Sleep Medicine Commons^™

The Effect Of Teenagers' Sleeping Deprivation On Cognition/Academic Outcome And Obesity, Dongyub Back

Annual Graduate Student Symposium

Sleeping disorder, deprivation, and deficient are common public health problem. Nearly 70 million American have chronic sleep disorders(Sleep Deprivation and Deficiency. 2019). Sleep deprivation is well known as a significant cause which increases the risk of a mental and physical health problem such as poor self-esteem, memory loss, obesity, and diabetes. This literature research focused on the sleeping deprivation of deficient of students. Also, trying to find the relation between sleeping derivation and students' health, education, and well-being will be reviewed by previous research. To reveal the impact of sleeping deprivation and deficient, this research will provide the conclusion and …

The Acute Effects Of Melatonin On Striatal Dopamine Release: Progressive Electrochemical Analysis In An Ex Vivo Mouse Model Utilizing Fast Scan Cyclic Voltammetry, Kevin D. Hughes

Masters Theses

The caudate putamen is a sub region of the basal ganglia, containing neural tracts important for cognition, reward learning, and voluntary motor function. Dopamine (DA) signaling received from the dopaminergic neurons of the substantia nigra pars compacta mediate locomotion, degradation of which is the characteristic neuropathology for Parkinson’s disease (PD). PD is an initially neurovegetative motor disorder but can progress to include cognitive impairments as well. Sundowner’s syndrome (SS) has been observed in patient populations with neurodegenerative diseases, characterized by the decline of cognition into evening hours. Due to the circadian influence which the hormone melatonin has on the sleep-wake …

Adults’ Knowledge And Beliefs Surrounding Obstructive Sleep Apnea, Mazen Homoud

Seton Hall University Dissertations and Theses (ETDs)

Undiagnosed individuals with signs and symptoms of obstructive sleep apnea (OSA) are at higher risk of severe health complications than healthy individuals, and they pose a huge economic burden on society as well. Some scholars reported the lack of public knowledge of OSA as a major contributor to this phenomenon. However, there is a lack of information about assessing public knowledge and health belief of OSA and its nature across the risk level of having OSA.

Two self-reporting questioners were used in this mixed method study, a PI developed survey, the Obstructive Sleep Apnea Knowledge and Belief (OSA-KAB) © was …

Toxoplasma Gondii Igg Associations With Sleepwake Problems, Sleep Duration And Timing, Celine C. Corona, Ma Zhang, Abhishek Wadhawan, Melanie L. Daue, Maureen W. Groer, Aline Dagang, Christopher A. Lowry, Kathleen A. Ryan, Andrew J. Hoisington, John W. Stiller, Dietmar Fuchs, Braxton D. Mitchell, Teodor T. Postolache

Faculty Publications

Background: Evidence links Toxoplasma gondii (T. gondii), a neurotropic parasite, with schizophrenia, mood disorders and suicidal behavior, all of which are associated and exacerbated by disrupted sleep. Moreover, low-grade immune activation and dopaminergic overstimulation, which are consequences of T. gondii infection, could alter sleep patterns and duration. Methods: Sleep data on 833 Amish participants [mean age (SD) = 44.28 (16.99) years; 59.06% women] were obtained via self-reported questionnaires that assessed sleep problems, duration and timing. T. gondii IgG was measured with ELISA. Data were analyzed using multivariable logistic regressions and linear mixed models, with adjustment for age, sex and family …

Diagnostic Accuracy Of Home Sleep Apnea Testing (Hsat) Based On Recording Duration, Angela Alnemri, Theodora Fynn, Prakash Vasudevan, Ritu Grewa, Karl Doghramji

Phase 1

Introduction: Obstructive Sleep Apnea (OSA) is a chronic sleeping disorder with serious health consequences. Currently, standard diagnosis is through in-lab polysomnography; however, there has been a shift to greater use of Home Sleep Apnea Testing (HSAT) for patients with a high pre-test probability of having OSA.

Objective: To investigate the minimum recording time needed during HSAT to accurately diagnose the presence and severity of OSA.

Methods: A retrospective review was conducted of HSATs done from January-October 2017. Each study was divided into 1-, 2-,3-,4-,5-, 6-, and 7 hour intervals beginning at the recording start time. The respiratory event index (REI) …

Comparing Treatment Efficacy Of Upper Airway Stimulation To Cpap For Obstructive Sleep Apnea, Alec Furstenberg, Colin Huntley, Md, Adam Vasconcellos, Md, Ayan Kumar, Karl Doghramji, Md, Maurits Boon, Md

Phase 1

Introduction

Upper airway stimulation (UAS) is newer treatment option for the management of Obstructive Sleep Apnea (OSA) and presents an alternative to the traditional Continuous Positive Airway Pressure (CPAP). Previously published data has shown good control of disease severity utilizing UAS with high patient tolerance and compliance. We aim to compare a cohort of patients treated with UAS and CPAP and evaluate therapy usage and disease control through use of the mean disease alleviation concept.

