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[PMID]:28449905
[Au] Autor:Xu X; Wu H; Zhuang J; Chen K; Huang B; Zhao Z; Zhao Z
[Ad] Endereço:Department of Neurology, Changzheng Hospital, Second Military Medical University of PLA, Shanghai, PR China.
[Ti] Título:Sleep-wake patterns, non-rapid eye movement, and rapid eye movement sleep cycles in teenage narcolepsy.
[So] Source:Sleep Med;33:47-56, 2017 May.
[Is] ISSN:1878-5506
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: To further characterize sleep disorders associated with narcolepsy, we assessed the sleep-wake patterns, rapid eye movement (REM), and non-REM (NREM) sleep cycles in Chinese teenagers with narcolepsy. METHODS: A total of 14 Chinese type 1 narcoleptic patients (13.4 ± 2.6 years of age) and 14 healthy age- and sex-matched control subjects (13.6 ± 1.8 years of age) were recruited. Ambulatory 24-h polysomnography was recorded for two days, with test subjects adapting to the instruments on day one and the study data collection performed on day two. RESULTS: Compared with the controls, the narcoleptic patients showed a 1.5-fold increase in total sleep time over 24 h, characterized by enhanced slow-wave sleep and REM sleep. Frequent sleep-wake transitions were identified in nocturnal sleep with all sleep stages switching to wakefulness, with more awakenings and time spent in wakefulness after sleep onset. Despite eight cases of narcolepsy with sleep onset REM periods at night, the mean duration of NREM-REM sleep cycle episode and the ratio of REM/NREM sleep between patients and controls were not significantly different. CONCLUSION: Our study identified hypersomnia in teenage narcolepsy despite excessive daytime sleepiness. Sleep fragmentation extended to all sleep stages, indicating impaired sleep-wake cycles and instability of sleep stages. The limited effects on NREM-REM sleep cycles suggest the relative conservation of ultradian regulation of sleep.
[Mh] Termos MeSH primário: Narcolepsia/diagnóstico
Narcolepsia/fisiopatologia
Fases do Sono/fisiologia
Sono REM/fisiologia
[Mh] Termos MeSH secundário: Adolescente
Estudos de Casos e Controles
Criança
China/epidemiologia
Ritmo Circadiano/fisiologia
Distúrbios do Sono por Sonolência Excessiva/complicações
Distúrbios do Sono por Sonolência Excessiva/epidemiologia
Distúrbios do Sono por Sonolência Excessiva/etiologia
Feminino
Seres Humanos
Masculino
Narcolepsia/epidemiologia
Polissonografia/métodos
Privação do Sono/diagnóstico
Privação do Sono/fisiopatologia
Ritmo Ultradiano/fisiologia
Vigília/fisiologia
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180216
[Lr] Data última revisão:
180216
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE


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[PMID]:28449903
[Au] Autor:Suzuki Y; Khoury S; El-Khatib H; Chauny JM; Paquet J; Giguère JF; Denis R; Gosselin N; Lavigne GJ; Arbour C
[Ad] Endereço:Hôpital du Sacré-Coeur de Montréal, Montreal, Quebec, Canada; Faculty of Dental Medicine, Université de Montréal, Montreal, Quebec, Canada.
[Ti] Título:Individuals with pain need more sleep in the early stage of mild traumatic brain injury.
[So] Source:Sleep Med;33:36-42, 2017 May.
[Is] ISSN:1878-5506
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Hypersomnia is frequently reported after mild traumatic brain injury (mTBI), but its cause(s) remain elusive. This study examined sleep/wake activity after mTBI and its association with pain, a comorbidity often associated with insomnia. METHODS: Actigraphy recording was performed for 7 ± 2 consecutive days in 56 individuals at one month post-mTBI (64% male; 38 ± 12 years), 24 individuals at one year post-mTBI (58% male; 44 ± 11years), and in 20 controls (50% male; 37 ± 12 years). Pain intensity and its effect on quality of life was assessed with a visual analogue scale and the Short Form Health Survey (SF-36) bodily pain subscale. RESULTS: Overall, few differences in sleep/wake patterns were found between mTBI patients and controls. However, higher percentages of mTBI individuals with moderate-to-severe pain were found to require more than eight hours of sleep per day (37% vs11%; p = 0.04) and to be frequent nappers (defined as those who took three or more naps per week) (42% vs 22%; p = 0.04) compared to those with mild or no pain at one month postinjury. Correcting for age and depression, The SF-36 score was found to be a significant predictor of sleep duration exceeding eight hours per day at one month (odds ratio = 0.95; 95% confidence interval = 0.92-0.99; p = 0.01), but not at one year post-mTBI. Pain and increased sleep need (in terms of hours per day or napping frequency) were found to co-exist in as much as 29% of mTBI patients at one month postinjury. CONCLUSION: Pain could be associated with more pronounced sleep need in about one-third of mTBI patients during early recovery. Unalleviated pain, found in more than 60% of mTBI patients, should therefore be looked for in all mTBI patients reporting new onset of sleep disorder, not only in those with insomnia.
