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Lima MG, Barros MBDA, Malta DC, Medina LDPB, Szwarcwald CL. Association of self-reported sleep problems with morbidities and multimorbidities according to sex: National Health Survey 2019. Epidemiol Serv Saude 2022; 31:e2021386. [PMID: 35730889 PMCID: PMC9897816 DOI: 10.1590/ss2237-9622202200007.especial] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 10/25/2021] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE To evaluate the association between self-reported sleep problems and the presence of non-communicable diseases (NCDs) and multimorbidity, and whether these associations differ by sex. METHODS This is a cross sectional study performed with data from the Brazilian National Health Survey, 2019. Prevalence ratios between morbidities, the number of NCDs, and the self-report of sleep problems were estimated by Poisson regression with robust variance, according to sex. RESULTS This study analysed data from 85,531 Brazilians age ≥ 18 years. The self-reported sleep problems were associated with all the herein studied morbidities and multimorbidities. The prevalence of sleep problems was higher in those who stated one or two (PR = 2.37; 95%CI 2.22;2.54) and three or more NCDs (PR = 4.73; 95%CI 4.37;5.11). Prevalence ratios of the association with diabetes, lung disease, mental disease, renal disease and multimorbidities were higher among males. CONCLUSION NCDs significantly impacted sleep quality, with a particularly stronger association in both, males and females.
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Affiliation(s)
| | | | | | | | - Célia Landmann Szwarcwald
- Fundação Instituto Oswaldo Cruz, Instituto de Comunicação e
Informação Científica e Tecnológica em Saúde, Rio de Janeiro, RJ, Brazil
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Scanlon PH. Improving the screening of risk factors in diabetic retinopathy. Expert Rev Endocrinol Metab 2022; 17:235-243. [PMID: 35730170 DOI: 10.1080/17446651.2022.2078305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Accepted: 05/12/2022] [Indexed: 10/17/2022]
Abstract
INTRODUCTION In 2002, Diabetic Retinopathy was reported as the leading cause of blindness in the working age group. The introduction of systematic screening programs in the UK has reduced visual loss and blindness due to diabetic retinopathy, but it does still occur with catastrophic consequences for the individual. AREAS COVERED The author conducted an ongoing search for articles relating to diabetic retinopathy since 2000 utilizing Zetoc Alert with keywords and contents page lists from relevant journals. This review covers the risk factors for loss of vision due to diabetic retinopathy and discusses ways in which the awareness of these risk factors can be used to further reduce visual loss. Some risk factors such as glycemic and B/P control are well known from landmark trials. This review has included these factors but concentrated more on the evidence behind those risk factors that are not so clearly defined or so well known. EXPERT OPINION The major risk factors are well known, but one continues to find that people with diabetes lose vision in situations in which a better awareness of the risks by both the individual with diabetes and the health workers involved may have prevented the visual loss.
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Affiliation(s)
- Peter H Scanlon
- Consultant Ophthalmologist, Department of Ophthalmologist, Gloucestershire Hospitals NHS Foundation Trust Cheltenham, UK
- National Clinical Lead, NHS Diabetic Eye Screening Programme (Ophthalmology), Public Health Commissioning and Operations, England
- Associate Professor, Nuffield Department of Clinical Neuroscience, University of Oxford, UK
- Visiting Professor, School of Health and Social Care, University of Gloucestershire, UK
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Currie AC, Kaur V, Carey I, Al-Rubaye H, Mahawar K, Madhok B, Small P, McGlone ER, Khan OA. Obstructive sleep apnea remission following bariatric surgery: a national registry cohort study. Surg Obes Relat Dis 2021; 17:1576-1582. [PMID: 34187745 DOI: 10.1016/j.soard.2021.05.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 05/10/2021] [Accepted: 05/21/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND Obstructive sleep apnea (OSA) is strongly associated with metabolic syndrome. Bariatric surgery is an effective available treatment for OSA; however, limited research predicts which patients undergoing bariatric surgery will undergo OSA resolution. OBJECTIVES To determine perioperative predictors for OSA resolution following bariatric surgery using a national database. SETTING United Kingdom national bariatric surgery database. METHODS The UK National Bariatric Surgery Registry (NBSR) was interrogated to identify all patients with OSA that underwent primary bariatric surgery between January 2009 and June 2017. Those with at least 1 follow-up recording postoperative OSA status were selected for further analysis. Demographic, pre- and postoperative outcomes were collected and analyzed. Poisson multivariate regression was conducted to identify predictors of OSA remission. RESULTS A total of 4015 bariatric cases were eligible for inclusion: 2482 (61.8%) patients underwent laparoscopic Roux-en-Y gastric bypass (LRYGB), 1196 (29.8%) sleeve gastrectomy (LSG), and 337 (8.4%) adjustable gastric banding (LAGB). Overall, the mean excess weight loss (EWL) % for the whole group was 61.2 (SD ± 27.2). OSA resolution was recorded in 2377 (59.2%) patients. Following Poisson regression, LRYGB (risk ratio [RR], 1.49 confidence interval [CI] 1.25-1.78) and LSG (RR, 1.46 [CI 1.22-1.75] were associated with approximately 50% increased likelihood of OSA remission compared with LAGB. Greater weight loss following intervention was associated with greater likelihood of OSA remission, while both greater age and greater preoperative body mass index (BMI) were associated with reduced likelihood of OSA remission (P < .001). CONCLUSION This study demonstrated that metabolic surgery results in OSA remission in the majority of patients with obesity. Younger age, lower BMI preprocedure, greater %EWL and the use of LSG or LRYGB positively predicted OSA remission.
