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Biomedical subjects

Kathryn J Reid

Publications and source records attributed to Kathryn J Reid.

7 recordsLinked to original sources
PubMed2006

The relationship between the rate of melatonin excretion and sleep consolidation for locomotive engineers in natural sleep settings.

BACKGROUND: The aim of the study was to examine the role that melatonin production plays in the regulation of sleep consolidation in a population of shiftworkers working and sleeping in their natural environments. METHODS: 253 locomotive engineers (249 male, 4 female, mean age = 39.7 years) participated in the study for a 2-week period whilst working their normal roster patterns. Participants recorded details for all sleep periods in a sleep diary and collected urine samples during each day's main sleep period. The samples were subsequently assayed for the metabolite of melatonin in urine, 6-sulphatoxymelatonin (aMT6s), and the rate of excretion during main sleep periods was calculated. RESULTS: Separate one-way factorial ANOVAs revealed a significant effect of time of sleep onset on aMT6s excretion rate, sleep duration, and subjective sleep quality. Generally, the rate of aMT6s excretion was lower, sleep duration was shorter, and sleep quality was lower for sleeps initiated during the daytime than for sleeps initiated at night. CONCLUSION: Combined with previous studies linking melatonin production and sleep propensity, and others demonstrating the relationship between sleep consolidation and melatonin production in forced desynchrony protocols, the current results indicate that low production of melatonin may play a role in the poor consolidation of daytime sleep in natural sleep settings.

Journal Article↗
PubMed2006

Sleep: a marker of physical and mental health in the elderly.

OBJECTIVE: The objective of this study was to determine the occurrence and recognition of common sleep-related problems and their relationship to health-related quality-of-life measures in the elderly. METHOD: A total of 1,503 participants with a mean age of 75.5 (+/- 6.8, range: 62-100) years from 11 primary care sites serving primarily elderly patients were interviewed. Subjects completed a five-item sleep questionnaire and the SF-12. A Physical Component Summary (PCS-12) and Mental Component Summary (MCS-12) score was calculated. A systematic medical chart review was conducted to determine whether sleep problems were identified by the healthcare providers. RESULTS: A total of 68.9% of patients reported at least one sleep complaint and 40% had two or more. Participants most commonly endorsed (45%) that they had "difficulty falling asleep, staying asleep, or being able to sleep." The number and type of sleep problems endorsed was associated with both physical and mental health quality-of-life status. Excessive daytime sleepiness was the best predictor of poor mental and physical health-related quality of life. Even when all five sleep questions were endorsed, a sleep complaint was only reported in the chart 19.2% of the time. CONCLUSIONS: When elicited, sleep complaints predicted the general physical and mental health-related quality-of-life status in elderly populations with comorbid medical and mental illnesses. Yet, questions regarding sleep are not an integral component of most clinical evaluations. Given the growing evidence of a relationship between sleep and health, identification of sleep disorders could lead to improved management of common age-related chronic illnesses and quality of life of elderly patients.

Aged↗
PubMed2005

Circadian rhythm sleep disorders.

Individuals who have circadian rhythm sleep disorders present with symptoms of insomnia or excessive sleepiness and complain of an inability to sleep at their desired time. Although the primary etiology of these disorders is a misalignment between the endogenous circadian clock and the external environment, social and behavioral factors can also play important roles in perpetuating or exacerbating these disorders. Currently, the management of circadian rhythm disorders is limited to the use of bright light and melatonin to realign the circadian clock with the desired sleep time.However, as the understanding of the physiologic and genetic basis of sleep and circadian rhythm regulation advances, even more practical and effective treatments should become available.

Humans↗
PubMed2005

Cystic fibrosis patients have poor sleep quality despite normal sleep latency and efficiency.

