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Wachinou AP, Fiogbe AA, Totah T, Salanon E, Solelhac GM, Berger M, Haba-Rubio J, Amidou S, Agodokpessi G, Houinato D, Heinzer R. EVALUATION OF A MODIFIED EPWORTH SLEEPINESS SCALE TO RELIABLY ASSESS EXCESSIVE DAYTIME SLEEPINESS IN LOW-INCOME COUNTRIES: RESULTS FROM THE BENIN SOCIETY AND SLEEP (BESAS) STUDY. West Afr J Med 2023; 40:S39-S40. [PMID: 38071478] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
Background The Epworth Sleepiness Scale (ESS) is a tool widely used to assess excessive daytime sleepiness. Unfortunately, it is not reliable in low-income countries where situations such as reading a book, watching TV or driving a car are not common. The aim of this study was thus to assess the performance of a modified version of the Epworth scale in a low-income country. Methods We used data from the Benin Society and Sleep (BeSAS) study where the ESS and a modified ESS (mESS) were administered to participants. In the mESS, questions four questions over eight were redesigned to reflect common living situations in Benin. The internal coherence of the mESS was assessed using the Cronbach alpha coefficient (CAC). The discriminatory ability of the scale was assessed by comparing the mean scores according to reported sleep quality, insomnia complaints and apnea-hypopnea index (AHI). Results A total of 2909 participants were recruited, 1129 were male (38.9%) with a mean age (SD) of 44.7 (14.5) y. Overall, 52.4% (1526) completed all the mESS questions while 453 (15.6%) completed the standard ESS. The CAC of the mES was 0.86 showing good internal coherence. Concerning the discriminatory ability, mean scores for mESS were 7.8 for participants with ISI < 8 vs 9.2 for participants with ISI≥8 (p<0.001), 7.8 for participants withPSQI<5 vs 8.3 for participants with PSQI≥5 (p=0.03). No difference was found when comparing the participants participants using different cut-offs of AHI (15 and 30). Conclusion The mES is more reliable than ES in the Beninese population. mESS shows good internal coherence and differentiates between insomniacs vs non-insomniacs and between good and poor sleepers. Although the mES is not a perfect score, it appears more relevant in the Benin population than the original Epworth scale but needs further validation/improvement in other low-income countries.
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Affiliation(s)
- A P Wachinou
- Faculty of Health Sciences, University of Abomey-Calavi, Cotonou, Benin.
- National Teaching Hospital for Tuberculosis and Pulmonary Diseases, Cotonou, Benin
- Laboratory of Epidemiology of Chronic and Neurologic Diseases, Faculty of Health. Sciences, University of Abomey-Calavi, Cotonou, Benin
| | - A A Fiogbe
- National Teaching Hospital for Tuberculosis and Pulmonary Diseases, Cotonou, Benin
| | - T Totah
- Laboratory of Epidemiology of Chronic and Neurologic Diseases, Faculty of Health. Sciences, University of Abomey-Calavi, Cotonou, Benin
| | - E Salanon
- Laboratory of Epidemiology of Chronic and Neurologic Diseases, Faculty of Health. Sciences, University of Abomey-Calavi, Cotonou, Benin
| | | | - M Berger
- Center of Investigation and Research on Sleep, Lausanne, Switzerland
| | - J Haba-Rubio
- Center of Investigation and Research on Sleep, Lausanne, Switzerland
| | - S Amidou
- Laboratory of Epidemiology of Chronic and Neurologic Diseases, Faculty of Health. Sciences, University of Abomey-Calavi, Cotonou, Benin
| | - G Agodokpessi
- Faculty of Health Sciences, University of Abomey-Calavi, Cotonou, Benin.
- National Teaching Hospital for Tuberculosis and Pulmonary Diseases, Cotonou, Benin
| | - D Houinato
- Faculty of Health Sciences, University of Abomey-Calavi, Cotonou, Benin.
