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Sleep Disorders: Chronic Medical Burden
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Sleep Disorders: Chronic Medical Burden

A special issue of Healthcare (ISSN 2227-9032). This special issue belongs to the section "Chronic Care".

Deadline for manuscript submissions: closed (1 March 2023) | Viewed by 14387

Special Issue Editors

Dr. Georgia Trakada

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Guest Editor
Department of Clinical Therapeutics, National and Kapodistrian University of Athens, School of Medicine, Alexandra Hospital, 11527 Athens, Greece
Interests: sleep medicine; sleep disorders and sleep medicine; polysomnography; pulmonology; apnea; OSA; CPAP; obstructive sleep apnea; asthma; sleep apnea
Special Issues, Collections and Topics in MDPI journals
Dr. Paschalis Steiropoulos

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Assistant Guest Editor
Department of Respiratory Medicine, Medical School, Democritus University of Thrace, University General Hospital Dragana, 68100 Alexandroupolis, Greece
Interests: pulmonary medicine; sleep disorder
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Beat Knechtle

E-Mail Website
Assistant Guest Editor
Institute of Primary Care, University of Zurich, 8091 Zurich, Switzerland
Interests: endurance; ultra-endurance; master athlete; supplementation; nutrition; swimming; cycling; running
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Ancient Greeks blessed the god Hypnos (ύπνος: sleep), and strongly appreciated the restorative power of sleep in body and mind. Sleep is a fundamental process in human survival and wellbeing.

It is estimated that 50 to 70 million Americans chronically suffer from a disorder of sleep and wakefulness, reporting symptoms of daytime sleepiness, insomnia, abnormal events during sleep, or irregular sleep schedules. There are at least 90 distinct sleep disorders. Moreover, lifestyle factors such as unbalanced diet, decreased physical activity, and excessive electronic media use  further affect the quantity and quality of sleep. Unfortunately, sleep problems are still underdiagnosed and underreported.

In adults, the long-term effects of sleep loss and disorders have been associated with increased morbidity, including cardiometabolic disease and obesity, as well as all-cause mortality. In school-aged children and adolescents, sleep deprivation has been associated with poor performance, obesity, depressive symptoms, and increased substance use. Besides, as sleep plays an important role in determining cognitive performance and vigilance, lack of sleep has been associated with traffic and industrial accidents, medical errors and decreased work productivity, with severe economic consequences.

This Special Issue aims to discuss disordered and insufficient sleep as an emergency medical issue that adversely affects daily functioning, health and longevity.

Dr. Georgia Trakada
Dr. Paschalis Steiropoulos
Prof. Dr. Beat Knechtle
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Healthcare is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • sleep
  • sleep disorders
  • sleep deprivation
  • sleepiness
  • insomnia
  • obstructive sleep apnea
  • circadian rhythms

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Published Papers (6 papers)

