Top PDF Excessive daytime sleepiness in secondary chronic headache from the general population

Excessive daytime sleepiness in secondary chronic headache from the general population

Excessive daytime sleepiness in secondary chronic headache from the general population

Chronic headache was defined as headache ≥15 days/ months for at least 3 months or ≥180 days/year. Chronic post-traumatic headache (CPTH) included head and whiplash traumas. Cervicogenic headache (CEH) was classified according to the criteria of the Cervicogenic Headache International Study Group, requiring at least three criteria to be fulfilled, not including blockade of the neck due to the non-interventional nature of our study (Table 1) [17]. Headache attributed to chronic rhinosinusitis (HACRS) was defined according to the criteria established by the American Academy of Otolaryngology – Head and Neck Surgery (Table 2) adding that the symptoms had persisted for 12 weeks or more [18].
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Psychological distress, neuroticism and disability associated with secondary chronic headache in the general population – the Akershus study of chronic headache

Psychological distress, neuroticism and disability associated with secondary chronic headache in the general population – the Akershus study of chronic headache

Results: Ninety-five of the 113 eligible participants (84%) completed the self-reported questionnaire. A total of 38 people had chronic post-traumatic headache, 21 had cervicogenic headache, and 39 had headache attributed to chronic rhinosinusitis, while 9 had co-occurrence of chronic post-traumatic and cervicogenic headache. Six persons had miscellaneous secondary chronic headaches. Overall, 49% of those with secondary chronic headache reported high psychological distress, which is significantly higher than in the general population. A high level of neuroticism was significantly more common in those with secondary chronic headache than in the general population. Severe headache-related disability was reported by 69%. 92 persons were followed up after 3 years. A low headache frequency was the only significant predictor of improvement of ≥ 25% in headache days. Having post-traumatic or cervicogenic headache and not headache attributed to chronic rhinosinusitis predicted an increased risk > 25% worsening of headache days or having a severe disability at 3 years follow-up.
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Management of secondary chronic headache in the general population: the Akershus study of chronic headache

Management of secondary chronic headache in the general population: the Akershus study of chronic headache

either physicians or by those practicing CAM. An alter- native may be that rhinosinusitis problems are com- monly present in other conditions with secondary headache, either by coincidence or by interactions based on medication use or other causal or interactive relation- ships such as sensitisation processes. We have previously described that HACRS may have a better prognosis than CPTH and especially CEH which support HACRS as a different entity [19,22]. The improvement among partici- pants with HACRS was seen especially in those who had interventions for their rhinosinusitis and who had reduced their nasal decongestants and their headache medication overuse [22]. This would seem to support the presence of HACRS as a chronic headache entity distinct from CPTH and CEH and that a focus and re- ferral practice reflecting this by traditional school medi- cine physicians may give a hope for a more effective treatment for a group of sufferers from secondary chronic headache.
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Association of excessive daytime sleepiness with migraine and headache frequency in the general population

Association of excessive daytime sleepiness with migraine and headache frequency in the general population

Another potential limitation is that the data reported in the present study were self-reported. This study asked about lifetime prevalence of migraine. The single ques- tion about lifetime occurrence of migraine, which was used, has previously been evaluated against a clinical interview by two physicians in another Norwegian sur- vey in eastern Akershus County, reporting a raw agree- ment rate of 0.81 and kappa (κ) of 0.62, which is considered to be a good agreement [23]. Two previous epidemiological surveys used the same screening ques- tion for migraine as in the present study, and the ob- served agreement rates were 0.92 and 0.94, and κ were 0.77 and 0.81, respectively [2, 40]. Due to the high num- ber of participants in our survey, it was not feasible to apply the gold standard, i.e. a clinical interview by a physician/neurologist with expertise in headache diag- nostics. The current study did not investigate the effect of EDS on clinical characteristics of migraine, which would require more detailed clinical information than is possible in a questionnaire-based general population survey.
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Prader Willi syndrome, excessive daytime sleepiness, and narcoleptic symptoms: a case report

Prader Willi syndrome, excessive daytime sleepiness, and narcoleptic symptoms: a case report