- Laboratory of Epidemiology of Chronic and Neurologic Diseases, Faculty of Health. Sciences, University of Abomey-Calavi, Cotonou, Benin
| | - R Heinzer
- Center of Investigation and Research on Sleep, Lausanne, Switzerland
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Wachinou AP, Fiogbe AA, Totah T, Salanon E, Solelhac G, Berger M, Haba-Rubio J, Amidou S, Agodokpessi G, Houinato D, Heinzer R. PERFORMANCE OF SIX SCREENING SCORES FOR OBSTRUCTIVE SLEEP APNOEA IN AN AFRICAN POPULATION. West Afr J Med 2023; 40:S38-S39. [PMID: 38071469] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
Introduction A screening tool for obstructive sleep apnoea (OSA) is useful in low-income countries where it may be difficult to access sleep recordings. The objective of this study was to assess the performance of six screening scores compared with objective sleep recording in an African population sample. Methods This analysis is based on the "Benin Sleep and Society" (BeSAS) populational study in which respiratory polygraphy (PG) was performed using a type III device and OSA screening questionnaires (STOP, STOP-Bang, Berlin, NOSAS [≥ 8 and ≥ 5), No-Apnea, GOAL) were administered to participants. PG-defined OSA severity categories were defined according to the apnoea-hypopnoea index (AHI): mild (AHI 5 to <15/h), moderate (AHI 15 to <30/h) or severe (AHI≥30/h), and these were compared to score findings. Results A total of 1810 subjects (mean age 45.4±14.6 years; 57.3% women) were included. For moderate to severe OSA, the area under the receiving operating characteristic (ROC) curve was greatest for GOAL and No-Apnea (0.70), followed by NoSAS5 (0.69). The highest sensitivity values were for NoSAS5 (0.73), No-Apnea (0.72), and GOAL (0.69), while NoSAS8 had the highest specificity (0.91), followed by Berlin (0.88) and GOAL (0.71). All scores performed poorly with respect to the positive predictive value (PPV), which was highest with NoSAS8 (0.38). Conclusion: This study provides the first comparison of the performance of screening scores for OSA in an African population. Although still low, PPV was highest with NoSAS8. Hence, NoSAS8 would be the screening method of choice for OSA in resource-constrained settings where formal sleep recordings are not accessible.
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Affiliation(s)
- A P Wachinou
- Faculty of Health Sciences, University of Abomey-Calavi, Cotonou, Benin
- National Teaching Hospital for Tuberculosis and Pulmonary Diseases, Cotonou, Benin
- Laboratory of Epidemiology of Chronic and Neurologic Diseases, Faculty of Health Sciences, University of Abomey-Calavi, Cotonou, Benin
| | - A A Fiogbe
- National Teaching Hospital for Tuberculosis and Pulmonary Diseases, Cotonou, Benin
| | - T Totah
- Laboratory of Epidemiology of Chronic and Neurologic Diseases, Faculty of Health Sciences, University of Abomey-Calavi, Cotonou, Benin
| | - E Salanon
- Laboratory of Epidemiology of Chronic and Neurologic Diseases, Faculty of Health Sciences, University of Abomey-Calavi, Cotonou, Benin
| | - G Solelhac
- Center of Investigation and Research on Sleep, Lausanne, Switzerland
| | - M Berger
- Center of Investigation and Research on Sleep, Lausanne, Switzerland
| | - J Haba-Rubio
- Center of Investigation and Research on Sleep, Lausanne, Switzerland
| | - S Amidou
- Laboratory of Epidemiology of Chronic and Neurologic Diseases, Faculty of Health Sciences, University of Abomey-Calavi, Cotonou, Benin
| | - G Agodokpessi
- Faculty of Health Sciences, University of Abomey-Calavi, Cotonou, Benin
- National Teaching Hospital for Tuberculosis and Pulmonary Diseases, Cotonou, Benin
| | - D Houinato
- Faculty of Health Sciences, University of Abomey-Calavi, Cotonou, Benin
- Laboratory of Epidemiology of Chronic and Neurologic Diseases, Faculty of Health Sciences, University of Abomey-Calavi, Cotonou, Benin
| | - R Heinzer
- Center of Investigation and Research on Sleep, Lausanne, Switzerland
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3
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Berger M, Solelhac G, Marchi NA, Dussez R, Bradley B, Lecciso G, Heiniger G, Bayon V, Van Den Broecke S, Haba-Rubio J, Siclari F, Heinzer R. Effect of oxybutynin and reboxetine on obstructive sleep apnea: a randomized, placebo-controlled, double blind, crossover trial. Sleep 2023:7067307. [PMID: 36861433 DOI: 10.1093/sleep/zsad051] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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: 08/22/2022] [Indexed: 03/03/2023] Open
Abstract
STUDY OBJECTIVES Although recent investigations combining noradrenergic and antimuscarinic drugs have shown promising short-term results to treat obstructive sleep apnea (OSA), the mid-term effect and optimal dosage remain uncertain. The present study aimed to evaluate the effect of one week of 5 mg oxybutynin and 6 mg reboxetine (oxy-reb) on OSA versus placebo. METHODS We performed a randomized, placebo-controlled, double-blind, crossover trial comparing the effect of one week of oxy-reb versus one week of placebo on OSA severity. At-home polysomnography was performed at baseline and after each week of intervention. RESULTS Fifteen participants (male 66.7%) aged 59 [44-62] years (median [interquartile range]) with a mean body mass index of 33.1 ± 6.6 kg.m -2 were included. No significant difference in apnea-hypopnea index (AHI) was observed between conditions (estimated marginal means (95% confidence interval) at baseline: 39.7 (28.5-55.3); oxy-reb: 34.5 (22.7-52.3); placebo: 37.9 (27.1-52.9); p=0.652), but oxy-reb improved average oxygen desaturation (p=0.016) and hypoxic burden (p=0.011) and lowered sleep efficiency (p=0.019) and rapid eye movement (REM) sleep (p=0.002). Moreover, participants reported reduced sleep quality during the week of oxy-reb compared to the week of placebo (4.7 (3.5; 5.9) vs. 6.5 (5.5; 7.5) on a 0-10 visual analogic scale, respectively; p=0.001). No significant differences in sleepiness, vigilance and fatigue were observed. No serious adverse events occurred. CONCLUSION Administration of oxybutynin 5 mg and reboxetine 6 mg did not improve OSA severity assessed by AHI, but did alter sleep architecture and sleep quality. Reduced average oxygen desaturation and hypoxic burden were also observed.
