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Biomedical subjects

M Partinen

Publications and source records attributed to M Partinen.

At least 37 records · Page 2Linked to original sources
PubMed1998

Sleeptalking in twins: epidemiology and psychiatric comorbidity.

Sleeptalking is usually benign but chronic cases in adults may relate to psychopathology. We hypothesize substantial genetic influences in the liability to sleeptalking and an association between sleeptalking and psychiatric disorders. In 1990 a questionnaire sent to the Finnish Twin Cohort yielded responses from 1298 monozygotic and 2419 dizygotic twin pairs aged 33-60 years. We used structural equation modelling to estimate genetic and environmental components of variance in the liability to sleeptalking. Register data on hospitalization and long-term antipsychotic medication were used to assess psychiatric comorbidity. The occurrence of childhood and adult sleeptalking was highly correlated. A gender difference was only seen in adults, with sleeptalking being more common in males than in females. The proportion of total phenotypic variance in liability to sleeptalking attributed to genetic influences in childhood sleeptalking was 54% (95% CI, 44-62%) in males and 51% (43-58%) in females, and for adults it was 37% (27-46%) among males and 48% (40-56%) among females. An association with psychiatric comorbidity was found only in adult sleeptalking, and it was highest in those with adult-onset sleeptalking (odds ratio, 3.77; 95% CI, 2.32-6.17). Sleeptalking is quite a persistent trait, also being common in adults. There are substantial genetic effects on sleeptalking both in childhood and as adults, which appear to be highly correlated. In adults psychiatric comorbidity is about twice as common in those with frequent sleeptalking, compared to those with infrequent or no sleeptalking, but most cases of sleeptalking are not associated with serious psychopathology.

Adult↗
PubMed1998

Sleep bruxism based on self-report in a nationwide twin cohort.

The relative roles of genetic and environmental factors in bruxism are not known. In 1990 a questionnaire sent to the Finnish Twin Cohort yielded responses from 1298 monozygotic and 2419 dizygotic twin pairs aged 33-60 years. We used structural equation modelling to estimate genetic and environmental components of variance in the liability to bruxism. There was a significant gender difference both in childhood (P = 0.001) and adult (P = 0.007) bruxism. Females compared to males reported childhood bruxism 'often' 5.2% vs 4.1% and 'sometimes' 17.4% vs 17.3%, and as adults 'weekly' 3.7% vs 3.8% and 'monthly' 3.9% vs 4.6%, respectively. Bruxism in childhood and adulthood is highly correlated (0.86 in males and 0.87 in females). The proportion of total phenotypic variance in liability to bruxism attributed to genetic influences in childhood bruxism was 49% (95% CI 37-60%) in males and 64% (55-71%) in females, and for adults 39% (27-50%) among males and 53% (44-62%) among females. The correlation between the genetic effects on childhood bruxism and the genetic effects on adult bruxism was estimated in a bivariate model to be 0.95 (95% CI 0.94-0.96) in males and 0.89 (0.88-0.90) in females. Bruxism appears to be quite a persistent trait. There are substantial genetic effects on bruxism both in childhood and as adults, which appear to be highly correlated.

Adult↗
PubMed1997

Sleep disorder related to Parkinson's disease.

Sleep disorders occur in 74-98% of patients with idiopathic Parkinson's disease (PD), adversely affecting their quality of life. Sleep disruption takes the form of sleep fragmentation with frequent and prolonged awakenings and daytime sleepiness. Nocturia, difficulty in turning over in bed, painful leg cramps, vivid dreams/nightmares, back pain, limb/facial dystonia and leg jerks are the main causes of nocturnal awakening in PD patients. Sleep disturbance gradually worsens with disease progression, suggesting that it is related to the severity of the disease. Sleep disturbances may be generally considered as part of the normal aging process, being more common in the elderly. However, no significant associations between sleep disturbances and either age or disease duration was found in a survey of 100 PD patients. Disturbed sleep maintenance in PD patients was more severe than in age-matched controls, and nocturnal awakening was frequently caused by nocturia, pain, stiffness and difficulty in turning over in bed. Sleep disturbance is also a complication of chronic levodopa therapy. Recent data suggest that controlled-release levodopa is less likely to cause nocturnal symptoms than standard levodopa, particularly in mild-to-moderate disease. Depression, which is common in PD patients, contributes to sleep disturbance but has a lesser influence than the disease process itself. Hypnotic and sedative agents, as well as anti-depressants if required, are useful in ameliorating sleep disturbances in PD patients; intranasal desmopressin appears to be effective in reducing nocturia.

