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Editorial

Another Sleep Journal? A Reprise in 2014. 717.
Stuart F. Quan, M.D., F.A.A.S.M.

Scientific Investigations

Prolonged Sleep under Stone Age Conditions. 719-722.
Hannah Piosczyk, Ph.D.1; Nina Landmann, M.A.1; Johannes Holz, Ph.D.1; Bernd Feige, Ph.D.1; Dieter Riemann, Ph.D.1; Christoph Nissen, M.D.1; Ulrich Voderholzer, M.D.1,2

BRIEF SUMMARY

Current Knowledge/Study Rationale: In comparison to prehistoric societies, profound lifestyle changes have emerged in today's industrialized world. Particularly a widespread reduction in sleep duration might be associated with various physical and mental health problems. However, despite an extensive theoretical framework, experimental data on the effects of prehistoric living conditions on sleep-wake behavior are largely lacking.

Study Impact: Our observations provide further experimental support for the long-held belief that people under prehistoric living conditions experienced prolonged sleep times compared to people under modern living conditions. Given the relevance of sufficient sleep to physical and mental health, sleep researchers and society at large are challenged to develop novel strategies for the prevalent problem of sleep deprivation.

Sleep Complaints in Older Blacks: Do Demographic and Health Indices Explain Poor Sleep Quality and Duration?. 725-731.
Alyssa A. Gamaldo, Ph.D.1,2; Charlene E. Gamaldo, M.D.,F.A.A.S.M.3; Jason C. Allaire, Ph.D.4; Adrienne T. Aiken-Morgan, Ph.D.5; Rachel E. Salas, M.D.3; Sarah Szanton, Ph.D., C.R.N.P.6; Keith E. Whitfield, Ph.D.5,7

BRIEF SUMMARY

Current Knowledge/Study Rationale: Given documented studies of poor sleep in Blacks, this study was conducted to examine the potential factors that explain sleep complaints in Blacks.

Study Impact: This study identifies potential factors that may explain poor sleep in Blacks. With additional research to support these findings, potential aids to address these issues could improve sleep in Blacks.

Development and Evaluation of a Measure to Assess Restorative Sleep. 733-741.
Christopher L. Drake, Ph.D.1; Ron D. Hays, Ph.D.2; Robert Morlock, Ph.D.1; Fong Wang, M.D.3; Richard Shikiar, Ph.D.4; Lori Frank, Ph.D.5; Ralph Downey, Ph.D.6; Thomas Roth, Ph.D.1

BRIEF SUMMARY

Current Knowledge/Study Rationale: There is a need for tools that adequately assess the restorative quality of sleep. The objective of the present study was to develop a reliable and valid patient-reported measure of NRS through both qualitative and quantitative methods in insomnia subjects with and without difficulty initiating and maintaining sleep.

Study Impact: The Restorative Sleep Questionnaire provides a valid and reliable measure for assessing nonrestorative sleep complaints. Future studies are needed to determine the sensitivity of this measure to therapeutic interventions.

Short Duration of Sleep Is Associated with Elevated High-Sensitivity C-Reactive Protein Level in Taiwanese Adults: A Cross-Sectional Study. 743-749.
Jui-Kun Chiang, M.D., M.Sc.

BRIEF SUMMARY

Current Knowledge/Study Rationale: Higher plasma levels of C-reactive protein could increase cardiometabolic risk, but the association with duration of sleep is not clear. The aim of the current study was to investigate the association between short duration of sleep and elevated high-sensitivity C-reactive protein levels in Taiwanese adults.

Study Impact: The study demonstrated that short sleep duration was significantly associated with elevated high-sensitivity C-reactive protein levels, independent of adiposity.

Validation of a Portable Monitor for the Diagnosis of Obstructive Sleep Apnea in Morbidly Obese Patients. 751-757.
Jan Magnus Fredheim, M.D.1,2,3; J. Røislien, Ph.D., M.Sc.1,4; J. Hjelmesæth, M.D., Ph.D.1,3

BRIEF SUMMARY

Current Knowledge/Study Rationale: The prevalence of obstructive sleep apnea in morbidly obese subjects is high, and overnight polysomnography is a resource demanding diagnostic method. This study validates a simple portable sleep monitor in a population of treatment seeking morbidly obese patients.