[Mh] Termos MeSH primário: Concussão Encefálica/complicações
Lesões Encefálicas/complicações
Distúrbios do Sono por Sonolência Excessiva/complicações
Dor/complicações
Transtornos do Sono-Vigília/complicações
Sono/fisiologia
[Mh] Termos MeSH secundário: Actigrafia/métodos
Adulto
Concussão Encefálica/epidemiologia
Concussão Encefálica/fisiopatologia
Lesões Encefálicas/epidemiologia
Comorbidade
Distúrbios do Sono por Sonolência Excessiva/fisiopatologia
Feminino
Seres Humanos
Masculino
Meia-Idade
Dor/epidemiologia
Dor/fisiopatologia
Dor/psicologia
Estudos Prospectivos
Qualidade de Vida
Autorrelato
Índice de Gravidade de Doença
Distúrbios do Início e da Manutenção do Sono/complicações
Transtornos do Sono-Vigília/epidemiologia
Transtornos do Sono-Vigília/etiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180216
[Lr] Data última revisão:
180216
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE


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[PMID]:28449902
[Au] Autor:Janssen KC; Phillipson S; O'Connor J; Johns MW
[Ad] Endereço:Faculty of Education, Monash University, Frankston, VIC, Australia. Electronic address: kitty.janssen@monash.edu.
[Ti] Título:Validation of the Epworth Sleepiness Scale for Children and Adolescents using Rasch analysis.
[So] Source:Sleep Med;33:30-35, 2017 May.
[Is] ISSN:1878-5506
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: A validated measure of daytime sleepiness for adolescents is needed to better explore emerging relationships between sleepiness and the mental and physical health of adolescents. The Epworth Sleepiness Scale (ESS) is a widely used scale for daytime sleepiness in adults but contains references to alcohol and driving. The Epworth Sleepiness Scale for Children and Adolescents (ESS-CHAD) has been proposed as the official modified version of the ESS for children and adolescents. This study describes the psychometric analysis of the ESS-CHAD as a measure of daytime sleepiness for adolescents. METHODS: The ESS-CHAD was completed by 297 adolescents, 12-18 years old, from two independent schools in Victoria, Australia. Exploratory factor analysis and Rasch analysis was conducted to determine the validity of the scale. RESULTS: Exploratory factor analysis and Rasch analysis indicated that ESS-CHAD has internal validity and a unidimensional structure with good model fit. Rasch analysis of four subgroups based on gender and year-level were consistent with the overall results. The results were consistent with published ESS results, which strongly indicates that the changes to the scale do not affect the scale's capacity to measure daytime sleepiness. CONCLUSIONS: It is concluded that the ESS-CHAD is a reliable and internally valid measure of daytime sleepiness in adolescents 12-18 years old. Further studies are needed to establish the internal validity of the ESS-CHAD for children under 12 years, and to establish external validity and accurate cut-off points for children and adolescents.
[Mh] Termos MeSH primário: Distúrbios do Sono por Sonolência Excessiva/diagnóstico
Fases do Sono/fisiologia
Transtornos do Sono-Vigília/diagnóstico
[Mh] Termos MeSH secundário: Adolescente
Austrália/epidemiologia
Criança
Distúrbios do Sono por Sonolência Excessiva/epidemiologia
Feminino
Seres Humanos
Masculino
Psicometria/métodos
Reprodutibilidade dos Testes
Transtornos do Sono-Vigília/epidemiologia
Inquéritos e Questionários
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180216
[Lr] Data última revisão:
180216
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE


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[PMID]:28449900
[Au] Autor:Matsui K; Sasai-Sakuma T; Ishigooka J; Inoue Y
[Ad] Endereço:Department of Psychiatry, Tokyo Women's Medical University, Tokyo, Japan; Japan Somnology Center, Neuropsychiatric Research Institute, Tokyo, Japan.
