Biomedical subjects

Jan Hedner

Publications and source records attributed to Jan Hedner.

At least 19 recordsLinked to original sources

PubMed2006

CPAP treatment of a population-based sample--what are the benefits and the treatment compliance?

BACKGROUND & PURPOSE: Continuous positive airway pressure (CPAP) treatment has positive effects, including improved insulin sensitivity in sleep-laboratory cohorts with obstructive sleep apnea syndrome. There is still a lack of data on benefits obtained and possibilities to treat less symptomatic individuals. The aim of this study was to evaluate the effect of CPAP treatment on metabolic profile and quality of life (QoL) in a population-based sample of men with sleep apnea. Another purpose was to investigate the compliance to CPAP in this population. PATIENTS AND METHODS: A population-based sample of 38 men with an AHI>or=10 were treated with CPAP regardless of symptom profile. The controls included men with AHI <10 matched for age and hypertension. The effects were evaluated after 3 weeks and 6 months. Insulin resistance was quantified using the homeostasis model assessment (HOMA). Daytime sleepiness, QoL and subjective symptom load was assessed using the Epworth Sleepiness Scale (ESS), the Medical Outcomes Study Short Form Health Survey (SF-36) and the Minor Symptoms Evaluation-Profile (MSE-P) questionnaires, respectively. RESULTS: Complete three-week data were obtained from 28 treated men and 28 controls. Compared with controls, the CPAP group displayed a greater reduction of fasting serum insulin (P=0.02), decrease in insulin resistance (P=0.01) and an increase in IGF-1 (P=0.005). The CPAP group further showed an improvement in the SF-36 domains of mental health (P=0.03) and vitality (P=0.06) and a reduction in symptom load in the sleep dimension of the MSE-P. Only 11 (29%) of subjects starting CPAP were still on treatment after 6 months. Those who still used CPAP had a higher score on ESS at baseline (11.3 (4.4) vs. 5.9 (3.4), P<0.0001). CONCLUSIONS: Benefits of short-term treatment included signs of reduced insulin resistance and improved QoL. However, in this population-based sample compliance with CPAP was very low. More severe sleepiness was a positive predictive factor for treatment compliance.

Adult↗

PubMed2006

Validation a portable monitoring device for sleep apnea diagnosis in a population based cohort using synchronized home polysomnography.

SUBJECT OBJECTIVE: To assess the accuracy of a portable monitoring device based on peripheral arterial tonometry to diagnose obstructive sleep apnea (OSA). To propose a new standard for limited-channel device validation using synchronized polysomnography (PSG) home recordings and a population-based cohort. DESIGN: Single-night, unattended PSG and Watch_PAT 100 (WP_100). SETTING: Home environment. PARTICIPANTS: Ninety-eight subjects (55 men; age, 60 +/- 7 year; body mass index, 28 +/- 4 kg/m2) consecutively recruited from the Skaraborg Hypertension and Diabetes Project. MEASUREMENTS AND RESULTS: The WP_100 records peripheral arterial tone, heart rate, oxygen saturation and actigraphy for automatic analysis of respiratory disturbance index (RDI), apnea-hypopnea index (AHI), oxygen desaturation index (ODI), and sleep-wake state. The accuracy of WP_100 in RDI, AHI, ODI, and sleep-wake detection was assessed by comparison with data from simultaneous PSG recordings. The mean PSG-AHI in this population was 25.5 +/- 22.9 events per hour. The WP_100 RDI, AHI, and ODI correlated closely (0.88, 0.90, and 0.92; p < .0001, respectively) with the corresponding indexes obtained by PSG. The areas under the curve for the receiver-operator characteristic curves for WP_100 AHI and RDI were 0.93 and 0.90 for the PSG-AHI and RDI thresholds 10 and 20 (p < .0001, respectively). The agreement of the sleep-wake assessment based on 30-second bins between the 2 systems was 82 +/- 7%. CONCLUSIONS: The WP_100 was reasonably accurate for unattended home diagnosis of OSA in a population sample not preselected for OSA symptoms. The current design, including simultaneous home PSG recordings in population-based cohorts, is proposed as a reasonable validation standard for assessment of simplified recording tools for OSA diagnosis.

