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4%; II, 22.9%; III, 33.7%; and IV, 48.7% (
= 0.014). A logistic regression model revealed that CCC was associated with FTP grade IV. After adjusting for age, sex, body mass index (BMI), and tonsil size (TS), the grade IV individuals had a 4.4-fold higher risk of having CCC than grade I individuals (
= 0.026). Multiple collapse sites and palatopharyngeal or combined (palatopharyngeal and hypopharyngeal) collapse were more prevalent in grade IV individuals.
OSA patients intolerant to CPAP have a strong positive correlation between the FTP grade and presence of retropalatal CCC. FTP grade IV is an independent risk factor for velum-CCC, controlling for sex, age, BMI, and TS grade.
OSA patients intolerant to CPAP have a strong positive correlation between the FTP grade and presence of retropalatal CCC. FTP grade IV is an independent risk factor for velum-CCC, controlling for sex, age, BMI, and TS grade.
Insomnia with objective short sleep duration (IOSSD) is associated with an increased risk of cardiovascular morbidity, diabetes, neurocognitive impairment, and mortality. Amlexanox Inflammation is believed to be one of the main links between IOSSD and these diseases. The role of nucleotide-binding domain and leucine-rich repeat protein-3 (NLRP3) inflammasome in inducing activation of inflammatory signaling in IOSSD is not clear. In this study, we investigated the expression of NLRP3 inflammasome in patients with IOSSD to clarify this issue.
Thirty-six patients with insomnia and 20 age- and sex-matched healthy controls were sequentially recruited. Subjects were categorized into three groups IOSSD (sleep duration < 6h, n=20), insomnia with objective normal sleep duration (IONSD, sleep duration ≥ 6h, n=16) and healthy controls (n=20). Objective sleep parameters were measured by overnight polysomnography. Peripheral NLRP3 inflammasome protein levels [NLRP3, apoptosis-associated speck-like protein containing a CARD (3 inflammasome.
Obstructive sleep apnea (OSA) is characterized by repetitive episodes of upper airway collapse during sleep. The contraction of upper airway dilator muscles plays a crucial role in maintaining UA patency. Chronic intermittent hypoxia (CIH) is the most important pathophysiological process of OSA. Exposure to CIH induced not only the damage of dilator muscles but also the plasticity of the muscles. This study aimed to dynamically assess the influence of CIH on the upper airway.
The experiments were performed on 44 rats. They were randomly divided into a normoxia (NO) group (n=22) and CIH group (n=22). In each group (n=6, respectively), EMG, transcranial magnetic stimulation (TMS) response, and critical pressure (Pcrit) value were recorded on day 0 (the day before exposure), and the 7th, 14th, 21st, and 28th day of air/CIH exposure. For each group, 16 rats were used for transmission electron microscopy observations on day 0, and the 7th, 14th and 28th day of air/CIH exposure (n=4 for every time point).
Compared to the NO group at the same point, the CIH group showed a damaged ultrastructure of genioglossus, increased activity of genioglossus corticomotor area, and increased Pcrit of the upper airway from the 7th to the 28th day of CIH. Increased EMG activity occurred at the 14th day of CIH and lasted for 2 weeks.
The elevated genioglossus corticomotor excitability in response to the CIH could not counterbalance the damage effect of CIH on upper airway dilator muscles, which ultimately increased the collapsibility of the upper airway.
The elevated genioglossus corticomotor excitability in response to the CIH could not counterbalance the damage effect of CIH on upper airway dilator muscles, which ultimately increased the collapsibility of the upper airway.
This study aimed to evaluate the longitudinal association between sleep duration and depressive symptoms among the elderly in China.
A data set from China Health and Retirement Longitudinal Study (CHARLS) in 2011, 2013 and 2015 was adopted with a total of 22,847 respondents aged ≥60-years-old. A linear regression analysis with generalized estimating equations was employed to examine the longitudinal associations between duration of total sleep, nighttime sleep and daytime nap, and depressive symptoms.
An extra hour of total sleep including nighttime sleep and daytime nap was associated with lower incidence of depressive symptoms among the elderly after adjusting all confounders (OR=0.83, 95% CI 0.82-0.84). In addition, an extra hour of nighttime sleep (OR=0.82, 95% CI 0.80-0.83) or daytime nap (OR=0.93, 95% CI 0.89-0.97) was also negatively associated with depressive symptoms among the elderly. After controlling the total sleep time, an extra hour of nighttime sleep was negatively associated with depressive symptoms (OR=0.88, 95% CI 0.84 to 0.92), while an extra hour of daytime nap displayed a positive association with depressive symptoms (OR=0.88, 95% CI 0.84 to 0.92). Compared with the moderate nappers, only extended nappers had significantly higher incidence of depressive symptoms (OR=1.32, 95% CI 1.19 to 1.45).
For the elderly in China, increasing their total sleep, nighttime sleep, and/or daytime nap duration would reduce the incidence of depressive symptoms. Moreover, after fixing the total sleep time, increasing nighttime sleep was more beneficial to the decrease of the incidence of depressive symptoms than daytime nap.
