Sleep Medicine Commons^™

The Use Of Online Cbt-I At Jefferson Sleep Disorder Clinic: A Quality Improvement Study, Kathy Tran, Do, Ritu Grewal, Md

Department of Sleep Medicine Posters

Objectives

We propose to introduce online CBT-I into our patient practice by distributing flyers to patients who complain of insomnia. We have made flyers available in all the exam rooms and educated physicians, nurse practitioners and staff. We will then review charts after the intervention period to evaluate for an increase in recommendation for CBT-I as a treatment option and education for patients.

Effect Of Manual Over Scoring On Automated Analysis Of Level 3 Home Sleep Testing (Hst) Results, Theodora Fynn, Ritu Grewal, Karl Doghramji, Prakash Vasudevan, Tingting Zhan

Department of Sleep Medicine Posters

No abstract provided.

Treatment Of Obstructive Sleep Apnea With Maxillo-Mandibular Advancement Surgery: Evaluation And Predictors Of Success, Daniel Taub, Dmd, Md, Michael Courtney, Dmd, Md, Karl Doghramji, Md

Department of Oral and Maxillofacial Surgery Posters

Obstructive sleep apnea (OSA) is a well-recognized disease entity affecting approximately 2% to 4% of the population. Maxillomandibular advancement (MMA) surgery is a highly successful surgical alternative to poorly tolerated CPAP therapy and achieves a success rate of 89% in the current literature. Our present study evaluates the effectiveness of MMA surgery in the treatment of patients with moderate to severe OSA based on Shers criteria of 50% reduction in AHI and AHI < 20. Radiographic and clinical treatment variables were evaluated in determining predictors of success for MMA in individuals with OSA.

Does Transition From Cpap To Bipap Improve Symptoms Of Aerophagia?, Kathy Tran, Do, Karl Doghramji, Md

Department of Sleep Medicine Posters

Introduction

Adherence to continuous positive airway pressure (CPAP) therapy has been an ongoing dilemma in obstructive sleep apnea patients and up to 83% of patients are noncompliant. It is believed that mask discomfort or pressure intolerance are the major causes. Aerophagia, or “air swallowing” may be an under-recognized and insidious cause for CPAP nonadherence. Patients generally complain of belching, bloating, abdominal pain and distention. Some studies have reported worsening gastrointestinal reflux symptoms from PAP-induced aerophagia. Although bi-level positive airway pressure (BIPAP) is often utilized in such circumstances, this practice had not been examined. We hypothesized that transitioning patients from CPAP ...

Mindfulness Meditation Targets Transdiagnostic Symptoms Implicated In Stress-Related Disorders: Understanding Relationships Between Changes In Mindfulness, Sleep Quality, And Physical Symptoms., Jeffrey M. Greeson, Haley Zarrin, Moria J. Smoski, Jeffrey G. Brantley, Thomas R. Lynch, Daniel M. Webber, Martica H. Hall, Edward C. Suarez, Ruth Q. Wolever

Student Papers & Posters

Mindfulness-Based Stress Reduction (MBSR) is an 8-week meditation program known to improve anxiety, depression, and psychological well-being. Other health-related effects, such as sleep quality, are less well established, as are the psychological processes associated with therapeutic change. This prospective, observational study (

The Effect Of Napping On Sleep Quality And Quantity In Healthy And Concussed Collegiate Athletes, Katie Stephenson-Brown

Theses and Dissertations

Clinicians are increasingly prescribing a regulated sleep schedule to athletes post injury; however, baseline sleep habits of collegiate athletes are unknown. Moreover, the connection between napping and sleep quality and quantity has not been studied in collegiate athletes. Therefore, the purpose of this study is to investigate napping behaviors and their effects on sleep quantity and quality in concussed and non-concussed collegiate athletes. In a sample of 233 non-concussed collegiate athletes, 74% (172/233) of participants reported napping. Napping was not significantly associated with sleep quantity (χ 2 (2) = .23, p = .64) or quality (χ 2 (1) = .42, p =.52 ...

Examining Eye-Level Light Exposure Patterns And Human Sleep Behavior, Larissa Hunt

Undergraduate Honors Theses

While laboratory studies have demonstrated that not only light exposure intensity, but also its duration, timing, and spectral composition are relevant for circadian physiology, most field studies examining links between light, circadian rhythms, sleep, and behavior rely on simple quantification of light intensity. Unpublished findings from the Circadian and Sleep Epidemiology Laboratory indicate that continuous light exposure levels of free-living individuals measured at the wrist are best captured by eight independent dimensions, represented by metrics including light intensity, timing, spectral composition, and the variability in timing of light exposure. However, wrist-level recordings of light have been shown to have error ...