Body Mass Index↗

PubMed2005

Diurnal and obstructive sleep apnea influences on arterial stiffness and central blood pressure in men.

STUDY OBJECTIVES: Nocturnal and early morning elevation of blood pressure are common acute manifestations of obstructive sleep apnea (OSA) that do not always carry over into a sustained daytime hypertension. Using pulse wave analysis, we examined the effect of OSA on arterial stiffness and central aortic blood pressure to assess whether each would be elevated independent of diurnal changes in peripheral blood pressure. DESIGN: Cross-sectional sleep laboratory cohort study. SETTING: Two university teaching hospitals. PATIENTS: 57 male nonsmokers referred for suspected OSA and free of known cardiovascular disease or blood-pressure and lipid-lowering medications. MEASUREMENTS AND RESULTS: The augmentation index, a quantification of augmentation of central aortic pressure due to the reflected component of the pulse pressure waveform, and brachial and aortic blood pressure were determined in the evening and early morning. The augmentation index consistently increased from evening to morning (P < .001) and was accompanied by an increase in central systolic blood pressure (P = .007) and a decrease in pulse pressure amplification (P < .001). However, these changes were unaccompanied by any changes in peripheral blood pressure. Overnight changes in mean blood pressure and heart rate were the only predictors of this effect, but they only accounted for a third of the variance (r2 = 0.339, P = .002). After adjustment for known confounders, the respiratory disturbance index was positively correlated with augmentation index at both time points (PM: P = .008, am: P = .016). The respiratory disturbance index did not correlate with any indexes of peripheral or central blood pressure. CONCLUSIONS: Systemic arterial stiffness is positively correlated with OSA severity and, in addition, is increased in magnitude in the early morning independent of OSA severity.

Adolescent↗

PubMed2005

A randomized placebo-controlled trial of an NMDA receptor antagonist in sleep-disordered breathing.

Hypoxemia is a powerful stimulus of glutamate release in the central nervous system (CNS) and a hallmark phenomenon in sleep disordered breathing (SDB). Glutamate effects that include neuronal damage and apoptosis following hypoxemia and apnea following microinjections in animal models are in part mediated via postjunctional N-methyl-D-aspartate (NMDA) receptors. This was a double blind, randomized, placebo-controlled single dose cross-over study of the NMDA receptor antagonist AR-R15896AR in 15 male patients with moderate to severe SDB. Seven patients received 120 mg and eight patients received 350 mg AR-R15896AR or corresponding placebo (given by 2 h infusion) starting half an hour before estimated sleep onset. AR-R15896AR concentrations were in line with the predicting kinetic model. A standard polysomnographic montage was applied. Repeated plasma samples were obtained in nine patients for analysis of plasma glutamate. Glutamate concentration in plasma did not change overnight and was unrelated to severity of SDB. Overall AHI (apnea-hypopnea index; primary efficacy variable) or investigated oxygen saturation variables were not significantly changed after AR-R15896AR at either dosage level. Side effects were mostly confined to the higher dose level and included vivid dreams, nightmares as well as in two cases mild hallucinations. The previously postulated role of glutamate in SDB could not be confirmed after AR-R15896AR induced NMDA-receptor blockade.

Adult↗

PubMed2004

A novel adaptive wrist actigraphy algorithm for sleep-wake assessment in sleep apnea patients.

