Obstructive sleep apnea is a chronic illness with increasing prevalence. In addition to associated cardiovascular comorbidities, obstructive sleep apnea syndrome has been linked to poor quality of life, occupational accidents, and motor vehicle crashes secondary to excessive daytime sleepiness. Although continuous positive airway pressure is the gold standard for sleep apnea treatment, its effects on quality of life are not well defined. In the current study we investigated the effects of treatment on quality of life using the data from the Apnea Positive Pressure Long-term Efficacy Study (APPLES), a randomized controlled trial of continuous positive airway pressure (CPAP) versus sham CPAP. The Calgary Sleep Apnea Quality of Life Index (SAQLI) was used to assess quality of life. Overall we found no significant improvement in quality of life among sleep apnea patients after CPAP treatment. However, after stratifying by OSA severity, it was found that long-term improvement in quality of life might occur with the use of CPAP in people with severe and possibly moderate sleep apnea, and no demonstrable improvement in quality of life was noted among participants with mild obstructive sleep apnea.

Obstructive sleep apnea syndrome (OSAS) is characterized by snoring, apneas and excessive daytime sleepiness (EDS). Obesity is a risk factor for snoring and sleep apnea, but data on other factors in relation to obesity are ambiguous. Symptoms of sleep apnea in women have not been fully elucidated. OSAS is an important risk factor for cardiovascular disease (CVD). A common feature in patients with CVD and sleep apnea is an increase in systemic inflammation. From the general population 7,051 women ≥ 20 years answered a questionnaire on snoring and sleep disturbances. Habitual snoring was found in 8% of the total population, and influenced by age, obesity and smoking. The highest prevalence (14%) was found in women 50-59 years. In lean women, alcohol dependence was associated with snoring, while physical inactivity was a risk factor for snoring in obese women. Further, 230 snoring women and 170 women regardless of snoring status were investigated with polysomnography, blood sampling and anthropometric measurements. Of these, 132 participants underwent an ocular and endoscopic examination of their upper airways. Several findings in the upper airways characterised normal-weight women with an apnea-hypopnea index (AHI) ≥ 10. In women with BMI of > 25, no pharyngeal characteristics predicted sleep apnea. When adjusting for age, obesity, smoking, AHI and sleep parameters, several aspects of daytime sleepiness correlated to snoring independently of AHI (EDS, falling asleep involuntarily during day, waking up unrefreshed and fatigue). No symptoms correlated to AHI independently of snoring. Blood samples were analysed for systemic inflammation (CRP, TNFα, IL-6, myeloperoxidase (MPO) and lysozyme). Strong correlations were found between obesity and inflammatory markers. AHI and nocturnal hypoxia correlated to all markers except MPO. When adjusting for age, obesity and smoking, only IL-6 and TNFα were independently associated with nocturnal hypoxia. In conclusion, age and obesity influence the prevalence of snoring and sleep apnea in women from the general population. Other risk factors differ according to BMI. Daytime symptoms are independently related to snoring per se. Despite a strong correlation between obesity and inflammation, an independent relationship between sleep apnea and inflammatory markers was found.

BACKGROUND: Sleep problems affect people of all ages, race, gender, and socioeconomic classifications. Undiagnosed sleep disorders significantly and adversely impact a person’s level of academic achievement, job performance, and subsequently, socioeconomic status. Undiagnosed sleep disorders also negatively impact both direct and indirect costs for employers, the national government, and the general public. Sleepiness has significant implications on quality of life by impacting occupational performance, driving ability, cognition, memory, and overall health. The purpose of this study is to describe the prevalence of daytime sleepiness, as well as other quantitative predictors of sleep continuity and quality. METHODS: Population data from the CDC program in fatigue surveillance were used for this secondary analysis seeking to characterize sleep quality and continuity variables. Each participant underwent a standard nocturnal polysomnography and a standard multiple sleep latency test (MSLT) on the subsequent day. Frequency and chi-square tests were used to describe the sample. One-Way Analysis of Variance (ANOVA) was used to compare sleep related variables of groups with sleep latencies of <5 >minutes, 5-10 minutes, and >10 minutes. Bivariate and multivariate logistic regression was used to examine the association of the sleep variables with sleep latency time. RESULTS: The mean (SD) sleep latency of the sample was 8.8 (4.9) minutes. Twenty-four individuals had ≥1 SOREM, and approximately 50% of participants (n = 100) met clinical criteria for a sleep disorder. Individuals with shorter sleep latencies, compared to those with longer latencies reported higher levels of subjective sleepiness, had higher sleep efficiency percentages, and longer sleep times. The Epworth Sleepiness Scale, sleep efficiency percentage, total sleep time, the presence of a sleep disorder, and limb movement index were positively associated with a mean sleep latency of <5 >minutes. CONCLUSIONS: The presence of a significant percentage of sleep disorders within our study sample validate prior suggestions that such disorders remain unrecognized, undiagnosed, and untreated. In addition, our findings confirm questionnaire-based surveys that suggest a significant number of the population is excessively sleepy, or hypersomnolent. Therefore, the high prevalence of sleep disorders and the negative public health effects of daytime sleepiness demand attention. Further studies are now required to better quantify levels daytime sleepiness, within a population based sample, to better understand their impact upon morbidity and mortality. This will not only expand on our current understanding of daytime sleepiness, but it will also raise awareness surrounding its significance and relation to public health.

