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Study Objectives: To examine (1) the prevalence of home-monitored sleep-disordered breathing (SDB) and obstructive sleep apnea syndrome in a Japanese working population and (2) whether home monitoring with a type 3 portable monitor and actigraphy can produce reliable data to analyze SDB in usual lifestyles., Methods: A cross-sectional survey using a self-administered questionnaire was conducted on a group of employees at a wholesale company in Osaka, Japan. Examinations by physicians and by sleep monitoring were also performed. Unattended home cardiorespiratory (type 3) sleep studies with actigraphy were conducted for 2 nights to diagnose SDB in 322 subjects. From the baseline questionnaires and sleep diaries, participants were assessed to follow their usual lifestyles during the study (e.g., time in bed, alcohol intake)., Results: Of 466 Japanese male employees, 396 responded to the questionnaire survey (85.0%). Results from 322 male employees aged 23 to 59 (43.8 +/- 8.4 years) were analyzed. Respiratory disturbance index (RDI), calculated from the type 3 portable monitors and actigraphy, was highly reliable with an intraclass correlation of 0.98 for interscorer reliability and with an intraclass correlation of 0.95 for night-to-night reliability. Prevalence of mild (5 < or = RDI < 15), moderate (15 < or = RDI < 30) and severe (RDI < or = 30) SDB in this population were 37.4%, 15.7%, and 6.6%, respectively. The prevalence of obstructive sleep apnea syndrome (RDI > or = 5 and Epworth Sleepiness Scale score > 10) was 17.6%., Conclusions: The prevalence of moderate to severe SDB (RDI > or = 15) was 22.3% in this Japanese male working population aged 23 to 59, measured in participant's usual life settings. Unattended home monitoring with type 3 portable monitors and actigraphy was highly reliable and may be suitable for analyzing SDB in the usual lifestyle setting.

Study Objectives: Hypoxemia increases corrected QT dispersion (QTcD), which is the difference between the maximum and minimum QT intervals and is a strong risk factor for cardiovascular mortality. The aim of this study was to investigate the QTcD in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS), and the relationship between the QTcD and (123)I-metaiodobenzylguanidine (MIBG) cardiac imaging, which reflects cardiac sympathetic activity., Setting: A university hospital., Patients: Forty-eight OSAHS patients without cardiac diseases (mean [+/- SD] age, 45.9 +/- 10.8 years; apnea-hypopnea index [AHI] 51.9 +/- 18.5 events per hour) who underwent polysomnography before treatment and on the first night of nasal continuous positive airway pressure (nCPAP) treatment., Methods: Before and after nCPAP treatment was started, we measured the QTcD with computer software, before, during, and after sleep, as well as the washout rate of the MIBG administered for cardiac imaging. As a control, QTcD was also measured in the morning from 26 healthy subjects., Results: Before treatment, the mean QTcD during sleep (65.0 +/- 14.6 ms) was greater than that before sleep (57.0 +/- 13.5 ms; p < 0.0001). Meanwhile, after 1 night of nCPAP therapy, the QTcD during sleep (50.6 +/- 11.4 ms) decreased from that before treatment (p < 0.0001) and was smaller than the QTcD before sleep (56.2 +/- 13.3 ms; p = 0.003). Before treatment, the QTcD during sleep correlated with the AHI (r = 0.38; p = 0.009) and the percentage of time that SaO(2) was < 90% (SaO(2) < 90% time) [r = 0.34; p = 0.018]. The QTcD did not correlate with the body mass index or the washout rate of MIBG. However, the washout rate of MIBG correlated with the AHI and the SaO(2) < 90% time., Conclusions: Nocturnal QTcD is increased in OSAHS patients but is decreased by nCPAP therapy independently of cardiac sympathetic function.

Background: There are few reports about sleep disturbances in patients with chronic obstructive pulmonary disease (COPD) in Asian countries. Objectives: To investigate the associations between sleep-disordered breathing (SDB) with hypoxemia and sleep quality, including sleep duration, in patients with COPD, we measured SDB and sleep quality including the objective sleep duration determined by an actigraph and portable monitoring. Methods: A cross-sectional epidemiological health survey of 303 male employees (means ± SD: age 43.9 ± 8.2 years; BMI 24.0 ± 3.1) was conducted. Sleep quality was measured using the Epworth Sleepiness Scale (ESS) and the Pittsburgh Sleep Quality Index (PSQI). A respiratory disturbance index (RDI) ≥5 indicated SDB. Results: Nineteen subjects (6.3%) had COPD. Among these, 11 (3.6%) had COPD with SDB (overlap syndrome). Sleep duration, ESS, and PSQI scores were not significantly different between COPD patients and normal control subjects. However, COPD patients had significantly longer sleep latency (p = 0.019), a lower sleep efficiency (p = 0.017), and a higher sleep fragmentation index (p = 0.041) and average activity (p = 0.0097) during sleep than control subjects. They also had a significantly higher RDI and more severe desaturation during sleep than control subjects (p < 0.01). The differences remained after adjustment for age and BMI but disappeared following adjustment for RDI. Conclusions: COPD patients with even mild-to-moderate airflow limitations had nocturnal desaturation and RDI-related impaired sleep quality without significant symptoms. © 2014 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

The article presents a study on relationships among obstructive sleep apnea (OSA), sleep duration, and the lipid profile in a community-based study in Japan. The study measured the respiratory disturbance index (RDI) and sleep duration by a type 3 portable device and actigraph in 275 men, of which 143 had dyslipidemia, in a Japanese company. It finds that short sleep duration was linked to serum total cholesterol levels and that RDI was positively associated with serum triglyceride levels.

