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nicated management was non-inferior to physician-led management, in terms of sleepiness, quality of life, as well as PAP adherence at 6 months.
Whether the association between sleep-disordered breathing (SDB) and cardiovascular disease (CVD) is independent of comorbid risk factors for CVD is controversial. The objective of this study is to elucidate whether the association between SDB severity and the surrogate markers of CVD evets differs in relation to the number of comorbidities.

This cross-sectional study included 7731 participants. Severity of SDB was determined by the oxygen desaturation index adjusted by actigraph-measured objective sleep time. Participants were stratified according to SDB severity and the number of comorbidities (hypertension, diabetes, dyslipidemia and obesity), and the associations between the maximum value of intima-media thickness of the common carotid artery (CCA-IMT-max), brachial-ankle pulse wave velocity (baPWV) and cardio-ankle vascular index (CAVI) were evaluated.

Among participants with no risk factor, CCA-IMT-max increased according to SDB severity (n = 1022,
<0.0001). Even after the matching of background, the median CCA-IMT-max value was 14% higher in moderate-severe SDB cases than those without SDB (n=45 in each group,
=0.020). The difference was not significant for baPWV and CAVI. On the other hand, a significant difference in CCA-IMT-max was not found in those with multiple comorbidities. Consistently, multiple regression analysis revealed an independent association between CCA-IMT-max and moderate-severe SDB for all study participants (β 0.0222 (95% confidence interval 0.0039-0.0405),
=0.017), but the association was not significant for stratified participants with multiple comorbidities.

SDB severity is associated with the CCA-IMT-max level, but the independent association becomes weaker for those with multiple comorbidities.
SDB severity is associated with the CCA-IMT-max level, but the independent association becomes weaker for those with multiple comorbidities.
To investigate the association of hot flashes and insomnia in pre- and postmenopausal women.

The study was performed using data from the Sao Paulo Epidemiological Sleep Study (EPISONO). Premenopausal women were classified as with regular menstrual cycles, anovulatory or hormonal contraceptive users. Menopausal women were classified as in perimenopause, early postmenopause or late postmenopause. Women reporting frequent insomnia symptoms and relevant daytime complaints were classified as having insomnia disorder. PSG alterations suggestive of insomnia were also identified.

The frequency of hot flashes was 42% among postmenopausal (mainly early postmenopause) and 9% among premenopausal women (mainly anovulatory - p<0.01). About 18.7% had insomnia disorder, 48% had isolated insomnia symptoms and 32.4% had PSG alterations. Comparing menopausal with premenopausal women, the diagnosis of insomnia was similar (premenopausal 18.9% vs. menopausal 17.5%), but menopausal women had more frequent isolated insomniep; hot flashes; insomnia; premenopause; postmenopause; polysomnography.
Obstructive sleep apnea (OSA) and short sleep duration have been separately associated with inadequate serum 25-hydroxyvitamin D (25OHD) levels. However, whether these 2 factors may concurrently influence 25OHD in the general population is unknown. We hypothesized that both OSA and short sleep duration would be independently associated with lower concentrations of 25OHD in a gender-dependent manner.

In this cross-sectional study, 712 individuals, part of the prospective EPISONO cohort (Brazil), underwent polysomnography, answered sleep questionnaires, and had their blood collected for serum 25OHD quantification.

Individuals with a sleep duration of <6 hours had 2-fold increased odds of 25OHD<20 ng/mL compared to those who reported 6 or more hours of sleep, even after adjusting for confounding factors. Subset gender analysis revealed that men with a sleep duration of <6 hours had 4-fold increased odds of 25OHD<20 ng/mL. In women, short sleep duration was not associated with lower 25OHD levelssifying them in mild, moderate, and severe OSA.
Because air leakage from masks is known as a common cause of low adherence to continuous positive airway pressure (CPAP) therapy, we analyzed the risk factors for air leakage related to parameters associated with auto-titrating positive airway pressure (APAP), polysomnography (PSG), InBody Test, and rhinomanometry.

Usage data and medical records of 120 APAP users were reviewed retrospectively. All patients used a nasal or pillow mask and were carefully monitored at scheduled follow-ups.

Use of a pillow mask, sex (male), age, and abdominal fat percentage were significantly associated with high average air leakage. The higher the APAP average and mean pressure, the more likely patients exhibited high rates of air leakage. The percentage of patients with high average air leakage increased over time (up to 6 months of follow-up).

Older male patients using a pillow mask and those with a high abdominal fat percentage and high APAP pressure may require close follow-up and continuous monitoring for air leakage. Because air leakage from a mask can change over time, mask-sealing capacity should be reassessed and masks should be changed regularly.
Older male patients using a pillow mask and those with a high abdominal fat percentage and high APAP pressure may require close follow-up and continuous monitoring for air leakage. Because air leakage from a mask can change over time, mask-sealing capacity should be reassessed and masks should be changed regularly.
This study aimed to prospectively identify the correlation between obstructive sleep apnea (OSA) severity, ocular microcirculation changes, and visual function changes in patients with glaucoma.

We prospectively enrolled patients with glaucoma who were willing to undergo overnight polysomnography (PSG). The enrolled patients were further divided into normal tension glaucoma (NTG),high-tension glaucoma (HTG), and control. Visual field (VF) progression was analyzed using sequential standard automated perimetry. Peripapillary and macular vessel density (VD) were assessed through optical coherence tomography angiography (OCT-Angiography). The associations between PSG parameters, OCT-Angiography parameters, and VF progression were analyzed.

