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Subjective Sleepiness (subjective + sleepiness)
Selected AbstractsSleep-disordered breathing in a general heart failure population: relationships to neurohumoral activation and subjective symptomsJOURNAL OF SLEEP RESEARCH, Issue 1 2006ARCHANA RAO Summary The aim of this study was to determine the prevalence of sleep-related breathing disorders (SDB) in a UK general heart failure (HF) population, and assess its impact on neurohumoral markers and symptoms of sleepiness and quality of life. Eighty-four ambulatory patients (72 male, mean (SD) age 68.6 (10) yrs) attending UK HF clinics underwent an overnight recording of respiratory impedance, SaO2 and heart rate using a portable monitor (Nexan). Brain natriuretic peptide (BNP) and urinary catecholamines were measured. Subjective sleepiness and the impairment in quality of life were assessed (Epworth Sleepiness Scale (ESS), SF-36 Health Performance Score). SDB was classified using the Apnoea/Hypopnoea Index (AHI). The prevalence of SDB (AHI > 15 events h,1) was 24%, increasing from 15% in mild-to-moderate HF to 39% in severe HF. Patients with SDB had significantly higher levels of BNP and noradrenaline than those without SDB (mean (SD) BNP: 187 (119) versus 73 (98) pg mL,1, P = 0.02; noradrenaline: 309 (183) versus 225 (148) nmol/24 h, P = 0.05). There was no significant difference in reported sleepiness or in any domain of SF-36, between groups with and without SDB (ESS: 7.8 (4.7) versus 7.5 (3.6), P = 0.87). In summary, in a general HF clinic population, the prevalence of SDB increased with the severity of HF. Patients with SDB had higher activation of a neurohumoral marker and more severe HF. Unlike obstructive sleep apnoea, SDB in HF had little discernible effect on sleepiness or quality of life as measured by standard subjective scales. [source] Dissociation between objective psychomotor impairment and subjective sleepiness after diazepam administration in the aged peopleHUMAN PSYCHOPHARMACOLOGY: CLINICAL AND EXPERIMENTAL, Issue 6 2007Masaru Echizenya Abstract The aim of the present study was to clarify whether subjective sleepiness accurately reflects benzodiazepine-related decline in psychomotor function after taking benzodiazepines (BZPs) in aged people. Subjects were eight healthy, young (mean age, 19.8,years) and seven healthy, older (mean age, 60.9,years) men. Placebo and diazepam (DZP) were administered orally in a single-blind crossover manner to the young subjects (placebo, 5,mg DZP and 10,mg DZP) and to the older subjects (placebo and 5,mg DZP). Plasma drug concentration, choice reaction time (CRT) as an objective measure of psychomotor function, and the Stanford Sleepiness Scale (SSS) as a measure of subjective sleepiness were monitored every 20,min from 1000 until 1600,h, being the drug administered at 1200,h. Pharmacokinetic variables did not differ significantly between the two age groups. DZP at 10,mg in young subjects induced significant increases in both the CRT and SSS score. DZP at 5,mg induced no significant increase in SSS score in either age group but did induce a significant increase in CRT only in the older subjects that matched that in young subjects given 10,mg DZP. The older subjects suffered from dissociation between subjective sleepiness and objective psychomotor impairment under DZP treatment. Such individuals may underestimate the detrimental effects on brain function. Copyright © 2007 John Wiley & Sons, Ltd. [source] Does nasal decongestion improve obstructive sleep apnea?JOURNAL OF SLEEP RESEARCH, Issue 4 2008CHRISTIAN F. CLARENBACH Summary Whether nasal congestion promotes obstructive sleep apnea is controversial. Therefore, we performed a randomized placebo-controlled cross-over trial on the effects of topical nasal decongestion in patients with obstructive sleep apnea syndrome (OSA) and nasal congestion. Twelve OSA patients with chronic nasal congestion (mean ± SD age 49.1 ± 11.1 years, apnea/hypopnea index 32.6 ± 24.5/h) were treated with nasal xylometazoline or placebo for 1 week each. At the end of treatment periods, polysomnography including monitoring of nasal conductance by an unobtrusive technique, vigilance by the OSLER test, and symptom scores were assessed. Data from xylometazoline and placebo treatments were compared. Mean nocturnal nasal conductance on xylometazoline was significantly higher than on placebo (8.6 ± 5.3 versus 6.3 ± 5.8 mL s,1Pa,1, P < 0.05) but the apnea/hypopnea index was similar (29.3 ± 32.5/h versus 33.2 ± 32.8/h, P = NS). However, 30,210 min after application of xylometazoline, at the time of the maximal pharmacologic effect, the apnea/hypopnea index was slightly reduced (27.3 ± 30.5/h versus 33.2 ± 33.9/h, P < 0.05). Xylometazoline did not alter sleep quality, sleep resistance time (33.6 ± 8.8 versus 33.4 ± 10.1 min, P = NS) and subjective sleepiness (Epworth score 10.5 ± 3.8 versus 11.8 ± 4.4, P = NS). The reduced apnea/hypopnea index during maximal nasal decongestion by xylometazoline suggests a pathophysiologic link but the efficacy of nasal decongestion was not sufficient to provide a clinically substantial improvement of OSA. ClinicalTrials.gov Identifier is NTC006030474. [source] Yawning and subjective sleepiness in the elderlyJOURNAL OF SLEEP RESEARCH, Issue 3 2008IOLE ZILLI Summary Yawning is related to sleep/wake transitions and time of day, probably reflecting the time course of sleepiness. As aging modifies sleep,wake and sleepiness rhythms, we suppose that yawning frequency and its time course vary as a function of