Pediatric sleep problems are among the most common yet significant pediatric health issues faced by families. Sleep problems can impact social-emotional and academic functioning of schoolchildren. Once identified, pediatric sleep problems and disorders are treatable with effective and rapid behavioral and medical interventions. The purpose of the current study was to determine the prevalence rates of symptoms of sleep disorders in a diverse school-based sample as well as the relationship between symptoms of sleep disorders and school behavior, academic achievement, and quality of life. The present study examined the relationship between the independent variables of No Sleep Disorders symptoms and Sleep Disorders symptoms derived from the Sleep Disorders Inventory for Students, Children's Form (SDIS-C) and the dependent variables Externalizing and Internalizing scales of the Behavior Assessment System for Children, Second Edition (BASC-2), Curriculum-based Measurement Re ading (R-CBM), Curriculum-based Measurement Math (M-CBM), PedsQL TM 4.0, and Students' Life Satisfaction Scale (SLSS). A Multivariate analysis of variance (MANOVA) was used to identify a significant difference between students with and without symptoms of sleep disorders on behavior, academics, and quality of life. Follow-up analyses using a modified Bonferroni adjustment determined significant differences between students with and without symptoms of sleep disorders on R-CBM, externalizing behaviors and internalizing behaviors. Medium effect sizes were reported for R-CBM, externalizing and internalizing behaviors and M-CBM. Very small effect sizes were found for PedsQL TM 4.0 and SLSS. Implications for School Psychologists and directions for future practice and research are discussed including understanding prevention, early identification and intervention, broadening the scope of school psychology training at the preservice and inservice levels and educating locally and nationall y.

A relationship between overweight and excessive daytime sleepiness (EDS) has been suggested in the adult population, and to a limited extent in the pediatric population. Daytime sleepiness can interfere with various components of daytime function. In light of the increase in the rates of pediatric overweight and obesity, the aim of this study was to investigate the relationship between weight and EDS in a pediatric population. Using a retrospective approach, data collected in a pediatric sleep clinic was analyzed. Objective measures of EDS were correlated with age, gender, body mass index percentile, and overnight sleep test recording variables. In males and in all children under the age of 13 years old, EDS was more common in those weighing above the normal range, EDS was present particularly during mid-morning hours. Additionally, weight above the normal range correlated with evidence of EDS after adjusting for measures of sleep pathologies.

A relationship between overweight and excessive daytime sleepiness (EDS) has been suggested in the adult population, and to a limited extent in the pediatric population. Daytime sleepiness can interfere with various components of daytime function. In light of the increase in the rates of pediatric overweight and obesity, the aim of this study was to investigate the relationship between weight and EDS in a pediatric population. Using a retrospective approach, data collected in a pediatric sleep clinic was analyzed. Objective measures of EDS were correlated with age, gender, body mass index percentile, and overnight sleep test recording variables. In males and in all children under the age of 13 years old, EDS was more common in those weighing above the normal range, EDS was present particularly during mid-morning hours. Additionally, weight above the normal range correlated with evidence of EDS after adjusting for measures of sleep pathologies.