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Affiliation(s)
- M Berger
- Center for Investigation and Research in Sleep, Department of Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.,Sainbiose, DVH, Inserm U1059, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - G Solelhac
- Center for Investigation and Research in Sleep, Department of Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - N A Marchi
- Center for Investigation and Research in Sleep, Department of Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - R Dussez
- Center for Investigation and Research in Sleep, Department of Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - B Bradley
- Center for Investigation and Research in Sleep, Department of Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - G Lecciso
- Center for Investigation and Research in Sleep, Department of Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - G Heiniger
- Center for Investigation and Research in Sleep, Department of Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - V Bayon
- Center for Investigation and Research in Sleep, Department of Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - S Van Den Broecke
- Center for Investigation and Research in Sleep, Department of Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - J Haba-Rubio
- Center for Investigation and Research in Sleep, Department of Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - F Siclari
- Center for Investigation and Research in Sleep, Department of Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - R Heinzer
- Center for Investigation and Research in Sleep, Department of Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
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4
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Marchi N, Berger M, Solelhac G, Haba-Rubio J, Draganski B, Heinzer R. Obstructive sleep apnea and cognitive decline in the elderly: the HypnoLaus study. Sleep Med 2022. [DOI: 10.1016/j.sleep.2022.05.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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5
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Marchi N, Solelhac G, Berger M, Lutti A, Haba-Rubio J, Heinzer R, Draganski B. MRI measurement of brain iron content in obstructive sleep apnea: the HypnoLaus study. Sleep Med 2022. [DOI: 10.1016/j.sleep.2022.05.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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6
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Berger M, Vakulin A, Hirotsu C, Marchi N, Solelhac G, Bayon V, Siclari F, Haba-Rubio J, Vaucher J, Waeber G, Vollenweider P, Marques-Vidal P, Appleton S, Heinzer R. Association of sleep microstructure with incident hypertension in a population-based sample: The HypnoLaus study. Sleep Med 2022. [DOI: 10.1016/j.sleep.2022.05.193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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7
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Miano S, Fanfulla F, Nobili L, Heinzer R, Haba-Rubio J, Berger M, Cereda C, Schmidt M, Manconi M, Bassetti C. SAS CARE 1: Sleep architecture changes in a cohort of patients with Ischemic Stroke/TIA. Sleep Med 2022; 98:106-113. [DOI: 10.1016/j.sleep.2022.06.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 05/25/2022] [Accepted: 06/02/2022] [Indexed: 12/12/2022]
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8
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Forni Ogna V, Ogna A, Haba-Rubio J, Heinzer R. 0699 Effect Of Kidney Transplantation On Sleep Apnea Severity: A Prospective Controlled Polysomnographic Study. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Renal failure-associated fluid overload has been associated with a high prevalence of sleep apnea (SA) in patients with end-stage kidney disease (ESKD). Kidney transplantation has been shown to restore a normal renal function but its effect on SA remains unclear. In this prospective study, we hypothesized that improvement of kidney function and hydration status after kidney transplantation (Tx) may result in an improvement of SA severity.
Methods
A total of 196 patients on kidney transplant waiting list were screened for SA using home nocturnal polysomnography (PSG) to measure the Apnea-Hypopnea Index (AHI) and underwent bioimpedance to assess body composition. Polysomnography and bioimpedance were repeated 6 months after kidney transplant. Patients still on the waiting list after 6 months underwent same investigations as a control group.
Results
Of 88 participants (44.9%) with SA (AHI ≥15/h) at baseline, 42 patients were reassessed 6 months post-Tx and were compared to 27 control patients remaining on the waiting list after 6 months. There was a significant, although partial, post-Tx improvement in SA severity as measured by the AHI (from 44.2±24.3/h to 34.7±20.9/h, p=0.02), with a concomitant reduction in body water (from 54.9% to 51.6%, p=0.003), suggesting a causal implication of fluid overload. A post-Tx increase in body fat mass (from 26% to 30%, p=0.003) may have blunted the beneficial impact of kidney Tx on SA. These parameters remained unchanged in the control group.