Humans↗
PubMed1997

Prevalence and genetics of sleepwalking: a population-based twin study.

We investigated the prevalence of sleepwalking using a well defined population previously used for epidemiologic investigations: the Finnish Twin Cohort. The study population consisted of 11,220 subjects aged 33 to 60 years, and it included 1,045 monozygotic and 1,899 dizygotic twin pairs. Questions on the frequency of sleepwalking were asked separately for occurrence in childhood and adulthood. Childhood sleepwalking was significantly more frequent in women ("often" in 2.8% of women and 2.0% of men and "sometimes" in 6.9% of women and 5.7% of men). As adults, sleepwalking had occurred in 3.9% of men and in 3.1% of women, and it was reported "weekly" in 0.4% for both genders. There was no significant difference in frequency between monozygotic and dizygotic twin individuals, either in childhood or adulthood. For sleepwalking in childhood the probandwise concordance rate was 0.55 for monozygotic and 0.35 for dizygotic pairs, and for adults, 0.32 for monozygotic, and 0.06 for dizygotic pairs. Those who reported never having walked in their sleep in childhood did so as adults rarely (0.6%), both men and women. Those who reported walking in their sleep often or sometimes in childhood did so as adults for 24.6% of men and for 18.3% of women. Of adult men sleepwalkers 88.9% had a positive history of sleepwalking in childhood, and in women, 84.5%. The proportion of total phenotypic variance attributed to genetic influences was 66% in men and 57% in women in childhood sleepwalking, and 80% in men and 36% in women in adult sleepwalking. Our results show that there are substantial genetic effects in sleepwalking in both childhood and adulthood.

Adult↗
PubMed1996

Daytime sleepiness in an adult, Finnish population.

OBJECTIVES: To investigate the prevalence of and the factors associated with daytime sleepiness occurring every or almost every day. DESIGN: A cross-sectional, questionnaire survey. SUBJECTS: A total of 11,354 adults (aged 33-60 years) representative of the Finnish population. MAIN OUTCOME MEASURES: Frequency of daytime sleepiness, naps and sleep attacks; occurrence of emotion-associated muscle weakness, sleep debt, insomnia, sleep apnoeas and type of snoring; Beck Depression Inventory score; and the use of hypnotics and tranquillisers. RESULTS: A total of 11.0% of women and 6.7% of men suffered from daytime sleepiness every or almost every day. Amongst those with sleepiness (n = 1,026) 19.5% of women and 42.3% of men reported snoring > or = 3 nights per week, 25% had scores suggesting moderate to severe depression, 11% used hypnotics or tranquilizers on more than 180 days per year, and 9% reported insufficient sleep. Insomnia at least every other day was reported by 20.7% of women and by 28.6% of men. Amongst those with sleepiness, narcolepsy was found in 0.3%, with the diagnosis confirmed in a sleep laboratory evaluation. CONCLUSIONS: Daytime sleepiness occurring daily or almost daily is most often associated with depression, insomnia and sleep-disordered breathing. In most cases, indications of the cause of sleepiness can be obtained by using simple screening questions.

Adult↗
PubMed1996

Narcolepsy-like symptoms among adult twins.

