Day 3 :
- Business in Sleep Medicine ,Mental and Physical Causes of Insomnia, Obstructive Sleep Apnea During Pregnancy, Mental Health Disorders Related to Sleep
Location: Sierra A
Chair
Yuichi Inoue
Tokyo Medical University, Japan
Session Introduction
Deok Won Lee
Kyung Hee University, Korea
Title: Simple and atraumatic technique for the advancement of the genioglossus muscle for treatment of obstructive sleep apnea
Biography:
Deok-Won Lee is currently working as an Associate Professor in the Department of Oral and Maxillofacial Surgery at Kyung Hee University Dental Hospital at Gangdong (Kyung Hee Neo Medical Center).
Abstract:
Obstructive sleep apnea (OSA) is the most common type of sleep apnea and a result of the upper airway obstruction. Untreated OSAS can cause various problems such as hypertension, diabetes, stroke, cardiac disease, daytime sleepiness. It has been demonstrated that genioglossus advancement (GA) is an eff ective procedure for the improvement of the upper airway in some of OSA patients. Th e various types of osteotomy have been designed for the advancement of genioglossus muscle and genial tubercle complex. Inferior saggital osteotomy (ISO), rectangular osteotomy and the circular osteotomy are commonly used for the surgical treatment of OSA. In this paper, we describe a new method for GA that uses specially designed two drills and “c-shaped†plate. Th is technique is more simple, atraumatic and cost eff ective comparing to traditional GA techniques. It helps surgeons to conduct GA surgeries in an effi cient way and shorten operation times. Also it can minimalize the patient’s damage during the surgery. Th is minimal invasive technique is expected to reduce postoperative complications like post-op bleeding, pain and swelling.
Kavitha Palaniappan
University of Newcastle, Singapore
Title: Bi-directional relationship between poor sleep and work-related stress: Management through transformational leadership and work organization
Biography:
Kavitha Palaniappan has completed her PhD in the fi eld of Environmental Health Engineering from Sri Ramachandra Medical University, India. She has been working as Occupational Health Lecturer at the University of Newcastle, Singapore for the past 5 years. Her research interests include lead exposure and its impacts in children including clinical, neurobehavioral and genetic changes. She is currently involved in research in the fi eld of mental health of foreign workers at Singapore and has published more than 15 papers in reputed journals.
Abstract:
Sleep is the most vital episode of human life as psychological and somatic restorative processes are said to happen during sleep. Several studies have recognized the causes for poor sleep as stress, worry, apprehension, everyday hassles, negative or positive experiences and work-related rumination. Likewise, the consequences of sleep deprivation have also been well established. Physiologically, sleep deprivation is said to cause hypometabolism of brain tissues and is also said to increase the risks of obesity, diabetes and cardiovascular diseases. However, it is also important to understand the two-way association between poor sleep and work-related stress which not only aff ects the physiology but also aff ects day time functioning, schematic thinking and causes diffi culties in concentrating and thereby increasing fatigue. Th us, poor sleep and work-related stress create a self-reinforcing vicious circle that slowly deteriorates a person’s well-being. Th is vicious circle can be interrupted by two management techniques: Transformational leadership and Work organization. Transformational leadership has oft en been used to improve productivity and health outcomes such as general well-being and job satisfaction. However, it can also be used to improve the sleeping patterns of individuals by lending them a high level of support and suitable mechanisms for the same need to be conceptualized. On the other hand, organization of tasks according to the nature, physical and mental demands of the job, time of day that the job can be performed, circadian cycles and homeostatic processes of the individuals who are going to perform those jobs would reduce work-related stress and also enable individuals to get a better sleep. Such work patterns need to be designed for every kind of work environment.
Sami Hamdan
Tel Aviv-Yaffo Academic College, Isarel
Title: The effect of Sleep problems on suicidal risk among young adults in the presence of depressive symptoms and cognitive processes
Biography:
Dr. Sami Hamdan is currently working as an Assistant Professor at the Academic College of Tel-Aviv Jaffa. He completed graduate studies in Clinical psychology at Bar-Ilan University. As a Fulbright scholar he spent his Post-doctoral fellowship at Western Psychiatric and Clinic Institution, University of Pittsburgh, with Prof. David Brent. His academic research focuses on Suicidal behaviors and Bereavement and psychopathology among minority groups. Dr. Hamdan has published several original papers and actively participated in scientific meetings.