Conclusion
SA is a frequent condition in ESKD patients. Kidney transplantation is associated with a reduction of fluid overload but an increase in fat mass, yielding only a partial improvement in SA severity. These results suggest that SA should be systematically assessed before and after kidney Tx
Support
Swiss Kidney Foundation, the Pulmonary League and the Organ Transplant Foundation of Lausanne
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Affiliation(s)
- V Forni Ogna
- Nephology Department, Locarno Hospital, Locarno, SWITZERLAND
| | - A Ogna
- Pulmonary Department, Locarno Hospital, Locarno, SWAZILAND
| | - J Haba-Rubio
- Center for investigation in Lseep (CIRS), Lausanne University Hospital, Lausanne, SWITZERLAND
| | - R Heinzer
- Lausanne University center for investigation and research in sleep, Lausanne, SWITZERLAND
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9
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Betta M, Handjaras G, Ricciardi E, Pietrini P, Haba-Rubio J, Siclari F, Heinzer R, Bernardi G. Quantifying peripheral sympathetic activations during sleep by means of an automatic method for pulse wave amplitude drop detection. Sleep Med 2020; 69:220-232. [DOI: 10.1016/j.sleep.2019.12.030] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 11/19/2019] [Accepted: 12/23/2019] [Indexed: 12/28/2022]
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10
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Cataldi J, Lecci S, Bernardi G, Haba-Rubio J, Siclari F. Behavioral and regional eeg features of parasomnia episodes in disorders of arousal. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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11
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Ogna VF, Ogna A, Haba-Rubio J, Burnier M, Pascual M, Heinzer R. Impact of kidney transplantation on sleep apnea severity: a prospective controlled polysomnographic study. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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12
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Lisan Q, Tafflet M, Thomas F, Boutouyrie P, Guibout C, Haba-Rubio J, Climie R, Périer MC, Van Sloten T, Pannier B, Marques-Vidal P, Jouven X, Empana JP. Body Silhouette Trajectories Over the Lifespan and Insomnia Symptoms: The Paris Prospective Study 3. Sci Rep 2019; 9:1581. [PMID: 30733545 PMCID: PMC6367427 DOI: 10.1038/s41598-018-38145-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 11/23/2018] [Indexed: 02/03/2023] Open
Abstract
Insomnia symptoms are highly prevalent and associated with several adverse medical conditions, but only few determinants, including non-modifiable ones, have been highlighted. We investigated associations between body silhouette trajectories over the lifespan and insomnia symptoms in adulthood. From a community-based study, 7 496 men and women aged 50–75 years recalled their body silhouette at age 8, 15, 25, 35 and 45, and rated the frequency of insomnia symptoms on a standardized sleep questionnaire. An Epworth Sleepiness Scale ≥11 defined excessive daytime sleepiness (EDS). Using a group-based trajectory modeling, we identified five body silhouette trajectories: a ‘lean-stable’ (32.7%), a ‘heavy-stable’ (8.1%), a ‘moderate-stable’ (32.5%), a ‘lean-increase’ (11%) and a ‘lean-marked increase’ (15.7%) trajectory. In multivariate logistic regression, compared to the ‘lean-stable’ trajectory, the ‘lean-marked increase’ and ‘heavy-stable’ trajectories were associated with a significant increased odd of having ≥1 insomnia symptoms as compared to none and of having a proxy for insomnia disorder (≥1 insomnia symptom and EDS). The association with the ‘lean-marked increase' trajectory’ was independent from body mass index measured at study recruitment. In conclusion, increasing body silhouette over the lifespan is associated with insomnia symptoms in adulthood, emphasizing the importance of weight gain prevention during the entire lifespan.
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Affiliation(s)
- Q Lisan
- Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France. .,INSERM, UMR-S970, Paris Cardiovascular Research Center, Department of Epidemiology, Paris, France. .,AP-HP, Georges Pompidou European Hospital, Department of Head and Neck surgery, Paris, France.