STUDY OBJECTIVES: Current actigraphic algorithms are relatively less accurate in detecting sleep and wake in sleep apnea patients than in people without sleep apnea. In the current study, we attempted to validate a novel automatic algorithm, which was developed for actigraphic studies in normal subjects and patients with obstructive sleep apnea by comparing it on an epoch-by-epoch basis to standard polysomnography. DESIGN: Prospective cohort study. SETTING: Multicenter, university hospital, sleep laboratories. PARTICIPANTS: A total of 228 subjects from 3 different sleep centers (Skara, Boston, Haifa) participated. INTERVENTION AND MEASUREMENTS: Simultaneous recording of polysomnography and Watch_PAT100, an ambulatory device that contains a built-in actigraph. The automatic sleep/wake algorithm is based on both the quantification of motion (magnitude and duration) and the various periodic movement patterns, such as those occurring in patients with moderate to severe obstructive sleep apnea. RESULTS: The overall sensitivity and specificity to identify sleep was 89% and 69%, respectively. The agreement ranged from 86% in the normal subjects to 86%, 84%, and 80% in the patients with mild, moderate, and severe obstructive sleep apnea, respectively. There was a tight agreement between actigraphy and polysomnography in determining sleep efficiency (78.4 +/- 9.9 vs 78.8 +/- 13.4%), total sleep time (690 +/- 152 vs 690 +/- 154 epochs), and sleep latency (56.8 +/- 31.4 vs 43.3 +/- 45.4 epochs). While for most individuals the difference between the polysomnography and actigraphy was relatively small, for some there was a substantial disagreement. CONCLUSIONS: We conclude that this actigraphy algorithm provides a reasonably accurate estimation of sleep and wakefulness in normal subjects and patients with obstructive sleep apnea on an epoch-by-epoch basis. This simple method for assessment of total sleep time may provide a useful tool for the accurate quantification of obstructive sleep apnea in the home environment.

Adaptation, Physiological↗

PubMed2004

Obstructive apneic events induce alpha-receptor mediated digital vasoconstriction.

STUDY OBJECTIVE: To characterize the role of alpha-receptors in autonomic control of digital skin blood flow change in response to obstructive apnea-hypopnea events. DESIGN: Experimental intervention study. SETTING: Sleep laboratory in a university hospital. PATIENTS: Eight male patients with severe obstructive sleep apnea (OSA). INTERVENTIONS: Patients received four cumulative dosage steps of phentolamine (0.066, 0.2, 2 and 5 [n=3] microg/min/100 ml forearm tissue) via brachial artery infusion during nonrapid eye movement sleep (stage 1 and 2). MEASUREMENTS AND RESULTS: The pulse amplitude determined with peripheral arterial tonometry (PAT) was periodically attenuated during the immediate post apnea-hypopnea period coinciding with arousal. PAT ratio (smallest pulse amplitude post apnea divided by largest pulse amplitude during apnea), was determined as a measure of digital vasoconstriction. We found that, compared with baseline, PAT ratio dose-dependently increased during phentolamine (0.2, 2 and 5 microg) infusion by 11.2+/-1.7%, 24.4+/-2.1% and 30.9+/-4.1%, respectively (P<0.001). Systemic blood pressure and heart rate were largely unaffected by the pharmacological intervention. CONCLUSION: OSA related alteration of the pulse amplitude includes a constriction of digital skin vasculature that to a large extent is mediated via sympathoadrenergic alpha-receptors.

Adrenergic alpha-Antagonists↗

PubMed2004

The heart rate response to exercise is blunted in patients with sleep-related breathing disorder.

BACKGROUND: This study addressed the hypothesis that cardiovascular reactivity during graded bicycle exercise is influenced by a coexisting sleep-related breathing disorder (SRBD). METHODS: Blood pressure and heart rate were assessed at rest and during graded exercise (110 W and maximal load) in 1,149 patients of a Sleep Disorders Center. The degree of SRBD, and potential confounders, including blood gases and pulmonary function, were determined. RESULTS: Maximal exercise capacity tended to decrease with SRBD activity (p = 0.07). The heart rate reactivity was blunted and reduced by -0.07 and -0.09 beats/min for every SRBD unit at 110 W (p < 0.001) and at maximal load (p < 0.001), respectively. Systolic and diastolic blood pressure reactivity at maximal load were positively associated with SRBD severity. These associations were independent of possible confounders. CONCLUSION: SRBD is associated with reduced physical working capacity and a modified hemodynamic response to exercise.