Obstructive sleep apnoea is common in patients with diabetes. Recently, it was reported that short sleep duration and sleepiness had deleterious effects on glucose metabolism. Thereafter, several reports showed relationships between glucose metabolism and obstructive sleep apnoea, sleep duration or sleepiness. But the interrelationships among those factors based on recent epidemiological data have not been examined. We analysed data on 275 male employees (age, 44 ± 8 years; body mass index, 23.9 ± 3.1 kg m−2) who underwent a cross-sectional health examination in Japan. We measured fasting plasma glucose, sleep duration using a sleep diary and an actigraph for 7 days, and respiratory disturbance index with a type 3 portable monitor for two nights. Fifty-four subjects (19.6%) had impaired glucose metabolism, with 21 having diabetes. Of those 21 (body mass index, 25.9 ± 3.8 kg m−2), 17 (81.0%) had obstructive sleep apnoea (respiratory disturbance index ≥ 5). Regarding the severity of obstructive sleep apnoea, 10, four and three had mild, moderate and severe obstructive sleep apnoea, respectively. The prevalence of obstructive sleep apnoea was greater in those with than without diabetes ( P = 0.037). Multiple regression analyses showed that the respiratory disturbance index independently related to fasting plasma glucose only in the diabetic subjects. In patients with diabetes, after adjustment for age, waist circumference, etc. sleep fragmentation had a greater correlation with fasting plasma glucose than sleep duration, but without significance ( P = 0.10). Because the prevalence of obstructive sleep apnoea is extremely high in patients with diabetes, sufficient sleep duration with treatment for obstructive sleep apnoea, which ameliorates sleep fragmentation, might improve fasting plasma glucose. [ABSTRACT FROM AUTHOR]

Summary Obstructive sleep apnoea (OSA) plays a significant role in increasing blood pressure. Significant decreases were reported in blood pressure of hypertensive OSA patients with sleepiness who underwent continuous positive airway pressure (CPAP) treatment, but not in non-sleepy hypertensive OSA patients. More recently, however, significant decreases in blood pressure in non-sleepy hypertensive OSA patients following CPAP were shown. Effects of sleepiness on hypertension in OSA patients have been investigated, but not the effects of hypertension on sleepiness in OSA patients. We investigated the relationships between hypertension and sleepiness in patients with OSA. We analysed data on 275 middle-aged male subjects from a cross-sectional epidemiological health survey. We measured blood pressure and sleep duration objectively using an actigraph for 7 days and the respiratory disturbance index (RDI) with a type 3 portable device for 2 nights, and assessed sleepiness using the Epworth Sleepiness Scale (ESS). The RDI correlated significantly with ESS scores in the 88 hypertensive subjects ( r = 0.33, P = 0.0024), but not in the 187 non-hypertensive subjects ( r = −0.01, P = 0.91). Short sleep duration correlated significantly with ESS scores in both groups. Both the RDI and short sleep duration were related independently to sleepiness in only hypertensive subjects. Furthermore, the RDI was related negatively significantly to sleep duration in hypertensive subjects. Although short sleep duration was related significantly to sleepiness in both groups, hypertension may be important for the sleepiness in OSA patients. Detailed mechanisms of the difference in the relationship between sleepiness and the severity of OSA with or without hypertension should be studied further. [ABSTRACT FROM AUTHOR]

: PurposeObesity has been associated with obstructive sleep apnea and hepatic steatosis. We investigated the effects of obstructive sleep apnea and treatment with nasal continuous positive airway pressure (CPAP) on serum aminotransferase levels in obese patients.: MethodsWe studied 40 obese men with obstructive sleep apnea syndrome. None had hepatitis B antigen or C antibody, autoimmune disease, or an excessive intake of alcohol. Serum levels of aspartate aminotransferase, alanine aminotransferase, triglyceride, glucose, insulin, and leptin were determined in the afternoon and in the morning immediately after sleep, before and after nasal CPAP treatment.: ResultsAminotransferase levels were abnormal in 35% (n = 14) of patients. Before treatment, mean (± SD) aspartate aminotransferase levels were higher in the morning than in the previous afternoon (presleep, 34 ± 20 IU/L; postsleep, 39 ± 28 IU/L; P = 0.006). The overnight mean increases in aminotransferase levels were less marked after the first night of nasal CPAP treatment (aspartate aminotransferase: from 6 ± 11 IU/L to 2 ± 6 IU/L, P = 0.0003; alanine aminotransferase: from 5 ± 9 IU/L to 2 ± 6 IU/L, P = 0.006). Leptin levels (n = 23) decreased significantly after treatment (P = 0.0002), whereas insulin resistance (calculated by the homeostasis model assessment method) and triglyceride levels were unchanged. Improvements in aspartate and alanine aminotransferase levels were maintained after 1 and 6 months of nasal CPAP treatment.: ConclusionNasal CPAP therapy may have beneficial effects on serum aminotransferase abnormalities in obese patients who have obstructive sleep apnea. [Copyright &y& Elsevier]