Laboratory and field studies have consistantly shown that sleep loss negatively impacts on neurobehavioural performance and alertness. Moreover, recent research suggests that the detrimental effects of sleep loss are qualitatively and quantitatively similar to the effects of alcohol intoxication. Despite this, sleepiness-related performance impairment has not been subject to the strict levels of regulatory intervention that govern alcohol consumption when driving and/or at work. It has been proposed that this failure to address the occupational, health and safety impact of sleep loss, and the subsequent lack of legislation to manage and control sleepiness in a manner commensurate with the associated statistical risks, may in part, reflect a failure to provide policy makers with a readily understood index of the relative risk associated with sleep loss. Therefore the aim of the studies in this thesis was to assess and quantify the effects of sleep loss on a range of measures, including neurobehavioural performance, sleepiness, and daytime sleep quality and quantity.

Thesis (Ph. D.)--University of Sydney, 1998. / Title from title screen (viewed Apr. 15, 2008). Submitted in fulfilment of the requirements for the degree of Doctor of Philosophy to the Dept. of Respiratory Medicine, Royal North Shore Hospital, Faculty of Medicine. Degree awarded 1998; thesis submitted 1997. Includes bibliography. Also available in print form.

Thesis (Ph.D.)--Drexel University, 2008. / Includes abstract and vita. Includes bibliographical references (leaves 83-91).

Thesis (M.Med.Sc.)--University of Hong Kong, 2004. / Also available in print.

Thesis Ph.D. - University of Queensland, 2005. / Includes bibliographical references.

Thesis (M.D.)--University of Hong Kong, 2006.

Orientadores: Luis Augusto Passeri / Texto em português e inglês / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-25T05:58:07Z (GMT). No. of bitstreams: 1 Rodrigues_MarcosMarques_M.pdf: 3650782 bytes, checksum: df078c3da580a9e227359e7addaff54e (MD5) Previous issue date: 2014 / Resumo: Introdução: A apneia obstrutiva do sono (AOS) ocorre por colapsos recorrentes da via aérea superior durante o sono o que resulta em redução total (apneia) ou parcial (hipopneia) do fluxo aéreo. Tem íntima relação com as alterações na via aérea superior (VAS). A tomografia de feixe cônico permite a análise da VAS e do seu volume, por meio de reconstrução tridimensional. Objetivo: Avaliar as alterações volumétricas da via aérea superior em pacientes com apneia obstrutiva do sono. Metodologia: Dissertação desenvolvida a partir de dois artigos científicos. Ambos são estudos retrospectivos, por meio da revisão de 33 prontuários de pacientes adultos com queixas sugestivas de AOS. Resultados: Foram avaliados 19 pacientes do gênero masculino e 14 do gênero feminino, com índice de massa corpórea (IMC) médio de 30,38kg/m2 e idade média de 49,35 anos. Destes, 14 apresentavam AOS grave, 7 moderada, 7 leve e 5 indivíduos não eram portadores da patologia. No artigo 1 foi avaliada a relação entre o volume da via aérea e a gravidade da AOS. O índice de correlação de Spearman entre o volume da VAS e o Índice de Apneia e Hipopnéia foi de -0,100 com p= 0,580. O teste de Mann-Whitney entre as categorias da AOS e o volume teve p = 0,4630. O artigo 2 avaliou a relação entre o volume da VAS e o Sistema de Estagiamento de Friedman (SEF). O teste de ANOVA comparando o Volume com o SEF foi de 0,018. Conclusão: O volume da via aérea superior não apresenta relação linear com a gravidade da Apneia Obstrutiva do Sono, quando avaliada pelo Índice de Apneia e Hipopneia. O volume da via aérea superior apresentou uma relação significativa e inversa com o Sistema de Estadiamento de Friedman, ou seja, quanto maior a classificação de Friedman menor o volume da via aérea superior. Introdução: A apneia obstrutiva do sono (AOS) ocorre por colapsos recorrentes da via aérea superior durante o sono o que resulta em redução total (apneia) ou parcial (hipopneia) do fluxo aéreo. Tem íntima relação com as alterações na via aérea superior (VAS). A tomografia de feixe cônico permite a análise da VAS e do seu volume, por meio de reconstrução tridimensional. Objetivo: Avaliar as alterações volumétricas da via aérea superior em pacientes com apneia obstrutiva do sono. Metodologia: Dissertação desenvolvida a partir de dois artigos científicos. Ambos são estudos retrospectivos, por meio da revisão de 33 prontuários de pacientes adultos com queixas sugestivas de AOS. Resultados: Foram avaliados 19 pacientes do gênero masculino e 14 do gênero feminino, com índice de massa corpórea (IMC) médio de 30,38kg/m2 e idade média de 49,35 anos. Destes, 14 apresentavam AOS grave, 7 moderada, 7 leve e 5 indivíduos não eram portadores da patologia. No artigo 1 foi avaliada a relação entre o volume da via aérea e a gravidade da AOS. O índice de correlação de Spearman entre o volume da VAS e o Índice de Apneia e Hipopnéia foi de -0,100 com p= 0,580. O teste de Mann-Whitney entre as categorias da AOS e o volume teve p = 0,4630. O artigo 2 avaliou a relação entre o volume da VAS e o Sistema de Estagiamento de Friedman (SEF). O teste de ANOVA comparando o Volume com o SEF foi de 0,018. Conclusão: O volume da via aérea superior não apresenta relação linear com a gravidade da Apneia Obstrutiva do Sono, quando avaliada pelo Índice de Apneia e Hipopneia. O volume da via aérea superior apresentou uma relação significativa e inversa com o Sistema de Estadiamento de Friedman, ou seja, quanto maior a classificação de Friedman menor o volume da via aérea superior / Abstract: Introduction : Obstructive Sleep Apnea (OSA) occurs by recurrent collapse of the upper airway during sleep, resulting in total (apnea) or partial (hypopnea)reduction of airflow and has relationship with changes in upper airway (UA). The cone beam tomography allows the analysis of UA¿s volume (UAV) by three-dimensional reconstruction. Objective: Evaluate the volumetric changes of the upper airway in patients with obstructive sleep apnea. Methodology: Dissertation developed from two scientific articles. Both are retrospective studies by reviewing the medical records of 33 adult patients with complaints suggestive of OSA. Results: We evaluated 19 male and 14 female, with average body mass index (BMI) of 30.38 kg/m2 and mean age of 49.35 years. Among them, 14 had severe OSA, 7 moderate, 7 mild and 5 subjects were heatlhy. In article 1 the relationship between the UAV and severity of OSA was evaluated. The index Spearman correlation between UAV and the Apnea-Hypopnea Index was -0.100 with p=0.580. The Mann-Whitney between categories of OSA and UAV was p=0.4630. Article 2 evaluated the relationship between UAV and the Friedman Staging System (FSS). The ANOVA test comparing the volume with the FSS was 0.018. Conclusion: The volume of the upper airway has no linear relationship with the severity of obstructive sleep apnea, as measured by the apnea-hypopnea index. The volume of the upper airway showed a significant inverse relationship with Friedman Staging System, high FSS is found in subjects with low volume of the upper airway / Mestrado / Fisiopatologia Cirúrgica / Mestre em Ciências

