Sleep-disordered Breathing and Neuropsychological Deficits

Kim, Hyon C.; Young, Terry; Matthews, Charles G.; Weber, Stephanie; Woodard, Austin; Palta, Mari

doi:10.1164/ajrccm.156.6.9610026

Cited by 260 publications

(163 citation statements)

References 24 publications

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“…Persons with OSA may increase risk of motor vehicle accidents, reduces the quality of life, and have a multiplicity of cardiovascular, psychiatric, cognitive dysfunction, and metabolic abnormalities [12][13][14][15]. To date, very few data of OSA are available for Thai persons [16].…”

Section: Brief Communication (Original)mentioning

confidence: 99%

Brief communication (Original). Sleep-disordered breathing and risk factors in Thailand

Kongsomboon

Neruntarat

2011

Asian Biomedicine

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Background: Sleep-disordered breathing or obstructive sleep apnea (OSA) has an important effect on the quality of life. Very few data of OSA are available for Thai persons. Objective: Investigate the prevalence of high risk to OSA and the relationship between OSA and risk factors in Thai medical students. Materials and methods: Three hundred seven subjects were recruited from all of the medical students (fourth year to sixth year) the Faculty of Medicine, Srinakharinwirot University, Thailand for this cross-sectional study. Data was collected between June and September 2010. The Berlin questionnaire was used to determine risk for OSA. Logistic regression analysis was performed with p-value less than 0.05 for statistical significance. Results: The prevalence of high risk to OSA was 6.8%. Total mean of sleep duration, bedtime, and wake-time was 6.59 hours. Bedtime of male students was significantly later than female students. The medical students with body mass index (BMI) >23 kilogram/meter 2 and with underlying diseases were at high-risk for OSA. Conclusion: Prevalence of high-risk to OSA of Thai medical students was 6.8%. The medical students with BMI >23 kilogram/meter 2 and with underlying diseases were at high risk for OSA but gender, age, academic year, and academic achievement did not relate to OSA.

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Section: Brief Communication (Original)mentioning

confidence: 99%

Brief communication (Original). Sleep-disordered breathing and risk factors in Thailand

Kongsomboon

Neruntarat

2011

Asian Biomedicine

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“…Affected individuals typically have fragmented sleep periods associated with snoring and intermittent airway obstruction. This fragmentation of sleep leads to chronic sleep deprivation and excessive daytime sleepiness, and is a likely cause of the cognitive dysfunction that has been found in this population (Bedard et al, 1993;Feuerstein et al, 1997;Kim et al, 1997). However, there are data suggesting that the cumulative effects of chronic repeated episodes of nocturnal hypoxia may also cause irreversible cognitive deficits (Nowak et al, 2006).…”

Section: Introductionmentioning

confidence: 99%

Driver performance in the moments surrounding a microsleep

Boyle

Tippin

Paul

et al. 2008

Transportation Research Part F: Traffic Psychology and Behaviou

133

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This study examined if individuals who are at increased risk for drowsy-driving because of obstructive sleep apnea syndrome (OSAS), have impairments in driving performance in the moments during microsleep episodes as opposed to during periods of wakefulness. Twenty-four licensed drivers diagnosed with OSAS based on standard clinical and polysomnographic criteria, participated in an hour-long drive in a high-fidelity driving simulator with synchronous electroencephalographic (EEG) recordings for identification of microsleeps. The drivers showed significant deterioration in vehicle control during the microsleep episodes compared to driving performance in the absence of microsleeps on equivalent segments of roadway. The degree of performance decrement correlated with microsleep duration, particularly on curved roads. Results indicate that driving performance deteriorates during microsleep episodes. Detecting microsleeps in real-time and identifying how these episodes of transition between wakefulness and sleep impair driver performance is relevant to the design and implementation of countermeasures such as drowsy driver detection and alerting systems that use EEG technology.

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“…lent and incident blood pressure; 6,7 (2) lower neurocognitive test scores; 8 and (3) automobile crashes due to sleepiness. 9 The respiratory review paper also provided suffi cient evidence for scoring hypopneas which caused as little as ≥ 20% to 30% fall in airfl ow and/or ≥ 2% or ≥ 3% desaturations.…”

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confidence: 99%

The AASM Scoring Manual Four Years Later

Grigg-Damberger

2012

Journal of Clinical Sleep Medicine

126

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lent and incident blood pressure; 6,7 (2) lower neurocognitive test scores; 8 and (3) automobile crashes due to sleepiness. 9 The respiratory review paper also provided suffi cient evidence for scoring hypopneas which caused as little as ≥ 20% to 30% fall in airfl ow and/or ≥ 2% or ≥ 3% desaturations. [10][11][12] However, the AASM wanted rules for scoring hypopneas which had substantial or excellent interscorer reliability. Interrater reliability (IRR) as it relates to scoring sleep in a PSG measures how closely individuals score the same sleep study. IRR when scoring a PSG depends upon the: (1) skill, experience, and training of scorer; (2) technical quality of study; (3) clarity and simplicity of scoring rules; (4) diligence with which scoring rules are applied; and (5) degree of physiological ambiguity of the sleep/wake patterns. 13 When two or more individuals score a stage of sleep or an event in a PSG differently, it can introduce enough variability to lead to a false positive or false negative for a particular diagnosis.The IRR for scoring respiratory events in a PSG is particularly affected by the: (1) duration of the event; (2) degree of reduction in the amplitude of the measured signal(s); (3) level of the oxyhemoglobin desaturation associated with it; and (4) presence and duration of arousal which accompanies it. Ayappa et al. found the percent scoring agreement for scoring apneas using a nasal pressure sensor was excellent (0.91) but only moderate for hypopneas (0.69) or fl ow limitation events (0.64).14 The more subtle the reduction in airfl ow, the more diffi cult to achieve good interscorer agreement: one scorer identifi ed 35% more fl ow limitation events than the other. Whitney et al. found a hypopnea associated with 2% to 5% desaturations could be scored with IRR of 0.90, but scoring agreement inPurpose of Review: Review published studies and critiques which evaluate the impact and effects of the American Academy of Sleep Medicine (AASM) Sleep Scoring Manual in the four years since its publication. Findings: Using the AASM Manual rules to score sleep and events in a polysomnogram (PSG) results in: (1) very large differences in apnea-hypopnea indexes (AHI) when using the recommended and alternative rule for scoring hypopneas in adults; (2) increases in NREM 1 and sleep stage shifts with compensatory decreases in NREM 2 in children and adults when following rule 5.C.b. for ending NREM 2 sleep; (3) increases in NREM 3 in adults scoring slow wave activity in the frontal EEG derivations; (4) improved interscorer reliability; and (5) successfully identifi ed fragmented sleep in children with obstructive sleep apnea (OSA) from primary snorers or normal controls because they had more NREM 1 and stage shifts using rule 5.C.b. Criticism of the Manual most often cited: (1) two rules for scoring hypopneas; (2) alternative EEG montage cancellation effects; (3) scoring stages 3 and 4 as NREM 3; and (4) too few rules for scoring arousals and REM sleep without atonia. Summary: Four years have passed since the...

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Sleep-disordered Breathing and Neuropsychological Deficits

Cited by 260 publications

References 24 publications

Brief communication (Original). Sleep-disordered breathing and risk factors in Thailand

Brief communication (Original). Sleep-disordered breathing and risk factors in Thailand

Driver performance in the moments surrounding a microsleep

The AASM Scoring Manual Four Years Later

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