Abstract:
We aimed to investigate the eff ect of sleep problems, depression and cognitive processes on suicidal risk among 460 young adults. Th ey completed self-report questionnaires assessing suicidal behavior, sleep quality, depressive symptoms, emotion regulation, rumination and impulsivity. Suicidal participants exhibited higher rates of depressive symptoms, sleep problems, expressive suppression, rumination and impulsivity. A confi rmatory factor analysis model revealed pathways to suicidal risk that showed no direct pathways between sleep problems and suicidal risk. Instead, sleep was related to suicidal risk via depression and rumination which in turn increased suicidal risk. Th ese results suggest that addressing sleep problems will be useful in either the treatment or prevention of depressive and rumination symptoms and reduction in suicidal risk.
Masako Okawa
Tokyo Medical University, Japan
Title: Circadian rhythm sleep disorders: Characteristics and entrainment pathology in delayed sleep phase and non-24 sleep-wake syndrome
Biography:
Masako Okawa completed her Postdoctoral Research Fellow in Sleep Laboratory Baylor College of Medicine, Houston, Texas, USA in 1975, MD in Gunma University School of Medicine, Maebashi in 1967. She worked as Senior Staff Associate in Department of Clinical Neurophysiology, Goteborg University, Sweden from 1979. She held the position as Director, Department of Psychophysiology National Institute of Mental Health, National Center for Neurology and Psychiatry, Ichikawa from 1991 & Japan Foundation for Neuroscience and Mental Health, Tokyo in 2013. She worked as Professor of Sleep Medicine, Shiga University of Medical Science, Otsu & Somnology, Tokyo Medical University, Tokyo in 2006 and 2013 respectively. In her career she was awarded with Baelz Prize for the research on “Biological Rhythms of Elderly Patients with Dementia and Paul Janssen Prize in 1989 and 2005 respectively.
Abstract:
The sleep-wake rhythm in humans is regulated by the circadian timing system and disorders of this system are known as circadian rhythm sleep disorders (CRSD) which can have multiple etiologies but result in mal-adjustment of the biological clock with respect to the environment. Th is presentation will focus on a clinical review of delayed sleep phase syndrome (DSPS) and non-24-h sleep-wake syndrome (non-24) which are representative syndromes in CRDS. Th ese syndromes seem to be common and under-recognized in society not only in the blind but also typicallyemerging during adolescence. Both types of syndrome can appear alternatively or intermittently in an individual patient. Psychiatric problems are also common in both syndromes. DSPS and non-24 could share common circadian rhythm pathology in terms of clinical process and biological evidence. Th e biological basis is characterized by a longer sleep period, a prolonged interval from the body temperature nadir-tosleep off set, a relatively advanced temperature rhythm, lower sleep propensity aft er total sleep deprivation and higher sensitivity to light than in normal controls. Th ere are multiple lines of evidence suggesting dysfunctions at the behavioral, physiological and genetic levels. Treatment procedures and prevention of the syndromes require further attention using behavioral, environmental and psychiatric approaches since an increasing number of patients in modern society suff er from these disorders.
Lamia Medhat Afi fi
Cairo University, Egypt
Title: Polysomnography and anti-diuretic hormone secretion pattern in children with primary nocturnal enuresis
Biography:
Lamia Medhat Afi fi completed her MD degree in clinical neurophysiology and Masters of Science in clinical neurophysiology at, Cairo University, Egypt in 2004 and 1999 respectively. She also possesses a GCE degree from the British council in Abu Dhabi, UAE in 1988. Afi fi working as a assistant professor in Clinical Neurophysiology Unit, Department of Neurology, Kasr El-Aini Faculty of Medicine, Cairo University, Egypt. She is also associated with Sleep Disorders Center, Stanford University, Egyptian Society of Neurology (Psychiatry and Neurosurgery), and World Academy of Sleep Medicine.
