Sleep Medicine Commons^™

Disability Injustice: A Latino’S Creative Autoethnographic Testimonio On The Organizational Culture Of Higher Education, Leonel A. Diaz Jr.

Organization, Information and Learning Sciences ETDs

Using creative autoethnographic testimonio (CAT), a story is told about the injustices within the learning environment and work environment of higher education toward a person with disabilities: sleep apnea, learning disabilities, negative mental health. The author explores the health difficulties of addressing sleep deprivation while attending graduate school and working full-time as a professional. With sleep apnea impacting his health, his mental health declines. As his health declines, there is an increase in discrimination, hostility, oppression, bullying, and toxic masculinity. Initially, the medical system dismisses his declining health and refuses to look further into it. Once he receives medical care …

A Screen For Sleep And Starvation Resistance Identifies A Wake-Promoting Role For The Auxiliary Channel Unc79, Kazuma Murakami, Justin Palermo, Bethany A. Stanhope, Allen G. Gibbs, Alex C. Keene

Life Sciences Faculty Research

The regulation of sleep and metabolism are highly interconnected, and dysregulation of sleep is linked to metabolic diseases that include obesity, diabetes, and heart disease. Furthermore, both acute and long-term changes in diet potently impact sleep duration and quality. To identify novel factors that modulate interactions between sleep and metabolic state, we performed a genetic screen for their roles in regulating sleep duration, starvation resistance, and starvation-dependent modulation of sleep. This screen identified a number of genes with potential roles in regulating sleep, metabolism, or both processes. One such gene encodes the auxiliary ion channel UNC79, which was implicated in …

Improving Follow Up Compliance For Patients With Sleep Disordered Breathing At Jefferson Sleep Center, E. Fares, Md, A. Ananth, Md, Z. Fast, Md

Health Equity and Quality Improvement (HEQI) Summit

Despite the high effectiveness of CPAP therapy, patient adherence remains variable and a hurdle towards appropriate treatment of their sleep-disordered breathing.

Patients often stop using their CPAP and are then lost to follow-up, which increases their risk of previously mentioned complications that are associated with OSA.

Goals for Improvement

To increase the follow-up rate for patients with OSA.

Prospective Patient-Reported Symptom Profiles Associated With Pediatric Acute Lymphoblastic Leukemia Relapse, Austin L Brown, Kimberly P Raghubar, Olga A Taylor, Melanie Brooke Bernhardt, Lisa S Kahalley, Wei Pan, Philip J Lupo, Marilyn J Hockenberry, Michael E Scheurer

Faculty, Staff and Students Publications

PURPOSE: Despite improvements in frontline pediatric acute lymphoblastic leukemia (ALL) treatment, relapse remains a concern. Research in adult cancer patients suggests that patient-reported symptoms may predict survival, but the relationship between symptoms and relapse for pediatric ALL has received little attention.

METHODS: Pediatric patients with ALL (age 2-18 years) and/or their primary caregivers completed symptom surveys at the end of induction, start of delayed intensification (DI), start of maintenance cycle 1 (MC1), and start of maintenance cycle 2 (MC2). Symptom clusters for co-occurring fatigue, pain, sleep disruptions, and nausea were defined using latent profile analysis. Hazard ratios (HR) and 95% …

Implementation Of A Perioperative Pathway For Individuals With Or At High Risk For Obstructive Sleep Apnea, Kimberly Claude

Doctor of Nursing Practice Scholarly Projects

Background At the Veterans Affairs Boston, pre-operative screening for obstructive sleep apnea using the STOP-Bang questionnaire and referral to pulmonary service for those who fail screening is not reliably completed. For patients identified as having OSA or at high risk for OSA, advice on how to reduce postoperative risk may not be adequately communicated through the perioperative process. The project aim is to construct and implement a perioperative pathway to ensure surgical patients with OSA or suspected OSA receive evidence-based care throughout the perioperative period.

