Search results for: sleep pattern

Authors: Nino Gogatishvili, Davit Kvernadze, Giorgi Japharidze

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Background and aims: Landau Kleffner syndrome (LKS) is a rare disorder with epileptic seizures and acquired aphasia. It usually starts in initially healthy children. The first symptoms are language regression and behavioral disturbances, and the sleep EEG reveals abnormal epileptiform activity. The aim was to discuss the efficacy of Clobazam for Landau Kleffner syndrome. Case report: We report a case of an 11-year-old boy with an uneventful pregnancy and delivery. He began to walk at 11 months and speak with simple phrases at the age of 2,5 years. At the age of 18 months, he had febrile convulsions; at the age of 5 years, the parents noticed language regression, stuttering, and serious behavioral dysfunction, including hyperactivity, temper outbursts. The epileptic seizure was not noticed. MRI was without any abnormality. Neuropsychological testing revealed verbal auditory agnosia. Sleep EEG showed abundant left fronto-temporal spikes, reaching over 85% during non-rapid eye movement sleep (non-REM sleep). Treatment was started with Clobazam. After ten weeks, EEG was improved. Stuttering and behavior also improved. Results: Since the start of Clobazam treatment, stuttering and behavior improved. Now, he is 11 years old, without antiseizure medication. Sleep EEG shows fronto-temporal spikes on the left side, over 10-49 % of non-REM sleep, bioccipital spikes, and slow-wave discharges and spike-waves. Conclusions: This case provides further support for the efficacy of Clobazam in patients with LKS.

Keywords: Landau-Kleffner syndrome, antiseizure medication, stuttering, aphasia

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Authors: Cheng-Yu Tsai, Wen-Te Liu, Chen-Chen Lo, Yin-Tzu Lin, Kang Lo

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Background: Driving fatigue related to inadequate or disordered sleep accounts for a major percentage of traffic accidents. Obstructive sleep apnea syndrome (OSAS) is a common respiratory disorder during sleep. However, the effects of OSAS severity on driving drowsiness remain unclear. Objective: The aim of this study is to investigate the relationship between OSAS severity and driving fatigue. Methodologies: The physical condition while driving was obtained from the questionnaires to classify the state of driving fatigue. OSAS severity was quantified as the polysomnography, and the mean hourly number of greater than 3% dips in oxygen saturation during examination in a hospital in New Taipei City (Taiwan). The severity of OSAS was diagnosed by the apnea and hypopnea index (AHI) with the American Academy of Sleep Medicine (AASM) guideline. The logistic regression model was used to examine the associations after adjusted age, gender, neck circumstance, waist circumstance, and body mass index (BMI). Results: There were 880 subjects recruited in this study, who had been done polysomnography for evaluating severity for OSAS as well as completed the driver condition questionnaire. 752 subjects were diagnosed with OSA, and 484 subjects had fatigue driving behavior in the past week. Patients diagnosed with OSAS had a 9.42-fold higher odds ratio (p < 0.01, 95% CI = 5.41 – 16.42) of driving drowsiness for cohorts with a normal degree. Conclusion: We observe the considerable correlation between OSAS and driving fatigue. For the purpose of promoting traffic safety, OSAS should be monitored and treated.

Keywords: obstructive sleep apnea syndrome, driving fatigue, polysomnography, apnea and hypopnea index

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Authors: Serena Salvi

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Ageistic stereotypes and practices have become a normal and therefore pervasive phenomenon in various aspects of everyday life. Over the past years, renewed awareness towards self-directed age stereotyping in older adults has given rise to a line of research focused on the potential role of attitudes towards ageing on seniors’ health and functioning. This set of studies has showed how a negative internalisation of ageistic stereotypes would discourage older adults in seeking medical advice, in addition to be associated to negative subjective health evaluation. An important dimension of mental health that is often affected in older adults is represented by sleep quality. Self-reported sleep quality among older adults has shown to be often unreliable when compared to their objective sleep measures. Investigations focused on self-reported sleep quality among older adults have suggested how this portion of the population would tend to accept disrupted sleep if believed to be up to standard for their age. On the other hand, unrealistic expectations, and dysfunctional beliefs towards sleep in ageing, might prompt older adults to report sleep disruption even in the absence of objective disrupted sleep. Objective of this study is to examine an association between personal attitudes towards ageing in adults aged 60+ and dysfunctional sleep related cognition. More in detail, this study aims to investigate a potential association between personal attitudes towards ageing, sleep locus of control and dysfunctional beliefs towards sleep among this portion of the population. Data in this study were statistically analysed in SPSS software. Participants were recruited through the online participants recruitment system Prolific. Inclusion of attention check questions throughout the questionnaire and consistency of responses were looked at. Prior to the commencement of this study, Ethical Approval was granted (ref. 39396). Descriptive statistics were used to determine the frequency, mean, and SDs of the variables. Pearson coefficient was used for interval variables, independent T-test for comparing means between two independent groups, analysis of variance (ANOVA) test for comparing the means in several independent groups, and hierarchical linear regression models for predicting criterion variables based on predictor variables. In this study self-perceptions of ageing were assessed using APQ-B’s subscales, while dysfunctional sleep related cognition was operationalised using the SLOC and the DBAS16 scales. Of the final subscales taken in consideration in the brief version of the APQ questionnaire, Emotional Representations (ER), Control Positive (PC) and Control and Consequences Negative (NC) have shown to be of particularly relevance for the remits of this study. Regression analysis show how an increase in the APQ-B subscale Emotional Representations (ER) predicts an increase in dysfunctional beliefs and attitudes towards sleep in this sample, after controlling for subjective sleep quality, level of depression and chronological age. A second regression analysis showed that APQ-B subscales Control Positive (PC) and Control and Consequences Negative (NC) were significant predictors in the change of variance of SLOC, after controlling for subjective sleep quality, level of depression and dysfunctional beliefs about sleep.

Keywords: sleep-related cognition, perceptions of aging, older adults, sleep quality

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Authors: Nancy Wilson

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In utero, fetal drug exposure is prevalent amongst birthing facilities. Assessment tools for neonatal abstinence syndrome (NAS) are often cumbersome and ill-fitting, harboring immense subjectivity. This paradox often leads the clinical assessor to be hypervigilant when assessing the newborn for subtle symptoms of NAS, often mistaken for normal newborn behaviors. As a quality improvement initiative, this project led to a more adaptable NAS tool termed eat, sleep, console (ESC). This function-based NAS assessment scores the infant based on the ability to accomplish three basic newborn necessities- to sleep, to eat, and to be consoled. Literature supports that ESC methodology improves patient and family outcomes while providing more cost-effective care.