| | - M Tafflet
- Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France.,INSERM, UMR-S970, Paris Cardiovascular Research Center, Department of Epidemiology, Paris, France
| | - F Thomas
- Preventive and Clinical Investigation Center, Paris, France
| | - P Boutouyrie
- Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France.,INSERM, UMR-S970, Paris Cardiovascular Research Center, Department of Epidemiology, Paris, France.,AP-HP, Georges Pompidou European Hospital, Department of Pharmacology, Paris, France
| | - C Guibout
- Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France.,INSERM, UMR-S970, Paris Cardiovascular Research Center, Department of Epidemiology, Paris, France
| | - J Haba-Rubio
- Center for Investigation and Research in Sleep, Lausanne University Hospital, Lausanne University, Lausanne, Switzerland
| | - R Climie
- Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France.,INSERM, UMR-S970, Paris Cardiovascular Research Center, Department of Epidemiology, Paris, France.,Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - M C Périer
- Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France.,INSERM, UMR-S970, Paris Cardiovascular Research Center, Department of Epidemiology, Paris, France
| | - T Van Sloten
- Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France.,INSERM, UMR-S970, Paris Cardiovascular Research Center, Department of Epidemiology, Paris, France.,CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands.,Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - B Pannier
- Preventive and Clinical Investigation Center, Paris, France
| | - P Marques-Vidal
- Center for Investigation and Research in Sleep, Lausanne University Hospital, Lausanne University, Lausanne, Switzerland.,Department of medicine, Service of internal medicine, Lausanne University Hospital, Lausanne, Switzerland
| | - X Jouven
- Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France.,INSERM, UMR-S970, Paris Cardiovascular Research Center, Department of Epidemiology, Paris, France.,AP-HP, Georges Pompidou European Hospital, Cardiology Department, Paris, France
| | - J P Empana
- Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France.,INSERM, UMR-S970, Paris Cardiovascular Research Center, Department of Epidemiology, Paris, France
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13
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Petrovic D, Stringhini S, Heinzer R, Haba-Rubio J. Social inequalities in sleep-related breathing disorders: evidence from the CoLaus study. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky212.277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- D Petrovic
- Centre Hospitalier Universitaire Vaudois (CHUV), Université de Lausanne, Lausanne, Switzerland
| | - S Stringhini
- Centre Hospitalier Universitaire Vaudois (CHUV), Université de Lausanne, Lausanne, Switzerland
| | - R Heinzer
- Centre Hospitalier Universitaire Vaudois (CHUV), Université de Lausanne, Lausanne, Switzerland
| | - J Haba-Rubio
- Centre Hospitalier Universitaire Vaudois (CHUV), Université de Lausanne, Lausanne, Switzerland
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14
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Hirotsu C, Heinzer R, Poyares D, Haba-Rubio J, Coelho FM, Bittencourt L, Tufik S. 0951 Insomnia, Short-sleepers And Rem-related Sleep Disordered Breathing As Risk Factors For Incident Depression In The Episono Cohort. Sleep 2018. [DOI: 10.1093/sleep/zsy061.950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- C Hirotsu
- Universidade Federal de Sao Paulo (Unifesp), Sao Paulo, BRAZIL
| | - R Heinzer
- Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, SWITZERL
| | - D Poyares
- Universidade Federal de Sao Paulo (Unifesp), Sao Paulo, BRAZIL
| | - J Haba-Rubio
- Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, SWITZERL
| | - F M Coelho
- Universidade Federal de Sao Paulo (Unifesp), Sao Paulo, BRAZIL
| | - L Bittencourt
- Universidade Federal de Sao Paulo (Unifesp), Sao Paulo, BRAZIL
| | - S Tufik
- Universidade Federal de Sao Paulo (Unifesp), Sao Paulo, BRAZIL
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15
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Lecci S, Cataldi J, Bernardi G, Haba-Rubio J, Heinzer R, Tononi G, Siclari F. 0122 The EEG Correlates Of Sleep Misperception. Sleep 2018. [DOI: 10.1093/sleep/zsy061.121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- S Lecci
- University Hospital Lausanne, Lausanne, SWITZERL
| | - J Cataldi
- University Hospital Lausanne, Lausanne, SWITZERL
| | - G Bernardi
- IMT School for Advanced Studies, Lucca, ITALY
| | - J Haba-Rubio
- University Hospital Lausanne, Lausanne, SWITZERL
| | - R Heinzer
- University Hospital Lausanne, Lausanne, SWITZERL
| | - G Tononi
- University of Wisconsin, Madison, WI
| | - F Siclari
- University Hospital Lausanne, Lausanne, SWITZERL
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16
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Heinzer R, Hirotsu C, Marques-Vidal P, Vollenweider P, Waeber G, Tafti M, Betta M, Bernardi G, Siclari F, Haba-Rubio J. 0889 Sleep Determinants of Incident Hypertension in a Population-Based Cohort: The CoLaus-HypnoLaus Study. Sleep 2018. [DOI: 10.1093/sleep/zsy061.888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- R Heinzer
- Center for Investigation and Research in Sleep, Lausanne, SWITZERL
| | - C Hirotsu
- Center for Investigation and Research in Sleep, Lausanne, SWITZERL
| | | | | | - G Waeber
- University Hospital of Lausanne, Lausanne, SWITZERL
| | - M Tafti
- Lausanne University Physiology Department, Lausanne, SWITZERL
| | - M Betta
- MoMiLab Unit, IMT School for Advanced Studies, Lucca, ITALY
| | - G Bernardi
- MoMiLab Unit, IMT School for Advanced Studies, Lucca, ITALY
| | - F Siclari
- Center for Investigation and Research in Sleep, Lausanne, SWITZERL
| | - J Haba-Rubio
- Center for Investigation and Research in Sleep, Lausanne, SWITZERL
