Indian Journal of Sleep Medicine

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2012 | January-March | Volume 7 | Issue 1

REVIEW ARTICLE

Ajit Bhalchandra Dahale, Hemendra Singh, Santosh Kumar Chaturvedi

Need for Sleep Clinics in Psychiatric Practice

[Year:2012] [Month:January-March] [Volume:7] [Number:1] [Pages:5] [Pages No:1 - 5]

Keywords: psychotropic,Sleep clinic, sleep disorder, psychiatric practice

PDF  |  DOI: 10.5958/j.0973-340X.7.1.001  |  Open Access |  How to cite  | 

Abstract

Sleep medicine is a rapidly developing specialty. Detection and treatment of sleep disorders is on the rise with changing lifestyles and more awareness. Sleep disturbances are increasingly commonly encountered in psychiatric practice compared with the general population. Sleep disturbances can be secondary to the psychiatric illness or might manifest as a side effect of psychotropic medications. However, they are frequently neglected or may be misdiagnosed as a primary psychiatric disorder and treated wrongly. Psychological disturbances such as depression can also occur due to primary sleep disorders. Comorbidity of sleep disorder and psychiatric disorder can affect treatment, course of both the disorders and ultimately affect the quality of life of the patients. Specialized sleep clinics are now a part of many specialties, such as pulmonary medicine. These clinics require specific standards with respect to staff and infrastructure; in addition, they necessitate effective liaison between multiple specialties. Development of sleep clinics in psychiatry would help in better detection, assessment, and treatment of sleep disturbances in psychiatric patients as well as those with primary sleep disturbances with secondary psychological distress. Sleep clinics would also help in understanding the complex relation between sleep and psychiatric disorders through research and would help in developing more effective management techniques.

REVIEW ARTICLE

J. C. Suri, M. K. Sen

Need for Sleep Clinics in Psychiatric Practice

[Year:2012] [Month:January-March] [Volume:7] [Number:1] [Pages:5] [Pages No:6 - 10]

PDF  |  DOI: 10.5958/j.0973340X.7.1.002  |  Open Access |  How to cite  | 

Abstract

Sleep is associated with important changes in upper airway, lung mechanics as well as respiratory control. The significance of monitoring of various physiological parameters during sleep are discussed.

REVIEW ARTICLE

J. C. Suri, M. K. Sen

Monitoring of Non-Invasive Ventilatory Support in Overlap Syndrome

[Year:2012] [Month:January-March] [Volume:7] [Number:1] [Pages:5] [Pages No:6 - 10]

PDF  |  DOI: 10.5958/j.0973-340X.7.1.002  |  Open Access |  How to cite  | 

Abstract

Sleep is associated with important changes in upper airway, lung mechanics as well as respiratory control. The significance of monitoring of various physiological parameters during sleep are discussed.

ORIGINAL ARTICLE

Orofacial Deformities and Obstructive Sleep Apnoea Syndrome

[Year:2012] [Month:January-March] [Volume:7] [Number:1] [Pages:3] [Pages No:11 - 13]

PDF  |  DOI: 10.5958/j.0973-340X.7.1.003  |  Open Access |  How to cite  | 

Abstract

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ORIGINAL ARTICLE

Orofacial Deformities and Obstructive Sleep Apnoea Syndrome

[Year:2012] [Month:January-March] [Volume:7] [Number:1] [Pages:3] [Pages No:11 - 13]

PDF  |  DOI: 10.5958/j.0973-340X.7.1.003  |  Open Access |  How to cite  | 

ORIGINAL ARTICLE

DP Rao, SKB Hegde, AM Joseph, A Sahu, G Gomez, A Kasthuri

Prevalence of Insomnia Among Elderly Residents in A Rural Area in Bangalore, Karnataka

[Year:2012] [Month:January-March] [Volume:7] [Number:1] [Pages:5] [Pages No:14 - 18]