[Ti] Título:Insufficient sleep rather than the apnea-hypopnea index can be associated with sleepiness-related driving problems of Japanese obstructive sleep apnea syndrome patients residing in metropolitan areas.
[So] Source:Sleep Med;33:19-22, 2017 May.
[Is] ISSN:1878-5506
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Obstructive sleep apnea syndrome (OSAS) and insufficient sleep might increase the risk of drowsy driving and sleepiness-related vehicular accidents. This study retrospectively investigated the factors associated with these driving problems, particularly addressing OSAS severity and sleep amounts of affected drivers. METHODS: This study examined 161 patients (146 male and 15 female) with OSAS (apnea-hypopnea index [AHI] ≥ 5) who drove on a routine basis and who completed study questionnaires. To investigate factors associated with drowsy driving during the prior year and sleepiness-related vehicular accidents or near-miss events during the prior five years, logistic regression analyses were performed with age, body mass index, monthly driving distance, habitual sleep duration on weekdays, the Japanese version of Epworth Sleepiness Scale score, AHI, and periodic limb movement index as independent variables. RESULTS: Of the patients, 68 (42.2%) reported drowsy driving experiences, and 86 (53.4%) reported sleepiness-related vehicular accidents or near-miss events. Analyses revealed the following: older age (46-65 years, ≥66 years) was negatively associated with drowsy driving (p <0.05, p <0.05), and habitually shorter sleep duration on weekdays (≤6 hours) was positively associated with drowsy driving (p <0.01). Habitual sleep duration of ≤6 hours (p <0.01) and Epworth Sleepiness Scale score of ≥11 (p <0.01) were positively associated with sleepiness-related vehicular accidents and near-miss events. However, AHI was not associated with these driving problems. CONCLUSION: Insufficient sleep, rather than severity of OSAS, was associated with sleepiness-related driving problems in these Japanese OSAS patients.
[Mh] Termos MeSH primário: Acidentes de Trânsito/estatística & dados numéricos
Condução de Veículo/estatística & dados numéricos
Distúrbios do Sono por Sonolência Excessiva/epidemiologia
Apneia Obstrutiva do Sono/complicações
Privação do Sono/fisiopatologia
Fases do Sono/fisiologia
[Mh] Termos MeSH secundário: Acidentes de Trânsito/prevenção & controle
Adulto
Idoso
Distúrbios do Sono por Sonolência Excessiva/classificação
Distúrbios do Sono por Sonolência Excessiva/fisiopatologia
Feminino
Seres Humanos
Japão/epidemiologia
Masculino
Meia-Idade
Polissonografia/métodos
Estudos Retrospectivos
Índice de Gravidade de Doença
Apneia Obstrutiva do Sono/epidemiologia
Privação do Sono/complicações
Privação do Sono/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180216
[Lr] Data última revisão:
180216
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE


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[PMID]:27779432
[Au] Autor:Sharma VK; Gupta V; Pathak M; Ramam M
[Ad] Endereço:a Department of Dermatology and Venereology , All India Institute of Medical Sciences , New Delhi , India.
[Ti] Título:An open-label prospective clinical study to assess the efficacy of increasing levocetirizine dose up to four times in chronic spontaneous urticaria not controlled with standard dose.
[So] Source:J Dermatolog Treat;28(6):539-543, 2017 Sep.
[Is] ISSN:1471-1753
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: The EAACI/GA LEN/EDF/WAO recommendation of increasing antihistamines' dose up to four times in urticaria not adequately controlled with the standard dose is largely based on expert opinion. The objective of this study is to test the current urticaria guidelines of up-dosing antihistamines as second-line treatment. METHODS: This was an open-label study conducted prospectively on 113 patients with chronic spontaneous urticaria. All patients were treated with sequentially increasing doses of levocetrizine (5 mg, 10 mg, 15 mg and 20 mg/day) every week till the patients became completely asymptomatic or dose of 20 mg/day reached. Urticaria Activity Score (UAS)-7, urticaria-related quality-of-life (CU-Q2oL) and patients' global assessment were used to assess treatment response. RESULTS: Twenty-one (18.58%) patients became asymptomatic with levocetirizine 5 mg/day, while 50 required higher doses of levocetirizine for complete control: 29/92 (31.52%), 6/63 (9.52%) and 15/57 (26.31%) with 10 mg, 15 mg and 20 mg/day, respectively. The percentage of patients experiencing >75% improvement increased with increasing doses of levocetirizine: 26.54%, 53.98%, 60.17% and 69.91% with 5 mg, 10 mg, 15 mg and 20 mg/day, respectively. Sequential up-dosing of levocetirizine produced a progressive improvement in both urticaria control (UAS-7) and quality-of-life (CU-Q2oL) without significantly increasing somnolence. CONCLUSIONS: Our results support the current recommendations of increasing antihistamines up to four times the standard dose in patients who fail the first-line treatment.
