Sleep Dysfunction is an Independent Predictor of Productivity Losses in Patients with Chronic Rhinosinusitis

2021 ◽  
pp. 000348942110059
Author(s):  
Gretchen M. Oakley ◽  
Kristine A. Smith ◽  
Shaelene Ashby ◽  
Richard R. Orlandi ◽  
Jeremiah A. Alt
Keyword(s):  
Sleep Quality ◽  
Chronic Rhinosinusitis ◽  
Disease Severity ◽  
Independent Predictor ◽  
Cross Sectional ◽  
Economic Productivity ◽  
Sleep Dysfunction ◽  
Productivity Losses ◽  
Obstructive Sleep ◽  
Lost Productivity

Background: Chronic rhinosinusitis (CRS) is known to have a significant impact on economic productivity. Sleep dysfunction is associated with staggering productivity losses and is highly prevalent in patients with CRS. The effect of sleep dysfunction on productivity in CRS has not been elucidated. The objective of this study was to determine the relationship between sleep dysfunction and lost productivity in patients with CRS. Methods: Eighty-two adult patients with CRS were prospectively enrolled into a cross-sectional cohort study. Patients with obstructive sleep apnea were excluded. Sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI). Presenteeism (reduced work efficiency), absenteeism (missed work days), and lost work, household, and overall productivity were analyzed. The primary aim was assessing the correlation between PSQI and productivity. Regression analyses were performed to account for disease severity, pain, and depression. Results: Sleep dysfunction is significantly correlated with overall lost productivity (R2 = 0.397, P < .05). Presenteeism is the most strongly affected by sleep dysfunction (R2 = –0.441, P < .001). Higher PSQI scores were significantly associated with productivity losses, whereas lower scores were not. Sleep remained an independent predictor of productivity when regression analysis accounted for disease severity, depression, and pain. Conclusion: Sleep dysfunction has a significant association with lost productivity in patients with CRS, particularly with worsening PSQI scores. More clearly defining those components of CRS that most impact a patient’s daily function will allow clinicians to more optimally manage and counsel patients with CRS.

scholarly journals 0416 Poor Sleep Quality Predicts Serum Markers of Neurodegeneration and Cognitive Deficits in Warriors with Mild Traumatic Brain Injury

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A159-A159
Author(s):  
K Werner ◽  
P Shahim ◽  
J Gill ◽  
R Nakase-Richardson ◽  
K Kenney
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Sleep Quality ◽  
Sleep Disorders ◽  
Cognitive Deficits ◽  
Neuronal Injury ◽  
Small Sample ◽  
Cross Sectional ◽  
Sleep Dysfunction ◽  
Obstructive Sleep

Abstract Introduction Increasing evidence links neurodegeneration to traumatic brain injury (TBI), and a separate body of literature links neurodegeneration to sleep dysfunction, implicating increased toxin production and decreased glymphatic clearance. Sleep disorders affect 50% of TBI patients, yet the sleep-neurodegeneration connection in these patients remains unexplored. We hypothesized that warfighters with TBI and sleep dysfunction would have increased neuronal injury, revealing potential mechanistic underpinnings for TBI outcomes. We measured plasma biomarkers, cognitive function and sleep surveys for correlation analysis. Methods In a retrospective cross-sectional study of warfighters (n=113 chronic mild TBI patients), the Pittsburgh sleep quality index (PSQI) was compared with amyloid β42 (Aβ42), neurofilament light (NFL), tau, and phospho-tau (threonine 181) isolated from plasma and exosomes. Executive function was tested with the categorical fluency test. Exosomes were precipitated from plasma. Proteins were measured with the Single Molecule Array (Quanterix). Linear models were adjusted for age, ApoE, and number of TBIs. Results Poor sleepers with TBI (PSQI&gt;8) had elevated NFL compared to good sleepers in plasma (p=0.007) and exosomes (p=0.00017), and PSQI directly correlated with NFL (plasma: Beta=0.23, p=0.0079; exosomes: Beta=2.19, p=0.0013) stronger than any other marker of neurodegeneration. Poor sleepers also showed higher obstructive sleep apnea (OSA) risk compared to good sleepers by STOP-BANG scores (3.6, SD=1.6 vs 2.8, SD=1.74; p=0.0014) as well as decreased categorical fluency (20.7, SD=4.1) (18.3, SD=4.6, p=.0067). Plasma tau and Aβ42 also correlated with PSQI (Beta=0.64, p=0.028, and Beta=0.40, p=0.049 respectively). Conclusion This is the first reported data correlating markers of neuronal injury and cognitive deficits with sleep complaints and OSA risk in patients with TBI - possibly identifying treatable pathophysiological mediators of TBI neurodegeneration. Limitations include a small sample size, lack of objective sleep measures, and inability to establish directionality due to cross-sectional design. Prospective trials will be required to further explore our proposed hypothesis. If confirmed, these findings would call for targeting sleep disorders in the TBI population to mitigate risk of neurodegeneration. Support This work was supported by grant funding from: Department of Defense, Chronic Effects of Neurotrauma Consortium (CENC) Award W81XWH-13-2-0095 and Department of Veterans Affairs CENC Award I01 CX001135.