Keywords: Elderly, Insomnia, Likelihood of Insomnia, Rural

PDF  |  DOI: 10.5958/j.0973-340X.7.1.004  |  Open Access |  How to cite  | 

Abstract

Introduction: Insomnia has been reported as a common health problem among the elderly. Objectives: To assess the prevalence of insomnia among the elderly residents of a rural area and to identify associations between insomnia and selected baseline variables. Materials and Methods: This was a cross-sectional study conducted among permanent elderly residents of Mugalur village near Bangalore. An interview schedule based on a validated insomnia-screening questionnaire was developed for the purpose of this study and administered to the study population. Materials and Methods: This was a cross-sectional study conducted among permanent elderly residents of Mugalur village near Bangalore. An interview schedule based on a validated insomnia-screening questionnaire was developed for the purpose of this study and administered to the study population. Conclusions: Prevalence of insomnia was 13.04%, with no significant associations.

ORIGINAL ARTICLE

DP Rao, SKB Hegde, AM Joseph, A Sahu, G Gomez, A Kasthuri

Prevalence of Insomnia Among Elderly Residents in A Rural Area in Bangalore, Karnataka

[Year:2012] [Month:January-March] [Volume:7] [Number:1] [Pages:5] [Pages No:14 - 18]

Keywords: Rural,Elderly, Insomnia, Likelihood of Insomnia

PDF  |  DOI: 10.5958/j.0973-340X.7.1.004  |  Open Access |  How to cite  | 

Abstract

Introduction: Insomnia has been reported as a common health problem among the elderly. Objectives: To assess the prevalence of insomnia among the elderly residents of a rural area and to identify associations between insomnia and selected baseline variables. Materials and Methods: This was a cross-sectional study conducted among permanent elderly residents of Mugalur village near Bangalore. An interview schedule based on a validated insomnia-screening questionnaire was developed for the purpose of this study and administered to the study population. Results: Among the 92 elderly studied, insomnia was prevalent in 13.04%. Among those with insomnia, 50% had parasomnias, 33.3% had circadian rhythm disturbances, 16.7% had sleep apnoea requiring further evaluation and 8.3% had movement disorders. A higher proportion of those that were currently unemployed, widowed, dependants, hypertensives, and diabetics, had urinary disturbances or had joint pains were suffering from insomnia. Conclusions: Prevalence of insomnia was 13.04%, with no significant associations.

ORIGINAL ARTICLE

S. Venkateswaran

A Survey of the Demographics and Sleep Habits in Medical Students and House Officers in Singapore

[Year:2012] [Month:January-March] [Volume:7] [Number:1] [Pages:4] [Pages No:19 - 22]

Keywords: Hypertension, Snoring, Sleep, Hypersomnolence,Demographics

PDF  |  DOI: 10.5958/j.0973-340X.7.1.005  |  Open Access |  How to cite  | 

Abstract

Background: To survey the sleep habits and the demographics of medical students and interns (house officers) at our institution. Methods: Third- and fifth-year medical students and interns at our hospital were surveyed between November 2006 and March 2007 using a confidential survey. Results: The response rate was 96.5%, with 221 individuals completing the survey. Of these, 59.2% were male and 38.0% were female, with 2.8% unknown. Their mean age was 23.8±1.4 years. There were 60 interns, 115 fifth-year medical students, and 46 third-year medical students. The mean sleep latency was 14.7±9.3 min, and the mean total sleep time was 6.1±1.0 h. Snoring was present in 13.6% of the subjects and 59.2% took afternoon naps on the weekends. Ten participants were admitted to having medical comorbidities, with hypertension affecting 2 people. The majority (77.3%) had daytime hypersomnolence, and 71.0% fell asleep returning home on public transport in the evenings. There were 16.7% who admitted to falling asleep at the wheel, but only 1.8% had car accidents attributable to falling asleep while driving. There were no significant differences between the three groups in all the categories. Conclusions: Participants of this survey were young and generally healthy, but were predominantly hypersomnolent during the day with a significant minority having microsleeps at the wheel. There may be more than one possible explanation for this.