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Affiliation(s)
- Andrew C Currie
- Department of Bariatric Surgery, Ashford & St Peter's Hospital NHS Trust, Chertsey, United Kingdom.
| | - Vasha Kaur
- Department of Upper GI Surgery, Epsom & St Helier NHS Trust, Epsom, United Kingdom
| | - Iain Carey
- Population Health Research Institute, St George's, University of London, London, United Kingdom
| | - Hussein Al-Rubaye
- Department of General Surgery, Ashford & St Peter's Hospital NHS Trust, Chertsey, United Kingdom
| | - Kamal Mahawar
- Bariatric Unit, Sunderland Royal Hospital, Sunderland, United Kingdom
| | - Brijesh Madhok
- East Midlands Bariatric and Metabolic Institute, University Hospitals of Derby & Burton NHS Foundation Trust, Derby, United Kingdom
| | - Peter Small
- Bariatric Unit, Sunderland Royal Hospital, Sunderland, United Kingdom
| | - Emma Rose McGlone
- Department of Metabolic and Investigative Medicine, Commonwealth Building, Hammersmith Hospital, Imperial College London, London, United Kingdom
| | - Omar A Khan
- Department of Upper Gastrointestinal and Bariatric Surgery, St George's Hospital, London, United Kingdom & Population Health Research Institute, St George's, University of London, London, United Kingdom
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Yoshikawa F, Kumashiro N, Shigiyama F, Miyagi M, Ando Y, Uchino H, Hirose T. Changes in subjective sleep quality in patients with type 2 diabetes who did not use Sleep agents: a cross-sectional study according to age and clinical background. Diabetol Int 2022; 13:142-7. [DOI: 10.1007/s13340-021-00516-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 05/25/2021] [Indexed: 10/21/2022]
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Yoshikawa F, Shigiyama F, Ando Y, Miyagi M, Uchino H, Hirose T, Kumashiro N. Chronotherapeutic efficacy of suvorexant on sleep quality and metabolic parameters in patients with type 2 diabetes and insomnia. Diabetes Res Clin Pract 2020; 169:108412. [PMID: 32911037 DOI: 10.1016/j.diabres.2020.108412] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 08/06/2020] [Accepted: 08/28/2020] [Indexed: 12/22/2022]
Abstract
AIMS This study aimed to assess the chronotherapeutic efficacy of suvorexant on subjective sleep parameters and metabolic parameters in patients with type 2 diabetes and insomnia. METHODS Thirteen patients with type 2 diabetes who met the Pittsburg Sleep Quality index criteria for primary insomnia took suvorexant 20 mg/day (15 mg/day for ≥65 years) for 14 ± 2 weeks. The following parameters were assessed before and after the treatment: sleep diary for sleep duration and quality (i.e., sleep onset latency, waking after sleep onset, and sleep efficiency [sSE]), Insomnia Severity Index, clinical and biochemical data, continuous glucose monitoring (CGM), and validated self-administered questionnaire on food intake. RESULTS Suvorexant significantly improved sSE, abdominal circumference, and sucrose intake (all p < 0.05), but did not change HbA1c, CGM parameters, or body weight. Correlation analysis revealed that changes in sSE were associated with those in HbA1c and body weight (r = -0.61 and r = -0.66, respectively; both p < 0.05). CONCLUSIONS Suvorexant significantly improved sleep quality and obesity-associated parameters in patients with type 2 diabetes in 14 weeks. Improvements in sleep quality were associated with improvements in glycemic control. Sleep disorder treatment using suvorexant may provide metabolic benefits for patients with type 2 diabetes.
