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Background: Shift-workers may experience sleep disturbances more frequently than day-workers. Interactions between obstructive sleep apnea (OSA), shift-work and other factors promoting sleepiness have never been studied. The present study was designed to assess the prevalence of excessive daytime sleepiness (EDS), high risk for OSA (HR) and insomnia in shift-workers and day-workers and to evaluate their mutual effects on the risk of home-to-work commuting car accidents or episodes of falling asleep during work., Methods: Workers (153 shift-workers, 85 day-workers) were evaluated for the presence of sleep disorders including HR and EDS. The relationships between sleepiness-related events, shift-work and sleep disorders were investigated by path analysis., Results: Forty-nine subjects had HR. EDS was more frequent in shift-workers than in day-workers (16.3% vs. 5.9%, P = 0.01) and in workers with HR (28.6% vs. 8.4%, P < 0.001) or insomnia (35.7% vs. 9.5%, P < 0.001). Path analysis support the evidence that EDS was directly linked to shift-work, HR and insomnia. Car accidents or falling asleep at work were directly associated with EDS and shift-work, and indirectly (via EDS) with HR and insomnia., Conclusions: Development of EDS in shift-workers is not only due to work schedule, but also to the presence of sleep disorders. OSA and insomnia co-promote falling asleep during work and sleepiness-related car accidents.

Background: Female sexual dysfunction (FSD) is diagnosed when an impairment in the sexual response cycle is associated with distress in women. The association between obstructive sleep apnea (OSA) and FSD has been poorly investigated with conflicting results., Aim: To assess the role of OSA in determining FSD in pre menopausal obese women., Methods: Forty-six women underwent standard polysomnography. Data on sexual function and sexual-related distress were obtained using the Female Sexual Function Index (FSFI) and the Female Sexual Distress Scale (FSDS). Women with both abnormal FSFI and FSDS scores were classified as having FSD., Results: Thirty-one women were classified as having OSA. Fourteen (30.4%) women had both sexual difficulties and sexual distress resulting in FSD; they showed higher values of sleep time spent with SpO(2) <90% (T(90) 16.8 ± 24.4 vs. 3.2 ± 5.2%; p = 0.004). FSD was present in 10 women with OSA (32.2%); in this group T(90) was higher (23.5 ± 26.3) in women with FSD than in those without FSD (4.8 ± 5.8; p = 0.003). In a logistic multiple regression analysis, T(90) was the only factor associated with an increased risk for FSD (odds ratio [OR] 1.07) (confidence interval [CI]) 1.006-1.13]; p = 0.03)., Conclusions: In premenopausal obese women the presence of FSD is correlated with OSA only when nocturnal hypoxia is present., (Copyright © 2013 Elsevier B.V. All rights reserved.)

The effects of inhaled bronchodilators at rest and during exercise were studied in 15 subjects with chronic obstructive pulmonary disease. In a crossover study against placebo, albuterol caused a significant increase in expiratory flow and reduced lung hyperinflation and dyspnea at rest, but this was not associated with differences in symptoms with exercise or any relevant parameter of physical performance. Dynamic hyperinflation occurred during exercise similarly after placebo or albuterol and was associated with a reduction of forced expiratory flows. This, in turn, was correlated with the bronchoconstrictor effect of deep inhalation determined at rest. In a parallel group study, expiratory flow was increased by 3-wk treatment with salmeterol (n = 9) but not with placebo (n = 6). However, in neither group was the response to exercise different from baseline. These results suggest that in chronic obstructive pulmonary disease effective pharmacological bronchodilation at rest may not be predictive of benefits of exercise tolerance. This may be related to the occurrence of airway narrowing during exercise, particularly when a deep inhalation at rest is followed by a decrease in expiratory flow.