ORIGINAL ARTICLE

S. Venkateswaran

A Survey of the Demographics and Sleep Habits in Medical Students and House Officers in Singapore

[Year:2012] [Month:January-March] [Volume:7] [Number:1] [Pages:4] [Pages No:19 - 22]

Keywords: Demographics, Hypertension, Snoring, Sleep, Hypersomnolence

PDF  |  DOI: 10.5958/j.0973-340X.7.1.005  |  Open Access |  How to cite  | 

Abstract

Background: To survey the sleep habits and the demographics of medical students and interns (house officers) at our institution. Methods: Third- and fifth-year medical students and interns at our hospital were surveyed between November 2006 and March 2007 using a confidential survey. Results: The response rate was 96.5%, with 221 individuals completing the survey. Of these, 59.2% were male and 38.0% were female, with 2.8% unknown. Their mean age was 23.8±1.4 years. There were 60 interns, 115 fifth-year medical students, and 46 third-year medical students. The mean sleep latency was 14.7±9.3 min, and the mean total sleep time was 6.1±1.0 h. Snoring was present in 13.6% of the subjects and 59.2% took afternoon naps on the weekends. Ten participants were admitted to having medical comorbidities, with hypertension affecting 2 people. The majority (77.3%) had daytime hypersomnolence, and 71.0% fell asleep returning home on public transport in the evenings. There were 16.7% who admitted to falling asleep at the wheel, but only 1.8% had car accidents attributable to falling asleep while driving. There were no significant differences between the three groups in all the categories. Conclusions: Participants of this survey were young and generally healthy, but were predominantly hypersomnolent during the day with a significant minority having microsleeps at the wheel. There may be more than one possible explanation for this.

ORIGINAL ARTICLE

J. C. Suri, M. K. Sen, M. Gupta, V. Pilaniya, P. Chatterjee, N. Sood, T. Adhikari

Prevalence of Nocturia in Sleep-Disordered Breathing and its Correlation with Severity of the Disease

[Year:2012] [Month:January-March] [Volume:7] [Number:1] [Pages:6] [Pages No:23 - 28]

Keywords: Polysomnography, Pathological nocturia,Sleep-disordered breathing, Obstructive sleep apnoea, Hypopnoea syndrome, Respiratory disturbance index

PDF  |  DOI: 10.5958/j.0973-340X.7.1.006  |  Open Access |  How to cite  | 

Abstract

Background: Nocturia is a common complaint in the general population and prevalence varies across studies. It not only causes significant sleep disruption and daytime consequences such as impaired concentration and fatigue but also is independently associated with the risk of cardiovascular morbidity. Nocturia may be associated with various disorders including sleep-disordered breathing (SDB). The mechanism by which SDB causes nocturia is not clear from the various studies conducted so far. Several different hypotheses suggesting various different mechanisms have been proposed. A systematic large-scale study of the association between nocturia and SDB indicating its prevalence and association with its severity has not been performed. Objective: To investigate the occurrence of nocturia in SDB, identify its prevalence and explore its correlation with severity of the disease. Methodology: A prospective case-controlled study was conducted among 150 adult patients of SDB with obstructive sleep events, along with 150 age- and sex-matched healthy adult controls. The cases were subclassified into mild (respiratory disturbance index [RDI] >5–15/ h), moderate (RDI >15–30/h) and severe (RDI >30/h) categories comprising 50 patients each. Scoring was done and the diagnosis was made in accordance with the latest American Academy of Sleep Medicine guidelines. Both cases and controls were evaluated for the presence of nocturia, pathological nocturia (PN) and frequency of nocturia through a common questionnaire. Nocturia was defined as self-reported awakening at least once per night to urinate, while PN was defined as awakening at least twice per night to urinate. Statistical analysis was carried out using SPSS 16.0 (SPSS Inc., Chicago, IL USA) and GraphPad Prism 6.01 software and a p value of < 0.05 was considered as statistically significant. Results: Nocturia was found to be present in more than 4/5of the patients, and half of the patient population had PN (p<0.0001). The mean frequency of nocturia in patients was 1.75±1.29 and that in the control group was 0.51±.071 (p<0.0001). Nocturia was found to be more common in females compared with males. The prevalence of PN differed significantly (p<0.05) between various severities of SDB, thereby showing an increase in the frequency with increasing severity of the disease. The correlation between severity of SDB and frequency of nocturia was also found to be positive (p<0.001). Conclusions: Nocturia and PN are more common in patients of SDB as compared to the general population, and more commonly seen with increased severity of SDB. The frequency of nocturia shows an independent positive correlation with severity of SDB irrespective of the presence of various confounders for nocturia. High prevalence of both PN and SDB in the population suggests the likelihood of the presence of a large percentage of patients with nocturia having concomitant SDB.