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Affiliation(s)
- Fukumi Yoshikawa
- Division of Diabetes, Metabolism, and Endocrinology, Department of Toho University Graduate School of Medicine, 6-11-1 Omori-Nishi, Ota-ku, Tokyo 143-8541, Japan
| | - Fumika Shigiyama
- Division of Diabetes, Metabolism, and Endocrinology, Department of Toho University Graduate School of Medicine, 6-11-1 Omori-Nishi, Ota-ku, Tokyo 143-8541, Japan
| | - Yasuyo Ando
- Division of Diabetes, Metabolism, and Endocrinology, Department of Toho University Graduate School of Medicine, 6-11-1 Omori-Nishi, Ota-ku, Tokyo 143-8541, Japan
| | - Masahiko Miyagi
- Division of Diabetes, Metabolism, and Endocrinology, Department of Toho University Graduate School of Medicine, 6-11-1 Omori-Nishi, Ota-ku, Tokyo 143-8541, Japan
| | - Hiroshi Uchino
- Division of Diabetes, Metabolism, and Endocrinology, Department of Toho University Graduate School of Medicine, 6-11-1 Omori-Nishi, Ota-ku, Tokyo 143-8541, Japan
| | - Takahisa Hirose
- Division of Diabetes, Metabolism, and Endocrinology, Department of Toho University Graduate School of Medicine, 6-11-1 Omori-Nishi, Ota-ku, Tokyo 143-8541, Japan
| | - Naoki Kumashiro
- Division of Diabetes, Metabolism, and Endocrinology, Department of Toho University Graduate School of Medicine, 6-11-1 Omori-Nishi, Ota-ku, Tokyo 143-8541, Japan.
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Weaver FM, Hickok A, Prasad B, Tarlov E, Zhang Q, Taylor A, Bartle B, Gordon H, Young R, Sarmiento K, Hynes DM. Comparing VA and Community-Based Care: Trends in Sleep Studies Following the Veterans Choice Act. J Gen Intern Med 2020; 35:2593-9. [PMID: 32242312 DOI: 10.1007/s11606-020-05802-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 03/12/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND To address concerns about access to care, the Veterans Access, Choice, and Accountability Act of 2014 was enacted to make care available in the community when Veterans Health Administration (VA) care was unavailable or not timely. This paper examined VA referrals for diagnostic sleep studies from federal fiscal year (FY) 2015-2018. DESIGN Sleep studies completed between FY2015 and 2018 for Veterans tested within VA facilities (VAF) or referred to VA community care (VACC) providers were identified using VA administrative data files. Sleep studies were divided into laboratory and home studies. KEY RESULTS The number of sleep studies conducted increased over time; the proportion of home studies increased in VAF (32 to 47%). Veterans were more likely to be referred for a sleep study to VACC if they lived in a rural or highly rural area (ORs = 1.47 and 1.55, respectively), and had public or public and private insurance (ORs = 2.01 and 1.35), and were less likely to be referred to VACC if they were age 65+ (OR = 0.72) and were in the highest utilization risk based on Nosos score (OR = 0.78). Regression analysis of sleep study type revealed that lab studies were much more likely for VACC referrals (OR = 3.16), for persons living in rural areas (OR = 1.21), with higher comorbidity scores (OR = 1.28) and for ages 44-54, 55 to 64, and 65+ (ORs = 1.12, 1.28, 1.45, respectively) compared to younger Veterans. Veterans with some or full VA copayments (ORs = 0.91 and 0.86, respectively), and overweight Veterans (OR = 0.94) were less likely to have lab studies. CONCLUSIONS The number of sleep studies performed on Veterans increased from 2015 to 2018. Access to sleep studies improved through a combination of providing care through the Veteran Choice Program, predominantly used by rural Veterans, and increased use of home sleep studies by VA.
