of clinical sleep disorders but also serves to stimulate inquiry, discovery and innovation.



Subjective sleep characteristics in elderly subjects- An analysis of 111 cases

[Year:2011] [Month:July-September] [Volume:6] [Number:3] [Pages:3] [Pages No:94 - 96]

   DOI: 10.5005/ijsm-6-3-94  |  Open Access |  How to cite  | 



Arpita Priyadarshini, R.K Nanda, R.V Hemamalini

Change of lipid profile in shift workers in western Odisha

[Year:2011] [Month:July-September] [Volume:6] [Number:3] [Pages:5] [Pages No:97 - 101]

Keywords: shift work, total cholesterol, triglycerides, HDL, LDL,VLDL

   DOI: 10.5005/ijsm-6-3-97  |  Open Access |  How to cite  | 


Almost all occupations or industries have employees engaged in shift work. Shift work has been associated with a number of health problems including cardiovascular disease, glucose and lipid metabolism, gastrointestinal, reproduction difficulties, and breast cancer. Number of persons doing shift work appears to be increasing. It ranges from 10-25% of all those employed. To study the effect of night shift work on lipid profile in industrial workers at Burla, a study was conducted in day workers (n = 50) and night shift workers (n = 50). The end points were increase in serum total cholesterol, increase in LDL, VLDL, decrease in HDL from baseline during the period of observation. The association between shift work and lipid disorders was investigated adjusting for age, body mass index. Study among the industrial workers revealed that night shift work was a significant independent risk factor for lipid disorder.



Rantu Paul, Rana Dey, Saikat Nag, Saswata Chatterjee, Madan Sarma, Goutam Jana, Sujan Bardhan, Parthasarathi Bhattacharyya

Can a Bengali version of Epworth Sleepiness Scale evaluate excessive daytime sleepiness: a validity study

[Year:2011] [Month:July-September] [Volume:6] [Number:3] [Pages:3] [Pages No:102 - 104]

Keywords: Epworth sleepiness scale (ESS), excessive daytime sleepiness (EDB), validation, obstructive sleep apnea (OSA), Sleep Disorder Breathing (SDB), Chronic Obstructive Airway Disease (COAD), Body Mass Index (BMI)

   DOI: 10.5005/ijsm-6-3-102  |  Open Access |  How to cite  | 


Background: Excessive daytime sleepiness (EDS) is an indicator of sleep disordered breathing (SDB) and the Epworth sleepiness scale (ESS) is a popular instrument to evaluate EDS subjectively. Although translated and validated in different languages including Hindi, but there has been no available and validated Bengali version of ESS so far. Methods: The original English version of ESS has been translated in Bengali and thereafter cross translated in English with proper human resources. The accepted Bengali version was then given to 30 patients of obstructive sleep apnea (OSA) and 30 normal individuals (based on polysomnographic diagnosis) along with the original English version to respond. The mean score of responses for both the versions were thereafter compared. Results: There was no significant difference on statistical analysis between the means obtained from using the two versions of ESS. Conclusion: The Bengali version of ESS is thus found valid and reliable and can be successfully used.



U. C. Ojha

Journal Scan

[Year:2011] [Month:July-September] [Volume:6] [Number:3] [Pages:8] [Pages No:105 - 112]

   DOI: 10.5005/ijsm-6-3-105  |  Open Access |  How to cite  | 


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