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Haba-Rubio J, Vujica J, Michel P, Heinzer R. Effect of CPAP treatment of sleep apnea on prognosis after ischemic stroke: an observational study. Sleep Med 2017. [DOI: 10.1016/j.sleep.2017.11.363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Betta M, Bernardi G, Ricciardi E, Pietrini P, Haba-Rubio J, Siclari F, Heinzer R. Quantifying peripheral sympathetic activation during sleep by means of an automatic method for pulse wave amplitude drop detection. Sleep Med 2017. [DOI: 10.1016/j.sleep.2017.11.091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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19
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Montamat S, Karunajeewa S, Navarrete M, Cervena K, Haba-Rubio J, Ibanez V. Sleep deprivation modifies the usual behavior of alpha oscillatory activity during cognitive tasks. Sleep Med 2017. [DOI: 10.1016/j.sleep.2017.11.670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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20
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Heinzer R, Vollenweider P, Marques-Vidal P, Preisig M, Tobback N, Andries D, Haba-Rubio J. Impact of gender and hormonal status on the prevalence and comorbidities of sleep-disordered breathing. Sleep Med 2017. [DOI: 10.1016/j.sleep.2017.11.378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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21
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Haba-Rubio J, Ouanes S, Popp J. Sleep characteristics, salivary cortisol and cognitive performance in non-demented subjects: A population-based study. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.2181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Chiaro G, Maestri M, Riccardi S, Haba-Rubio J, Miano S, Bassetti CL, Heinzer R, Manconi M. 0737 SLEEP-RELATED RHYTHMIC MOVEMENT DISORDER AND SLEEP APNEA IN FIVE ADULT PATIENTS. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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23
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Ogna A, Forni Ogna V, Mihalache A, Pruijm M, Halabi G, Phan O, Cornette F, Haba-Rubio J, Burnier M, Heinzer R. Effects of fluid removal by hemodialysis on sleep apnea in end-stage renal disease patients. Sleep Med 2015. [DOI: 10.1016/j.sleep.2015.02.483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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24
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Haba-Rubio J, Marti-Soler H, Tobback N, Andries D, Tafti M, Heinzer R. Prevalence and determinants of periodic limb movements during sleep in the general population: The HypnoLaus study. Sleep Med 2015. [DOI: 10.1016/j.sleep.2015.02.460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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25
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Haba-Rubio J, Tobback N, Andries D, Preisig M, Castelao E, Tafti M, Heinzer R, Popp J. Association between sleep characteristics and mild cognitive impairment: The HypnoLaus/Psycholaus study. Sleep Med 2015. [DOI: 10.1016/j.sleep.2015.02.096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Heinzer R, Vat S, Marques-Vidal P, Marti-Soler H, Andries D, Tobback N, Mooser V, Preisig M, Malhotra A, Waeber G, Vollenweider P, Tafti M, Haba-Rubio J. Prevalence of sleep-disordered breathing in the general population: the HypnoLaus study. Lancet Respir Med 2015; 3:310-8. [PMID: 25682233 DOI: 10.1016/s2213-2600(15)00043-0] [Citation(s) in RCA: 1485] [Impact Index Per Article: 165.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Accepted: 01/12/2015] [Indexed: 12/29/2022]
Abstract
BACKGROUND Sleep-disordered breathing is associated with major morbidity and mortality. However, its prevalence has mainly been selectively studied in populations at risk for sleep-disordered breathing or cardiovascular diseases. Taking into account improvements in recording techniques and new criteria used to define respiratory events, we aimed to assess the prevalence of sleep-disordered breathing and associated clinical features in a large population-based sample. METHODS Between Sept 1, 2009, and June 30, 2013, we did a population-based study (HypnoLaus) in Lausanne, Switzerland. We invited a cohort of 3043 consecutive participants of the CoLaus/PsyCoLaus study to take part. Polysomnography data from 2121 people were included in the final analysis. 1024 (48%) participants were men, with a median age of 57 years (IQR 49-68, range 40-85) and mean body-mass index (BMI) of 25·6 kg/m(2) (SD 4·1). Participants underwent complete polysomnographic recordings at home and had extensive phenotyping for diabetes, hypertension, metabolic syndrome, and depression. The primary outcome was prevalence of sleep-disordered breathing, assessed by the apnoea-hypopnoea index. FINDINGS The median apnoea-hypopnoea index was 6·9 events per h (IQR 2·7-14·1) in women and 14·9 per h (7·2-27·1) in men. The prevalence of moderate-to-severe sleep-disordered breathing (≥15 events per h) was 23·4% (95% CI 20·9-26·0) in women and 49·7% (46·6-52·8) in men. After multivariable adjustment, the upper quartile for the apnoea-hypopnoea index (>20·6 events per h) was associated independently with the presence of hypertension (odds ratio 1·60, 95% CI 1·14-2·26; p=0·0292 for trend across severity quartiles), diabetes (2·00, 1·05-3·99; p=0·0467), metabolic syndrome (2·80, 1·86-4·29; p<0·0001), and depression (1·92, 1·01-3·64; p=0·0292). INTERPRETATION The high prevalence of sleep-disordered breathing recorded in our population-based sample might be attributable to the increased sensitivity of current recording techniques and scoring criteria. These results suggest that sleep-disordered breathing is highly prevalent, with important public health outcomes, and that the definition of the disorder should be revised. FUNDING Faculty of Biology and Medicine of Lausanne, Lausanne University Hospital, Swiss National Science Foundation, Leenaards Foundation, GlaxoSmithKline, Ligue Pulmonaire Vaudoise.
