Natural history of snoring and other sleep-disordered breathing (SDB) symptoms in 7-year-old New Zealand children: a follow-up from age 3.

PubMed

Luo, Rebekah; Schaughency, Elizabeth; Gill, Amelia I; Dawes, Patrick J D; Galland, Barbara C

2015-09-01

We aimed to examine the natural history of snoring and associated symptoms in a community sample of New Zealand children at ages 3 and 7 years, and identify factors associated with habitual snoring at age 7 years. Parent/s of children (n = 839) who completed the community survey about their child's sleep and breathing at age 3 years were re-contacted via mail 4 years later when children were aged 7 years. Parents were asked to complete a follow-up questionnaire which included items relating to their child's sleep and health, and family demographic information. There was a 54.8% (n = 460) response rate. At follow-up, habitual snoring was prevalent in 9.2% of the sample, similar to the 11.3% reported at age 3 years. However, habitual snoring status changed over time; 36.2% (n = 21/58) remained habitual snorers; 63.8% (n = 37/58) were no longer snoring habitually, while 5.3% (n = 21/397) had started habitual snoring since the initial survey. Overall, the reported severity of SDB-related symptoms decreased over time, regardless of initial habitual snoring status. Nonetheless, habitual snoring at follow-up was significantly associated with mouth breathing, sleeping with the neck extended, sweating profusely, night waking, and parent-reported child irritability. Our findings highlight the dynamic nature of SDB, where habitual snoring and related symptoms can develop, remain present, or resolve at different times, over early-mid-childhood years. Given the dynamic nature of habitual snoring over the early childhood years, pediatricians should continue to screen for snoring and sleep apnea on an annual basis throughout childhood.

Sex-specific association between serum uric acid and self-reported snoring in rural China: a cross-sectional study.

PubMed

Wang, Haoyu; Li, Zhao; Chen, Yintao; Ye, Ning; Wang, Pengbo; Sun, Yingxian

2017-12-01

Until now, information has been rare on the association of serum uric acid (SUA) with self-reported snoring. Therefore, the purpose of this study was to explore the sex-specific relationship between SUA and self-reported snoring in a general Chinese population. A large cross-sectional study of 10,912 participants aged ≥35 years old were recruited from rural areas of Liaoning Province in China during 2012 to 2013. SUA were divided into quartiles separated for males and females. Anthropometric measurements and blood biochemical indexes were examined according to standard protocols. Sleep duration and self-reported snoring status were investigated by trained personnel using a structured questionnaire. The prevalence of self-reported snoring was 37.9% (n = 2197) among females and 47.4% (n = 2420) among males, respectively. The proportion of self-reported snoring presented a significant linear increase across the quartile of SUA level in both sexes. In multivariate logistic regression analysis adjusted for possible confounders, the odds ratio (OR) for SUA with regard to self-reported snoring was significantly higher in females. The OR of self-reported snoring associated with per 1 SD increase in SUA was 1.208 (95%CI 1.118-1.305, P<0.001). The highest quartile of SUA (>293 μmol/L) conferred an independently increased risk for self-reported snoring with OR of 1.643 (95%CI 1.384-1.950, p < 0.001) compared to the lowest quartile of SUA (<209 μmol/L). However, there were no significant relationships between SUA and self-reported snoring among males in all the models. Our study showed that in rural China, SUA was positively correlated with an increased risk for self-reported snoring in females but not in males. The strong association of SUA levels with self-reported snoring in females emphasizes the necessity of stratifying the sex in investigations of self-reported snoring and encourages exploration of SUA as an effective clinical tool of self-reported snoring risk.

Automatic Recognition of Breathing Route During Sleep Using Snoring Sounds

NASA Astrophysics Data System (ADS)

Mikami, Tsuyoshi; Kojima, Yohichiro

This letter classifies snoring sounds into three breathing routes (oral, nasal, and oronasal) with discriminant analysis of the power spectra and k-nearest neighbor method. It is necessary to recognize breathing route during snoring, because oral snoring is a typical symptom of sleep apnea but we cannot know our own breathing and snoring condition during sleep. As a result, about 98.8% classification rate is obtained by using leave-one-out test for performance evaluation.

The impact of the microphone position on the frequency analysis of snoring sounds.

PubMed

Herzog, Michael; Kühnel, Thomas; Bremert, Thomas; Herzog, Beatrice; Hosemann, Werner; Kaftan, Holger

2009-08-01

Frequency analysis of snoring sounds has been reported as a diagnostic tool to differentiate between different sources of snoring. Several studies have been published presenting diverging results of the frequency analyses of snoring sounds. Depending on the position of the used microphones, the results of the frequency analysis of snoring sounds vary. The present study investigated the influence of different microphone positions on the outcome of the frequency analysis of snoring sounds. Nocturnal snoring was recorded simultaneously at six positions (air-coupled: 30 cm middle, 100 cm middle, 30 cm lateral to both sides of the patients' head; body contact: neck and parasternal) in five patients. The used microphones had a flat frequency response and a similar frequency range (10/40 Hz-18 kHz). Frequency analysis was performed by fast Fourier transformation and frequency bands as well as peak intensities (Peaks 1-5) were detected. Air-coupled microphones presented a wider frequency range (60 Hz-10 kHz) compared to contact microphones. The contact microphone at cervical position presented a cut off at frequencies above 300 Hz, whereas the contact microphone at parasternal position revealed a cut off above 100 Hz. On an exemplary base, the study demonstrates that frequencies above 1,000 Hz do appear in complex snoring patterns, and it is emphasised that high frequencies are imported for the interpretation of snoring sounds with respect to the identification of the source of snoring. Contact microphones might be used in screening devices, but for a natural analysis of snoring sounds the use of air-coupled microphones is indispensable.

Self-Reported Snoring Is Associated with Dyslipidemia, High Total Cholesterol, and High Low-Density Lipoprotein Cholesterol in Obesity: A Cross-Sectional Study from a Rural Area of China.

PubMed

Zhang, Naijin; Chen, Yintao; Chen, Shuang; Jia, Pengyu; Guo, Xiaofan; Sun, Guozhe; Sun, Yingxian

2017-01-17

Studies to explore the relationship between self-reported snoring and dyslipidemia, especially high total cholesterol (TC) and high low-density lipoprotein cholesterol (LDL-C), in the general population are still lacking. Our study was designed to examine whether self-reported snoring is significantly associated with dyslipidemia and ascertain the effects of different snoring intensities on dyslipidemia. There were 10,139 participants in our study. After adjustment for all confounding factors, self-reported snoring (OR = 1.207; p = 0.003), moderate (OR = 1.229; p = 0.015), strong (OR = 1.222; p = 0.033), and very strong (OR = 1.467; p = 0.012) snoring intensity, but not low (OR = 1.110; p = 0.224) snoring intensity, were significantly associated with dyslipidemia among adults with BMI (body mass index) ≥ 25 kg/m². In addition, self-reported snoring was significantly associated with high TC (OR = 1.167; p = 0.048) and high LDL-C (OR = 1.228; p = 0.044), rather than low HDL-C (OR = 1.171; p = 0.057) and high triglyceride (TG) (OR = 1.110; p = 0.141). In conclusion, adults with BMI ≥ 25 kg/m² and who experience snoring, especially moderate, strong, and very strong intensity levels of snoring, should be on the alert regarding the possibility of dyslipidemia, especially high LDL-C and high TC.

Sleep disordered breathing (SDB) experiences associated with snoring in adult Nigerians.

PubMed

Sogebi, O A; Oyewole, E A; Olusoga-Peters, O O

2011-09-01

Snorers often experience symptoms of sleep disordered breathing (SDB) which is largely undiagnosed in the population. Information on SDB experiences is needed to target high-risk individuals that may benefit from treatment of snoring. This study compares the experience of the nighttime and daytime symptoms of SDB of habitual snorers with that of non-habitually snoring adult subjects in a tertiary health facility in Nigeria. A cross-sectional, comparative, hospital based study was conducted. Berlin questionnaire was administered to consecutive adult patients (subjects) attending ENT Clinic of OOUTH, Sagamu, Nigeria. Based on the responses to their experience of snoring, the subjects were categorized as habitual snorers or non-habitual snorers. General physical examinations with emphases on the nose, throat and neck were performed on the subjects. The experiences of nighttime and daytime symptoms of SDB were recorded and those of habitual snorers compared to non-habitual snorers. One hundred and ninety- five subjects participated in the study. M:F =1.3:1. Overall prevalence of snoring was 37.9% and habitual snoring was 18.5%. Habitual snoring was significantly associated with age, marital status and obesity (BMI>=30.0). There were statistically significant increased odds of experiencing the nighttime and daytime symptoms of SDB in habitual snorers compared to non-habitual snorers. Adults that snore habitually had significantly more nighttime and daytime symptoms of SDB compared to those who do not snore habitually. Habitual snoring predisposes adult subjects to experiencing symptoms of SDB.

Dynamics of snoring sounds and its connection with obstructive sleep apnea

NASA Astrophysics Data System (ADS)

Alencar, Adriano M.; da Silva, Diego Greatti Vaz; Oliveira, Carolina Beatriz; Vieira, André P.; Moriya, Henrique T.; Lorenzi-Filho, Geraldo

2013-01-01

Snoring is extremely common in the general population and when irregular may indicate the presence of obstructive sleep apnea. We analyze the overnight sequence of wave packets - the snore sound - recorded during full polysomnography in patients referred to the Sleep Laboratory due to suspected obstructive sleep apnea. We hypothesize that irregular snore, with duration in the range between 10 and 100 s, correlates with respiratory obstructive events. We find that the number of irregular snores - easily accessible, and quantified by what we call the snore time interval index (STII) - is in good agreement with the well-known apnea-hypopnea index, which expresses the severity of obstructive sleep apnea and is extracted only from polysomnography. In addition, the Hurst analysis of the snore sound itself, which calculates the fluctuations in the signal as a function of time interval, is used to build a classifier that is able to distinguish between patients with no or mild apnea and patients with moderate or severe apnea.

21 CFR 872.5570 - Intraoral devices for snoring and intraoral devices for snoring and obstructive sleep apnea.

Code of Federal Regulations, 2013 CFR

2013-04-01

... devices for snoring and obstructive sleep apnea. 872.5570 Section 872.5570 Food and Drugs FOOD AND DRUG... obstructive sleep apnea are devices that are worn during sleep to reduce the incidence of snoring and to treat obstructive sleep apnea. The devices are designed to increase the patency of the airway and to decrease air...

21 CFR 872.5570 - Intraoral devices for snoring and intraoral devices for snoring and obstructive sleep apnea.

Code of Federal Regulations, 2012 CFR

2012-04-01

... devices for snoring and obstructive sleep apnea. 872.5570 Section 872.5570 Food and Drugs FOOD AND DRUG... obstructive sleep apnea are devices that are worn during sleep to reduce the incidence of snoring and to treat obstructive sleep apnea. The devices are designed to increase the patency of the airway and to decrease air...

21 CFR 872.5570 - Intraoral devices for snoring and intraoral devices for snoring and obstructive sleep apnea.

Code of Federal Regulations, 2011 CFR

2011-04-01

... devices for snoring and obstructive sleep apnea. 872.5570 Section 872.5570 Food and Drugs FOOD AND DRUG... obstructive sleep apnea are devices that are worn during sleep to reduce the incidence of snoring and to treat obstructive sleep apnea. The devices are designed to increase the patency of the airway and to decrease air...

21 CFR 872.5570 - Intraoral devices for snoring and intraoral devices for snoring and obstructive sleep apnea.

Code of Federal Regulations, 2014 CFR

2014-04-01

... devices for snoring and obstructive sleep apnea. 872.5570 Section 872.5570 Food and Drugs FOOD AND DRUG... obstructive sleep apnea are devices that are worn during sleep to reduce the incidence of snoring and to treat obstructive sleep apnea. The devices are designed to increase the patency of the airway and to decrease air...

Habitual snoring in school-aged children: environmental and biological predictors.

PubMed

Li, Shenghui; Jin, Xinming; Yan, Chonghuai; Wu, Shenghu; Jiang, Fan; Shen, Xiaoming

2010-10-19

Habitual snoring, a prominent symptom of sleep-disordered breathing, is an important indicator for a number of health problems in children. Compared to adults, large epidemiological studies on childhood habitual snoring and associated predisposing factors are extremely scarce. The present study aimed to assess the prevalence and associated factors of habitual snoring among Chinese school-aged children. A random sample of 20,152 children aged 5.08 to 11.99 years old participated in a cross-sectional survey, which was conducted in eight cities of China. Parent-administrated questionnaires were used to collect information on children's snoring frequency and the possible correlates. The prevalence of habitual snoring was 12.0% (14.5% for boys vs. 9.5% for girls) in our sampled children. Following factors were associated with an increased risk for habitual snoring: lower family income (adjusted odds ratio [OR] = 1.46), lower father's education (OR = 1.38 and 1.14 for middle school or under and high school of educational level, respectively), breastfeeding duration < 6 months (OR = 1.17), pregnancy maternal smoking (OR = 1.51), obesity (OR = 1.50), overweight (OR = 1.35), several respiratory problems associated with atopy and infection, such as chronic/allergic rhinitis (OR = 1.94), asthma (OR = 1.43), adenotonsillar hypertrophy (OR = 2.17), and chronic otitis media (OR = 1.31), and family history of habitual snoring (OR = 1.70). The prevalence of habitual snoring in Chinese children was similar to that observed in other countries. The potential predisposing factors covered socioeconomic characteristics, environmental exposures, chronic health problems, and family susceptibility. Compared to socioeconomic status and family susceptibility, environmental exposures and chronic health problems had greater impact, indicating childhood habitual snoring could be partly prevented by health promotion and environmental intervention.

Snoring intensity after a first session of soft palate radiofrequency: predictive value of the final result.

PubMed

Blumen, Marc Bernard; Vezina, Jean Philippe; Bequignon, Emilie; Chabolle, Frederic

2013-06-01

To determine whether snoring sound intensity measured after a first soft palate radiofrequency (RF) session for simple snoring helps predict the final result of the treatment. Observational retrospective study. We conducted a retrospective review of 105 subjects presenting with simple snoring or mild sleep apnea. All patients underwent two to three sessions of RF-assisted stiffening of the soft palate. In addition, uvulectomy was performed in case of a long uvula, and two paramedian trenches were created in the presence of palatal webbing. Snoring sound intensity was evaluated by the bed partner after each session. Eighty-six men and 19 women were included in the study. Mean age was 51.7 ± 9.8 years, and mean body mass index was 24.7 ± 4.4 kg/m(2) . The mean apnea/hypopnea index was 6.6 ± 4.2/h. The mean snoring sound intensity, as evaluated on a 10-cm visual analog scale (VAS), decreased from 8.2 ± 1.5 to 3.5 ± 2.2 after all sessions (P < .0001). A score of 3 was determined as being a score that satisfied the bed partner. Two groups were formed according to the final snoring sound intensity, using 3 as a threshold. Both groups had similar preoperative characteristics, but the snoring sound intensity was significantly lower after the first session in the group with final score <3 (P = .01). Similarly, a VAS score >7 after the first session was associated with a final score <3 in 30% of the cases. Snoring sound intensity after the first RF session helps predict the final outcome of RF-assisted stiffening of the soft palate for simple snoring. Copyright © 2012 The American Laryngological, Rhinological and Otological Society, Inc.

Unconstrained snoring detection using a smartphone during ordinary sleep.

PubMed

Shin, Hangsik; Cho, Jaegeol

2014-08-15

Snoring can be a representative symptom of a sleep disorder, and thus snoring detection is quite important to improving the quality of an individual's daily life. The purpose of this research is to develop an unconstrained snoring detection technique that can be integrated into a smartphone application. In contrast with previous studies, we developed a practical technique for snoring detection during ordinary sleep by using the built-in sound recording system of a smartphone, and the recording was carried out in a standard private bedroom. The experimental protocol was designed to include a variety of actions that frequently produce noise (including coughing, playing music, talking, rining an alarm, opening/closing doors, running a fan, playing the radio, and walking) in order to accurately recreate the actual circumstances during sleep. The sound data were recorded for 10 individuals during actual sleep. In total, 44 snoring data sets and 75 noise datasets were acquired. The algorithm uses formant analysis to examine sound features according to the frequency and magnitude. Then, a quadratic classifier is used to distinguish snoring from non-snoring noises. Ten-fold cross validation was used to evaluate the developed snoring detection methods, and validation was repeated 100 times randomly to improve statistical effectiveness. The overall results showed that the proposed method is competitive with those from previous research. The proposed method presented 95.07% accuracy, 98.58% sensitivity, 94.62% specificity, and 70.38% positive predictivity. Though there was a relatively high false positive rate, the results show the possibility for ubiquitous personal snoring detection through a smartphone application that takes into account data from normally occurring noises without training using preexisting data.

Treatment Options for Adults with Snoring

MedlinePlus

... entnet.org . Snoring is a sound produced by vibration of the soft tissues of the upper airway ... in stiffening of the palate, and subsequently, less vibration and flutter that causes snoring. Potential benefits of ...

Does Snoring Intensity Correlate with the Severity of Obstructive Sleep Apnea?

PubMed Central

Maimon, Nimrod; Hanly, Patrick J.

2010-01-01

Study Objectives: It is commonly believed that louder snoring is associated with more severe obstructive sleep apnea (OSA). We evaluated the association between snoring intensity and the severity of OSA to better understand this clinical correlation. We also investigated the relationships between body mass index (BMI), neck size, sleep stage, and body position with the intensity of snoring. Methods: Overnight polysomnography, including objective measurement of snoring intensity, in 1643 habitual snorers referred for evaluation of sleep apnea. Results: Sixty-five percent of patients were male; the cohort had a mean age of 48.7 ± 13.7 y and BMI of 30.9 ± 8.8 kg/m2. The mean apnea-hypopnea index (AHI) was 28.2 ± 26. The severity of OSA was graded as no OSA (AHI < 5), mild (AHI 5 to 15), moderate (AHI 15 to 30), severe (AHI 30 to 50), and very severe OSA (AHI > 50). Snoring intensity increased progressively across all 5 categories of AHI frequency and ranged from 46.3 ± 3.6 db in patients with AHI < 5 to 60.5 ± 6.4 db in those with AHI > 50. Furthermore, there was a positive correlation between the intensity of snoring and the AHI (r = 0.66, p < 0.01). Conclusions: The intensity of snoring increases as OSA becomes more severe. Citation: Maimon N; Hanly PJ. Does snoring intensity correlate with the severity of obstructive sleep apnea? J Clin Sleep Med 2010;6(5):475-478. PMID:20957849

The association between sleep duration, snoring and prevalent type 2 diabetes mellitus with regard to gender and menopausal status: the CKB study in Zhejiang rural area, China.

PubMed

Wu, Hai-Bin; Wang, Hao; Hu, Ru-Ying; Zhong, Jie-Ming; Qian, Yi-Jian; Wang, Chun-Mei; Xie, Kai-Xu; Chen, Ling-Li; Gong, Wei-Wei; Guo, Yu; Bian, Zheng; Chen, Zheng-Ming; Li, Li-Ming; Yu, Min

2017-01-01

To evaluate the association between sleep duration, snoring and diabetes according to gender and menopausal status in rural China. The data were part of the baseline survey of China Kadoorie Biobank, from a rural county in the south-east costal Zhejiang province. Participants including 24,027 men and 33,677 women aged 30-79 years were enrolled during 2004-2008. Multivariable logistic regression was used to calculate adjusted odds ratios (ORs) and 95 % confidence intervals (CIs) for diabetes. Sleep duration was shown to have a U-shaped association with diabetes in women, in particular in postmenopausal women after adjustment for potential confounders. Compared with 7-h sleepers, ORs (95 % CIs) of sleep duration ≤5 and ≥10 h for diabetes were 1.32 (1.02-1.69) and 1.30 (1.03-1.65), respectively, in postmenopausal women (P for quadratic trend = 0.016). However, this U-shaped association was not obvious in men and premenopausal women. Frequently snoring was positively associated with diabetes in all participants. However, this association was not independent of socioeconomic status, health behaviors, obesity and chronic diseases. With increasing sleep duration, the proportion of frequently snoring increased in all participants (P trend <0.05). Postmenopausal women had 23 % (95 % CI 6-44 %) higher odds of diabetes compared with premenopausal women, and the duration of menopause had cumulative effects on diabetes. Short and long sleep durations were significantly associated with diabetes in postmenopausal women, independent of potential confounders. The proportion of frequently snoring had linear trend with sleep duration. Postmenopausal status and the duration of menopause increased the odds of diabetes.

Preliminary study for the personal handheld device based snoring detection in ordinary sleep situation.

PubMed

Shin, Hangsik; Choi, Wangrim; Kim, Yi-gon; Cho, Jaegeol

2014-01-01

Snoring is one of the representative phenomena of the sleep disorder and detection of snoring is quite important for improving quality of daily human life. The purpose of this research is to define the noises of the ordinary sleep situation and to find its characteristics as a preliminary research of snoring detection. Differently from previous snoring researches, we use a built-in sound recording system of Smartphone for practical use in ordinary sleep condition, and recording was carried out in a general private bedroom. Especially, we designed the experimental protocol, including the various noises could be frequently occurred during sleep such as cough, music, talking, alarm, door open/close, fan, radio and footstep to make closer to the actual sleep circumstance. The sound data set was recorded during actual sleep from 10 normal subjects. Totally 44 snoring data set and 75-noise dataset is acquired and analyzed.

Comparison of snoring sounds between natural and drug-induced sleep recorded using a smartphone.

PubMed

Koo, Soo Kweon; Kwon, Soon Bok; Moon, Ji Seung; Lee, Sang Hoon; Lee, Ho Byung; Lee, Sang Jun

2018-08-01

Snoring is an important clinical feature of obstructive sleep apnea (OSA), and recent studies suggest that the acoustic quality of snoring sounds is markedly different in drug-induced sleep compared with natural sleep. However, considering differences in sound recording methods and analysis parameters, further studies are required. This study explored whether acoustic analysis of drug-induced sleep is useful as a screening test that reflects the characteristics of natural sleep in snoring patients. The snoring sounds of 30 male subjects (mean age=41.8years) were recorded using a smartphone during natural and induced sleep, with the site of vibration noted during drug-induced sleep endoscopy (DISE); then, we compared the sound intensity (dB), formant frequencies, and spectrograms of snoring sounds. Regarding the intensity of snoring sounds, there were minor differences within the retrolingual level obstruction group, but there was no significant difference between natural and induced sleep at either obstruction site. There was no significant difference in the F 1 and F 2 formant frequencies of snoring sounds between natural sleep and induced sleep at either obstruction site. Compared with natural sleep, induced sleep was slightly more irregular, with a stronger intensity on the spectrogram, but the spectrograms showed the same pattern at both obstruction sites. Although further studies are required, the spectrograms and formant frequencies of the snoring sounds of induced sleep did not differ significantly from those of natural sleep, and may be used as a screening test that reflects the characteristics of natural sleep according to the obstruction site. Copyright © 2017 Elsevier B.V. All rights reserved.

Snoring classified: The Munich-Passau Snore Sound Corpus.

PubMed

Janott, Christoph; Schmitt, Maximilian; Zhang, Yue; Qian, Kun; Pandit, Vedhas; Zhang, Zixing; Heiser, Clemens; Hohenhorst, Winfried; Herzog, Michael; Hemmert, Werner; Schuller, Björn

2018-03-01

Snoring can be excited in different locations within the upper airways during sleep. It was hypothesised that the excitation locations are correlated with distinct acoustic characteristics of the snoring noise. To verify this hypothesis, a database of snore sounds is developed, labelled with the location of sound excitation. Video and audio recordings taken during drug induced sleep endoscopy (DISE) examinations from three medical centres have been semi-automatically screened for snore events, which subsequently have been classified by ENT experts into four classes based on the VOTE classification. The resulting dataset containing 828 snore events from 219 subjects has been split into Train, Development, and Test sets. An SVM classifier has been trained using low level descriptors (LLDs) related to energy, spectral features, mel frequency cepstral coefficients (MFCC), formants, voicing, harmonic-to-noise ratio (HNR), spectral harmonicity, pitch, and microprosodic features. An unweighted average recall (UAR) of 55.8% could be achieved using the full set of LLDs including formants. Best performing subset is the MFCC-related set of LLDs. A strong difference in performance could be observed between the permutations of train, development, and test partition, which may be caused by the relatively low number of subjects included in the smaller classes of the strongly unbalanced data set. A database of snoring sounds is presented which are classified according to their sound excitation location based on objective criteria and verifiable video material. With the database, it could be demonstrated that machine classifiers can distinguish different excitation location of snoring sounds in the upper airway based on acoustic parameters. Copyright © 2018 Elsevier Ltd. All rights reserved.

Cardiorespiratory and autonomic interactions during snoring related resistive breathing.

PubMed

Mateika, J H; Mitru, G

2001-03-15

We hypothesized that blood pressure (BP) is less during snoring as compared to periods of non-snoring in non-apneic individuals. Furthermore, we hypothesized that this reduction may be accompanied by a simultaneous decrease in sympathetic (SNSA) and parasympathetic (PNSA) nervous system activity and an increase in heart rate (HR). N/A. N/A. N/A. The variables mentioned above in addition to breathing frequency were measured in 9 subjects during NREM sleep. In addition, the lowest systolic (SBP) and diastolic blood pressure (DBP) during inspiration and the highest SBP and DBP during expiration was determined breath-by-breath from segments selected from each NREM cycle. Heart rate variability was used as a marker of autonomic nervous system activity. Our results showed that BP during snoring decreased compared to non-snoring and the breath-by-breath BP analysis suggested that this difference may have been mediated by changes in intrathoracic pressure. In conjunction with the decrease in BP, SNSA decreased and HR increased however PNSA remained constant. Thus, a decrease in PNSA was likely not the primary mechanism responsible for the HR response. We conclude that BP responses and SNSA during snoring are similar to that reported previously in non-snoring individuals. However, the causal mechanisms maybe different and manifested in other measures such as HR. Thus, nocturnal cardiovascular and autonomic function maybe uniquely different in non-apneic snoring individuals.

