Polysomnography

About: Polysomnography is a research topic. Over the lifetime, 19527 publications have been published within this topic receiving 858718 citations. The topic is also known as: PSG & polysomnogram.

Association between sleep and blood pressure in midlife: the CARDIA sleep study.

Abstract: Nearly one-third of Americans have high blood pressure,1 and worldwide 7 million deaths are attributed to high blood pressure each year.2 Recently, two large epidemiologic studies reported an association between self-reported sleep duration and the prevalence or incidence of hypertension.3, 4 Identifying a novel lifestyle risk factor for high blood pressure could lead to new interventions to prevent or reduce high blood pressure. Laboratory studies of short-term sleep deprivation have suggested potential mechanisms for a causal link between sleep loss and hypertension. Partial sleep deprivation is associated with increased sympathetic activity estimated from measures of heart rate variability.5, 6 Other studies have observed increased blood pressure after a night of partial 7, 8 or total sleep deprivation.9 Thus, sleep loss may lead to increased sympathetic nervous activity which could cause high blood pressure if sleep loss were chronic. On a population level, previous epidemiologic studies have observed associations between shorter sleep duration and increased blood pressure.3, 4, 10-13 However, most of these studies were cross-sectional and relied on self-reported usual sleep duration, which is only moderately correlated with objectively-measured sleep duration.14, 15 Furthermore, the possible role of sleep quality independent of sleep duration as a risk factor for high blood pressure has not been explored in adults. The goal of our study was to determine if objectively-measured sleep duration or quality predicted 5-year incidence of hypertension and changes in systolic and diastolic blood pressure in a community-based sample of persons in early middle age.

Nasal CPAP: an objective evaluation of patient compliance.

Abstract: Nasal continuous positive airway pressure (NCPAP) improves sleepiness and prognosis in obstructive sleep apnea (OSA). Our objective was to document NCPAP compliance and the percentage of time that the effective pressure shown to eliminate 95% of the obstructive apneas and hypopneas was maintained. We built and covertly installed an elapsed timer and mask pressure transducer recorder in NCPAP units of 47 OSA patients. Subjects were seen at 2- to 8-wk intervals over 6 months. Group mean age was 51 yr; 38 males, with mean body mass index of 42; all complained of daytime sleepiness. Initial full night polysomnography demonstrated a mean apnea-hypopnea index (AHI) of 58 +/- 2.6 SEM (range, 10 to 115). Nine subjects discontinued therapy within 3 months for various reasons. In the remaining subjects (n = 38) the actual mean nightly hours of use was 4.7 which represents 68% of the stated total sleep time (compliance). However, effective mean hours of use was 4.3 which represents 91% of the time that prescribed effective pressure was maintained at the mask. The AHI did not correlate with compliance, but did correlate with effective use (R = 0.27048, p = 0.0006). Subjective initial complaints of daytime sleepiness correlated with compliance only during the first visit (R = 0.38590, p = 0.05). No predictors for compliance were found.

Diagnosis and Initial Management of Obstructive Sleep Apnea without Polysomnography: A Randomized Validation Study

Abstract: Results: The PSG and ambulatory groups had similar median BMI (38 kg/m 2 ), age (55 years), ESS score (14 points), and respiratory disturbance index (31 episodes of respiratory disturbance/h). Each episode is determined by a computer algorithm based on analysis of oxygen saturation measured by pulse oximetry. After 3 months, there were no differences in the primary outcome, AHI on CPAP (median, 3.2 vs. 2.5; difference, 0.8/h [95% CI, 0.9 to 2.3]) (P 0.31), between the PSG and ambulatory groups, or in the secondary outcomes, ESS score, Sleep Apnea Quality of Life Index, and CPAP. Adherence to CPAP therapy was better in the ambulatory group than in the PSG group (median, 5.4 vs. 6.0; difference, 1.12 h/night [CI, 2.0 to 0.2]) (P 0.021). Conclusions: In the initial management of patients with a high probability of obstructive sleep apnea, PSG confers no advantage over the ambulatory approach in terms of diagnosis and CPAP titration. The ambulatory approach may improve adherence to treatment. When access to PSG is inadequate, the ambulatory approach can be used to expedite management of patients most in need of treatment.

