Minority status and lower socioeconomic position were associated with shorter self-reported sleep durations.

Background and aim At present, there is no consensus regarding how to medically manage chronic insomnia in the long term. The unstated standard of practice is for patients to use hypnotics intermittently. The present study aimed to compare a partial reinforcement strategy with nightly and intermittent dosing strategies for its potential as a maintenance therapy. Methods A mixed model was used in the study. One between-subjects factor: group (n = 4). One repeated-measures factor: time (12 weekly assessments). A total of 74 subjects with chronic Insomnia were treated with 10 mg zolpidem for 4 weeks. Treatment respondents were randomized to nightly dosing with 10 mg or 5 mg (QHS-10 and QHS-5), intermittent dosing with 10 mg (IDS-10 [3–5 days weekly]), or partial reinforcement dosing with 10 mg (PRS-10 [nightly pill use with 50% active medication and 50% placebos]) for 12 weeks. Results It was found, in compliant subjects (n = 55), that all four strategies evaluated maintained treatment response over time (ie, prevented or delayed relapse). For the subjects that remained in remission, the subjects in the intermittent dosing group (IDS-10) group exhibited poorer sleep continuity. Conclusions While best considered a preliminary study, the present findings suggest that the partial reinforcement strategy may be a viable means toward maintaining treatment gains over time with less active medication.

Background The association between OSA and hypertension by race/ethnicity has not been well characterized in a national sample. Subjects Adult participants in the 2007–2008 National Health and Nutrition Examination Survey. Methods We reviewed self-reports of sleep apnea diagnosis, snorting, gasping or stopping breathing during sleep and snoring to derive whether OSA was probable (pOSA). Multivariable logistic regression determined whether pOSA predicted hypertension in the cohort, and BMI and ethno-racial strata. Results pOSA predicted hypertension in several groups: 1) Within BMI strata, there was a significant association among overweight individuals [OR (95% CI) =1.82 (1.26–2.62)]; 2) In race/ethnicity subgroups, the association was significant among Hispanic/Latinos [OR (95% CI) =1.69 (1.13, 2.53)] and whites [OR (95% CI) =1.40 (1.07, 1.84)]; 3) In models stratified by both race/ethnicity and weight, pOSA predicted hypertension among overweight Black/African Americans [OR (95% CI) =4.74 (1.86–12.03)], overweight whites [OR (95% CI) =1.65 (1.06, 2.57)], and obese Hispanic/Latino participants [OR (95% CI) =2.01 (1.16, 3.49)]. Conclusions A simple, self-report tool for OSA was strongly associated with hypertension, and may serve as a potential future opportunity for OSA diagnosis.