Study Impact: The results of this study might help non-specialists to diagnose obstructive sleep apnea in morbidly obese patients and refer patients for further sleep evaluation or treatment. Accordingly, a higher number of morbidly obese with obstructive sleep apnea might be diagnosed and treated appropriately.

Circulation Time Measurement from Sleep Studies in Patients with Obstructive Sleep Apnea. 759-765.
Younghoon Kwon, M.D.1,2; Talha Khan, M.D.3; Marc Pritzker, M.D.1; Conrad Iber, M.D.2

BRIEF SUMMARY

Current Knowledge/Study Rationale: Although measurement of lung to periphery circulation time from PSG has been described, its use has been limited due to uncertainty of methodology and lack of known clinical implication. Standardizing methodology and defining the factors affecting circulation time may be important in defining the utility of this measure in clinical and research settings.

Study Impact: LFCT can be reliably measured from PSG within subjects and was prolonged in patients with a clinical diagnosis of HF. Prospective studies are needed to define the role of prolonged LFCT identified during the PSG in determining likelihood of coexisting HF.

Sleep Disordered Breathing and Polysomnography in Australia: Trends in Provision from 2005 to 2012 and the Impact of Home-Based Diagnosis. 767-772.
Cindy E. Woods, Ph.D.1,2; Kim J. Usher, Ph.D.2; Hubertus Jersmann, M.B.B.S., M.D., Ph.D.3,4; Graeme Paul Maguire, Ph.D., M.B.B.S., B.Med.Sc.1,3,5

BRIEF SUMMARY

Current Knowledge/Study Rationale: This study describes the growth of PSGs performed in Australia since 2004. It also assesses the impact of the implementation of in-home PSG on service activity and overall funding.

Study Impact: This study is the first to provide contemporary data regarding PSG utilisation in Australia over the period from 2005 to 2012. PSG provision per 100,000 Medicare enrolees has increased by 79% from 2005 to 2012, with the majority of growth attributable to the introduction of Medicare funded in-home PSG in 2008.

The Impact of Hypoxemia on Nephropathy in Extremely Obese Patients with Type 2 Diabetes Mellitus. 773-778.
Wen Bun Leong, M.B.Ch.B.1,2; Melissa Nolen, B.P.E3; G. Neil Thomas, Ph.D.4,5; Paymanè Adab, M.D.4; Dev Banerjee, M.B.Ch.B., M.D.6,7; Shahrad Taheri, M.B.B.S., Ph.D.8,9

BRIEF SUMMARY

Current Knowledge/Study Rationale: Nephropathy is a well-known microvascular complication of diabetes mellitus (DM), and one of the most common causes of chronic kidney disease and end-stage renal disease needing renal replacement therapy. Since DM is also closely associated with obstructive sleep apnea (OSA), our study examined the potential relationship between chronic nocturnal hypoxemia and renal function in DM individuals with extreme obesity.

Study Impact: Our findings demonstrate that not only do apnea and hypopnea episodes have a negative impact on renal function in DM, but also that the duration of nocturnal hypoxemia is important. Our findings suggest that apart from glycemic, blood pressure, and lipid control, there is potentially also a need to consider treatment of hypoxemia in efforts to preserve and delay progression of renal disease among DM individuals.

Article Is Eligible For CME Credits Restless Legs Syndrome, Sleep, and Quality of Life among Adolescents and Young Adults. 779-786.
Graciela E. Silva, Ph.D., M.P.H.1; James L. Goodwin, Ph.D.2,3,4; Kimberly D. Vana, D.N.P.5; Monica M. Vasquez, M.P.H.2; Peter G. Wilcox, B.S.N., D.N.P.5; Stuart F. Quan, M.D., F.A.A.S.M.2,3,6

BRIEF SUMMARY

Current Knowledge/Study Rationale: Clinical reports in children implicate restless legs syndrome (RLS) with sleep and behavior problems. The purpose of this study is to investigate the prevalence of symptoms consistent with RLS in a community sample of adolescents and young adults and its association with sleep and health-related quality of life.

Study Impact: Results from this study show that RLS symptoms in adolescents and young adults are similar to previously published RLS prevalence rates in adults. RLS symptoms were significantly with greater odds of having trouble falling asleep, and trouble falling asleep was associated with lower health-related quality of life.