O impacto da dimensão matutinidade/vespertinidade pode interferir no comportamento social e na saúde do indivíduo. Nos últimos anos, esta dimensão tem sido amplamente estudada dentro do âmbito da cronobiologia. Este estudo transversal teve como objetivo determinar o cronotipo de estudantes universitários do 6º semestre dos cursos de turno integral da Universidade de Passo Fundo - Rio Grande do Sul e observar a associação desses cronotipos com parâmetros sociodemográficos, comportamentais e também com a qualidade do sono, a sonolência diurna e distúrbios psiquiátricos menores. Os instrumentos utilizados na pesquisa foram: Pittsburg (PSQI), para avaliar a prevalência da qualidade do sono; Horne Ostberg (MEQ), para determinar o cronotipo; o SRQ20, para os distúrbios psiquiátricos menores; o Epwort (ESS), para sonolência diurna; o AUDIT, para o uso de álcool, e um questionário para variáveis sociodemográficas e comportamentais. Participaram do estudo 372 estudantes, 66,7% do sexo feminino e 33,3% masculino, com idade média de 21,6 anos DP±3,08 (IC min18 max 50); 92,2% não faziam uso de tabaco; 58,9% praticam atividade física e 58,6 % apresentaram consumo de risco para o álcool; referiram trabalhar no terceiro turno 19,7%. Quanto à prevalência para os cronotipos, foram encontrados cronotipos indiferentes 55,9%, seguidos de 39,5% para vespertinos e 4,6% matutinos. Cronotipos vespertinos foram associados ao sexo masculino odds ratio OR=1,72; pobre qualidade do sono OR=1,89; distúrbios psiquiátricos menores OR=1,92 e uso de tabaco OR=3,65. Estes resultados apontam a necessidade de ações educativas e preventivas para esta população vulnerável, no intuito de minimizar possíveis danos à sua saúde física e mental. / The impact of morningness-eveningness dimension can affect social behavior and individual health. The aim of the present study was to determine the chronotype of full time university students in the 6th semester of the Universidade de Passo Fundo - Rio Grande do Sul, Brazil - and evaluate its influence in behavioral parameters. The instruments used in the study were: a demographic questionnaire; PSQI to evaluate sleep quality; MEQ to determine chronotypes; SRQ-20 to minor psychiatric disorders; ESS to daytime sleepiness; AUDIT to alcohol use. 372 students participated in the study: 66.7% were female and 33.3% were male; aged 21.6 years + 3.08 (mean +SD). 92,2% did not use tobacco, 58.9% practiced physical activity and 58,6 showed risks of alcohol abuse; 19.7% reported working in third shift. Regarding the prevalence of chronotypes, it was found 55,9% of indifferent chronotypes, 39,5% of evening, and 4,6% of morning type. Evening chronotypes was associated that male gender odds ratio OR =1,72; poor sleep quality OR=1,89; minor psyquiatric disorders OR= 1,92 and tobacco use OR=3,65. So this study concluded that evening chronotype was related with gender, poor sleep quality, minor psychiatric disorders and tobacco use in the studied population and points to preventive actions and education for this vulnerable population.

O impacto da dimensão matutinidade/vespertinidade pode interferir no comportamento social e na saúde do indivíduo. Nos últimos anos, esta dimensão tem sido amplamente estudada dentro do âmbito da cronobiologia. Este estudo transversal teve como objetivo determinar o cronotipo de estudantes universitários do 6º semestre dos cursos de turno integral da Universidade de Passo Fundo - Rio Grande do Sul e observar a associação desses cronotipos com parâmetros sociodemográficos, comportamentais e também com a qualidade do sono, a sonolência diurna e distúrbios psiquiátricos menores. Os instrumentos utilizados na pesquisa foram: Pittsburg (PSQI), para avaliar a prevalência da qualidade do sono; Horne Ostberg (MEQ), para determinar o cronotipo; o SRQ20, para os distúrbios psiquiátricos menores; o Epwort (ESS), para sonolência diurna; o AUDIT, para o uso de álcool, e um questionário para variáveis sociodemográficas e comportamentais. Participaram do estudo 372 estudantes, 66,7% do sexo feminino e 33,3% masculino, com idade média de 21,6 anos DP±3,08 (IC min18 max 50); 92,2% não faziam uso de tabaco; 58,9% praticam atividade física e 58,6 % apresentaram consumo de risco para o álcool; referiram trabalhar no terceiro turno 19,7%. Quanto à prevalência para os cronotipos, foram encontrados cronotipos indiferentes 55,9%, seguidos de 39,5% para vespertinos e 4,6% matutinos. Cronotipos vespertinos foram associados ao sexo masculino odds ratio OR=1,72; pobre qualidade do sono OR=1,89; distúrbios psiquiátricos menores OR=1,92 e uso de tabaco OR=3,65. Estes resultados apontam a necessidade de ações educativas e preventivas para esta população vulnerável, no intuito de minimizar possíveis danos à sua saúde física e mental. / The impact of morningness-eveningness dimension can affect social behavior and individual health. The aim of the present study was to determine the chronotype of full time university students in the 6th semester of the Universidade de Passo Fundo - Rio Grande do Sul, Brazil - and evaluate its influence in behavioral parameters. The instruments used in the study were: a demographic questionnaire; PSQI to evaluate sleep quality; MEQ to determine chronotypes; SRQ-20 to minor psychiatric disorders; ESS to daytime sleepiness; AUDIT to alcohol use. 372 students participated in the study: 66.7% were female and 33.3% were male; aged 21.6 years + 3.08 (mean +SD). 92,2% did not use tobacco, 58.9% practiced physical activity and 58,6 showed risks of alcohol abuse; 19.7% reported working in third shift. Regarding the prevalence of chronotypes, it was found 55,9% of indifferent chronotypes, 39,5% of evening, and 4,6% of morning type. Evening chronotypes was associated that male gender odds ratio OR =1,72; poor sleep quality OR=1,89; minor psyquiatric disorders OR= 1,92 and tobacco use OR=3,65. So this study concluded that evening chronotype was related with gender, poor sleep quality, minor psychiatric disorders and tobacco use in the studied population and points to preventive actions and education for this vulnerable population.