Adult↗

PubMed2004

Association between estrus cycle-related aggression and tidal volume variability in female Wistar rats.

Premenstrual dysphoria is characterized by symptoms such as irritability and depressed mood, present during the luteal phase of the menstrual cycle, and disappearing shortly after the onset of menstruation. Subjects with premenstrual dysphoria have previously been reported to display enhanced respiratory variability, and to experience anxiety when exposed to panicogens, such as CO2. In the present study, the possible influence of the estrus cycle and estrus cycle-related aggression on respiratory variability was investigated in female rats of the Wistar strain. The rats were subdivided into two groups: those displaying estrus cycle-related aggression, as evaluated using the resident intruder paradigm, and those not showing aggression throughout the estrus cycle. This model has been developed to serve as an animal model of premenstrual irritability. The former group was found to display higher tidal volume variability in diestrus, as compared to the non-aggressive rats. There was no effect of estrus cycle phase on respiratory variability. These results are well in line with the clinical observation that women with premenstrual dysphoria display higher respiratory variability than controls, and the notion that respiratory variability is a parameter of interest in this context. In our opinion, they also strengthen the concept of this animal model as a model of premenstrual irritability.

Aggression↗

PubMed2004

Paroxetine influences respiration in rats: implications for the treatment of panic disorder.

Since hyperventilation and shortness of breath are characteristic features of panic attacks, and since the attacks can be elicited by CO(2) inhalation, an involvement of central or peripheral chemoreceptors in the pathophysiology of panic disorder has been suggested. Prompted by clinical reports suggesting that the susceptibility to spontaneous as well as CO(2)-induced anxiety and hyperventilation is attenuated by serotonin reuptake inhibitors (SRIs), we undertook the present study in order to explore the possible effect of an SRI, paroxetine, on baseline respiration and CO(2)-induced hyperventilation in freely moving Wistar rats. A significant increase in baseline respiratory rate was seen both after 5 and 15 weeks of treatment with paroxetine. CO(2) exposure induced a dose-dependent increase in respiratory rate, but not tidal volume, in both paroxetine-treated rats and controls; this response was reduced after 15 weeks of paroxetine treatment, but not after 5 weeks of treatment. We suggest that an influence on the regulation of respiration may be of importance for the anti-panic effect of SRIs.

Animals↗

PubMed2003

Reduction of sleep-disordered breathing after physostigmine.

The cholinesterase inhibitor physostigmine (PHYS) was investigated in a double-blind, placebo-controlled, randomized, crossover trial of 10 male patients with moderate to severe obstructive sleep apnea. PHYS (0.12 microg/minute/kg, 7-hour infusion) reduced mean apnea/hypopnea index (AHI) by 13.6 (95% confidence interval [CI], 2.2-25.1) corresponding to 21.4% (95% CI, -5.5 to 47.9) and increased minimum SaO2 by 8.7% (95% CI, -0.3 to 17.7) corresponding to 23.2% (95% CI, 4.8-41.3). During the last third of the night, coinciding with predicted plasma concentration steady state, non-REM sleep AHI decreased by 19.2 (95% CI, 0.1-38.3) or 14.9% (95% CI, -43.6 to 77.7) and REM AHI by 33.8 (95% CI, 13.7-54.0) or 67.5% (95% CI, 49.7-85.3). Mean total sleep time was reduced by 74 minutes (95% CI, 33.9-114.9), but patients with the least pronounced sleep shortening had the largest reduction of AHI (r = 0.73, p < 0.02). The nocturnal decline in heart rate was reduced by PHYS. Moreover, resting (early-night placebo heart rate) was positively correlated with proportional reduction of REM apnea index (r = 0.69, p < 0.02). Body mass index was negatively correlated with reduction of REM AHI (r = 0.77, p < 0.02). This, predominantly REM-related, reduction of obstructive sleep apnea after PHYS may provide a new treatment option if the effects are maintained in long-term studies.