Methods

We evaluated demographic, pre and post-treatment sleep study, and therapy utilization data of cohorts of patients with OSA treated with CPAP and UAS. We …

A Multicomponent Quality Improvement Project To Improve Sleep In Hospitalized Patients: A Single Center Pilot Experience, Michelle Konkoly, Alan Kubey, Md

Phase 1

No abstract provided.

An Exploratory Study Examining The Associations Between Sunlight Exposure, Sleep Behaviours And Sleep Outcomes During An Arctic Summer, Margaret M. Lubas, Ralitsa S. Maduro, Mariana Szklo-Coxe

Community & Environmental Health Faculty Publications

Few evidence-based recommendations exist for maintaining healthy sleep during Arctic summers. Our study aimed to examine associations between sleep hygiene, sunlight exposure and sleep outcomes in workers living in and/or near the Arctic Circle during a 24-h light period. A survey was administered July 2017 to 19 workers at 3 Arctic base camps in Northeastern Alaska. Participants with poorer sleep hygiene reported increased sleepiness (r=.62, p=0.01); this correlation remained moderately strong, albeit not statistically significant (NS), after controlling for shift work (r=.46, p=0.06). No other statistically significant correlations between sleep hygiene and sleep outcomes were found. Weekly daytime (8pm) sunlight …

Doppler Radar-Based Non-Contact Health Monitoring For Obstructive Sleep Apnea Diagnosis: A Comprehensive Review, Vinh Phuc Tran, Adel Ali Al-Jumaily, Syed Mohammed Shamsul Islam

Research outputs 2014 to 2021

Today’s rapid growth of elderly populations and aging problems coupled with the prevalence of obstructive sleep apnea (OSA) and other health related issues have affected many aspects of society. This has led to high demands for a more robust healthcare monitoring, diagnosing and treatments facilities. In particular to Sleep Medicine, sleep has a key role to play in both physical and mental health. The quality and duration of sleep have a direct and significant impact on people’s learning, memory, metabolism, weight, safety, mood, cardio-vascular health, diseases, and immune system function. The gold-standard for OSA diagnosis is the overnight sleep monitoring …

Investigating The Relationships Between Hypothalamic Volume And Measures Of Circadian Rhythm And Habitual Sleep In Premanifest Huntington's Disease, Danielle M. Bartlett, Juan F. Domínguez D, Alvaro Reyes, Pauline Zaenker, Kirk W. Feindel, Robert U. Newton, Anthony J. Hannan, James A. Slater, Peter R. Eastwood, Alpar S. Lazar, Mel Ziman, Travis Cruickshank

Research outputs 2014 to 2021

Objective

Pathological changes within the hypothalamus have been proposed to mediate circadian rhythm and habitual sleep disturbances in individuals with Huntington’s disease (HD). However, investigations examining the relationships between hypothalamic volume and circadian rhythm and habitual sleep in individuals with HD are sparse. This study aimed to comprehensively evaluate the relationships between hypothalamic pathology and circadian rhythm and habitual sleep disturbances in individuals with premanifest HD.

Methods

Thirty-two individuals with premanifest HD and twenty-nine healthy age- and gender-matched controls participated in this dual-site, cross-sectional study. Magnetic resonance imaging scans were performed to evaluate hypothalamic volume. Circadian rhythm and habitual sleep …

Use Of Telemedicine To Improve Cpap Non-Adherence In Patients With Obstructive Sleep Apnea, A Pilot Study, Kristin L. Hanger

Doctor of Nursing Practice (DNP) Final Clinical Projects, 2016-2019

Abstract

The aim of this project is to improve continuous positive airway pressure (CPAP) non-adherence in patients newly diagnosed with obstructive sleep apnea. Obstructive sleep apnea (OSA) is caused by recurrent collapse of the upper airway during sleep. Untreated, OSA is associated with co-morbidity and decreased quality of life. The standard for OSA treatment is CPAP. Adherence to CPAP is not optimal. Applying telemedicine technology to monitor adherence of CPAP treatment, allows for early intervention. Prior research has shown mixed results with use of telemedicine on non-adherence rates.