scholarly journals The impact of chronic rhinosinusitis on sleep-disordered breathing

2016 ◽  
Vol 54 (1) ◽  
pp. 75-79
Author(s):  
Rong-San Jiang ◽  
Kai-Li Liang ◽  
Chung-Han Hsin ◽  
Mao-Chang Sun
Keyword(s):  
Sleep Quality ◽  
Chronic Rhinosinusitis ◽  
Nasal Obstruction ◽  
Sleep Disordered Breathing ◽  
Sleep Problems ◽  
Sleep Apnea Syndrome ◽  
Sinus Surgery ◽  
Obstructive Sleep ◽  
The Impact ◽  
Disordered Breathing

Background: The nose plays an important role in sleep quality. Very little is known about sleep problems in patients with chronic rhinosinusitis (CRS). The aim of this study was to investigate the impact of CRS on sleep-disordered breathing. Methodology: CRS patients who underwent functional endoscopic sinus surgery were collected between July 2010 and May 2015. Before surgery, they filled 20-item Sino-Nasal Outcome Test and Epworth Sleepiness Scale questionnaires, were asked about the severity of nasal obstruction, and received acoustic rhinometry, smell test, an endoscopic examination, sinus computed tomography, and a one-night polysomnography. Sleep quality was evaluated in these patients and was correlated with the severity of rhinosinusitis. Results: One hundred and thirty-nine CRS patients were enrolled in the study. Among them, 38.1% complained of daytime sleepiness, and this sleep problem was correlated with the symptom of nasal obstruction. Obstructive sleep apnea syndrome (OSAS) was diagnosed in 64.7% of the patients, but there was no correlation with the severity of rhinosinusitis. Nasal polyps did not worsen sleep problems in the CRS patients. Conclusions: This study showed that CRS patents had a high prevalence of OSAS, and worse OSAS in CRS patients was not correlated with the severity of rhinosinusitis.

scholarly journals Examining relationships between sleep posture, waking spinal symptoms and quality of sleep: A cross sectional study

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0260582
Author(s):  
Doug Cary ◽  
Angela Jacques ◽  
Kathy Briffa
Keyword(s):  
Sleep Quality ◽  
Online Survey ◽  
General Information ◽  
Control Group ◽  
Quality Of Sleep ◽  
Cross Sectional ◽  
Obstructive Sleep ◽  
Patient Reported ◽  
Sleep Posture