The genetic architecture of narcolepsy is poorly known. Genetic and environmental components of symptoms characteristic of narcolepsy, excessive sleepiness and cataplexy were assessed in a population-based sample of middle-aged like-sexed twin pairs. Questionnaire assessment of the 11-item Ullanlinna Narcolepsy Scale (UNS), a validated screening instrument for narcolepsy [J. Sleep Res. (1994) 3, 52-59] and two subscales (sleepiness and cataplexy-like symptoms) was obtained from both twins of 3785 pairs aged 33-60 y (541 male MZ pairs, 1089 male DZ pairs, 781 female MZ and 1374 female DZ pairs) from the population-based Finnish Twin Cohort. For the UNS scores, the intraclass correlation for male MZ pairs was 0.365 and for male DZ pairs 0.072, while for female pairs the MZ correlation was 0.375 and for DZ pairs 0.155. Structural equation model fitting indicated that a model with additive and non-additive genetic effects, and idiosyncratic environmental effects best accounted for the pattern of twin resemblance in both men and women. Genetic effects accounted for 35% (in men) and for 39% (in women) of total phenotypic variance in UNS. Analysis of the subscales suggested that there may be a greater genetic component to the sleepiness subscale, while environmental components play more of a role in the development of cataplexy-like symptoms. Further investigation of the complex genetic architecture of narcolepsy and its symptoms is warranted.

Adolescent↗
PubMed1996

Striatal dopamine D1 receptors in narcolepsy: a PET study with [11C]NNC 756.

We investigated dopamine D1 receptors in the putamen and caudate nucleus with positron emission tomography in six patients with narcolepsy and five healthy controls using [11C]NNC 756 as ligand. The caudate-to-cerebellum and putamen-to-cerebellum ratios of [11C]NNC 756 were within normal limits in patients with narcolepsy. No evidence of increased D1 receptor binding in narcolepsy was found.

Adult↗
PubMed1996

Nasal-CPAP, surgery, and conservative management for treatment of obstructive sleep apnea syndrome. A randomized study.

STUDY OBJECTIVE: To assess separately the effectiveness and safety of nasal-continuous positive airway pressure (N-CPAP) and that of surgery in comparison to conservative management in patients with obstructive sleep apnea syndrome (OSAS). DESIGN. A randomized study with 1-year follow-up. SETTING: A university hospital acting as a referral center for OSAS. PATIENTS: Symptomatic patients with OSAS (72 male and 4 female patients aged 18 to 65 years), who had oxygen desaturations in the overnight recording. INTERVENTIONS: After the initial diagnostic workup, patients were considered to be candidates for either N-CPAP (44 patients) or surgical treatment (uvulopalatopharyngoplasty [UPPP] with or without mandibular osteotomy) (32 patients). Within the groups, the patients were then randomized to either the assigned treatment or conservative management. MAIN OUTCOME MEASURES: The number of nocturnal oxygen desaturation events of 4% or more per hour in bed (ODI4); daytime somnolence; side effects. RESULTS: N-CPAP Group: Compliance with N-CPAP therapy at 1 year was 13 of 21. The most common reason for noncompliance was general intolerance of CPAP. All compliant patients had a normal ODI4 ( < 10), whereas 1 of 20 of their control subjects had a normal finding. Patients receiving active treatment were significantly less somnolent than their control subjects at 1 year (p < 0.05). SURGERY GROUP: At 1 year, 7 of 18 of the surgically treated and 1 of 14 of the conservatively treated patients had a normal ODI4 (p < 0.001). Daytime somnolence was significantly less severe in the surgically treated patients compared with their control subjects (p < 0.001) both at 3 and 12 months. The overall postoperative complication rate was 22%. CONCLUSIONS: N-CPAP is an effective therapy for OSAS, but compliance is a problem. Surgical therapy (UPPP with or without mandibular osteotomy) needs further evaluation.

Adolescent↗
PubMed1995

Use of computerized visual performance test in assessing day-time vigilance in patients with sleep apneas and restless sleep.