[Mh] Termos MeSH primário: Cetirizina/uso terapêutico
Antagonistas dos Receptores Histamínicos H1 não Sedativos/uso terapêutico
Urticária/tratamento farmacológico
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Cetirizina/efeitos adversos
Doença Crônica
Distúrbios do Sono por Sonolência Excessiva/etiologia
Relação Dose-Resposta a Droga
Feminino
Antagonistas dos Receptores Histamínicos H1 não Sedativos/efeitos adversos
Seres Humanos
Masculino
Meia-Idade
Estudos Prospectivos
Qualidade de Vida
Índice de Gravidade de Doença
Resultado do Tratamento
Urticária/patologia
Adulto Jovem
[Pt] Tipo de publicação:CLINICAL TRIAL; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Histamine H1 Antagonists, Non-Sedating); 6U5EA9RT2O (levocetirizine); YO7261ME24 (Cetirizine)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180110
[Lr] Data última revisão:
180110
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161026
[St] Status:MEDLINE
[do] DOI:10.1080/09546634.2016.1246705


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[PMID]:28847794
[Au] Autor:Suzuki K; Okuma Y; Uchiyama T; Miyamoto M; Sakakibara R; Shimo Y; Hattori N; Kuwabara S; Yamamoto T; Kaji Y; Hirano S; Kadowaki T; Hirata K; Kanto NMPD investigators
[Ad] Endereço:Department of Neurology, Dokkyo Medical University, Tochigi, Japan.
[Ti] Título:Impact of sleep-related symptoms on clinical motor subtypes and disability in Parkinson's disease: a multicentre cross-sectional study.
[So] Source:J Neurol Neurosurg Psychiatry;88(11):953-959, 2017 Nov.
[Is] ISSN:1468-330X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: To investigate the impact of sleep disturbances on Parkinson's disease (PD) clinical motor subtypes and disease-related disability in a multicentre setting. METHODS: We report a cross-sectional relationship between sleep-related symptoms and clinical motor subtypes (tremor dominant (TD); intermediate; postural instability and gait disturbances (PIGDs)) identified in a multicentre study, including 436 patients with PD and 401 age-matched controls. PD-related sleep problems (PD-SP), excessive daytime sleepiness (EDS) and probable REM sleep behaviour disorder (pRBD) were evaluated using the PD sleep scale (PDSS)-2, Epworth Sleepiness Scale (ESS) and RBD screening questionnaire-Japanese version (RBDSQ-J), respectively. RESULTS: PD-SP (PDSS-2 ≥18; 35.1% vs 7.0%), EDS (ESS ≥10; 37.8% vs 15.5%) and pRBD (RBDSQ-J ≥5; 35.1% vs 7.7%) were more common in patients with PD than in controls. The prevalence of restless legs syndrome did not differ between patients with PD and controls (3.4% vs 2.7%). After adjusting for age, sex, disease duration and Movement Disorder Society-Unified PD Rating Scale (MDS-UPDRS) part III score, the PIGD group had higher PDSS-2 and ESS scores than the TD group. The RBDSQ-J scores did not differ among the TD, intermediate and PIGD groups. A stepwise regression model predicting the MDS-UPDRS part II score identified the Hoehn and Yahr stage, followed by the number of sleep-related symptoms (PD-SP, EDS and pRBD), disease duration, MDS-UPDRS part III score, PIGD subtype, depression and MDS-UPDRS part IV score as significant predictors. CONCLUSION: Our study found a significant relationship between sleep disturbances and clinical motor subtypes. An increased number of sleep-related symptoms had an impact on disease-related disability.