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Gomes MF, Giannasi LC, Fillietaz-Bacigalupo E, de Mancilha GP, de Carvalho Silva GR, Soviero LD, da Silva GYS, Nazario LDM, Dutra MTDS, Silvestre PR, de Oliveira LVF, Nacif SR, de Oliveira EF, Serafim IM, Pereira BD, Greca AR, Goulart MDGV, Rode SDM, Tanaka MH, Koga-Ito CY, Amorim JBDO, Salgado MAC. Evaluation of the masticatory biomechanical function in Down syndrome and its Influence on sleep disorders, body adiposity and salivary parameters. J Oral Rehabil 2020; 47:1007-1022. [PMID: 32463923 DOI: 10.1111/joor.13023] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2019] [Revised: 04/29/2020] [Accepted: 05/11/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To evaluate the phenotypic features of the masticatory biomechanics in atypical subjects with Down syndrome (DS). Its influence was analysed on sleep disorders, body adiposity and its risks, and some physicochemical properties of saliva. METHODS Seventy subjects were enrolled to assess masticatory biomechanical function and divided into two groups: DS and control groups. Electrical activities of the masseter and temporal muscles (at rest and in maximum voluntary clench-MVC), maximum bite force-MBF and maximum mouth opening-MMO were investigated. Among the atypical subjects, just 24 participants underwent the anthropometry, the polysomnography II and the saliva testing (salivary flow rate-SFR, buffer capacity-BC and salivary cortisol levels, morning/SC-AM and night/SC-PM). RESULTS MVC and MBF values showed high statistical significance in the control group (P < .001) than in the DS group of 35. MMO values were slightly increased in the DS group in relation to the control group. Overweight and obesity were found in both genders. Atypical women showed higher risk to develop cardiovascular-metabolic diseases than in atypical men. OSA severe was 20% for atypical women and 42.8% for atypical men, whereas snoring index was present in all genders. SFR was reduced in 100% of atypical subjects (hyposalivation in 10% women and 28.5% men). Furthermore, 100% BC, 66.6% SC-AM and 91.6% SC-PM showed normal patterns. CONCLUSION Masseter and temporal muscle hypotonia was found in all atypical subjects with DS. This muscle dysfunction strongly was related to overweight/obesity, risks for development of cardiovascular/metabolic diseases, OSA severity, successive snoring episodes and salivary flow reduction in DS.
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Affiliation(s)
- Mônica Fernandes Gomes
- Center of Biosciences Applied to Patients with Special Health Care Needs (CEBAPE) and Multiprofessional Service of Oral Medicine for People with Disability and Caregivers (SEMMO) of the Institute of Science and Technology, São José dos Campos Campus, São Paulo State University-UNESP, São Paulo, Brazil
| | - Lilian Chrystiane Giannasi
- Center of Biosciences Applied to Patients with Special Health Care Needs (CEBAPE) and Multiprofessional Service of Oral Medicine for People with Disability and Caregivers (SEMMO) of the Institute of Science and Technology, São José dos Campos Campus, São Paulo State University-UNESP, São Paulo, Brazil
| | - Elaine Fillietaz-Bacigalupo
- Center of Biosciences Applied to Patients with Special Health Care Needs (CEBAPE) and Multiprofessional Service of Oral Medicine for People with Disability and Caregivers (SEMMO) of the Institute of Science and Technology, São José dos Campos Campus, São Paulo State University-UNESP, São Paulo, Brazil
| | - Gabriela Pinto de Mancilha
- Center of Biosciences Applied to Patients with Special Health Care Needs (CEBAPE) and Multiprofessional Service of Oral Medicine for People with Disability and Caregivers (SEMMO) of the Institute of Science and Technology, São José dos Campos Campus, São Paulo State University-UNESP, São Paulo, Brazil
| | - Gabriela Raine de Carvalho Silva
- Center of Biosciences Applied to Patients with Special Health Care Needs (CEBAPE) and Multiprofessional Service of Oral Medicine for People with Disability and Caregivers (SEMMO) of the Institute of Science and Technology, São José dos Campos Campus, São Paulo State University-UNESP, São Paulo, Brazil
| | - Laura Dias Soviero