Snoring Sounds Predict Obstruction Sites and Surgical Response in Patients with Obstructive Sleep Apnea Hypopnea Syndrome

PubMed Central

Lee, Li-Ang; Lo, Yu-Lun; Yu, Jen-Fang; Lee, Gui-She; Ni, Yung-Lun; Chen, Ning-Hung; Fang, Tuan-Jen; Huang, Chung-Guei; Cheng, Wen-Nuan; Li, Hsueh-Yu

2016-01-01

Snoring sounds generated by different vibrators of the upper airway may be useful indicators of obstruction sites in patients with obstructive sleep apnea hypopnea syndrome (OSAHS). This study aimed to investigate associations between snoring sounds, obstruction sites, and surgical responses (≥50% reduction in the apnea-hypopnea index [AHI] and <10 events/hour) in patients with OSAHS. This prospective cohort study recruited 36 OSAHS patients for 6-hour snoring sound recordings during in-lab full-night polysomnography, drug-induced sleep endoscopy (DISE), and relocation pharyngoplasty. All patients received follow-up polysomnography after 6 months. Fifteen (42%) patients with at least two complete obstruction sites defined by DISE were significantly, positively associated with maximal snoring sound intensity (40–300 Hz; odds ratio [OR], 1.25, 95% confidence interval [CI] 1.05–1.49) and body mass index (OR, 1.48, 95% CI 1.02–2.15) after logistic regression analysis. Tonsil obstruction was significantly, inversely correlated with mean snoring sound intensity (301–850 Hz; OR, 0.84, 95% CI 0.74–0.96). Moreover, baseline tonsil obstruction detected by either DISE or mean snoring sound intensity (301–850 Hz), and AHI could significantly predict the surgical response. Our findings suggest that snoring sound detection may be helpful in determining obstruction sites and predict surgical responses. PMID:27471038

Synchronized imaging and acoustic analysis of the upper airway in patients with sleep-disordered breathing.

PubMed

Chang, Yi-Chung; Huon, Leh-Kiong; Pham, Van-Truong; Chen, Yunn-Jy; Jiang, Sun-Fen; Shih, Tiffany Ting-Fang; Tran, Thi-Thao; Wang, Yung-Hung; Lin, Chen; Tsao, Jenho; Lo, Men-Tzung; Wang, Pa-Chun

2014-12-01

Progressive narrowing of the upper airway increases airflow resistance and can produce snoring sounds and apnea/hypopnea events associated with sleep-disordered breathing due to airway collapse. Recent studies have shown that acoustic properties during snoring can be altered with anatomic changes at the site of obstruction. To evaluate the instantaneous association between acoustic features of snoring and the anatomic sites of obstruction, a novel method was developed and applied in nine patients to extract the snoring sounds during sleep while performing dynamic magnetic resonance imaging (MRI). The degree of airway narrowing during the snoring events was then quantified by the collapse index (ratio of airway diameter preceding and during the events) and correlated with the synchronized acoustic features. A total of 201 snoring events (102 pure retropalatal and 99 combined retropalatal and retroglossal events) were recorded, and the collapse index as well as the soft tissue vibration time were significantly different between pure retropalatal (collapse index, 2 ± 11%; vibration time, 0.2 ± 0.3 s) and combined (retropalatal and retroglossal) snores (collapse index, 13 ± 7% [P ≤ 0.0001]; vibration time, 1.2 ± 0.7 s [P ≤ 0.0001]). The synchronized dynamic MRI and acoustic recordings successfully characterized the sites of obstruction and established the dynamic relationship between the anatomic site of obstruction and snoring acoustics.

Association between Self-reported Snoring and Prediabetes among Adults Aged 40 Years and Older without Diabetes.

PubMed

Wang, Hai-Bin; Yan, Wen-Hua; Dou, Jing-Tao; Lu, Zhao-Hui; Wang, Bao-An; Mu, Yi-Ming

2017-04-05

Several previous studies have shown that snoring is associated with glucose metabolism and the development of diabetes, but rare study has shown the association between snoring frequency and prediabetes, particularly in China. We hypothesized that individuals who snore might have a higher risk of prediabetes. This study aimed to investigate the association between self-reported snoring and prediabetes in a Chinese population. A cross-sectional study was performed in three large communities of Beijing from December 2011 to August 2012 by recruiting individuals aged ≥40 years old. All participants were requested to complete a detailed questionnaire and undergo anthropometric measurements. A 75 g oral glucose tolerance test was performed in individuals without diabetes. Blood samples of all participants were collected; blood glucose and blood fat levels were measured. Multivariate logistic regression models were built to assess the association between snoring frequency and prediabetes. A total of 13,592 participants (female: 66.56%; mean age: 56.8 ± 7.9 years; mean body mass index: 25.5 ± 3.4 kg/m2) were included in the final analysis. Of these, 30.9% were diagnosed with prediabetes, while 41.3% and 25.4% had occasional and habitual snoring, respectively. Habitual snoring was associated with an increased risk of prediabetes (odds ratio [OR]: 1.3, 95% confidence interval [CI]: 1.1-1.4, P< 0.001), after adjusting for diabetes and sleep-related confounders in the multivariable models. Habitual snoring was also associated with isolated impaired fasting glucose (IFG; OR: 1.3, 95% CI: 1.0-1.6; P< 0.001) and isolated impaired glucose tolerance (IGT; OR: 1.3, 95% CI: 1.2-1.5; P< 0.001), but not IFG + IGT (OR: 1.1, 95% CI: 0.9-1.4; P = 0.281). When stratified by total cholesterol (TC) levels, this association between habitual snoring and prediabetes was observed only in individuals with TC <5.6 mmol/L (OR: 1.4, 95% CI: 1.2-1.6; P< 0.001). Habitual snoring is associated with prediabetes, but only in individuals with TC <5.6 mmol/L. Further prospective studies are needed to confirm this finding.

The Efficacy of Low-Level Continuous Positive Airway Pressure for the Treatment of Snoring

PubMed Central

Guzman, Michelle A.; Sgambati, Francis P.; Pho, Huy; Arias, Rafael S.; Hawks, Erin M.; Wolfe, Erica M.; Ötvös, Tamás; Rosenberg, Russell; Dakheel, Riad; Schneider, Hartmut; Kirkness, Jason P.; Smith, Philip L.; Schwartz, Alan R.

2017-01-01

Study Objectives: To assess effects of low-level continuous positive airway pressure (CPAP) on snoring in habitual snorers without obstructive sleep apnea (OSA). Methods: A multicenter prospective in-laboratory reversal crossover intervention trial was conducted between September 2013 and August 2014. Habitual snorers were included if they snored (inspiratory sound pressure level ≥ 40 dBA) for ≥ 30% all sleep breaths on a baseline sleep study (Night 1), and if significant OSA and daytime somnolence were absent. Included participants then underwent a CPAP titration study at 2, 4, or 6 cm H2O (Night 2) to examine snoring responses to step-increases in nasal pressure, a treatment night at optimal pressure (Night 3), followed by baseline night (Night 4). At each pressure, snoring intensity was measured on each breath. Snoring frequency was quantified as a percentage of sleep breaths at thresholds of 40, 45, 50, and 55 dBA. Sleep architecture and OSA severity were characterized using standard measurements. Results: On baseline sleep studies, participants demonstrated snoring at ≥ 40 dBA on 53 ± 3% and ≥ 45 dBA on 35 ± 4% of breaths. Snoring frequency decreased progressively as nasal pressure increased from 0 to 4 cm H2O at each threshold, and plateaued thereafter. CPAP decreased snoring frequency by 67% and 85% at 40 and 45 dBA, respectively. Intervention did not alter sleep architecture and sleep apnea decreased minimally. Conclusions: Low-level CPAP below the range required to treat OSA diminished nocturnal snoring, and produced uniform reduction in nightly noise production below the World Health Organization's limit of 45 dBA. Clinical Trial Registration: ClinicalTrials.gov, identifier: NCT01949584. Citation: Guzman MA, Sgambati FP, Pho H, Arias RS, Hawks EM, Wolfe EM, Ötvös T, Rosenberg R, Dakheel R, Schneider H, Kirkness JP, Smith PL, Schwartz AR. The efficacy of low-level continuous positive airway pressure for the treatment of snoring. J Clin Sleep Med. 2017;13(5):703–711. PMID:28356182

[Treatment of simple snoring by radiofrequency velar coblation].

PubMed

Pessey, J-J; Rose, X; Michenet, F; Calmels, M-N; Lagleyre, S

2005-02-01

Short- and long-term evaluation of the efficacy and safety of radiofrequency velar coblation for simple snoring. From February 2000 to May 2004, 175 patients underwent a single radiofrequency session for velar coblation. All patients suffered from snoring without sleep apnea. They presented modifications of the velo-pharyngeal region but did not have tonsillar or basilingual hypertrophy. Outcome was assessed in terms of pain, changes in snoring, secondary effects and complications at three months and one, two, and three years. Secondary uvulectomy was performed in 28 patients. At three months, snoring had decreased in 82% of patients with complete resolution in 12%. Outcome remained unchanged in 70% of patients at one, two, and three years. After uvulectomy, snoring declined in 96% of patients with complete resolution in 48%. Post-treatment pain lasted less than five days in 68% of patients. Mean duration was three days. Fifteen patients developed pharyngeal paresthesia which regressed at one year. Two patients had a nasal voice and three developed necrosis of the uvula. Velar coblation is a simple treatment for snoring which can be performed in a single session. The best results are achieved in patients whose body mass index is below 25 and after secondary uvulectomy.

Sleep apnea syndrome and snoring in patients with hypothyroidism with relation to overweight.

PubMed

Misiolek, M; Marek, B; Namyslowski, G; Scierski, W; Zwirska-Korczala, K; Kazmierczak-Zagorska, Z; Kajdaniuk, D; Misiolek, H

2007-03-01

The relation between snoring and obstructive sleep apnea as well as hypothyroidism is the object of interest of many authors. The respiratory disturbances during sleep are often observed in patients suffering from hypothyroidism. The relation of snoring to overweight in those patients has not been taken into account. The aim of the study was to evaluate the relations between hypothyroidism and quantitative and qualitative respiratory disturbances during sleep. Additional aim was to establish the relations of sleep apnea syndrome, snoring, hypothyroidism and overweight. The subjects included 15 patients (11 females and 4 males) aged from 28 to 73 (mean 50.3) suffering from hypothyroidism. All of them underwent thyroid testing before and after the hormonal treatment. TSH and fT4 concentrations were determined. At the same time the sleep assessment (PolyMESAM) was performed twice. Data were obtained from sleep studies and questionnaires (Epworth sleepiness scale). After the thyroid hormones stabilization significant decrease of snoring severity was observed. On the contrary, the respiratory disturbance index (RDI), desaturation index (DI), the lowest saturation (LSAT) did not change significantly, however, the Epworth scale score showed significant improvement. The correlations showed the strong relation between loud snoring and TSH (r=0.73, p<0.01) and fT4 (r=-0.66, p<0.003) concentrations before the treatment. The analysis showed no correlation between body mass (BMI) and snoring. The hormonal stabilization in patients suffering from hypothyroidism causes improvement in snoring severity. Based on our investigation the relationship between hypothyroidism and severity of snoring and excessive daytime somnolence was confirmed. It indicates a possible connection between hypothyroidism and upper airway resistance syndrome.

Snoring and its management.

PubMed

Calhoun, Karen H; Templer, Jerry; Patenaude, Bart

2006-01-01

There are numerous strategies, devices and procedures available to treat snoring. The surgical procedures have an overall success rate of 60-70%, but this probably decreases over time, especially if there is weight gain. There are no long-term rigorously-designed studies comparing the various procedures for decreasing snoring.

Maternal Snoring May Predict Adverse Pregnancy Outcomes: A Cohort Study in China.

PubMed

Ge, Xing; Tao, Fangbiao; Huang, Kun; Mao, Leijing; Huang, Sanhuan; Niu, Ying; Hao, Jiahu; Sun, Yanli; Rutayisire, Erigene

2016-01-01

To examine the prevalence of snoring during pregnancy and its effects on key pregnancy outcomes. Pregnant women were consecutively recruited in their first trimester. Habitual snoring was screened by using a questionnaire in the 1st and 3rd trimester, respectively. According to the time of snoring, participants were divided into pregnancy onset snorers, chronic snorers and non-snorers. Logistic regressions were performed to examine the associations between snoring and pregnancy outcomes. Of 3 079 pregnant women, 16.6% were habitual snorers, with 11.7% were pregnancy onset snorers and 4.9% were chronic snorers. After adjusting for potential confounders, chronic snorers were independently associated with gestational diabetes mellitus (GDM) (RR 1.66, 95%CI 1.09-2.53). Both pregnancy onset and chronic snorers were independently associated with placental adhesion (RR 1.96, 95%CI 1.17-3.27, and RR 2.33, 95%CI 1.22-4.46, respectively). Pregnancy onset snorers were at higher risk of caesarean delivery (RR 1.37, 95%CI 1.09-1.73) and having macrosomia (RR 1.54, 95%CI 1.05-2.27) and large for gestational age (LGA) (RR 1.71, 95%CI 1.31-2.24) infants. In addition, being overweight or obese before pregnancy plays an important role in mediating snoring and adverse pregnancy outcomes. Maternal snoring may increase the risk of adverse pregnancy outcomes, and being overweight or obese before pregnancy with snoring is remarkable for researchers. Further studies are still needed to confirm our results.

Snoring during early childhood and academic performance at ages thirteen to fourteen years.

PubMed

Gozal, D; Pope, D W

2001-06-01

Obstructive sleep apnea syndrome in young children is associated with an adverse effect on learning. However, the long-term impact of sleep-disordered breathing (SDB) during early childhood on learning remains unknown. Questionnaires were mailed to seventh and eighth graders attending public schools whose class ranking was either in the top 25% (high performance [HP]) or bottom 25% of their class (low performance [LP]), and who were matched for age, gender, race, school, and street of residence. Snoring frequency and loudness at 2 to 6 years of age, tonsillectomy and adenoidectomy (T&A) for snoring or recurrent infection, school grades, and parental smoking and snoring were assessed. The questionnaire response rate was 82.8%. Because of ongoing ring, 13 responders were excluded, such that 1588 questionnaires could be analyzed (797 in LP and 791 in HP group). Frequent and loud snoring during early childhood was reported in 103 LP children (12.9%) compared with 40 HP children (5.1%; odds ratio: 2.79; confidence interval: 1.88-4.15). Furthermore, 24 LP and 7 HP children underwent T&A for snoring (odds ratio: 3.40; confidence interval: 1.47-7.84), while 21 LP and 19 HP children required surgery for recurrent tonsillitis. Children with lower academic performance in middle school are more likely to have snored during early childhood and to require T&A for snoring compared with better performing schoolmates. These findings support the concept that SDB-associated neurocognitive morbidity may be only partially reversible or that a "learning debt" may develop with SDB during early childhood and hamper subsequent school performance.

Maternal Snoring May Predict Adverse Pregnancy Outcomes: A Cohort Study in China

PubMed Central

Ge, Xing; Tao, Fangbiao

2016-01-01

Objective To examine the prevalence of snoring during pregnancy and its effects on key pregnancy outcomes. Methods Pregnant women were consecutively recruited in their first trimester. Habitual snoring was screened by using a questionnaire in the 1st and 3rd trimester, respectively. According to the time of snoring, participants were divided into pregnancy onset snorers, chronic snorers and non-snorers. Logistic regressions were performed to examine the associations between snoring and pregnancy outcomes. Results Of 3 079 pregnant women, 16.6% were habitual snorers, with 11.7% were pregnancy onset snorers and 4.9% were chronic snorers. After adjusting for potential confounders, chronic snorers were independently associated with gestational diabetes mellitus (GDM) (RR 1.66, 95%CI 1.09–2.53). Both pregnancy onset and chronic snorers were independently associated with placental adhesion (RR 1.96, 95%CI 1.17–3.27, and RR 2.33, 95%CI 1.22–4.46, respectively). Pregnancy onset snorers were at higher risk of caesarean delivery (RR 1.37, 95%CI 1.09–1.73) and having macrosomia (RR 1.54, 95%CI 1.05–2.27) and large for gestational age (LGA) (RR 1.71, 95%CI 1.31–2.24) infants. In addition, being overweight or obese before pregnancy plays an important role in mediating snoring and adverse pregnancy outcomes. Conclusions Maternal snoring may increase the risk of adverse pregnancy outcomes, and being overweight or obese before pregnancy with snoring is remarkable for researchers. Further studies are still needed to confirm our results. PMID:26871434

Monitoring sound to quantify snoring and sleep apnea severity using a smartphone: proof of concept.

PubMed

Nakano, Hiroshi; Hirayama, Kenji; Sadamitsu, Yumiko; Toshimitsu, Ayaka; Fujita, Hisayuki; Shin, Shizue; Tanigawa, Takeshi

2014-01-15

Habitual snoring is a prevalent condition that is not only a marker of obstructive sleep apnea (OSA) but can also lead to vascular risk. However, it is not easy to check snoring status at home. We attempted to develop a snoring sound monitor consisting of a smartphone alone, which is aimed to quantify snoring and OSA severity. The subjects included 50 patients who underwent diagnostic polysomnography (PSG), of which the data of 10 patients were used for developing the program and that of 40 patients were used for validating the program. A smartphone was attached to the anterior chest wall over the sternum. It acquired ambient sound from the built-in microphone and analyzed it using a fast Fourier transform on a real-time basis. Snoring time measured by the smartphone highly correlated with snoring time measured by PSG (r = 0.93). The top 1 percentile value of sound pressure level (L1) determined by the smartphone correlated with the ambient sound L1 during sleep determined by PSG (r = 0.92). Moreover, the respiratory disturbance index estimated by the smartphone (smart-RDI) highly correlated with the apnea-hypopnea index (AHI) obtained by PSG (r = 0.94). The diagnostic sensitivity and specificity of the smart-RDI for diagnosing OSA (AHI ≥ 15) were 0.70 and 0.94, respectively. A smartphone can be used for effectively monitoring snoring and OSA in a controlled laboratory setting. Use of this technology in a noisy home environment remains unproven, and further investigation is needed.

Uvulectomy in the office setting.

PubMed

Ariyasu, L; Young, G; Spinelli, F

1995-10-01

Snoring is a common problem which affects 50% of male and 30% of female patients. In a small number of patients, partial uvulopalatoplasty in the office setting has been found to ameliorate loud snoring. In our study, 28 patients had uvulectomy for snoring, 17 of whom responded to our survey. The procedure was somewhat beneficial (rated 3.2 on a scale of 10, with 10 representing no snoring) and had little impact on quality of life (rated 2.7 on a scale of 10, with 10 representing great improvement). After the procedure patients had considerable pain (rated 7.4 on a scale of 10, with 10 representing excruciating pain) which lasted > 10 days in 35% and led to a mean of 2.9 missed work days. There were no complications. Fourteen of 17 patients wanted additional treatment to reduce snoring.

Monitoring Sound To Quantify Snoring and Sleep Apnea Severity Using a Smartphone: Proof of Concept

PubMed Central

Nakano, Hiroshi; Hirayama, Kenji; Sadamitsu, Yumiko; Toshimitsu, Ayaka; Fujita, Hisayuki; Shin, Shizue; Tanigawa, Takeshi

2014-01-01

Study Objectives: Habitual snoring is a prevalent condition that is not only a marker of obstructive sleep apnea (OSA) but can also lead to vascular risk. However, it is not easy to check snoring status at home. We attempted to develop a snoring sound monitor consisting of a smartphone alone, which is aimed to quantify snoring and OSA severity. Methods: The subjects included 50 patients who underwent diagnostic polysomnography (PSG), of which the data of 10 patients were used for developing the program and that of 40 patients were used for validating the program. A smartphone was attached to the anterior chest wall over the sternum. It acquired ambient sound from the built-in microphone and analyzed it using a fast Fourier transform on a real-time basis. Results: Snoring time measured by the smartphone highly correlated with snoring time measured by PSG (r = 0.93). The top 1 percentile value of sound pressure level (L1) determined by the smartphone correlated with the ambient sound L1 during sleep determined by PSG (r = 0.92). Moreover, the respiratory disturbance index estimated by the smartphone (smart-RDI) highly correlated with the apnea-hypopnea index (AHI) obtained by PSG (r = 0.94). The diagnostic sensitivity and specificity of the smart-RDI for diagnosing OSA (AHI ≥ 15) were 0.70 and 0.94, respectively. Conclusions: A smartphone can be used for effectively monitoring snoring and OSA in a controlled laboratory setting. Use of this technology in a noisy home environment remains unproven, and further investigation is needed. Commentary: A commentary on this article appears in this issue on page 79. Citation: Nakano H; Hirayama K; Sadamitsu Y; Toshimitsu A; Fujita H; Shin S; Tanigawa T. Monitoring sound to quantify snoring and sleep apnea severity using a smartphone: proof of concept. J Clin Sleep Med 2014;10(1):73-78. PMID:24426823

[The relationship between the abnormal behavior and serum C-reactive protein in children with obstructive sleep apnea-hypopnea syndrome].

PubMed

Wang, Yan; Li, Yanzhong; Wang, Xin

2009-12-01

To explore the pathogenesis of abnormal behavior in children with obstructive sleep apnea-hypopnea syndrome (OSAHS). The behavioral problems and C-reactive protein were measured in 40 children with OSAHS and 30 children with habitual snoring who underwent overnight Polysomnography, 40 cases of healthy children for the control group. The ratio of abnormal behavior in OSAHS and habitual snoring children was significantly higher than that of the healthy control group, while no significant difference between the two groups. The content of C-reactive protein in OSAHS children (4.24 mg/L) was significantly higher than habitual snoring (2.76 mg/L) and healthy control group (1.27 mg/L); in habitual snoring children C-reactive protein was higher than in healthy control group. The content of serum C-reactive protein in OSAHS children accompanied by abnormal behavior (4.63 mg/L) was significantly higher than that without abnormal behavior (3.23 mg/L). The content of serum C-reactive protein content in habitual snoring children accompanied by abnormal behavior (3.63 mg/L) was significantly higher than that without abnormal behavior (1.76 mg/L). OSAHS and habitual snoring children have more behavior problems. C-reactive protein levels are higher in children with OSAHS and habitual snoring, and the levels of C-reactive protein are related to the abnormal behavior in these children.

Mucosal-strip/uvulectomy by the CO2 laser as a method of treating simple snoring.

PubMed

Morar, P; Nandapalan, V; Lesser, T H; Swift, A C

1995-08-01

The effect of stiffening the soft palate by inducing scarring after removing a central strip of mucosa with a CO2 laser was investigated in 25 heavy snorers. The results were assessed using a series of Visual Analogue Score (VAS) assessment questionnaires completed by the partner over a period of 6 months. Of the 22 patients who had the laser-strip and uvulectomy, snoring improved in 18 (82%) (median improvement of 75% at 3 months). Four patients did not improve. Between 3 and 6 months, snoring increased in one patient and decreased in four (< 10% change on VAS). Snoring did not improve in the three patients who did not undergo uvulectomy. We conclude that the laser-strip/uvulectomy can reduce snoring to a tolerable level in eight out of 10 heavy snorers, but the procedure is painful for several days.

Self-reported snoring frequency and incidence of cardiovascular disease: the Circulatory Risk in Communities Study (CIRCS).

PubMed

Nagayoshi, Mako; Tanigawa, Takeshi; Yamagishi, Kazumasa; Sakurai, Susumu; Kitamura, Akihiko; Kiyama, Masahiko; Okada, Takeo; Maeda, Kenji; Ohira, Tetsuya; Imano, Hironori; Sato, Shinichi; Iso, Hiroyasu

2012-01-01

Although associations between snoring and cardiovascular disease have been reported in several prospective studies, there is limited evidence from Asian populations. The objective of this study was to determine if there is an association between self-reported snoring frequency and the incidence of cardiovascular disease in Japanese. The subjects were 2350 men and 4163 women aged 40 to 69 years who lived in 3 communities in Japan. All subjects were participants in the Circulatory Risk in Communities Study (CIRCS) and were followed for 6 years. Incidence of cardiovascular disease during the follow-up period comprised events of myocardial infarction, angina pectoris, sudden cardiac death and stroke. During the 6-year follow-up period, 97 participants (56 men and 41 women) had cardiovascular events. After adjustment for potential confounding factors, self-reported snoring frequency was associated with an increased risk of cardiovascular events among women but not men. The hazard ratios (95% CI) for cardiovascular events were 0.9 (0.4-2.0) for sometimes snoring and 2.5 (1.0-6.1) for everyday snoring in women and 0.7 (0.3-1.3) and 1.0 (0.5-2.1), respectively, in men. Further adjustment for body mass index attenuated the association in women; the respective hazard ratios for cardiovascular events were 0.9 (0.4-1.9) and 2.1 (0.9-5.4). Self-reported habitual snoring was associated with increased risk of cardiovascular events among Japanese women. Overweight may partly mediate this association.

Excessive daytime sleepiness at work and subjective work performance in the general population and among heavy snorers and patients with obstructive sleep apnea.

PubMed

Ulfberg, J; Carter, N; Talbäck, M; Edling, C

1996-09-01

To evaluate excessive daytime sleepiness (EDS) at work and effects on reported work performance among men in the general population and male patients suffering from snoring and obstructive sleep apnea syndrome (OSAS). A cross-sectional study of Swedish men between the ages of 30 and 64 years in the county of Kopparberg, in mid-Sweden. A random sample of the general population (n = 285) and consecutive patients referred to a sleep laboratory who fulfilled objective diagnostic criteria (snorers = 289, OSAS = 62) responded to a questionnaire. Responders from the general population were divided into 2 groups, nonsnorers (n = 223) and snorers (n = 62). To validate a question on snoring in the questionnaire, 50 men, randomly selected from the sample of the general population, underwent sleep apnea screening in their homes. The specificity of the questions about snoring was 83% and the sensitivity was 42%. The risk ratios for reporting EDS at work were 4-fold for snorers in the general population, 20-fold for snoring patients, and 40-fold for patients with OSAS as compared with nonsnoring men in the general population. Patients with OSAS and snoring patients both showed increased ratios on measures of difficulties with concentration, learning new tasks, and performing monotonous tasks when compared with nonsnorers. Snoring and sleep apnea were highly associated with excessive EDS at work and subjective work performance problems. The results provide additional evidence that snoring is not merely a nuisance.

Impact of sleep disordered breathing on behaviour among elementary school-aged children: a cross-sectional analysis of a large community-based sample.