STUDY OBJECTIVES: Cystic fibrosis (CF) patients may be predisposed to poor sleep quality due to upper and lower airway abnormalities and impaired gas exchange. Previous sleep investigations of CF patients using single-night polysomnography have reported conflicting results. We hypothesized that sampling sleep for a prolonged period in a patient's normal environment may give a more representative assessment of sleep quality than a single-night polysomnogram, and that impaired sleep quality would correlate with pulmonary disease severity and self-assessed sleep quality. DESIGN: Using wrist actigraphy, we measured sleep quality in clinically stable CF patients and age-matched control subjects. In addition, each CF patient and control subject completed the following three questionnaires: the Epworth sleepiness scale; the Pittsburgh sleep quality index (PSQI); and the Medical Outcomes Study 36-item short form. RESULTS: Twenty CF patients and control subjects were enrolled in the study, and were well-matched for age, sex, and body mass index. The mean (+/- SD) FEV(1) for CF patients was 61.0 +/- 20.1% predicted. CF patients and control subjects had similar sleep duration, sleep latency, and sleep efficiency. However, CF patients had higher PSQI scores (6.45 vs 4.55, respectively; p = .04), a higher fragmentation index (FI) [31.72 vs 18.02, respectively; p < 0.001], and less immobile time (88.87 vs 91.89, respectively; p = 0.02). There was a significant correlation of FI with FEV(1) and PSQI scores. CONCLUSIONS: Stable CF patients have disrupted sleep, and sleep disruption may in part be related to the severity of pulmonary disease. In addition, the PSQI may be useful in detecting CF patients with poor sleep quality.

Adult↗
PubMed2004

Circadian rhythm disorders.

Circadian rhythm sleep disorders occur when individuals attempt to sleep at the wrong circadian time. The misalignment between the internal circadian timing system and the external environment is typically due to either an alteration in the functioning of the circadian timing system (e.g., delayed or advanced sleep phase syndrome) or to changes in the external environment (e.g., jet lag). However, the clinical presentation of most of the circadian rhythm sleep disorders is influenced by a combination of physiological, behavioral, and environmental factors. These disorders lead to complaints of insomnia and excessive daytime sleepiness, with impairment in important areas of functioning and quality of life. Current treatments primarily involve the use of circadian synchronizing agents, such as light, to realign the internal and external environment. These treatments are limited by the availability of adequate diagnostic tools and well-controlled clinical trials. A better understanding of the pathophysiology of these disorders is required to develop more effective treatments.

Humans↗
PubMed2003

Laser-assisted uvulopalatoplasty and tonsillectomy for the management of obstructive sleep apnea syndrome.

OBJECTIVES/HYPOTHESIS: Laser-assisted uvulopalatoplasty (LAUP) is a widely accepted procedure for the management of snoring, but its role in the treatment of obstructive sleep apnea syndrome is currently unclear. The objective of the study was to evaluate the role of LAUP in treating moderate and severe obstructive sleep apnea syndrome. STUDY DESIGN: Retrospective review of a surgical treatment protocol for obstructive sleep apnea syndrome. METHODS: Between October 1993 and January 1999, 80 patients with moderate or severe obstructive sleep apnea syndrome and a significant component of retropalatal obstruction were treated with surgery at the Department of Otolaryngology at Northwestern University Medical School (Chicago, IL). Surgery consisted of LAUP with tonsillectomy (if tonsils were present) with the patient under general anesthesia or LAUP alone with local anesthesia (if the tonsils were absent). No patients received traditional uvulopalatopharyngoplasty. Sixty-four of the 80 patients underwent both preoperative and postoperative polysomnograms. Surgical "response" was defined as a 50% decrease in the apnea-hypopnea index (AHI) (the total number of apneic and hypopneic events per hour of sleep); surgical "cure" was defined as a 50% decrease in AHI and a final AHI of less than 20. RESULTS: The surgical response rate was 59% (38 of 64 patients), and the surgical cure rate was 39% (25 of 64 patients). Twelve patients (18.8%) had a higher AHI after surgery. The AHI (mean +/- SD) changed significantly from 51.4 +/- 30.9 preoperatively to 26.3 +/- 20.8 on postoperative polysomnogram (P = 7.0 x 10-9). Laser-assisted uvulopalatoplasty alone was performed in 33 patients with a response rate of 61% and a cure rate of 42%. Laser-assisted uvulopalatoplasty with tonsillectomy was performed in 31 patients with a response rate of 58% and a cure rate of 35%. The overall incidence of nasopharyngeal insufficiency was 0%. CONCLUSION: The results of the study suggested that LAUP with adjunctive tonsillectomy is an effective treatment for patients with obstructive sleep apnea syndrome and retropalatal obstruction with a lower complication rate than standard surgical therapy (uvulopalatopharyngoplasty).

Adult↗