Sleep Medicine Commons^™

Disposable Equipment For Efficient Home Sleep Apnea Testing And Minimizing Human Handling At The Sleep Laboratory, Abigail Quintos, Robert Tavella, Karl Doghramji

Health Equity and Quality Improvement (HEQI) Summit

As part of the disease mitigation strategy at the time of the pandemic, the Jefferson sleep laboratory has completely shifted towards utilization of the third-party vendor for HSATs. The vendor specializes in handling, shipping and disinfecting the HSAT equipment. They send the data electronically to the Jefferson sleep laboratory for interpretation.

We propose a single-use, fully disposable HSAT kit (WatchPAT One) to further minimize potential virus exposures and spread. The single-use design allows no return shipment, no charging or downloading, no cleaning and no infection transmission risk.

Since the equipment utilizes a different mechanism - peripheral arterial tone (PAT) signal …

Urine Drug Screening At The Sleep Disorder Center, Rohin Saroya, Md, Karl Doghramji, Md

Health Equity and Quality Improvement (HEQI) Summit

Aim

• Introduce UDS for all patients undergoing MSLT or MWT
• Eliminate false positive and negative results
• Optimize management of disorder

Goal

• To have 100% of patients undergoing an MSLT or MWT to have a UDS

A Positive Framed Message To Improve Cpap Compliance For Patients With Osa, Frances Clark

Evidence-Based Practice Project Reports

Obstructive sleep apnea (OSA) affects 24% of the US population (DiNapoli, 2014). Untreated OSA causes many diseases, affects one’s quality of life, and increases mortality (Pengo et al., 2018). Continuous positive airway pressure (CPAP) is the lifelong treatment for OSA; yet 30%-80% of OSA patients are CPAP noncompliant within one year. The purpose of this EBP project was to determine if implementing a positive frame message intervention would improve CPAP compliance for newly diagnosed OSA patients. Based on the evidence, implementation of behavioral interventions, such as a positive framed message, was effective in improving CPAP compliance (Pengo et al., 2018). …

Sleep Deprivation And High-Fat Diet During Adolescence Protect Stress Effects On Object Memory During Adulthood, Karina Glushchak

Honors Scholars Collaborative Projects

No abstract provided.

Relationship Between Sleep And Obesity Among U.S. And South Korean College Students, Jaesin Sa, Siyoung Choe, Beom-Young Cho, Jean-Philippe Chaput, Gyurin Kim, Chae-Hee Park, Joon Chung, Yoojin Choi, Beatrice Nelson, Yongkyu Kim

Background

Little is known about the relationship between sleep and obesity in young adults, particularly college students. This study examined the relationship between sleep (i.e., sleep duration and quality) and obesity in a large and diverse binational sample of college students.

Methods

Analyses were based on a 40-item paper survey from 2016/2017 to 2017/2018 academic years, with a 72% response rate. The samples were 1578 college students aged 18–25 years from five universities (two in the U.S. and three in South Korea). Weight and height were measured objectively; other measures (e.g., health behaviors) were self-reported. Multinomial logistic regression was used …

Effect Of Sleep Deprivation And Sleep Recovery On Heart Rate And Heart Rate Variability In Males Versus Females, Abrianna Lochner Spt, Elena Crooks Pt, Dpt, Phd, Myles Gordon Finlay Ba, Julie A. Erwin Ms, Kimberly Honn Phd

2020 Symposium Posters

Introduction

Elevated heart rate (HR) and low HR variability (HRV) are indicators of increased sympathetic tone and cardiovascular risk. Here, we assess the effect of one night of sleep deprivation and a subsequent night of recovery sleep on HR and HRV in healthy males versus females.

Methods

Fifty-nine subjects (29.5±8.5y, n=35 female) completed a 4-day/3-night laboratory study. Subjects had a baseline sleep opportunity (22:00–08:00), followed by 38h of sleep deprivation, and a recovery sleep opportunity (22:00–08:00). EKG was monitored via Holter monitors to measure HR and the pNN50 and rMMSD variables of HRV. Time points used for analyses included 09:00–09:20 …

Medical Student Knowledge Of Narcolepsy, Alyssa Sinko, Karl Doghramji, Md

Phase 1

Background: Narcolepsy is a sleep disorder, whose main symptoms include daytime sleepiness, cataplexy, sleep paralysis, disturbed sleep, and hypnagogic hallucinations. The disorder is poorly identified in medical settings. We hypothesized that lack of knowledge of narcolepsy and its hallmark symptoms are a cause for the low levels of identification of this disorder. This was a pilot study into medical student knowledge of narcolepsy at Sidney Kimmel Medical College of Thomas Jefferson University (SKMC).

Methods: Two groups of SKMC students, years 1 and 2 (before sleep medicine education) and years 3 and 4 (after sleep medicine education) were the subjects of …

Creating A Noise-Reducing, Wearable Intervention For Newborns In The Nicu, Mohammad Rasool, Alexandra A. Mccullough, Alison Romisher, Robert S. Pugliese, Pharmd, Bcps, Bon Ku, Md, Mpp

Phase 1

Background: Excessive auditory stimulation can have negative effects on the growth and development of newborn babies. The American Academy of Pediatrics states that newborns should not be exposed to sounds in excess of 45dB while they are in the hospital, however noise levels in NICUs across the country are often between 50-100dB. A design project was conducted to develop an intervention that could reduce infant exposure to excessive noise.