Methods The intervention for this quality improvement project was an evidence-based perioperative pathway which includes …

Obstructive Sleep Apnea And Dementia-Common Gene Associations Through Network-Based Identification Of Common Driver Genes, Hyun-Hwan Jeong, Arvind Chandrakantan, Adam C Adler

Faculty, Staff and Students Publications

BACKGROUND: Obstructive Sleep Apnea (OSA) occurs in 7% of the adult population. The relationship between neurodegenerative diseases such as dementia and sleep disorders have long attracted clinical attention; however, no comprehensive data exists elucidating common gene expression between the two diseases. The objective of this study was to (1) demonstrate the practicability and feasibility of utilizing a systems biology approach called network-based identification of common driver genes (NICD) to identify common genomic features between two associated diseases and (2) utilize this approach to identify genes associated with both OSA and dementia.

METHODS: This study utilized 2 public databases (PCNet, DisGeNET) …

The Physiology Of The Circadian Rhythm, Jessica S. Ken-Kwofie

Student Publications

This paper discusses the importance and origin of the Circadian Rhythm. First recorded by Jean Jacque d’Ortous de Mairan in 1729, the Circadian Rhythm is understood to be a fundamental biological system that is tailored to Earth’s axis. Having impacts on peripheral organs, sleep patterns, and hormonal balances, this process influences almost every aspect of the human body and several other mammals. Focusing on the Circadian Rhythm is vital to further understanding the “clock-like” patterns of the human body and future research and development of treatments could be the solution to current detrimental diseases and disorders.

The Use Of Actigraphy And Its Impact On Perceived Sleep Quality And Activity Levels In Individuals With Traumatic Brain Injury In An Inpatient Rehabilitation Setting., Lina Shkokani, Amanda Reyes, Bachar Hazim, Jason Kisser, Philip T. Roskos

Conference Presentation Abstracts

No abstract provided.

Prior Sleep Problems And Adverse Post-Traumatic Neuropsychiatric Sequelae Of Motor Vehicle Collision In The Aurora Study, Thomas C Neylan, Ronald C Kessler, Kerry J Ressler, Gari Clifford, Francesca L Beaudoin, Xinming An, Jennifer S Stevens, Donglin Zeng, Sarah D Linnstaedt, Laura T Germine, Sophia Sheikh, Alan B Storrow, Brittany E Punches, Kamran Mohiuddin, Nina T Gentile, Meghan E Mcgrath, Sanne J H Van Rooij, John P Haran, David A Peak, Robert M Domeier, Claire Pearson, Leon D Sanchez, Niels K Rathlev, William F Peacock, Steven E Bruce, Jutta Joormann, Deanna M Barch, Diego A Pizzagalli, John F Sheridan, Steven E Harte, James M Elliott, Irving Hwang, Maria V Petukhova, Nancy A Sampson, Karestan C Koenen, Samuel A Mclean

Faculty, Staff and Students Publications

STUDY OBJECTIVES: Many patients in Emergency Departments (EDs) after motor vehicle collisions (MVCs) develop post-traumatic stress disorder (PTSD) or major depressive episode (MDE). This report from the AURORA study focuses on associations of pre-MVC sleep problems with these outcomes 8 weeks after MVC mediated through peritraumatic distress and dissociation and 2-week outcomes.

METHODS: A total of 666 AURORA patients completed self-report assessments in the ED and at 2 and 8 weeks after MVC. Peritraumatic distress, peritraumatic dissociation, and pre-MVC sleep characteristics (insomnia, nightmares, daytime sleepiness, and sleep duration in the 30 days before the MVC, trait sleep stress reactivity) were …

Prediction Of Obstructive Sleep Apnea Using Fast Fourier Transform Of Overnight Breath Recordings, Nicole L. Molin, Clifford Molin, Rohan J. Dalpatadu, Ashok K. Singh

Mathematical Sciences Faculty Research

The objective of this study is to address the problem of predicting the risk of obstructive sleep apnea (OSA) from overnight breath recordings collected by a subject using a smartphone or an iPhone. The dataset used in this study was collected at a health care facility and consists of breathing amplitudes of 42 subjects using the smart phone App ZeeAppnea. A total of four data mining multi-level classifiers are used on the Fast Fourier Transform (FFT) of each time series, and prediction accuracies are computed. The Random Forest (RF) and the Support Vector Machine (SVM) classifiers yielded the best results, …

Reduced Recovery Times With Total Intravenous Anesthesia In Patients With Obstructive Sleep Apnea, Leonard Estephan, Matthew Stewart, Maurits Boon, Colin Huntley

Phase 1

Introduction: There are currently no specific anesthetic guidelines for patients with obstructive sleep apnea (OSA) undergoing upper airway surgery. Two consistently utilized anesthetic approaches during such procedures include inhalational gas anesthesia and total intravenous anesthesia (TIVA), however whether either is more efficacious remains undefined. We hypothesize that administration of TIVA will lead to reduced post-operative recovery time in patients with comorbid OSA undergoing upper airway surgery.

