Biomedical subjects

W H Bonekat

Publications and source records attributed to W H Bonekat.

5 recordsLinked to original sources

PubMed2000

Effects of varying approaches for identifying respiratory disturbances on sleep apnea assessment.

Varying approaches to measuring the respiratory disturbance index (RDI) may lead to discrepant estimates of the severity of sleep-disordered breathing (SDB). In this study, we assessed the impact of varying the use of corroborative data (presence and degree of desaturation and/or arousal) to identify hypopneas and apneas. The relationships among 10 RDIs defined by various definitions of apneas and hypopneas were assessed in 5,046 participants in the Sleep Heart Health Study (SHHS) who underwent overnight unattended 12-channel polysomnography (PSG). The magnitude of the median RDI varied 10-fold (i.e., 29.3 when the RDI was based on events identified on the basis of flow or volume amplitude criteria alone to 2.0 for an RDI that required an associated 5% desaturation with events). The correlation between RDIs based on different definitions ranged from 0.99 to 0.68. The highest correlations were among RDIs that required apneas and hypopneas to be associated with some level of desaturation. Lower correlations were observed between RDIs that required desaturation as compared with RDIs defined on the basis of amplitude criteria alone or associated arousal. These data suggest that different approaches for measuring the RDI may contribute to substantial variability in identification and classification of the disorder.

Adult↗

PubMed1999

Relation of sleepiness to respiratory disturbance index: the Sleep Heart Health Study.

Obstructive sleep apnea syndrome is a well recognized cause of excessive sleepiness; however, the relation of sleepiness to mild sleep-disordered breathing (SDB), which affects as much as half the adult population, is uncertain. In order to explore this relation, we conducted a cross-sectional cohort study of community-dwelling adults participating in the Sleep Heart Health Study, a longitudinal study of the cardiovascular consequences of SDB. The study sample comprises 886 men and 938 women, with a mean age of 65 (SD 11) yr. Sleepiness was quantified using the Epworth Sleepiness Scale (ESS). Sleep-disordered breathing was quantified by the respiratory disturbance index (RDI), defined as the number of apneas plus hypopneas per hour of sleep, measured during in-home polysomnography. When RDI was categorized into four groups (< 5, 5 to < 15, 15 to < 30, >/= 30), a significantly progressive increase in mean ESS score was seen across all four levels of SDB, from 7.2 (4.3) in subjects with RDI < 5 to 9.3 (4.9) in subjects with RDI >/= 30 (p < 0.001). There was no significant modification of this effect by age, sex, body mass index, or evidence of chronic restriction of sleep time or periodic limb movement disorder. The percentage of subjects with excessive sleepiness, defined as an ESS score >/= 11, increased from 21% in subjects with RDI < 5 to 35% in those with RDI >/= 30 (p < 0. 001). We conclude that SDB is associated with excess sleepiness in community-dwelling, middle-aged and older adults, not limited to those with clinically apparent sleep apnea.

Aged↗

PubMed1998

Methods for obtaining and analyzing unattended polysomnography data for a multicenter study. Sleep Heart Health Research Group.

This paper reviews the data collection, processing, and analysis approaches developed to obtain comprehensive unattended polysomnographic data for the Sleep Heart Health Study, a multicenter study of the cardiovascular consequences of sleep-disordered breathing. Protocols were developed and implemented to standardize in-home data collection procedures and to perform centralized sleep scoring. Of 7027 studies performed on 6697 participants, 5534 studies were determined to be technically acceptable (failure rate 5.3%). Quality grades varied over time, reflecting the influences of variable technician experience, and equipment aging and modifications. Eighty-seven percent of studies were judged to be of "good" quality or better, and 75% were judged to be of sufficient quality to provide reliable sleep staging and arousal data. Poor submental EMG (electromyogram) accounted for the largest proportion of poor signal grades (9% of studies had <2 hours artifact free EMG signal). These data suggest that with rigorous training and clear protocols for data collection and processing, good-quality multichannel polysomnography data can be obtained for a majority of unattended studies performed in a research setting. Data most susceptible to poor signal quality are sleep staging and arousal data that require clear EEG (electroencephalograph) and EMG signals.

Electroencephalography↗

PubMed1990

Aerobic capacity of older adults: a training study.

The effects of a four month aerobic conditioning program on heart rate, blood pressure, maximal oxygen consumption (VO2max), and physical work capacity of 55-70 year old sedentary individuals were evaluated. Twenty-eight men and women participated in either 4 months of supervised fast walking or jogging at a prescribed target heart rate or stretching exercises for one hour, three days per week. Gains in VO2max (ml/kg/min) obtained during a Balke maximal treadmill test in aerobic and exercise control subjects were 27% and 9%, respectively. At posttesting subjects in both groups demonstrated improved maximal work rate, increased treadmill time, and experienced lower resting and recovery heart rates, lower resting systolic blood pressure, and fewer premature ventricular depolarizations during exercise testing. In 67 physician-supervised maximal exercise tests, only one subject did not achieve VO2max due to exercise induced arrhythmias. No events of morbidity or mortality occurred as a result of the exercise testing and training. Subjects were contacted 4 years after study participation to determine if they were adhering to an exercise program. Sixty-four percent reported exercising at least 3 days per week in large muscle activities. We conclude that four months of supervised aerobic and nonaerobic exercise training is sufficient to improve aerobic capacity and other indicators of fitness in older, sedentary men and women, and that these previously sedentary people are likely to continue exercising on an individual basis once they have experienced improved physical capacity.

Aged↗

PubMed1988

Cardio-respiratory fitness of young and older active and sedentary men.

Physiological profiles are described for 30 healthy young (20-31 years) and 30 healthy older (50-62 years) men. Half of the individuals in each group reported that during the previous five years they participated frequently in strenuous physical exercises; the other half reported sedentary lifestyles. A treadmill exercise test was used to determine maximal aerobic power (VO2 max). Heart rate and blood pressure were measured during rest, maximal exercise and recovery. The active older men demonstrated significantly lower resting heart rates, lower resting systolic and diastolic blood pressures, higher VO2 max, lower maximal exercise diastolic blood pressure and lower recovery heart rates than the age-matched sedentary men. Compared with the young sedentary men, the older active men had lower resting heart rates and higher VO2 max, walked longer on the treadmill, had lower recovery heart rates and weighed less. Older active men also had higher VO2 max levels than young sedentary men. In summary, physiological profiles of the older active men more closely resembled profiles of active men who were 30 years younger than those of older sedentary men. These results emphasize the range of benefits associated with exercise.

Adult↗