[Mh] Termos MeSH primário: Avaliação da Deficiência
Distúrbios do Sono por Sonolência Excessiva/classificação
Distúrbios do Sono por Sonolência Excessiva/diagnóstico
Doença de Parkinson/classificação
Doença de Parkinson/diagnóstico
Transtorno do Comportamento do Sono REM/classificação
Transtorno do Comportamento do Sono REM/diagnóstico
[Mh] Termos MeSH secundário: Idoso
Estudos de Casos e Controles
Estudos Transversais
Distúrbios do Sono por Sonolência Excessiva/epidemiologia
Feminino
Seres Humanos
Masculino
Meia-Idade
Exame Neurológico
Doença de Parkinson/epidemiologia
Transtorno do Comportamento do Sono REM/epidemiologia
Estatística como Assunto
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171114
[Lr] Data última revisão:
171114
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170830
[St] Status:MEDLINE
[do] DOI:10.1136/jnnp-2017-316136


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[PMID]:28726523
[Au] Autor:de Biase S; Nilo A; Gigli GL; Valente M
[Ad] Endereço:a Neurology Unit, Department of Experimental and Clinical Medical Sciences , University of Udine Medical School , Udine , Italy.
[Ti] Título:Investigational therapies for the treatment of narcolepsy.
[So] Source:Expert Opin Investig Drugs;26(8):953-963, 2017 Aug.
[Is] ISSN:1744-7658
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Narcolepsy is a chronic sleep disorder characterized by a pentad of excessive daytime sleepiness (EDS), cataplexy, sleep paralysis, hypnagogic/hypnopompic hallucinations, and disturbed nocturnal sleep. While non-pharmacological treatments are sometimes helpful, more than 90% of narcoleptic patients require a pharmacological treatment. Areas covered: The present review is based on an extensive Internet and PubMed search from 1994 to 2017. It is focused on drugs currently in development for the treatment of narcolepsy. Expert opinion: Currently there is no cure for narcolepsy, with treatment focusing on symptoms control. However, these symptomatic treatments are often unsatisfactory. The research is leading to a better understanding of narcolepsy and its symptoms. New classes of compounds with possible applications in the development of novel stimulant/anticataplectic medications are described. H3 receptor antagonists represent a new therapeutic option for EDS in narcolepsy. JZP-110, with its distinct mechanism of action, would be a new therapeutic option for the treatment of EDS in the coming years. In the future, hypocretin-based therapies and immune-based therapies, could modify the clinical course of the disease. However, more information would be necessary to completely understand the autoimmune process and also how this process can be altered for therapeutic benefits.
[Mh] Termos MeSH primário: Desenho de Drogas
Drogas em Investigação/uso terapêutico
Narcolepsia/tratamento farmacológico
[Mh] Termos MeSH secundário: Animais
Distúrbios do Sono por Sonolência Excessiva/tratamento farmacológico
Distúrbios do Sono por Sonolência Excessiva/fisiopatologia
Drogas em Investigação/farmacologia
Antagonistas dos Receptores Histamínicos H3/farmacologia
Antagonistas dos Receptores Histamínicos H3/uso terapêutico
Seres Humanos
Narcolepsia/fisiopatologia
Orexinas/metabolismo
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Drugs, Investigational); 0 (Histamine H3 Antagonists); 0 (Orexins)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170807
[Lr] Data última revisão:
170807
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170721
[St] Status:MEDLINE
[do] DOI:10.1080/13543784.2017.1356819


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[PMID]:28605521
[Au] Autor:Jawinski P; Kittel J; Sander C; Huang J; Spada J; Ulke C; Wirkner K; Hensch T; Hegerl U
[Ad] Endereço:LIFE-Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany.
[Ti] Título:Recorded and Reported Sleepiness: The Association Between Brain Arousal in Resting State and Subjective Daytime Sleepiness.
[So] Source:Sleep;40(7), 2017 Jul 01.