For the elderly in China, increasing their total sleep, nighttime sleep, and/or daytime nap duration would reduce the incidence of depressive symptoms. Moreover, after fixing the total sleep time, increasing nighttime sleep was more beneficial to the decrease of the incidence of depressive symptoms than daytime nap.
The study sought to assess demographics, clinical features, comorbidities, and polysomnographic features of a large cohort of clinic-based patients with rapid eye movement-predominant obstructive sleep apnea (REM-predominant-OSA) in both genders, while assessing the relationship between REM-predominant OSA in one hand and menopausal status and age on the other.
This prospective observational study was conducted between January 2003 and December 2017. REM-predominant OSA diagnostic criteria included an AHI of ≥5/h, with REM-AHI/non-REM-AHI of >2, a non-REM-AHI of <15/h, and a minimum of 15 min of REM sleep. Patients who had an AHI>5 events/h and did not meet the criteria for REM-predominant OSA were included in the non-stage-specific OSA group (NSS).
The study consisted of 1346 men and 823 women (total=2169). REM-predominant OSA was diagnosed in 17% (n=369). The prevalence of REM-predominant OSA in women was 25% compared with 12% in men. Several independent associations of REM-predominant OSA wedominant OSA. Among women, a younger age but not menopausal status was a correlate of REM-predominant OSA. Asthma was independently associated with REM-predominant OSA.Narcolepsy is a sleep disorder marked by chronic, debilitating excessive daytime sleepiness and can be associated with cataplexy, sleep paralysis and sleep-related hallucinations. Pharmacological therapy for narcolepsy primarily aims to increase wakefulness and reduce cataplexy attacks. Pitolisant is a first-in-class agent utilizing histamine to improve wakefulness by acting as an antagonist/inverse agonist of the presynaptic histamine 3 receptor. This review summarizes the clinical efficacy, safety and tolerability of pitolisant in treating the symptoms of narcolepsy. Randomized and observational studies demonstrate pitolisant to be effective in treating both hypersomnolence and cataplexy while generally being well tolerated at prescribed doses. The most common adverse reactions include headache, insomnia and nausea.
The objective of this study was to investigate whether the serum biomarkers S100 calcium binding protein B (S100B), glial fibrillary acidic protein (GFAP), brain-derived neurotrophic factor (BDNF), and glial cell line-derived neurotrophic factor (GDNF) change in patients with chronic insomnia disorder (CID), and if this is the case, whether the altered levels of these serum biomarkers are associated with poor sleep quality and cognitive decline in CID.
Fifty-seven CID outpatients constituted the CID group; thirty healthy controls (HC) were also enrolled. Questionnaires, polysomnography, Chinese-Beijing Version of Montreal Cognitive Assessment (MoCA-C) and Nine Box Maze Test (NBMT) were used to assess their sleep and neuropsychological function. Serum S100B, GFAP, BDNF, and GDNF were evaluated using enzyme-linked immunosorbent assay.
The CID group had higher levels of S100B and GFAP and lower levels of BDNF and GDNF than the HC group. Spearman correlation analysis revealed that poor sleep quality, assessn patients with CID, indicating astrocyte damage, and were associated with insomnia severity or/and cognitive dysfunction.
The goal of this study was to assess the effectiveness of healthcare spending among the leading Asian economies.
We have selected a total of nine Asian nations, based on the strength of their economic output and long-term real GDP growth rates. The OECD members included Japan and the Republic of Korea, while the seven non-OECD nations were China, India, Indonesia, Malaysia, Pakistan, the Philippines, and Thailand. Healthcare systems efficiency was analyzed over the period 1996-2017. To assess the effectiveness of healthcare expenditure of each group of countries, the two-way fixed effects model (country- and year effects) was used.
Quality of governance and current health expenditure determine healthcare system performance. Population density and urbanization are positively associated with a healthy life expectancy in the non-OECD Asian countries. In this group, unsafe water drinking has a statistically negative effect on healthy life expectancy. Interestingly, only per capita consumption of carbohydratindicators, while South Korea is ranked second. The only exception is per capita carbon dioxide emissions, which have maximal values in the Republic of Korea and Japan. Non-OECD nations' outcomes were led by China, as the largest economy. This group was characterized with substantial improvement in efficiency of health spending since the middle of the 1990s. Yet, progress was noted with remarkable heterogeneity within the group.
Intimate partner violence is a serious and widespread problem worldwide. It is a domestic violence by a spouse or partner in an intimate relationship against the other spouse or partner. Even though Ethiopia is also one of the countries where the condition has been seriously happening, there is a dearth of information in the study area.
To assess the prevalence of intimate partner violence and its sociocultural practice, and its associated factors among married women in Oromia, Central Ethiopia.
A community-based cross-sectional study was conducted on 671 women of Ambo district who were in marriage from March 1 to 30, 2018. Multistage sampling method was employed to select study participants. Data were collected using interviewer-administered WHO Multi-country Study on Women's Health and Life Experiences Questionnaire. Descriptive, bivariate, and multivariate logistic regression analyses were done using SPSS version 20.0.
Out of 671 married women expected to participate, 657 of them participated in the study making a response rate of 98%.