Introduction Research with a focus on sleep posture has been conducted in association with sleep pathologies such as insomnia and positional obstructive sleep apnoea. Research examining the potential role sleep posture may have on waking spinal symptoms and quality of sleep is however limited. The aims of this research were to compare sleep posture and sleep quality in participants with and without waking spinal symptoms. Methods Fifty-three participants (36 female) were, based on symptoms, allocated to one of three groups; Control (n = 20, 16 female), Cervical (n = 13, 10 female) and Lumbar (n = 20, 10 female). Participants completed an online survey to collect general information and patient reported outcomes and were videoed over two consecutive nights to determine sleep posture using a validated classification system including intermediate sleep postures. Results Participants in the symptomatic groups also reported a lower sleep quality than the Control group. Compared to Control group participants, those in the Cervical group had more frequent posture changes (mean (SD); 18.3(6.5) versus 23.6(6.6)), spent more time in undesirable/provocative sleep postures (median IQR; 83.8(16.4,105.2) versus 185.1(118.0,251.8)) minutes and had more long periods of immobility in a provocative posture, (median IQR: 0.5(0.0,1.5) versus 2.0 (1.5,4.0)). There were no significant differences between the Control and Lumbar groups in the number of posture changes (18.3(6.5) versus 22.9(9.1)) or the time spent in provocative sleep postures (0.5(0.0,1.5) versus 1.5(1.5,3.4)) minutes. Discussion This is the first study using a validated objective measure of sleep posture to compare symptomatic and Control group participants sleeping in their home environment. In general, participants with waking spinal symptoms spent more time in provocative sleep postures, and experienced poorer sleep quality.

scholarly journals Hubungan Berat Badan dengan Kualitas Tidur pada Mahasiswa Fakultas Kedokteran dan Ilmu Kesehatan, Universitas Kristen Krida Wacana Angkatan 2016

2020 ◽  
Vol 26 (2) ◽  
Author(s):  
Mohamad Naim Bin Hasan ◽  
William William ◽  
Flora Rumiati
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Sleep Quality ◽  
Quality Index ◽  
Pittsburgh Sleep Quality Index ◽  
Chi Square ◽  
Cross Sectional ◽  
Purposive Sampling ◽  
Obstructive Sleep

Kelebihan berat badan merupakan faktor independen yang berkontribusi terhadap kualitas tidur yang buruk. Sleep apnea merupakan timbulnya episode abnormal pada frekuensi napas yang berhubungan dengan penyempitan saluran napas atas pada saat tidur. Sleep apnea dapat berupa henti napas (apnea) atau menurunnya ventilasi yang akan menyebabkan gangguan bernapas saat tidur. Semakin besar nilai Indeks Massa Tubuh (IMT) atau bertambahnya berat badan, kemungkinan untuk mengalami Obstructive Sleep Apnea (OSA) semakin tinggi. Tujuan dari penelitian ini adalah untuk mengetahui hubungan antara IMT dengan kualitas tidur pada mahasiswa kedokteran angkatan 2016 FKIK Ukrida. Jenis penelitian yang digunakan adalah penelitian cross sectional dengan menggunakan studi komparatif, yaitu untuk mengetahui hubungan antara IMT dengan kualitas tidur pada mahasiswa golongan berat badan lebih dan berat badan normal. Teknik sampling yang digunakan dalam penelitian ini adalah purposive sampling. Sebanyak  88 responden berpartisipasi dalam penelitian ini, terdiri dari 44 mahasiswa yang mempunyai berat badan normal dan 44 mahasiswa yang mempunyai berat badan lebih. Responden mengisi kuesioner Pittsburgh Sleep Quality Index (PSQI).   Hasil penelitian menunjukkan sebanyak 64 responden (72,7%) mempunyai kualitas tidur buruk, dan 24 responden (27,3%) memiliki kualitas tidur yang baik, serta durasi tidur terbanyak adalah < 6 jam.  Berdasarkan uji Chi-Square, disimpulkan adanya hubungan antara berat badan dengan kualitas tidur (p = 0,000, p < 0,05) pada mahasiswa Fakultas Kedokteran angkatan 2016 FKIK Ukrida.

scholarly journals 1056 Perceived Financial Difficulty Predicts Sleep Quality In Participants With Type 2 Diabetes And Obstructive Sleep Apnea

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A401-A401
Author(s):  
J L Morris ◽  
L Baniak ◽  
S M Belcher ◽  
C Imes ◽  
F Luyster ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Obstructive Sleep Apnea ◽  
African American ◽  
Sleep Quality ◽  
Disease Severity ◽  
Poor Sleep ◽  
Financial Difficulty ◽  
Poor Sleep Quality ◽  
Obstructive Sleep