PubMed

Smith, Dale L; Gozal, David; Hunter, Scott J; Philby, Mona F; Kaylegian, Jaeson; Kheirandish-Gozal, Leila

2016-12-01

Sleep disordered breathing (SDB) in children has been associated with inattention, impulsivity and hyperactivity, but the associations between SDB severity and the type and severity of behavioural disruption are unclear.1022 children aged 5-7 years old prospectively underwent sleep studies and behavioural assessments through completion of standardised instruments. Participants were subdivided into four categorical groups based on the apnoea-hypopnoea index (AHI; measured per hour of total sleep time (hTST)), i.e. Group 1: nonsnoring and AHI <1 hTST -1 ; Group 2: habitual snoring and AHI <1 hTST -1 ; Group 3: habitual snoring and AHI 1-5 hTST -1 ; and Group 4: habitual snoring and AHI >5 hTST -1 , followed by comparisons of behavioural functioning across the groups.All 10 behavioural variables differed significantly between Group 1 and all other groups. Post hoc comparisons indicated that Group 2 was the most impaired for most behavioural measures. Furthermore, differences between Group 2 and more severe sleep pathology conditions were rarely significant.This large community-based paediatric cohort confirms earlier findings highlighting a significant impact of SDB on behavioural regulation, with the greatest impact being already apparent among habitually snoring children. Thus, a likely low asymptote exists regarding SDB behavioural impact, such that further increases in severity do not measurably increase parent-rated difficulties with behavioural regulation relative to controls. Our findings do support the need for considering early intervention, particularly among those children manifesting a behavioural impact of SDB. Copyright ©ERS 2016.

Sleep problems in children and adolescents at pediatric clinics

PubMed Central

Kim, Dong Soon; Lee, Cho Long

2017-01-01

Purpose To investigate the frequency of childhood sleep problems at pediatric clinics in Seoul and Gyeonggi provinces. Methods Children (n=936) and their parents who visited 5 primary and 1 secondary pediatric outpatient clinics were invited to complete a Pediatric Sleep Questionnaire. Results Among patients, 901 (96.3%) answered questionnaires in sufficient detail for evaluation. The participant's mean age was 4.35±3.02 years (range, 0–18 years). The male to female ratio was 1:0.93 (466 boys, 435 girls). Habitual snoring (>3 day/week) was reported in 16.9% of the participants. The prevalence of habitual snoring in children <2 years and those between 2–5 years was 9% and 18%, respectively. Sleep disordered breathing was found in 15.1% (106 of 700) of children >2 years. Insomnia was reported in 13.2% of children. The prevalence of sleepwalking, night terrors, and bruxism, is 1.6%, 19%, and 21.1%, respectively. Snoring was associated with increased incidence of sleepwalking, night terrors, and bruxism. Age was associated with insomnia and habitual snoring (P<0.05). Insomnia was more prevalent in younger (21%) than in older children (6%). Snoring was more frequent in both preschool (34%) and school-aged children (33%). The frequency of sleep disordered breathing and insomnia did not vary significantly with gender. However, snoring was more prevalent in boys. Conclusion Sleep problems are frequent among children in Korea. Children with snoring have an increased risk of sleepwalking, night terror, and bruxism. Primary clinicians should consider children's sleep habits to improve their health. PMID:28592979

Self-Reported Snoring Frequency and Incidence of Cardiovascular Disease: The Circulatory Risk in Communities Study (CIRCS)

PubMed Central

Nagayoshi, Mako; Tanigawa, Takeshi; Yamagishi, Kazumasa; Sakurai, Susumu; Kitamura, Akihiko; Kiyama, Masahiko; Okada, Takeo; Maeda, Kenji; Ohira, Tetsuya; Imano, Hironori; Sato, Shinichi; Iso, Hiroyasu

2012-01-01

Background Although associations between snoring and cardiovascular disease have been reported in several prospective studies, there is limited evidence from Asian populations. The objective of this study was to determine if there is an association between self-reported snoring frequency and the incidence of cardiovascular disease in Japanese. Methods The subjects were 2350 men and 4163 women aged 40 to 69 years who lived in 3 communities in Japan. All subjects were participants in the Circulatory Risk in Communities Study (CIRCS) and were followed for 6 years. Incidence of cardiovascular disease during the follow-up period comprised events of myocardial infarction, angina pectoris, sudden cardiac death and stroke. Results During the 6-year follow-up period, 97 participants (56 men and 41 women) had cardiovascular events. After adjustment for potential confounding factors, self-reported snoring frequency was associated with an increased risk of cardiovascular events among women but not men. The hazard ratios (95% CI) for cardiovascular events were 0.9 (0.4–2.0) for sometimes snoring and 2.5 (1.0–6.1) for everyday snoring in women and 0.7 (0.3–1.3) and 1.0 (0.5–2.1), respectively, in men. Further adjustment for body mass index attenuated the association in women; the respective hazard ratios for cardiovascular events were 0.9 (0.4–1.9) and 2.1 (0.9–5.4). Conclusions Self-reported habitual snoring was associated with increased risk of cardiovascular events among Japanese women. Overweight may partly mediate this association. PMID:22447210

Practice parameters for the treatment of snoring and obstructive sleep apnea with oral appliances. American Sleep Disorders Association.

PubMed

1995-07-01

These clinical guidelines, which have been reviewed and approved by the Board of Directors of the American Sleep Disorders Association (ASDA), provide recommendations for the practice of sleep medicine in North American with regards to the use of oral appliances for the treatment of snoring and obstructive sleep apnea. Oral appliances have been developed for the treatment of snoring and have been applied to the treatment of obstructive sleep apnea, a syndrome associated with morbidity. Based on a review of the relevant scientific literature, the Standards of Practice Committee of the ASDA has developed guidelines describing the use of oral appliances for the treatment of snoring and obstructive sleep apnea in adults.

Pre-diagnostic Sleep Duration and Sleep Quality in Relation to Subsequent Cancer Survival

PubMed Central

Phipps, Amanda I.; Bhatti, Parveen; Neuhouser, Marian L.; Chen, Chu; Crane, Tracy E.; Kroenke, Candyce H.; Ochs-Balcom, Heather; Rissling, Michelle; Snively, Beverly M.; Stefanick, Marcia L.; Treggiari, Miriam M.; Watson, Nathaniel F.

2016-01-01

Study Objectives: Poor sleep quality and short sleep duration have been associated with elevated risk for several cancer types; however, the relationship between sleep and cancer outcomes has not been well characterized. We assessed the association between pre-diagnostic sleep attributes and subsequent cancer survival within the Women's Health Initiative (WHI). Methods: We identified WHI participants in whom a first primary invasive cancer had been diagnosed during follow-up (n = 21,230). Participants provided information on sleep characteristics at enrollment. Cox regression was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for associations between these pre-diagnostic sleep characteristics and cancer-specific survival for all cancers combined and separately for common cancers. Analyses were adjusted for age, study arm, cancer site, marital status, income, smoking, physical activity, and time to diagnosis. Results: No individual pre-diagnostic sleep characteristics were found to be significantly associated with cancer survival in analyses of all cancer sites combined; however, women who reported short sleep duration (≤ 6 h sleep/night) combined with frequent snoring (≥ 5 nights/w experienced significantly poorer cancer-specific survival than those who reported 7–8 h of sleep/night and no snoring (HR = 1.32, 95% CI: 1.14–1.54). Short sleep duration (HR = 1.46, 95% CI: 1.07–1.99) and frequent snoring (HR = 1.34, 95% CI: 0.98–1.85) were each associated with poorer breast cancer survival; those reporting short sleep combined with frequent snoring combined had substantially poorer breast cancer survival than those reporting neither (HR = 2.14, 95% CI: 1.47–3.13). Conclusions: Short sleep duration combined with frequent snoring reported prior to cancer diagnosis may influence subsequent cancer survival, particularly breast cancer survival. Citation: Phipps AI, Bhatti P, Neuhouser ML, Chen C, Crane TE, Kroenke CH, Ochs-Balcom H, Rissling M, Snively BM, Stefanick ML, Treggiari MM, Watson NF. Pre-diagnostic sleep duration and sleep quality in relation to subsequent cancer survival. J Clin Sleep Med 2016;12(4):495–503. PMID:26612513

Age Effects on Cerebral Oxygenation and Behavior in Children with Sleep-disordered Breathing.

PubMed

Tamanyan, Knarik; Walter, Lisa M; Weichard, Aidan; Davey, Margot J; Nixon, Gillian M; Biggs, Sarah N; Horne, Rosemary S C

2018-06-01

Childhood sleep-disordered breathing ranges in severity from primary snoring to obstructive sleep apnea and is associated with behavioral and neurocognitive deficits. It remains unknown why children with primary snoring, who do not experience peripheral oxygen desaturation or sleep fragmentation, experience similar daytime deficits as those with obstructive sleep apnea or why effects are age-dependent. To examine cerebral tissue oxygenation and oxygen extraction as an explanation for daytime deficits in children with primary snoring. Children referred for suspected sleep-disordered breathing and nonsnoring control subjects underwent overnight polysomnography with near-infrared spectroscopy. Children were categorized into 3- to 6-year (n = 87) and 7- to 12-year (n = 72) old groups, and according to the obstructive apnea-hypopnea index into primary snoring (≤1 event/h), mild (>1-5 events/h), and moderate/severe obstructive sleep apnea (>5 events/h). Cognitive and behavioral performance were assessed. In the 3- to 6-year group, there were no differences in cerebral oxygenation or oxygen extraction between severity groups. In the 7- to 12-year group, cerebral oxygenation was significantly lower, although these differences were small, in control subjects versus primary snoring during quiet wakefulness before sleep onset, N1, and REM. Oxygen extraction was significantly higher in control subjects versus primary snoring during N1 sleep, with no differences between primary snoring and obstructive sleep apnea groups. Cerebral oxygenation was not associated with cognitive performance in either age group or behavior in the 3- to 6-year group; however, it was associated with behavior in the school-aged children. Children with sleep-disordered breathing are able to maintain cerebral oxygenation, and the small changes observed are not related to cognitive deficits. However, in older children these differences were related to behavioral measures.

Snoring-Induced Vibratory Angioedema

PubMed Central

Kalathoor, Ipe

2015-01-01

Patient: Female, 70 Final Diagnosis: Snoring induced vibratory angioedema Symptoms: Swelling of tongue • roof of mouth and throat • multiple episodes at night Medication: — Clinical Procedure: Continuous positive airway pressure therapy Specialty: Allergology Objective: Rare disease Background: Vibratory angioedema (VA) is a rare physical urticaria, with symptoms of itching and swelling of the skin or mucosa when it is exposed to vibration. Avoidance of vibration is the best way to manage this condition. This case report will assist physicians to diagnose this rare condition. Here, a previously unpublished potential successful treatment modality is being presented, with good symptom control, along with some photographs taken during an acute attack. A literature review points towards potential undiagnosed cases. Case Report: A 70-year-old woman had multiple emergency department visits for tongue and throat swelling over 3 years. The episodes always happened at night. Detailed history elicited some episodes of itching and swelling of hands when driving as well as significant snoring while sleeping. Physical examination was unremarkable except for morbid obesity. Complement factor 4 and C1esterase inhibitor level were within normal limits. A tentative diagnosis of angioedema induced by oropharyngeal vibration from snoring was made. A sleep study confirmed sleep apnea with severe snoring. After CPAP (continuous positive airway pressure) treatment, she had successful symptom control. Conclusions: Snoring-induced VA is very likely an under-diagnosed condition in the community. The typical history is the key to the diagnosis. This condition could be confirmed by vibration test or by the resolution of symptoms with elimination of vibration. Effective symptom control is possible by avoidance of oropharyngeal vibration from snoring with the administration of CPAP therapy, making it a potential novel indication for this condition. PMID:26437464

Acoustic analysis of snoring sounds recorded with a smartphone according to obstruction site in OSAS patients.

PubMed

Koo, Soo Kweon; Kwon, Soon Bok; Kim, Yang Jae; Moon, J I Seung; Kim, Young Jun; Jung, Sung Hoon

2017-03-01

Snoring is a sign of increased upper airway resistance and is the most common symptom suggestive of obstructive sleep apnea. Acoustic analysis of snoring sounds is a non-invasive diagnostic technique and may provide a screening test that can determine the location of obstruction sites. We recorded snoring sounds according to obstruction level, measured by DISE, using a smartphone and focused on the analysis of formant frequencies. The study group comprised 32 male patients (mean age 42.9 years). The spectrogram pattern, intensity (dB), fundamental frequencies (F 0 ), and formant frequencies (F 1 , F 2 , and F 3 ) of the snoring sounds were analyzed for each subject. On spectrographic analysis, retropalatal level obstruction tended to produce sharp and regular peaks, while retrolingual level obstruction tended to show peaks with a gradual onset and decay. On formant frequency analysis, F 1 (retropalatal level vs. retrolingual level: 488.1 ± 125.8 vs. 634.7 ± 196.6 Hz) and F 2 (retropalatal level vs. retrolingual level: 1267.3 ± 306.6 vs. 1723.7 ± 550.0 Hz) of retrolingual level obstructions showed significantly higher values than retropalatal level obstruction (p < 0.05). This suggests that the upper airway is more severely obstructed with retrolingual level obstruction and that there is a greater change in tongue position. Acoustic analysis of snoring is a non-invasive diagnostic technique that can be easily applied at a relatively low cost. The analysis of formant frequencies will be a useful screening test for the prediction of occlusion sites. Moreover, smartphone can be effective for recording snoring sounds.

Hypertension, Snoring, and Obstructive Sleep Apnea During Pregnancy: A Cohort Study

PubMed Central

O’Brien, Louise M.; Bullough, Alexandra S.; Chames, Mark C.; Shelgikar, Anita V.; Armitage, Roseanne; Guilleminualt, Christian; Sullivan, Colin E.; Johnson, Timothy R. B.; Chervin, Ronald D.

2014-01-01

Objective To assess the frequency of obstructive sleep apnea among women with and without hypertensive disorders of pregnancy. Design Cohort study. Setting Obstetric clinics at an academic medical center. Population Pregnant women with hypertensive disorders (chronic hypertension, gestational hypertension, or pre-eclampsia) and normotensive women. Methods Women completed a questionnaire about habitual snoring and underwent overnight ambulatory polysomnography. Main Outcome Measures The presence and severity of obstructive sleep apnea. Results Obstructive sleep apnoea was found among 21 of 51 women with hypertensive disorders (41%), but in only three of 16 women who were normotensive (19%, chi-square test, P = 0.005). Non-snoring hypertensive women typically had mild obstructive sleep apnea but >25% of snoring hypertensive women had moderate-to-severe obstructive sleep apnea. Among the hypertensive women, the mean apnea/hypopnea index was substantially higher in snorers than non-snorers (19.9±34.1 vs. 3.4±3.1, p=0.013) and the oxyhemoglobin saturation nadir was significantly lower (86.4±6.6 vs. 90.2±3.5, p=0.021). Among hypertensive women, after stratification by obesity the pooled relative risk for obstructive sleep apnea in snoring women with hypertension compared to non-snoring hypertension was 2.0 [95%CI 1.4–2.8]. Conclusions Pregnant women with hypertension are at high risk for unrecognised obstructive sleep apnea. While longitudinal and intervention studies are urgently needed, it would seem pertinent given the known relationship between obstructive sleep apnea and hypertension in the general population, that hypertensive pregnant women who snore should be tested for obstructive sleep apnea, a condition believed to cause or promote hypertension. PMID:24888772

Hypertension, snoring, and obstructive sleep apnoea during pregnancy: a cohort study.

PubMed

O'Brien, L M; Bullough, A S; Chames, M C; Shelgikar, A V; Armitage, R; Guilleminualt, C; Sullivan, C E; Johnson, T R B; Chervin, R D

2014-12-01

To assess the frequency of obstructive sleep apnoea among women with and without hypertensive disorders of pregnancy. Cohort study. Obstetric clinics at an academic medical centre. Pregnant women with hypertensive disorders (chronic hypertension, gestational hypertension, or pre-eclampsia) and women who were normotensive. Women completed a questionnaire about habitual snoring and underwent overnight ambulatory polysomnography. The presence and severity of obstructive sleep apnoea. Obstructive sleep apnoea was found among 21 of 51 women with hypertensive disorders (41%), but in only three of 16 women who were normotensive (19%, chi-square test, P=0.005). [Author correction added on 16 June 2014, after first online publication: Results mentioned in the abstract were amended.] Non-snoring women with hypertensive disorders typically had mild obstructive sleep apnoea, but >25% of snoring women with hypertensive disorders had moderate to severe obstructive sleep apnoea. Among women with hypertensive disorders, the mean apnoea/hypopnoea index was substantially higher in snorers than in non-snorers (19.9±34.1 versus 3.4±3.1, P=0.013), and the oxyhaemoglobin saturation nadir was significantly lower (86.4±6.6 versus 90.2±3.5, P=0.021). Among women with hypertensive disorders, after stratification by obesity, the pooled relative risk for obstructive sleep apnoea in snoring women with hypertension compared with non-snoring women with hypertension was 2.0 (95% CI 1.4-2.8). Pregnant women with hypertension are at high risk for unrecognised obstructive sleep apnoea. Although longitudinal and intervention studies are urgently needed, given the known relationship between obstructive sleep apnoea and hypertension in the general population, it would seem pertinent that hypertensive pregnant women who snore should be tested for obstructive sleep apnoea, a condition believed to cause or promote hypertension. © 2014 Royal College of Obstetricians and Gynaecologists.

Outpatient erbium:YAG (2940 nm) laser treatment for snoring: a prospective study on 40 patients.

PubMed

Storchi, Isabelle Fini; Parker, Steven; Bovis, Francesca; Benedicenti, Stefano; Amaroli, Andrea

2018-02-01

Snoring is a sleep phenomenon due to the partial upper airway obstruction during sleep which causes vibration of the tissues of the rhino-oro-hypopharynx and less frequently the larynx. This study evaluated the use and effectiveness of the erbium:YAG 2940-nm laser as an adjunctive in providing treatment for patients suffering from chronic snoring-related sleep disorders. A prospective study of 40 consecutive patients with snoring and sleep disorders was performed, assessing data before and after three Er:YAG laser treatment sessions. During laser treatment, the pain was almost absent. There were no side effects, except a very mild sore throat in 1 out of 40 patients. The patient's evaluation of satisfaction of the results obtained after the treatments showed that 85% of cases were very satisfied, 5 patients (12.5%) reported being fairly satisfied with the treatment and only 1 subject (2.5%) was not satisfied. Mallampati, Friedman Tongue Position, and degree of O (oropharynx) at nose oropharynx hypopharynx and larynx classification were significantly decreased after the laser sessions. The decrease of Epworth Sleepiness Scale and Visual Analogue Scale for loudness of snoring, waking up during sleep because of snoring, dry mouth on waking, and choking was all statistically significant. The incidence of dreaming during the night also raised significantly; 30/40 (75%) of cases perceived less tightness in their throat and better breathing after treatment. These results were stable at 20 months follow-up (14-24 q) in 72% of cases. Nonsurgical and non-invasive Er:YAG laser treatment demonstrated to be a valid procedure in reducing the loudness of snoring.

Treatment of snoring with positional therapy in patients with positional obstructive sleep apnea syndrome

PubMed Central

Chen, Wen-Chyuan; Lee, Li-Ang; Chen, Ning-Hung; Fang, Tuan-Jen; Huang, Chung-Guei; Cheng, Wen-Nuan; Li, Hsueh-Yu

2015-01-01

Position therapy plays a role in treating snoring and obstructive sleep apnea syndrome (OSAS). The purpose of this study was to investigate whether position therapy using a head-positioning pillow (HPP) could reduce snoring sounds in patients with mild-to-moderate positional OSAS, taking into account the potential confounding effects of body weight. A total of 25 adults with positional OSAS (apnea-hypopnea index [AHI]supine:AHInon-supine ≥ 2) were prospectively enrolled. Patients were asked to use their own pillows at home during the first night (N0), and the HPP during the second (N1) and third (N2) nights. The primary outcome measures included the subjective snoring severity (SS, measured on a visual analogue scale ranging from 0 to 10) and the objective snoring index (SI, expressed as the number of snoring events per hour measured on an acoustic analytical program). Both endpoints were recorded over three consecutive nights. From N0 to N2, the median SS and SI values in the entire study cohort decreased significantly from 5.0 to 4.0 and from 218.0 events/h to 115.0 events/h, respectively. In the subgroup of overweight patients, SS showed a significant improvement, whereas SI did not. Both SS and SI were found to be significantly improved in normal-weight patients. PMID:26657174

Snoring surgery: a retrospective review.

PubMed

Jones, T M; Earis, J E; Calverley, P M A; De, S; Swift, A C

2005-11-01

To undertake a retrospective, questionnaire review of surgery for heavy snoring, to ascertain patients' perception of the procedure and its effect on their snoring. A specifically designed postal questionnaire was sent to 261 patients who underwent snoring surgery at University Hospital Aintree, Liverpool, UK, between April 1993 and March 2000. One hundred ninety-three patients responded (73.9%), including 151 men and 42 women. Mean age was 49.0 years (range, 24-74 yrs). Twenty-two patients had a uvulopalatopharyngoplasty, 53 a traditional laser palatoplasty and uvulectomy, and 118 an uvulopalatal elevation palatoplasty. There was a 26% patient-reported postoperative infection rate. Morbidity regarding postoperative swallowing, pharyngeal sensation or voice change appeared minimal. Seventy-six percent scored postoperative pain as "moderate" or "severe," irrespective of the operation performed (P = 0.989). Thirty-seven percent of patients perceived an improvement in postoperative sleep quality. Twenty-four percent of patients reported no improvement in snoring after surgery. Forty-three percent reported an initial improvement that was not sustained for 2 years, whereas 34% of patients benefited from an improvement sustained for longer than 2 years, irrespective of the operation performed (P = 0.143). Only 47%, with hindsight, would have undergone surgery. These data highlight that snoring surgery has a high postoperative morbidity rate and a high failure rate. Research endeavors should be directed to the development of a strategy which enables reliable preoperative identification of patients' who enjoy sustained benefit postoperatively.

Increased risk of snoring and adenotonsillectomy in children referred for tympanostomy tube insertion.

PubMed

Tauman, Riva; Derowe, Ari; Ophir, Orna; Greenfeld, Michal; Sivan, Yakov

2010-02-01

Eustachian tube dysfunction and sleep-disordered breathing (SDB) share common pathophysiologic mechanisms. Our objective was to investigate whether children referred for isolated TTI (tympanostomy tube insertion) are at increased risk for snoring and upper airway procedures. Telephone interviews to parents of children who underwent isolated TTI and to age- and gender-matched controls were conducted. Four hundred fifty-seven children were included in the study; 352 had isolated TTI (study group) and 105 children were controls. Twenty-two percent of children in the study group were reported to snore compared with 7.6% in the controls (p=0.001). Eighteen percent of children in the study group were reported to have undergone adenotonsillectomy compared with 4.8% in the controls (p=0.0005). Future SDB, i.e., either snoring or adenotonsillectomy following TTI, was found in 34% of children in the study group compared with 11% in the controls (p=0.0004). Children who underwent isolated TTI were at increased risk for future snoring (OR=3.4, CI: 1.6-7.2) and future adenotonsillectomy (OR=4.4, CI: 1.7-11.2). Children who undergo isolated TTI are at increased risk for snoring and for adenotonsillectomy. We suggest that these children be followed for symptoms of SDB on a scheduled basis to allow for early diagnosis and intervention. 2009 Elsevier B.V. All rights reserved.

Snoring

MedlinePlus

... Hall Award Winning Abstracts from AADSM 2018 Qualified Dentist Designation Practice Resources Practice Resources Product Store Medicare ... Directory For Patients For Patients Find-An-AADSM-Dentist Snoring Obstructive Sleep Apnea Oral Appliance Therapy Teen ...

Prevalence of upper airway tumors and cysts among patients who snore.

PubMed

Suzuki, Masaaki; Saigusa, Hanako; Chiba, Shintaro; Hoshino, Tadahiko; Okamoto, Makito

2007-11-01

Sleep specialists usually do not pay much attention to the upper airway in patients who snore, because they can make the diagnosis of sleep-disordered breathing without performing nasopharyngeal endoscopy if they have the Epworth Sleepiness Scale scores and the results of polysomnography. The purpose of this study was to determine the prevalence of benign and malignant tumors and cysts in the upper airway in patients who snore. A retrospective multicenter trial was performed in 4 sleep laboratories. Adult male and female patients whose chief complaint on their first visit was witnessed snoring were enrolled in this study. All of the patients were evaluated by otolaryngologists using nasopharyngeal endoscopy to detect organic diseases in the upper airway. Among 2,923 patients, 2 patients had malignant tumors, 5 had benign tumors, and 2 had cysts in the upper airway. The prevalence of upper airway benign and malignant tumors and cysts among adult male and female patients was 0.24%. Routine detailed nasopharyngeal endoscopy should be carried out in each institution so as not to overlook organic diseases in the upper airway among patients who snore.

Apps in sleep medicine.

PubMed

Stippig, Andreas; Hübers, Ulrich; Emerich, Markus

2015-03-01

Users of mobile devices such as iPhones or iPads are offered a wide range of applications (apps) regarding sleep and sleep medicine. This article will give an overview about the apps that are available. Moreover, it will present how they work and determine if they can be used in therapy. The apps' competence to count snoring noises had to be evaluated. This was done with a three-piece test set-up to analyze the apps' ability to distinguish between snoring sounds and disturbing noises such as cars driving past the window, conversations in the bedroom, or even just the rustling of sheets and blankets. The tested apps monitor and record snoring noises well as long as they are used in a soundproof environment. In a real-life environment with various disturbing noises, the apps show difficulties in telling snoring sounds and other noises apart. The tested apps are not accurate enough to replace the common diagnostic standard in therapy. However, they can be a helpful addition. Especially, singles could use them who do not know if their snoring has improved with an OA and do not have anybody to ask.

Drug-induced sleep endoscopy changes snoring management plan very significantly compared to standard clinical evaluation.