[Is] ISSN:1550-9109
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Objectives: Daytime sleepiness is a significant public health concern. Early evidence points toward the computerized VIGALL (Vigilance Algorithm Leipzig) as time-efficient tool to assess sleepiness objectively. In the present study, we investigated the association between VIGALL variables of EEG vigilance (indicating brain arousal in resting state) and subjective daytime sleepiness in the LIFE cohort study. Additionally, we validated VIGALL against the self-rated likelihood of having fallen asleep during the conducted resting EEG and against heart periods. Methods: Participants of the primary sample LIFE 60+ (N = 1927, 60-79 years) and replication sample LIFE 40+ (N = 293, 40-56 years) completed the Epworth Sleepiness Scale (ESS). After an average interval of 3 weeks (LIFE 60+) and 65 weeks (LIFE 40+), respectively, participants underwent a single 20-minute resting EEG, analyzed using VIGALL 2.1. Results: Analyses revealed significant associations between ESS and EEG vigilance in LIFE 60+ (rho = -0.17, p = 1E-14) and LIFE 40+ (rho = -0.24, p = 2E-5). Correlations between EEG vigilance and self-rated sleep likelihood reached rho = -0.43 (p = 2E-91) in LIFE 60+ and rho = -0.50 (p = 5E-20) in LIFE 40+. Overall, strongest correlations were obtained for EEG vigilance variable "slope index." Furthermore, lower EEG vigilance was consistently associated with longer heart periods. Conclusions: The present study contributes to the validation of VIGALL. Despite the considerable interval between ESS and EEG assessment dates, the strength of ESS-VIGALL association approximates prior ESS-Multiple Sleep Latency Test results. In this light, VIGALL might constitute an economical choice for the objective assessment of daytime sleepiness in large cohort studies. The discriminative power to identify disorders of hypersomnolence, however, remains to be addressed.
[Mh] Termos MeSH primário: Nível de Alerta/fisiologia
Encéfalo/fisiologia
Descanso/fisiologia
Fases do Sono/fisiologia
[Mh] Termos MeSH secundário: Adulto
Idoso
Algoritmos
Estudos de Coortes
Distúrbios do Sono por Sonolência Excessiva/fisiopatologia
Eletroencefalografia
Feminino
Seres Humanos
Masculino
Meia-Idade
Reprodutibilidade dos Testes
Vigília/fisiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171102
[Lr] Data última revisão:
171102
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170613
[St] Status:MEDLINE
[do] DOI:10.1093/sleep/zsx099


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[PMID]:28554959
[Au] Autor:Amara AW; Chahine LM; Caspell-Garcia C; Long JD; Coffey C; Högl B; Videnovic A; Iranzo A; Mayer G; Foldvary-Schaefer N; Postuma R; Oertel W; Lasch S; Marek K; Simuni T; Parkinson's Progression Markers Initiative
[Ad] Endereço:Department of Neurology, The University of Alabama at Birmingham, Birmingham, Alabama, USA.
[Ti] Título:Longitudinal assessment of excessive daytime sleepiness in early Parkinson's disease.
[So] Source:J Neurol Neurosurg Psychiatry;88(8):653-662, 2017 Aug.
[Is] ISSN:1468-330X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Excessive daytime sleepiness (EDS) is common and disabling in Parkinson's disease (PD). Predictors of EDS are unclear, and data on biological correlates of EDS in PD are limited. We investigated clinical, imaging and biological variables associated with longitudinal changes in sleepiness in early PD. METHODS: The Parkinson's Progression Markers Initiative is a prospective cohort study evaluating progression markers in participants with PD who are unmedicated at baseline (n=423) and healthy controls (HC; n=196). EDS was measured with the Epworth Sleepiness Scale (ESS). Clinical, biological and imaging variables were assessed for associations with EDS for up to 3 years. A machine learning approach (random survival forests) was used to investigate baseline predictors of incident EDS. RESULTS: ESS increased in PD from baseline to year 3 (mean±SD 5.8±3.5 to 7.55±4.6, p<0.0001), with no change in HC. Longitudinally, EDS in PD was associated with non-tremor dominant phenotype, autonomic dysfunction, depression, anxiety and probable behaviour disorder, but not cognitive dysfunction or motor severity. Dopaminergic therapy was associated with EDS at years 2 and 3, as dose increased. EDS was also associated with presynaptic dopaminergic dysfunction, whereas biofluid markers at year 1 showed no significant associations with EDS. A predictive index for EDS was generated, which included seven baseline characteristics, including non-motor symptoms and cerebrospinal fluid phosphorylated-tau/total-tau ratio. CONCLUSIONS: In early PD, EDS increases significantly over time and is associated with several clinical variables. The influence of dopaminergic therapy on EDS is dose dependent. Further longitudinal analyses will better characterise associations with imaging and biomarkers.