O impacto da dimensão matutinidade/vespertinidade pode interferir no comportamento social e na saúde do indivíduo. Nos últimos anos, esta dimensão tem sido amplamente estudada dentro do âmbito da cronobiologia. Este estudo transversal teve como objetivo determinar o cronotipo de estudantes universitários do 6º semestre dos cursos de turno integral da Universidade de Passo Fundo - Rio Grande do Sul e observar a associação desses cronotipos com parâmetros sociodemográficos, comportamentais e também com a qualidade do sono, a sonolência diurna e distúrbios psiquiátricos menores. Os instrumentos utilizados na pesquisa foram: Pittsburg (PSQI), para avaliar a prevalência da qualidade do sono; Horne Ostberg (MEQ), para determinar o cronotipo; o SRQ20, para os distúrbios psiquiátricos menores; o Epwort (ESS), para sonolência diurna; o AUDIT, para o uso de álcool, e um questionário para variáveis sociodemográficas e comportamentais. Participaram do estudo 372 estudantes, 66,7% do sexo feminino e 33,3% masculino, com idade média de 21,6 anos DP±3,08 (IC min18 max 50); 92,2% não faziam uso de tabaco; 58,9% praticam atividade física e 58,6 % apresentaram consumo de risco para o álcool; referiram trabalhar no terceiro turno 19,7%. Quanto à prevalência para os cronotipos, foram encontrados cronotipos indiferentes 55,9%, seguidos de 39,5% para vespertinos e 4,6% matutinos. Cronotipos vespertinos foram associados ao sexo masculino odds ratio OR=1,72; pobre qualidade do sono OR=1,89; distúrbios psiquiátricos menores OR=1,92 e uso de tabaco OR=3,65. Estes resultados apontam a necessidade de ações educativas e preventivas para esta população vulnerável, no intuito de minimizar possíveis danos à sua saúde física e mental. / The impact of morningness-eveningness dimension can affect social behavior and individual health. The aim of the present study was to determine the chronotype of full time university students in the 6th semester of the Universidade de Passo Fundo - Rio Grande do Sul, Brazil - and evaluate its influence in behavioral parameters. The instruments used in the study were: a demographic questionnaire; PSQI to evaluate sleep quality; MEQ to determine chronotypes; SRQ-20 to minor psychiatric disorders; ESS to daytime sleepiness; AUDIT to alcohol use. 372 students participated in the study: 66.7% were female and 33.3% were male; aged 21.6 years + 3.08 (mean +SD). 92,2% did not use tobacco, 58.9% practiced physical activity and 58,6 showed risks of alcohol abuse; 19.7% reported working in third shift. Regarding the prevalence of chronotypes, it was found 55,9% of indifferent chronotypes, 39,5% of evening, and 4,6% of morning type. Evening chronotypes was associated that male gender odds ratio OR =1,72; poor sleep quality OR=1,89; minor psyquiatric disorders OR= 1,92 and tobacco use OR=3,65. So this study concluded that evening chronotype was related with gender, poor sleep quality, minor psychiatric disorders and tobacco use in the studied population and points to preventive actions and education for this vulnerable population.

Commercial vehicle drivers are required to maintain Department Of Transportation medical certification which entails a Commercial Driver Medical Examination (CDME) and optimally leads to a two-year certification. The examination must be performed by a licensed "medical examiner" administered by a variety of health care providers including physicians, advanced registered nurse practitioners, physician assistants and doctors of chiropractic. Unfavorable findings in the examination can yield either a shortened medical certification period or denial of certification. Sleep disorders including sleep apnea are assessed by a single question located in the health history portion of the CDME form which is filled-out by the examinee. A positive response to this single item often prompts the medical examiner to further supplement this question using a subjective questionnaire, such as the Epworth Sleepiness Scale. This particular questionnaire generates a total score based on the examinee's subjective responses to eight items regarding the propensity to doze-off or fall asleep in different scenarios, thus indicating daytime sleepiness. Commercial drivers depend on the medical certification for their livelihood and it is hypothesized that subjective responses regarding daytime sleepiness are distorted in an effort to attain optimal DOT certification.