Keywords: neonatal abstinence syndrome, neonatal opioid withdrawal, maternal substance abuse, pregnancy, and addiction, Finnegan neonatal abstinence syndrome tool, eat, sleep, console

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Authors: H. Alabed, K. Abuzayan. L. Fgie, K. Zarug

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Ramadan requires individuals to abstain from food and fluid intake between sunrise and sunset; physiological considerations predict that poorer mood, physical performance and mental performance will result. In addition, any difficulties will be worsened because preparations for fasting and recovery from it often mean that nocturnal sleep is decreased in length, and this independently affects mood and performance. A difficulty of interpretation in many studies is that the observed changes could be due to fasting but also to the decreased length of sleep and altered food and fluid intakes before and after the daytime fasting. These factors were separated in this study, which took place over three separate days and compared the effects of different durations of fasting (4, 8 or 16h) upon a wide variety of measures (including subjective and objective assessments of performance, body composition, dehydration and responses to a short bout of exercise) - but with an unchanged amount of nocturnal sleep, controlled supper the previous evening, controlled intakes at breakfast and daytime naps not being allowed. Many of the negative effects of fasting observed in previous studies were present in this experiment also. These findings indicate that fasting was responsible for many of the changes previously observed, though some effect of sleep loss, particularly if occurring on successive days (as would occur in Ramadan) cannot be excluded.

Keywords: drinking, eating, mental performance, physical performance, social activity, blood, sleepiness

Procedia PDF Downloads 368

Authors: Chi Wu, Dean Wu, Wen-Te Liu, Cheng-Yu Tsai, Shin-Mei Hsu, Yin-Tzu Lin, Ru-Yin Yang

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Background: The results of previous studies compared the benefits and risks of receiving insomnia medication. However, the effects between hypnotic drugs used and enhancement of sleep quality were still unclear. Objective: The aim of this study is to establish a prediction model for hypnotic drugs' dosage used for insomnia subjects and associated the relationship between sleep stage ratio change and drug types. Methodologies: According to American Academy of Sleep Medicine (AASM) guideline, sleep stages were classified and transformed to hypnogram via the polysomnography (PSG) in a hospital in New Taipei City (Taiwan). The subjects with diagnosis for insomnia without receiving hypnotic drugs treatment were be set as the comparison group. Conversely, hypnotic drugs dosage within the past three months was obtained from the clinical registration for each subject. Furthermore, the collecting subjects were divided into two groups for training and testing. After training convolution neuron network (CNN) to predict types of hypnotics used and dosages are taken, the test group was used to evaluate the accuracy of classification. Results: We recruited 76 subjects in this study, who had been done PSG for transforming hypnogram from their sleep stages. The accuracy of dosages obtained from confusion matrix on the test group by CNN is 81.94%, and accuracy of hypnotic drug types used is 74.22%. Moreover, the subjects with high ratio of wake stage were correctly classified as requiring medical treatment. Conclusion: CNN with hypnogram was potentially used for adjusting the dosage of hypnotic drugs and providing subjects to pre-screening the types of hypnotic drugs taken.

Keywords: convolution neuron network, hypnotic drugs, insomnia, polysomnography

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Authors: Natcha Lueangapapong, Chariya Chuthapisith, Lunliya Thampratankul

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Background: There is a need to find an appropriate tool to help healthcare providers determine sleep problems in children for early diagnosis and management. The Japanese Sleep Questionnaire for Preschoolers (JSQ-P) is a parent-reported sleep questionnaire that has good psychometric properties and can be used in the context of Asian culture, which is likely suitable for Thai children. Objectives: This study aimed to translate and validate the Japanese Sleep Questionnaire for Preschoolers (JSQ-P) into a Thai version and to evaluate factors associated with sleep disorders in preschoolers. Methods: After approval by the original developer, the cross-cultural adaptation process of JSQ-P was performed, including forward translation, reconciliation, backward translation, and final approval of the Thai version of JSQ-P (TH-JSQ-P) by the original creator. This study was conducted between March 2021 and February 2022. The TH-JSQ-P was completed by 2,613 guardians whose children were aged 2-6 years twice in 10-14 days to assess its reliability and validity. Content validity was measured by an index of item-objective congruence (IOC) and a content validity index (CVI). Face validity, content validity, structural validity, construct validity (discriminant validity), criterion validity and predictive validity were assessed. The sensitivity and specificity of the TH-JSQ-P were also measured by using a total JSQ-P score cutoff point 84, recommended by the original JSQ-P and each subscale score among the clinical samples of obstructive sleep apnea syndrome. Results: Internal consistency reliability, evaluated by Cronbach’s α coefficient, showed acceptable reliability in all subscales of JSQ-P. It also had good test-retest reliability, as the intraclass correlation coefficient (ICC) for all items ranged between 0.42-0.84. The content validity was acceptable. For structural validity, our results indicated that the final factor solution for the Th-JSQ-P was comparable to the original JSQ-P. For construct validity, age group was one of the clinical parameters associated with some sleep problems. In detail, parasomnias, insomnia, daytime excessive sleepiness and sleep habits significantly decreased when the children got older; on the other hand, insufficient sleep was significantly increased with age. For criterion validity, all subscales showed a correlation with the Epworth Sleepiness Scale (r = -0.049-0.349). In predictive validity, the Epworth Sleepiness Scale was significantly a strong factor that correlated to sleep problems in all subscales of JSQ-P except in the subscale of sleep habit. The sensitivity and specificity of the total JSQ-P score were 0.72 and 0.66, respectively. Conclusion: The Thai version of JSQ-P has good internal consistency reliability and test-retest reliability. It passed 6 validity tests, and this can be used to evaluate sleep problems in preschool children in Thailand. Furthermore, it has satisfactory general psychometric properties and good reliability and validity. The data collected in examining the sensitivity of the Thai version revealed that the JSQ-P could detect differences in sleep problems among children with obstructive sleep apnea syndrome. This confirmed that the measure is sensitive and can be used to discriminate sleep problems among different children.