Methods: Neonatologists, nurses, audiologists, music therapists, sound designers, soft materials experts, and medical device designers were interviewed and consulted throughout the design process. A 24-hour sound recording using a REED-SD-4023 meter …

Sound Dampening Headband For Infants, Alexandra A. Mccullough, Mohammad Rasool, Alison Romisher, Robert S. Pugliese, Pharmd, Bcps, Bon Ku, Md, Mpp

Phase 1

Background: Noise in the Intensive Care Nursery (ICN) has been linked to sleep disruption, vital sign destabilization, abnormal development, and stress response induction in infants. Specifically, a sound level ≥60 decibels (dB) was linked to sleep disruption in infants, and the American Academy of Pediatrics (AAP) set a maximum recommended sound level of 45dB in ICNs. The present work was conducted to confirm that the Jefferson ICN exceeds the 60dB and 45dB levels, like most hospitals do, and to conduct preliminary testing on materials for a wearable intervention to reduce infants’ exposure to noise.

Methods: A group of …

Cognitive Changes In Patients Treated For Obstructive Sleep Apnea With Upper Airway Stimulation, Maxillomandibular Advancement, Or Expansion Sphincter Pharyngoplasty, Nicolas Zingas, Colin Huntley, Matthew Stewart, Ramez Philips

Phase 1

Introduction: Obstructive sleep apnea (OSA) is a prevalent diagnosis that has been shown to not only affect sleepiness, but daytime cognitive function — specifically attention, working memory, and executive function. CPAP treatment is troublesome for some patients and it is possible that superior treatment options, specifically novel surgical techniques, are available, though none have been evaluated for their long-term effects on neurocognition. We hypothesize that treating patients with upper airway stimulation surgery (UAS) UAS, maxillomandibular advancement surgery (MMA), and expansion sphincter pharyngoplasty surgery (ESP) for OSA produces a significant improvement in cognition from baseline.

Methods: For inclusion in the study, …

Identifying The Prevalence Of Underdiagnosed Obstructive Sleep Apnea (Osa) In The Primary Care Population Via Targeted Screening Measures, Risa Goldberg, Alyssa Givens, Cynthia Cheng, Md, Phd

Phase 1

Introduction: Obstructive sleep apnea (OSA) is a condition with detrimental health consequences, yet over 75% of OSA cases remain undiagnosed in the United States. This study aimed to determine the efficacy of using targeted screening measures to determine the prevalence of undiagnosed OSA in a primary care population.

Methods: This prospective pilot study utilized a primary care population from Thomas Jefferson University’s family medicine department. Participants were selected using three risk criteria for OSA from STOP-BANG identifiable from their EMR records (BMI >35, age over 50, and hypertension). After screening out patients previously diagnosed with OSA, patients were called and …

Motivational Interviewing For Cpap Adherence, Grayton Downing, Caitlin Green, Cynthia Cheng, Md, Phd

Phase 1

Introduction: Untreated obstructive sleep apnea (OSA) leads to negative health outcomes. Yet, compliance rates for continuous positive airway pressure (CPAP), the gold standard of treatment, range from 30-60%. This study examines how motivational interviewing (MI), a goal-oriented form of psychotherapy, increases CPAP adherence. We hypothesize that MI increases CPAP compliance when incorporated into CPAP follow-up care.

Methods: We developed and trained our staff with a novel MI training protocol consisting of MI background readings and videos, CPAP technician shadowing, and MI role-play for certification. For the clinical trial, newly diagnosed OSA patients from Jefferson’s sleep center will be randomized …

Mci: Cpap Treatment Of Osa, Kaitlin Berry, Cindy Cheng, Md, Phd, Karl Doghramji, Md

Phase 1

Introduction: An estimated 30 percent of adults (20% of men and 10% of women) in the US have sleep apnea. Approximately 60% of patients with Mild Cognitive Impairment (MCI) are also diagnosed with Obstructive Sleep Apnea (OSA). The suggested mechanism of this is damage to the brain due to hypoxia during sleep. Few studies have investigated the effect of Continuous Positive Airway Pressure (CPAP) treatment for OSA, on mild cognitive impairment.