A total of 22 patients with NTG, 30 patients with HTG, and 24 control patients were enrolled. Through regression analysis, glaucoma was found to be an independent predictor of moderate-to-severe OSA (
= .035); furthermore, moderate-to-severe OSA was significantly associated with VF progression (
=.008 in the HTG subgroup, and
= .008 in the overall glaucoma). Additionally, OSA severity was negatively correlated with the ganglion cell complex thinning rate in the NTG subgroup.

Presence of glaucoma increased the risk of moderate-to-severe OSA compare with the control group. OSA severity was related to VF deterioration in patients with glaucoma and further associated with structural progression in the NTG subgroup. Careful monitoring of the comorbid OSA status of patients with glaucoma is essential to prevent disease progression.
Presence of glaucoma increased the risk of moderate-to-severe OSA compare with the control group. OSA severity was related to VF deterioration in patients with glaucoma and further associated with structural progression in the NTG subgroup. Careful monitoring of the comorbid OSA status of patients with glaucoma is essential to prevent disease progression.
Obstructive sleep apnea (OSA) is more prevalent and severe in men than women. The American Academy of Sleep Medicine (AASM) offers 2 definitions for scoring hypopneas "acceptable" = associated with a >4% oxygen desaturation, adopted by Center for Medicare and Medicaid Services (CMS), and "recommended" = associated with a >3% oxygen desaturation and / or an arousal. We hypothesized that CMS versus AASM scoring criteria would differentially impact continuous positive airway pressure (CPAP) eligibility in women and men.

We conducted a retrospective review of adult diagnostic in-lab polysomnography (PSG) at an urban academic institution. All PSGs were scored by both CMS and AASM scoring criteria, and an analysis by sex was performed that took into account demographics and other PSG variables.

Of 969 PSGs reviewed, 674 (69.6%) were in women. Women were younger (51.5 vs. 53.3 y/o) and had a higher body mass index (BMI 38.6 kg/m
vs. 33.8 kg/m
) but had similar Epworth Sleepiness Scale scores when compared to men. The odds of an AASM AHI > 5 being missed by CMS scoring in women was 1.89 (95% CI 1.40-2.53; p<0.001) compared to men and increased to 6.87 among women 40-60 years of age with a BMI≥40 kg/m
. After controlling for age, BMI, % REM sleep and mean oxygen saturation, the sex effect remained significant (OR 1.87; 95% CI 1.36-2.58; p<0.001).

CMS scoring criteria imparts a sex bias towards women potentially resulting in denial of therapy to symptomatic women with OSA. selleck chemical Larger, prospective cohort studies are needed to confirm these findings.
CMS scoring criteria imparts a sex bias towards women potentially resulting in denial of therapy to symptomatic women with OSA. Larger, prospective cohort studies are needed to confirm these findings.
Children with Down syndrome (DS) are at risk of obstructive sleep apnea (OSA), but the access to sleep lab polysomnography (PSG) is limited. Simplified techniques are needed, such as polygraphy coupled with pulse transit time (PTT-PG) that detects respiratory events and total autonomic arousals index (PTTAI). Our objective was to assess the ability of PTT-PG compared to PSG to diagnose OSA in children with DS.

In this prospective multicenter study, patients with DS underwent a full-night PSG coupled with PTT. Sleep questionnaires (Sleep Disturbance Scale for Children [SDSC] and Pediatric Sleep Questionnaire [PSQ]) were filled by parents. PSG and PTT-PG results were compared to test their sensibility and specificity to diagnose OSA.

A total of 53 DS patients were included, their median age was 9.3 years. An obstructive apnea-hypopnea index (OAHI) by PSG >1 event/h was found in 36 (68%) patients, OAHI was > 1 and < 5 events/h in 18 (34%), ≥ 5 and < 10 events/h in 11 (21%), and ≥10 events/h in 7 (13%). OAHI was larger in PSG than in PTT-PG (
). For OSA diagnosis, the sensitivity was excellent for OAHI by PTT-PG if added total PTTAI was > 1 event/h (1.0) and the specificity was high for PSQ (0.88) and OAHI > 1 event/h in PTT-PG (1.0).

More than two-thirds of children with DS referred for screening by genetic specialist had OSA diagnosed by PSG. With its excellent sensitivity and specificity, PTT-PG could be a good and simplified alternative to PSG to diagnose OSA in children with DS.
More than two-thirds of children with DS referred for screening by genetic specialist had OSA diagnosed by PSG. With its excellent sensitivity and specificity, PTT-PG could be a good and simplified alternative to PSG to diagnose OSA in children with DS.
Subjective insomnia complaints and objective sleep changes are mostly studied outside of clinical trial studies. In this study, we tested whether 240 genetic variants associated with subjectively reported insomnia were also associated with objective insomnia parameters extracted from polysomnographic recordings (PSG) in three studies.

The study sample (total N = 2,770) was composed of the Wisconsin Sleep Cohort (N = 1,091) and the Osteoporotic Fractures in Men (N = 1,026) study, two population-based studies, and the Stanford Sleep Cohort, a sleep center patient-based sample (N = 653). Seven objective PSG features related to insomnia defined outcome variables, with each variant allele serving as predictor. Meta-regression was performed, accounting for common confounders as well as variance differences between studies. Additionally, a normalized genetic risk score (nGRS) was generated for each subject to serve as a predictor variable in separate linear mixed models assessing objective insomnia features.

After correction for multiple testing, single nucleotide polymorphisms (SNPs) associated with subjective insomnia were not significantly associated with 6 of 7 objective sleep measures.
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