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Affiliation(s)
- R Heinzer
- Center for Investigation and Research in Sleep, University Hospital of Lausanne, Lausanne, Switzerland; Pulmonary Department, University Hospital of Lausanne, Lausanne, Switzerland.
| | - S Vat
- Center for Investigation and Research in Sleep, University Hospital of Lausanne, Lausanne, Switzerland; Pulmonary Medicine Department, University Hospital of Montreal, Montreal, QC, Canada
| | - P Marques-Vidal
- Department of Internal Medicine, University Hospital of Lausanne, Lausanne, Switzerland
| | - H Marti-Soler
- Institute of Social and Preventive Medicine, University of Lausanne, Lausanne, Switzerland
| | - D Andries
- Center for Investigation and Research in Sleep, University Hospital of Lausanne, Lausanne, Switzerland
| | - N Tobback
- Center for Investigation and Research in Sleep, University Hospital of Lausanne, Lausanne, Switzerland
| | - V Mooser
- Laboratory Department, University Hospital of Lausanne, Lausanne, Switzerland
| | - M Preisig
- Psychiatry Department, University Hospital of Lausanne, Lausanne, Switzerland
| | - A Malhotra
- University of Southern California San Diego, Division of Pulmonary and Critical Care, La Jolla, CA, USA
| | - G Waeber
- Department of Internal Medicine, University Hospital of Lausanne, Lausanne, Switzerland
| | - P Vollenweider
- Department of Internal Medicine, University Hospital of Lausanne, Lausanne, Switzerland
| | - M Tafti
- Center for Investigation and Research in Sleep, University Hospital of Lausanne, Lausanne, Switzerland; Center for Integrative Genomics, University of Lausanne, Lausanne, Switzerland
| | - J Haba-Rubio
- Center for Investigation and Research in Sleep, University Hospital of Lausanne, Lausanne, Switzerland
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Stringhini S, Haba-Rubio J, Marques-Vidal P, Waeber G, Preisig M, Guessous I, Bovet P, Vollenweider P, Tafti M, Heinzer R. Association of socioeconomic status with sleep disturbances in the Swiss population-based CoLaus study. Eur J Public Health 2014. [DOI: 10.1093/eurpub/cku151.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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28
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Heinzer R, Saugy J, Tobback N, Rupp T, Haba-Rubio J, Millet G. Effects of real vs simulated altitude on sleep and sleep disordered breathing. Sleep Med 2013. [DOI: 10.1016/j.sleep.2013.11.697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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29
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Haba-Rubio J, Marques-Vidal P, Andries D, Tobback N, Tafti M, Heinzer R. Antidepressants and RLS/PLMS in the general population. Sleep Med 2013. [DOI: 10.1016/j.sleep.2013.11.332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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30
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Haba-Rubio J, Vat S, Andries D, Tobback N, Tafti M, Heinzer R. Prevalence and characteristics of sleep disordered breathing in pre- and post-menopausal women. Sleep Med 2013. [DOI: 10.1016/j.sleep.2013.11.333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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31
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Haba-Rubio J, Marques-Vidal P, Andries D, Tobback N, Tafti M, Heinzer R. Sleep structure and cardiometabolic disorders in the general population. Sleep Med 2013. [DOI: 10.1016/j.sleep.2013.11.085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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32
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Vat S, Haba-Rubio J, Andries D, Tobback N, Tafti M, Heinzer R. Prevalence of the upper airway resistance syndrome in the general population. Sleep Med 2013. [DOI: 10.1016/j.sleep.2013.11.723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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33
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Vat S, Haba-Rubio J, Andries D, Tobback N, Tafti M, Heinzer R. Screening for sleep-disordered breathing in the general population: predictive performance of four questionnaires. Sleep Med 2013. [DOI: 10.1016/j.sleep.2013.11.724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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34
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Vat S, Haba-Rubio J, Heinzer R. [Positional obstructive sleep apnea syndrome]. Rev Med Suisse 2013; 9:2150-2154. [PMID: 24354249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Obstructive sleep apnea (OSA) tends to worsen on the supine posture due to the effect of gravity on tongue position. In some cases, OSA is present exclusively on the supine posture (exclusive postural OSA). These patients may benefit from positional therapy (PT), which aim is to prevent sleep in the supine posture using different types of devices. Before opting for this therapeutic option, a sleep study with PT should be perform in order to confirm its efficacy and assess the patients' tolerance. Because the efficacy of PT is inferior to continuous positive airway pressure (CPAP), the latter treatment remains the first line of therapy. Also, the discomfort of the existing devices appears to limit the long term use of PT. Further studies assessing the long term effects of PT on metabolic and neurocognitive outcomes are needed.