Methods: A retrospective chart review was performed for patients with comorbid OSA that underwent surgery (upper airway stimulation, nasal surgery, palate surgery) between January 2019 and December 2019. Included patients received either inhaled …

Effects Of Continuous Positive Airway Pressure (Cpap) Sleep Apnea Treatment On Mild Cognitive Impairment (Mci) And Cardiovascular Risk, Olivia Taylor, Cynthia Cheng, Md, Phd

Phase 1

There is a documented association between sleep apnea and earlier onset of cognitive impairment later in life. We hypothesize that nightly treatment with CPAP therapy will improve MCI status as estimated by a panel of neuropsychiatry tests in patients >55 with OSA and concomitant memory complaints. With a prospective cohort design, patients compliant with CPAP therapy are being compared to noncompliant patients and a non-OSA control group. My role in this multi-site project was to screen potential patients from Jefferson’s sleep clinic for eligibility for study enrollment. This study is still ongoing. OSA’s high prevalence makes it a worthwhile endeavor …

Effects Of Continuous Positive Airway Pressure On Blood Pressure In Obstructive Sleep Apnea, Amy He, Dani Yellanki, Grace Severance, Peter Zhang, Zachary Feuer, Natali Salinas, Cynthia Cheng, Md, Phd

Phase 1

Introduction:

Obstructive sleep apnea (OSA) has been previously linked to the development of hypertension, possibly through the proposed mechanism of recurrent episodes of intermittent hypoxia leading to endothelial dysfunction, inflammation, and metabolic dysregulation. This study aims to investigate continuous positive airway pressure (CPAP) therapy, a first-line therapy for OSA, and its effects on blood pressure in patients with moderate to severe OSA. We hypothesize that compliance to CPAP leads to a decrease in average annual systolic and diastolic blood pressure, compared to noncompliant and non-CPAP use.

Methods:

Our study is a combined retrospective and prospective EPIC chart review study. Moderate …

Usage Of Sleep Domain Of Snot-22 Scores In Screening For Osa In Patients Of Chronic Rhinosinusitis., Patrick Zhu, Mindy Rabinowitz, Md

Phase 1

Introduction: SNOT-22 is a screening tool universally applied in perioperative settings for endoscopic sinus surgery (ESS), typically for chronic rhinosinusitis (CRS). Comorbid obstructive sleep apnea (OSA) increases risk of perioperative complications following ESS, yet pre-ESS OSA screening is not performed. This study sought to determine whether the sleep subdomain SNOT-22 (SD-SNOT) score could be useful for OSA screening.

Methods: A retrospective study was performed by reviewing electronic records of 108 patients that underwent endoscopic sinus surgery between November 2019 – January 2020. Pre-operative and 2 months post-operative SD-SNOT scores were compared with the presence or absence of OSA.

Results: Mean …

The Effect Of Cpap Treatment On T2dm In Moderate To Severe Osa Subjects, Dani Yellanki, Amy He, Grace Severance, Peter Zhang, Zach Feuer, Natali Salinas, Olivia Taylor, Rani Patel, Hannah Kostan, Carl Sun, Catherine Liu, Humaal Khan, Katie Keck, Mikayla Cochrane, Ronak Ahir, Sammy Alfonsi, Will Connolly, Cynthia Cheng, Md, Phd

Phase 1

Introduction: Obstructive sleep apnea (OSA) is a significant risk factor for type 2 diabetes mellitus (T2DM). CPAP treatment can potentially improve glycemic control in such subjects. However, the exact effects of CPAP treatment on diabetes are uncertain. The objective of this study is to examine the effect of CPAP treatment on HbA1c levels in subjects with moderate to severe OSA and T2DM.