This is a pilot study using telemedicine to monitor adherence data to …

Sleep Paralysis: Dreams, Demons And Rem-Atonia, Joshua G. Christensen

Capstones

Have you ever woken up from a dream only to find you can’t move? You’re paralyzed and, sometimes, you are even having vivid hallucinations. It’s terrifying, but harmless and very common. Regardless of it being so innocuous, Sleep Paralysis has inspired fear for centuries and many still believe it to be a supernatural phenomenon. This is, most likely, because most people who get Sleep Paralysis, don’t really know what it is. People just like me.

https://medium.com/@joshua.christensen/sleep-paralysis-dreams-demons-and-rem-atonia-27f46c2748cf

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 & Projects

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

Graduate 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, …

Mechanisms Of Sleep And The Brain, Doungbagai Leo

Honors Theses

One of the most important homeostatic functions of the brain and body is sleep. This literary review analyzes the genes that are involved in sleep: Clock, Bmal1, Period, and Cryptochrome. It also explains the role of melatonin, GABA, orexin, and melanopsin during sleep regulation. The genes and neurotransmitters influence the suprachiasmatic nuclei and the circadian rhythm that our brain, and every cell of our bodies, have connections to. These connection help to ensure the homeostatic function of our bodies. The analysis of sleep-like states in other animals may show an evolutionary connection of sleep from non-mammals to mammals, but may …

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 or …

Intermittent Hypoxemia In Preterm Infants, Elie G. Abu Jawdeh

Theses and Dissertations--Clinical and Translational Science

Intermittent hypoxemia (IH) is defined as episodic drops in oxygen saturation (SpO₂). Virtually all preterm infants have IH events. Extremely preterm infants have hundreds of IH events per day. The extent of IH is not apparent clinically as accurately documenting cardiorespiratory events for day-to-day patient care management is challenging. High resolution pulse oximeters with 2 second averaging time are currently the ideal methods to measure IH. We have developed novel methods and processes to accurately and efficiently calculate an IH profile that reflects to spectrum of the problem.

The natural progression of IH is dynamic. There is low …

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 children …

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 …

A Systematic Review Of Non-Pharmacological Interventions To Improve Nighttime Sleep Among Residents Of Long-Term Care Settings, Elizabeth Capezuti, Rana Sagha Zadeh, Kevin Pain, Aleksa Basara, Nancy Ziyan Jiang, Ana C. Krieger

Publications and Research

Background: Disturbances in sleep and circadian rhythms are common among residents of long-term care facilities. In this systematic review, we aim to identify and evaluate the literature documenting the outcomes associated with non-pharmacological interventions to improve nighttime sleep among long-term care residents.

Methods: The Preferred Reporting Items for Systematic Reviews guided searches of five databases (MEDLINE, Embase, CINAHL, Scopus, and Cochrane Library) for articles reporting results of experimental or quasi-experimental studies conducted in long-term care settings (nursing homes, assisted-living facilities, or group homes) in which nighttime sleep was subjectively or objectively measured as a primary outcome. We categorized each intervention …

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 …

Predictors Of Sleepiness In Obstructive Sleep Apnoea At Baseline And After 6 Months Of Continuous Positive Airway Pressure Therapy., Rohit Budhiraja, Clete A Kushida, Deborah A Nichols, James K Walsh, Richard D Simon, Daniel J Gottlieb, Stuart F Quan

Articles, Abstracts, and Reports

We evaluated factors associated with subjective and objective sleepiness at baseline and after 6 months of continuous positive airway pressure (CPAP) therapy in patients with obstructive sleep apnoea (OSA).We analysed data from the Apnoea Positive Pressure Long-term Efficacy Study (APPLES), a prospective 6-month multicentre randomised controlled trial with 1105 subjects with OSA, 558 of who were randomised to active CPAP. Epworth sleepiness scale (ESS) scores and the mean sleep latency (MSL) on the maintenance of wakefulness test at baseline and after 6 months of CPAP therapy were recorded.Excessive sleepiness (ESS score >10) was present in 543 (49.1%) participants. Younger age, …

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

Dartmouth Scholarship

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 49 …

Bedtime Fading With Response Cost For Treatment Of Sleep Disturbances In Children With Autism Spectrum Disorder, Sela Ann Sanberg

Theses & Dissertations

As many as 82% of children with Autism Spectrum Disorders (ASD) experience numerous chronic sleep-related problems and at a much higher frequency and severity than their typically developing peers. Behavioral treatments are considered best practice and first-line treatment to address sleep problems. These treatments tend to address one specific sleep-related behavior at a time. Bedtime Fading with Response Cost (BFRC) is a promising intervention that targets a multitude of sleep problems concurrently and has yet to be replicated by more than one investigative team in the home setting with children on the autism spectrum. This study evaluated the effectiveness of …

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 Conference (2016-2019)

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 second chapter …