Adult↗

PubMed2003

Finger plethysmography--a method for monitoring finger blood flow during sleep disordered breathing.

We investigated a non-invasive measurement for changes in finger blood flow during wakefulness and sleep. Changes in finger blood flow, reflected by pulse wave amplitude (PWA) derived from finger plethysmography, were compared with changes in forearm vascular flow assessed by venous occlusion plethysmography after intra-arterial infusion of norepinephrine (NE), phentolamine, and isoproterenol (n=15, 15, 14 subjects, respectively). Moreover, PWA was assessed during obstructive breathing during sleep (n=8 patients). Vasoconstriction in the finger (PWA) was stronger than that obtained in the forearm vascular bed in the higher NE dose range both without (ANOVA, P=0.002) and with concomitant phentolamine-induced alpha-receptor blockade (P=0.02). Isoproterenol increased forearm blood flow but did not induce flow changes detectable by the finger plethysmographic technique (P<0.001). PWA was significantly reduced during arousal from obstructive sleep apnea (-37.5+/-16.1%, P=0.002, n=6 patients), suggesting vasoconstriction in the digital vascular bed. PWA derived from finger plethysmography allows continuous, non-invasive measurement of changes in finger blood flow during wakefulness and sleep. However, as may be expected from the anatomical and functional differences between the finger and forearm vascular beds and demonstrated by the lack of response to beta(2)-receptor stimulation, PWA does not mimic forearm vascular flow characteristics. Thus, finger plethysmography may be a useful complement to current vascular research techniques, in particular to monitor sympathetic influences on skin blood flow in the finger.

Adrenergic alpha-Antagonists↗

PubMed2003

Serotonin depletion increases respiratory variability in freely moving rats: implications for panic disorder.

To elucidate if serotonergic transmission affects respiratory variability, a parameter consistently found increased in patients with panic disorder, we studied the effect of a serotonin synthesis inhibitor, para-chlorophenylalanine (PCPA), on respiratory variability at baseline and during CO2-induced hyperventilation in awake and unrestrained rats. Forty male Wistar rats were given intraperitoneal injections of PCPA (300 mg/kg) or saline 72, 48 and 24 h before registration of respiration in a plethysmograph allowing the animals to move freely. PCPA-treated rats displayed significantly higher tidal volume variability and minute volume variability, both at baseline and during CO2 exposure, compared to controls. The results support the notion that serotonin dysfunction may contribute to the enhanced respiratory variability observed in patients with panic disorder.

Analysis of Variance↗

PubMed2002

[Sleep apnea a risk factor of cardiovascular disease].

Obstructive sleep apnea (OSA) affects almost one fifth of the male and 10% of the female middle-aged population. Only one fifth of subjects with more or less severe disorder of breathing report simultaneous daytime sleepiness. There is growing research evidence for an independent association between OSA and cardiovascular disease (CVD). The suggestion that this link is not only correlative but also causative is strongly supported by a series of recent clinical and epidemiological studies. The association between OSA and traditionally recognized cardiovascular risk factors suggests that OSA may provide an additive and synergistic risk in cases with co-existing obesity, insulin resistance, diabetes and/or dyslipidaemia. These recent insights advocate better awareness of OSA and potentially also a wider use of screening-tools for early identification and treatment of sleep related breathing disorders. Moreover, current research within the fields of obesity and cardiovascular prevention needs to identify OSA as a study confounder. Continuous intense research into pathophysiological mechanisms and therapeutic possibilities of CVD related to OSA appears to be an important and potentially rewarding area of disease prevention.