PubMed

Pilaete, Karen; De Medts, Joris; Delsupehe, Kathelijne Godelieve

2014-05-01

Drug-induced sleep endoscopy (DISE) is a new tool in the work-up of patients with sleep-disordered breathing (SDB). We assessed the impact of DISE on the treatment plan of snoring patients. This is a single institution prospective longitudinal clinical trial. The setting is a private teaching hospital. A consecutive series of 100 snoring patients prospectively underwent a standardised questionnaire, clinical examination, rhinomanometry, allergy skin prick testing, DISE and polysomnography. Management plan before and after DISE evaluation was compared. In 61 patients (excluding 16 patients sent for continuous positive airway pressure, three patients refused sleep endoscopy and 20 were lost to follow-up), we compared the treatment plans. DISE showed single level airway collapse in 13 and multilevel collapse in 48 patients. The site of flutter did not add additional information as compared to the pattern and the location of the collapse. After DISE, the initial management plan changed in 41% of patients irrespective of the type of initial management plan. The only somewhat accurate initial treatment plan was uvulopalatopharyngoplasty (unchanged in 11/13 patients). Excluding moderate to severe obstructive sleep apnea patients DISE is an indispensable tool in treatment decision in all SDB patients. We suggest to simplify the protocol for DISE reporting.

Current child, but not maternal, snoring is bi-directionally related to adiposity and cardiometabolic risk markers: A cross-sectional and a prospective cohort analysis.

PubMed

Farr, Olivia M; Rifas-Shiman, Sheryl L; Oken, Emily; Taveras, Elsie M; Mantzoros, Christos S

2017-11-01

Obstructive sleep apnea (OSA), typically manifested as snoring, is closely associated with obesity. However, the directionality of associations of OSA with cardiometabolic risk markers is unclear, as obesity increases risk for OSA, and OSA results in excess weight gain and its metabolic consequences. Less is known about how obesity and OSA may relate in children and adolescents and whether maternal OSA may influence the development of obesity and cardiometabolic dysfunction in offspring. Among 1078 children from the Project Viva cohort, we examined cross-sectionally and prospectively associations of parent-reported child or maternal snoring with cardiometabolic outcomes, including adiposity, adipokines, and insulin resistance. Cross-sectionally, child snoring was related to adiposity and metabolic risk, particularly body mass index (BMI; β 0.61kg/m 2 , 95% CI 0.33, 0.89; p<0.001), trunk fat mass index (β 0.23kg/m 2 , CI 0.12, 0.34; p<0.001), high-density lipoprotein cholesterol (β -1.47mg/dL, CI -2.69, -0.25; p=0.02), and metabolic risk z-score (β 0.08, CI 0.02, 0.14; p=0.01) after correction for covariates. Prospectively, adiposity (BMI, trunk fat, fat mass, and waist circumference) and cardiometabolic (leptin, HOMA-IR, CRP, and global metabolic risk) measures at mid-childhood (~7y) were associated with child snoring at the early teen visit (~12y) after correction for covariates. Child snoring at ~9y was related to changes in adiposity between mid-childhood and early teen visits. Child but not maternal snoring, was related to child adiposity and cardiometabolic outcomes. Adiposity and child snoring are associated with each other cross-sectionally and are each predictive of the other among children/adolescents prospectively. These results suggest similar mechanisms in pediatric/adolescent populations as in adults for the development of sleep-disordered breathing and sleep apnea that will need to be confirmed in randomized clinical trials. Importantly, this research points to the need to target both sleep and obesity in order to break this vicious cycle. Copyright © 2017 Elsevier Inc. All rights reserved.

Snoring

MedlinePlus

... a sign of a serious sleep disorder called sleep apnea. You should see your health care provider if you are often tired during the day, don't feel that you sleep well, or wake up gasping. To reduce snoring ...

Snoring-Induced Vibratory Angioedema.

PubMed

Kalathoor, Ipe

2015-10-01

Vibratory angioedema (VA) is a rare physical urticaria, with symptoms of itching and swelling of the skin or mucosa when it is exposed to vibration. Avoidance of vibration is the best way to manage this condition. This case report will assist physicians to diagnose this rare condition. Here, a previously unpublished potential successful treatment modality is being presented, with good symptom control, along with some photographs taken during an acute attack. A literature review points towards potential undiagnosed cases. A 70-year-old woman had multiple emergency department visits for tongue and throat swelling over 3 years. The episodes always happened at night. Detailed history elicited some episodes of itching and swelling of hands when driving as well as significant snoring while sleeping. Physical examination was unremarkable except for morbid obesity. Complement factor 4 and C1esterase inhibitor level were within normal limits. A tentative diagnosis of angioedema induced by oropharyngeal vibration from snoring was made. A sleep study confirmed sleep apnea with severe snoring. After CPAP (continuous positive airway pressure) treatment, she had successful symptom control. Snoring-induced VA is very likely an under-diagnosed condition in the community. The typical history is the key to the diagnosis. This condition could be confirmed by vibration test or by the resolution of symptoms with elimination of vibration. Effective symptom control is possible by avoidance of oropharyngeal vibration from snoring with the administration of CPAP therapy, making it a potential novel indication for this condition.

Influence of uvulopalatopharyngoplasty on alpha-EEG arousals in nonapnoeic snorers.

PubMed

Boudewyns, A; De Cock, W; Willemen, M; Wagemans, M; De Backer, W; Van de Heyning, P H

1997-01-01

Arousals are more numerous in heavy snorers than in nonsnorers and might be a cause of excessive daytime sleepiness (EDS) in these patients. The present study investigated whether treatment of snoring by uvulopalatopharyngoplasty (UPPP) had an influence on sleep microstructure in nonapnoeic snorers. The polysomnographic records of 10 nonapnoeic snorers were reviewed retrospectively and arousals scored according to the American Sleep Disorders Association (ASDA) 3 s definition. Scores for snoring, EDS and polysomnographic data were compared before and after UPPP (mean (+/-SD) time interval 249 +/- 183 days). UPPP resulted in a subjective improvement of snoring and a significant decrease in the arousal index (mean 14.6, 95% confidence interval (95% CI) 8.5-20.8 vs mean 9.1, 95% CI 6.6-11.5) (p = 0.01). EDS and the amount of slow-wave sleep remained unchanged. Uvulopalatopharyngoplasty resulted in an improvement of subjective snoring and a significant decrease of arousals in nonapnoeic snorers. Although these data do not provide any insight into whether the improvement observed can be maintained on a long-term basis, uvulopalatopharyngoplasty can be considered as a useful treatment modality to reduce sleep fragmentation and snoring in nonapnoeic snorers.

The effect of sitting and calf activity on leg fluid and snoring.

PubMed

Singh, Bhajan; Yadollahi, Azadeh; Lyons, Owen; Alshaer, Hisham; Bradley, T Douglas

2017-06-01

Prolonged sitting may promote leg fluid retention that redistributes to the neck during sleep and contributes to snoring. This could be attenuated by calf activity while sitting. In 16 healthy non-obese subjects we measured leg fluid volume (LFV) below the knees using bioelectrical impedance while sitting for 4h, snoring using a portable BresoDx™ device, and Mallampati grade. Using a double cross-over study design, subjects were randomized to one of two arms and crossed-over one week later: control arm - no calf exercise while sitting; intervention arm - calf contraction against a pedal resistance while sitting. The effects of sitting±calf activity on LFV and snoring were compared. We found that LFV increased by 216±101.0ml (p<0.0001) after sitting. Calf activity while sitting attenuated LFV by 53.8ml (p<0.0001) and, in all five subjects with severe upper airway narrowing (Mallampati grade IV), reduced snoring duration (from 357±132.9 to 116.2±72.1s/h, p=0.02) suggesting reduced overnight rostral fluid shift to the neck. Copyright © 2017 Elsevier B.V. All rights reserved.

Uvulopalatopharyngoplasty: The Leicester experience.

PubMed

Prichard, A J; Marshall, J; Ahmed, A; Thomas, R S; Hanning, C D

1994-08-01

Twenty-nine patients undergoing uvulopalatopharyngoplasty (UPPP) for snoring are presented. Ninety per cent expressed an overall improvement in their symptoms: 21 per cent had complete abolition of snoring. Post-operative complications included nasal regurgitation of food/fluids and hyponasal speech development.

[Acoustic information in snoring noises].

PubMed

Janott, C; Schuller, B; Heiser, C

2017-02-01

More than one third of all people snore regularly. Snoring is a common accompaniment of obstructive sleep apnea (OSA) and is often disruptive for the bed partner. This work gives an overview of the history of and state of research on acoustic analysis of snoring for classification of OSA severity, detection of obstructive events, measurement of annoyance, and identification of the sound excitation location. Based on these objectives, searches were conducted in the literature databases PubMed and IEEE Xplore. Publications dealing with the respective objectives according to title and abstract were selected from the search results. A total of 48 publications concerning the above objectives were considered. The limiting factor of many studies is the small number of subjects upon which the analyses are based. Recent research findings show promising results, such that acoustic analysis may find a place in the framework of sleep diagnostics, thus supplementing the recognized standard methods.

Four novel prosthodontic methods for managing upper airway resistance syndrome: an investigative analysis revealing the efficacy of the new nasopharyngeal aperture guard appliance.

PubMed

Venkat, R; Gopichander, N; Vasantakumar, M

2010-01-01

Obstructive sleep apnea is the most frequent cause for insomnia in the populace. Snoring is mulled over as the potential factor that can lead the sequel to obstructive sleep apnea. Although the etiology and deterrence measures for snoring are yet to be undoubtedly clarified by our scientific sorority, various means of surgical corrections have been affirmed and put into practice, with a substantial degree of success. Despite this, it is implicit that a noninvasive method of managing obstructive sleep apnea is more relevant for overcoming this condition. This manuscript intends to establish how snoring can be controlled prosthodontically by different modalities of scientifically defensible approaches. The most effective among the modalities was affirmed as the investigative analyses of the treatment outcomes with each modality. NOVEL METHODS: Four new methods of managing obstructive sleep apnea--uvula lift appliance, uvula and velopharynx lift appliance, nasopharyngeal aperture guard, and soft palate lift appliance were demonstrated through this article. The four new modalities stated and one conventional modality of mandibular advancement appliance for managing obstructive sleep apnea, a total of five types of appliance therapies, were described with case reports for each. Five individuals undergoing the appliance therapy were chosen for each modality. The treatment outcome with each modality was examined by analysis of clinical predictors and also by means of standard investigation, with nasal and oral endoscopic analyses. Among the five types of appliance therapies, the nasopharyngeal aperture guard provided the best treatment outcome in terms of clinical predictors and endoscopic analyses. Nasopharyngeal aperture guard, the novel method stated in this article is the better modality for managing obstructive sleep apnea, among the five different appliance therapies.

Relationship between sleep characteristics and measures of body size and composition in a nationally-representative sample.

PubMed

Xiao, Qian; Gu, Fangyi; Caporaso, Neil; Matthews, Charles E

2016-01-01

Short sleep has been linked to obesity. However, sleep is a multidimensional behavior that cannot be characterized solely by sleep duration. There is limited study that comprehensively examined different sleep characteristics in relation to obesity. We examined various aspects of sleep in relation to adiposity in 2005-2006 NHANES participants who were 18 or older and free of cardiovascular disease, cancer, emphysema, chronic bronchitis and depression ( N  = 3995). Sleep characteristics were self-reported, and included duration, overall quality, onset latency, fragmentation, daytime sleepiness, snoring, and sleep disorders. Body measurements included weight, height, waist circumference, and dual-energy X-ray absorptiometry measured fat mass. Snoring was associated with higher BMI (adjusted difference in kg/m 2 comparing snoring for 5+ nights/week with no snoring (95 % confidence interval), 1.85 (0.88, 2.83)), larger waist circumference (cm, 4.52 (2.29, 6.75)), higher percentage of body fat (%, 1.61 (0.84, 2.38)), and higher android/gynoid ratio (0.03 (0.01, 0.06)). The associations were independent of sleep duration and sleep quality, and cannot be explained by the existence of sleep disorders such as sleep apnea. Poor sleep quality (two or more problematic sleep conditions) and short sleep duration (<6 h) were also associated with higher measures of body size and fat composition, although the effects were attenuated after snoring was adjusted. In a nationally representative sample of healthy US adults, snoring, short sleep, and poor sleep quality were associated with higher adiposity.

Radiofrequency of the soft palate for sleep-disordered breathing: a 6-year follow-up study.

PubMed

De Kermadec, H; Blumen, M-B; Engalenc, D; Vezina, J-P; Chabolle, F

2014-02-01

To determine the long-term (>3 years) outcome of patients suffering from simple snoring or non-severe obstructive sleep apnea syndrome (OSAS) treated by radiofrequency ablation of the soft palate. Observational retrospective study. Tertiary care university hospital. Seventy-seven subjects were included between 1999 and 2006. Twenty-seven suffered from mild or moderate OSAS. All patients were treated by radiofrequency-assisted stiffening of the soft palate, with or without uvulectomy. Snoring (assessed on a 10 cm visual analog scale (VAS)), marital status, presence of cardiovascular risk factors or pathologies and follow-up time were evaluated by postal questionnaire. Mean follow-up time was 6.3 ± 2.3 years. Mean snoring intensity decreased significantly in the immediate postoperative period (8.1 ± 2.9 to 3.5 ± 2.2 cm on VAS). Over the longer term, however, we observed a significant increase in snoring intensity (5.7 ± 2.9 cm), which nevertheless remained below the preoperative values (P<0.001). Bed-partners noticed a relapse of snoring in 92.7% of cases. Nine percent of couples separated. Hypertension and diabetes were diagnosed during follow-up in 12.1% and 6.6% of the subjects, respectively. A majority of patients failed to undergo repeat polysomnography or further treatment. Relapse of snoring was observed in nearly all patients in the long run, although intensity appears to remain lower than preoperatively. Most patients did not comply with the follow-up instructions and did not seek other forms of treatment when recurrence occurred. Copyright © 2013. Published by Elsevier Masson SAS.

Self-reported exposure to traffic pollution in relation to daytime sleepiness and habitual snoring: a questionnaire study in seven North-European cities.

PubMed

Gislason, Thorarinn; Bertelsen, Randi J; Real, Francisco Gomez; Sigsgaard, Torben; Franklin, Karl A; Lindberg, Eva; Janson, Christer; Arnardottir, Erna Sif; Hellgren, Johan; Benediktsdottir, Bryndis; Forsberg, Bertil; Johannessen, Ane

2016-08-01

Little is known about associations between traffic exposure and sleep disturbances. We examined if self-reported exposure to traffic is associated with habitual snoring and daytime sleepiness in a general population. In the RHINE III study, 12184 adults answered questions on sleep disturbances and traffic exposure. We analysed bedrooms near roads with traffic, bedrooms with traffic noise, and travelling regularly along busy roads as proxies for traffic exposures, using logistic regression. Adjustment factors were study centre, gender, age, smoking habits, educational level, body mass index, physical activity, obstructive sleep apnoea, and sleep duration. One in ten lived near a busy road, 6% slept in a bedroom with traffic noise, and 11% travelled regularly along busy roads. Habitual snoring affected 25% and daytime sleepiness 21%. More men reported snoring and more women reported daytime sleepiness. Having a bedroom with traffic noise was associated with snoring (adjusted OR 1.29, [95% CI 1.12, 1.48]). For daytime sleepiness, on the other hand, bedroom with traffic noise and high exposure to traffic pollution have significant risk factors (adjusted ORs 1.46 [1.11, 1.92] and 1.65 [1.11, 2.45]). Results were consistent across study centres. Daytime sleepiness is associated with traffic pollution and traffic noise, while habitual snoring is only associated with traffic noise. Self-reported traffic exposure should be taken into account when diagnosing and planning treatment for patients with sleep disturbances, because reducing noise and pollution exposure in the bedroom may have a beneficial effect. Copyright © 2016 Elsevier B.V. All rights reserved.

Investigation of sequential properties of snoring episodes for obstructive sleep apnoea identification.

PubMed

Cavusoglu, M; Ciloglu, T; Serinagaoglu, Y; Kamasak, M; Erogul, O; Akcam, T

2008-08-01

In this paper, 'snore regularity' is studied in terms of the variations of snoring sound episode durations, separations and average powers in simple snorers and in obstructive sleep apnoea (OSA) patients. The goal was to explore the possibility of distinguishing among simple snorers and OSA patients using only sleep sound recordings of individuals and to ultimately eliminate the need for spending a whole night in the clinic for polysomnographic recording. Sequences that contain snoring episode durations (SED), snoring episode separations (SES) and average snoring episode powers (SEP) were constructed from snoring sound recordings of 30 individuals (18 simple snorers and 12 OSA patients) who were also under polysomnographic recording in Gülhane Military Medical Academy Sleep Studies Laboratory (GMMA-SSL), Ankara, Turkey. Snore regularity is quantified in terms of mean, standard deviation and coefficient of variation values for the SED, SES and SEP sequences. In all three of these sequences, OSA patients' data displayed a higher variation than those of simple snorers. To exclude the effects of slow variations in the base-line of these sequences, new sequences that contain the coefficient of variation of the sample values in a 'short' signal frame, i.e., short time coefficient of variation (STCV) sequences, were defined. The mean, the standard deviation and the coefficient of variation values calculated from the STCV sequences displayed a stronger potential to distinguish among simple snorers and OSA patients than those obtained from the SED, SES and SEP sequences themselves. Spider charts were used to jointly visualize the three parameters, i.e., the mean, the standard deviation and the coefficient of variation values of the SED, SES and SEP sequences, and the corresponding STCV sequences as two-dimensional plots. Our observations showed that the statistical parameters obtained from the SED and SES sequences, and the corresponding STCV sequences, possessed a strong potential to distinguish among simple snorers and OSA patients, both marginally, i.e., when the parameters are examined individually, and jointly. The parameters obtained from the SEP sequences and the corresponding STCV sequences, on the other hand, did not have a strong discrimination capability. However, the joint behaviour of these parameters showed some potential to distinguish among simple snorers and OSA patients.

Effect of Modified Fujita Technique Uvulopalatoplasty on Oxidative DNA Damage Levels in Patients With Obstructive Sleep Apnea Syndrome.

PubMed

Bakan, Ebubekir; Fidan, Vural; Alp, Hamit Hakan; Baygutalp, Nurcan Kilic; Cokluk, Erdem

2015-07-01

Snoring is a social hindrance problem and it can cause life threatening problems. Because of this it must be taken seriously and must be treated. Although there are many ways for treating this problem, still uvulopalatopharngoplasty (UPPP) which is an accepted classical method maintains its importance. Antioxidant status in patients with snoring have been investigated. All studies investigated the effect of CPAP treatment on the level of antioxidant agents. In this study we have examined the effect of UPPP on the level of antioxidant agents in patients with snoring.

Comparison of SVM and ANFIS for Snore Related Sounds Classification by Using the Largest Lyapunov Exponent and Entropy

PubMed Central

Ankışhan, Haydar; Yılmaz, Derya

2013-01-01

Snoring, which may be decisive for many diseases, is an important indicator especially for sleep disorders. In recent years, many studies have been performed on the snore related sounds (SRSs) due to producing useful results for detection of sleep apnea/hypopnea syndrome (SAHS). The first important step of these studies is the detection of snore from SRSs by using different time and frequency domain features. The SRSs have a complex nature that is originated from several physiological and physical conditions. The nonlinear characteristics of SRSs can be examined with chaos theory methods which are widely used to evaluate the biomedical signals and systems, recently. The aim of this study is to classify the SRSs as snore/breathing/silence by using the largest Lyapunov exponent (LLE) and entropy with multiclass support vector machines (SVMs) and adaptive network fuzzy inference system (ANFIS). Two different experiments were performed for different training and test data sets. Experimental results show that the multiclass SVMs can produce the better classification results than ANFIS with used nonlinear quantities. Additionally, these nonlinear features are carrying meaningful information for classifying SRSs and are able to be used for diagnosis of sleep disorders such as SAHS. PMID:24194786

Follow-up of obstructive sleep apnea in children.

PubMed

Barros, Emília Leite de; Pradella-Hallinan, Marcia; Moreira, Gustavo Antonio; Stefanini, Daniele de Oliveira Soares; Tufik, Sergio; Fujita, Reginaldo Raimundo

2014-01-01

the evolution of snoring and OSAS in children is not well established since few studies of patients without surgical treatment have been published. to evaluate the evolution of sleep disordered breathing in children who had not been submitted to upper airway surgery. twenty-six children with snoring who had not undergone upper airway surgery were evaluated prospectively. Patients were evaluated by full physical examination and nocturnal polysomnography, after which they were divided into 2 groups: apnea (16 children) and snoring (10 children). After 6 months following the initial evaluation, patients were submitted to a new nocturnal polysomnography, and all data were compared to those of the first examination. the groups did not show any differences regarding age, weight, height and airway physical examination. After 6 months of follow-up, the apnea index did not change, but the respiratory disturbance index increased in the snoring group and the number of hypopneas decreased in the group apnea. there was an increase in the percentage of N1 sleep stage and the respiratory disturbance index in the patients with primary snore. The AHI did not show significant alteration in both groups, but the number of hypopneas decreased in patients with SAOS. Copyright © 2014 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

Obstructive apnea hypopnea index estimation by analysis of nocturnal snoring signals in adults.

PubMed

Ben-Israel, Nir; Tarasiuk, Ariel; Zigel, Yaniv

2012-09-01

To develop a whole-night snore sounds analysis algorithm enabling estimation of obstructive apnea hypopnea index (AHI(EST)) among adult subjects. Snore sounds were recorded using a directional condenser microphone placed 1 m above the bed. Acoustic features exploring intra-(mel- cepstability, pitch density) and inter-(running variance, apnea phase ratio, inter-event silence) snore properties were extracted and integrated to assess AHI(EST). University-affiliated sleep-wake disorder center and biomedical signal processing laboratory. Ninety subjects (age 53 ± 13 years, BMI 31 ± 5 kg/m(2)) referred for polysomnography (PSG) diagnosis of OSA were prospectively and consecutively recruited. The system was trained and tested on 60 subjects. Validation was blindly performed on the additional 30 consecutive subjects. AHI(EST) correlated with AHI (AHI(PSG); r(2) = 0.81, P < 0.001). Area under the receiver operating characteristic curve of 85% and 92% for thresholds of 10 and 20 events/h, respectively, were obtained for OSA detection. Both Altman-Bland analysis and diagnostic agreement criteria revealed 80% and 83% agreements of AHI(EST) with AHI(PSG), respectively. Acoustic analysis based on intra- and inter-snore properties can differentiate subjects according to AHI. An acoustic-based screening system may address the growing needs for reliable OSA screening tool. Further studies are needed to support these findings.

Using the Karolinska Sleep Questionnaire to identify obstructive sleep apnea syndrome in a sleep clinic population.

PubMed

Westerlund, Anna; Brandt, Lena; Harlid, Richard; Åkerstedt, Torbjörn; Lagerros, Ylva Trolle

2014-10-01

In Scandinavia, portable monitoring has virtually replaced standard polysomnography for diagnosis of obstructive sleep apnea syndrome (OSAS). Because waiting times for specialized OSAS care remain long, an accurate screening tool to exclude low-risk patients from diagnostic testing would be valuable. To examine the diagnostic accuracy of the Karolinska Sleep Questionnaire (KSQ) for OSAS. Consecutive patients, 30–66 years old, attending a large sleep clinic in Sweden for OSAS evaluation completed the KSQ and underwent in-home portable monitoring and medical history evaluation. OSAS was defined as apnea-hypopnea index ≥5 with symptoms of disease. We calculated sensitivity and specificity of apnea/snoring and sleepiness indices of the KSQ. Retrospectively, we combined six KSQ items (snoring, breathing cessations, disturbed sleep, etc.) and four clinical variables (age, sex, body mass index, smoking status) predictive of OSAS into a new instrument, which we also evaluated. Instrument score ranged between 0 and 21; a higher score indicated more severe symptoms. Of 103 patients, 62 were diagnosed with OSAS. Sensitivity and specificity of the indices were 0.56 and 0.68 (apnea/snoring), and 0.37 and 0.71 (sleepiness). The new instrument performed optimally at a score of 9. Sensitivity was 0.76 (95% confidence interval 0.63–0.86) and specificity 0.88 (0.74–0.96). Between 19.4% and 50.5% of patients were unaware of having apnea/snoring symptoms. Diagnostic accuracy of the apnea/snoring and sleepiness indices for OSAS was poor but could be improved by combining clinical and KSQ items. The usefulness of the apnea/snoring index and the combined instrument was questionable because of extensive symptom unawareness.

Seasonal trends in sleep-disordered breathing: evidence from Internet search engine query data.

PubMed

Ingram, David G; Matthews, Camilla K; Plante, David T

2015-03-01

The primary aim of the current study was to test the hypothesis that there is a seasonal component to snoring and obstructive sleep apnea (OSA) through the use of Google search engine query data. Internet search engine query data were retrieved from Google Trends from January 2006 to December 2012. Monthly normalized search volume was obtained over that 7-year period in the USA and Australia for the following search terms: "snoring" and "sleep apnea". Seasonal effects were investigated by fitting cosinor regression models. In addition, the search terms "snoring children" and "sleep apnea children" were evaluated to examine seasonal effects in pediatric populations. Statistically significant seasonal effects were found using cosinor analysis in both USA and Australia for "snoring" (p < 0.00001 for both countries). Similarly, seasonal patterns were observed for "sleep apnea" in the USA (p = 0.001); however, cosinor analysis was not significant for this search term in Australia (p = 0.13). Seasonal patterns for "snoring children" and "sleep apnea children" were observed in the USA (p = 0.002 and p < 0.00001, respectively), with insufficient search volume to examine these search terms in Australia. All searches peaked in the winter or early spring in both countries, with the magnitude of seasonal effect ranging from 5 to 50 %. Our findings indicate that there are significant seasonal trends for both snoring and sleep apnea internet search engine queries, with a peak in the winter and early spring. Further research is indicated to determine the mechanisms underlying these findings, whether they have clinical impact, and if they are associated with other comorbid medical conditions that have similar patterns of seasonal exacerbation.

A prospective single-blind randomized-controlled trial comparing two surgical techniques for the treatment of snoring: laser palatoplasty versus uvulectomy with punctate palatal diathermy.

PubMed

Uppal, S; Nadig, S; Jones, C; Nicolaides, A R; Coatesworth, A P

2004-06-01

The aim of this study was to compare laser palatoplasty with uvulectomy with punctate palatal diathermy as treatment modalities for snoring. The study design was a prospective, single-blind, randomized-controlled trial. Eighty-three patients entered the trial. After a mean follow-up period of more than 18 months there was no statistically significant difference between the two groups regarding the patient perception of benefit from surgery or the subjective improvement in snoring. However, there was a statistically significant difference in the degree of pain in the immediate postoperative period (mean difference = 22.14, 95% CI = 7.98-36.31, P = 0.003), with the pain being worse in the laser palatoplasty group. Relative risk of complications for laser palatoplasty was 1.42 (95% CI = 0.93-2.17). The snoring scores and Glasgow Benefit Inventory scores decreased with time in both the groups but there was no statistically significant difference between the two groups.