Keywords: preschooler, questionnaire, validation, Thai version

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Authors: H. Alabed, K. Abuzayan, J. Ezarrugh, S. Ali, M. Touba

Abstract:

Ramadan requires individuals to abstain from food and fluid intake between sunrise and sunset, Physiological considerations predict that poorer mood, Physical performance and mental performance will result. In addition, Any difficulties will be worsened because preparations for fasting and recovery from it often mean that nocturnal sleep is decreased in length and this independently affects mood and performance. A difficulty of interpretation in many studies is that the observed changes could be due to fasting but also to the decreased length of sleep and altered food and fluid intakes before and after the daytime fasting. These factors were separated in this study, Which took place over three separate days and compared the effects of different durations of fasting (4, 8 or 16 h) upon a wide variety of measures (including subjective and objective assessments of performance, body composition, Dehydration and responses to a short bout of exercise) but with an unchanged amount of nocturnal sleep, Controlled supper the previous evening, Controlled intakes at breakfast and daytime naps not being allowed. Many of the negative effects of fasting observed in previous studies were present in this experiment also. These findings indicate that fasting was responsible for many of the changes previously observed, Though some effect of sleep loss, Particularly if occurring on successive days (as would occur in Ramadan) cannot be excluded.

Keywords: Drinking, eating, mental performance, physical performance, social activity, blood, sleepiness

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Authors: Apurba Kanti Chowdhury, Taslima Zahan

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The inclusion of mungbean in a cropping pattern not only increases the cropping intensity but also enriches soil health as well as ensures nutrition for the fast-growing population of Bangladesh. A study was conducted in the farmers’ field during 2013-14 and 2014-15 to observe the performance of four-crop based improve cropping pattern Potato-Mungbean-Jute -t.aman rice against the existing cropping pattern Potato-Jute -t.aman rice at Domar, Nilphamari followed by randomized complete block design with three replications. Two years study revealed that inclusion of mungbean and better management practices in improved cropping pattern provided higher economic benefit over the existing pattern by 73.1%. Moreover, the average yield of potato increased in the improved pattern by 64.3% compared to the existing pattern; however yield of jute and t.aman rice in improved pattern declined by 5.6% and 10.7% than the existing pattern, respectively. Nevertheless, the additional yield of mungbean in the improved pattern helped to increase rice equivalent yield of the whole pattern by 38.7% over the existing pattern. Thus, the addition of mungbean in the existing pattern Potato-Jute -t.aman rice seems to be profitable for the farmers and also might be sustainable if the market channel of mungbean developed.

Keywords: crop diversity, food nutrition, production efficiency, yield improvement

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Authors: Lavinia Flueckiger, Roselind Lieb, Andrea H. Meyer, Cornelia Witthauer, Jutta Mata

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Objective: Health behaviors tend to show a high variability over time within the same person. However, most existing research can only assess a snapshot of a person’s behavior and not capture this natural daily variability. Two intensive longitudinal studies examine the variability in health behavior over one academic year and their implications for other aspects of daily life such as affect and academic performance. Can already a single day of increased physical activity, snacking, or improved sleep have beneficial effects? Methods: In two intensive longitudinal studies with up to 65 assessment days over an entire academic year, university students (Study 1: N = 292; Study 2: N = 304) reported sleep quality, physical activity, snacking, positive and negative affect, and learning goal achievement. Results: Multilevel structural equation models showed that on days on which participants reported better sleep quality or more physical activity than usual, they also reported increased positive affect, decreased negative affect, and better learning goal achievement. Higher day-to-day snacking was only associated with increased positive affect. Both, increased day-to-day sleep quality and physical activity were indirectly associated with better learning goal achievement through changes in positive and negative affect; results for snacking were mixed. Importantly, day-to-day sleep quality was a stronger predictor for affect and learning goal achievement than physical activity or snacking. Conclusion: One day of better sleep or more physical activity than usual is associated with improved affect and academic performance. These findings have important implications for low-threshold interventions targeting the improvement of daily functioning.

Keywords: sleep quality, physical activity, snacking, affect, academic performance, multilevel structural equation model

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Authors: Güler Duru Aşiret

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Introduction: Poor sleep quality is a common problem among the older people living in nursing homes. Our study aimed at assessing the effect of individual reminiscence therapy on the sleep quality of the elderly living in nursing homes. Methods: The study had 22 people in the intervention group and 24 people in the control group. The intervention group had reminiscence therapy once a week for 12 weeks in the form of individual sessions of 25-30 minutes. In our study, we first determined the dates suitable for the intervention group and researcher and planned the date and time of individual reminiscence therapies, which would take 12 weeks. While preparing this schedule, we considered subjects’ time schedules for their regular visits to health facilities and the arrival of their visitors. At this stage, the researcher informed the participants that their regular attendance in sessions would affect the intervention outcome. One topic was discussed every week. Weekly topics included: introduction in the first week; childhood and family life, school days, starting work and work life (a day at home for housewives), a fun day out of home, marriage (friendship for the singles), plants and animals they loved, babies and children, food and cooking, holidays and travelling, special days and celebrations, assessment and closure, in the following weeks respectively. The control group had no intervention. Study data was collected by using an introductory information form and the Pittsburgh Sleep Quality Index (PSQI). Results: In our study, participants’ average age was 76.02 ± 7.31. 58.7% of them were male and 84.8% were single. All of them had at least one chronic disease. 76.1% did not need help for performing their daily life activities. The length of stay in the institution was 6.32 ± 3.85 years. According to the participants’ descriptive characteristics, there was no difference between groups. While there was no statistically significant difference between the pretest PSQI median scores (p > 0.05) of both groups, PSQI median score had a statistically significant decrease after 12 weeks of reminiscence therapy (p < 0.05). There was no statistically significant change in the median scores of the subcomponents of sleep latency, sleep duration, sleep efficiency, sleep disturbance and use of sleep medication before and after reminiscence therapy. After the 12-weeks reminiscence therapy, there was a statistically significant change in the median scores for the PSQI subcomponents of subjective sleep quality (p<0.05). Conclusion: Our study found that reminiscence therapy increased the sleep quality of the elderly living in nursing homes. Acknowledgment: This study (project no 2017-037) was supported by the Scientific Research Projects Coordination Unit of Aksaray University. We thank the elderly subjects for their kind participation.

Keywords: nursing, older people, reminiscence therapy, sleep

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Authors: M. Trousselard, D. Steiler, C. Drogou, P. van-Beers, G. Lamour, S. N. Crosnier, O. Bouilland, P. Dubost, M. Chennaoui, D. Léger

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According to published data, undersea navigation for long periods (nuclear-powered ballistic missile submarine, SSBN) constitutes an extreme environment in which crews are subjected to multiple stresses, including the absence of natural light, illuminance below 1,000 lux, and watch schedules that do not respect natural chronobiological rhythms, for a period of 60-80 days. These stresses seem clearly detrimental to the submariners’ sleep, with consequences for their affective (seasonal affective disorder-like) and cognitive functioning. In the long term, there are abundant publications regarding the consequences of sleep disruption for the occurrence of organic cardiovascular, metabolic, immunological or malignant diseases. It seems essential to propose countermeasures for the duration of the patrol in order to reduce the negative physiological effects on the sleep and mood of submariners. Light therapy, the preferred treatment for dysfunctions of the internal biological clock and the resulting seasonal depression, cannot be used without data to assist knowledge of submariners’ chronobiology (melatonin secretion curve) during patrols, given the unusual characteristics of their working environment. These data are not available in the literature. The aim of this project was to assess, in the course of two studies, the benefits of two environmental techniques for managing chronobiological stress: techniques for optimizing potential (TOP; study 1)3, an existing programme to help in the psychophysiological regulation of stress and sleep in the armed forces, and dawn and dusk simulators (DDS, study 2). For each experiment, psychological, physiological (sleep) or biological (melatonin secretion) data were collected on D20 and D50 of patrol. In the first experiment, we studied sleep and depressive distress in 19 submariners in an operational setting on board an SSBM during a first patrol, and assessed the impact of TOP on the quality of sleep and depressive distress in these same submariners over the course of a second patrol. The submariners were trained in TOP between the two patrols for a 2-month period, at a rate of 1 h of training per week, and assigned daily informal exercises. Results show moderate disruptions in sleep pattern and duration associated with the intensity of depressive distress. The use of TOP during the following patrol improved sleep and depressive mood only in submariners who regularly practiced the techniques. In light of these limited benefits, we assessed, in a second experiment, the benefits of DDS on chronobiology (daily secretion of melatonin) and depressive distress. Ninety submariners were randomly allocated to two groups, group 1 using DDS daily, and group 2 constituting the control group. Although the placebo effect was not controlled, results showed a beneficial effect on chronobiology and depressive mood for submariners with a morning chronotype. Conclusions: These findings demonstrate the difficulty of practicing the tools of psychophysiological management in real life. They raise the question of the subjects’ autonomy with respect to using aids that involve regular practice. It seems important to study autonomy in future studies, as a cognitive resource resulting from the interaction between internal positive resources and “coping” resources, to gain a better understanding of compliance problems.

Keywords: chronobiology, light therapy, seasonal affective disorder, sleep, stress, stress management, submarine

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Authors: Maria Korman, Carmit Gal, Ella Gabitov, Avi Karni

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The main question addressed in this study was whether the time-of-day wherein training is afforded is a significant factor for motor skill ('how-to', procedural knowledge) acquisition and consolidation into long term memory in the healthy elderly population. Twenty-nine older adults (60-75 years) practiced an explicitly instructed 5-element key-press sequence by repeatedly generating the sequence ‘as fast and accurately as possible’. Contribution of three parameters to acquisition, 24h post-training consolidation, and 1-week retention gains in motor sequence speed was assessed: (a) time of training (morning vs. evening group) (b) sleep quality (actigraphy) and (c) chronotype. All study participants were moderately morning type, according to the Morningness-Eveningness Questionnaire score. All participants had sleep patterns typical of age, with average sleep efficiency of ~ 82%, and approximately 6 hours of sleep. Speed of motor sequence performance in both groups improved to a similar extent during training session. Nevertheless, evening group expressed small but significant overnight consolidation phase gains, while morning group showed only maintenance of performance level attained at the end of training. By 1-week retention test, both groups showed similar performance levels with no significant gains or losses with respect to 24h test. Changes in the tapping patterns at 24h and 1-week post-training were assessed based on normalized Pearson correlation coefficients using the Fisher’s z-transformation in reference to the tapping pattern attained at the end of the training. Significant differences between the groups were found: the evening group showed larger changes in tapping patterns across the consolidation and retention windows. Our results show that morning-oriented older adults effectively acquired, consolidated, and maintained a new sequence of finger movements, following both morning and evening practice sessions. However, time-of-training affected the time-course of skill evolution in terms of performance speed, as well as the re-organization of tapping patterns during the consolidation period. These results are in line with the notion that motor training preceding a sleep interval may be beneficial for the long-term memory in the elderly. Evening training should be considered an appropriate time window for motor skill learning in older adults, even in individuals with morning chronotype.

Keywords: time-of-day, elderly, motor learning, memory consolidation, chronotype

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Authors: Krismonika Khoirunnisa

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This research article aims to describe the variation of the Javanese lexicon "Sleep " and its distribution in the Jombang area, East Java. The objectives of this study were (1) to classify the variation of the "Sleep" lexicon in the Jombang area and (2) to design the fish rips for the variation of the "Sleep" lexicon according to their distribution. This type of research is a qualitative descriptive study using the method of leading proficiency, namely conducting interviews with speakers without directly meeting the speakers (interviews via WhatsApp and email as the media). This research article uses techniques record as support and tools for mapping and classifying data, collecting data in this study conducted at four points, namely the Kaliwungu village (Jombang City), Banjardowo village (District of Jombang), Mayangan Village (Subdistrict Jogoroto), and Karobelah village (Subdistrict Mojoagung) as a target investigators to conduct the interview. This study uses the dialectology theory as a basis for analyzing the data obtained. The results of this study found that the Javanese language variation "Sleep" has many different linguals, meanings, and forms even though they are in the same area (Jombang).

Keywords: geographical dialectology, lexicon variations, jombangan dialect, sssavanese language

Procedia PDF Downloads 191

Authors: Amin Nakhostin-Ansari, Samaneh Akbarour, Khosro Sadeghniiat Haghighi, Zahra Banafsheh Alemohammad, Farnaz Etesam, Arezu Najafi, Mahnaz Khalafehnilsaz

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Introduction: The outbreak of coronavirus disease has considerably burdened the healthcare system in Iran. This study aimed to evaluate the characteristics of insomnia experienced by the general Iranian population during the COVID-19 pandemic. Method: A scale(FCV-19) was used for Fear of COVID-19, Insomnia Severity Index (ISI), Patient Health Questionnaire-2 (PHQ-2), and Generalized Anxiety Disorder Scale-2 (GAD-2) for detailed characterization of insomnia and its patterns Results: In total, 675 people with insomnia with the mean age of 40.28 years (SD=11.15) participated in this study. Prevalence of difficulty initiating sleep (DIS), difficulty maintaining sleep (DMS), and early morning awakening (EMA) were 91.4%, 86.7%, and 77%, respectively. DIS, DMS, and EMA were more common in people with depression and anxiety. FCV-19 score was higher in those with more severe types of DIS, DMS, and EMA (P<0.001). FCV-19 was a risk factor for all patterns of insomnia (OR=1.19, 1.12, 1.02 for DIS, DMS, and EMA, respectively). Conclusion: fear of COVID-19 is a major factor to insomnia patterns. Investigation of COVID-19 fear in people with insomnia and the addition of attributed relieving or management strategies to conventional management of insomnia are reasonable approaches to improve the sleep condition of people in the pandemic.

Keywords: insomnia, difficulty maintaining sleep, COVID-19, Coronavirus

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Authors: Cheng-Yu Tsai, Wen-Te Liu, Shin-Mei Hsu, Yin-Tzu Lin, Chi Wu

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Background: Obstructive Sleep apnea syndrome (OSAS) is a common respiratory disorder during sleep. In addition, Body parameters were identified high predictive importance for OSAS severity. However, the effects of body parameters on OSAS severity remain unclear. Objective: In this study, the objective is to establish a prediction model for OSAS by using body parameters and investigate the effects of body parameters in OSAS. Methodologies: Severity was quantified as the polysomnography and the mean hourly number of greater than 3% dips in oxygen saturation during examination in a hospital in New Taipei City (Taiwan). Four levels of OSAS severity were classified by the apnea and hypopnea index (AHI) with American Academy of Sleep Medicine (AASM) guideline. Body parameters, including neck circumference, waist size, and body mass index (BMI) were obtained from questionnaire. Next, dividing the collecting subjects into two groups: training and testing groups. The training group was used to establish the random forest (RF) to predicting, and test group was used to evaluated the accuracy of classification. Results: There were 3330 subjects recruited in this study, whom had been done polysomnography for evaluating severity for OSAS. A RF of 1000 trees achieved correctly classified 79.94 % of test cases. When further evaluated on the test cohort, RF showed the waist and BMI as the high import factors in OSAS. Conclusion It is possible to provide patient with prescreening by body parameters which can pre-evaluate the health risks.

Keywords: apnea and hypopnea index, Body parameters, obstructive sleep apnea syndrome, Random Forest

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Authors: Christina Hagen, Pragathi Kamale Gurmurthy, Thorsten M. Buzug

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CFD simulations are performed in the upper airway of a patient suffering from obstructive sleep apnea (OSA) that is a sleep related breathing disorder characterized by repetitive partial or complete closures of the upper airways. The simulations are aimed at getting a better understanding of the pathophysiological flow patterns in an OSA patient. The simulation is compared to medical data of a sleep endoscopic examination under sedation. A digital model consisting of surface triangles of the upper airway is extracted from the MR images by a region growing segmentation process and is followed by a careful manual refinement. The computational domain includes the nasal cavity with the nostrils as the inlet areas and the pharyngeal volume with an outlet underneath the larynx. At the nostrils a flat inflow velocity profile is prescribed by choosing the velocity such that a volume flow rate of 150 ml/s is reached. Behind the larynx at the outlet a pressure of -10 Pa is prescribed. The stationary incompressible Navier-Stokes equations are numerically solved using finite elements. A grid convergence study has been performed. The results show an amplification of the maximal velocity of about 2.5 times the inlet velocity at a constriction of the pharyngeal volume in the area of the tongue. It is the same region that also shows the highest pressure drop from about 5 Pa. This is in agreement with the sleep endoscopic examinations of the same patient under sedation showing complete contractions in the area of the tongue. CFD simulations can become a useful tool in the diagnosis and therapy of obstructive sleep apnea by giving insight into the patient’s individual fluid dynamical situation in the upper airways giving a better understanding of the disease where experimental measurements are not feasible. Within this study, it could been shown on one hand that constriction areas within the upper airway lead to a significant pressure drop and on the other hand a good agreement of the area of pressure drop and the area of contraction could be shown.

Keywords: biomedical engineering, obstructive sleep apnea, pharynx, upper airways

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Authors: Tzu-Yang Lin, Chuan-Ching Sue

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Sleep mechanisms are commonly used to ensure the energy efficiency of each optical network unit (ONU) that concerns a single class delay constraint in the Ethernet Passive Optical Network (EPON). How long the ONUs can sleep without violating the delay constraint has become a research problem. Particularly, we can derive an analytical model to determine the optimal sleep time of ONUs in every cycle without violating the maximum class delay constraint. The bandwidth allocation considering such optimal sleep time is called Green Bandwidth Allocation (GBA). Although the GBA mechanism guarantees that the different class delay constraints do not violate the maximum class delay constraint, packets with a more relaxed delay constraint will be treated as those with the most stringent delay constraint and may be sent early. This means that the ONU will waste energy in active mode to send packets in advance which did not need to be sent at the current time. Accordingly, we proposed a QoS-aware GBA using a novel intra-ONU scheduling to control the packets to be sent according to their respective delay constraints, thereby enhancing energy efficiency without deteriorating delay performance. If packets are not explicitly classified but with different packet delay constraints, we can modify the intra-ONU scheduling to classify packets according to their packet delay constraints rather than their classes. Moreover, we propose the switchable ONU architecture in which the ONU can switch the architecture according to the sleep time length, thus improving energy efficiency in the QoS-aware GBA. The simulation results show that the QoS-aware GBA ensures that packets in different classes or with different delay constraints do not violate their respective delay constraints and consume less power than the original GBA.

Keywords: Passive Optical Networks, PONs, Optical Network Unit, ONU, energy efficiency, delay constraint

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Authors: Phong Nguyen, Phap Nguyen, Thang Nguyen

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High Efficiency Video Coding (HEVC) or H.265 Standard fulfills the demand of high resolution video storage and transmission since it achieves high compression ratio. However, it requires a huge amount of calculation. Since Motion Estimation (ME) block composes about 80 % of calculation load of HEVC, there are a lot of researches to reduce the computation cost. In this paper, we propose a new algorithm to lower the number of Motion Estimation’s searching points. The number of computing points in search pattern is down from 77 for Diamond Pattern and 81 for Square Pattern to only 31. Meanwhile, the Peak Signal to Noise Ratio (PSNR) and bit rate are almost equal to those of conventional patterns. The motion estimation time of new algorithm reduces by at 68.23%, 65.83%compared to the recommended search pattern of diamond pattern, square pattern, respectively.

Keywords: motion estimation, wide diamond, search pattern, H.265, test zone search, HM software

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Authors: Sachin Singh, Thomas Penzel, Dinesh Nandan

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Accurate identification of Sleep Apnea Hypopnea Syndrom Diagnosis is difficult problem for human expert because of variability among persons and unwanted noise. This paper proposes the diagonosis of Sleep Apnea Hypopnea Syndrome (SAHS) using airflow, ECG, Pulse and SaO2 signals. The features of each type of these signals are extracted using statistical methods and ANN learning methods. These extracted features are used to approximate the patient's Apnea Hypopnea Index(AHI) using sample signals in model. Advance signal processing is also applied to snore sound signal to locate snore event and SaO2 signal is used to support whether determined snore event is true or noise. Finally, Apnea Hypopnea Index (AHI) event is calculated as per true snore event detected. Experiment results shows that the sensitivity can reach up to 96% and specificity to 96% as AHI greater than equal to 5.

Keywords: neural network, AHI, statistical methods, autoregressive models

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Authors: Yasmeen Jamal Alabdallat, Almutazballlah Bassam Qablan, Hamza Al-Salhi, Salameh Alarood, Ibraheem Alkhawaldeh, Obada Abunar, Adam Abdallah

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Obstructive sleep apnea (OSA) is a disorder caused by the repeated collapse of the upper airway during sleep. It is the most common cause of sleep-related breathing disorder, as OSA can cause loud snoring, daytime fatigue, or more severe problems such as high blood pressure, cardiovascular disease, coronary artery disease, insulin-resistant diabetes, and depression. The hypoglossal nerve stimulator (HNS) is an implantable medical device that reduces the occurrence of obstructive sleep apnea by electrically stimulating the hypoglossal nerve in rhythm with the patient's breathing, causing the tongue to move. This stimulation helps keep the patient's airways clear while they sleep. This systematic review and meta-analysis aimed to assess the clinical outcome of hypoglossal nerve stimulation as a treatment of obstructive sleep apnea. A computer literature search of PubMed, Scopus, Web of Science, and Cochrane Central Register of Controlled Trials was conducted from inception until August 2022. Studies assessing the following clinical outcomes (Apnea-Hypopnea Index (AHI), Epworth Sleepiness Scale (ESS), Functional Outcomes of Sleep Questionnaire (FOSQ), Oxygen Desaturation Indices (ODI), (Oxygen Saturation (SaO2)) were pooled in the meta-analysis using Review Manager Software. We assessed the quality of studies according to the Cochrane risk-of-bias tool for randomized trials (RoB2), Risk of Bias In Non-randomized Studies - of Interventions (ROBINS-I), and a modified version of NOS for the non-comparative cohort studies.13 Studies (Six Clinical Trials and Seven prospective cohort studies) with a total of 817 patients were included in the meta-analysis. The results of AHI were reported in 11 studies examining OSA 696 patients. We found that there was a significant improvement in the AHI after 12 months of HNS (MD = 18.2 with 95% CI, (16.7 to 19.7; I2 = 0%); P < 0.00001). Further, 12 studies reported the results of ESS after 12 months of intervention with a significant improvement in the range of sleepiness among the examined 757 OSA patients (MD = 5.3 with 95% CI, (4.75 to 5.86; I2 = 65%); P < 0.0001). Moreover, nine studies involving 699 participants reported the results of FOSQ after 12 months of HNS with a significant reported improvement (MD = -3.09 with 95% CI, (-3.41 to 2.77; I2 = 0%); P < 0.00001). In addition, ten studies reported the results of ODI with a significant improvement after 12 months of HNS among the 817 examined patients (MD = 14.8 with 95% CI, (13.25 to 16.32; I2 = 0%); P < 000001). The Hypoglossal Nerve Stimulation showed a significant positive impact on obstructive sleep apnea patients after 12 months of therapy in terms of apnea-hypopnea index, oxygen desaturation indices, manifestations of the behavioral morbidity associated with obstructive sleep apnea, and functional status resulting from sleepiness.

Keywords: apnea, meta-analysis, hypoglossal, stimulation

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Authors: Hossam N. Alhawatmeh, Areen I. Albustanji

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Hemodialysis negatively affects physical and psychological health. Pain, poor sleep quality, and low self-esteem are highly prevalent among patients with end-stage renal disease (ESRD) who receive hemodialysis, significantly increasing mortality and morbidity of those patients. Mind-body interventions (MBI), such as mindfulness meditation, have been recently gaining popularity that improved pain, sleep quality, and self-esteem in different populations. However, to our best knowledge, its effects on these health problems in patients receiving hemodialysis have not been studied in Jordan. Thus, the purpose of the study was to examine the effect of mindfulness meditation on pain, sleep quality, and self-esteem in patients with ESR receiving hemodialysis in Jordan. An experimental repeated-measures, randomized, parallel control design was conducted on (n =60) end-stage renal disease patients undergoing hemodialysis between March and June 2023 in the dialysis center at a public hospital in Jordan. Participants were randomly assigned to the experimental (n =30) and control groups (n =30) using a simple random assignment method. The experimental group practiced mindfulness meditation for 30 minutes three times per week for five weeks during their hemodialysis treatments. The control group's patients continued to receive hemodialysis treatment as usual for five weeks during hemodialysis sessions. The study variables for both groups were measured at baseline (Time 0), two weeks after intervention (Time 1), and at the end of intervention (Time 3). The numerical rating scale (NRS), the Rosenberg Self-Esteem Scale (RSES-M), and the Pittsburgh Sleep Quality Index (PSQI) were used to measure pain, self-esteem, and sleep quality, respectively. SPSS version 25 was used to analyze the study data. The sample was described by frequency, mean, and standard deviation as an appropriate. The repeated measures analysis of variance (ANOVA) tests were run to test the study hypotheses. The results of repeated measures ANOVA (within-subject) revealed that mindfulness meditation significantly decrease pain by the end of the intervention in the experimental group. Additionally, mindfulness meditation improved sleep quality and self-esteem in the experimental group, and these improvements occurred significantly after two weeks of the intervention and at the end of the intervention. The results of repeated measures ANOVA (within and between-subject) revealed that the experimental group, compared to the control group, experienced lower levels of pain and higher levels of sleep quality and self-esteem over time. In conclusion, the results provided substantial evidence supporting the positive impacts of mindfulness meditation on pain, sleep quality, and self-esteem in patients with ESRD undergoing hemodialysis. These results highlight the potential of mindfulness meditation as an adjunctive therapy in the comprehensive care of this patient population. Incorporating mindfulness meditation into the treatment plan for patients receiving hemodialysis may contribute to improved well-being and overall quality of life.

Keywords: hemodialysis, pain, sleep quality, self-esteem, mindfulness

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Authors: Seyed Mahdi Jameii, Arash Nikdel, Seyed Mohsen Jameii

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Energy efficiency is an important issue in the field of Wireless Sensor Networks (WSNs). So, minimizing the energy consumption in this kind of networks should be an essential consideration. Sleep/wake scheduling mechanism is an efficient approach to handling this issue. In this paper, we propose a Genetic Algorithm-based Sleep-Wake up Area Coverage protocol called GA-SWAC. The proposed protocol puts the minimum of nodes in active mode and adjusts the sensing radius of each active node to decrease the energy consumption while maintaining the network’s coverage. The proposed protocol is simulated. The results demonstrate the efficiency of the proposed protocol in terms of coverage ratio, number of active nodes and energy consumption.

Keywords: wireless sensor networks, genetic algorithm, coverage, connectivity

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Authors: Oyuntsetseg Sandag, Lkhagvadorj Khosbayar, Naidansuren Tsendeekhuu, Densenbal Dansran, Bandi Solongo

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Introduction: Obstructive sleep apnea (OSA) is a common disorder affecting at least 2% to 4% of the adult population. It is estimated that nearly 80% of men and 93% of women with moderate to severe sleep apnea are undiagnosed. A number of screening questionnaires and clinical screening models have been developed to help identify patients with OSA, also it’s indeed to clinical practice. Purpose of study: Determine dependence of obstructive sleep apnea between for severe risk and risk factor. Material and Methods: A cross-sectional study included 114 patients presenting from theCentral state 3th hospital and Central state 1th hospital. Patients who had obstructive sleep apnea (OSA)selected in this study. Standard StopBang questionnaire was obtained from all patients.According to the patients’ response to the StopBang questionnaire was divided into low risk, intermediate risk, and high risk.Descriptive statistics were presented mean ± standard deviation (SD). Each questionnaire was compared on the likelihood ratio for a positive result, the likelihood ratio for a negative test result of regression. Statistical analyses were performed utilizing SPSS 16. Results: 114 patients were obtained (mean age 48 ± 16, male 57)that divided to low risk 54 (47.4%), intermediate risk 33 (28.9%), high risk 27 (23.7%). Result of risk factor showed significantly increasing that mean age (38 ± 13vs. 54 ± 14 vs. 59 ± 10, p<0.05), blood pressure (115 ± 18vs. 133 ± 19vs. 142 ± 21, p<0.05), BMI(24 IQR 22; 26 vs. 24 IQR 22; 29 vs. 28 IQR 25; 34, p<0.001), neck circumference (35 ± 3.4 vs. 38 ± 4.7 vs. 41 ± 4.4, p<0.05)were increased. Results from multiple logistic regressions showed that age is significantly independently factor for OSA (odds ratio 1.07, 95% CI 1.02-1.23, p<0.01). Predictive value of age was significantly higher factor for OSA (AUC=0.833, 95% CI 0.758-0.909, p<0.001). Our study showing that risk of OSA is beginning 47 years old (sensitivity 78.3%, specifity74.1%). Conclusions: According to most of all patients’ response had intermediate risk and high risk. Also, age, blood pressure, neck circumference and BMI were increased such as risk factor was increased for OSA. Especially age is independently factor and highest significance for OSA. Patients’ age one year is increased likelihood risk factor 1.1 times is increased.

Keywords: obstructive sleep apnea, Stop-Bang, BMI (Body Mass Index), blood pressure

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Authors: Kyungae Jo, Eun Young Kim, Byungsoo Shin, Kwang Soon Shin, Hyung Joo Suh

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Gamma-aminobutyric acid (GABA) and 5-hydroxytryptophan (5-HTP) are amino acids of digested nutrients or food ingredients and these can possibly be utilized as non-pharmacologic treatment for sleep disorder. We previously investigated the GABA/5-HTP mixture is the principal concept of sleep-promoting and activity-repressing management in nervous system of D. melanogaster. Two experiments in this study were designed to evaluate sleep-promoting effect of GABA/5-HTP mixture, to clarify the possible ratio of sleep-promoting action in the Drosophila invertebrate model system. Behavioral assays were applied to investigate distance traveled, velocity, movement, mobility, turn angle, angular velocity and meander of two amino acids and GABA/5-HTP mixture with caffeine treated flies. In addition, differentially expressed gene (DEG) analyses from next generation sequencing (NGS) were applied to investigate the signaling pathway and functional interaction network of GABA/5-HTP mixture administration. GABA/5-HTP mixture resulted in significant differences between groups related to behavior (p < 0.01) and significantly induced locomotor activity in the awake model (p < 0.05). As a result of the sequencing, the molecular function of various genes has relationship with motor activity and biological regulation. These results showed that GABA/5-HTP mixture administration significantly involved the inhibition of motor behavior. In this regard, we successfully demonstrated that using a GABA/5-HTP mixture modulates locomotor activity to a greater extent than single administration of each amino acid, and that this modulation occurs via the neuronal system, neurotransmitter release cycle and transmission across chemical synapses.