Methods: This is a combined retrospective and prospective study collecting data through EPIC medical record reviews. We are collecting HbA1c levels (primary outcome variable) before and after CPAP treatment in subjects with moderate to severe OSA and T2DM. …

Prevalence And Risk Factors For Abnormal M-Tics, Maëlys Yepes, Michael Chang, Cynthia Cheng, Md, Phd

Phase 1

Introduction: The lack of effective treatments for Alzheimer’s Disease (AD) underscores the importance of prevention and early detection of amnestic mild cognitive impairment (aMCI), its prodromal state. While studies have proposed a number of potential mechanisms underlying the pathogenesis of AD, such as hypoxia and neuropsychiatric symptoms, little research has been done to evaluate predictive risk factors.

Objective: The objective of this pilot study is to assess the prevalence and risk factors for aMCI.

Methods: This cross-sectional study was performed using data from patients screened for Memories 2, a clinical trial evaluating the effect of CPAP usage in patients with …

Effect Of Trazodone On Upper Airway Resistance In Chronic Spinal Cord Injury, Geoffrey M. Ginter, Sean Carroll, Abdulghani Sankari, Safwan Badr

Medical Student Research Symposium

Background:

Spinal cord injury (SCI) is a known risk factor for sleep-disordered breathing. While device-based therapies such as CPAP are beneficial in these individuals, adherence to these treatments is often low; consequently, pharmacotherapies for sleep-disordered breathing in patients with SCI are in high demand. Trazodone is an atypical antidepressant with a complex mechanism of action, including alpha adrenergic agonist activity and inhibition of serotonin reuptake. Serotonin (5-HT) is a known modulator of respiratory circuitry, which has been shown to influence the ventilatory drive. Trazodone is commonly prescribed as a sleep aid, but its impact on breathing during sleep is still …

Visit-To-Visit Blood Pressure Variability And Sleep Architecture, Xiaoyue Liu, Jeongok Logan, Younghoon Kwon, Jennifer M. Lobo, Hyojung Kang, Min-Woong Sohn

Health Management and Policy Faculty Publications

Visit‐to‐visit blood pressure (BP) variability (BPV) is an independent risk factor of cardiovascular disease (CVD). Sleep architecture characterizes the distribution of different stages of sleep and may be important in CVD development. We examined the association between visit‐to‐visit BPV and sleep architecture using in‐lab polysomnographic data from 3,565 patients referred to an academic sleep center. BPV was calculated using the intra‐individual coefficient of variation of BP measures collected 12 months before the sleep study. We conducted multiple linear regression analyses to assess the association of systolic and diastolic BPV with sleep architecture—rapid eye movement (REM) and non‐rapid eye movement (NREM) …

Associations Between Daily Affect And Sleep Vary By Sleep Assessment Type: What Can Ambulatory Eeg Add To The Picture?, Brett Messman, Danica C. Slavish, Jessica R. Dietch, Brooke N. Jenkins, Maia Ten Brink, Daniel J. Taylor

Psychology Faculty Articles and Research

Objective/Background

Disrupted sleep can be a cause and a consequence of affective experiences. However, daily longitudinal studies show sleep assessed via sleep diaries is more consistently associated with positive and negative affect than sleep assessed via actigraphy. The objective of the study was to test whether sleep parameters derived from ambulatory electroencephalography (EEG) in a naturalistic setting were associated with day-to-day changes in affect.

Participants/Method

Eighty adults (mean age = 32.65 years, 63% female) completed 7 days of affect and sleep assessments. We examined bidirectional associations between morning positive affect and negative affect with sleep assessed via diary, actigraphy, and …

Aromatherapy As A Non-Pharmacological Complementary And Integrative Sleep Intervention For Veterans, Amy D. Stewart

Doctor of Nursing Practice Projects

Twenty-seven percent to 54% of military personnel and veterans experience insomnia, with apnea and insomnia being the most common disorders in this same population. Due to high incidences of sleep disorders in the veteran population, this project sought to identify and validate a non-pharmacological intervention, aromatherapy, as a viable option for veterans with sleep problems. Aromatherapy, essential oils, have proven to be a natural, safe, low-cost, and non-pharmacological option for improving patient health outcomes and patient satisfaction.