Further understanding of how genes in the PWS locus are connected to sleep functioning offers insight into an underlying cause of the sleep abnormalities ob- served in PWS. For example, one of the genes linked to the phenotype of PWS is MAGEL2 which is expressed in the suprachiasmatic nucleus (SCN) [13], the loca- tion of the body’s core circadian clock. These findings in the mouse model of PWS suggest a possible connec- tion between the genetics of the PWS, disrupted circa- dian rhythm and the observed sleep abnormalities. A disrupted circadian rhythm associated with PWS might also manifest as specific clinical metabolic (central obesity, type 2 diabetes, and cardiovascular disease) and sleep abnormalities observed in this condition. Research has also illustrated the contribution that al- tered circadian rhythm and sleep patterns might result in disrupted metabolic functioning, including impaired insulin sensitivity and increased risk of diabetes, obes- ity and cardiovascular events in the general population (Figure 1) [14]. Therefore, it is important to treat sleep issues in patients with PWS not only for improvement of sleep and energy levels, but also to prevent further meta- bolic deterioration in this disease. While one open-label
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Excessive Daytime Sleepiness and Hypertension in Cameroonian Adult Population

Excessive Daytime Sleepiness and Hypertension in Cameroonian Adult Population

Excessive daytime sleepiness (EDS) is a common clinical problem. It is one of the main consequences of sleep disorders and it is associated with a reduction of the quality of life, road accidents and workplace accidents [1, 2]. EDS is an inability to maintain vigilance and alertness during major period of the day when subject is expected to be awake, with sleep occurring unintentionally or at inappropriate times and this almost daily [3]. Its prevalence is estimated between 10 and 20% in the general population [4–12] and reaches 68% in some groups of patients [13]. The independent association between EDS and hypertension is found in several studies including patients with sleep apnea syndrome (SAS) [13–16]. Hypertension is a common condition in the general population and is one of the major risk factors for cardiovascular mortality and morbidity [17]. Studies of the relationship between EDS and hypertension in the general population regardless of association with SAS are scarce. In a prospective cohort study carried out in a relatively healthy adult population, Goldstein et al. found a high risk of developing hypertension in subjects with EDS [18]. Otherwise, in a recent prospective cohort study in Brazil, Drager et al. did not find any association between hypertension and EDS [19]. Moreover, in a group of subjects recruited from a sleep laboratory in China, normotensive subjects had a more severe SDE than hypertensive subjects with OSA [20]. The factors associated with EDS in hypertensive subjects are obesity, type 2 diabetes and uncontrolled hypertension [21]. In this light, we carried out this study having as objective to investigate the association between the EDS and hypertension, and to determine the factors associated with the EDS in the subjects having hypertension in the general adult population of Cameroon.
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Atopic Dermatitis and Excessive Daytime Sleepiness: Analysis of Data from 8362 Adult Subjects in a Sub-Saharan Africa Country

Atopic Dermatitis and Excessive Daytime Sleepiness: Analysis of Data from 8362 Adult Subjects in a Sub-Saharan Africa Country

and allergic rhinitis symptoms). In the study by Li et al., the severity of AD is associated with an increase in nocturnal sleep disturbances and the severity of daytime sleepiness [14]. In our univariate analysis, the nocturnal sleep disturbances were slightly more frequent in patient with AD and EDS, but this association was no longer found after multivariate analysis. Also, in a Japanese study of 112 adult subjects, a low to moderate correlation was found between the severity of AD measured by Severity Scoring of Atopic Dermatitis (SCORAD) index [17] and sleep disorders assessed by Pittsburgh Sleep Quality Index [18]. Silverberg at al. found an association between sleep disorders in subjects with AD and other allergic diseases, female sex, older age and low income [13]. In our study, the association between allergic rhinitis and EDS in subjects with AD was borderline in univariate analysis but was not in the multivariate analysis after including other confounding factors. The association between obesity and EDS in subjects with AD was not found in our study as reported in the study Li et al. [14]. However, in the general population EDS is associated to BMI irrespectively of other comorbidities as also shown in this study [19, 20].
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Excessive daytime sleepiness is associated with an exacerbation of migraine: A population-based study