Keywords: sleep, γ-aminobutyric acid, 5-hydroxytryptophan, Drosophila melanogaster

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Authors: Parastoo Vasli

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In today's society, more and more people work during ‘non-standard’ working hours, including shift and night work, which are perceived danger factors for health, safety, and social prosperity. Appropriate preventive and protective measures are needed to reduce side effects and ensure that the worker can adapt sufficiently. Of the many health effects associated with shift work, sleep disorders are the most widely recognized. The most troubling acute symptoms are difficulty falling asleep, short sleep, and drowsiness during working hours that last for days on end. The outcomes checked on plainly exhibit that shift work is related to expanded mental, social, and physiological drowsiness. Apparently, the effects are due to circadian and hemostatic compounds (sleep loss). Drowsiness is especially evident during night shifts and may lead to drowsiness in real workplace accidents. In some occupations, this is clearly a risk that could endanger human lives and has enormous financial outcomes. These dangers clearly affect a large number of people and should be of great importance to society. In particular, safety on night shifts is consistently reduced.

Keywords: shift work, night work, safety, health, drowsiness

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Authors: Pragathi Gurumurthy, Christina Hagen, Patricia Ulloa, Martin A. Koch, Thorsten M. Buzug

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Obstructive sleep apnea (OSA) is a sleep disorder where the patient suffers a disturbed airflow during sleep due to partial or complete occlusion of the pharyngeal airway. Recently, numerical simulations have been used to better understand the mechanism of pharyngeal collapse. However, to gain confidence in the solutions so obtained, an experimental validation is required. Therefore, in this study an experimental validation of computational fluid dynamics (CFD) used for the study of human pharyngeal flow patterns during OSA is performed. A stationary incompressible Navier-Stokes equation solved using the finite element method was used to numerically study the flow patterns in a computed tomography-based human pharynx model. The inlet flow rate was set to 250 ml/s and such that a flat profile was maintained at the inlet. The outlet pressure was set to 0 Pa. The experimental technique used for the validation of CFD of fluid flow patterns is phase contrast-MRI (PC-MRI). Using the same computed tomography data of the human pharynx as in the simulations, a phantom for the experiment was 3 D printed. Glycerol (55.27% weight) in water was used as a test fluid at 25°C. Inflow conditions similar to the CFD study were simulated using an MRI compatible flow pump (CardioFlow-5000MR, Shelley Medical Imaging Technologies). The entire experiment was done on a 3 T MR system (Ingenia, Philips) with 108 channel body coil using an RF-spoiled, gradient echo sequence. A comparison of the axial velocity obtained in the pharynx from the numerical simulations and PC-MRI shows good agreement. The region of jet impingement and recirculation also coincide, therefore validating the numerical simulations. Hence, the experimental validation proves the reliability and correctness of the numerical simulations.

Keywords: computational fluid dynamics, experimental validation, phase contrast-MRI, obstructive sleep apnea

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Authors: Stelios A. Mitilineos, Nicolas-Alexander Tatlas, Georgia Korompili, Lampros Kokkalas, Stelios M. Potirakis

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Obstructive Sleep Apnea Hypopnea Syndrome (OSAHS) is a widespread chronic disease that mostly remains undetected, mainly due to the fact that it is diagnosed via polysomnography which is a time and resource-intensive procedure. Screening the disease’s symptoms at home could be used as an alternative approach in order to alert individuals that potentially suffer from OSAHS without compromising their everyday routine. Since snoring is usually linked to OSAHS, developing a snore detector is appealing as an enabling technology for screening OSAHS at home using ubiquitous equipment like commodity microphones (included in, e.g., smartphones). In this context, this study developed a snore detection tool and herein present the approach and selection of specific sound features that discriminate snoring vs. environmental sounds, as well as the performance of the proposed tool. Furthermore, a Real-Time Snore Detector (RTSD) is built upon the snore detection tool and employed in whole-night sleep sound recordings resulting to a large dataset of snoring sound excerpts that are made freely available to the public. The RTSD may be used either as a stand-alone tool that offers insight to an individual’s sleep quality or as an independent component of OSAHS screening applications in future developments.

Keywords: obstructive sleep apnea hypopnea syndrome, apnea screening, snoring detection, machine learning, neural networks

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Authors: Sriparna Bandopadhyay

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It is known that irreducible sign patterns in general may not allow diagonalizability and in particular irreducible sign patterns with minimum rank greater than or equal to 4. It is also known that every irreducible sign pattern matrix with minimum rank of 2 allow diagonalizability with rank of 2 and the maximum rank of the sign pattern. In general sign patterns with minimum rank of 3 may not allow diagonalizability if the condition of irreducibility is dropped, but the problem of whether every irreducible sign pattern with minimum rank of 3 allows diagonalizability remains open. In this paper it is shown that irreducible sign patterns with minimum rank of 3 under certain conditions on the underlying graph allow diagonalizability. An alternate proof of the results that every sign pattern matrix with minimum rank of 2 and no zero lines allow diagonalizability with rank of 2 and also that every full sign pattern allows diagonalizability with all permissible ranks of the sign pattern is given. Some open problems regarding composite cycles in an irreducible symmetric sign pattern that support of a rank principal certificate are also answered.

Keywords: irreducible sign patterns, minimum rank, symmetric sign patterns, rank -principal certificate, allowing diagonalizability

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Authors: B. G. Abiona, E. O. Fakoya, S. O. Adeogun, J. O. Blessed

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This study assessed the influence of communication pattern on agricultural employees’ job performance. Data were collected from 61 randomly selected respondents using a structured questionnaire. Perceived communication pattern that influence job performance include: the attitude of the administrators (x̅ = 3.41, physical barriers to communication flow among employees (x̅ = 3.21). Major challenges to respondents’ job performance were different language among employees (x̅ = 3.12), employees perception on organizational issues (x̅ = 3.09), networking (x̅ = 2.88), and unclear definition of work (x̅ = 2.74). A significant relationship was found between employees’ perceived communication pattern (r = 0.423, p < 0.00) and job performance. Information must be well designed in such a way that would positively influence employees’ job performance as this is essential in any agricultural organizations.

Keywords: communication pattern, job performance, agricultural employees, constraint, administrators, attitude

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