American Association for Respiratory Care
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AARC Sleep Section

November-December 2013

Journal Webcast Zeroes in on Pediatric Sleep Apnea

Teresa Volsko, MHHS, RRT, FAARC, will provide an overview of the Editor’s Choice paper in the December issue of Respiratory Care, “Role of a Respiratory Therapist in Improving Adherence with Positive Airway Pressure Treatment in a Pediatric Sleep Apnea Clinic,” in a webcast scheduled for Dec. 20. REGISTER NOW to learn more about the research design used in this study and hear an interpretation of the results.

OSA Linked to Early Marker of Heart Damage

Boston investigators have linked a known marker of early myocardial injury to sleep apnea. Their study included 1645 middle-aged or older participants who were free of coronary heart disease and heart failure at baseline. All underwent overnight home polysomnography, then were followed for a median of 12.4 years. OSA severity was categorized as none, mild, moderate, or severe using the respiratory disturbance index. High sensitivity troponin T (hs-TnT) levels were significantly associated with OSA after adjustment for 17 potential confounders. In all OSA severity categories, hs-TnT was significantly related to the risk of death or incident heart failure, and this relationship was strongest in the severe OSA group. Study author Amil M. Shah, MD, MPH, from Brigham and Women’s Hospital, believes monitoring of hs-TnT levels in OSA patients may have prognostic value, particularly in patients with severe OSA. The study was published ahead of print by the American Journal of Respiratory and Critical Care Medicine in October. READ PRESS RELEASE

Actigraphy Strengths and Weaknesses

U.S. researchers shed some light on the strengths and weaknesses of actigraphy as a tool to measure sleep in clinical and population studies in a new study conducted among 77 participants with an average age of 35. All underwent actigraphy and polysomnography (PSG) simultaneously in the sleep laboratory over multiple nights. Results showed:

  • Sensitivity (0.965) and accuracy (0.863) were high, whereas specificity (0.329) was low; each was only slightly modified by gender, insomnia, and day/night sleep timing.
  • Increasing age slightly reduced specificity.
  • Mean wakefulness after sleep onset (WASO)/night was 49.1 min by PSG compared to 36.8 min/night by actigraphy, unbiased when WASO < 30 min/night, and overestimated when WASO > 30 min/night.

“We conclude that actigraphy is overall a useful and valid means for estimating total sleep time and wakefulness after sleep onset in field and workplace studies, with some limitations in specificity,” write the authors. The study was published in the November edition of Sleep. READ ABSTRACT

Lights Off!

South Korean researchers working with colleagues in California find sleeping with the light on can significantly impact sleep quality. In a study published ahead of print in Sleep Medicine on Oct. 16, they report results for ten healthy sleepers tested during two nights of PSG, one with lights on and the other with lights off. During the lights on night, the investigators noted increased stage 1 sleep, decreased slow-wave sleep, and increased arousal index. Theta power (4-8Hz) during REM sleep and slow oscillation (0.5-1Hz), delta (1-4Hz), and spindle (10-16Hz) power during NREM sleep as measured by spectral analysis all decreased when the lights were left on as well. “Sleeping with the light on not only causes shallow sleep and frequent arousals but also has a persistent effect on brain oscillations, especially those implicated in sleep depth and stability,” conclude the authors. READ ABSTRACT

Poor Sleep Linked to Alzheimer’s Marker

A new study out of Johns Hopkins has linked shorter duration of sleep and poorer sleep quality to higher levels of the key marker for Alzheimer’s disease. In a cross-sectional study of adults with an average age of 76, they examined the association between self-reported sleep variables and β-Amyloid deposition. Study participants reported sleep that ranged from more than seven hours to no more than five hours. Patients who reported shorter sleep times and lower sleep quality were more likely to have a greater buildup of β-Amyloid. Noting that sleep disturbances can be treated in older people, study author Adam Spira, PhD, suggests that treating these conditions or encouraging older people to maintain healthy sleep patterns could help slow the progression of Alzheimer’s disease or even prevent it. The study was published online by JAMA Neurology in October. READ PRESS RELEASE

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