The development and use of a new scale, the Epworth sleepiness scale (ESS), is described. This is a simple, self-administered questionnaire which is shown to provide a measurement of the subject's general level of daytime sleepiness. One hundred and eighty adults answered the ESS, including 30 normal men and women as controls and 150 patients with a range of sleep disorders. They rated the chances that they would doze off or fall asleep when in eight different situations commonly encountered in daily life. Total ESS scores significantly distinguished normal subjects from patients in various diagnostic groups including obstructive sleep apnea syndrome, narcolepsy and idiopathic hypersomnia. ESS scores were significantly correlated with sleep latency measured during the multiple sleep latency test and during overnight polysomnography. In patients with obstructive sleep apnea syndrome ESS scores were significantly correlated with the respiratory disturbance index and the minimum SaO2 recorded overnight. ESS scores of patients who simply snored did not differ from controls.

A new method for measuring daytime sleepiness: the Epworth sleepiness scale.

Background Limited data have suggested that sleep-disordered breathing, a condition of repeated episodes of apnea and hypopnea during sleep, is prevalent among adults. Data from the Wisconsin Sleep Cohort Study, a longitudinal study of the natural history of cardiopulmonary disorders of sleep, were used to estimate the prevalence of undiagnosed sleep-disordered breathing among adults and address its importance to the public health. Methods A random sample of 602 employed men and women 30 to 60 years old were studied by overnight polysomnography to determine the frequency of episodes of apnea and hypopnea per hour of sleep (the apnea-hypopnea score). We measured the age- and sex-specific prevalence of sleep-disordered breathing in this group using three cutoff points for the apnea-hypopnea score (≥ 5, ≥ 10, and ≥ 15); we used logistic regression to investigate risk factors. Results The estimated prevalence of sleep-disordered breathing, defined as an apnea-hypopnea score of 5 or higher, was 9 percent for w...

The Occurrence of Sleep-Disordered Breathing among Middle-Aged Adults

At high concentrations, free radicals and radical-derived, nonradical reactive species are hazardous for living organisms and damage all major cellular constituents. At moderate concentrations, how...

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Free Radicals in the Physiological Control of Cell Function

https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(05)71141-7.pdf

Long-term cardiovascular outcomes in men with obstructive sleep apnoea-hypopnoea with or without treatment with continuous positive airway pressure: an observational study

Population-based epidemiologic studies have uncovered the high prevalence and wide severity spectrum of undiagnosed obstructive sleep apnea, and have consistently found that even mild obstructive sleep apnea is associated with significant morbidity. Evidence from methodologically strong cohort studies indicates that undiagnosed obstructive sleep apnea, with or without symptoms, is independently associated with increased likelihood of hypertension, cardiovascular disease, stroke, daytime sleepiness, motor vehicle accidents, and diminished quality of life. Strategies to decrease the high prevalence and associated morbidity of obstructive sleep apnea are critically needed. The reduction or elimination of risk factors through public health initiatives with clinical support holds promise. Potentially modifiable risk factors considered in this review include overweight and obesity, alcohol, smoking, nasal congestion, and estrogen depletion in menopause. Data suggest that obstructive sleep apnea is associated with all these factors, but at present the only intervention strategy supported with adequate evidence is weight loss. A focus on weight control is especially important given the expanding epidemic of overweight and obesity in the United States. Primary care providers will be central to clinical approaches for addressing the burden and the development of cost-effective case-finding strategies and feasible treatment for mild obstructive sleep apnea warrants high priority.

Epidemiology of obstructive sleep apnea: a population health perspective.

1. Normal Sleep and Its Variations History Of Sleep Physiology And Medicine Normal Human Sleep: An Overview Normal Ageing Daytime Sleepiness And Alertness Sleep Deprivation Phylogeny Of Sleep Regulation Mammalian Sleep 2. Sleep Mechanisms Brain Electrical Activity And Sensory Processing During Waking And Sleep States Brainstem Mechanisms Generating REM Sleep Basic Mechanisms Of Sleep-Wake States Control Of Motoneurons During Sleep 3. Physiology in Sleep Physiological Regulation in Sleep Cardiovascular Physiology: Central and Autonomic Regulation Cardiovascular Physiology: The Peripheral Circulation Respiratory Physiology: Central Neural Control Respiratory Physiology: Control of Ventilation Respiratory Physiology: Breathing in Normal Subjects Respiratory Physiology: Sleep at High Altitudes Host Defense Endocrine Physiology Gastrointestinal Physiology Temperature Regulation **Sleep-related Penile Erections 4. Chronobiology Introduction: Chronobiology Circadian Rhythms in Mammals: Formal Properties and Environmental Influences Anatomy and Physiology of the Mammalian Circadian System Molecular Genetic Basis for Mammalian Circadian System The Human Circadian Timing System and Sleep-Wake Regulation **Sleep Homeostasis and Models of Sleep Regulation Circadian Rhythms in Fatigue, Alertness and Performance Melatonin in the Regulations of Sleep & Circadian Rhythms 5. Pharmacology Hypnotics: Basic Mechanisms and Pharmacology Hypnotics: Efficacy and Adverse Effects Stimulants: Basic Mechanisms and Pharmacology Stimulants: Efficacy and Adverse Effects Drugs Which Disturb Sleep and Wakefulness 6. Psychobiology and Dreaming Approaches to the Study of Dream Content: Methods Measures

Principles and Practice of Sleep Medicine

Sleep disturbance and psychiatric disorders: A longitudinal epidemiological study of young Adults

/pdf/guidelines-for-the-multiple-sleep-latency-test-mslt-a-2yl70wmqd5.pdf

Guidelines for the multiple sleep latency Test (MSLT) : a standard measure of sleepiness

Mortality and apnea index in obstructive sleep apnea: experience in 385 male patients

Excessive daytime sleepiness and loud snoring are the major symptoms of obstructive sleep apnea, often leading to serious medical complications if unrecognized and untreated. Tracheostomy has been the only effective treatment in most adult cases. This paper reports on a new surgical approach to treat obstructive sleep apnea by uvulopalatopharyngoplasty designed to enlarge the potential airspace in the oropharynx. Twelve patients underwent this operation. In nine there was relief of symptoms and in eight there was objective improvement in nocturnal respiration and sleep pattern, demonstrated by polysomnography.

Thomas Roth

Papers

Principles and Practice of Sleep Medicine

Sleep disturbance and psychiatric disorders: A longitudinal epidemiological study of young Adults

Guidelines for the multiple sleep latency Test (MSLT) : a standard measure of sleepiness

Mortality and apnea index in obstructive sleep apnea: experience in 385 male patients

Surgical Correction of Anatomic Abnormalities in Obstructive Sleep Apnea Syndrome: Uvulopalatopharyngoplasty: