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Prevalence of obstructive sleep apnea in a patient population undergoing cardiac rehabilitation.
Sharma S, Parker AT.
Department of Internal Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, Brody School of Medicine, Greenville, North Carolina 27834, USA. sharmas@ecu.edu
J Cardiopulm Rehabil Prev. 2011 May-Jun;31(3):188-92. doi: 10.1097/HCR.0b013e318203339b.
OBJECTIVES:
: The primary objective of this study was to determine the prevalence of undiagnosed or untreated obstructive sleep apnea (OSA) in patients undergoing cardiac rehabilitation.
METHODS:
: A total of 132 consecutive patients were screened by Berlin Questionnaire to determine the presence or absence of OSA.
RESULTS:
: Fourteen patients did not consent to participate. Of the remaining 118 patients, 20 (17%) were found to have a preexisting formal diagnosis of OSA. Of the remaining 98 patients (69 males and 29 females), 43 (44%) were found to have a high probability of OSA as predicted by the Berlin Questionnaire. There was no significant difference in the prevalence (P < .05) between males (29/69, 42%) and females (14/29, 48%) who were predicted to have OSA. Similarly, no significant differences were observed in the ages or body mass index between OSA and non-OSA patients. A significantly greater frequency (P < .05) of coronary artery disease was observed in the OSA group than in the non-OSA group.
CONCLUSIONS:
: Overall, the rate of preexisting and predicted OSA (53%) suggests a high prevalence of OSA in patients with cardiovascular diseases in a cardiac rehabilitation setting. Moreover, the high rate of undiagnosed OSA, as suggested by the Berlin Questionnaire, further adds to the growing literature that a large number of patients with significant cardiovascular disease carry the burden of sleep disordered breathing.
Sharma S, Parker AT.
Department of Internal Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, Brody School of Medicine, Greenville, North Carolina 27834, USA. sharmas@ecu.edu
J Cardiopulm Rehabil Prev. 2011 May-Jun;31(3):188-92. doi: 10.1097/HCR.0b013e318203339b.
OBJECTIVES:
: The primary objective of this study was to determine the prevalence of undiagnosed or untreated obstructive sleep apnea (OSA) in patients undergoing cardiac rehabilitation.
METHODS:
: A total of 132 consecutive patients were screened by Berlin Questionnaire to determine the presence or absence of OSA.
RESULTS:
: Fourteen patients did not consent to participate. Of the remaining 118 patients, 20 (17%) were found to have a preexisting formal diagnosis of OSA. Of the remaining 98 patients (69 males and 29 females), 43 (44%) were found to have a high probability of OSA as predicted by the Berlin Questionnaire. -
Disorders of glucose metabolism and insulin resistance in patients with obstructive sleep apnoea syndrome.
Bulcun E, Ekici M, Ekici A.
Department of Chest Disease, School of Medicine, Kirikkale University, Kirikkale, Turkey.
Int J Clin Pract. 2012 Jan;66(1):91-7. doi: 10.1111/j.1742-1241.2011.02795.x.
Objective: Insulin resistance (IR) and disorders of glucose metabolism (DGM) are risk factors for cardiovascular diseases. There are different reasons for development of DGM in patients with obstructive sleep apnoea syndrome (OSAS) and this association is controversial. We investigated the frequency of DGM and IR in patients with OSAS and determining factors for these disorders. Method: One hundred and twelve untreated patients with OSAS and 19 non-apnoeic snoring subjects upon polysomnography were included in this study. Oral glucose tolerance test (OGTT) was performed in all subjects who had fasting blood glucose < 125 mg/dl. IR method was analysed using homeostasis assessment model (HOMA-IR). Diabetes mellitus (DM), impaired glucose tolerance (IGT) and impaired fasting glucose (IFG) were defined according to values of OGTT. DGM was defined as having one of the diagnoses of DM, IGT or IFG. Subjective sleepiness of all subjects was assessed with Epworth Sleepiness Scale (ESS). Excessive daytime sleepiness (EDS) was described as ESS score ≥ 10. Results: Fasting glucose and the rate of DGM in patients with OSAS were higher than in non-apnoeic snoring subjects. DGM were shown in % 15.7 of non-apnoeic snoring subjects, 29.6% of mild sleep apnoea, 50% of moderate sleep apnoea and 61.8% of severe sleep apnoea. The rate of DGM in patients with moderate and severe OSAS was higher than in non-apnoeic snoring subjects and in patients with severe OSAS higher than in patients with mild OSAS. DGM are associated with body mass index (BMI), severity of OSAS, arousal index and EDS. In addition, IR is associated with apnoea hypopnoea index, BMI, arousal index and ESS score. Conclusion: Obstructive sleep apnoea syndrome is associated with high frequency of DGM. In addition, the progression of disease from simple snoring and mild OSAS to severe OSAS increases the rate of DGM. Thus, DGM especially in patients with severe OSAS should be examined in regular periods.
© 2011 Blackwell Publishing Ltd.
Bulcun E, Ekici M, Ekici A.
Department of Chest Disease, School of Medicine, Kirikkale University, Kirikkale, Turkey.
Int J Clin Pract. 2012 Jan;66(1):91-7. doi: 10.1111/j.1742-1241.2011.02795.x.
Objective: Insulin resistance (IR) and disorders of glucose metabolism (DGM) are risk factors for cardiovascular diseases. There are different reasons for development of DGM in patients with obstructive sleep apnoea syndrome (OSAS) and this association is controversial. We investigated the frequency of DGM and IR in patients with OSAS and determining factors for these disorders. Method: One hundred and twelve untreated patients with OSAS and 19 non-apnoeic snoring subjects upon polysomnography were included in this study. Oral glucose tolerance test (OGTT) was performed in all subjects who had fasting blood glucose < 125 mg/dl. IR method was analysed using homeostasis assessment model (HOMA-IR).
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Effect of three weeks of continuous positive airway pressure treatment on mood in patients with obstructive sleep apnoea: A rand
Lee IS, Bardwell W, Ancoli-Israel S, Loredo JS, Dimsdale JE.
Department of Psychiatry, University of California, San Diego, CA, USA.
Sleep Med. 2011 Dec 13.
BACKGROUND:
Patients with obstructive sleep apnoea (OSA) commonly have mood symptoms such as depression and anxiety. However, the results of randomized controlled trials on the therapeutic effect of CPAP on mood symptoms have been inconsistent. The present study examined whether three weeks of CPAP treatment had specific therapeutic effects on mood symptoms in patients with OSA compared with placebo.
METHODS:
A double-blind, parallel, randomized controlled trial using therapeutic and placebo CPAP was performed in 71 patients newly diagnosed with OSA (apnoea-hypopnoea index [AHI]⩾10). Mood was assessed by the Center for Epidemiologic Studies-Depression (CES-D) Scale, the Profile of Mood States (POMS), and the Brief Symptom Inventory (BSI) before and after three weeks of treatment. AHI was used to assess the severity of apnoea. The two groups were compared using a simple comparison of the changes within each arm and repeated measures analysis of variance.
RESULTS:
Fifty-six subjects completed the study: 26 in the CPAP group and 30 in the placebo group. The two groups were well matched at baseline, with no significant differences in demographic, mood and apnoea variables. Both groups had severe apnoea, mild depression, and anxiety at baseline. After three weeks of treatment, AHI decreased significantly in the CPAP group. The mean change in AHI was -30.7 (standard deviation [SD] 23.1) in the CPAP group and -5.8 (SD 18.3) in the placebo group (difference between groups P<0.001). However, after three weeks of treatment, there were no significant time by treatment effects in relation to mood, as assessed by the CES-D, POMS Depression, POMS Tension, BSI Depression, or BSI Anxiety (all P>0.05).
CONCLUSION:
In conclusion, three weeks of CPAP treatment did not show a specific therapeutic effect on mood symptoms in patients with OSA.Published by Elsevier B.V.
Lee IS, Bardwell W, Ancoli-Israel S, Loredo JS, Dimsdale JE.
Department of Psychiatry, University of California, San Diego, CA, USA.
Sleep Med. 2011 Dec 13.
BACKGROUND:
Patients with obstructive sleep apnoea (OSA) commonly have mood symptoms such as depression and anxiety. However, the results of randomized controlled trials on the therapeutic effect of CPAP on mood symptoms have been inconsistent. The present study examined whether three weeks of CPAP treatment had specific therapeutic effects on mood symptoms in patients with OSA compared with placebo.
METHODS:
A double-blind, parallel, randomized controlled trial using therapeutic and placebo CPAP was performed in 71 patients newly diagnosed with OSA (apnoea-hypopnoea index [AHI]⩾10). -
Predicting changes in sleep complaints from baseline values and changes in work demands, work control, and work preoccupation -
Kerstedt T, Nordin M, Alfredsson L, Westerholm P, Kecklund G.
Stress Research Institute, Stockholm University, Stockholm, Sweden; Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
Sleep Med. 2012 Jan;13(1):73-80. Epub 2011 Dec 15.
STUDY OBJECTIVE:
Stress as a cause of disturbed sleep is often taken for granted, but the longitudinal evidence is limited. The aim of this study was to evaluate new cases of poor sleep as a function of changes in reported work demands, work control, and work preoccupation.
METHODS:
Longitudinal study of change with measures occurring twice within a 5-year interval during a period when the prevalence of impaired sleep was increasing in Sweden. The sample of companies was taken from northern Sweden (Norrland) and included 3637 individuals from the "WOLF Norrland" longitudinal cohort, collected through company health services.
MEASUREMENT AND RESULTS:
During the measurement period, 16% of those studied developed new cases of impaired sleep. Logistic regressions adjusted for demographics, work environment factors, and disturbed sleep at T1 period one showed a significant increase in new cases for high work demands and high work preoccupation (OR=1.37; Ci=1.09-1.72 and OR=1.80; CI=1.42-2.28, respectively). The analysis of change in the predictors showed effects of a change from low to high work demands (OR=1.39; Ci=1.00-1.95) on new cases of impaired sleep. Consistent high work demands (high at both points) showed a similar increase (OR=1.49; Ci=1.06-2.11) but no effect was seen for reduced demands. Change in work preoccupation yielded stronger effects with OR=2.47 (1.78-2.47) for increased work preoccupation and OR=3.79 (2.70-5.31) for consistent high work preoccupation. Also, a reduction in work preoccupation was associated with a reduction in new cases of disturbed sleep. Control at work was not related to sleep. Stratification with respect to gender mainly led to fewer significant results (particularly for women) due to larger confidence intervals.
CONCLUSIONS:
It was concluded that self-reported work preoccupation predicts subsequent impairment of sleep and that increased preoccupation is associated with new cases of impaired sleep. Similar, but weaker, results were obtained for work demands.Copyright © 2011 Elsevier B.V. All rights reserved.
Kerstedt T, Nordin M, Alfredsson L, Westerholm P, Kecklund G.
Stress Research Institute, Stockholm University, Stockholm, Sweden; Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
Sleep Med. 2012 Jan;13(1):73-80. Epub 2011 Dec 15.
STUDY OBJECTIVE:
Stress as a cause of disturbed sleep is often taken for granted, but the longitudinal evidence is limited. The aim of this study was to evaluate new cases of poor sleep as a function of changes in reported work demands, work control, and work preoccupation.
METHODS:
Longitudinal study of change with measures occurring twice within a 5-year interval during a period when the prevalence of impaired sleep was increasing in Sweden. The sample of companies was taken from northern Sweden (Norrland) and included 3637 individuals from the "WOLF Norrland" longitudinal cohort, collected through company health services. -
Insomnia symptoms as a predictor of incident treatment for depression: Prospective cohort study of 40,791 men and women.
Salo P, Sivertsen B, Oksanen T, Sjösten N, Pentti J, Virtanen M, Kivimäki M, Vahtera J.
Centre of Expertise for Work Organizations, Finnish Institute of Occupational Health, Lemminkäisenkatu 14-18 B, FI-20520 Turku, Finland.
Sleep Med. 2011 Dec 14.
OBJECTIVE:
To examine the quantity and quality of insomnia symptoms as predictors of treatment for depression in the largest cohort study to date.
METHODS:
Forty thousand seven hundred and ninety-one Finnish public sector employees (mean age 43.9years, 81% female), free of depression at baseline, participated in this prospective observational cohort study. Participants responded to the survey in 2000-2002 or 2004 and the mean follow-up was 3.3years. Self-reported sleep was linked to comprehensive individual-level health registers to assess treatment for depression (antidepressant medication, commencements of psychotherapy or hospitalization due to depression).
RESULTS:
One thousand seven hundred and three participants fulfilled any of our set criteria for depression-related treatment. After adjustments for baseline characteristics, insomnia symptoms five to seven nights/week were associated with an increased risk of incident treatment for depression, hazard ratio 1.64 (95% confidence interval 1.44-1.86). Hazard ratio for symptoms two to four nights/week was 1.46 (1.29-1.64). Difficulties initiating or maintaining sleep and non-refreshing sleep increased the risk when analyzed separately. Those reporting all four symptoms at least twice a week had 2.09-fold (1.75-2.49) risk. The findings did not materially change after excluding depression cases within the first two years of the follow-up.
CONCLUSIONS:
These data suggest an association between insomnia symptoms and moderately increased risk of clinically significant depression outcomes. Insomnia should be considered as a component in prediction models for new-onset depression.Copyright © 2011 Elsevier B.V. All rights reserved.
Salo P, Sivertsen B, Oksanen T, Sjösten N, Pentti J, Virtanen M, Kivimäki M, Vahtera J.
Centre of Expertise for Work Organizations, Finnish Institute of Occupational Health, Lemminkäisenkatu 14-18 B, FI-20520 Turku, Finland.
Sleep Med. 2011 Dec 14.
OBJECTIVE:
To examine the quantity and quality of insomnia symptoms as predictors of treatment for depression in the largest cohort study to date.
METHODS:
Forty thousand seven hundred and ninety-one Finnish public sector employees (mean age 43.9years, 81% female), free of depression at baseline, participated in this prospective observational cohort study. Participants responded to the survey in 2000-2002 or 2004 and the mean follow-up was 3.3years. Self-reported sleep was linked to comprehensive individual-level health registers to assess treatment for depression (antidepressant medication, commencements of psychotherapy or hospitalization due to depression). -
Effects of acute and chronic sleep deprivation on daytime alertness and cognitive performance of healthy snorers and non-snorers
Tassi P, Schimchowitsch S, Rohmer O, Elbaz M, Bonnefond A, Sagaspe P, Taillard J, Léger D, Philip P.
Laboratoire de Psychologie des Cognitions, Université de Strasbourg, France.
Sleep Med. 2012 Jan;13(1):29-35. Epub 2011 Dec 15.
BACKGROUND:
Respiratory events during sleep usually lead to micro arousals resulting in consecutive daytime sleepiness even in healthy snorers. The present study investigated the evolution of subjective and objective daytime sleepiness and reaction time in healthy snorers submitted to acute and chronic sleep deprivation.
METHODS:
Objective sleepiness was measured by the MSLT, subjective sleepiness by the Karolinska Sleepiness Scale (KSS), and reaction time (RT) by the Psychomotor Vigilance Test. Mean sleep latencies, KSS scores and performance were analyzed through repeated measures ANOVAs with one between-factor (snorers and non-snorers) and two within-factors (sleep deprivation [baseline, acute, and chronic sleep deprivation] and time-of-day).
RESULTS:
The findings reveal that sleep deprivation does not enhance snoring but that, during baseline, objective daytime sleepiness is higher in snorers than in non-snorers (shorter sleep latencies) with no difference in subjective assessments. The effects of acute and chronic sleep deprivation on sleep are similar in both groups, but, after acute sleep deprivation, RT and attentional lapses (RT >500ms) are higher in snorers. Chronic sleep deprivation produces similar results in both groups.
CONCLUSION:
These results suggest that respiratory efforts may be involved in the increased vulnerability to sleep deprivation of healthy snorers when compared to non-snorers.Copyright © 2011 Elsevier B.V. All rights reserved.
Tassi P, Schimchowitsch S, Rohmer O, Elbaz M, Bonnefond A, Sagaspe P, Taillard J, Léger D, Philip P.
Laboratoire de Psychologie des Cognitions, Université de Strasbourg, France.
Sleep Med. 2012 Jan;13(1):29-35. Epub 2011 Dec 15.
BACKGROUND:
Respiratory events during sleep usually lead to micro arousals resulting in consecutive daytime sleepiness even in healthy snorers. The present study investigated the evolution of subjective and objective daytime sleepiness and reaction time in healthy snorers submitted to acute and chronic sleep deprivation.