Abstract Introduction People with multiple chronic conditions such as type 2 diabetes (T2D) and obstructive sleep apnea (OSA) are at increased risk for poor sleep quality. It is unclear if social determinants of health (SDoH) such as race, perceived financial difficulty, education, gender, and marital status are associated with sleep quality in this population. The purpose of this cross-sectional secondary analysis of data from the Diabetes Sleep Treatment Trial was to explore SDoH and disease severity as predictors of sleep quality in persons with both OSA and T2D. Methods Disease severity was measured by Apnea-Hypopnea Index [(AHI) ≥ 5] and A1C for glycemic control. SDoH included perceived financial difficulty (none/moderate-severe), race (White/African American), sex (f/m), marital status (no/yes), education (≤ or &gt; 2 years post high school), and age. Sleep quality was measured by Pittsburgh Sleep Quality Index (PSQI). Correlations and linear regression modeling investigated associations between SDoH and disease severity on sleep quality. Post-hoc correlations were explored for significant relations among SDoH. Results The sample (N = 229) was middle-aged (57.6 ± 10.0; 66 % White and 34% African American; and 54 % men vs. 46% women. Participants carried a high burden of disease (mean AHI = 20.7±18.1, mean A1C = 7.9 %±1.7%). Disease severity was not significantly associated with sleep quality (all p &gt;.05). The perception of worse financial difficulty was the only SDoH that predicted worse sleep quality (b=-1.54, p=.015). Characteristics significantly associated with worse financial difficulty were being African American, female, ≤ 2 years post high school, and younger (all p&lt;.01). Conclusion Financial difficulty may be a more important predictor of subjective measures of sleep quality than disease severity in patients with OSA and T2D. Researchers and clinicians should be aware of these characteristics as potential markers of vulnerability to poor sleep quality in this population. Support The National Institute of Diabetes and Digestive and Kidney Diseases (R01DK096028) and through the Clinical +Translational Research Institute grants UL1TR001857 and UL1TR000005.

scholarly journals Sleep quality and disease severity in patients with chronic rhinosinusitis

2013 ◽  
pp. n/a-n/a ◽  
Author(s):  
Jeremiah A. Alt ◽  
Timothy L. Smith ◽  
Jess C. Mace ◽  
Zachary M. Soler
Keyword(s):  
Sleep Quality ◽  
Chronic Rhinosinusitis ◽  
Disease Severity

scholarly journals Sleep inadequacy and incident cardiovascular disease among adults in Greece

2021 ◽  
Vol 10 (Supplement_1) ◽  
Author(s):  
PN Fountoulakis ◽  
A Terzoudi ◽  
D Tsiptsios ◽  
AS Triantafyllis ◽  
A Matziridis ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Risk Factor ◽  
Sleep Quality ◽  
Sleep Duration ◽  
Berlin Questionnaire ◽  
Poor Sleep ◽  
Short Sleep Duration ◽  
Cross Sectional ◽  
Obstructive Sleep ◽  
Increased Risk

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Sleep disorders are an emerging and modifiable risk factor for cardiovascular disease (CVD). Purpose The aim of our study was to investigate potential associations between sleep insufficiency and incident CVD. Methods In this cross-sectional study, 957 participants, (mean age 49.62 ± 14.79) from the region of Thrace, Greece were enrolled and classified into three groups [short (&lt;6 h), normal (6-8 h) and long (&gt;8 h) sleep duration]. CVD was assessed by a positive response to the following questions: "Have you been told by a doctor that you have had a heart attack or angina (chest pain or exertion that is relieved by medication)?" or "Have you been told by a doctor that you have had a stroke?". Participants’ sleep quality was estimated with the Epworth Sleepiness Scale, Athens Insomnia Scale, Pittsburgh Sleep Quality Index, and Berlin Questionnaire. Results The overall prevalence of CVD was 9.5%. The population with CVD exhibited reduced sleep duration and efficiency reduced by 33 min and 10%, respectively. After adjusting for all possible cofounders, short sleep duration was 3.07-times more frequent in patients with CVD and sleep duration of less than 5:33 hours could be a potential risk factor for CVD, especially among females. Additionally, CVD was significantly associated with excessive increased daytime sleepiness, insomnia, poor sleep quality and increased risk of obstructive sleep apnea. Conclusion(s): Our study depicts a strong correlation of sleep insufficiency with CVD and promotes early pharmacological or cognitive behavioral interventions in order to protect cardiovascular health. Abstract Figure. Results

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