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Research

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13 pages, 795 KiB  
Article
The Impact of Transoral Robotic Surgery on Erectile Dysfunction and Lower Urinary Tract Symptoms in Male Patients with Moderate-to-Severe Obstructive Sleep Apnea
by Chih-Kai Peng, Chien-Han Tsao, Wen-Wei Sung, Shao-Chuan Wang, Wen-Jung Chen, Tzuo-Yi Hsieh, Min-Hsin Yang, Tsung-Hsien Lee and Sung-Lang Chen
Healthcare 2022, 10(9), 1633; https://doi.org/10.3390/healthcare10091633 - 26 Aug 2022
Cited by 1 | Viewed by 1563
Abstract
Obstructive sleep apnea (OSA), lower urinary tract symptoms (LUTS), and erectile dysfunction (ED) are chronic conditions that seriously affect middle-aged men. This study aimed to evaluate the changes in the presence of these conditions after transoral robotic surgery (TORS) for OSA. This prospective [...] Read more.
Obstructive sleep apnea (OSA), lower urinary tract symptoms (LUTS), and erectile dysfunction (ED) are chronic conditions that seriously affect middle-aged men. This study aimed to evaluate the changes in the presence of these conditions after transoral robotic surgery (TORS) for OSA. This prospective observational study recruited 48 men with moderate-to-severe OSA (mean age 40.6 ± 8.1 years) who underwent TORS from October 2019 to November 2021 at a tertiary center. Baseline polysomnographic parameters, Epworth Sleepiness Scale (ESS), and demographic characteristics were measured. The evaluations of LUTS and ED were based on self-administered International Prostate Symptom Score (IPSS) and International Index of Erectile Function (IIEF-5) questionnaires, respectively, before TORS. The treatment outcomes were assessed three months postoperatively in the patients undergoing TORS due to moderate-to-severe OSA. There was significant Apnea-Hypopnea Index (AHI) reduction from 53.10 ± 25.77 to 31.66 ± 20.34 three months after undergoing TORS (p < 0.001). There was also a significant decrease in the total IPSS score (5.06 ± 5.42 at baseline to 2.98 ± 2.71 at three months postoperatively, p = 0.001), the storage domain, and the voiding domain (p < 0.05). The ED also improved significantly, as seen in the IIEF score (20.98 ± 3.32 to 22.17± 3.60, p = 0.007). The reduction of AHI was associated with changes in body weight and the lowest oxygen saturation (SpO2) levels during sleep (rho = 0.395, p = 0.005; rho = 0.526, p < 0.001, respectively). However, the reduction in AHI was not significantly associated with improvement in IPSS or IIEF scores (p > 0.05). For men with moderate-to-severe OSA, TORS can significantly improve the polysomnography parameters, sleep-related questionnaire scores, and quality of life, and alleviate ED and LUTS. AHI reduction is not a crucial factor for ED and LUTS improvement after TORS for OSA, especially in ED. Full article
(This article belongs to the Special Issue Sleep Disorders: Chronic Medical Burden)
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10 pages, 685 KiB  
Article
Health-Related Quality of Life Sleep Score Predicts Transfer to Hemodialysis among Patients on Peritoneal Dialysis
by Tomoki Nagasaka, Naoki Washida, Kiyotaka Uchiyama, Eriko Yoshida Hama, Ei Kusahana, Takashin Nakayama, Itaru Yasuda, Kohkichi Morimoto and Hiroshi Itoh
Healthcare 2022, 10(6), 1030; https://doi.org/10.3390/healthcare10061030 - 1 Jun 2022
Cited by 2 | Viewed by 2217
Abstract
Despite the superiority of peritoneal dialysis (PD) over hemodialysis (HD) regarding health-related quality of life (HRQOL), the specific HRQOL domain(s) that predict unplanned HD transfer remains uncertain. In this cohort study, we assessed the HRQOL of 50 outpatients undergoing PD using the Japanese [...] Read more.
Despite the superiority of peritoneal dialysis (PD) over hemodialysis (HD) regarding health-related quality of life (HRQOL), the specific HRQOL domain(s) that predict unplanned HD transfer remains uncertain. In this cohort study, we assessed the HRQOL of 50 outpatients undergoing PD using the Japanese version 1.3 Kidney Disease Quality of Life-Short Form from March 2017 to March 2018 and prospectively analyzed the association of each HRQOL component with HD transfer until June 2021. During the follow-up (41.5 (13.0–50.1) months), 21 patients were transferred to HD. In a multivariate Cox proportional hazards model adjusted for age, sex, PD vintage, urine output, Charlson comorbidity index, and incremental shuttle walking test, a higher sleep score was significantly associated with lower HD transfer rates (HR 0.70 per 10, p = 0.01). An adjusted subdistribution hazard model where elected transition to HD, death, and transplantation were considered competing events of unintended HD transfer that showed sleep score as an exclusive predictor of HD transfer (HR 0.70 per 10, p = 0.002). Our results suggest that sleep score among the HRQOL subscales is instrumental in predicting HD transfer in patients undergoing PD. Full article
