Author
Andrew Vakulin
Other affiliations: Repatriation General Hospital, University of Adelaide, Woolcock Institute of Medical Research ...read more
Bio: Andrew Vakulin is an academic researcher from Flinders University. The author has contributed to research in topics: Obstructive sleep apnea & Polysomnography. The author has an hindex of 21, co-authored 70 publications receiving 1280 citations. Previous affiliations of Andrew Vakulin include Repatriation General Hospital & University of Adelaide.
Papers
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TL;DR: The 'International Biomarkers Workshop on Wearables in Sleep and Circadian Science' was held at the 2018 SLEEP Meeting of the Associated Professional Sleep Societies and proposed a set of best practices for validation studies and guidelines regarding how to choose a wearable device for research and clinical use.
Abstract: The "International Biomarkers Workshop on Wearables in Sleep and Circadian Science" was held at the 2018 SLEEP Meeting of the Associated Professional Sleep Societies. The workshop brought together experts in consumer sleep technologies and medical devices, sleep and circadian physiology, clinical translational research, and clinical practice. The goals of the workshop were: (1) characterize the term "wearable" for use in sleep and circadian science and identify relevant sleep and circadian metrics for wearables to measure; (2) assess the current use of wearables in sleep and circadian science; (3) identify current barriers for applying wearables to sleep and circadian science; and (4) identify goals and opportunities for wearables to advance sleep and circadian science. For the purposes of biomarker development in the sleep and circadian fields, the workshop included the terms "wearables," "nearables," and "ingestibles." Given the state of the current science and technology, the limited validation of wearable devices against gold standard measurements is the primary factor limiting large-scale use of wearable technologies for sleep and circadian research. As such, the workshop committee proposed a set of best practices for validation studies and guidelines regarding how to choose a wearable device for research and clinical use. To complement validation studies, the workshop committee recommends the development of a public data repository for wearable data. Finally, sleep and circadian scientists must actively engage in the development and use of wearable devices to maintain the rigor of scientific findings and public health messages based on wearable technology.
140 citations
TL;DR: It is concluded that cybersickness is associated with changes in cutaneous thermoregulatory vascular tone; this further supports the idea of a tight link between motion sickness and thermoreGulation.
127 citations
TL;DR: In men not considered to have OSA (AHI < 10), hypertension was associated with OSA during REM sleep, and REM OSA may need consideration as an important clinical entity requiring treatment.
97 citations
TL;DR: The effects of 2 common lifestyle factors, low-dose alcohol and acute partial sleep deprivation, on driving simulator performance between untreated patients with OSA and healthy matched control participants are compared.
Abstract: BACKGROUND: Because of previous sleep disturbance and sleep hypoxia, patients with obstructive sleep apnea (OSA) might be more vulnerable to the effects of alcohol and sleep restriction than healthy persons. OBJECTIVE: To compare the effects of sleep restriction and alcohol on driving simulator performance in patients with OSA and age-matched control participants. DESIGN: Driving simulator assessments in 2 groups under 3 different conditions presented in random order. SETTING: Adelaide Institute for Sleep Health, Sleep Laboratory, Adelaide, Australia. PARTICIPANTS: 38 untreated patients with OSA and 20 control participants. MEASUREMENTS: Steering deviation, crashes, and braking reaction time. INTERVENTION: Unrestricted sleep, sleep restricted to a maximum of 4 hours, and ingestion of an amount of 40% vodka calculated to achieve a blood alcohol level of 0.05 g/dL. RESULTS: Patients with OSA demonstrated increased steering deviation compared with control participants (mean, 50.5 cm [95% CI, 46.1 to 54.9 cm] in the OSA group and 38.4 cm [CI, 32.4 to 44.4 cm] in the control group; P 2 seconds) and microsleeps (> 2 seconds of theta activity on electroencephalography) were significant crash predictors (OR, 19.2 and 7.2, respectively; P Language: en
85 citations
TL;DR: Combining low-dose alcohol with moderate sleep restriction results in significant decrements to subjective alertness and performance as well as to some driving performance and EEG parameters, highlighting the potential risks of driving after consumption of low and legal doses of alcohol when also sleep restricted.
Abstract: Study Objective: To determine the combined effects of sleep restriction and low-dose alcohol on driving simulator performance, EEG, and subjective levels of sleepiness and performance in the mid-afternoon. Design: Repeated measures with 4 experimental conditions. Normal sleep without alcohol, sleep restriction alone (4 hours) and sleep restriction in combination with 2 different low blood alcohol concentrations (0.025 g/dL and 0.035 g/dL). Setting: Sleep Laboratory, Adelaide Institute for Sleep Health. Participants: Twenty-one healthy young men, aged 18-30 years, mean (±SD) = 22.5(±3.7) years, BMI = 25(±6.7) kg/m2; all had normal sleep patterns and were free of sleep disorders. Measurements: Participants completed a 70-minute simulated driving session, commencing at 14:00. Driving parameters included steering deviation, braking reaction time, and number of collisions. Alpha and theta EEG activity and subjective driving performance and sleepiness were also measured throughout the driving task. Results: All measures were significantly affected by time. Steering deviation increased significantly when sleep restriction was combined with the higher dose alcohol. This combination also resulted in a significant increase in alpha/theta EEG activity throughout the drive, as well as greater subjective sleepiness and negative driving performance ratings compared to control or sleep restriction alone. Discussion: These data indicate that combining low-dose alcohol with moderate sleep restriction results in significant decrements to subjective alertness and performance as well as to some driving performance and EEG parameters. This highlights the potential risks of driving after consumption of low and legal doses of alcohol when also sleep restricted.