Article Is Eligible For CME Credits Sleep Education Improves the Sleep Duration of Adolescents: A Randomized Controlled Pilot Study. 787-792.
Geoff Kira, Ph.D.1; Ralph Maddison, Ph.D.2; Michelle Hull, M.P.H.3; Sarah Blunden, Ph.D.4; Timothy Olds, Ph.D.5

BRIEF SUMMARY

Current Knowledge/Study Rationale: Poor sleep is associated with a multitude of physical and psychological problems. Adolescence represents a time of disrupted sleep patterns and school-based sleep education programs may be a conduit for better health.

Study Impact: Sleep education may be limited in its ability to improve sleep patterns. This study has highlighted several issues, including long-term cluster randomized trials, which should be considered to effectively determine whether sleep intervention can improve adolescent sleep and influence health outcomes.

The Mediating Effect of Sleep Quality on the Relationship between PTSD and Physical Activity. 795-801.
Lisa S. Talbot, Ph.D.1,2; Thomas C. Neylan, M.D., F.A.A.S.M.1,2; Thomas J. Metzler, M.S.1; Beth E. Cohen, M.D., M.A.S.1,3

BRIEF SUMMARY

Current Knowledge/Study Rationale: Both physical activity and sleep have been linked to health outcomes such as obesity. We examined the influence of sleep on physical activity as a novel approach to understand these relationships, particularly in posttraumatic stress disorder, a disorder associated with sleep disturbance, physical inactivity, and poor health outcomes.

Study Impact: Worse sleep quality predicts lower physical activity in PTSD, providing possible evidence for a behavioral pathway from disturbed sleep to poor physical health outcomes.

The AASM Recommended and Acceptable EEG Montages are Comparable for the Staging of Sleep and Scoring of EEG Arousals. 803-809.
Brett Duce, BSc (Hons); Conchita Rego, MSc; Jasmina Milosavljevic, MBBS, MPH; Craig Hukins, MBBS

BRIEF SUMMARY

Current Knowledge/Study Rationale: The American Academy of Sleep Medicine's Manual for the Scoring of Sleep and Associated Events allows for the use of either a recommended EEG montage or an acceptable EEG Montage in polysomnographic recordings. In this study we compared sleep and EEG arousals indices derived from the two montages to determine their equivalence.

Study Impact: There was very little difference between montages in sleep parameters such as total sleep time, EEG arousal index and sleep stage proportions. Greater inter-scorer agreement was observed with the recommended montage but likely reflects the scorers' greater familiarity with the montage.

Commentary

The “Realities” of our Modern Light-Dark Cycle. 723-724.
Katherine M. Sharkey, M.D., Ph.D., F.A.A.S.M.1,2,3; Eliza Van Reen, Ph.D.2,3,4
Evidence for a School-Based Sleep Health Education Program?. 793-794.
Michelle M. Perfect, Ph.D.

Case Reports

γ-Hydroxybutyric Acid-Induced Electrographic Seizures. 811-812.
Joseph Cheung, M.D., M.S.; Brendan P. Lucey, M.D.; Stephen P. Duntley, M.D., F.A.A.S.M.; Rachel S. Darken, M.D., Ph.D.
Resolution of Severe Obstructive Sleep Apnea after Treatment of Anti-Muscle Kinase Receptor-Positive Myasthenia Gravis Despite 60-Pound Weight Gain. 813-814.
Michael Morgenstern, M.D.; Effie Singas, M.D.; Bashar Zleik, M.D.; Harly Greenberg, M.D., F.A.A.S.M.
Elevated Body Position Early after Delivery Increased Airway Size during Wakefulness, and Decreased Apnea Hypopnea Index in a Woman with Pregnancy Related Sleep Apnea. 815-817.
Stefanie Jung, M.D.1,2; Sebastian Zaremba, M.D.1,3; Anne Heisig1; Matthias Eikermann, M.D., Ph.D.1,4

Sleep Medicine Pearls

PAPnip: An “Alarming” Source of Leak during ASV Therapy. 819-821.
Praveen Jinnur, M.D.1; Timothy I. Morgenthaler, M.D., F.A.A.S.M.1; Peter C. Gay, M.D., F.A.A.S.M.1; Erik K. St. Louis, M.D., F.A.A.S.M.1,2
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July 15, 2014
Volume 10, Issue 07


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