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Affiliation(s)
- S Vat
- Centre d'investigation et de recherche sur le sommeil (CIRS), CHUV, 1010 Lausanne.
| | - J Haba-Rubio
- Centre d'investigation et de recherche sur le sommeil (CIRS), CHUV, 1010 Lausanne
| | - R Heinzer
- Centre d'investigation et de recherche sur le sommeil (CIRS), Service de pneumologie, CHUV, 1010 Lausanne
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Haba-Rubio J, Luca G, Dauvilliers Y, Arnulf I, Lammers G, Heinzer R, Tafti M. Caractéristiques cliniques et polysomnographiques de la narcolepsie avec cataplexie : données de la « European Narcolepsy Network Database ». Neurophysiol Clin 2012. [DOI: 10.1016/j.neucli.2012.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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36
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Tobback N, Andries D, Beaud-Goetschmann V, Rossetti A, Lecciso G, Haba-Rubio J, Heinzer R. Effets d’un sommeil polyphasique avec et sans lumière bleue nocturne chez un navigateur en solitaire. Neurophysiol Clin 2012. [DOI: 10.1016/j.neucli.2012.02.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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37
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Haba-Rubio J. [Parasomnias]. Rev Med Suisse 2012; 8:157. [PMID: 22338494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Affiliation(s)
- J Haba-Rubio
- Centre d'investigation et de recherche sur le sommeil, CHUV, 1011 Lausanne.
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Heinzer R, Haba-Rubio J, Tafti M. [HypnoLaus sleep cohort study]. Rev Med Suisse 2011; 7:2137-2141. [PMID: 22187783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Normal sleep patterns and prevalence of sleep disorders in the general population are largely unknown. The aim of HypnoLaus cohort study is to record sleep and analyze sleep characteristics in a large population-based sample, which had undergone comprehensive genetic, somatic, and psychiatric investigations. Full polysomnography has already been performed in more than 1100 middle aged men and women randomly selected from Lausanne general population (goal 2000-3000 sleep recordings). Over 4000 additional subjects from the same population have filled various questionnaires on their sleep habits and complaints. These results combined with genetic, cardiovascular, metabolic, and psychiatric data provide a unique opportunity to determine the interaction between sleep, its genetic determinants and cardiovascular, psychiatric, or metabolic diseases.
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Affiliation(s)
- R Heinzer
- Service de pneumologie, Centre d'investigation et de recherche sur le sommeil (CIRS), CHUV, 1011 Lausanne.
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Haba-Rubio J, Rossetti A, Tafti M, Heinzer R. Narcolepsie avec cataplexie après vaccination anti-H1N1. Rev Neurol (Paris) 2011; 167:563-6. [DOI: 10.1016/j.neurol.2011.04.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2011] [Revised: 04/13/2011] [Accepted: 04/15/2011] [Indexed: 12/01/2022]
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Haba-Rubio J, Mahour K, Berroir S. I - 1 Myélo-myélo : une autre facette de la pathologie du cuivre. Rev Neurol (Paris) 2007. [DOI: 10.1016/s0035-3787(07)90576-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abstract
Regional brain iron levels of two patients with haemochromatosis and severe restless legs syndrome (RLS) were assessed using R2' magnetic resonance imaging (MRI) sequences in both patients and in nine healthy controls. R2' relaxation rates in the patients were decreased in the substantia nigra, red nucleus, and pallidum when compared with the controls. These results indicate that local brain iron deficiency may occur in patients with haemochromatosis and suggest a role for brain iron metabolism in the pathophysiology of RLS.
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Affiliation(s)
- J Haba-Rubio
- Institute for Research in Neurosciences and Neuropsychiatry, Rouffach, France.
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Abstract
Altered vigilance performance has been documented in patients with sleep-related breathing disorders (SRBDs). Sleep fragmentation, sleepiness, respiratory disturbances and nocturnal hypoxaemia have been suggested as the pathogenesis of these deficits, yet it remains difficult to find a good correlation between performance deficits and the above factors. In the present study, which performance measure better characterised SRBD patients and the main factors implicated in these disturbances were examined. The study group consisted of 152 patients and 45 controls, all examined using a performance vigilance task and subjective sleepiness assessment. Speed and accuracy in the psychomotor vigilance task (PVT) were measured in patients and controls. Objective daytime sleepiness was assessed in the patient group using the maintenance of wakefulness test. In comparison with controls, PVT accuracy rather than speed seems to be affected in SRBD patients, with lapses and false responses significantly greater in patients with more severe objective sleepiness and higher apnoea/hypopnoea index. Although slowing and increased variability in reaction time were associated with shorter sleep latency in the maintenance of wakefulness test, subjective sleepiness, sleep fragmentation, nocturnal hypoxaemia and apnoea/hypopnoea index influenced mainly PVT accuracy. It is concluded that vigilance impairment, sleep fragmentation and severity of disease may partially and differentially contribute to the diurnal performance consequences found in sleep-related breathing disorders. Since the psychomotor vigilance task worsening is more marked in accuracy that in speed, measurement of lapses and false responses would better characterise the degree of diurnal impairment in these patients.
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Affiliation(s)
- E Sforza
- Sleep Laboratory, Dept of Psychiatry, Geneva University Hospital, Geneva, Switzerland.
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