Predicting Arterial Oxygen Desaturation Events Via Patient Journal And Pulse Oximetry Data In Postoperative Ambulatory Surgery Patients, Charles R. Elam Iv

Theses and Dissertations

Associations between patient and procedural factors on the nature and quality of the immediate in-home recovery from anesthesia following ambulatory orthopedic surgery are unknown. Further, there is a paucity of outcomes research quantitatively categorizing in-home

patient recovery and safety following discharge from same-day orthopedic procedures. Tools are available, however, to shed light on outcomes in this population, and integration of such available measures is critical.

Ambulatory orthopedic surgery is a burgeoning specialty, with growth expected over the foreseeable future. The expected increased patient caseload subsequent to implementation of the Affordable Care Act and aging Baby Boom generation suggests greater morbidity ...

Does Chronotype Moderate The Relationship Between Time Of Day And Performance In Human Anatomy Laboratory (Iphy3415)?, Amy Bazzoni

Undergraduate Honors Theses

Chronotype, an individual’s propensity and preference for sleep and wakefulness behavior, has been shown in numerous studies to be importantly related to high school and college student success. Students who are “larks” generally have peak alertness in the morning and perform better in morning classes. Students who are “owls” struggle to maintain alertness in morning classes and perform better in afternoon classes. This project extends this chronotype research by investigating the relationship between chronotype and performance in the Integrative Physiology Department’s Human Anatomy Laboratory course which has sections offered at different times throughout the day. The study design ...

The Relationship Between Iron Status, Limb Movements, And Sleep Architecture In Children, David G. Ingram Md, Gaylyn Perry Md, Zarmina Ehsan Md, Baha Al-Shawwa Md

Posters

Background

•Iron status is an important aspect of the evaluation of children with excessive limb movements during sleep. •While there is clear data in adults to support this relationship, the data in children is less well established. •We evaluated the association between iron status and limb movements during sleep in a large pediatric sample. Methods •This is a retrospective analysis of a single institution sleep program looking at all patients who underwent overnight polysomnogram and ferritin test within 24 hours of doing the sleep study between January 2015 and October 2017. •Those with sleep apnea (Central Apnea Index >5/hr ...

The Relationship Between Vitamin D Status, Limb Movements, And Sleep Architecture In Children, David G. Ingram Md, Gaylyn Perry Md, Zarmina Ehsan Md, Baha Al-Shawwa Md

Posters

Background

•Vitamin D deficiency has recently been posited as an important factor in the pathogenesis of restless leg syndrome.

•We evaluated the association between vitamin D deficiency and limb movements and sleep architecture in a pediatric sample.

Methods

•This is a retrospective analysis of a single institution sleep program looking at all patients who underwent overnight polysomnogram and 25-OH vitamin D within 60 days of doing the sleep study between January 2015 and October 2017. •Those with sleep apnea (Central Apnea Index >5/hr or Obstructive Apnea Hypopnea Index >2/ hr) were excluded. Results •There were a total of 83 ...

Cpap-Mad Combination Therapy For Cpap Intolerant Patients With Moderate To Severe Osa, Jacob Stadiem

Theses & Dissertations

The treatment of obstructive sleep apnea (OSA) allows for a multidisciplinary approach between dentistry and medicine. Continuous positive airway pressure (CPAP) is the gold standard for OSA treatment, but the non-adherence rates are high. The mandibular advancement device (MAD) has a higher acceptance rate than the CPAP, however the efficacy is much lower in cases of moderate to severe OSA. This thesis attempted to evaluate if there was a change in compliance when a MAD was added as a combination therapy to moderate to severe OSA subjects that were currently non-compliant with their CPAP. In addition, the change in air ...

Patient-Predicted Sleep Position Vs. Hst Data: A Tendency To Underestimate Supine Sleep, Adam J. Sorscher, Anthony P. Anzivino, Todd Mackenzie

Open Dartmouth: Faculty Open Access Articles

Purpose The purpose of this study is to measure people’s accuracy when they estimate what proportion of their nightly sleep at home is supine vs. non-supine. Methods A series of patients referred for obstructive sleep apnea (OSA) evaluation were asked if they Bknew with confidence^ how they slept with regard to their body position. BYes^ responders were then asked to estimate what percentage of their sleep was supine vs. non-supine. This value was compared with the actual proportion of supine vs. non-supine sleep that they exhibited in a home sleep test (HST) that followed. Results We obtained data from ...