Friedman tongue position: age distribution and relationship to sleep-disordered breathing.

PubMed

Ingram, David G; Ruiz, Amanda; Friedman, Norman R

2015-05-01

Friedman tongue position (FTP) may play an important role in the evaluation of children with sleep-related breathing disorders (SRBD), but there are no previous data on FTP distribution by age. The objective of the current study was to determine the distribution of FTP by age and examine the relationship between FTP and snoring in children. Prospective cross-sectional study of 199 children (mean age, 6.8 years; 59% male) had tongue position assessed by FTP as part of their clinical examination of the oral cavity during routine ENT visits at a tertiary care children's hospital. The FTP and snoring frequency of participants was examined across the entire age range as well as by comparing those older (middle childhood and above) and younger than 5 years of age. Tongue position did not correlate with age or snoring frequency. The proportion of children with FTP III/IV was not significantly different in children younger than five years of age compared to older than five. Habitual snoring was not associated with having a higher FTP. Among children who snored <3 times per week, those who had previously undergone tonsillectomy did have higher FTP compared to those who had not (p=0.007). BMI-%-for-age was significantly correlated with FTP (p=0.003). The percent of children having FTP class III/IV differed significantly between ethnicities (22% of whites, 26% of others, 45% of hispanics, 53% of African-Americans; p=0.011). Inter-rater reliability among pediatric otolaryngologist was excellent (kappa=0.93, p<0.001). There does not appear to be an association between FTP with age or snoring frequency in children. The excellent inter-rater reliability for FTP among pediatric ENT providers suggests the null findings are not due to rater bias. These findings may serve as an important reference for those studying the role of tongue position in pediatric SRBD and complement previous studies examining FTP among children with known OSA or snoring. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Associations of Self-Reported Sleep Duration and Snoring with Colorectal Cancer Risk in Men and Women

PubMed Central

Zhang, Xuehong; Giovannucci, Edward L.; Wu, Kana; Gao, Xiang; Hu, Frank; Ogino, Shuji; Schernhammer, Eva S.; Fuchs, Charles S.; Redline, Susan; Willett, Walter C.; Ma, Jing

2013-01-01

Study Objectives: We assessed the relationship between sleep duration, snoring and colorectal cancer risk. Design: Prospective cohort studies. Setting: United States. Participants: A total of 30,121 men aged 41 to 79 years in the Health Professionals Follow-up Study and 76,368 women aged 40 to 73 years in the Nurses' Health Study. Interventions: None. Measurements and Results: We queried information on sleep duration and snoring in 1986/87. Cox proportional hazards regression models were used to estimate multivariable hazard ratios (HRs, 95% CIs). We documented 1,973 incident colorectal cancer cases (709 men and 1,264 women) over a 22-year follow-up period. Compared to sleep an average 7 h, ≥ 9 h of sleep was significantly associated with a higher risk of colorectal cancer among men (HR = 1.35, 95% CI: 1.00, 1.82), and to a lesser degree, among women (HR = 1.11, 95% CI: 0.85, 1.44). The risk associated with longer sleep was restricted to individuals who regularly snored (men: HR = 1.80, 95% CI: 1.14, 2.84; women: HR = 2.32, 95% CI: 1.24, 4.36) and to overweight individuals (i.e., BMI ≥ 25 kg/m2) (men: HR = 1.52, 95% CI: 1.04, 2.21; women: HR = 1.37, 95% CI: 0.97, 1.94). Short sleep duration (≤ 5 h) was not associated with an increased risk of colorectal cancer in the entire sample or in subgroups stratified by snoring or BMI. Conclusions: Longer sleep duration was associated with an increased risk of developing colorectal cancer among individuals who were overweight or snored regularly. This observation raises the possibility that sleep apnea and its attendant intermittent hypoxemia may contribute to cancer risk. Citation: Zhang X; Giovannucci EL; Wu K; Gao X; Hu F; Ogino S; Schernhammer ES; Fuchs CS; Redline S; Willett WC; Ma J. Associations of self-reported sleep duration and snoring with colorectal cancer risk in men and women. SLEEP 2013;36(5):681-688. PMID:23633750

Prevalence of Snoring in College Students

ERIC Educational Resources Information Center

Patel, Minal; Tran, Duyen; Chakrabarti, Ashoke; Vasquez, Audrey; Gilbert, Paul; Davidson, Terence

2008-01-01

Snoring in college students may be the earliest presentation of adult sleep-disordered breathing, yet the literature contains few studies that demonstrate its effects on learning or whether early diagnosis leads to interruption of disease progression or prevention of comorbidities. Objective and Participants: The authors conducted this study in…

Prevalence of major obstructive sleep apnea syndrome symptoms in coal miners and healthy adults.

PubMed

Kart, Levent; Dutkun, Yalçın; Altın, Remzi; Ornek, Tacettin; Kıran, Sibel

2010-01-01

Obstructive sleep apnea syndrome obstructive sleep apnea syndrome is associated with symptoms including habitual snoring, witness apnea and excessive daytime sleepiness. Also obstructive sleep apnea syndrome is related to some occupations which are needed attention for work accident. We aimed to determine the prevalence of snoring, witnessed apnea and excessive daytime sleepiness in coal workers and healthy adults in Zonguldak city center, and also evaluate the differences between these groups. This study consisted of 423 underground coal workers and 355 individuals living in centre of Zonguldak. Study and comparison group were chosen by nonstratified randomized sampling method. Data were collected by a questionnaire that included information regarding snoring, witnessed apnea and excessive daytime sleepiness. Mean age was 43.3 ± 6.05 years in miners and 44.3 ± 11.8 years in comparison group. In miners, snoring frequency was determined as 42.6%, witnessed apneas were 4.0%, and daytime sleepiness were 4.7%. In comparison group, these symptoms were 38.6%, 4.8% and 2.8% respectively. There were no statistical differences between coal workers and comparison group in these symptoms. Also snoring prevalence was higher in smoker miners. We found that major symptoms of obstructive sleep apnea syndrome in coal workers are similar to general population in Zonguldak. Further studies that constucted higher populations and with polysomnography are needed to evaluate these findings.

Ambulatory treatment of snoring with CO2 laser: laser-assisted UPPP (LAUP), results on 856 patients

NASA Astrophysics Data System (ADS)

Kamami, Yves-Victor

1995-05-01

The usual treatment of snoring in the absence of sleep apneas has been UPPP. Patients are often reluctant to undergo this painful procedure under general anesthesia. The Laser Assisted Uvulopalatoplasty (LAUP) is a new procedure, introduced six years ago by the author, using local anesthesia for the treatment of snoring in an office setting. This technique is designed to correct breathing abnormalities during sleep, caused by pharyngeal airway obstruction in patients suffering of Snoring or Obstructive Sleep Apnea Syndrome. This is done by reducing the amount of tissue in the uvula, the velum, and the upper part of the posterior pillars. LAUP allows surgery for the relief of snoring to be performed in the office, under local anesthesia. LAUP has many advantages over the traditional UPPP. It is simple, reliable, hemostatic, and less painful. It is also less expensive as it can be performed as an outpatient. This makes the LAUP more accessible to patients. Our experience with LAUP in 856 patients from December 1988 to July 1994 (141 women and 715 men) is described. Good results were obtained in 94.8% of patients and there were no complications. This new technique can be easily performed by other otolaryngologists after serious suitable training. LAUP provides a simple alternative for many patients who do not wish to undergo a traditional UPPP.

[The prevalence of obstructive sleep apnea-hypopnea syndrome in adults aged over 20 years in Changchun city].

PubMed

Li, Ming-xian; Wang, Ying; Hua, Shu-cheng; Li, Chun-mei; Wang, Mu-peng; Liu, Yang; Li, Zhong-min; Wang, Chun-yong; Fan, Jin-rong; Wang, Jing-Hua; Kong, Fan-yu; Wang, Min

2005-12-01

To investigate the prevalence of obstructive sleep apnea-hypopnea syndrome (OSAHS) in adults aged over 20 years in Changchun city, providing epidemiological data for treatment and prevention of the disease. 3,960 subjects were derived from a stratified cluster and random sampling of the population in two districts of Changchun city. They were asked to answer the questions from a questionnaire in their houses. According to the degree of snoring, 200 subjects with a snoring score >or= 2 degree were selected to undergo polysomnography for a whole night and the prevalence of the disease was estimated. A total of 3,648 (97.64%) validated questionnaires was collected. Of them 31.00% had a snoring score >or= 2 degree, the prevalence was higher in males (40.07%) than in females (21.76%). The prevalence of snoring was higher in drivers (42.47%) than in other occupations. The estimated prevalence of OSAHS defined by apnea-hypopnea index (AHI) >or= 5, Epworth sleepiness scale (ESS) >or= 9 and arterial oxygen saturation (SaO(2)) < 90% was 4.81%. The estimated prevalence of OSAHS in adults aged over 20 years in Changchun city was 4.81%. Doctors should pay more attention to the disease and the ordinary people should be informed of the health impact of snoring and OSAHS.

Treatment of snorers with a volatile oil: a randomized, double-blind placebo-controlled trial.

PubMed

Ulfberg, J; Nyström, B

2001-01-01

Snoring is a significant problem both for the patient and for the bed partner. Seventy-two male and female heavy snorers and their bed partners participated in a double-blinded, placebo-controlled study on the effects of a volatile oil administered by gargling. The patients were diagnosed as heavy snorers after they underwent overnight polysomnography showing that their apnea indexes were below 5, thus sleep apnea patients were not included in the study. The participants and their partners filled out evaluations concerning snoring intensity, mouth dryness, nasal stuffiness and the Epworth Sleepiness Scale prior to and after using the volatile oil or placebo for 14 consecutive nights. There were no statistically significant decreases in snoring as graded by the bed partner or in mouth dryness, nasal stuffiness, or the Epworth Sleepiness Scale scores graded by the patients who were randomized to use the volatile oil. The results of this study indicate that this volatile oil is not an effective treatment in patients presenting with symptoms of snoring. Copyright 2001 S. Karger AG, Basel

Snoring and obstructive sleep apnoea in children: why should we treat?

PubMed

Gozal, David; O'Brien, Louise M

2004-01-01

Frequent and loud snoring is a very frequent condition in prepubertal children affecting approximately 10% of all 2-8 year old children. If polysomnographical evaluations are performed in these snoring children, approximately 10% will be diagnosed with obstructive sleep apnoea (OSA). The pathophysiology of OSA in children is still poorly understood. Indeed, while adenotonsillar hypertrophy is certainly a major contributor to OSA, other factors need to be implicated for OSA to develop. In recent years, it has become apparent that OSA and snoring are not as innocuous as previously thought. Indeed, epidemiological and pre-post treatment analyses have identified substantial morbidities that primarily affect cardiovascular and neurobehavioural systems, namely pulmonary hypertension, systemic elevation of arterial blood pressure, nocturnal enuresis, reduced somatic growth, behavioural problems that resemble attention deficit-hyperactivity disorder, as well as learning and cognitive deficits. These problems are associated with marked increases in healthcare-related costs. More importantly, if timely diagnosis and intervention are not implemented, some of these morbid complications may not be completely reversible, leading to long-lasting residual consequences.

Headache, snoring and sleep apnoea.

PubMed

Ulfberg, J; Carter, N; Talbäck, M; Edling, C

1996-09-01

To evaluate reported headache prevalence among the general population and patients suffering from snoring and obstructive sleep apnoea syndrome (OSAS), a cross-sectional study was performed among those aged 30-64 years residing in Kopparberg county in central Sweden. Consecutive patients referred to the sleep laboratory in the catchment area who fulfilled objective diagnostic criteria (snorers = 448, OSAS = 324) and a random sample of the general population (n = 583) responded to the same questionnaire. Patients were selected following sleep apnoea screening with 100% specificity for both OSAS and snoring. Responders from the general population were divided into snorers or non-snorers on the basis of self-report. To validate the self-report question on snoring in the questionnaire, 50 males and 49 females, randomly selected from the sample of the general population, underwent sleep apnoea screening in their homes. Headache among both men and women was found to be more prevalent among heavy snorers and OSAS patients compared with the control group. Morning headache, in particular, was at least three times more common among male and female heavy snorers and OSAS patients then among the general population. Headache in the control group was more common among snorers than non-snorers. Among responders, 5% of the general population reported experiencing headache often or very often upon awakening. For the heavy snoring and OSAS groups, 18% reported experiencing headache often or very often upon awakening. The results indicate that headache is common among heavy snorers and OSAS patients regardless of gender.

Occupational exposure to organic solvents and sleep-disordered breathing.

PubMed

Ulfberg, J; Carter, N; Talbäck, M; Edling, C

1997-01-01

To investigate whether people with occupational exposure to organic solvents have a higher prevalence of obstructive sleep apnea syndrome (OSAS) than the general population and to examine the relationship between snoring and exposure to organic solvents. Consecutive patients, aged 30-64 years, referred during a 3-year period to the sleep laboratory at Avesta Hospital, Sweden, because of suspected OSAS made up the patient groups. Following admission, patients underwent a simplified sleep apnea investigation and were divided into two groups, OSAS (n = 320) and snorers (n = 443). A random sample of 296 men and 289 women aged 30-64 years obtained from a register of all country residents maintained by the county tax authority served as referents (controls). Both patients and referents responded to two questionnaires, including questions about occupation, exposure to organic solvents, and other chemical and physical agents. Men with OSAS or snoring and women with snoring had more often been occupationally exposed to organic solvents than the referents, showing an almost twofold increase in risk for those exposed during whole workdays. For men, the risk of OSAS or snoring increased with increasing exposure. The result indicates that occupational exposure to organic solvents might cause sleep apnea. A new observation is that even snoring could be caused by exposure to organic solvents. It is important to elucidate whether exposure to organic solvents is a cause of OSAS, because such a finding may have important implications for prevention and treatment of sleep disturbances.

Tissue Vibration Induces Carotid Artery Endothelial Dysfunction: A Mechanism Linking Snoring and Carotid Atherosclerosis?

PubMed Central

Cho, Jin-Gun; Witting, Paul K.; Verma, Manisha; Wu, Ben J.; Shanu, Anu; Kairaitis, Kristina; Amis, Terence C.; Wheatley, John R.

2011-01-01

Study Objectives: We have previously identified heavy snoring as an independent risk factor for carotid atherosclerosis. In order to explore the hypothesis that snoring-associated vibration of the carotid artery induces endothelial dysfunction (an established atherogenic precursor), we utilized an animal model to examine direct effects of peri-carotid tissue vibration on carotid artery endothelial function and structure. Design: In supine anesthetized, ventilated rabbits, the right carotid artery (RCA) was directly exposed to vibrations for 6 h (peak frequency 60 Hz, energy matched to that of induced snoring in rabbits). Similarly instrumented unvibrated rabbits served as controls. Features of OSA such as hypoxemia, large intra-pleural swings and blood pressure volatility were prevented. Carotid endothelial function was then examined: (1) biochemically by measurement of tissue cyclic guanosine monophosphate (cGMP) to acetylcholine (ACh) and sodium nitroprusside (SNP); and (2) functionally by monitoring vessel relaxation with acetylcholine in a myobath. Measurement and Results: Vessel cGMP after stimulation with ACh was reduced in vibrated RCA compared with unvibrated (control) arteries in a vibration energy dose-dependent manner. Vibrated RCA also showed decreased vasorelaxation to ACh compared with control arteries. Notably, after addition of SNP (nitric oxide donor), cGMP levels did not differ between vibrated and control arteries, thereby isolating vibration-induced dysfunction to the endothelium alone. This dysfunction occurred in the presence of a morphologically intact endothelium without increased apoptosis. Conclusions: Carotid arteries subjected to 6 h of continuous peri-carotid tissue vibration displayed endothelial dysfunction, suggesting a direct plausible mechanism linking heavy snoring to the development of carotid atherosclerosis. Citation: Cho JG; Witting PK; Verma M; Wu BJ; Shanu A; Kairaitis K; Amis TC; Wheatley JR. Tissue vibration induces carotid artery endothelial dysfunction: a mechanism linking snoring and carotid atherosclerosis?. SLEEP 2011;34(6):751-757. PMID:21629363

Does the length of uvula affect the palatal implant outcome in the management of habitual snoring?

PubMed

Akpinar, Meltem Esen; Yigit, Ozgur; Kocak, Ismail; Altundag, Aytug

2011-05-01

To evaluate the impact of the uvular length on the efficacy of palatal implants in primary snoring. Prospective case series, tertiary hospital, snoring and respiratory sleep disorders center. Forty subjects with inserted palatal implants and diagnoses of primary snoring were included. All met the inclusion criteria of age >18 years, body mass index <30, apnea-hypopnea index <5, tonsil grade <3, soft-palate length >25 mm, and Friedman tongue position <3 following clinical, endoscopic, and polysomnographic evaluation. Epworth sleepiness scale (ESS) and the snoring-intensity visual analogue scale (VAS) were recorded before and 9 months after the implant. Four subjects with extruded implants were excluded; the remaining 36 subjects were divided into two groups, Group I and Group II, with uvular lengths of ≤15 mm and >15 mm, respectively. The study assessed and compared subjective outcome measures including the partner's satisfaction (PS), partner's reported improvement (PRI), 50% VAS and ESS reduction, and subjective success (SS) defined as 50% VAS reduction. The Student t test, χ(2) test, and logistic regression models were used for statistical evaluation. SS (50% VAS reduction), PS, PRI, and 50% ESS reduction were significantly higher in Group I (P < .001, P = .0257, P = .027, P < .001). The overall SS, PRI, PS, and 50% ESS reduction were 33%, 78%, 50%, and 50%, respectively. The uvular length was found to be the determinant factor of SS (P = .005; odds ratio = 0.75), PRI (P = .039; odds ratio = 0.83), and 50% ESS reduction (P = .038; odds ratio: 0.84) following implant insertion through stepwise logistic regression analysis. Excess uvular length (>15 mm) is an important anatomic feature decreasing the efficacy of palatal implants in snoring, and additional measures, such as uvulectomy, should be considered simultaneously for better outcomes (level 4). Copyright © 2011 The American Laryngological, Rhinological, and Otological Society, Inc.

Chronic Snoring and Sleep in Children: A Demonstration of Sleep Disruption

ERIC Educational Resources Information Center

Lopes, M. Cecilia; Guilleminault, Christian

2007-01-01

Objective: Chronic snoring that does not adhere to the criteria for a diagnosis of obstructive sleep apnea syndrome may be associated with learning and behavioral problems. We investigated the sleep structure of chronic snorers who had an apnea-hypopnea index of less than 1 event per hour and analyzed the cyclic alternating pattern. Methods:…

Magnetic therapy is ineffective for the treatment of snoring and obstructive sleep apnea syndrome.

PubMed

Dexter, D

1997-03-01

Snoring and the obstructive sleep apnea syndrome are common and chronic ailments with potentially serious medical complications. There are several accepted treatments, but these can be uncomfortable, inconvenient, and expensive. A number of alternative treatments have been reported to be beneficial in the treatment of obstructive sleep apnea and snoring. They are advertised in magazines, on the radio and television, and on the Internet. The lay press is reporting about the effectiveness of these treatments without the benefit of clinical trials or scientific studies. Among the therapies currently being promoted for the treatment of snoring and sleep apnea is biomagnetic therapy. Unlike many of the other treatments which have not undergone scientific evaluation, biomagnetic therapy has been evaluated in the past. In fact, the evaluation of biomagnetic therapy is one of the first controlled scientific investigations found in the literature. This report showed that magnet therapy had no medicinal value. Despite this clear evidence, magnetic therapy continues to be utilized today and currently is being promoted for the treatment of snoring and sleep apnea. At out Sleep Disorder Center, we have had the opportunity to evaluate a patient with severe obstructive sleep apnea both before and after treatment with magnetic therapy, as well as with conventional therapy. Our study clearly indicates there was no benefit from magnetic therapy in this case. While alternative therapy may be helpful in the treatment of certain medical conditions, extreme care must be exercised to prevent inappropriate treatment or undertreat-ment of significant medical problems. Close clinical follow-up and controlled studies are important in determining the effectiveness of therapies.

The association of snoring and risk of obstructive sleep apnea with poor academic performance among university students.

PubMed

Khassawneh, Basheer Y; Alkhatib, Loiy L; Ibnian, Ali M; Khader, Yousef S

2018-04-20

Subjects with obstructive sleep apnea (OSA) have neurocognitive dysfunction. The aim of this study was to estimate the prevalence of symptoms and risk of OSA among university students and the association with academic performance. A cross-sectional study was conducted at Jordan University of Science and Technology. Students from faculties of engineering, medicine, nursing, pharmacy, and dentistry were asked to participate in this study. The Berlin Sleep Questionnaire was used to report symptoms and risk of OSA. Below average cumulative scores were considered poor academic performance. A total of 777 students (51% female; mean age, 20 years) completed the study questionnaire. According to the study definition, 42 students (5.4%) had high risk for OSA. Snoring was reported by 11% and daytime sleepiness and fatigue by 30%. Compared to female students, male students had more snoring (14.6 vs. 7.6%, p = 0.002) and higher risk for OSA (6.5 vs. 1.6%, p = 0.001). Both self-reported snoring and being at high risk for OSA were associated with poor academic performance (27.9 vs. 11.6% and 23.1 vs. 9.2%, respectively; p < 0.02). After adjusting for confounding factors, the odds ratio of having poor academic performance in students at high risk for OSA was 2.4 (CI 1.11-5.2, p = 0.027). Snoring and OSA were uncommon among university students. However, both were more common among male students and were associated with poor academic performance.

[Obstructive Sleep Apnea Syndrom during pregnancy: prevalence of main symptoms and relationship with Pregnancy Induced-Hypertension and Intra-Uterine Growth Retardation].

PubMed

Calaora-Tournadre, D; Ragot, S; Meurice, J C; Pourrat, O; D'Halluin, G; Magnin, G; Pierre, F

2006-04-01

To investigate the frequency of main symptoms of Obstructive Sleep Apnea Syndrom (OSAS) and their relationship with Pregnancy Induced-Hypertension (PIH) as well as Intrauterine Growth Retardation (IGR) as suggested by recent studies. Four hundred (and) thirty-eight enquiry forms completed during post-partum period were analysed, after exclusion of multiple pregnancies. Collected data were demographic characteristics, obstetrical events, sleep disorders during last trimester, screening of snoring and vigilance troubles with an Epworth score. Forty-five percentages of the patients reported to have habitual snoring during pregnancy. Among these, 85% were non-snorers before pregnancy. Daytime somnolence concerned 84,5% of the population with an Epworth score significatively increased (P<0,0001). The prevalence of PIH was found to be 4,5%, with two apparently independent risk factors: the body mass index (OR=1,1) and an association between snoring and increased vigilance trouble (OR=2,6). No statistical difference was found concerning IGR. SAS symptoms are frequent during pregnancy and snoring appears to be linked with PIH. However, polysomnographic data are not yet sufficient to explain pathophysiological mechanisms and find relevant diagnostic markers during pregnancy.

Latest trends in the assessment and management of paediatric snoring and sleep apnoea.

PubMed

Sharma, S D; Kanona, H; Kumar, G; Kotecha, B

2016-05-01

To investigate the assessment and management of paediatric snoring and obstructive sleep apnoea in UK otolaryngology departments. A telephone questionnaire survey of UK otolaryngology departments was conducted over a 16-week period. The response rate was 61 per cent (85 out of 139 trusts). Use of pre-operative pulse oximetry was reported by 84 per cent of respondents, mainly to diagnose obstructive sleep apnoea (73 per cent) or stratify post-operative risk (46 per cent). Thirty-one per cent of respondents reported using post-operative pulse oximetry. Twenty-five per cent of respondents have a dedicated management protocol for paediatric obstructive sleep apnoea and snoring. Thirty-four per cent require prior clinical commissioning group approval before performing surgery. Fifty-eight per cent of respondents reported following up their obstructive sleep apnoea patients after surgery. The mean follow-up period (±standard deviation) was 6.8 ± 1.2 weeks. There is variation in the assessment and management of paediatric snoring and obstructive sleep apnoea across the UK, particularly in the use of pre- and post-operative pulse oximetry monitoring, and further guidelines regarding this are necessary.

Adverse health effects among women living with heavy snorers.

PubMed

Ulfberg, J; Carter, N; Talbäck, M; Edling, C

2000-03-01

Women living with heavy snorers were more frequently affected by symptoms of insomnia, morning headache, daytime sleepiness, and fatigue than women living with non-snorers. Questionnaire data were collected from 1,032 women 30 to 64 years of age residing in Dalarna county, in mid-Sweden. There were indications of a "dose-response relationship" between the conjectured sound exposure and reported symptoms, regardless of whether the female herself snored. Sleeping in separate bedrooms did not seem to give the women any alleviation. The results point to a possible contributory cause of disturbed sleep, morning headache, and daytime sleepiness among women living with a snoring spouse. The results also indicate that prevention and treatment of snoring are important issues for the couple as well as for the snorer.

Preschool Children with Obstructive Sleep Apnea: The Beginnings of Elevated Blood Pressure?

PubMed Central

Nisbet, Lauren C.; Yiallourou, Stephanie R.; Biggs, Sarah N.; Nixon, Gillian M.; Davey, Margot J.; Trinder, John A.; Walter, Lisa M.; Horne, Rosemary S. C.