Ideographic Modeling And Data Visualization Of Sleep, Affect, And Psychotic Symptoms: A Case Example, D M. Weiss, E Aslinger, W L. Cook, K A. Johnson, K M. Elacqua, R I. Mesholam-Gately, K A. Woodberry

Costas T. Lambrew Research Retreat 2021

Background:

1. Psychotic disorders are heterogeneous.

2. Current diagnostic categorizations are unable to capture individuals’ unique symptom experiences.

3. Newly-developed ideographic analyses and data visualization tools may be useful in assessing individuals’ symptom experiences and stimulating data informed care.

The Sleep Of Shift Workers In A Remote Mining Operation: Methodology For A Randomized Control Trial To Determine Evidence-Based Interventions, Gemma Maisey, Marcus Cattani, Amanda Devine, Johnny Lo, Ian C. Dunican

Research outputs 2014 to 2021

© Copyright © 2021 Maisey, Cattani, Devine, Lo and Dunican. Shiftwork may adversely impact an individual’s sleep-wake patterns and result in sleep loss ( < 6 h. following night shift), due to the circadian misalignment and the design of rosters and shifts. Within a mining operation, this sleep loss may have significant consequences due to fatigue, including an increased risk of accidents and chronic health conditions. This study aims to (i) determine the efficacy of an intervention that comprises a sleep education program and biofeedback through a smartphone app on sleep quality, quantity, and alertness (ii) determine the prevalence of risk for a potential sleep disorder, and (iii) quantify and describe the sleep habits and behaviors of shift workers in a remote mining operation. This study consists of a randomized controlled trial whereby eighty-eight shift workers within a remote mining operation are randomized to a control group or one of three different treatment groups that are: (i) a sleep education program, (ii) biofeedback on sleep through a smartphone app, or (iii) a sleep education program and biofeedback on sleep through a smartphone app. This study utilizes wrist-activity monitors, biomathematical modeling, and a survey instrument to obtain data on sleep quantity, quality, and alertness. A variety of statistical methods will determine the prevalence of risk for a potential sleep disorder and associations with body mass index, alcohol, and caffeine consumption. A generalized linear mixed model will examine the dependent sleep variables assessed at baseline and post-intervention for the control group and intervention groups, as well as within and between groups to determine changes. The findings from this study will contribute to the current understanding of sleep and alertness behaviors, and sleep problems and disorders amongst shift workers. Importantly, the results may inform fatigue policy and practice on interventions to manage fatigue risk within the mining industry. This study protocol may have a broader application in other shiftwork industries, including oil and gas, aviation, rail, and healthcare.

J Mich Dent Assoc January 2021

The Journal of the Michigan Dental Association

Every month, The Journal of the Michigan Dental Association brings news, information, and features about Michigan dentistry to our state's oral health community and the MDA's 6,200+ members. No publication reaches more Michigan dentists!

In this issue, the reader will find the following original content:

• A cover story on “The Dentist’s Role in Recognizing Sleep-Disordered Breathing in Children”.
• A feature article, “Dental Sleep Medicine Education: Do You Want a Nap or a Full Night’s Sleep?”.
• The feature article, “In-office Plans: Where Are We Now? What Have We Learned?”
• News you need, Editorial and regular department articles on MDA Foundation activities, …

The Use Of Continuous Positive Airway Pressure In Patients With Obstructive Sleep Apnea To Decrease The Risk And Progression Of Cardiovascular Disease, Haley Duncan

Capstone Showcase

Introduction: Cardiovascular disease is one of the most prevalent illnesses worldwide and the leading cause of death in the United States. Obstructive sleep apnea (OSA) has been found to be a risk factor correlated to cardiovascular disease and events. Treatment for OSA includes the use of continuous positive airway pressure (CPAP), but patients are often non-compliant due to discomfort. Therefore, the following clinical question arises: [P] In an adult patient (35-75 years old) diagnosed with OSA, [I] does the use of CPAP [C: compared to patients with OSA who do not use CPAP] [O]decrease the risk and/or progression of cardiovascular …

Sleep Characteristics And Mood Of Professional Esports Athletes: A Multi-National Study, Sangha Lee, Daniel Bonnar, Brandy Roane, Michael Gradisar, Ian C. Dunican, Michele Lastella, Gemma Maisey, Sooyeon Suh