83 citations
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TL;DR: It is confirmed that advancing age, male sex, and higher body-mass index increase OSA prevalence, and the prevalence was also greater in obese men and women.
1,294 citations
TL;DR: This guideline takes a holistic approach, addressing all aspects of the care of people with schizophrenia and related disorders, not only correct diagnosis and symptom relief but also optimal recovery of social function, and uses a clinical staging model as a framework for recommendations regarding assessment, treatment and ongoing care.
Abstract: Objectives:This guideline provides recommendations for the clinical management of schizophrenia and related disorders for health professionals working in Australia and New Zealand. It aims to encou...
641 citations
Journal Article•
TL;DR: In this case-control family study of sleep-disordered breathing (SDB), a strong relationship was demonstrated between the respiratory disturbance index (RDI) and age and age, and racial differences also were observed in the relationship between RDI and age.
Abstract: In this case-control family study of sleep-disordered breathing (SDB), we describe the distributions of SDB and SDB risk factors in African-Americans and Caucasians. A total of 225 African-Americans and 622 Caucasians, ages 2 to 86 yr, recruited as members of families with an individual with known sleep apnea (85 index families) or as members of neighborhood control families (63 families) were studied with an overnight home sleep-study, questionnaires, and physical measurements. A subsample underwent cephalometry. Outcome measures were the respiratory disturbance index (RDI) and a binary variable indicating the presence of increased apneic activity (IAA). In both races, a strong relationship was demonstrated between the (log transformed) RDI and age and age2. African-Americans with SDB were younger than Caucasians with SDB (37.2 +/- 19.5 versus 45.6 +/- 18.7 yr, p < 0.01). In subjects < or = 25 yr, RDI level and IAA prevalence were higher in African-Americans (odds ratio, adjusted for obesity, sex, proban...
502 citations
TL;DR: Effective treatments for obstructive sleep apnea include weight loss and exercise, positive airway pressure, oral appliances that hold the jaw forward during sleep, and surgical modification of the pharyngeal soft tissues or facial skeleton to enlarge the upper airway.
Abstract: Importance Obstructive sleep apnea (OSA) affects 17% of women and 34% of men in the US and has a similar prevalence in other countries. This review provides an update on the diagnosis and treatment of OSA. Observations The most common presenting symptom of OSA is excessive sleepiness, although this symptom is reported by as few as 15% to 50% of people with OSA in the general population. OSA is associated with a 2- to 3-fold increased risk of cardiovascular and metabolic disease. In many patients, OSA can be diagnosed with home sleep apnea testing, which has a sensitivity of approximately 80%. Effective treatments include weight loss and exercise, positive airway pressure, oral appliances that hold the jaw forward during sleep, and surgical modification of the pharyngeal soft tissues or facial skeleton to enlarge the upper airway. Hypoglossal nerve stimulation is effective in select patients with a body mass index less than 32. There are currently no effective pharmacological therapies. Treatment with positive airway pressure lowers blood pressure, especially in patients with resistant hypertension; however, randomized clinical trials of OSA treatment have not demonstrated significant benefit on rates of cardiovascular or cerebrovascular events. Conclusions and Relevance OSA is common and the prevalence is increasing with the increased prevalence of obesity. Daytime sleepiness is among the most common symptoms, but many patients with OSA are asymptomatic. Patients with OSA who are asymptomatic, or whose symptoms are minimally bothersome and pose no apparent risk to driving safety, can be treated with behavioral measures, such as weight loss and exercise. Interventions such as positive airway pressure are recommended for those with excessive sleepiness and resistant hypertension. Managing asymptomatic OSA to reduce cardiovascular and cerebrovascular events is not currently supported by high-quality evidence.
476 citations
TL;DR: It is highlighted that addressing sleep issues, which are not often considered as a risk factor for depression and academic failure, should be encouraged and Promotion of university and college policies and class schedules that encourage healthy and adequate sleep could have a significant impact on the sleep, learning, and health of college students.
Abstract: Daytime sleepiness, sleep deprivation, and irregular sleep schedules are highly prevalent among college students, as 50% report daytime sleepiness and 70% attain insufficient sleep. The consequences of sleep deprivation and daytime sleepiness are especially problematic to college students and can result in lower grade point averages, increased risk of academic failure, compromised learning, impaired mood, and increased risk of motor vehicle accidents. This article reviews the current prevalence of sleepiness and sleep deprivation among college students, contributing factors for sleep deprivation, and the role of sleep in learning and memory. The impact of sleep and sleep disorders on academics, grade point average, driving, and mood will be examined. Most importantly, effective and viable interventions to decrease sleepiness and sleep deprivation through sleep education classes, online programs, encouragement of naps, and adjustment of class time will be reviewed. This paper highlights that addressing sleep issues, which are not often considered as a risk factor for depression and academic failure, should be encouraged. Promotion of university and college policies and class schedules that encourage healthy and adequate sleep could have a significant impact on the sleep, learning, and health of college students. Future research to investigate effective and feasible interventions, which disseminate both sleep knowledge and encouragement of healthy sleep habits to college students in a time and cost effective manner, is a priority.
415 citations