(This article belongs to the Special Issue Sleep Disorders: Chronic Medical Burden)
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7 pages, 251 KiB  
Article
Chronic Lumbar Pain and Insomnia in College-Aged Students
by Katsumi Hamaoka, Ryouta Ashizawa, Mitsumasa Hida, Ippei Suganuma and Yoshinobu Yoshimoto
Healthcare 2022, 10(4), 701; https://doi.org/10.3390/healthcare10040701 - 9 Apr 2022
Cited by 5 | Viewed by 2501
Abstract
Insomnia in college students has a significant impact on academic performance and mental health (e.g., depression). Although the mechanisms underlying insomnia and chronic pain are becoming clearer, only a few studies on college students have examined these factors by their location in the [...] Read more.
Insomnia in college students has a significant impact on academic performance and mental health (e.g., depression). Although the mechanisms underlying insomnia and chronic pain are becoming clearer, only a few studies on college students have examined these factors by their location in the body. The purpose of the present study was to identify the location of chronic pain in the body most associated with insomnia in college students. A web-based survey was used to collect information pertaining to nine questions from 494 university students: sex, age, presence of chronic pain, intensity of chronic pain, location of chronic pain, and duration of chronic pain, as well as scores from the Athens Insomnia Scale (AIS), Pain Catastrophizing Scale, and Hospital Anxiety and Depression Scale. To examine the association between insomnia and the site of chronic pain, stepwise logistic regression analysis was conducted with AIS as the target variable. The results showed a significant positive correlation between chronic pain in the lumbar region and AIS scores. Future longitudinal studies including multiple factors are necessary to clarify the causal relationship between insomnia and chronic lower back pain. Full article
(This article belongs to the Special Issue Sleep Disorders: Chronic Medical Burden)
13 pages, 879 KiB  
Article
Evaluation of Sleep Disturbances in Patients with Nocturnal Epileptic Seizures in a Romanian Cross-Sectional Study
by Réka Szabó, Florica Voiță-Mekereș, Cristina Tudoran, Ahmed Abu-Awwad, Mariana Tudoran, Petru Mihancea and Codrin Dan Nicolae Ilea
Healthcare 2022, 10(3), 588; https://doi.org/10.3390/healthcare10030588 - 21 Mar 2022
Cited by 2 | Viewed by 2171
Abstract
(1) Background: Based on the premise that epilepsy is frequently associated with hypnopathies, in this study we aim to analyze the prevalence of sleep disturbances among patients with epilepsy, with exclusively or predominantly nocturnal seizures, in relation to demographic factors as well as [...] Read more.
(1) Background: Based on the premise that epilepsy is frequently associated with hypnopathies, in this study we aim to analyze the prevalence of sleep disturbances among patients with epilepsy, with exclusively or predominantly nocturnal seizures, in relation to demographic factors as well as clinical and electroencephalography (EEG) aspects. (2) Methods: 69 patients with nocturnal epilepsy were included in our study. Sleep disturbances were measured with the Pittsburgh Sleep Quality Index (PSQI) questionnaire, followed by a long-term video-EEG monitoring during sleep. We analyzed the PSQI results in relation to patients’ gender and age and determined the correlations between the PSQI scores and the modifications on video-EEG recordings, in comparison to a control group of 25 patients with epilepsy but without nocturnal seizures. (3) Results: We found a statistically significant difference between the PSQI of patients with nocturnal seizures compared to those without nocturnal epileptic manifestations. In the experimental group, the mean PSQI score was 7.36 ± 3.91 versus 5.04 ± 2.56 in controls. In women, the average PSQI score was 8.26, whilst in men it only reached 6.41, highlighting a statistically significant difference between genders (p ˂ 0.01). By examining the relationships between the PSQI scores and certain sleep-related factors, evidenced on the nocturnal video-EEG, we found a statistically significant difference between PSQI values of patients who reached the N2 stage, and those who reached the N3 stage of nonrapid eye movement (NREM) sleep, highlighting that those with a more superficial nocturnal sleep also had higher PSQI scores. There were no statistically significant differences regarding the PSQI scores between patients with or without interictal epileptiform discharges, and also in the few patients with nocturnal seizures where we captured ictal activity. (4) Conclusions: we evidenced in this study a poor quality of sleep in patients with nocturnal epilepsy, mostly in women, independent of age. We observed that sleep disturbances were due to superficial and fragmented sleep with frequent microarousals, not necessarily caused by the electrical epileptiform activity. Full article