Excessive daytime sleepiness is associated with an exacerbation of migraine: A population-based study

The association between EDS and several common neurological diseases such as Parkinson’ s disease, epi- lepsy, and migraine has been previously reported. A case-controlled study from Italy noted that subjects with episodic migraine (EM) showed an increased odds ratio [14 % vs. 5 %; odds ratio (OR) = 3.1; 95 % confidence interval (CI) 1.1–8.9] for EDS compared to age- and sex- matched healthy controls [15]. Another case-controlled study showed a positive association between EDS and chronic migraine (CM) [20]. A case-series study in the United States showed that a significant proportion of participants with migraine also had EDS [21]. A community-based study in Norway showed increased ORs (OR = 3.3, 95 % CI 1.0–10.2) for EDS among migraineurs compared to headache-free individuals [22]. However, previous reports regarding the association between EDS and migraine were predominantly clinic- based studies and the association between them has seldom been examined in the general population. In addition, the clinical characteristics of migraine associ- ated with EDS have not yet been reported.
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Risk of obstructive sleep apnea and excessive daytime sleepiness in hospitalized psychiatric patients

Risk of obstructive sleep apnea and excessive daytime sleepiness in hospitalized psychiatric patients

lence of sleep apnea in this sample was found to be higher in males, which is consistent with the literature (Table 1). The prevalence of sleep apnea was not found to be higher in older patients, which is unusual per the literature. Being in the younger age range was found to be a predictor of OSA (Table 3). Despite having a low odds ratio (OR), this finding was still significant. This underscores the importance of not overlooking OSA symptoms and their risks in the young psychiatric patient population. This could also be explained by the small sample size when compared to larger general population studies. The prevalence of OSA in this study, was found to be higher than available prevalence data from our region regarding OSA which showed a prevalence ranging up to 21% in special populations, such as end-stage renal failure patients. 8,9,28 The high prevalence in this study, may be due to
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Factors Associated with Smoking Behaviors among Military Cadets of King Khalid Military Academy (KKMA), Riyadh, Saudi Arabia (2015-2016)

Factors Associated with Smoking Behaviors among Military Cadets of King Khalid Military Academy (KKMA), Riyadh, Saudi Arabia (2015-2016)

The present study showed that the excessive daytime sleepiness was prevalent among the medical students, The University of Tabuk, no significant statistical differences was found between the students with the excessive daytime sleepiness and others without this serious sleep disorder regarding age, sex, hours spent in Technology/day, coffee intake, use of sleep medications, and chronic diseases. The current data showed that the use of Technology was higher among those with excessive daytime sleepiness. It is a well-established fact that attentiveness during class time is a significant determinant of academic achievement; excessive daytime sleepiness could lead to fatigue and substantially impair attention. 6 The situation of excessive daytime
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Impact of sleep disordered breathing on performance in judo players

Impact of sleep disordered breathing on performance in judo players

results The percentages of young heavyweight-class judo players with EDS (ESS ≥11) and those with SDB (RDI ≥5) were both 63%, which was unexpectedly high for the age class. Seven of the participants underwent continuous positive airway pressure therapy, which improved both RDI and ESS scores (p<0.05 for each) and subsequently the sleep quality and judo performance of the participants. Conclusions Our study indicates that young judo players might silently suffer from SDB, leading to poorer judo performance and to future cardiovascular diseases. Clinicians should be aware of the possible presence of SDB in young sports players and consider the application of diagnostic and therapeutic remedies.
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Neuropsychiatric Complications of Patients with Obstructive Sleep Apnea Syndrome