Indiana University-Purdue University Indianapolis (IUPUI) / The study evaluated the effects of a mandibular repositioning appliance (MRA) in patients with obstructive sleep apnea. The MRA was designed to hold the mandible anteriorly in an attempt to maintain a patent airway. Eleven subjects completed a full-night polysomnogram wherein their normal sleep was recorded half the night without the appliance (control) and the other half with the appliance (test). The sequencing of test and control halves was randomly assigned to avoid bias. After seven subjects were tested with the MRA, the MRA was modified for four additional patients by placing anterior vertical elastics (MRA*) to minimize the opening of the mandible. The skeletal and soft tissue changes with both appliances were analyzed using lateral cephalometric radiographs. The MRA was found to have no significant effect on the obstructive sleep apnea patients as a group. Individual response to the appliance varied from noticeably worse to marked improvement. Subject #2A exhibited the reduction of a moderate-to-severe apnea (Apnea-hypopnea index 55.92) to a clinically acceptable level (Apnea-hypopnea index 9.57) with appliance wear. The treatment was considered successful. Significant cephalometric changes with appliance wear were increased lower facial height, a superiorly positioned hyoid bone relative to the mandibular plane, and a decreased posterior airway space. No cephalometric measurement could accurately predict the outcome of the treatment, and posterior airway space, commonly measured in sleep research, was not reliable. The mandibular repositioning appliance was effective in treating a small percentage of individuals with obstructive sleep apnea. A polysomnogram was needed to quantitatively measure the effectiveness of treatment. Under no circumstance should a subjective evaluation by the patient or the clinician be used to assess treatment results. Further investigation is required to evaluate the long-term effectiveness of this treatment. Periodic follow-up sleep studies are required for any patient treated with this appliance until more long term studies are completed.

Obstructive Sleep Apnea (OSA) is becoming an increasingly prevalent health problem, affecting 4% of men and 2% of women in North America. OSA is associated with many debilitating side-effects and co-morbidities; the most common being excessive daytime sleepiness (EDS), which effects the majority of OSA sufferers. EDS is negatively associated with physical activity (PA) and exercise. As a result, EDS may decrease the levels of PA performed by OSA patients. Previous research has revealed that the OSA population engages in less physical activity than the average healthy population. Studies show that CPAP treatment positively impacts EDS, and therefore; may impact PA. The primary purpose of this study was to objectively measure OSA patients' PA levels prior to CPAP treatment and 8 weeks after treatment initiation to assess whether CPAP treatment' impacts PA levels.Actigraph GT 1 M measures PA was assessed at baseline (prior to CPAP) and 8-weeks after. initiation of CPAP treatment. At each time frame, cardiovascular., blood data, body composition, and maximal cycle ergometer exercise measures were obtained. Also, subjective questionnaires, 1 reflective of sleep apnea and 1 regarding PA, were completed by the subjects.Six male subjects with severe OSA (AHI = 41.2 ± 28.4 events/hr) started and completed the study. No significant changes occurred in PA, represented as steps/day nor mean activity counts/day, throughout the 8 weeks of CPAP treatment. Significant changes were found in diastolic blood pressure, total cholesterol, high-density lipoprotein cholesterol, and Epworth sleepiness scale scores. No significant changes occurred in any other body composition, heart rate, systolic blood pressure, triglycerides, and blood glucose. Exercise parameters, total test time, peak Watts, and V02max trended toward an increase and maximal heart rate and blood pressure toward a decrease, but none changed significantly.In conclusion, these results demonstrated that 8 weeks of CPAP treatment was not successful in increasing PA levels of severe OSA patients. The OSA subjects were categorized as sedentary according to their steps/day. Compliance to CPAP could have been an issue with subjects' average nightly usage ranging from 1.85 – 6.6hours/night. Consequently, more research regarding OSA patients PA habits and CPAP treatments effects on PA should be investigated. / School of Physical Education, Sport, and Exercise Science

Thesis (M.S.)--West Virginia University, 2004. / Title from document title page. Document formatted into pages; contains vii, 47 p. : ill. (some col.). Vita. Includes abstract. Includes bibliographical references (p. 30-31).