A Quality Improvement Project To Reduce The Wait Time For Initial Appointment In An Urban Outpatient Sleep Center, Anasua Chakraborty, Md, Ritu G. Grewal, Md

House Staff Quality Improvement and Patient Safety Posters

Project aim:

In this study we aimed to see if replacing one face to face follow up visit after sleep study with a phone call by a trained office staff will

• decrease the total number of follow up office visits, thus decreasing health care cost
• increase the number of new patients seen during the 6 month follow up period
• Did not decrease patient compliance

Poster presented at annual Thomas Jefferson University Hospital House Staff Quality Improvement and Patient Safety conference.

The Acquisition And Analysis Of Electroencephalogram Data For The Classification Of Benign Partial Epilepsy Of Childhood With Centrotemporal Spikes, Jessica A. Scarborough

Master's Theses

In this thesis, I will expand upon each step in the process of acquiring and analyzing electroencephalogram (EEG) for the classification of benign childhood epilepsy with centrotemporal spikes. Despite huge advancements in the field of health informatics—natural language processing, machine learning, predictive modeling—there are significant barriers to the access of clinical data. These barriers include information blocking, privacy policy concerns, and a lack of stakeholder support. We will see that these roadblocks are all responsible for stunting biomedical research in some way, including my own experiences in acquiring the data for the second chapter of this thesis.

This ...

Commentary: How To Make The Ghosts In My Bedroom Disappear? Focused-Attention Meditation Combined With Muscle Relaxation (Mr Therapy)-A Direct Treatment Intervention For Sleep Paralysis., Brian A. Sharpless, Karl Doghramji

Department of Sleep Medicine Faculty Papers

No abstract provided.

Consequences Of Untreated Obstructive Sleep Apnea, Binyamin S. Kanter

The Science Journal of the Lander College of Arts and Sciences

Over the past few years, awareness of the prevalence of obstructive sleep apnea has significantly increased. Indeed, sleep apnea may be more common now with the increasing incidence of obesity and the growing number of elderly individuals in our population. How serious is this condition, and what are the potential long-term effects and consequences of obstructive sleep apnea if left untreated? An overlap of many serious conditions with obstructive sleep apnea has been noticed. These conditions include hypertension, heart disease and failure, stroke, diabetes, neurological diseases, depression, and a number of other serious health concerns. The purpose of this paper ...

Effects Of Screen Light Filtering Software On Sleep And Morning Alertness, Hengyu Chi

All Master's Theses

Research has shown that blue light can impact the circadian rhythm. Research has also suggested that use of electronic devices, such as computers and televisions that emit blue light before sleep, can negatively impact sleep quality. This research has led to the creation of computer software which lowers the levels of blue light in the evening to help with sleep. This study looked at the impact of wavelength filtering software on sleep onset, sleep duration and subjective alertness after morning waking of four college students. The college students were randomized into two groups and had the wavelength filtering software f ...

Objective Snoring Time And Carotid Intima-Media Thickness In Non-Apneic Female Snorers, Jinyoung Kim, Allan I. Pack, Barbara Riegel, Julio A. Chirinos, Alexandra Hanlon, Seung Ku Lee, Chol Shin

School of Nursing Departmental Papers

Controversy persists about whether snoring can affect atherosclerotic changes in adjacent vessels, independently of obstructive sleep apnea and other cardiovascular risk factors. This study examined the independent association between snoring and carotid artery intima-media thickness (IMT) in non-apneic snorers and non-snorers. We studied 180 non-apneic snorers and non-snorers participating in a full-night home-based sleep study. Snoring sound was measured objectively by a microphone. Based on snoring time across the night, participants were classified as non-snorers (snoring time: 0%), mild snorers (1-25%) and moderate to heavy snorers (≥25%). We measured IMT on both common carotid arteries. The three groups were matched ...

Improving The Adherence Of Providers To The American Academy Of Sleep Medicine Guidelines For The Evaluation, Treatment, And Management Of Obstructive Sleep, Heather Miles

Doctor of Nursing Practice

The purpose of this project is to increase the adherence of clinic providers to the American Academy of Sleep Medicine’s Clinical Guidelines for the Evaluation, Management, and Longterm Care of Obstructive Sleep Apnea in Adults. OSA is a chronic condition that effects from 2% to 10% of the U.S. adult population. Implications of undiagnosed OSA include excessive daytime sleepiness, fatigue, irritability, difficulty controlling chronic diseases including diabetes and hypertension, heart arrhythmias, gastroesophageal reflux disease, mood disorders, attention deficit disorder, and an increased potential for dementia if left untreated. A protocol was created to align providers with the clinical ...