Background/Objectives: To assess the prevalence of undiagnosed obstructive sleep apnea (OSA) among general medical inpatients and to investigate whether OSA risk is associated with in-hospital sleep quantity and quality. Design: Prospective cohort study. Setting: General medicine ward in academic medical center Participants: 424 hospitalized adult patients ≥ 50 years old without a sleep disorder diagnosis (mean age 65 years, 57% female, 72% African American). Main Measures: The Berlin questionnaire, a validated screen for determining risk of OSA, was administered to hospitalized medical patients. Sleep duration and effi ciency were measured via wrist actigraphy. Self-reported sleep quality was evaluated using Karolinska Sleep Quality Index (KSQI). Key Results: Two of every 5 inpatients ≥ 50 years old (39.5%, n = 168) were found to be at high risk for OSA. Mean in-hospital sleep duration was ~ 5 h and mean sleep effi ciency was 70%. Using random effects linear regression models, we found that patients who screened at high risk for OSA obtained ~ 40 min less sleep per night (-39.6 min [-66.5, -12.8], p = 0.004). These fi ndings remained signifi cant after controlling for African American race, sex, and age quartiles. In similar models, those patients who screened at high risk had ~ 5.5% less sleep effi ciency per night (-5.50 [-9.96
S C I E N T I F I C I N V E S T I G A T I O N SO bstructive sleep apnea (OSA) is a common sleep disorder that affects approximately 1 of every 4 adults in the United States.1,2 Unfortunately, up to 90% of people with OSA are undiagnosed.3 Without treatment, severe OSA is associated with increased risk of cardiovascular and cerebrovascular morbidity and mortality in both men and women.3-5 Early diagnosis and treatment of OSA have been recommended to improve patient health outcomes.Hospitalized patients are likely at high risk of OSA. One reason is that OSA is especially prevalent among patients with medical conditions that can result in hospitalization, such as congestive heart failure. [4][5][6][7] Hospitalized patients with OSA also have an increased risk of postoperative complications and exacerbations of chronic conditions. 8,9 Because hospitalization has been characterized as a period of acute sleep loss due to environmental factors, inpatients with undiagnosed OSA may experience even more sleep disruptions than their healthier counterparts.10 Despite these associations, in one study of inpatients, there was no documentation of sleep histories or any sleep-associated symptoms in their hospital charts.11 In addition, there is a high frequency of sleep disordered breathing in hospitalized patients referred for polysomnography, especially in patients with underlying cardiopulmonary disease.
12These fi ndings suggest that hospitalization may represent a missed opportunity to screen patients for sleep disorders.
Risk of Sleep Apnea in Hospitalized Older Patients
BRIEF SUMMARYCurrent Knowledge/Study Rationale: While the prevalence of OSA in the US is estimated at approximately 25%, it ...
Investigators from Boston University and the University of San Francisco studied whether EEG could be reliably used as an early biomarker for diagnosis of autism spectrum disorder (ASD).
Several recent reports have demonstrated that nonsteroidal anti-inflammatory drugs (NSAIDs) inhibit the growth of various malignant cells suggesting their application as anticancer agents. In this study, we prepared six nanometer-sized prodrugs (nanoprodrugs) of NSAIDs, ibuprofen, indomethacin, and naproxen through the spontaneous emulsification mechanism using monomeric and dimeric derivatives of the NSAIDs. We evaluated their effect on the proliferation of U87-MG glioma cells by cell counting, WST-1 cell proliferation reagent, and propidium iodide incorporation. The two ibuprofen nanoprodrugs inhibited the cell growth more potently than the indomethacin nanoprodrugs, whereas the naproxen nanoprodrugs did not show any significant effect. Remarkably, ibuprofen did not show any effect at an equimolar concentration. Approximately, 4.4% of the ibuprofen nanoprodrugs was found in the cell, whereas no ibuprofen could be detected suggesting that the superior effect of the nanoprodrugs can be attributed to the efficient cellular uptake of the nanoprodrugs.
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