A multicenter, placebo-controlled trial of melatonin for sleep disturbance in Alzheimer's disease.

Abstract: Objectives: To determine the safety and efficacy of 2 dose formulations of melatonin for the treatment of insomnia in patients with Alzheimer's disease. Design: A multicenter, randomized, placebo-controlled clinical trial of 2 dose formulations of oral melatonin coordinated by the National Institute of Aging-funded Alzheimer's Disease Cooperative Study. Subjects with Alzheimer's disease and nighttime sleep disturbance were randomly assigned to 1 of 3 treatment groups: placebo, 2.5-mg slow-release melatonin, or 10-mg melatonin. Setting: Private homes and long-term care facilities. Participants: 157 individuals were recruited by 36 Alzheimer's disease research centers. Subjects with a diagnosis of Alzheimer's disease were eligible if they averaged less than 7 hours of sleep per night (as documented by wrist actigraphy) and had 2 or more episodes per week of nighttime awakenings reported by the caregiver. Measurements: Nocturnal total sleep time, sleep efficiency, wake-time after sleep onset, and day-night sleep ratio during 2- to 3-week baseline and 2-month treatment periods. Sleep was defined by an automated algorithmic analysis of wrist actigraph data. Results: No statistically significant differences in objective sleep measures were seen between baseline and treatment periods for the any of the 3 groups. Nonsignificant trends for increased nocturnal total sleep time and decreased wake after sleep onset were observed in the melatonin groups relative to placebo. Trends for a greater percentage of subjects having more than a 30-minute increase in nocturnal total sleep time in the 10-mg melatonin group and for a decline in the day-night sleep ratio in the 2.5-mg sustained-release melatonin group, compared to placebo, were also seen. On subjective measures, caregiver ratings of sleep quality showed improvement in the 2.5-mg sustained-release melatonin group relative to placebo. There were no significant differences in the number or seriousness of adverse events between the placebo and melatonin groups. Conclusions: Based on actigraphy as an objective measure of sleep time, melatonin is not an effective soporific agent in people with Alzheimer's disease. Citation: Singer C; Tractenberg RE; Kaye J et al. A multicenter, placebo-controlled trial of melatonin for sleep disturbance in Alzheimer's disease.

Agreement rates between actigraphy, diary, and questionnaire for children's sleep patterns.

Abstract: OBJECTIVES: To describe sleep-wake patterns in kindergarten children by measures derived from questionnaire, diary, and actigraphy and to report rates of agreement between methods according to Bland and Altman. DESIGN: Cross-sectional study, data from 7 nights of actigraph recordings and sleep diary and from a questionnaire. SETTING: Children studied in their homes. PARTICIPANTS: Fifty children, aged 4 to 7 years. MAIN OUTCOME MEASURES: Sleep start, sleep end, assumed sleep, actual sleep time, and nocturnal wake time derived from different methods. RESULTS: Differences between actigraphy and diary were +/- 28 minutes for sleep start, +/- 24 minutes for sleep end, and +/- 32 minutes for assumed sleep, indicating satisfactory agreement between methods, whereas for actual sleep time and nocturnal wake time, agreement rates were not sufficient (+/- 106 minutes and +/- 55 minutes, respectively). Agreement rates between actigraphy and questionnaire as well as between diary and questionnaire were insufficient for all variables. Sex and age of children and socioeconomic status did not influence the differences between methods for all variables. CONCLUSIONS: Actigraphy and diary may be interchangeably used for the assessment of sleep start, sleep end, and assumed sleep but not for nocturnal wake times. The diary is a cost-effective and valid source of information about children's sleep-schedule times, while actigraphy may provide additional information about nocturnal wake times or may be used if parents are unable to report in detail. It is insufficient to collect information by a questionnaire or an interview asking about children's normal sleep patterns.