Methods: Patients are screened for eligibility based on specific inclusion and exclusion criteria. Potentially eligible patients who screen positive for MCI using the Telephone Interview for Cognitive Status …

A Qualitative Study On Adequate Sleep In Preschool Children – Can We Sleep On It?, Seema Zainulabdin Lasi, Noreen Afzal, Somal Kayani

Human Development Programme

Sleep is a significant marker of physical and psychological health. The present research was undertaken to explore perceptions of parents, teachers and pediatricians about preschool children’s sleep patterns, habits, and problems from urban Karachi, Pakistan. A qualitative research approach was employed; data collection methods were Focus Group Discussion (FGDs) and Key Informant Interviews (KIIs). The themes identified were children’s sleep patterns, sleep environment, sleep rituals, distractions, sleep problems, the impact of inadequate sleep, and recommendations to improve. Emergent themes were inconsistency of rules from parents, lack of opportunities for outdoor physical activity, different kinds of stresses, social and cultural events …

Efficacy Of Cpap Compared To Standard Pharmacotherapy In Reducing Cognitive Impairment Symptoms In Patients With Alzheimer's Disease, Nicholas Moylan

Capstone Showcase

This review analyzed the following question: In adults age 65 years old or older diagnosed with Alzheimer’s Disease (P), is nightly use of CPAP (I) more effective in reducing cognitive impairment symptoms (O) than standard pharmacotherapy options (C)? A literature search conducted through Google Scholar and PubMed granted six relevant articles that provided data for this review. No current studies compared CPAP treatment with pharmacotherapy, and each study used unique measures of cognitive function, making direct comparison of the two therapies difficult. Results demonstrated that first line pharmacotherapy can improve cognitive function, but only in limited way and only in …

Motivational Interviewing For Cpap Adherence, Caitlin Green, Grayton Downing, Cindy Cheng, Md, Phd

Phase 1

Background: Continuous Positive Air Pressure (CPAP), is the gold standard for obstructive sleep apnea (OSA) treatment. If left untreated, patients with OSA can experience serious and potentially life-threatening consequences. However, patient CPAP adherence is an ongoing problem, as compliance rates are historically low (typically 30-60%). Engaging patients in motivational interviewing (MI) by trained providers could promote increased CPAP adherence.

Question/Purpose: Assess CPAP compliance in patients who receive motivational interviewing compared to a control attention intervention.

Methods: A team of medical students were trained in MI interviewing techniques through a novel training protocol. The training protocol includes reading articles and watching …

Primary Care Obstructive Sleep Apnea Screening (Pcosa), Alyssa Givens, Risa Goldberg, Cynthia Cheng, Md, Phd

Phase 1

Introduction: Obstructive sleep apnea (OSA) is a largely underdiagnosed disorder of upper airway collapse during sleep. Primary care providers do not routinely screen for OSA. This project aims to determine the yield of using the STOP-BANG questionnaire to identify previously undiagnosed OSA in a primary care population.

Methods: This prospective quality improvement pilot project included 181 patients of the Jefferson Department of Family Medicine identified as high-risk for OSA based on 3 EMR-based search criteria taken from STOP-BANG: hypertension, age >50 years, and BMI >35 kg/m². We attempted contact with patients by mail, followed by up to …

Examining The Relationship Of Exercise And Sleep In Students Across Multiple Academic Disciplines, Taylor Zewe

Honors Projects

Students in college learn the importance of balancing their academic studies with their sleep and exercise habits. The amount of sleep and exercise a student recieves has been examined in previous research studies. In these studies it was found that exercise had a postive affect on the amount of sleep received. However, there is little research on the affect academic discipline has on sleep habits and/or exercise habits of students in college. The purpose of this study is to examine the sleep and exercise habits among students in multiple academic majors at Bowling Green State University.

Acne Severity And Sleep Quality In Adults., Kory P Schrom, Sayeeda Ahsanuddin, Michelle Baechtold, Raghav Tripathi, Amy Ramser, Elma Baron

Ambulatory and Primary Care Articles

Poor sleep quality is extremely prevalent, with about one third of adults in the USA obtaining less than the recommended amount of sleep. In addition, poor sleep quality has been linked to an increased risk of many conditions, including diabetes, hypertension, psychiatric conditions, and overall all-cause mortality. Research has shown that sleep disturbance does impact skin disease, although many details of this relationship are still unclear. The goal of this study is to determine if there is a relationship between acne severity and sleep quality in adults. Forty subjects with acne were recruited from dermatology clinics in Cleveland, OH, to …

Multi-Ancestry Sleep-By-Snp Interaction Analysis In 126,926 Individuals Reveals Lipid Loci Stratified By Sleep Duration, Raymond Noordam, Maxime M. Bos, Heming Wang, Thomas W. Winkler, Amy R. Bentley, Tuomas O. Kilpeläinen, Paul S. De Vries, Yun Ju Sung, Karen Schwander, Brian E. Cade, Alisa Manning, Hugues Aschard, Michael R. Brown, Han Chen, Nora Franceschini, Solomon K. Musani, Melissa Richard, Dina Vojinovic, Stella Aslibekyan, Traci M. Bartz, Donna K. Arnett

Epidemiology and Environmental Health Faculty Publications

Both short and long sleep are associated with an adverse lipid profile, likely through different biological pathways. To elucidate the biology of sleep-associated adverse lipid profile, we conduct multi-ancestry genome-wide sleep-SNP interaction analyses on three lipid traits (HDL-c, LDL-c and triglycerides). In the total study sample (discovery + replication) of 126,926 individuals from 5 different ancestry groups, when considering either long or short total sleep time interactions in joint analyses, we identify 49 previously unreported lipid loci, and 10 additional previously unreported lipid loci in a restricted sample of European-ancestry cohorts. In addition, we identify new gene-sleep interactions for known …