METHODS:
Objective sleepiness was measured by the MSLT, subjective sleepiness by the Karolinska Sleepiness Scale (KSS), and reaction time (RT) by the Psychomotor Vigilance Test. -
Pain-related Insomnia Versus Primary Insomnia: A Comparison Study of Sleep Pattern, Psychological Characteristics, and Cognitive
Tang NK, Goodchild CE, Hester J, Salkovskis PM.
*Arthritis Research UK Primary Care Centre, Primary Care Sciences, Keele University, Staffordshire †Department of Psychology, Institute of Psychiatry, King's College London ‡Pain Relief Unit, King's College Hospital, London §Department of Psychology, University of Bath, Bath, UK.
Clin J Pain. 2011 Dec 15.
BACKGROUND:
Recent applications of cognitive-behavior therapy for primary insomnia in the management of pain-related insomnia are based on the implicit assumption that the 2 types of insomnia share the same presentation and maintaining mechanisms. The objectives of this study were to compare the characteristics of patients who have pain-related insomnia with those reporting primary insomnia and to identify psychological factors that predict pain-related insomnia.
METHODS:
Chronic pain patients with concomitant insomnia (n=137; Pain-related Insomnia Group) completed a selection of questionnaires that measure sleep patterns, psychological attributes, and cognitive-behavioral processes associated with the persistence of insomnia. Their responses were compared with those of primary insomnia patients (n=33; Primary Insomnia Group), using 3 sets of multivariate analyses of covariance that took account of demographic differences. Hierarchical regression analyses were performed to identify predictors of insomnia severity among the chronic pain patients.
RESULTS:
The Pain-related Insomnia Group did not differ from the Primary Insomnia Group in their pattern and severity of sleep disturbance. The 2 groups were largely comparable in terms of their psychological characteristics, except that the Primary Insomnia Group was distinguishable from the Pain-related Insomnia Group by their greater tendency to worry. Patients in the Pain-related Insomnia Group reported levels of sleep-related anxiety and presleep somatic arousal that matched with those reported by patients in the Primary Insomnia Group. However, relative to patients in the Pain-related Insomnia Group, those in the Primary Insomnia Group reported more dysfunctional sleep beliefs and presleep cognitive arousal. In addition to pain intensity, depression, and presleep cognitive arousal were significant predictors of insomnia severity within the Pain-related Insomnia Group.
CONCLUSIONS:
There are more similarities than differences between the 2 types of insomnia. Besides pain, mood, and presleep, thought processes also seem to have a role in the manifestation of pain-related insomnia. It is suggested that hybrid treatments that seek to simultaneously address factors across these domains may represent more effective treatments than 1-dimensional interventions.
Tang NK, Goodchild CE, Hester J, Salkovskis PM.
*Arthritis Research UK Primary Care Centre, Primary Care Sciences, Keele University, Staffordshire †Department of Psychology, Institute of Psychiatry, King's College London ‡Pain Relief Unit, King's College Hospital, London §Department of Psychology, University of Bath, Bath, UK.
Clin J Pain. 2011 Dec 15.
BACKGROUND:
Recent applications of cognitive-behavior therapy for primary insomnia in the management of pain-related insomnia are based on the implicit assumption that the 2 types of insomnia share the same presentation and maintaining mechanisms. The objectives of this study were to compare the characteristics of patients who have pain-related insomnia with those reporting primary insomnia and to identify psychological factors that predict pain-related insomnia. -
Narcolepsy and sleep-disordered breathing.
Pataka AD, Frangulyan RR, Mackay TW, Douglas NJ, Riha RL.
Respiratory Failure Unit, G. Papanikolaou Hospital, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece Department of Sleep Medicine, Royal Infirmary of Edinburgh, Edinburgh, UK.
Eur J Neurol. 2011 Dec 19. doi: 10.1111/j.1468-1331.2011.03610.x.
