BackgroundSleep duration may be an important regulator of body weight and metabolism. An association between short habitual sleep time and increased body mass index (BMI) has been reported in large population samples. The potential role of metabolic hormones in this association is unknown.Methods and FindingsStudy participants were 1,024 volunteers from the Wisconsin Sleep Cohort Study, a population-based longitudinal study of sleep disorders. Participants underwent nocturnal polysomnography and reported on their sleep habits through questionnaires and sleep diaries. Following polysomnography, morning, fasted blood samples were evaluated for serum leptin and ghrelin (two key opposing hormones in appetite regulation), adiponectin, insulin, glucose, and lipid profile. Relationships among these measures, BMI, and sleep duration (habitual and immediately prior to blood sampling) were examined using multiple variable regressions with control for confounding factors.A U-shaped curvilinear association between sleep duration and BMI was observed. In persons sleeping less than 8 h (74.4% of the sample), increased BMI was proportional to decreased sleep. Short sleep was associated with low leptin (p for slope = 0.01), with a predicted 15.5% lower leptin for habitual sleep of 5 h versus 8 h, and high ghrelin (p for slope = 0.008), with a predicted 14.9% higher ghrelin for nocturnal (polysomnographic) sleep of 5 h versus 8 h, independent of BMI.ConclusionParticipants with short sleep had reduced leptin and elevated ghrelin. These differences in leptin and ghrelin are likely to increase appetite, possibly explaining the increased BMI observed with short sleep duration. In Western societies, where chronic sleep restriction is common and food is widely available, changes in appetite regulatory hormones with sleep curtailment may contribute to obesity.

Research in normal and disordered phonology requires measures of speech production that are biolinguistically appropriate and psychometrically robust. Their conceptual and numeric properties must be well characterized, particularly because speech measures are increasingly appearing in large-scale epidemiologic, genetic, and other descriptive-explanatory database studies. This work provides a rationale for extensions to an articulation competence metric titled the Percentage of Consonants Correct [PCC; Shriberg & Kwiatkowski, 1982; Shriberg, Kwiatkowski, Best, Hengst, & Terselic-Weber, 1986], which is computed from a 5- to 10-minute conversational speech sample. Reliability and standard error of measurement estimates are provided for 9 of a set of 10 speech metric including the PCC. Discussion includes rationale for selecting one or more of the 10 metrics for specific clinical and research needs.

Rationale: Cross-sectional association has been reported between sleep-disordered breathing (SDB) and insulin resistance, but no prospective studies have been performed to determine whether SDB is causal in the development of diabetes. Objectives: The purpose of our study was to investigate the prevalence and incidence of type II diabetes in subjects with SDB and whether an independent relationship exists between them. Methods: A cross-sectional and longitudinal analysis was performed in 1,387 participants of the Wisconsin Sleep Cohort. Full polysomnography was used to characterize SDB. Diabetes was defined in two ways: (1 ) physician-diagnosis alone or (2 ) for those with glucose measurements, either fasting glucose у 126 mg/dl or physician diagnosis. Measurements and Main Results:There was a greater prevalence of diabetes in subjects with increasing levels of SDB. A total of 14.7% of subjects with an apnea-hypopnea index (AHI) of 15 or more had a diagnosis of diabetes compared with 2.8% of subjects with an AHI of less than 5. The odds ratio for having a physician diagnoses of diabetes mellitus with an AHI of 15 or greater versus an AHI of less than 5 was 2.30 (95% confidence interval, 1.28-4.11; p ϭ 0.005) after adjustment for age, sex, and body habitus. The odds ratio for developing diabetes mellitus within 4 yr with an AHI of 15 or more compared with an AHI of less than 5 was 1.62 (95% confidence interval, 0.67-3.65; p ϭ 0.24) when adjusting for age, sex, and body habitus. Conclusions: Diabetes is more prevalent in SDB and this relationship is independent of other risk factors. However, it is not clear that SDB is causal in the development of diabetes.Keywords: diabetes; incidence; prevalence; sleep apnea Sleep-disordered breathing (SDB) and diabetes mellitus (DM) are prevalent diseases that share several risk factors, including advanced age and obesity (1, 2). Diabetes was the sixth leading cause of death listed on U.S. death certificates in 2003 and is associated with a higher incidence of cardiovascular, cerebrovascular, and renal disease (3, 4). There is also mounting evidence that SDB may be an independent risk factor for cardiovascular and cerebrovascular disease (5). Interest in a potential independent link between the two diseases continues to grow.Several studies have explored this relationship with conflicting results. Four recent studies demonstrated an inverse relationship between apnea-hypopnea index (AHI) and insulin sensitiv- ity (6-9). The relationship was independent of body mass index (BMI) and age in all three studies. Another study found a relationship between fasting insulin levels and increasing AHI in patients with BMI of 29 or greater, but not in those with lower BMIs (10). Finally, Stoohs and colleagues found the relationship between worsening insulin sensitivity and SDB in a group of 50 "healthy, normotensive individuals" was completely accounted for by increased BMI (11). The primary objective of these studies was to explore the relationship between insulin sensitivity, or surroga...

Expanding access to meaningful employment has been a long-standing emphasis of policy and legislative initiatives focused on transition-age youth and young adults with disabilities (National Council on Disability, 2008;Phelps & Hanley-Maxwell, 1997; President's Commission on Excellence in Special Education, 2002). Indeed, improving employment outcomes was a prominent element within early conceptualizations of transition education (Halpern, 1985;Will, 1984). Although frameworks for high-quality transition services and supports have evolved over the last 25 years, equipping youth to secure meaningful work after high school or college has endured as an essential outcome of education in the United States. This abiding accent is apparent within the Individuals With Disabilities Education Improvement Act (IDEA) of 2004, which states that a central purpose of special education is to "prepare [students with disabilities] for further education, employment, and independent living" as part of a national policy aimed at "ensuring equality of opportunity, full participation, independent living, and economic self-sufficiency for individuals with disabilities" (Public Law 108-442).The exigency to better prepare students with disabilities for future careers is especially apparent when considering the current outcomes encountered by adults with severe disabilities.Most available indicators suggest that a relatively small proportion of adults with severe intellectual disabilities, autism, or multiple disabilities access paid work experiences in their local communities (Boeltzig, Timmons,

Menopause is considered to be a risk factor for sleep-disordered breathing, but this hypothesis has not been adequately tested. The association of premenopause, perimenopause, and postmenopause with sleep-disordered breathing was investigated with a population-based sample of 589 women enrolled in the Wisconsin Sleep Cohort Study. Menopausal status was determined from menstrual history, gynecologic surgery, hormone replacement therapy, follicle-stimulating hormone, and vasomotor symptoms. Sleep-disordered breathing was indicated by the frequency of apnea and hypopnea events per hour of sleep, measured by in-laboratory polysomnography. Multivariable logistic regression was used to estimate odds ratios for having 5 or more and 15 or more apnea and hypopnea events per hour. Odds ratios (95% confidence interval), adjusted for age, body habitus, smoking, and other potential confounding factors, for 5 or more apnea and hypopnea events per hour were 1.2 (0.7, 2.2) with perimenopause and 2.6 (1.4, 4.8) with postmenopause; odds ratios for 15 or more apnea and hypopnea events per hour were 1.1 (0.5, 2.2) with perimenopause and 3.5 (1.4, 8.8) with postmenopause. The menopausal transition is significantly associated with an increased likelihood of having sleep-disordered breathing, independent of known confounding factors. Evaluation for sleep-disordered breathing should be a priority for menopausal women with complaints of snoring, daytime sleepiness, or unsatisfactory sleep.