- Center of Biosciences Applied to Patients with Special Health Care Needs (CEBAPE) and Multiprofessional Service of Oral Medicine for People with Disability and Caregivers (SEMMO) of the Institute of Science and Technology, São José dos Campos Campus, São Paulo State University-UNESP, São Paulo, Brazil
| | - Gabriella Yasmin Santos da Silva
- Center of Biosciences Applied to Patients with Special Health Care Needs (CEBAPE) and Multiprofessional Service of Oral Medicine for People with Disability and Caregivers (SEMMO) of the Institute of Science and Technology, São José dos Campos Campus, São Paulo State University-UNESP, São Paulo, Brazil
| | - Letícia de Miguel Nazario
- Center of Biosciences Applied to Patients with Special Health Care Needs (CEBAPE) and Multiprofessional Service of Oral Medicine for People with Disability and Caregivers (SEMMO) of the Institute of Science and Technology, São José dos Campos Campus, São Paulo State University-UNESP, São Paulo, Brazil
| | - Marignês Theotonio Dos Santos Dutra
- Center of Biosciences Applied to Patients with Special Health Care Needs (CEBAPE) and Multiprofessional Service of Oral Medicine for People with Disability and Caregivers (SEMMO) of the Institute of Science and Technology, São José dos Campos Campus, São Paulo State University-UNESP, São Paulo, Brazil
| | | | | | | | | | - Irene Moreira Serafim
- Center of Biosciences Applied to Patients with Special Health Care Needs (CEBAPE) and Multiprofessional Service of Oral Medicine for People with Disability and Caregivers (SEMMO) of the Institute of Science and Technology, São José dos Campos Campus, São Paulo State University-UNESP, São Paulo, Brazil
| | - Bruna Dicieri Pereira
- Center of Biosciences Applied to Patients with Special Health Care Needs (CEBAPE) and Multiprofessional Service of Oral Medicine for People with Disability and Caregivers (SEMMO) of the Institute of Science and Technology, São José dos Campos Campus, São Paulo State University-UNESP, São Paulo, Brazil
| | - Amanda Reis Greca
- Center of Biosciences Applied to Patients with Special Health Care Needs (CEBAPE) and Multiprofessional Service of Oral Medicine for People with Disability and Caregivers (SEMMO) of the Institute of Science and Technology, São José dos Campos Campus, São Paulo State University-UNESP, São Paulo, Brazil
| | - Maria das Graças Vilela Goulart
- Center of Biosciences Applied to Patients with Special Health Care Needs (CEBAPE) and Multiprofessional Service of Oral Medicine for People with Disability and Caregivers (SEMMO) of the Institute of Science and Technology, São José dos Campos Campus, São Paulo State University-UNESP, São Paulo, Brazil
| | - Sigmar de Mello Rode
- Center of Biosciences Applied to Patients with Special Health Care Needs (CEBAPE) and Multiprofessional Service of Oral Medicine for People with Disability and Caregivers (SEMMO) of the Institute of Science and Technology, São José dos Campos Campus, São Paulo State University-UNESP, São Paulo, Brazil
| | | | - Cristiane Yumi Koga-Ito
- Center of Biosciences Applied to Patients with Special Health Care Needs (CEBAPE) and Multiprofessional Service of Oral Medicine for People with Disability and Caregivers (SEMMO) of the Institute of Science and Technology, São José dos Campos Campus, São Paulo State University-UNESP, São Paulo, Brazil
| | - José Benedito de Oliveira Amorim
- Center of Biosciences Applied to Patients with Special Health Care Needs (CEBAPE) and Multiprofessional Service of Oral Medicine for People with Disability and Caregivers (SEMMO) of the Institute of Science and Technology, São José dos Campos Campus, São Paulo State University-UNESP, São Paulo, Brazil
| | - Miguel Angel Castillo Salgado
- Center of Biosciences Applied to Patients with Special Health Care Needs (CEBAPE) and Multiprofessional Service of Oral Medicine for People with Disability and Caregivers (SEMMO) of the Institute of Science and Technology, São José dos Campos Campus, São Paulo State University-UNESP, São Paulo, Brazil
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Affiliation(s)
- B Balkau
- CESP Centre for Research in Epidemiology and Population Health, University Paris-Saclay, University Paris Sud, Villejuif, France
- European Regional Editor, Diabetic Medicine
| | - R I G Holt
- Human Development and Health, Faculty of Medicine, Medicine, University of Southampton, Southampton, UK
- Editor in Chief, Diabetic Medicine
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