Background and purpose: There is a high incidence of sleep-disordered breathing (SDB) in narcoleptic patients. Some narcoleptics with SDB may benefit from treatment with continuous positive airway pressure therapy (CPAP). The aim of this study was to examine the prevalence of SDB in narcoleptics referred to a tertiary sleep disorders clinic and assess the effectiveness of CPAP as adjunctive therapy. Methods: A retrospective review of patients meeting ICSD-2 criteria for the diagnosis of narcolepsy from 2000 to 2009. Results: One hundred and two patients (61 women) with narcolepsy were included in the study. Twenty-nine (29) patients (eight women, 21 men) were diagnosed with obstructive sleep apnoea-hypopnoea syndrome (OSAHS) of whom 26 commenced CPAP therapy with 11 patients concurrently treated with stimulants. Patients with narcolepsy and OSAHS were older (P = 0.009) and heavier (BMI, 29.6 ± 4.8 vs. 27.3 ± 6, P = 0.042), but their ESS did not differ from patients with narcolepsy alone. Patients treated with both CPAP and stimulants were younger (P = 0.008) and less obese (BMI, 29.1 ± 4.6 vs. 30.4 ± 5.4, P = 0.044) with higher apnoea-hypopnoea index (36.15 ± 21.9 vs. 31.5 ± 16.7, P = 0.03) than those treated with CPAP alone. The ESS of CPAP-treated patients improved during follow-up (19 ± 3.6 vs. 15.8 ± 4.5, P = 0.006), but BMI increased (30.6 ± 5 vs. 31.7 ± 5.6, P = 0.05). The use of stimulants did not seem to improve on the effectiveness of CPAP. Conclusion: Coexisting SDB is common in narcoleptics (28.5%). CPAP therapy in narcoleptics with OSAHS remains a useful second-line adjunct to standard therapy.
© 2011 The Author(s). European Journal of Neurology © 2011 EFNS.
Pataka AD, Frangulyan RR, Mackay TW, Douglas NJ, Riha RL.
Respiratory Failure Unit, G. Papanikolaou Hospital, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece Department of Sleep Medicine, Royal Infirmary of Edinburgh, Edinburgh, UK.
Eur J Neurol. 2011 Dec 19. doi: 10.1111/j.1468-1331.2011.03610.x.
Background and purpose: There is a high incidence of sleep-disordered breathing (SDB) in narcoleptic patients. Some narcoleptics with SDB may benefit from treatment with continuous positive airway pressure therapy (CPAP). The aim of this study was to examine the prevalence of SDB in narcoleptics referred to a tertiary sleep disorders clinic and assess the effectiveness of CPAP as adjunctive therapy. Methods: A retrospective review of patients meeting ICSD-2 criteria for the diagnosis of narcolepsy from 2000 to 2009.
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Sleep disorders, health, and safety in police officers.
Rajaratnam SM, Barger LK, Lockley SW, Shea SA, Wang W, Landrigan CP, O'Brien CS, Qadri S, Sullivan JP, Cade BE, Epstein LJ, White DP, Czeisler CA; Harvard Work Hours, Health and Safety Group.
Division of Sleep Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA.
JAMA. 2011 Dec 21;306(23):2567-78.
CONTEXT:
Sleep disorders often remain undiagnosed. Untreated sleep disorders among police officers may adversely affect their health and safety and pose a risk to the public.
OBJECTIVE:
To quantify associations between sleep disorder risk and self-reported health, safety, and performance outcomes in police officers.
DESIGN, SETTING, AND PARTICIPANTS:
Cross-sectional and prospective cohort study of North American police officers participating in either an online or an on-site screening (n=4957) and monthly follow-up surveys (n=3545 officers representing 15,735 person-months) between July 2005 and December 2007. A total of 3693 officers in the United States and Canada participated in the online screening survey, and 1264 officers from a municipal police department and a state police department participated in the on-site survey.
MAIN OUTCOME MEASURES:
Comorbid health conditions (cross-sectional); performance and safety outcomes (prospective).