Research outputs 2014 to 2021

© 2021 by the authors. Licensee MDPI, Basel, Switzerland. Esports is becoming increasingly professionalized, yet research on performance management is remarkably lacking. The present study aimed to investigate the sleep and mood of professional esports athletes. Participants were 17 professional esports athletes from South Korea (N = 8), Australia (N = 4), and the United States (N = 5) who played first person shooter games (mean age 20 ± 3.5 years, 100% male). All participants wore a wrist-activity monitor for 7–14 days and completed subjective sleep and mood questionnaires. Participants had a median total sleep time of 6.8 h and …

How Duty Rosters And Stress Relate To Sleep Problems And Fatigue Of International Pilots, Marion Venus, Martin Grosse Holtforth

International Journal of Aviation, Aeronautics, and Aerospace

While previous research focused on pilots’ fatigue, rosters, potential performance-impairment and aviation-safety, this research investigates, how pilots’ work-related and psychosocial stress and rosters can affect their sleep and fatigue. A cross-sectional online survey was completed by 192 pilots flying for European operators, 180 Australian pilots and 34 pilots from UAE, Turkey and Asia Pacific. Pilots reported their actual duty- and flight-hours, flown sectors, standby, rest, vacation days, number of early starts, night-flights and sports-hours for the last two months. Schedule-related data, way to work, age, flight-hours on the present type of aircraft, subjective job-security and psychosocial stress were used as …

Sleep-Related Problems, Sleep-Related Distress, And Sleep-Related Functional Status Among Adult Inpatients Receiving Palliative Care, Lisa C. Sievers

Theses and Dissertations

Palliative care patients may be at a higher risk for sleep-related problems and their negative effects compared to the general population, yet limited sleep research has been done with this population. The purpose of this dissertation was to determine prevalence rates for excessive sleepiness, insomnia, restless legs syndrome (RLS), and high risk for sleep apnea (HRSA); examine relationships between the aforementioned sleep-related problems, sleep-related distress (SD), and sleep-related functional status (SFS); and to determine which sleep-related problem measures along with age and gender predicted SD and SFS among a sample of adult palliative care inpatients. Secondary aims were to understand …

The Physiological Interaction Of Sleep Deprivation And Zoledronate On Distal Femur Trabecular Thickness Of Ovariectomized Rats, Erin Nolte, Frank Frisch, Oliver Lopez

Health Sciences and Kinesiology Faculty Articles

Osteoporosis, a disease resulting in an increased risk of fracture due to compromised bone, affects 1 in 3 postmenopausal women. Discontinuities in the microarchitecture of bone, such as trabeculae, are seen in postmenopausal osteoporosis. This study aimed to evaluate how sleep deprivation affects the distal femur trabecular thickness of estrogen-deficient rats treated with Zoledronate. 29 ovariectomized Wistar female rats were separated into 4 groups. The control group (C) was housed in standard housing with a 12-hour light/dark cycle and was given an intravenous injection of 0.45 mL of 0.9% saline. The Zoledronate group (Z) were also housed in standard conditions …

J Mich Dent Assoc December 2020

The Journal of the Michigan Dental Association

Every month, The Journal of the Michigan Dental Association brings news, information, and features about Michigan dentistry to our state's oral health community and the MDA's 6,200+ members. No publication reaches more Michigan dentists!

In this issue, the reader will find the following original content:

• A cover story on “The Dentist’s Role in Recognizing Sleep-Related Breathing Disorders: A Two-Part Series”.
• The “2020 Author/Title Index to the Journal of the Michigan Dental Association”.
• News you need, Editorial and regular department articles on MDA Foundation activities, Dentistry and the Law, Staff Matters, and component news.

This issue also includes three articles reprinted …

Determining The Severity Of Obstructive Sleep Apnea (Osa) By Using Numerical Analysis, Ming Lok Ang

Student Works (2020-2029)

Computational technologies and biomechanical theories have been applied to study upper airway mechanics in obstructive sleep apnea (OSA). In this study, the patient is selected from ENT Department, UMMC, diagnosed with mild to severe OSA. In addition, the patient underwent maxillomandibular advancement (MMA) surgical treatment. Therefore, 3-dimensional modeling software will be used to model the upper airway, based on patient specific geometrical characteristics obtained from medical imaging and computed tomography (CT). Hence, providing an accurate assessment of airflow characteristics. Computational fluid dynamics (CFD) analysis will be combined with upper airway geometries obtained before and after surgical to determine the effects …