ORIGINAL ARTICLE

J. C. Suri, M. K. Sen, M. Gupta, V. Pilaniya, P. Chatterjee, N. Sood, T. Adhikari

Prevalence of Nocturia in Sleep-Disordered Breathing and its Correlation with Severity of the Disease

[Year:2012] [Month:January-March] [Volume:7] [Number:1] [Pages:6] [Pages No:23 - 28]

Keywords: Hypopnoea syndrome, Respiratory disturbance index, Polysomnography, Pathological nocturia,Sleep-disordered breathing, Obstructive sleep apnoea

PDF  |  DOI: 10.5958/j.0973-340X.7.1.006  |  Open Access |  How to cite  | 

Abstract

Background: Nocturia is a common complaint in the general population and prevalence varies across studies. It not only causes significant sleep disruption and daytime consequences such as impaired concentration and fatigue but also is independently associated with the risk of cardiovascular morbidity. Nocturia may be associated with various disorders including sleep-disordered breathing (SDB). The mechanism by which SDB causes nocturia is not clear from the various studies conducted so far. Several different hypotheses suggesting various different mechanisms have been proposed. A systematic large-scale study of the association between nocturia and SDB indicating its prevalence and association with its severity has not been performed. Objective: To investigate the occurrence of nocturia in SDB, identify its prevalence and explore its correlation with severity of the disease. Methodology: A prospective case-controlled study was conducted among 150 adult patients of SDB with obstructive sleep events, along with 150 age- and sex-matched healthy adult controls. The cases were subclassified into mild (respiratory disturbance index [RDI] >5-15/h), moderate (RDI >15-30/h) and severe (RDI >30/h) categories comprising 50 patients each. Scoring was done and the diagnosis was made in accordance with the latest American Academy of Sleep Medicine guidelines. Both cases and controls were evaluated for the presence of nocturia, pathological nocturia (PN) and frequency of nocturia through a common questionnaire. Nocturia was defined as self-reported awakening at least once per night to urinate, while PN was defined as awakening at least twice per night to urinate. Statistical analysis was carried out using SPSS 16.0 (SPSS Inc., Chicago, IL USA) and Graph Pad Prism 6.01 software and a p value of <0.05 was considered as statistically significant. Results: Nocturia was found to be present in more than 4/5of the patients, and half of the patient population had PN (p <0.0001). The mean frequency of nocturia in patients was 1.75±1.29 and that in the control group was 0.51±.071 (p <0.0001). Nocturia was found to be more common in females compared with males. The prevalence of PN differed significantly (p <0.05) between various severities of SDB, thereby showing an increase in the frequency with increasing severity of the disease. The correlation between severity of SDB and frequency of nocturia was also found to be positive (p <0.001). Conclusions: Nocturia and PN are more common in patients of SDB as compared to the general population, and more commonly seen with increased severity of SDB. The frequency of nocturia shows an independent positive correlation with severity of SDB irrespective of the presence of various confounders for nocturia. High prevalence of both PN and SDB in the population suggests the likelihood of the presence of a large percentage of patients with nocturia having concomitant SDB.

JOURNAL SCAN

U. C. Ojha

Journal Scan

[Year:2012] [Month:January-March] [Volume:7] [Number:1] [Pages:4] [Pages No:29 - 32]

Keywords: *

PDF  |  DOI: 10.5005/ijsm-7-1-29  |  Open Access |  How to cite  | 

Abstract

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