RESULTS:
Of the 4957 participants, 40.4% screened positive for at least 1 sleep disorder, most of whom had not been diagnosed previously. Of the total cohort, 1666 (33.6%) screened positive for obstructive sleep apnea, 281 (6.5%) for moderate to severe insomnia, 269 (5.4%) for shift work disorder (14.5% of those who worked the night shift). Of the 4608 participants who completed the sleepiness scale, 1312 (28.5%) reported excessive sleepiness. Of the total cohort, 1294 (26.1%) reported falling asleep while driving at least 1 time a month. Respondents who screened positive for obstructive sleep apnea or any sleep disorder had an increased prevalence of reported physical and mental health conditions, including diabetes, depression, and cardiovascular disease. An analysis of up to 2 years of monthly follow-up surveys showed that those respondents who screened positive for a sleep disorder vs those who did not had a higher rate of reporting that they had made a serious administrative error (17.9% vs 12.7%; adjusted odds ratio [OR], 1.43 [95% CI, 1.23-1.67]); of falling asleep while driving (14.4% vs 9.2%; adjusted OR, 1.51 [95% CI, 1.20-1.90]); of making an error or safety violation attributed to fatigue (23.7% vs 15.5%; adjusted OR, 1.63 [95% CI, 1.43-1.85]); and of exhibiting other adverse work-related outcomes including uncontrolled anger toward suspects (34.1% vs 28.5%; adjusted OR, 1.25 [95% CI, 1.09-1.43]), absenteeism (26.0% vs 20.9%; adjusted OR, 1.23 [95% CI, 1.08-1.40]), and falling asleep during meetings (14.1% vs 7.0%; adjusted OR, 1.95 [95% CI, 1.52-2.52]).
CONCLUSION:
Among a group of North American police officers, sleep disorders were common and were significantly associated with increased risk of self-reported adverse health, performance, and safety outcomes.
Rajaratnam SM, Barger LK, Lockley SW, Shea SA, Wang W, Landrigan CP, O'Brien CS, Qadri S, Sullivan JP, Cade BE, Epstein LJ, White DP, Czeisler CA; Harvard Work Hours, Health and Safety Group.
Division of Sleep Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA.
JAMA. 2011 Dec 21;306(23):2567-78.
CONTEXT:
Sleep disorders often remain undiagnosed. Untreated sleep disorders among police officers may adversely affect their health and safety and pose a risk to the public.
OBJECTIVE:
To quantify associations between sleep disorder risk and self-reported health, safety, and performance outcomes in police officers. -
Randomized Controlled Trial on The Effects of A Combined Sleep Hygiene Education and Behavioral Approach Program on Sleep Qualit
Kaku A, Nishinoue N, Takano T, Eto R, Kato N, Ono Y, Tanaka K.
Department of Occupational Mental Health, Graduate School of Medical Sciences, Kitasato University.
Ind Health. 2011 Dec 15.
To evaluate the effects of a combined sleep hygiene education and behavioral approach program on sleep quality in workers with insomnia, we conducted a randomized controlled trial at a design engineering unit in Japan. Employees evaluated for insomnia by the Athens Insomnia Scale (≥6 points) were divided into an intervention and control group. The intervention group received a short-term intervention (30 min) program that included sleep hygiene education and behavioral approaches (relaxation training, stimulus control, and sleep restriction) performed by occupational health professionals. We calculated differences in change in Pittsburgh Sleep Quality Index (PSQI) scores between the two groups from baseline to three months after the start of intervention after adjusting for gender, age, job title, job category, average number of hours of overtime during the study period, marital status, smoking habit, average number of days of alcohol consumption per week, exercise habits, K6 score, and baseline PSQI score. Results showed that the average PSQI score decreased by 1.0 in the intervention group but increased by 0.9 in the control group. Additionally, the difference in variation between the two groups was 1.9 (95% confidence interval: 0.6 to 3.4), which was significant. Taken together, these results indicate that the intervention program significantly improved the sleep quality of workers with insomnia.
Kaku A, Nishinoue N, Takano T, Eto R, Kato N, Ono Y, Tanaka K.
Department of Occupational Mental Health, Graduate School of Medical Sciences, Kitasato University.
Ind Health. 2011 Dec 15.
To evaluate the effects of a combined sleep hygiene education and behavioral approach program on sleep quality in workers with insomnia, we conducted a randomized controlled trial at a design engineering unit in Japan. Employees evaluated for insomnia by the Athens Insomnia Scale (≥6 points) were divided into an intervention and control group. The intervention group received a short-term intervention (30 min) program that included sleep hygiene education and behavioral approaches (relaxation training, stimulus control, and sleep restriction) performed by occupational health professionals.