Neuropsychiatric Complications of Patients with Obstructive Sleep Apnea Syndrome

This may suggest that some of the psycho- physiological consequences of OSA do not reflect a general psychological and mood effect but rather the specific consequences of sleepiness and impaired alertness. This could suggest that the sleepiness reported by OSA patients translates both the inability to stay awake, as measured by sleepiness questionnaires, as well as a subjective feeling of "loss of energy" [46]. In addition, the impairment of quality of life among OSA is correlated with cognitive impairments and increased risk for depression and anxiety, it also correlated with AHI, minimum Sao2% and disturbed sleep architecture. However, the pathways producing alterations in behavioral outcomes are complex and may involve both chronic and acute insults acting on cerebral structure or function [47]. Experimental evidence suggests that mild to moderate hypoxia can reduce turnover of acetylcholine [48], potentially producing global and diffuse cortical slowing. In more severe hypoxemia, loci of cerebral anoxic damage could be produced. One speculative mechanism involves both sleep fragmentation and hypoxemia acting synergistically to produce irreversible neuronal damage. Such cerebral damage in OSA might be mediated by abnormalities in ventilatory drive, potentiated by sleep disruption, leading to alterations to intracranial haemodynamic. These path physiological changes might potentially act in a positive feedback loop to produce cerebral ischemia, an agent of irreversible damage to neuronal structure and function.
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Management of primary chronic headache in the general population: the Akershus study of chronic headache

Management of primary chronic headache in the general population: the Akershus study of chronic headache

Headache is a common complaint in the general popula- tion. The personal burden, social impact and economic cost for both the sufferer and society are significant [1]. The International Classification of Headache Disorders (ICHD- II) divides headaches into primary and secondary forms [2]. The most common primary headaches are migraine and tension-type headaches, while other primary headaches are rare [3]. The primary headaches are usually paroxysmal, but 3% of the general population has primary chronic headache, i.e. more than 15 headache days per months [4]. Headache accounts for 4% of the general practitioners (GPs) consultations, and 2–4% of these are referred to specialists or hospitals [5, 6]. Headache is probably the most common reason for referral to neurologists [5–7]. Approximately 20–30% of all new referrals to out-patients neurological departments are due to headache [5, 6, 8, 9]. E. S. Kristoffersen R. B. Grande K. Aaseth C. Lundqvist
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Daytime sleepiness in Japanese patients with multiple system atrophy: prevalence and determinants

Daytime sleepiness in Japanese patients with multiple system atrophy: prevalence and determinants

polygraph (SomnoStarPro; VIASYS, Yorba Linda, CA, USA), and the PSG records were evaluated by clinical technologists who were certified by the Japanese Society of Sleep Research and blinded to the patients’ clinical status. The scoring of sleep stages, arousals, and respira- tory events was done manually from the PSG records according to the 1999 recommendations of the American Academy of Sleep Medicine Task Force [21]. SDB was defined as an apnea-hypopnea index (AHI) of 5 or more apnea or hypopnea episodes/h, and severe SDB was defined as an AHI of 30 or more apnea or hypopnea episodes/h. The periodic leg movement (PLM) index was calculated on the basis of the number of PLMs/h in sleep. A PLM index greater than 15 was defined as an abnormal PLMS according to Version 2 of the Inter- national Classification of Sleep Disorders. The PLM arousal index was defined as the number of PLM-related electroencephalographic arousals/h of sleep. RLS was diagnosed when patients met the 4 minimal criteria of the syndrome as defined by an international study group [22]. In the event of an inability to fall asleep, subjects were administered a nonbenzodiazepine sedative/hypnotic (zolpidem, 5 mg) at the beginning of polysomnography. The calculation of the L-3,4-dihydroxyphenylalanine (L-dopa)-equivalent dose (LED) was based on its the- oretical equivalence to L-dopa, as described in previ- ous reports [23-25] as follows: 100 mg L-dopa with dopa-decarboxylase inhibitor = 1 mg pergolide = 1.5 mg of cabergoline = 1 mg of pramipexole. Fiberoptic laryn- goscopy was performed during wakefulness as well as under sedation by intravenously injecting propofol [6].
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Clinical Reasoning: A teenage girl with excessive daytime sleepiness, “fainting spells,” and dream mentations

Clinical Reasoning: A teenage girl with excessive daytime sleepiness, “fainting spells,” and dream mentations

Based on her sleep habits, and the sleep study findings, she also has DSPS, the most common type of circadian rhythm sleep disorder seen in adoles- cents. This is characterized by sleep and wake times that are later than desired, often resulting in daytime sleepiness when conventional waking times are enforced. 4