[Mh] Termos MeSH primário: Distúrbios do Sono por Sonolência Excessiva/diagnóstico
Doença de Parkinson/diagnóstico
[Mh] Termos MeSH secundário: Adulto
Idoso
Estudos de Casos e Controles
Estudos Transversais
Distúrbios do Sono por Sonolência Excessiva/induzido quimicamente
Distúrbios do Sono por Sonolência Excessiva/epidemiologia
Dopaminérgicos/efeitos adversos
Dopaminérgicos/uso terapêutico
Relação Dose-Resposta a Droga
Feminino
Seres Humanos
Estudos Longitudinais
Masculino
Meia-Idade
Exame Neurológico/efeitos dos fármacos
Doença de Parkinson/tratamento farmacológico
Doença de Parkinson/epidemiologia
Prognóstico
Transtornos do Sono-Vigília/diagnóstico
Transtornos do Sono-Vigília/tratamento farmacológico
Transtornos do Sono-Vigília/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; OBSERVATIONAL STUDY
[Nm] Nome de substância:
0 (Dopamine Agents)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:171114
[Lr] Data última revisão:
171114
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170531
[St] Status:MEDLINE
[do] DOI:10.1136/jnnp-2016-315023


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[PMID]:28520763
[Au] Autor:Chen YC; Chen KD; Su MC; Chin CH; Chen CJ; Liou CW; Chen TW; Chang YC; Huang KT; Wang CC; Wang TY; Chang JC; Lin YY; Zheng YX; Lin MC; Hsiao CC
[Ad] Endereço:Division of Pulmonary and Critical Care Medicine, Department of Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
[Ti] Título:Genome-wide gene expression array identifies novel genes related to disease severity and excessive daytime sleepiness in patients with obstructive sleep apnea.
[So] Source:PLoS One;12(5):e0176575, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:We aimed to identify novel molecular associations between chronic intermittent hypoxia with re-oxygenation and adverse consequences in obstructive sleep apnea (OSA). We analyzed gene expression profiles of peripheral blood mononuclear cells from 48 patients with sleep-disordered breathing stratified into four groups: primary snoring (PS), moderate to severe OSA (MSO), very severe OSA (VSO), and very severe OSA patients on long-term continuous positive airway pressure treatment (VSOC). Comparisons of the microarray gene expression data identified eight genes up-regulated with OSA and down-regulated with CPAP treatment, and five genes down-regulated with OSA and up-regulated with CPAP treatment. Protein expression levels of two genes related to endothelial tight junction (AMOT P130, and PLEKHH3), and three genes related to anti-or pro-apoptosis (BIRC3, ADAR1 P150, and LGALS3) were all increased in the VSO group, while AMOT P130 was further increased, and PLEKHH3, BIRC3, and ADAR1 P150 were all decreased in the VSOC group. Subgroup analyses revealed that AMOT P130 protein expression was increased in OSA patients with excessive daytime sleepiness, BIRC3 protein expression was decreased in OSA patients with hypertension, and LGALS3 protein expression was increased in OSA patients with chronic kidney disease. In vitro short-term intermittent hypoxia with re-oxygenation experiment showed immediate over-expression of ADAR1 P150. In conclusion, we identified a novel association between AMOT/PLEKHH3/BIRC3/ADAR1/LGALS3 over-expressions and high severity index in OSA patients. AMOT and GALIG may constitute an important determinant for the development of hypersomnia and kidney injury, respectively, while BIRC3 may play a protective role in the development of hypertension.
[Mh] Termos MeSH primário: Distúrbios do Sono por Sonolência Excessiva/diagnóstico
Distúrbios do Sono por Sonolência Excessiva/etiologia
Perfilação da Expressão Gênica
Predisposição Genética para Doença
Estudo de Associação Genômica Ampla
Apneia Obstrutiva do Sono/complicações
Apneia Obstrutiva do Sono/genética
[Mh] Termos MeSH secundário: Adulto
Biomarcadores
Comorbidade
Feminino
Regulação da Expressão Gênica
Redes Reguladoras de Genes
Seres Humanos
Leucócitos Mononucleares/metabolismo
Masculino
Meia-Idade
Proteômica/métodos
Índice de Gravidade de Doença
Transdução de Sinais
Apneia Obstrutiva do Sono/diagnóstico
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Biomarkers)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170911
[Lr] Data última revisão:
170911
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170519
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0176575



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