Arrhythmias, Cardiac↗

PubMed2002

Association between estrus cycle-related changes in respiration and estrus cycle-related aggression in outbred female Wistar rats.

Premenstrual dysphoric disorder is characterized by irritability surfacing during the luteal phase of the menstrual cycle, and disappearing shortly after the onset of menstruation. Although the cardinal symptoms of premenstrual dysphoria are different from those of panic disorder, the two conditions share a number of traits indicating that they both may be associated with abnormalities in the regulation of respiration. Both subjects with panic disorder and subjects with premenstrual dysphoria are hence reported to display enhanced respiratory variability, and to experience anxiety when exposed to CO(2). In the present study, the possible influence of the estrus cycle on respiratory parameters in outbred female rats of the Wistar strain was investigated. Before being tested with respect to respiration, the rats were subdivided into two groups: those displaying estrus cycle-related variation in aggression, as evaluated using the resident intruder paradigm, and those not showing aggression throughout the cycle. Whereas the former group was found to display higher respiratory rate during the diestrus phase than during the proestrus/estrus phase, no cycle-related variation in respiration was observed in animals not showing cycle-related variation in aggression. The results support previous studies indicating that the estrus cycle exerts an influence on respiration, and suggest that rats prone to cycle-related aggression are more sensitive also to the influence of hormonal cyclicity on respiration. The possible bearing of these findings for the aberration in respiration displayed by subjects with premenstrual dysphoria is discussed.

Aggression↗

PubMed2002

Increased incidence of cardiovascular disease in middle-aged men with obstructive sleep apnea: a 7-year follow-up.

The incidence of a cardiovascular disease (CVD) was explored in a consecutive sleep clinic cohort of 182 middle-aged men (mean age, 46.8 +/- 9.3; range, 30-69 years in 1991) with or without obstructive sleep apnea (OSA). All subjects were free of hypertension or other CVD, pulmonary disease, diabetes mellitus, psychiatric disorder, alcohol dependency, as well as malignancy at baseline. Data were collected via the Swedish Hospital Discharge Register covering a 7-year period before December 31, 1998, as well as questionnaires. Effectiveness of OSA treatment initiated during the period as well as age, body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP) at baseline, and smoking habits were controlled. The incidence of at least one CVD was observed in 22 of 60 (36.7%) cases with OSA (overnight oxygen desaturations of 30 or more) compared with in 8 of 122 (6.6%) subjects without OSA (p < 0.001). In a multiple logistic regression model, significant predictors of CVD incidence were OSA at baseline (odds ratio [OR] 4.9; 95% confidence interval [CI], 1.8-13.6) and age (OR 23.4; 95% CI, 2.7-197.5) after adjustment for BMI, SBP, and DBP at baseline. In the OSA group, CVD incidence was observed in 21 of 37 (56.8%) incompletely treated cases compared with in 1 of 15 (6.7%) efficiently treated subjects (p < 0.001). In a multiple regression analysis, efficient treatment was associated with a significant risk reduction for CVD incidence (OR 0.1; 95% CI, 0.0-0.7) after adjustment for age and SBP at baseline in the OSA subjects. We conclude that the risk of developing CVD is increased in middle-aged OSA subjects independently of age, BMI, SBP, DBP, and smoking. Furthermore, efficient treatment of OSA reduces the excess CVD risk and may be considered also in relatively mild OSA without regard to daytime sleepiness.

Aged↗

PubMed2002

Plasma vascular endothelial growth factor in sleep apnea syndrome: effects of nasal continuous positive air pressure treatment.