age. Thirteen aged healthy subjects (77.15 ± 4.09 years) and 12 young adults (24.41 ± 3.31 years) were instructed to keep their habitual sleep schedules for three consecutive work-days, during which they were required to signal every yawning occurrence and to evaluate hourly their sleepiness level. Results showed that aged subjects yawn less frequently than young adults, particularly during morning and mid-afternoon hours. The time course of yawning was different between the two age groups: aged subjects showed earlier morning peak and evening rise compared with young adults; in addition, aged subjects showed two minor peaks in-between. Differences as a function of age in the time course of yawning were associated with differences in the time course of sleepiness. The only exception pertained to the early morning yawning peak, which was close to the awakening but it was not associated with high sleepiness in aged subjects. Our study discloses that aging modifies yawning frequency and its time course. Furthermore, as in the elderly yawning after the awakening is not associated with high sleepiness level as in young adult, we put forward that sleepiness level and the proximity of sleep/wake transitions could separately affect yawning. [source] The circadian and homeostatic modulation of sleep pressure during wakefulness differs between morning and evening chronotypesJOURNAL OF SLEEP RESEARCH, Issue 4 2003Jacques Taillard Summary The purpose of this study was to evaluate homeostatic and circadian sleep process in ,larks' and ,owls' under daily life conditions. Core body temperature, subjective sleepiness and waking electroencephalogram (EEG) theta,alpha activity (6.25,9 Hz) were assessed in 18 healthy men (nine morning and nine evening chronotypes, 21.4 ± 1.9 years) during a 36-h constant routine that followed a week of a normal ,working' sleep,wake schedule (bedtime: 23.30 h, wake time: 07.30 h). The phase of the circadian rhythm of temperature and sleepiness occurred respectively, 1.5 h (P = 0.01) and 2 h (P = 0.009) later in evening- than in morning-type subjects. Only morning-type subjects showed a bimodal rhythm of sleep,wake propensity. The buildup of subjective sleepiness, as quantified by linear regression, was slower in evening than in morning types (P = 0.04). The time course of EEG theta,alpha activity of both chronotypes could be closely fitted by an exponential curve. The time constant of evening types was longer than that of morning types (P = 0.03), indicating a slower increase in sleep pressure during extended wakefulness. These results suggest that both the circadian signal and the kinetics of sleep pressure buildup differ between the two chronotypes even under prior naturalistic conditions mimicking the usual working day. [source] Simulated driving performance following prolonged wakefulness and alcohol consumption: separate and combined contributions to impairmentJOURNAL OF SLEEP RESEARCH, Issue 3 2000Arnedt The separate and combined effects of prolonged wakefulness and alcohol were compared on measures of subjective sleepiness, simulated driving performance and drivers' ability to judge impairment. Twenty-two males aged between 19 and 35 years were tested on four occasions. Subjects drove for 30 min on a simulated driving task under conditions determined by the factorial combination of 16 and 20 h of wakefulness and blood alcohol concentrations of 0.00 and 0.08%. The simulated driving session took place 30 min postingestion; subjects in the two alcohol conditions participated in a second 30-min driving session 90-min postingestion. Subjects made simultaneous ratings of their impairment while driving and retrospective ratings at the end of each test session. Subjective sleepiness measures were completed before and after each driving session. The combination of 20 h of prolonged wakefulness and alcohol produced significantly lower ratings of subjective sleepiness and driving performance that was worse, but not significantly so, than would be expected from the additive effects of each condition alone. Driving performance was always worse in the second driving session, during the elimination phase of alcohol metabolism, despite blood alcohol concentrations being lower than during the first driving session. There was a modest association between perceived and actual impairments in driving performance following prolonged wakefulness and alcohol. The findings suggest that the combination of prolonged wakefulness and alcohol consumption produced greater decrements in simulated driving performance than each condition alone and that drivers have only a modest ability to appreciate the magnitude of their impairment. [source] Marital Conflict and Disruption of Children's SleepCHILD DEVELOPMENT, Issue 1 2006Mona El-Sheikh Marital conflict was examined as a predictor of the quality and quantity of sleep in a sample of healthy 8- to 9-year-olds. Parents and children reported on marital conflict, the quantity and quality of children's sleep were examined through an actigraph worn for 7 consecutive nights, and child sleepiness was derived from child and mother reports. Increased marital conflict was associated with disruptions in the quantity and quality of children's sleep as well as subjective sleepiness, even after controlling for child age, ethnic group membership, socioeconomic status, sex, and body mass index. The results support the sensitization hypothesis in that exposure to marital conflict may influence an important facet of children's biological regulation, namely sleep. [source] | ||||||||||