2013-01-01

Study Objectives: In adults and older children, snoring and obstructive sleep apnea (OSA) are associated with elevated blood pressure (BP). However, BP has not been assessed in preschool children, the age of highest OSA prevalence. We aimed to assess overnight BP in preschool children with snoring and OSA using pulse transit time (PTT), an inverse continuous indicator of BP changes. Design: Overnight polysomnography including PTT. Children were grouped according to their obstructive apnea-hypopnea index (OAHI); control (no snoring, with OAHI of one event or less per hour), primary snoring (OAHI one event or less per hour), mild OSA (OAHI greater than one event to five events per hour) and moderate-severe OSA (OAHI more than five events per hour). Setting: Pediatric sleep laboratory. Patients: There were 128 clinically referred children (aged 3-5 years) and 35 nonsnoring community control children. Measurement and Results: PTT was averaged for each 30-sec epoch of rapid eye movement (REM) or nonrapid eye movement (NREM) sleep and normalized to each child's mean wake PTT. PTT during NREM was significantly higher than during REM sleep in all groups (P < 0.001 for all). During REM sleep, the moderate-severe OSA group had significantly lower PTT than the mild and primary snoring groups (P < 0.05 for both). This difference persisted after removal of event-related PTT changes. Conclusions: Moderate-severe OSA in preschool children has a significant effect on pulse transit time during REM sleep, indicating that these young children have a higher baseline BP during this state. We propose that the REM-related elevation in BP may be the first step toward development of daytime BP abnormalities. Given that increased BP during childhood predicts hypertension in adulthood, longitudinal studies are needed to determine the effect of resolution of snoring and/or OSA at this age. Citation: Nisbet LC; Yiallourou SR; Biggs SN; Nixon GM; Davey MJ; Trinder JA; Walter LM; Horne RSC. Preschool children with obstructive sleep apnea: the beginnings of elevated blood pressure? SLEEP 2013;36(8):1219-1226. PMID:23904682

Sleep disordered breathing and daytime sleepiness are associated with poor academic performance in teenagers. A study using the Pediatric Daytime Sleepiness Scale (PDSS).

PubMed

Perez-Chada, Daniel; Perez-Lloret, Santiago; Videla, Alejandro J; Cardinali, Daniel; Bergna, Miguel A; Fernández-Acquier, Mariano; Larrateguy, Luis; Zabert, Gustavo E; Drake, Christopher

2007-12-01

Inadequate sleep and sleep disordered breathing (SDB) can impair learning skills. Questionnaires used to evaluate sleepiness in adults are usually inadequate for adolescents. We conducted a study to evaluate the performance of a Spanish version of the Pediatric Daytime Sleepiness Scale (PDSS) and to assess the impact of sleepiness and SDB on academic performance. A cross-sectional survey of students from 7 schools in 4 cities of Argentina. A questionnaire with a Spanish version of the PDSS was used. Questions on the occurrence of snoring and witnessed apneas were answered by the parents. Mathematics and language grades were used as indicators of academic performance. The sample included 2,884 students (50% males; age: 13.3 +/- 1.5 years) Response rate was 85%; 678 cases were excluded due to missing data. Half the students slept <9 h per night on weekdays. The mean PDSS value was 15.74 +/- 5.93. Parental reporting of snoring occurred in 511 subjects (23%); snoring was occasional in 14% and frequent in 9%. Apneas were witnessed in 237 cases (11%), being frequent in 4% and occasional in 7%. Frequent snorers had higher mean PDSS scores than occasional or nonsnorers (18 +/- 5, 15.7 +/- 6 and 15.5 +/- 6, respectively; P < 0.001). Reported snoring or apneas and the PDSS were significant univariate predictors of failure and remained significant in multivariate logistic regression analysis after adjusting for age, sex, body mass index, specific school attended, and sleep habits. Insufficient hours of sleep were prevalent in this population. The Spanish version of the PDSS was a reliable tool in middle-school-aged children. Reports of snoring or witnessed apneas and daytime sleepiness as measured by PDSS were independent predictors of poor academic performance.

Prognosis for Spontaneous Resolution of OSA in Children

PubMed Central

Ellenberg, Susan S.; Hou, Xiaoling; Marcus, Carole L.; Garetz, Susan L.; Katz, Eliot S.; Hodges, Elise K.; Mitchell, Ron B.; Jones, Dwight T.; Arens, Raanan; Amin, Raouf; Redline, Susan; Rosen, Carol L.; Katz, Eliot; Ware, Janice; Jones, Dwight; Redline, Susan; Wang, Rui; Mitchell, Ron; Paruthi, Shalini; Snyder, Karen; Marcus, Carole; Thomas, Nina H.; Elden, Lisa; Amin, Raouf; Beebe, Dean; Willging, Paul; Arens, Raanan; Muzumdar, Hiren; Harris, Shelby; Rosen, Carol; Taylor, H. Gerry; Sprecher, Robert; Arnold, James; Gozal, David; Chervin, Ronald; Garetz, Susan; Giordani, Bruno; Hoban, Tim; Ellenberg, Susan; Moore, Reneé H.; Lacy, Kim

2015-01-01

BACKGROUND: Adenotonsillectomy (AT) is commonly performed for childhood OSA syndrome (OSAS), but little is known about prognosis without treatment. METHODS: The Childhood Adenotonsillectomy Trial (CHAT) randomized 50% of eligible children with OSAS to a control arm (watchful waiting), with 7-month follow-up symptom inventories, physical examinations, and polysomnography. Polysomnographic and symptomatic resolution were defined respectively by an apnea/hypopnea index (AHI) <2 and obstructive apnea index (OAI) <1 and by an OSAS symptom score (Pediatric Sleep Questionnaire [PSQ]) < 0.33 with ≥ 25% improvement from baseline. RESULTS: After 194 children aged 5 to 9 years underwent 7 months of watchful waiting, 82 (42%) no longer met polysomnographic criteria for OSAS. Baseline predictors of resolution included lower AHI, better oxygen saturation, smaller waist circumference or percentile, higher-positioned soft palate, smaller neck circumference, and non-black race (each P < .05). Among these, the independent predictors were lower AHI and waist circumference percentile < 90%. Among 167 children with baseline PSQ scores ≥ 0.33, only 25 (15%) experienced symptomatic resolution. Baseline predictors were low PSQ and PSQ snoring subscale scores; absence of habitual snoring, loud snoring, observed apneas, or a household smoker; higher quality of life; fewer attention-deficit/hyperactivity disorder symptoms; and female sex. Only lower PSQ and snoring scores were independent predictors. CONCLUSIONS: Many candidates for AT no longer have OSAS on polysomnography after 7 months of watchful waiting, whereas meaningful improvement in symptoms is not common. In practice, a baseline low AHI and normal waist circumference, or low PSQ and snoring score, may help identify an opportunity to avoid AT. TRIAL REGISTRY: ClinicalTrials.gov; No.: NCT00560859; URL: www.clinicaltrials.gov. PMID:25811889

Changes in emotional state of bed partners of snoring and obstructive sleep apnea patients following radiofrequency tissue ablation: a pilot study.

PubMed

Uloza, Virgilijus; Balsevicius, Tomas; Sakalauskas, Raimundas; Miliauskas, Skaidrius; Zemaitiene, Nida

2010-06-01

To test the hypothesis that obstructive sleep apnea/hypopnea syndrome (OSAHS) and snoring affect not only the patients but also their bed partners, resulting in increased severity of symptoms of depression and sleepiness that may improve after the patients receive radiofrequency tissue ablation (RFTA) treatment. Thirty-six snoring and/or OSAHS patients from 24 to 63 years of age (mean age 41.67 +/- 9.86 years) underwent full-night polysomnography (PSG) and two sessions of RFTA at palatal or palatal and tongue base levels. Follow-up PSG was carried out within the period of 2-3 months after the second RFTA session. The baseline and posttreatment clinical tests battery consisting of Spielberg's Trait-State Anxiety Inventory, Beck Depression Inventory-Second Edition (BDI-II), and Epworth Sleepiness Scale (ESS) were applied to assess the changes in emotional state of study group patient's bed partners. Mean apnea/hypopnea index decreased from 13.16 +/- 10.76 preoperatively to 10.69 +/- 8.28 postoperatively (p = 0.043) for the entire group of the patients. A statistically significant decrease of the mean BDI-II scores (12.69 +/- 7.66 preoperatively to 9.17 +/- 6.88 postoperatively, p < 0.005) for the entire group of the patients' bed partners was observed. There was no statistically significant difference between pre- and posttreatment mean daytime sleepiness scores in both OSAHS and in simple snoring patients' bed partners when measured with ESS. Based on present study results, we conclude that RFTA therapy results in improved depression scores for the bed partners of snoring and OSAHS patients during a short follow-up period, as measured with BDI-II.

Assessment of Snoring and obstructive sleep apnoea in a Nigerian university: Association with cardiovascular risk factors

PubMed Central

Akintunde, Adeseye A.; Salawu, Afolabi A.; Opadijo, Oladimeji G.

2014-01-01

Background: Snoring remains under diagnosed in general population. It however has significant morbidity and mortality risk factors with multiple effects on the cardiovascular system. The Berlin questionnaire is a worldwide validated instrument to identify those at increased risk for obstructive sleep apnoea (OSA). Materials and Methods: In all, 206 workers of LAUTECH were invited to participate in the study. The Berlin questionnaire was used for this study. It was a cross-sectional study. Socio-demographic and clinical data were taken with a data form. Statistical Package for the Social Sciences software (SPSS 17.0) was used for statistical analysis. P < 0.05 was taken as statistically significant value. Results: The study participants consisted of 96 males (46.6%) and 110 (53.4%) females. The mean age was 45.3 ± 7.9 years. The mean body mass index was 28.5 ± 6.0 kg/m². The frequency of occurrence of snoring was 91 (44.2%) including 50 males (54.9% and 41 females (37.3 %, P <0.05). Using the Berlin score, 63 (30.6%) including 34 females (30.9%) were assessed to be at high risk for OSA. Snorers were more likely to be at higher risk of OSA compared to non snorers: odd risk was 113.8, relative risk was 3.3. Snoring was most likely to be associated with obesity, elevated blood pressure and male gender in this study. Conclusion: We concluded that snoring and high risk for sleep apnoea is common among this unselected University population and they are closely related to many conventional cardiovascular risk factors. Appropriate interventional strategies are indicated to reduce the burden of the increased morbidity and mortality associated with sleep apnoea in our population. PMID:25538364

Analysis of respiratory events in obstructive sleep apnea syndrome: Inter-relations and association to simple nocturnal features.

PubMed

Ghandeharioun, H; Rezaeitalab, F; Lotfi, R

2016-01-01

This study carefully evaluates the association of different respiration-related events to each other and to simple nocturnal features in obstructive sleep apnea-hypopnea syndrome (OSAS). The events include apneas, hypopneas, respiratory event-related arousals and snores. We conducted a statistical study on 158 adults who underwent polysomnography between July 2012 and May 2014. To monitor relevance, along with linear statistical strategies like analysis of variance and bootstrapping a correlation coefficient standard error, the non-linear method of mutual information is also applied to illuminate vague results of linear techniques. Based on normalized mutual information weights (NMIW), indices of apnea are 1.3 times more relevant to AHI values than those of hypopnea. NMIW for the number of blood oxygen desaturation below 95% is considerable (0.531). The next relevant feature is "respiratory arousals index" with NMIW of 0.501. Snore indices (0.314), and BMI (0.203) take the next place. Based on NMIW values, snoring events are nearly one-third (29.9%) more dependent to hypopneas than RERAs. 1. The more sever the OSAS is, the more frequently the apneic events happen. 2. The association of snore with hypopnea/RERA revealed which is routinely ignored in regression-based OSAS modeling. 3. The statistical dependencies of oximetry features potentially can lead to home-based screening of OSAS. 4. Poor ESS-AHI relevance in the database under study indicates its disability for the OSA diagnosis compared to oximetry. 5. Based on poor RERA-snore/ESS relevance, detailed history of the symptoms plus polysomnography is suggested for accurate diagnosis of RERAs. Copyright © 2015 Sociedade Portuguesa de Pneumologia. Published by Elsevier España, S.L.U. All rights reserved.

Is passive smoking associated with sleep disturbance among pregnant women?

PubMed

Ohida, Takashi; Kaneita, Yoshitaka; Osaki, Yoneatsu; Harano, Satoru; Tanihata, Takeo; Takemura, Shinji; Wada, Kiyoshi; Kanda, Hideyuki; Hayashi, Kenji; Uchiyama, Makoto

2007-09-01

Pregnant women suffer from sleep disturbance, which may be aggravated by passive smoking. In this study we investigated the effects of passive smoking on sleep disturbance during pregnancy. Two cross-sectional questionnaire surveys conducted in 2002 and 2006. Clinical institutions specializing in obstetrics and gynecology that participated in the nationwide surveys: 260 in the 2002 survey and 344 in the 2006 survey. 16,396 and 19,386 pregnant women in Japan surveyed in 2002 and 2006, respectively. N/A. Pregnant women exposed to passive smoking were likely to have sleep disturbances, such as subjective insufficient sleep, difficulty in initiating sleep, short sleep duration, and snoring loudly/breathing uncomfortably. Smoking pregnant women had the same sleep disturbances and also experienced excessive daytime sleepiness and early morning awakening. The prevalence of 5 types of sleep disturbance (insufficient sleep, difficulty in initiating sleep, short sleep duration, excessive daytime sleepiness, and snoring loudly/breathing uncomfortably) among nonsmokers with environmental tobacco smoke showed a mean value intermediate between that of active smokers and that of nonsmokers without environmental tobacco smoke. Passive smoking is independently associated with increased sleep disturbance during pregnancy.

Prevalence of human papillomavirus and Epstein-Barr virus DNA in Chinese children with tonsillar and/or adenoidal hypertrophy.

PubMed

Xue, Xiao-cheng; Chen, Xiao-ping; Yao, Wen-hao; Zhang, Yi; Sun, Guang-bin; Tan, Xue-jun

2014-06-01

Tonsillar and adenoidal hypertrophy are prevalent otolaryngologic disorders in children, but their pathogenesis is largely unknown. The presence of human papillomavirus (HPV) and Epstein-Barr virus (EBV) DNA in 146 tonsil and/or adenoid tissue specimens from 104 Chinese children with tonsillar and/or adenoidal hypertrophy were screened using flow-through hybridization gene-chip technology and real-time fluorescence-based quantitative PCR. Then, the relationships between the prevalence of the viruses and other clinical characteristics of tonsillar and/or adenoidal hypertrophy were analyzed. No patient had HPV DNA. EBV DNA was detected in 19/42 (45.2%) tonsil tissues and 72/104 (69.2%) adenoid tissue specimens (P < 0.05). EBV DNA was not related to the patients' age, gender, disease course, or nationality, but children positive for EBV were less likely to snore; 14/15 (93.3%) patients who did not snore and 59/89 (66.3%) patients who snored were EBV positive. EBV DNA, but not HPV DNA was detected in Chinese children with tonsillar and/or adenoidal hypertrophy. Adenoid tissues might more susceptible than tonsil tissues to EBV infection. In addition, EBV infection did not aggravate snoring in patients with tonsillar and/or adenoidal hypertrophy. © 2014 Wiley Periodicals, Inc.

Accelerating Biomedical Signal Processing Using GPU: A Case Study of Snore Sound Feature Extraction.

PubMed

Guo, Jian; Qian, Kun; Zhang, Gongxuan; Xu, Huijie; Schuller, Björn

2017-12-01

The advent of 'Big Data' and 'Deep Learning' offers both, a great challenge and a huge opportunity for personalised health-care. In machine learning-based biomedical data analysis, feature extraction is a key step for 'feeding' the subsequent classifiers. With increasing numbers of biomedical data, extracting features from these 'big' data is an intensive and time-consuming task. In this case study, we employ a Graphics Processing Unit (GPU) via Python to extract features from a large corpus of snore sound data. Those features can subsequently be imported into many well-known deep learning training frameworks without any format processing. The snore sound data were collected from several hospitals (20 subjects, with 770-990 MB per subject - in total 17.20 GB). Experimental results show that our GPU-based processing significantly speeds up the feature extraction phase, by up to seven times, as compared to the previous CPU system.

The Efficacy of a Chinstrap in Treating Sleep Disordered Breathing and Snoring

PubMed Central

Bhat, Sushanth; Gushway-Henry, Neola; Polos, Peter G.; DeBari, Vincent A.; Riar, Sandeep; Gupta, Divya; Lysenko, Liudmila; Patel, Disha; Pi, Justin; Chokroverty, Sudhansu

2014-01-01

Study Objectives: A previously published case report suggested that a chinstrap alone might improve obstructive sleep apnea (OSA). We conducted this study to determine whether a chinstrap was a feasible alternative to continuous positive airway pressure (CPAP) in patients with OSA. Methods: 26 adult patients with OSA (apnea-hypopnea index [AHI] > 5/h on diagnostic polysomnogram [PSG]) underwent a modified split-night PSG, using only a chinstrap for the first 2 hours of sleep, followed by CPAP titration for the remainder of the night. Improvements in AHI, arterial oxygen saturation (SpO2), and snoring with chinstrap use were compared to results with optimal CPAP pressures. Results: There was no significant difference between the diagnostic PSG and the chinstrap portion of the split-night PSG in the following parameters: general AHI (median [IQR] 16.0/h [9.7-26.0] vs. 25.9/h [10.7-42.7]), SpO2 nadir (84.0% [80.5-87.5] vs. 87.0 [84.0-88.5]), AHI in REM sleep (26.7/h [16.8-43.7] vs. 42.4/h [21.3-57.7]), AHI in supine sleep (24.9/h [11.9-51.5] vs. 29.8/h [11.7-55.5]), snoring index (253.2/h [147.5-353.1] vs. 180.0/h [9.8-393.3]) or subjective snoring scale (3.0 [0.8-3.0] vs. 2.5 [0.4-3.0]). The AHI and SpO2 nadir in the 13 patients with mild OSA also did not improve with chinstrap use (9.6/h [8.1-12.2] vs. 10.6/h [6.8-35.4] and 87.0% [83.0-90.0] vs. 88.0% [87.0-89.0]). All these parameters showed significant improvement with optimal CPAP titration (p < 0.05). Conclusions: A chinstrap alone is not an effective treatment for OSA. It does not improve sleep disordered breathing, even in mild OSA, nor does it improve the AHI in REM sleep or supine sleep. It is also ineffective in improving snoring. Citation: Bhat S, Gushway-Henry N, Polos PG, DeBari VA, Riar S, Gupta D, Lysenko L, Patel D, Pi J, Chokroverty S. The efficacy of a chinstrap in treating sleep disordered breathing and snoring. J Clin Sleep Med 2014;10(8):887-892. PMID:25126035

Omission of polysomnography in treatment of snoring: common reasons and medico-legal implications.

PubMed

Goh, Y H; Choy, D K

2000-07-01

Although polysomnography (PSG) is an important investigation in the treatment of snorers, it was observed that a large number of patients did not have pre-operative PSG assessment in a tertiary hospital in Singapore. Of the 118 Asian patients who underwent surgery for snoring from January 1997 to December 1998, 36 (30.5 per cent) of patients did not have pre-operative PSG and only 21 (17.8 per cent) of patients had post-operative PSG. In this cohort, 43 (36.4 per cent) patients presented with snoring as their only complaint and not associated with symptoms indicative of obstructive sleep apnoea syndrome (OSAS). Thirty-one of these 'simple snorers' underwent sleep studies with the following outcome: two (6.5 per cent) true simple snorers, two (6.5 per cent) upper airway resistance syndrome, nine (29 per cent) mild OSAS, seven (22.6 per cent) moderate OSAS and 11 (35.5 per cent) severe OSAS. Our study showed that without the aid of PSG, it would be difficult to predict the severity of sleep apnoea based on clinical history alone. In an increasingly litigation-conscious society such as Singapore, there is therefore little justification in omitting PSG in the treatment of snoring. The common reasons for omission of pre-operative PSG and the medico-legal implications are also discussed.

Habitual snoring, intermittent hypoxia, and impaired behavior in primary school children.

PubMed

Urschitz, Michael S; Eitner, Steffen; Guenther, Anke; Eggebrecht, Esther; Wolff, Judith; Urschitz-Duprat, Pilar M; Schlaud, Martin; Poets, Christian F

2004-10-01

Sleep-disordered breathing is associated with impaired behavior and poor academic performance in children. We aimed to determine the extent of behavioral problems in snoring children, clarify the role of intermittent hypoxia, and test the reversibility of impaired behavior and poor academic performance. In 1144 children, habitual snoring (HS; snoring frequently or always) and impaired behavior were assessed using parental questionnaires. Intermittent hypoxia (ie, presence of > or =5 arterial oxygen desaturations by > or =4% or > or =1 desaturation to < or =90%) was investigated with pulse oximetry. Poor academic performance (grade 4-6 on a 6-point scale in mathematics, science, or spelling) was based on the last school report. HS, impaired behavior, and academic performance were reevaluated after 1 year. Adjusted odds ratios (ORs) were calculated using unconditional logistic regression. HS was significantly associated with hyperactive (OR: 2.4) and inattentive behavior (OR: 4.0), daytime tiredness (OR: 7.1), and sleepiness (OR: 2.6-4.8). These associations were independent of intermittent hypoxia. HS was also significantly associated with bad conduct (OR: 2.8), emotional symptoms (OR: 5.5), and peer problems (OR: 9.7). At follow-up, hyperactive and inattentive behavior but not academic success had significantly improved in children in whom HS had ceased. We suggest that impaired behavior is a key feature of HS independent of intermittent hypoxia and improves when HS ceases.

Sleep apnoea in heart failure: To treat or not to treat?

PubMed

Naughton, Matthew T; Kee, Kirk

2017-02-01

Heart failure (HF) and sleep apnoea are common disorders which frequently coexist. Two main types of apnoea occur: one is obstructive which, through recurring episodes of snoring, hypoxaemia, large negative intra-thoracic pressures and arousals from sleep leading to downstream inflammatory and autonomic nervous system changes, is thought to be a causative factor to the development of systemic hypertension and HF. The other type of apnoea, Cheyne-Stokes respiration with central sleep apnoea (CSR-CSA), is characterized by an oscillatory pattern of ventilation with a prevailing hyperventilation-induced hypocapnia, often in the absence of significant hypoxaemia and snoring, and is thought to be a consequence of advanced HF-related low cardiac output, high sympathetic nervous system activation and pulmonary congestion. CSR-CSA may be a compensatory response to advanced HF. Rostral fluid shift during sleep may play an important role in the pathogenesis of both obstructive sleep apnoea (OSA) and CSA. Studies of positive airway pressure (PAP) treatment of OSA and CSA in HF have shown short-term improvements in cardiac and autonomic function; however, there is no evidence of improved survival. Loop gain may provide useful marker of continuous PAP (CPAP) responsiveness in patients with central apnoea. A greater understanding of the pathophysiology of the interaction between obstructive and central apnoea and the various types of HF, and the mechanisms of therapies, such as PAP, is required to develop new strategies to overcome the disabling symptoms, and perhaps improve the mortality, that accompany HF with sleep apnoea. © 2016 Asian Pacific Society of Respirology.

Laser plaltopharyngoplasty (LPPP)

NASA Astrophysics Data System (ADS)

Ru, Yi-zhong; Hu, Zai-Wen

1998-11-01

The snoring disease is apt to give rise to the obstructive seep apnea syndrome. Its clinical feature is noisy stertorous breathing during sleeping, accompanied with frequency stoppages of breathing. As the sufferer is subjected to a state of chronic anoxemia during the night, he is liable to spiritlessness, obliviousness, and disordered sensibility in the day. Arrhythmia, hypertension, etc. may follow in severer case. We have obtained satisfactory therapeutic effects by laser palatopharyngoplasty on 20 cases of snoring disease for the period February 1992 - January 1996.

Italian recommendations on dental support in the treatment of adult obstructive sleep apnea syndrome (OSAS)

PubMed Central

Levrini, Luca; Sacchi, Franco; Milano, Francesca; Polimeni, Antonella; Cozza, Paolo; Bernkopf, Edoardo; Segù, Marzia; Zucconi, Marco; Vicini, Claudio; Brunello, Enrico

2015-01-01

Summary Background The aim of the present article is to present a set of proposed clinical recommendations aimed at Italian dentists involved in the management of patients with obstructive sleep apnea syndrome or snoring. Methods With the purpose of creating a study group, some of the most important Italian scientific societies operating in fields relevant to the issue of sleep medicine in dentistry were asked to appoint a representative. Each member of the study group was required to answer questions regarding the clinical management of OSAS and snoring. Results Oral appliances can be used to treat: - simple snoring, in patients who do not respond to, or do not appear to be suitable candidates for behavioral measures such as weight loss or positional therapy; - mild or moderate OSAS, in patients who prefer OAs to continuous positive airway pressure (CPAP) or who are not suitable candidates for CPAP, because of its failure or failure of behavioral approaches like weight loss or positional therapy; - severe OSAS, in patients who do not respond to or do not tolerate CPAP and in whom no indication for either maxillofacial or ENT surgery appears applicable. Conclusions The application of oral appliances is highly desirable in cases of simple snoring or mild to moderate OSAS, whereas considerable caution is warranted when treating severe OSAS. It is fundamental to ensure that the patient understands his problem and, at the same time, to present all the various treatment options. PMID:26941893

Epidemiology of pediatric obstructive sleep apnea.

PubMed

Lumeng, Julie C; Chervin, Ronald D

2008-02-15

Pediatric obstructive sleep apnea (OSA) has become widely recognized only in the last few decades as a likely cause of significant morbidity among children. Many of the clinical characteristics of pediatric OSA, and the determinants of its epidemiology, differ from those of adult OSA. We systematically reviewed studies on the epidemiology of conditions considered part of a pediatric sleep-disordered breathing (SDB) continuum, ranging from primary snoring to OSA. We highlight a number of methodologic challenges, including widely variable methodologies for collection of questionnaire data about symptomatology, definitions of habitual snoring, criteria for advancing to further diagnostic testing, and objective diagnostic criteria for SDB or OSA. In the face of these limitations, estimated population prevalences are as follows: parent-reported "always" snoring, 1.5 to 6%; parent-reported apneic events during sleep, 0.2 to 4%; SDB by varying constellations of parent-reported symptoms on questionnaire, 4 to 11%; OSA diagnosed by varying criteria on diagnostic studies, 1 to 4%. Overall prevalence of parent-reported snoring by any definition in meta-analysis was 7.45% (95% confidence interval, 5.75-9.61). A reasonable preponderance of evidence now suggests that SDB is more common among boys than girls, and among children who are heavier than others, with emerging data to suggest a higher prevalence among African Americans. Less convincing data exist to prove differences in prevalence based on age. We conclude by outlining specific future research needs in the epidemiology of pediatric SDB.

Novel porous oral patches for patients with mild obstructive sleep apnea and mouth breathing: a pilot study.