We have studied day-time vigilance in 31 patients (median age 49 years) with suspected sleep disorders using a new visual reaction time and performance test. The findings in the day-time vigilance test were compared with the number of desaturation events and movement arousals measured with a sensitive movement detector in the night-time. In our statistical model the high number of desaturations correlated with a high dispersion in reaction-times. The squared multiple r was 0.465 in a model where the dispersion of reaction times was the dependent variable and the number of desaturations, duration of quiet sleep and the mode of oxygen saturation were independent variables. A high amount of body movements (movement arousals, duration less than 5 seconds) correlated with gradual deterioration in the performance test. The squared multiple r was 0.447 in a model where the regression coefficient of reaction times was the dependent variable and active sleep and number of body movements less than 5 seconds in duration were the independent variables. Frequent arousals in apnoeic patients are observed in hyper-excitable responders and are known to cause sleep deprivation and hypersomnia. Our findings in desaturating patients indicate that in those with a low chemoreceptor response to hypoxia the failure in day-time regulation of vigilance may differ from the failure associated with sleep-deprivation.

Arousal↗
PubMed1995

Epidemiology of obstructive sleep apnea syndrome.

Obstructive sleep apnea syndrome is the most common organic sleep disorder resulting in excessive daytime somnolence. It is almost as common as asthma. According to recent epidemiologic studies, the prevalence of obstructive sleep apnea syndrome is probably about 2% in women and somewhere around 4% in adult men in general. Many elderly people have the syndrome, and it is very common among patients who are morbidly obese, acromegalic, asthmatic; patients with arterial hypertension and heart disease, those with adult onset diabetes; and among patients with craniofacial abnormalities. In those groups, more than 30% or 40% of patients may have obstructive sleep apnea syndrome. Even more patients may have sleep apnea without daytime symptoms or partial upper airway obstruction during sleep. Among children, symptoms such as snoring and apneic episodes are relatively rare, but a high proportion of children with these symptoms have hypoxic respiratory events. Some recent methodologic issues and use of questionnaires are discussed.

Adult↗
PubMed1995

Basic Nordic Sleep Questionnaire (BNSQ): a quantitated measure of subjective sleep complaints.

Sleep-related breathing disturbances, especially obstructive sleep apnoea syndrome (OSAS), are commonly encountered. Epidemiological studies from different countries have shown that poor sleep and complaints about insufficient sleep or poor sleep are often related to poor health. Different studies are, however, difficult to compare with each other. One of the main reasons for this is the frequent methodological differences between questionnaires. There is a need for uniform methods: we need to know the prevalence and incidence of sleep disorders, judged using the same criteria, and also the severity of each problem, i.e. how often a problem or a symptom happens/occurs. In 1988 the Scandinavian Sleep Research Society formed a task group for developing a standardized questionnaire that could be used as a basis for questionnaires used in the Nordic countries. In this article we describe the Basic Nordic Sleep Questionnaire (BNSQ). The main change compared to many previous questionnaires is the five-point scale (scale from 1 to 5) stressing on how many nights/days per week something happens. The basic scale is: 1, 'never or less than once per month'; 2, 'less than once per week'; 3, 'on 1-2 nights per week'; 4, 'on 3-5 nights per week'; and 5, 'every night or almost every night'. For questions about specific rare events the first category may be divided into 'never' and 'less than once per month'. Habitually occurring events such as 'habitual snoring' are defined here as snoring every night or almost every night. The BNSQ has been used widely in a variety of studies performed in Nordic countries during the last years, and it has proven to be a valid tool.

Journal Article↗
PubMed1995

Ischaemic stroke, snoring and obstructive sleep apnoea.

Ischaemic stroke occurs most often during the morning hours before noon. In recent studies the peak time of onset has been between 10.00 and 12.00 hours. Snoring every night or almost every night (habitual snoring) is in relation with ischaemic stroke. Snoring occasionally, on the contrary, is not significantly related with stroke. Habitual snoring is the most typical sign of obstructive sleep apnoea syndrome and it is strongly associated with being overweight. Other possible pathophysiological factors that are in relation with habitual snoring, obstructive sleep apnoea and stroke include arterial hypertension, changes in fibrinolytic activity, adult onset diabetes and smoking. It remains to be seen whether nightly occurring partial upper airway obstruction (habitual snoring) with intrathoracic pressure changes is an independent risk factor of ischaemic stroke, There is recent evidence that everything cannot be explained by other known risk factors.