Abstract:
Background: Data regarding sleep patterns in nocturnal enuresis (NE) and its relation to anti-diuretic hormone (ADH) secretion pattern is defi cient. Normally, ADH secretion is increased at night compared to morning so that urine volume decreases during sleep. NE can be caused by nocturnal polyuria due to ADH defi ciency or detrusor muscle hyperactivity. We aimed to evaluate the ADH secretion pattern in children with primary NE and compare the polysomnography (PSG) fi ndings between children with a normal ADH secretion pattern to those with a reversed secretion pattern. Subjects & Methods: Th is study included 28 children, aged 6-18 years with primary mono-symptomatic severe NE. Th ey were subjected to a single overnight attended full PSG. Assay of ADH levels was performed at 9-11 am and 9-11 pm. Results: Reversal of circadian rhythm of ADH secretion was present in 23 children (82%) and normal rhythm was present in 5(18%). PSG revealed that children with reversed ADH rhythm showed less stage N1 percentage and higher sleep effi ciency than the group with normal ADH rhythm. Th e apnea hypopnea index and periodic limb movements’ indices were similar between both groups. Conclusion: Reversed ADH secretion pattern is very frequent in children with NE. Children with reversed ADH secretion had a higher sleep effi ciency than NE children with a normal pattern implying that children with nocturnal polyuria have a more consolidated sleep than those with detrusor muscle hyperactivity.
Harmanjit Singh Hira
Mulana Azad Medical College, India
Title: Plasma level of hypoxanthine/xanthine as markers of oxidative stress with different stages of obstructive sleep apnea syndrome
Biography:
Dr. Harmanjit Singh Hira is currently working as Professor & Head in the Department of Internal and Pulmonary Medicine, Maulana Azad Medical College and Lok Nayak Hospital, University of Delhi, New Delhi, India.
Abstract:
Background: Increased plasma level of hypoxanthine/xanthine as a criterion of tissue hypoxia is established. We presumed that plasma levels of hypoxanthine/xanthine might be high among patients of obstructive sleep apnea syndrome (OSAS) due to oxidative stress. Material & Methods: A case control study of forty three patients with OSAS diagnosed by overnight polysomnography (PSG), were included in study. Age and sex matched 43 subjects in whom presence of OSAS ruled out by overnight PSG were enrolled as healthy controls. Severity of disease was based on apnea-hypopnea index (AHI). Out of 43 patients, nine were of moderate severity, other 14 were of severe OSAS; none was with mild OSAS. Venous blood sample was collected in morning following PSG. Hematological and biochemical investigations were done. Plasma levels of hypoxanthine/xanthine were measured by fl uorometric analysis. Data collected was analyzed statistically by SPSS version-14soft ware, student’s unpaired T test, Chi square test and Mann-Whitney U test and Pearson’s correlation coeffi cient. Results: Mean plasma levels of hypoxanthine/xanthine in patients of OSAS and controls were 5.38±5.11 mmol/L and 1.23±0.42 mmol/L respectively. Statistically signifi cant (p value 0.000) diff erence was found between them. Among patients, positive correlation between hypoxanthine/xanthine levels with age, AHI and serum triglyceride levels was observed. Joint explanatory power of these signifi cant factors was found to be 59.6% (p-value<0.001). Multivariate analysis revealed the positive correlation between neck circumference, serum cholesterol level, plasma levels of hypoxanthine/xanthine and severity of OSAS. Conclusion: Plasma levels of xanthine/hypoxanthine were signifi cantly elevated in patients of OSAS and these were positively correlated with age, serum triglyceride levels, AHI and severity of the disease. Probability of OSAS was higher with subjects with increased neck circumference, serum cholesterol and xanthine/hypoxanthine levels. Clinical Implications: Level of increase in marker of oxidative stress in the blood of OSAS patients varies with severity of the syndrome and therefore, its measurement may be suitable for a clinical follow-up of these patients.