PubMed

Huang, Tsung-Wei; Young, Tai-Horng

2015-02-01

Habitual open-mouth breathing (OMB) during sleep can cause snoring and obstructive sleep apnea (OSA). This study used a porous oral patch (POP) to treat patients with mild OSA and OMB during sleep. The subjective and objective outcomes were evaluated. Prospective study. Tertiary referral center. Patients with ≥5 events hourly but <15 hourly on the apnea-hypopnea index (AHI) were enrolled. All patients slept with their mouths closed by using the POP, which is a porous skin pad consisting of 3 layers: silicone sheet, polyurethane foam, and polyurethane film. Before treatment and during treatment, subjective outcomes were assessed using the Epworth Sleepiness Scale (ESS) and visual analog scale (VAS) of snoring. Objective outcomes were assessed using polysomnography and cephalometry. Thirty patients were enrolled in this study. All patients slept with their mouths closed while using a POP. The ESS and VAS of snoring scores were 8.1 ± 1.5 and 7.5 ± 2.0 before the POP, respectively, in contrast to 5.2 ± 1.6 and 2.4 ± 1.4 while using a POP, respectively (P < .05). The median AHI score was significantly decreased by using a POP from 12.0 per hour before treatment to 7.8 per hour during treatment (P < .01). The snoring intensity and median snoring index were 49.1 ± 10.8 dB and 146.7 per hour before the POP, respectively, which decreased to 41.1 ± 7.8 dB and 40.0 per hour while using a POP, respectively (P < .01). Cephalometry revealed that the retropalatal space and retrolingual space were 7.4 ± 1.6 mm and 6.8 ± 2.5 mm before the POP, respectively, compared with 8.6 ± 1.2 mm and 10.2 ± 1.8 mm during treatment, respectively (P < .01). The POP is a useful device to treat patients with mild OSA and habitual OMB. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2014.

The efficacy of a chinstrap in treating sleep disordered breathing and snoring.

PubMed

Bhat, Sushanth; Gushway-Henry, Neola; Polos, Peter G; DeBari, Vincent A; Riar, Sandeep; Gupta, Divya; Lysenko, Liudmila; Patel, Disha; Pi, Justin; Chokroverty, Sudhansu

2014-08-15

A previously published case report suggested that a chinstrap alone might improve obstructive sleep apnea (OSA). We conducted this study to determine whether a chinstrap was a feasible alternative to continuous positive airway pressure (CPAP) in patients with OSA. 26 adult patients with OSA (apnea-hypopnea index [AHI] > 5/h on diagnostic polysomnogram [PSG]) underwent a modified split-night PSG, using only a chinstrap for the first 2 hours of sleep, followed by CPAP titration for the remainder of the night. Improvements in AHI, arterial oxygen saturation (SpO2), and snoring with chinstrap use were compared to results with optimal CPAP pressures. There was no significant difference between the diagnostic PSG and the chinstrap portion of the split-night PSG in the following parameters: general AHI (median [IQR] 16.0/h [9.7-26.0] vs. 25.9/h [10.7-42.7]), SpO2 nadir (84.0% [80.5-87.5] vs. 87.0 [84.0-88.5]), AHI in REM sleep (26.7/h [16.8-43.7] vs. 42.4/h [21.3-57.7]), AHI in supine sleep (24.9/h [11.9-51.5] vs. 29.8/h [11.7-55.5]), snoring index (253.2/h [147.5-353.1] vs. 180.0/h [9.8-393.3]) or subjective snoring scale (3.0 [0.8-3.0] vs. 2.5 [0.4-3.0]). The AHI and SpO2 nadir in the 13 patients with mild OSA also did not improve with chinstrap use (9.6/h [8.1-12.2] vs. 10.6/h [6.8-35.4] and 87.0% [83.0-90.0] vs. 88.0% [87.0-89.0]). All these parameters showed significant improvement with optimal CPAP titration (p < 0.05). A chinstrap alone is not an effective treatment for OSA. It does not improve sleep disordered breathing, even in mild OSA, nor does it improve the AHI in REM sleep or supine sleep. It is also ineffective in improving snoring.

Sleep Disordered Breathing And Daytime Sleepiness Are Associated With Poor Academic Performance In Teenagers. A Study Using The Pediatric Daytime Sleepiness Scale (PDSS)

PubMed Central

Perez-Chada, Daniel; Perez-Lloret, Santiago; Videla, Alejandro J.; Cardinali, Daniel; Bergna, Miguel A.; Fernández-Acquier, Mariano; Larrateguy, Luis; Zabert, Gustavo E.; Drake, Christopher

2007-01-01

Study Objectives: Inadequate sleep and sleep disordered breathing (SDB) can impair learning skills. Questionnaires used to evaluate sleepiness in adults are usually inadequate for adolescents. We conducted a study to evaluate the performance of a Spanish version of the Pediatric Daytime Sleepiness Scale (PDSS) and to assess the impact of sleepiness and SDB on academic performance. Design: A cross-sectional survey of students from 7 schools in 4 cities of Argentina. Measurements: A questionnaire with a Spanish version of the PDSS was used. Questions on the occurrence of snoring and witnessed apneas were answered by the parents. Mathematics and language grades were used as indicators of academic performance. Participants: The sample included 2,884 students (50% males; age: 13.3 ± 1.5 years) Results: Response rate was 85%; 678 cases were excluded due to missing data. Half the students slept <9 h per night on weekdays. The mean PDSS value was 15.74 ± 5.93. Parental reporting of snoring occurred in 511 subjects (23%); snoring was occasional in 14% and frequent in 9%. Apneas were witnessed in 237 cases (11%), being frequent in 4% and occasional in 7%. Frequent snorers had higher mean PDSS scores than occasional or nonsnorers (18 ± 5, 15.7 ± 6 and 15.5 ± 6, respectively; P < 0.001). Reported snoring or apneas and the PDSS were significant univariate predictors of failure and remained significant in multivariate logistic regression analysis after adjusting for age, sex, body mass index, specific school attended, and sleep habits. Conclusions: Insufficient hours of sleep were prevalent in this population. The Spanish version of the PDSS was a reliable tool in middle–school-aged children. Reports of snoring or witnessed apneas and daytime sleepiness as measured by PDSS were independent predictors of poor academic performance. Citation: Perez-Chada D; Perez-Lloret S; Videla AJ; Cardinali D; Bergna MA; Fernández-Acquier M; Larrateguy L; Zabert GE; Drake C. Sleep disordered breathing and daytime sleepiness are associated with poor academic performance in teenagers. A study using the pediatric daytime sleepiness scale (PDSS). SLEEP 2007;30(12):1698-1703. PMID:18246979

Physics-based analysis and control of human snoring

NASA Astrophysics Data System (ADS)

Sanchez, Yaselly; Wang, Junshi; Han, Pan; Xi, Jinxiang; Dong, Haibo

2017-11-01

In order to advance the understanding of biological fluid dynamics and its effects on the acoustics of human snoring, the study pursued a physics-based computational approach. From human magnetic resonance image (MRI) scans, the researchers were able to develop both anatomically and dynamically accurate airway-uvula models. With airways defined as rigid, and the uvula defined as flexible, computational models were created with various pharynx thickness and geometries. In order to determine vortex shedding with prescribed uvula movement, the uvula fluctuation was categorized by its specific parameters: magnitude, frequency, and phase lag. Uvula vibration modes were based on one oscillation, or one harmonic frequency, and pressure probes were located in seven different positions throughout the airway-uvula model. By taking fast Fourier transforms (FFT) from the pressure probe data, it was seen that four harmonics were created throughout the simulation within one oscillation of uvula movement. Of the four harmonics, there were two pressure probes which maintained high amplitudes and led the researcher to believe that different vortices formed with different snoring frequencies. This work is supported by the NSF Grant CBET-1605434.

Sleep duration, snoring habits, and cardiovascular disease risk factors in an ethnically diverse population.

PubMed

Mosca, Matthew; Aggarwal, Brooke

2012-01-01

Lack of sleep has been associated with an increased risk for cardiovascular disease (CVD) and all-cause mortality, but the mechanisms are not fully understood. Prior research has often been conducted in select populations and has not consistently adjusted for confounders, especially psychosocial factors. The aims of this study were to assess the association between sleep habits and established risk factors for CVD and to evaluate potential interactions by race and gender. Participants were part of a CVD screening and educational outreach program in New York City. Free-living men older than 40 years and women older than 50 years (n = 371, mean age = 60 years, 57% women, 60% racial/ethnic minorities) were systematically assessed for CVD risk (including traditional, lifestyle, and psychosocial risk factors) and completed a standardized questionnaire regarding sleep habits (including sleep duration and snoring). Lipids were analyzed by validated finger-stick technology. Stress at work and at home was assessed using a validated screening tool from the INTERHEART study. Associations between participants' sleep habits and CVD risk factors/demographic factors were assessed using multivariable logistic regression. The proportion of participants who reported sleeping less than 6 hours per night on average was 28%, and 52% of participants reported snoring. Sleeping less than 6 hours per night was significantly (P < .05) associated with female gender, being single, increased stress at home, increased financial stress, and low-density lipoprotein cholesterol (LDL-C) level. Gender modified the association between sleep duration and LDL-C level (P = .04): Sleeping less than 6 hours per night was significantly associated with reduced LDL-C level among women and increased LDL-C level among men. Snoring was significantly associated with low high-density lipoprotein cholesterol (HDL-C) level (<40 mg/dL for men/<50 mg/dL for women), being married, increased stress at work and at home, less than 30 minutes of exercise per day, less than 5 servings of fruits and vegetables per day, and being overweight/obese (body mass index ≥25 kg/m). The association between snoring and low HDL-C level remained significant in logistic regression models adjusted for demographic confounders (odds ratio, 1.83; 95% confidence interval, 1.06-3.19) but not after adjustment for body mass index greater than 25 kg/m. Sleeping less than 6 hours per night was associated with several traditional and psychosocial CVD risk factors, and snoring was associated with low HDL-C level, likely mediated through overweight/obesity. These data may have significance for health care providers to identify individuals who may be at increased CVD risk based on sleep habits.

All APAPs Are Not Equivalent for the Treatment of Sleep Disordered Breathing: A Bench Evaluation of Eleven Commercially Available Devices.

PubMed

Zhu, Kaixian; Roisman, Gabriel; Aouf, Sami; Escourrou, Pierre

2015-07-15

This study challenged on a bench-test the efficacy of auto-titrating positive airway pressure (APAP) devices for obstructive sleep disordered breathing treatment and evaluated the accuracy of the device reports. Our bench consisted of an active lung simulator and a Starling resistor. Eleven commercially available APAP devices were evaluated on their reactions to single-type SDB sequences (obstructive apnea and hypopnea, central apnea, and snoring), and to a long general breathing scenario (5.75 h) simulating various SDB during four sleep cycles and to a short scenario (95 min) simulating one sleep cycle. In the single-type sequence of 30-minute repetitive obstructive apneas, only 5 devices normalized the airflow (> 70% of baseline breathing amplitude). Similarly, normalized breathing was recorded with 8 devices only for a 20-min obstructive hypopnea sequence. Five devices increased the pressure in response to snoring. Only 4 devices maintained a constant minimum pressure when subjected to repeated central apneas with an open upper airway. In the long general breathing scenario, the pressure responses and the treatment efficacy differed among devices: only 5 devices obtained a residual obstructive AHI < 5/h. During the short general breathing scenario, only 2 devices reached the same treatment efficacy (p < 0.001), and 3 devices underestimated the AHI by > 10% (p < 0.001). The long scenario led to more consistent device reports. Large differences between APAP devices in the treatment efficacy and the accuracy of report were evidenced in the current study. © 2015 American Academy of Sleep Medicine.

Sleep History and Hypertension Burden in First-Generation Chinese Migrants Settled in Italy: The CHIinese In Prato Cross-Sectional Survey

PubMed Central

Modesti, Pietro A.; Calabrese, Maria; Perruolo, Eleonora; Bussotti, Alessandro; Malandrino, Danilo; Bamoshmoosh, Mohamed; Biggeri, Annibale; Zhao, Dong

2016-01-01

Abstract Migration flows from China are largely directed towards the South of Europe, Chinese being now the third largest overseas-born population in Italy. The aim of the study was to investigate hypertension burden and self-reported sleep disorders among 1608 first-generation Chinese migrants aged 16 to 59 years settled in Prato and recruited in a cross-sectional survey. Hypertension was defined as systolic BP ≥140 mm Hg and/or diastolic BP ≥90 mm Hg or self-reported antihypertensive treatment; potential impact of sleep disorders was analyzed by logistic regression adjusted for age, sex, marital status, education, health insurance, current smoking, parental hypertension, alcohol drinking, overweight or obesity, central obesity, diabetes, high total cholesterol, and high triglycerides. Among the 1608 participants, 21.7% were hypertensive (age-standardized prevalence 19.2%; 95% Cl: 18.5–20.0); 54% of hypertensive subjects were aware of their condition; 70% of aware hypertensive subjects received drugs, and 39% of treated subjects had blood pressure controlled. Self-reported snoring increased the risk of hypertension; when compared with no snoring, the age- and sex-adjusted OR for hypertension of snoring 3 to 6 d/week was 2.11 (95% Cl: 1.48–3.01) and 2.48 (95% Cl: 1.79–3.46) of snoring every day. When compared with a sleep duration ≤5 hours, subjects with sleep duration of 7 hours had reduced risk of high triglycerides (adjusted OR: 0.66; 95% Cl: 0.43–0.95). Despite a high level of awareness, low treatment rates for hypertension were observed among Chinese participants, independently of health insurance. Sleep history is to be considered in screening and prevention programs. PMID:27057856

Characteristics and correlates of sleep duration, daytime napping, snoring and insomnia symptoms among 0.5 million Chinese men and women.

PubMed

Chen, Yiping; Kartsonaki, Christiana; Clarke, Robert; Guo, Yu; Yu, Canqing; Bian, Zheng; Jiang, Qilian; Li, Shanpeng; Chen, Junshi; Li, Liming; Chen, Zhengming

2018-04-01

Inadequate sleep duration and insomnia can affect both physical and mental health. There is limited evidence, however, on characteristics and correlates of sleep patterns and insomnia in urban and rural China. This cross-sectional study, involving 512,891 adults aged 30-79 years from ten (five urban and five rural) diverse areas in China, recorded detailed information, using interviewer-administered laptop-based questionnaires, on sleep patterns (duration, daytime napping and snoring) and insomnia symptoms. Logistic regression was used to examine the associations of sleep patterns and insomnia symptoms with a range of socio-economic, lifestyle, behaviour and health-related factors. Overall, the mean (SD) sleep duration was 7.38 (1.37) h, with 23% reporting short (≤6 h) and 16% reporting long (≥9 h) sleep duration, 21% taking daytime naps and 22% having frequent snoring. Overall, 17% reported having insomnia symptoms, with a higher proportion in women than in men (19% vs 13%), in rural than in urban residents (19% vs 15%), and in individuals who were living alone (23%). The adjusted odds ratios (ORs) of having insomnia symptoms were significantly higher among people with major depressive episodes (6.10, 95% CI: 5.69-6.55), generalised anxiety disorders (7.46, 6.65-8.37) and any chronic diseases (1.46; 1.44-1.49). In contrast, the ORs of insomnia symptoms were significantly lower among those reporting napping (0.77, 0.75-0.78) and frequent snoring (0.86, 0.84-0.87). Among Chinese adults, sleep patterns varied greatly by socio-economic, lifestyle and health-related factors. The risk of insomnia symptoms was associated with both poor mental and physical health status. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

Long-Term Improvements in Sleep and Respiratory Parameters in Preschool Children Following Treatment of Sleep Disordered Breathing.

PubMed

Walter, Lisa M; Biggs, Sarah N; Nisbet, Lauren C; Weichard, Aidan J; Hollis, Samantha L; Davey, Margot J; Anderson, Vicki; Nixon, Gillian M; Horne, Rosemary S C

2015-10-15

Sleep disordered breathing (SDB) in preschool-aged children is common, but long-term outcomes have not been investigated. We aimed to compare sleep and respiratory parameters in preschool children to examine the effects of treatment or non-treatment after 3 years. Children (3-5 years) diagnosed with SDB (n = 45) and non-snoring controls (n = 30) returned for repeat overnight polysomnography (39% of original cohort), 3 years following baseline polysomnography. Children with SDB were grouped according to whether they had received treatment or not. SDB resolution was defined as an obstructive apnea hypopnea index (OAHI) ≤ 1 event/h, no snoring detected on polysomnography and habitual snoring not indicated by parents on questionnaire. Fifty-one percent (n = 23) of the children with SDB were treated. Overall, SDB resolved in 49% (n = 22), either spontaneously (n = 8) or with treatment (n = 14). SDB remained unresolved in 39% (n = 9) of those treated and 64% (n = 14) of the children who were untreated. Two of the non-snoring controls developed SDB at follow-up. The treated group had significantly lower OAHI (p < 0.01), respiratory disturbance index (p < 0.001), total arousal and respiratory arousal indices (p < 0.01 for both) at follow-up compared with baseline. There were no differences between studies for the untreated group. Although treatment resulted in an improvement in indices related to SDB severity, 39% had SDB 3 years following diagnosis. These findings highlight that parents should be made aware of the possibility that SDB may persist or recur several years after treatment. This is relevant regardless of the severity of SDB at baseline and the treatment given. © 2015 American Academy of Sleep Medicine.

Pharmacological treatment of obstructive sleep apnea with a combination of pseudoephedrine and domperidone.

PubMed

Larrain, Augusto; Kapur, Vishesh K; Gooley, Ted A; Pope, Charles E

2010-04-15

To determine the effect of the drug combination domperidone and pseudoephedrine on nocturnal oximetry measurements and daytime sleepiness in patients with obstructive sleep apnea. We recruited patients with severe snoring and apneic episodes willing to undergo repeated nocturnal oximetry testing. Following baseline clinical history, Epworth Sleepiness Scale administration, and home overnight nocturnal oximetry, patients were started on weight-adjusted doses of domperidone and pseudoephedrine. Follow-up oximetry studies were performed at the patient's convenience. On the final visit, a repeat clinical history, Epworth score, and oximetry were obtained. Seventeen of 23 patients noted disappearance of snoring and apneic episodes. Another 2 patients reported improvement in snoring and no apneic episodes. All but one patient had a decrease in Epworth scores (mean decrease 9.4 (95% CI, 6.8-12.1, p < 0.0001). Mean oxygen saturation (2.5; 95% Cl, 0.66-4.41, p = 0.008), percent time with oxygen saturation < 90% (14.8; 95% CI, 24.4 to 5.2, p = 0.003), and the 4% oxygen desaturation index (18.2; 95% CI, 27.3 to 9.1, p < 0.0001) improved significantly. No adverse effects of treatment were noted. The combination of domperidone and pseudoephedrine improved self reported snoring and sleepiness, and may have improved apneic episodes and sleep-related nocturnal oxygen desaturation in patients with obstructive sleep apnea provided the proportion of time spent asleep did not diminish. This drug combination warrants further study as a treatment for obstructive sleep apnea. Obstructive sleep apnea; oximetry; sleepiness; domperidone; pseudoephedrine; pharmacotherapy; desaturation; treatment Larrain A; Kapur VK; Gooley TA; Pope CE. Pharmacological treatment of obstructive sleep apnea with a combination of pseudoephedrine and domperidone.

Pharmacological Treatment of Obstructive Sleep Apnea with a Combination of Pseudoephedrine and Domperidone

PubMed Central

Larrain, Augusto; Kapur, Vishesh K.; Gooley, Ted A.; Pope, Charles E.

2010-01-01

Study Objectives: To determine the effect of the drug combination domperidone and pseudoephedrine on nocturnal oximetry measurements and daytime sleepiness in patients with obstructive sleep apnea. Methods: We recruited patients with severe snoring and apneic episodes willing to undergo repeated nocturnal oximetry testing. Following baseline clinical history, Epworth Sleepiness Scale administration, and home overnight nocturnal oximetry, patients were started on weight-adjusted doses of domperidone and pseudoephedrine. Follow-up oximetry studies were performed at the patient's convenience. On the final visit, a repeat clinical history, Epworth score, and oximetry were obtained. Results: Sixteen of 23 patients noted disappearance of snoring and apneic episodes. Another 3 patients reported improvement in snoring and no apneic episodes. All but one patient had a decrease in Epworth scores (mean decrease 9.9 (95% CI, 7.2-12.6, p < 0.0001). Mean oxygen saturation (2.5; 95% CI, 0.66-4.41, p = 0.008), percent time with oxygen saturation < 90% (14.8; 95% CI, 24.4 to 5.2, p = 0.003), and the 4% oxygen desaturation index (18.2; 95% CI, 27.3 to 9.1, p < 0.0001) improved significantly. No adverse effects of treatment were noted. Conclusions: The combination of domperidone and pseudoephedrine improved self reported snoring and sleepiness, and may have improved apneic episodes and sleep-related nocturnal oxygen desaturation in patients with obstructive sleep apnea provided the proportion of time spent asleep did not diminish. This drug combination warrants further study as a treatment for obstructive sleep apnea. Citation: Larrain A; Kapur VK; Gooley TA; Pope CE. Pharmacological treatment of obstructive sleep apnea with a combination of pseudoephedrine and domperidone. J Clin Sleep Med 2010;6(2):117-123. PMID:20411686

Sleep disturbances and cognitive decline in the Northern Manhattan Study

PubMed Central

Ramos, Alberto R.; Gardener, Hannah; Rundek, Tatjana; Elkind, Mitchell S.V.; Boden-Albala, Bernadette; Dong, Chuanhui; Cheung, Ying Kuen; Stern, Yaakov; Sacco, Ralph L.

2016-01-01

Objective: To examine frequent snoring, sleepiness, and sleep duration with baseline and longitudinal performance on neuropsychological (NP) battery. Methods: The analysis consists of 711 participants of the Northern Manhattan Study (NOMAS) with sleep data and NP assessment (age 63 ± 8 years, 62% women, 18% white, 17% black, 67% Hispanic) and 687 with repeat NP testing (at a mean of 6 ± 2 years). The main exposures were snoring, sleepiness, and sleep duration obtained during annual follow-up. Using factor analysis–derived domain-specific Z scores for episodic memory, language, executive function, and processing speed, we constructed multivariable regression models to evaluate sleep symptoms with baseline NP performance and change in performance in each NP domain. Results: In the cross-sectional analysis, adjusting for demographics and the NOMAS vascular risk score, participants with frequent snoring had worse executive function (β = −12; p = 0.04) and processing speed (β = −13; p = 0.02), but no difference in with episodic memory or language. Those with severe daytime sleepiness (β = −26; p = 0.009) had worse executive function, but no changes in the other NP domains. There was no cross-sectional association between sleep duration and NP performance. Frequent snoring (β = −29; p = 0.0007), severe daytime sleepiness (β = −29; p = 0.05), and long sleep duration (β = −29; p = 0.04) predicted decline in executive function, adjusting for demographic characteristics and NOMAS vascular risk score. Sleep symptoms did not explain change in episodic memory, language, or processing speed. Conclusions: In this race-ethnically diverse community-based cohort, sleep symptoms led to worse cognitive performance and predicted decline in executive function. PMID:27590286

SNORAP: A Device for the Correction of Impaired Sleep Health by Using Tactile Stimulation for Individuals with Mild and Moderate Sleep Disordered Breathing.

PubMed

Yağanoğlu, Mete; Kayabekir, Murat; Köse, Cemal

2017-09-01

Sleep physiology and sleep hygiene play significant roles in maintaining the daily lives of individuals given that sleep is an important physiological need to protect the functions of the human brain. Sleep disordered breathing (SDB) is an important disease that disturbs this need. Snoring and Obstructive Sleep Apnea Syndrome (OSAS) are clinical conditions that affect all body organs and systems that intermittently, repeatedly, with at least 10 s or more breathing stops that decrease throughout the night and disturb sleep integrity. The aim of this study was to produce a new device for the treatment of patients especially with position and rapid eye movement (REM)-dependent mild and moderate OSAS. For this purpose, the main components of the device (the microphone (snore sensor), the heart rate sensor, and the vibration motor, which we named SNORAP) were applied to five volunteer patients (male, mean age: 33.2, body mass index mean: 29.3). After receiving the sound in real time with the microphone, the snoring sound was detected by using the Audio Fingerprint method with a success rate of 98.9%. According to the results obtained, the severity and the number of the snoring of the patients using SNORAP were found to be significantly lower than in the experimental conditions in the apnea hypopnea index (AHI), apnea index, hypopnea index, in supine position's AHI, and REM position's AHI before using SNORAP (Paired Sample Test, p < 0.05). REM sleep duration and nocturnal oxygen saturation were significantly higher when compared to the group not using the SNORAP (Paired Sample Test, p < 0.05).

[Current research of dentistry on obstructive sleep apnea hypopnea syndrome].

PubMed

Zeng, Xiang-long; Gao, Xue-mei

2009-02-18

Obstructive sleep apnea hypopnea syndrome (OSAHS) has been the main research area of the Dental Therapy Center for Sleep Apnea, Peking University School and Hospital of Stomatology. The basic research in the center includes: epidemic survey of OSAHS and snoring in a Beijing population, setting up the cephalometric and MRI standard of airway and surrounding structures for non-snoring Chinese, aetology exploring OSAHS from views of airway size, craniofacial form, neck circumference and genioglossus muscle activity. Clinically, different dental appliances were developed. The treatment effects of the oral appliances for OSAHS patients were evaluated quantitatively. Two and three dimension changes of the airway and surrounding structures, genioglossus muscle activity, as well as snoring loudness following mandible advancing and opening were studied. Besides, research was expended to OSAHS in children recently. Under the support of National Nature Science Foundation 7 PhD and 3 MS students have graduated. More than 60 papers were published domestically and abroad and two awards were received from the National Ministry of Education and Chinese Medical Association in the past 10 years. This paper is a review of the past and current situation of dental research on OSAHS in China.

Is Passive Smoking Associated With Sleep Disturbance Among Pregnant Women?