Sleep apnea syndrome is associated with recurrent episodic hypoxia during sleep, which has been implicated in the development of cardiovascular morbidity. Hypoxia is the major stimulus of vascular endothelial growth factor (VEGF), which is a potent angiogenic cytokine. In the present article we describe the results of three experiments in which plasma concentrations of VEGF were measured in patients with sleep apnea. In Experiment 1, apnea-hypopnea index was found to be a significant independent predictor of morning VEGF concentrations in 85 male subjects investigated in the sleep laboratory, of whom 47 had an apnea-hypopnea index greater than 20. In Experiment 2, VEGF concentrations measured hourly during the sleep period were found to be significantly higher in a group of five sleep apnea patients compared with six age-similar snorers and six normal young adults (129.1 +/- 43.4 versus 74.6 +/- 11.5 and 32.5 +/- 12.8 pg/ml, respectively [p < 0.007]). In Experiment 3, VEGF concentrations were compared in patients with sleep apnea before and 1 year after nasal continuous positive airway pressure treatment. A significant decrease in VEGF concentrations was found only in patients in whom nocturnal hypoxia improved after treatment (57.1 +/- 62.5 versus 39.6 +/- 46.9 pg/ml, p < 0.01). There was no comparable improvement in patients who did not accept treatment (53.9 +/- 23.6 versus 54.0 +/- 21.5 pg/ml, ns). These results raise the possibility that VEGF may contribute to the long-term adaptation of sleep apnea syndrome to recurrent nocturnal hypoxia.

Adult↗

PubMed2002

Improvement in neuropsychological performance following surgical treatment for obstructive sleep apnea syndrome.

Obstructive sleep apnea syndrome (OSAS) is characterized by snoring and apnea during sleep leading to decreased oxygen saturation and disturbed sleep, excessive daytime sleepiness and neuropsychological disturbances. This study investigates cognitive neuropsychological abilities in a group of 53 OSAS patients before and after treatment with uvulopalatopharyngoplasty. General intellectual ability, verbal learning and memory as well as executive functioning were measured at baseline and 6 months postoperatively. After surgery there were significant improvements in verbal learning and memory (mean change -39, SD 57.3, p < 0.001), recall (mean change -24.3, SD 39.3, p < 0.001) and executive functioning (as assessed by percentage of errors on the Wisconsin Card Sorting Test; mean change -9.1, SD 15.7, p < 0.001). These improvements were in accordance with improvements in the degree of sleep apnea, the oxygen desaturation index (mean change -9.7, SD 15.9, p < 0.001) and arterial minimum oxygen saturation (mean change 4.5%, SD 10.2%, p < 0.01). Surgical treatment seems to improve verbal learning, memory and recall and executive functions in parallel with better oxygenation in OSAS.

Humans↗

PubMed2002

Sleep habits and their association with mortality during 5-year follow-up after coronary artery bypass surgery.

OBJECTIVE: To study various aspects of sleep quality and sleep patterns prior to and after coronary artery bypass surgery and their implications for 5-year survival. METHODS: All patients from western Sweden who underwent coronary artery bypass grafting (CABG) between 1988 and 1991 (n = 2,121) received a questionnaire addressing sleep habits prior to and I year after surgery. Various symptoms and habits related to sleep at the two evaluations were compared. Symptoms and habits related to sleep prior to CABG were then related to 5-year survival. RESULTS: In all, 1,224 patients took part in the evaluation. A highly significant improvement was observed with regard to the following symptoms and habits related to sleep: feeling refreshed upon awakening, feeling tired during daytime, waking up with headache, nightmares, sweating during night time, medication for pain relief at bedtime, involuntarily falling asleep during daytime, apnoea during sleep and mouth dryness during the night. Various symptoms and habits associated with sleep prior to CABG were generally not strongly related to prognosis. Exceptions were feeling refreshed upon awakening and infrequent consumption of pain relief medication at bedtime which both were associated with an improved long-term survival. CONCLUSIONS: A variety of symptoms associated with sleep improve highly significantly after CABG. The occurrence of these symptoms prior to CABG do not generally seem to influence the long-term prognosis.

Adult↗