Journal Article↗
PubMed1995

Positron emission tomography study of human narcolepsy: no increase in striatal dopamine D2 receptors.

We investigated dopamine D2 receptors in the caudate nucleus and putamen with positron emission tomography in seven patients with narcolepsy and seven healthy controls by using [11C]raclopride as a ligand. We applied an equilibrium method and Scatchard principle to give a quantitative estimation of the number (Bmax) and dissociation constant (Kd) of the receptors. Both the Bmax and Kd were within the normal range in the caudate nucleus and putamen in narcoleptic patients. We found no evidence for increased D2 receptor binding in narcolepsy.

Adolescent↗
PubMed1995

Familial aggregates in obstructive sleep apnea syndrome.

Obstructive sleep apnea syndrome (OSAS) was diagnosed in157 subjects based on clinical symptoms, physical evaluation, cephalometric x-ray films, and polysomnography. These index cases identified 844 living first-degree relatives. Mailings were sent to 792 (94%). The mailing consisted of two identical questionnaires, one for the family member of the index case and one to be given to a friend (not a relative) of approximately the same age. In response, we received 531 (63%) questionnaires from relatives and 198 (25%) questionnaires from age-matched nonrelated friends, which were used as a control group. A more extensive investigation was performed on first-degree relatives of the index group living in the San Francisco Bay Area or vicinity. Two hundred seventy-nine relatives (100%) were identified. One hundred sixty-six subjects (59%) as well as 69 age-matched friends (ie, 41% of the 166 relatives and 25% of the potential total group) agreed to participate in further studies. These subjects had interviews, clinical investigations, and nonattended ambulatory monitoring. Cephalometric x-ray films could be obtained on only 22 of 166 participating relatives and 6 of 69 friends. Body mass index was not a differentiating measure between relatives and friends. Odds ratios (ORs) were calculated from the questionnaiare data. The report of tiredness, fatigue, and sleepiness did not distinguish family members from friends. The OR, however, progressively increases when there is a positive history of near nightly loud snoring (OR = 1.78; 95% confidence interval [CI] 1.25-2.54) or a positive history of daytime sleepiness in conjunction with near nightly loud snoring (OR = 3.11; 95% CI = 1.94-4.99). The investigation in the Bay Area indicated that, when first-degree relatives were compared with friends, the complaint of daytime tiredness, sleepiness, or both with the presence of a high and narrow(ogival) hard palate sharply differentiated between friends and relatives (OR = 10.9, 95, CI = 5.31-22.5). An Epworth Sleepiness Scale score of 9 or greater with the presence of another symptom associated with OSAS, and a respiratory disturbance index greater than 5 (number of apneas and hypopneas per hour of sleep > 5) gave an OR of 45.6 (95% CI = 18.8-11.0). Disproportionate craniofacial anatomy was common in familial groups with OSAS. Craniofacial familial features can be a strong indicator of risk for the development of OSAS.

Adolescent↗
PubMed1995

What does the multiple sleep latency test measure in a community sample?

Multiple sleep latency test (MSLT)-defined daytime sleepiness and its relationships with nocturnal and daytime psychophysiological activation were investigated in a random community sample of 77 subjects aged 35-55 years. The correlation structure between all study variables was explained by a simple model of daytime sleepiness. The model suggested that indicators of psychophysiological arousal (psychological distress, nocturnal motor activity and serum thyrotropin level) and daytime reported tiredness, body mass index (BMI) and age were related significantly and independently to MSLT-defined daytime sleepiness. The arousal theory of insomnia and poor sleep in relation to MSLT behavior is discussed and the need of a multivariate approach is emphasized in MSLT studies.

Adult↗