Insomnia Subtypes and Their Relationships to Daytime Sleepiness in Patients with Obstructive Sleep Apnea

Chung, Ka Fai

doi:10.1159/000087668

Cited by 118 publications

(93 citation statements)

References 43 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…It is estimated that half of patients with OSA suffered clinical significance insomnia. That is to mean about 50% to 55% of patients with OSA present with complaints of insomnia in the same time [44]. Insomnia with short sleep duration is also associated with increased risk of hypertension like OSA [45].…”

Section: Discussionmentioning

confidence: 99%

Epworth Sleepiness Scale may be an indicator for blood pressure profile and prevalence of coronary artery disease and cerebrovascular disease in patients with obstructive sleep apnea

Feng

Zhang

et al. 2011

Sleep Breath

View full text Add to dashboard Cite

In severe OSA patients with comparable AHI, EDS may identify a subset of individuals with OSA at higher risk of hypertension, R-HTN, IN-HTN, CAD, and CVD. Overall, nighttime ABP seems to be more sensitive to be influenced by EDS than other ABP parameters. Future studies should investigate the potential dose-effect relationship between EDS and hypertension and the possibility that diagnosis and treatment of EDS could aid in BP reduction and ultimately in decreased morbidity and mortality from cardiovascular and cerebrovascular complications (TMUIRB20010002 at www.clinicaltrials.gov ).

show abstract

Section: Discussionmentioning

confidence: 99%

Epworth Sleepiness Scale may be an indicator for blood pressure profile and prevalence of coronary artery disease and cerebrovascular disease in patients with obstructive sleep apnea

Feng

Zhang

et al. 2011

Sleep Breath

View full text Add to dashboard Cite

show abstract

“…83 Sleep-onset insomnia has also been documented in patients with OSA. 85 OSA may promote and exacerbate insomnia symptoms through psychophysiologic conditioning in response to repeated complete arousals. 83 Such awakenings may lead to ruminations and a state of hyperarousal that result in difficulties in initiating or maintaining sleep.…”

Section: Insomnia and Arousalsmentioning

confidence: 99%

Adult Obstructive Sleep Apnea

Patil

Schneider

Schwartz

et al. 2007

Chest

439

169

View full text Add to dashboard Cite

Obstructive sleep apnea (OSA) is a highly prevalent disease characterized by recurrent episodes of upper airway obstruction that result in recurrent arousals and episodic oxyhemoglobin desaturations during sleep. Significant clinical consequences of the disorder cover a wide spectrum, including daytime hypersomnolence, neurocognitive dysfunction, cardiovascular disease, metabolic dysfunction, and cor pulmonale. The major risk factors for the disorder include obesity, male gender, and age. Current understanding of the pathophysiologic basis of the disorder suggests that a balance of anatomically imposed mechanical loads and compensatory neuromuscular responses are important in maintaining upper airway patency during sleep. OSA develops in the presence of both elevated mechanical loads on the upper airway and defects in compensatory neuromuscular responses. A sleep history and physical examination is important in identification of patients and appropriate referral for polysomnography. Understanding nuances in the spectrum of presenting complaints and polysomnography correlates are important for diagnostic and therapeutic approaches. Knowledge of common patterns of OSA may help to identify patients and guide therapy.Keywords critical pressure; diagnosis; obstructive sleep apnea; pathophysiology Obstructive sleep apnea (OSA) is a highly prevalent disease, affecting 4% of men and 2% of women, 1 and strongly linked to the current obesity epidemic. The disorder is characterized by recurrent episodes of upper airway obstruction, and is associated with reductions in ventilation, resulting in recurrent arousals and episodic oxyhemoglobin desaturations during sleep.2 Significant clinical consequences of the disorder cover a wide spectrum including daytime hypersomnolence,3 , 4 neurocognitive dysfunction, 5 cardiovascular disease (hypertension, stroke, myocardial infarction, heart failure), 6, 7 metabolic dysfunction,8 -10 respiratory failure, and cor pulmonale. 11 The major risk factors for the disorder include obesity, male gender, postmeno-pausal status, and age, and are discussed in detail elsewhere. [12][13][14] The rising prevalence of obesity in the United States suggests that OSA will represent an escalating public health burden. 15 Therefore, knowledge and understanding of the pathogenic basis, clinical presentation, and diagnosis of OSA are essential for the development of preventive, screening, and therapeutic strategies to reduce the public health burden of the disorder. In this review, we * The manuscript was supported by grants HL50381, HL37379, and HL77137 from the National Heart, Lung, Blood Institute, National NIH Public Access Author ManuscriptChest. Author manuscript; available in PMC 2010 January 29. Published in final edited form as:Chest. Pathophysiology of Upper Airway Obstruction in OSAThe pharynx is a complex structure that serves several purposes including speech, swallowing, and respiration. The human pharynx is composed of > 20 muscles and divided into four sections that include the nas...

show abstract

“…In OSA patients, Chung suggested that sleep initiation difficulties may be due to a state of hyperarousal, while sleep maintenance difficulties and early awakenings may be due to sleep fragmentation and frequent arousals from the effects of SDB. (15) A recent study showed that Asians may have a higher predisposition to OSA than Caucasians due to craniofacial profile differences. (16) Although Asian populations have a lower incidence of obesity, they have similar prevalence rates for OSA as Caucasian populations.…”

Section: Introductionmentioning

confidence: 99%

Review of sleep studies of patients with chronic insomnia at a sleep disorder unit

Wong

2015

smedj

View full text Add to dashboard Cite

INTRODUCTIONChronic insomnia is associated with many physical and psychiatric illnesses, and its underlying aetiology needs to be identified in order to achieve safe and effective treatment. Obstructive sleep apnoea (OSA) and periodic limb movement disorder (PLMD) are common primary sleep disorders that can lead to chronic insomnia. Patients with these conditions are evaluated using polysomnography (PSG). METHODSThe PSG records of 106 patients with chronic insomnia who presented to a multidisciplinary sleep clinic in Singapore over a five-year period were reviewed. To examine the utility of PSG in the evaluation of chronic insomnia, the clinical diagnoses of the patients before and after the sleep studies were compared.RESULTS Among the 106 patients, 69 (65.4%) were suspected to have primary sleep disorders based on clinical history and examination alone. Following PSG evaluation, 42.5% and 4.7% of the study population were diagnosed with OSA and PLMD, respectively. OSA was found in 35.9% of the 39 patients who had underlying psychiatric conditions. CONCLUSION This study illustrates that many patients with chronic insomnia have underlying primary sleep disorders.It also highlights the danger of attributing chronic insomnia in psychiatric patients to their illness, without giving due consideration to other possible aetiologies. Clinicians should maintain a high index of suspicion for the presence of other aetiologies, and make timely and targeted referrals for sleep studies where appropriate.

show abstract

Insomnia Subtypes and Their Relationships to Daytime Sleepiness in Patients with Obstructive Sleep Apnea

Cited by 118 publications

References 43 publications

Epworth Sleepiness Scale may be an indicator for blood pressure profile and prevalence of coronary artery disease and cerebrovascular disease in patients with obstructive sleep apnea

Epworth Sleepiness Scale may be an indicator for blood pressure profile and prevalence of coronary artery disease and cerebrovascular disease in patients with obstructive sleep apnea

Adult Obstructive Sleep Apnea

Review of sleep studies of patients with chronic insomnia at a sleep disorder unit

Contact Info

Product

Resources

About