(This article belongs to the Special Issue Sleep Disorders: Chronic Medical Burden)
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10 pages, 1052 KiB  
Communication
The Effect of Telemonitoring (TM) on Improving Adherence with Continuous Positive Airway Pressure (CPAP) in Obstructive Sleep Apnoea (OSA): A Service Improvement Project (SIP)
by Abubacarr Gassama, Deyashini Mukherjee, Urwah Ahmed, Shirley Coelho, Mindi Daniels and Rahul Mukherjee
Healthcare 2022, 10(3), 465; https://doi.org/10.3390/healthcare10030465 - 2 Mar 2022
Cited by 6 | Viewed by 3133
Abstract
The benefits of CPAP demonstrated in clinical trials are difficult to deliver in real life due to the lack of adherence. We analysed the effect of a Telemonitoring (TM)-related intervention on adherence as part of a Service Improvement Project (SIP) analysed as a [...] Read more.
The benefits of CPAP demonstrated in clinical trials are difficult to deliver in real life due to the lack of adherence. We analysed the effect of a Telemonitoring (TM)-related intervention on adherence as part of a Service Improvement Project (SIP) analysed as a retrospective cohort study. The ‘historical control’ (HC) cohort (followed up in conventional clinics) included all patients who commenced on CPAP between 1 February and 30 April 2019 (n = 142). The ‘telemonitoring’ (TM) cohort included all patients who commenced on CPAP between 1 May and 31 July 2019 (n = 166). Adherence was checked at 30 days (baseline) and 73 days for both cohorts. Wilcoxon—Rank test was used for statistical analysis (results reported as mean ± SEM). Both cohorts had similar adherence at the 30-day baseline, compared to a significantly lower adherence in the HC-cohort at 73 days (55.7 ± 3.0 vs. 51.8 ± 3.2% of days ≥ 4 h: p = 0.0072, average usage 255 ± 12.8 vs. 236 ± 13.7 min: p = 0.0003). There was a significantly higher adherence in the TM-cohort at 73 days (50.8 ± 2.5 vs. 56.1 ± 2.9% of days ≥ 4 h: p = 0.0075; average usage 234 ± 10.4 vs. 252 ± 12.1 min: p = 0.0456). Telemonitoring-feedback is effective at improving adherence with CPAP, suggesting its potential beneficial role in the community setting, particularly in the post-COVID reality of increased remote consultations. Full article
(This article belongs to the Special Issue Sleep Disorders: Chronic Medical Burden)
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6 pages, 553 KiB  
Case Report
“Peculiar” Snoring in a 40-Year-Old Patient: A Case Report and Review of Literature
by Nicholas-Tiberio Economou, Kyriaki Cholidou, Anastasios Kallianos, Katja Weiss, Beat Knechtle, Pantelis T. Nikolaidis and Georgia Trakada
Healthcare 2022, 10(6), 1051; https://doi.org/10.3390/healthcare10061051 - 6 Jun 2022
Viewed by 1809
Abstract
This is a case description of a patient with previously diagnosed rapid eye movement sleep behavior disorder (RBD) and nocturnal enuresis, who complained about a “peculiar sound” while sleeping and, occasionally, while awake during intensive exercise, for the last three months. A home [...] Read more.
This is a case description of a patient with previously diagnosed rapid eye movement sleep behavior disorder (RBD) and nocturnal enuresis, who complained about a “peculiar sound” while sleeping and, occasionally, while awake during intensive exercise, for the last three months. A home audio recording, which his wife obtained while he was sleeping, showed a high-pitched sound identified as stridor. Full video polysomnography revealed no apneas or hypopneas. The flow-volume loop yielded an inspiratory plateau, indicating variable extrathoracic obstruction. The upper and lower respiratory system computed tomography did not show any anomalies or mechanical lesions (e.g., masses and scars). Fiberoptic laryngoscopy revealed an abnormal activity of the vocal cord abductor during quiet breathing and inspiration in a supine position, leading to partial obstruction. A positive dopamine transporter scan and the coexistence of stridor, RBD, and nocturnal enuresis were diagnostic for multiple system atrophy. The patient was treated with continuous positive airway pressure as a symptomatic therapy for stridor and levodopa. Full article
(This article belongs to the Special Issue Sleep Disorders: Chronic Medical Burden)
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