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Prevalence of sleep disorders and its association with Obesity and academic performance among medical undergraduate students in North Karnataka

Prevalence of sleep disorders and its association with Obesity and academic performance among medical undergraduate students in North Karnataka

a self-administered questionnaire with 8 questions. Respondents are asked to rate, on a 4-point scale (0-3), their usual chances of dozing off or falling asleep while engaged in eight different activities. The ESS score (the sum of 8 item scores, 0-3) can range from 0 to 24. The higher the ESS score, the higher that person’s average sleep propensity in daily life (ASP), or their ‘daytime sleepiness’. The reference range of ‘normal’ ESS scores is zero to 10. That is the same as the range defined by the 2.5 and 97.5 percentiles. While ESS scores of 11-24 represent increasing levels of ‘excessive daytime sleepiness’ (EDS) [7] . A total of 157 students returned
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Immediate effect of CPAP titration on perceived health related quality of life: a prospective observational study

Immediate effect of CPAP titration on perceived health related quality of life: a prospective observational study

AHI: Apnea hypopnea index; BMI: Body mass index; CPAP: Continuous positive airway pressure; EDS: Excessive daytime sleepiness; ES: Effect size; ESS: Epworth sleepiness scale; HRQoL: Health related quality of life; MCS: SF-12 Mental Component Summary; OSA: Obstructive Sleep Apnea; PCS: SF- 12 Physical Component Summary; PGWBI: Psychological General Well- Being Index; SF-12: 12-Item Short-Form Health Survey; T0: Before first visit and nocturnal diagnostic examination; T1: The morning after CPAP titration; TSat90: Percent study-time at less than 90% oxygen saturation
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Sleep Problems among Pre-School Children in Qazvin, Iran

Sleep Problems among Pre-School Children in Qazvin, Iran

The study population consisted of 299 boys (51.6%) and 280 (48.3%) girls, with a mean age of 4.1 years (SD 0.8). The mean body mass index (BMI) of the children was 15.0 (SD 2.1) (P > 0.05). The average sleep duration among the children was 10:54 h/day (SD 00:48), and they went to bed late (23.18 h; SD 00:48) and woke early (09:26 h; SD: 01:00). Delayed (> 20 min) sleep onset latency was observed in 7.4% of the children, and daytime sleepiness was reported by 6.9% of the participating children. The incidence of awakening during the night, sleep-disordered breathing and snoring was 13.9%, 1.2%, and 2.7% respectively. Most of the children shared a room with their parents (87.0%) (P > 0.05 ).
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Excessive daytime sleepiness and adherence to antihypertensive medications among Blacks: analysis of the counseling African Americans to control hypertension (CAATCH) trial

Excessive daytime sleepiness and adherence to antihypertensive medications among Blacks: analysis of the counseling African Americans to control hypertension (CAATCH) trial

such associations are not entirely understood. The authors of the aforementioned study concluded that the association between sleepiness and adherence might be explained by cognitive impairment. Cognitive impairment might not have played a significant role in our study, because we included only individuals who were unimpaired. Conceivably, the overall disease burden might be an explanatory factor, given that patients with hypertension often have several comorbid conditions, including diabetes and obesity. 31 However, we

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The Psychosocial Problems of Children With Narcolepsy and Those With Excessive Daytime Sleepiness of Uncertain Origin

The Psychosocial Problems of Children With Narcolepsy and Those With Excessive Daytime Sleepiness of Uncertain Origin

abstract form, and details of these children were not stated apart from the fact that 7 of them were “at least 16 years old.” No control group was used, but comparisons were made with normative data available for the several psychosocial assessment scales used. The children with narcolepsy were reported to be more moody than aver- age, to have more adjustment problems, and to be more often engaged in delinquent behavior. When inter- viewed, most parents of the children with narcolepsy expressed concern about their child’s academic perfor- mance and their emotional lability. The findings in the present study are in broad agreement with these con- clusions, although, in the absence of detail about the sample in the account by Kashden et al, 14 precise com-
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