PubMed Central

Ohida, Takashi; Kaneita, Yoshitaka; Osaki, Yoneatsu; Harano, Satoru; Tanihata, Takeo; Takemura, Shinji; Wada, Kiyoshi; Kanda, Hideyuki; Hayashi, Kenji; Uchiyama, Makoto

2007-01-01

Study Objective: Pregnant women suffer from sleep disturbance, which may be aggravated by passive smoking. In this study we investigated the effects of passive smoking on sleep disturbance during pregnancy. Design: Two cross-sectional questionnaire surveys conducted in 2002 and 2006. Setting: Clinical institutions specializing in obstetrics and gynecology that participated in the nationwide surveys: 260 in the 2002 survey and 344 in the 2006 survey. Participants: 16,396 and 19,386 pregnant women in Japan surveyed in 2002 and 2006, respectively. Intervention: N/A. Measurements and Results: Pregnant women exposed to passive smoking were likely to have sleep disturbances, such as subjective insufficient sleep, difficulty in initiating sleep, short sleep duration, and snoring loudly/breathing uncomfortably. Smoking pregnant women had the same sleep disturbances and also experienced excessive daytime sleepiness and early morning awakening. The prevalence of 5 types of sleep disturbance (insufficient sleep, difficulty in initiating sleep, short sleep duration, excessive daytime sleepiness, and snoring loudly/breathing uncomfortably) among nonsmokers with environmental tobacco smoke showed a mean value intermediate between that of active smokers and that of nonsmokers without environmental tobacco smoke. Conclusion: Passive smoking is independently associated with increased sleep disturbance during pregnancy. Citation: Ohida T; Kaneita Y; Osaki Y; Harano S; Tanihata T; Takemura S; Wada K; Kanda H; Hayashi K; Uchiyama M. Is passive smoking associated with sleep disturbance among pregnant women? SLEEP 2007;30(9):1155-1161. PMID:17910387

All APAPs Are Not Equivalent for the Treatment of Sleep Disordered Breathing: A Bench Evaluation of Eleven Commercially Available Devices

PubMed Central

Zhu, Kaixian; Roisman, Gabriel; Aouf, Sami; Escourrou, Pierre

2015-01-01

Study Objectives: This study challenged on a bench-test the efficacy of auto-titrating positive airway pressure (APAP) devices for obstructive sleep disordered breathing treatment and evaluated the accuracy of the device reports. Methods: Our bench consisted of an active lung simulator and a Starling resistor. Eleven commercially available APAP devices were evaluated on their reactions to single-type SDB sequences (obstructive apnea and hypopnea, central apnea, and snoring), and to a long general breathing scenario (5.75 h) simulating various SDB during four sleep cycles and to a short scenario (95 min) simulating one sleep cycle. Results: In the single-type sequence of 30-minute repetitive obstructive apneas, only 5 devices normalized the airflow (> 70% of baseline breathing amplitude). Similarly, normalized breathing was recorded with 8 devices only for a 20-min obstructive hypopnea sequence. Five devices increased the pressure in response to snoring. Only 4 devices maintained a constant minimum pressure when subjected to repeated central apneas with an open upper airway. In the long general breathing scenario, the pressure responses and the treatment efficacy differed among devices: only 5 devices obtained a residual obstructive AHI < 5/h. During the short general breathing scenario, only 2 devices reached the same treatment efficacy (p < 0.001), and 3 devices underestimated the AHI by > 10% (p < 0.001). The long scenario led to more consistent device reports. Conclusion: Large differences between APAP devices in the treatment efficacy and the accuracy of report were evidenced in the current study. Citation: Zhu K, Roisman G, Aouf S, Escourrou P. All APAPs are not equivalent for the treatment of sleep disordered breathing: a bench evaluation of eleven commercially available devices. J Clin Sleep Med 2015;11(7):725–734. PMID:25766708

Snoring and Sleep Apnea

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Elevated serum aminotransferase levels in children at risk for obstructive sleep apnea.

PubMed

Kheirandish-Gozal, Leila; Sans Capdevila, Oscar; Kheirandish, Ebrahim; Gozal, David

2008-01-01

Fatty liver disease (FLD) is a highly prevalent condition in obese (Ob) children, who are at increased risk for obstructive sleep apnea (OSA). However, the contribution of OSA to FLD remains unknown. Prospective study. Polysomnographic evaluation and assessment of plasma levels of insulin, glucose, and lipids, and liver function tests. A total of 518 consecutive snoring children 4 to 17 years of age who were being evaluated for habitual snoring and suspected OSA. A total of 376 children had body mass index z score of < 1.20 (non-Ob children), 3 children (<1%) had elevated serum aminotransferase (LFT) levels, and 248 had OSA (65.9%). Among the 142 overweight/Ob children, 46 had elevated LFT levels (32.4%); of these children, 42 had OSA (91.3%). In contrast, OSA was present in only 71.8% of Ob children without elevated LFT level (p < 0.01). Insulin resistance and hyperlipidemia were more likely to occur in children with FLD. Furthermore, FLD was improved after treatment of OSA in 32 of 42 Ob children (p < 0.0001). Increased liver enzyme levels are frequently found in Ob snoring children, particularly among those with OSA and/or metabolic dysfunction. Effective treatment of OSA results in improved liver function test results in the vast majority of these patients.

Insufficient sleep and suicidality in adolescents.

PubMed

Lee, Yu Jin; Cho, Seong-Jin; Cho, In Hee; Kim, Seog Ju

2012-04-01

To investigate the association between the behaviorally induced insufficient sleep and suicidality among adolescents. A population-based, cross-sectional survey. General community. A sample of 8,530 students (grades 7-11) was recruited in the Republic of Korea. The participants were 8,010 students who completed all questionnaires. N/A. The survey included the Beck Scale for Suicidal Ideation (SSI), the Beck Depression Inventory (BDI), a modified Epworth Sleepiness Scale (ESS), and questionnaires about sleep (weekday/weekend sleep schedule/duration, insomnia and snoring). Adolescents with behaviorally induced insufficient sleep syndrome (BISS) had higher SSI scores than those who slept ≥ 7 hours on weekdays, even after controlling for age, sex, and BDI score (F = 11.71, P < 0.001). After controlling for age and sex, longer weekend oversleep and shorter weekday sleep duration predicted a higher SSI score (β = 0.19, P < 0.001; β = 0.37, P < 0.001). The association between weekend oversleep and SSI score remained significant even after additionally controlling for BDI and ESS scores and presence of insomnia and snoring (β = 0.07, P < 0.01). BISS was found to be associated with increased suicidality. Weekend oversleep was associated with suicidality independently of depression, daytime sleepiness, snoring, and insomnia. The study findings suggest that chronic sleep restriction among adolescents may increase suicidal risk.

Comparing the clinical profile of non obese children with sleep apnea and snoring.

PubMed

Stefanini, Daniele de Oliveira Soares; Barros, Emília Leite de; Stefanini, Renato; Pradella-Hallinan, Márcia Lurdes de Cássia; Pignatari, Shirley Shizue Nagata; Fujita, Reginaldo Raimundo

2012-10-01

Few studies in the literature have looked into the cardiovascular and metabolic effects of Obstructive Sleep Apnea Syndrome (OSAS) in children. This study aims to evaluate the metabolic profile of non-obese children with OSAS. Fifty-two children were enrolled in this study, 21 girls and 31 boys. Patients were divided into two groups: OSAS (28 children) and Snore (22 children) according to polysomnographic evaluation. All children were submitted to ENT examination, measurements of weight, height and blood pressure. Blood samples were tested for hemoglobin, hematocrit, fasting glucose, fasting insulin, triglycerides, total cholesterol, HDL, LDL, VLDL, TSH and T4. The gathered data sets were compared between groups and also within the OSAS group according to the severity of the syndrome. The children from both groups had no alterations in blood pressure levels. The results of the blood tests were normal for both groups. Results of hemoglobin, hematocrit, and HDL were all significantly higher in the Snore group when compared to the OSAS group; by their turn, VLDL levels were higher in the OSAS group. There was no statistical difference between the groups based on OSAS severity. Non-obese children with OSAS present no significant alterations in metabolic tests or blood pressure levels.

Treatment Options for Adults with Snoring

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Reconstructive procedures for disturbed functions within the upper airway: pharyngeal breathing/snoring

PubMed Central

Verse, Thomas

2005-01-01

Breathing disorders which have their origin within the pharynx mainly occur during sleep. These so-called obstructive sleep-related breathing disorders include three different disturbances which have to be distinguished properly: simple snoring, upper airway resistance syndrome (UARS) and obstructive sleep apnea (OSA). Each disturbance requires a different treatment. Simple snoring does not affect the physical health of the snorer himself, but often leads to social problems due to the annoying character of the breathing sounds. Appropriate treatment modalities are oral devices and transcutaneous or ttransmucosal electrical stimulation of the muscles of the floor of the mouth via surface electrodes. As reconstructive surgical procedures adenotomies, tonsillectomies, tonsillotomies, or adenotonsillectomies are successfully used in children. Moreover, in adults radiofrequency treatments of the tonsils, the soft palate and of the base of tongue, as well as uvulopalatopharyngoplasty (UPPP), laser-assisted uvulopalatoplasty (LAUP) and palatal implants are adequate treatments for simple snoring. Adequate therapies for UARS and mild OSA (less than 20 breathing events per hour of sleep) are oral appliances. Nasal continuos positive airway pressure (NCPAP) ventilation is a very successful treatment modality, but shows low compliance in these patients, as daytime symptoms like excessive sleepiness or or impaired cognitive functions are often unincisive in patients with mild OSA. Reconstructive procedures like UPPP, radiofrequency surgery of the tonsils or the base of tongue, hyoid suspension, mandibular osteotomy with genioglossus advancement (MO) are successful treatment options either as isolated procedures or in combination within so-called multi-level surgery concepts. Goldstandard for the treatment of moderate to severe OSA is the nCPAP ventilation. All patients should at least try this treatment modality. Only in the rare cases of nCPAP failure (2%) and in the relatively frequent cases of nCPAP incompliance (30%) reconstructive surgical procedures become necessary as second choice treatments. These are adenectomies, tonsillectomies, tonsillotomies in children and hyoid suspension, MO, multi-level surgery concepts, or maxillomandibular advancement osteotomies in adults. PMID:22073056

Associations of Sleep Duration and Disturbances With Hypertension in Metropolitan Cities of Delhi, Chennai, and Karachi in South Asia: Cross-Sectional Analysis of the CARRS Study.

PubMed

Shivashankar, Roopa; Kondal, Dimple; Ali, Mohammed K; Gupta, Ruby; Pradeepa, Rajendra; Mohan, Viswanathan; Kadir, Muhammad Masood; Narayan, K M Venkat; Tandon, Nikhil; Prabhakaran, Dorairaj; Peasey, Anne

2017-09-01

Sleep duration and disturbances may be risk factors for hypertension. Despite the high burden of hypertension in South Asia, little is known about this relationship in this region. We analyzed population-level cross-sectional data from the Centre for Cardiometabolic Risk Reduction in South Asia (CARRS) study that recruited representative samples of adults ≥ 20 years from three cities-Delhi, Chennai (India), and Karachi (Pakistan) during 2010-2011. We defined hypertension as self-reported treatment or measured blood pressure (BP) ≥140/90 mm Hg. Data on usual duration of sleep, insomnia, and snoring were collected using "The Sleep Habits Questionnaire" and excessive daytime sleepiness (EDS) using Epworth Sleepiness Score. Logistic and linear regression were done with hypertension and BP as outcome variables, respectively. Age, gender, education, wealth index, family history, and body mass index (BMI) were included as covariates. We used multiple imputation to account for missing variables. Prevalence of hypertension was 30.1%. The mean (SD) sleep duration was 7.3 (1.2) hours. Insomnia, snoring, and EDS were present in 13.6%, 28.7%, and 4.6%, respectively. Moderate and habitual snoring were associated with increased odds of hypertension (odds ratio [OR] = 1.18, 95% confidence interval [CI] [1.04 to 1.33] and 1.47 [1.29 to 1.67], respectively), after adjusting for covariates. Rare, occasional, and frequent insomnia were associated with increased hypertension (OR 1.41 [1.12 to 1.77], 1.39 [1.16 to 1.67], and 1.34 [1.09 to 1.65], respectively). Sleep duration and EDS were not associated with hypertension. Self-reported snoring and insomnia were associated with hypertension in South Asia. This relationship needs further exploration through robust longitudinal studies in this region. © Sleep Research Society 2017. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

Sleep Disordered Breathing in Four Resource-Limited Settings in Peru: Prevalence, Risk Factors, and Association with Chronic Diseases.

PubMed

Schwartz, Noah G; Rattner, Adi; Schwartz, Alan R; Mokhlesi, Babak; Gilman, Robert H; Bernabe-Ortiz, Antonio; Miranda, J Jaime; Checkley, William

2015-09-01

Sleep disordered breathing (SDB) is a highly prevalent condition in high-income countries, with major consequences for cardiopulmonary health, public safety, healthcare utilization, and mortality. However, its prevalence and effect in low- and middle-income countries are less well known. We sought to determine the prevalence, risk factors, and comorbidities of SDB symptoms in four resource-limited settings. Cross-sectional analysis of the CRONICAS Cohort, a population-based age- and sex-stratified sample. Four resource-limited settings in Peru varying in altitude, urbanization, and air pollution. There were 2,682 adults aged 35 to 92 y. Self-reported SDB symptoms (habitual snoring, observed apneas, Epworth Sleepiness Scale), sociodemographics, medical history, anthropometrics, spirometry, blood biomarkers were reported. We found a high prevalence of habitual snoring (30.2%, 95% confidence interval [CI] 28.5-32.0%), observed apneas (20.9%, 95% CI 19.4-22.5%) and excessive daytime sleepiness (18.6%, 95% CI 17.1-20.1%). SDB symptoms varied across sites; prevalence and adjusted odds for habitual snoring were greatest at sea level, whereas those for observed apneas were greatest at high altitude. In multivariable analysis, habitual snoring was associated with older age, male sex, body mass index (BMI), and higher socioeconomic status; observed apneas were associated with BMI; and excessive daytime sleepiness was associated with older age, female sex, and medium socioeconomic status. Adjusted odds of cardiovascular disease, depression, and hypertension and total chronic disease burden increased progressively with the number of SDB symptoms. A threefold increase in the odds of having an additional chronic comorbid disease (adjusted odds ratio 3.57, 95% CI 2.18-5.84) was observed in those with all three versus no SDB symptoms. Sleep disordered breathing symptoms were highly prevalent, varied widely across four resource-limited settings in Peru, and exhibited strong independent associations with chronic diseases. © 2015 Associated Professional Sleep Societies, LLC.

Snoring and Sleep Apnea

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Snoring

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The Finite Element Simulation of the Upper Airway of Patients with Moderate and Severe Obstructive Sleep Apnea Hypopnea Syndrome

PubMed Central

Luo, Huiping; Scholp, Austin

2017-01-01

Objectives To investigate the snoring modes of patients with Obstructive Sleep Apnea Hypopnea Syndrome and to discover the main sources of snoring in soft tissue vibrations. Methods A three-dimensional finite element model was developed with SolidEdge to simulate the human upper airway. The inherent modal simulation was conducted to obtain the frequencies and the corresponding shapes of the soft tissue vibrations. The respiration process was simulated with the fluid-solid interaction method through ANSYS. Results The first 6 orders of modal vibration were 12 Hz, 18 Hz, 21 Hz, 22 Hz, 36 Hz, and 39 Hz. Frequencies of modes 1, 2, 4, and 5 were from tongue vibrations. Frequencies of modes 3 and 6 were from soft palate vibrations. Steady pressure distribution and air distribution lines in the upper airway were shown clearly in the fluid-solid interaction simulation results. Conclusions We were able to observe the vibrations of soft tissue and the modeled airflow by applying the finite element methods. Future studies could focus on improving the soft tissues vibration compliances by adjusting the model parameters. Additionally, more attention should be paid to vibrational components below 20 Hz when performing an acoustic analysis of human snore sounds due to the presence of these frequencies in this model. PMID:29204444

[Symptoms of obstructive sleep apnea-hypopnea syndrome in children].

PubMed

Gregório, Paloma Baiardi; Athanazio, Rodrigo Abensur; Bitencourt, Almir Galvão Vieira; Neves, Flávia Branco Cerqueira Serra; Terse, Regina; Hora, Francisco

2008-06-01

To investigate the symptoms most frequently found in children with a polysomnographic diagnosis of obstructive sleep apnea-hypopnea syndrome (OSAHS). We evaluated 38 children consecutively referred to the sleep laboratory with suspicion of OSAHS between June of 2003 and December of 2004. The patients were submitted to a pre-sleep questionnaire and to polysomnography. The mean age was 7.8 +/- 4 years (range, 2-15 years), and 50% of the children were male. Children without apnea accounted for 7.9% of the sample. The obstructive sleep apnea observed in the remainder was mild in 42.1%, moderate in 28.9% and severe in 22.1%. Severe cases of apnea were most common among children under the age of six (pre-school age). In children with OSAHS, the most common symptoms were snoring and nasal obstruction, which were observed in 74.3 and 72.7% of the children, respectively. Excessive sleepiness and bruxism were seen in 29.4 and 34.3%, respectively, and reflux disease was seen in only 3.1%. Restless legs and difficulty in falling asleep were identified in 65 and 33%, respectively. All of the children diagnosed with severe OSAHS also presented snoring and bruxism. Snoring and nasal obstruction were the most common symptoms found in our sample of children and adolescents with OSAHS. In addition, OSAHS severity was associated with being in the lower age bracket.

The Finite Element Simulation of the Upper Airway of Patients with Moderate and Severe Obstructive Sleep Apnea Hypopnea Syndrome.

PubMed

Luo, Huiping; Scholp, Austin; Jiang, Jack J

2017-01-01

To investigate the snoring modes of patients with Obstructive Sleep Apnea Hypopnea Syndrome and to discover the main sources of snoring in soft tissue vibrations. A three-dimensional finite element model was developed with SolidEdge to simulate the human upper airway. The inherent modal simulation was conducted to obtain the frequencies and the corresponding shapes of the soft tissue vibrations. The respiration process was simulated with the fluid-solid interaction method through ANSYS. The first 6 orders of modal vibration were 12 Hz, 18 Hz, 21 Hz, 22 Hz, 36 Hz, and 39 Hz. Frequencies of modes 1, 2, 4, and 5 were from tongue vibrations. Frequencies of modes 3 and 6 were from soft palate vibrations. Steady pressure distribution and air distribution lines in the upper airway were shown clearly in the fluid-solid interaction simulation results. We were able to observe the vibrations of soft tissue and the modeled airflow by applying the finite element methods. Future studies could focus on improving the soft tissues vibration compliances by adjusting the model parameters. Additionally, more attention should be paid to vibrational components below 20 Hz when performing an acoustic analysis of human snore sounds due to the presence of these frequencies in this model.

Nocturnal snoring decreases daytime baroreceptor sensitivity.

PubMed

Schöbel, Christoph; Fietze, Ingo; Glos, Martin; Schary, Inett; Blau, Alexander; Baumann, Gert; Penzel, Thomas

2014-07-01

In patients with obstructive sleep apnea heart rate variability and baroreceptor sensitivity during night and daytime are impaired. Snoring without obstructive sleep apnea may already influence heart rate variability and baroreceptor sensitivity during daytime. Cardiovascular daytime testing was performed in 11 snorers and age, BMI, and gender matched controls. Sleep apnea and snoring were quantified by sleep recordings. Paced breathing was performed during daytime with ECG, non-invasive blood pressure, and respiration recorded. Heart rate variability and blood pressure variability were analyzed in the time and frequency domain. Baroreceptor sensitivity (alpha gain) was calculated. In snorers a significant increase in high frequency systolic blood pressure variability (SBPV-HF) compared to control group (0.37 mm Hg(2) vs. 0.11 mm Hg(2) for 12 breaths and 0.35 mm Hg(2) vs. 0.10 mm Hg(2) for 15 breaths) was demonstrated. Furthermore a lower baroreceptor sensitivity was found in snorers compared to controls (9.2 ms/mm Hg vs. 16.2 ms/mm Hg for 12 breaths and 8.5 ms/mm Hg vs. 17.4 ms/mm Hg for 15 breaths per minute) using the paced breathing protocol. Mean heart rate was elevated in snorers as well. Snorers may have a reduced parasympathetic tone during daytime rather than an increased sympathetic tone. Copyright © 2014 Elsevier Ltd. All rights reserved.

Ambulatory treatment of sleep apnea syndrome with CO2 laser: laser-assisted UPPP (LAUP), results on 70 patients

NASA Astrophysics Data System (ADS)

Kamami, Yves-Victor

1995-05-01

The pharyngeal airway obstruction during sleep in the Obstructive Sleep Apnea Syndrome (OSAS) can be improved after treatment by LAUP (Laser Assisted Uvulopalatoplasty). This new technique, performed under local anesthesia, permits the snoring treatment without any hospitalization, or general anesthetic; like an ordinary dental visit. This is done by reducing the amount of tissue in the uvula, the velum, and the upper part of the posterior pillars. Our experience with the LAUP in Sleep Apnea Syndrome is described, from December 1988 to May 1994, in 70 patients. Among 62 patients classified as successful `responders', the respiratory disturbance index was reduced more than 50%. Among all the 70 patients: in 51.4 % of cases (36 patients), there's a healing of snoring and Sleep Apnea Syndrome. In 37.2% of cases (26 patients), there's an improvement reduction of length and number of apneas and a significant improvement in nocturnal oxygen saturation. 11.4% (8 patients), are relative failures, with always decrease of snoring, but still Sleep Apnea Syndrome, (with a higher B.M.I.). There were no important complications reported. Patients withstand it well and there's had a better tolerance of the C.P.A.P. in the cases of OSAS LRPP failures. Popularization of LAUP will require serious training of surgeon and further long-term studies.

Minimally Invasive, Single-Stage, Multilevel Surgery for Obstructive Sleep Apnea in Asian Patients.

PubMed

Lin, Hsin-Ching; Friedman, Michael; Chang, Hsueh-Wen; Bonzelaar, Lauren; Salapatas, Anna M; Lin, Meng-Chih; Huang, Kuo-Tung

2017-02-01

This study adds to the literature on the efficacy and low complication rates associated with minimally invasive, single-stage, multilevel surgery for Asian adults with obstructive sleep apnea (OSA) for whom conservative treatment had failed. Overall, our experience has produced results that make this procedure an option for select patients with snoring and OSA. To investigate the effectiveness and safety of anatomy-based, minimally invasive, single-stage, multilevel surgery in the treatment of OSA in an Asian population. This retrospective study enrolled 59 consecutive patients with OSA from a tertiary academic medical center who had multilevel obstruction and unsuccessful conservative therapy and then underwent minimally invasive, single-stage, multilevel surgery. The subjective symptoms and objective polysomnographic findings were collected preoperatively and at a minimum of 3 months postoperatively. The Global Patient Assessment questionnaire was used to assess patient satisfaction after minimally invasive, single-stage, multilevel surgery. Scores on the Epworth Sleepiness Scale and bed partner evaluation of patient's snoring on a visual analog scale (scale of 0-10, with 0 indicating no snoring and 10 indicating the bed partner to leave the room or sleep separately, as assessed by the bed partner). The primary outcomes are a 50% decrease in bed partner's snoring visual analog scale level postoperatively and an improvement of 50% or more in apnea-hypopnea index by an at least 3-month follow-up. Adverse events and patient-reported quality measures were also assessed. Forty-seven patients (36 men and 11 women; mean [SD], 47.3 [10.9] years) with a minimum 3-month follow-up and complete data were included in the analysis. None of the patients had serious perioperative or postoperative complications. Three months postoperatively, the mean (SD) scores on the Epworth Sleepiness Scale and bed partner evaluation of patient's snoring on the visual analog scale decreased from 11.6 (4.3) to 9.2 (3.1), with a mean (SD) difference of -2.4 (3.7) (95% CI, -3.5 to -1.3), and 9.4 (1.5) to 3.9 (1.9), with a mean (SD) difference of -5.6 (2.0) (95% CI, -6.2 to -5.0), respectively. The mean (SD) apnea-hypopnea index and lowest oxygen saturation changed from 30.5 (18.8) to 26.0 (16.5), with a mean (SD) difference of -4.5 (14.1) (95% CI, -8.6 to -0.3), and 78.2% (9.9%) to 80.8% (8.2%), with a mean (SD) difference of +2.6 (8.7) (95% CI, 0-5.1), respectively. The surgical response rate was 46.8% (22 of 47 patients) (95% CI, 32.5%-61.1%). The success rate by the classic definition was 14.9% (7 of 47 patients) (95% CI, 6.2%-28.3%). This study reveals the improvement of the 2 relevant clinical outcomes in snoring severity and daytime sleepiness after minimally invasive, single-stage, multilevel surgery for patients with OSA but the limited effects on the polysomnographic parameters. Although the current role of minimally invasive, single-stage, multilevel surgery for Asian adults with OSA remains to be established, it is hoped that ongoing and future studies will solidify their role in the treatment of OSA.

Snoring -- adults

MedlinePlus

... In: Kryger M, Roth T, Dement WC, eds. Principles and Practice of Sleep Medicine . 6th ed. Philadelphia, ... member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www. ...

Prevalence and Persistence of Sleep Disordered Breathing Symptoms in Young Children: A 6-Year Population-Based Cohort Study

PubMed Central

Bonuck, Karen A.; Chervin, Ronald D.; Cole, Timothy J.; Emond, Alan; Henderson, John; Xu, Linzhi; Freeman, Katherine

2011-01-01

Study Objectives: To describe the prevalence, persistence, and characteristics associated with sleep disordered breathing (SDB) symptoms in a population-based cohort followed from 6 months to 6.75 years. Design: Avon Longitudinal Study of Parents and Children (ALSPAC). Setting: England, 1991-1999. Participants: 12,447 children in ALSPAC with parental report of apnea, snoring, or mouth-breathing frequency on any one of 7 questionnaires. Measurements: Symptom prevalence rates—assessed as “Always” and “Habitually”—are reported at 0.5, 1.5, 2.5, 3.5, 4.75, 5.75, and 6.75 years of age. The proportion of children in whom symptoms develop, persist or abate between observation points is reported. Exploratory multivariate analyses identified SDB risk factors at 1.5, 4.75, and 6.75 years. Results: The prevalence of apnea (“Always”) is 1%-2% at all ages assessed. In contrast, snoring “Always” ranges from 3.6% to 7.7%, and snoring “Habitually” ranges from 9.6% to 21.2%, with a notable increase from 1.5- 2.5 years. At 6 years old, 25% are habitual mouth-breathers. The “Always” and “Habitual” incidence of each symptom between time points is 1%-5% and 5%-10%, respectively. In multivariate analyses of combined symptoms, socioeconomic factors have stronger, more persistent effects upon increased SDB risk than gestational age, gender, or race (aside from 1.5 years); adenoidectomy decreases risk by 40%-50%. Conclusions: This is the first natural history study of the primary symptoms of SDB across a key 6-year period in the development of SDB symptoms. Snoring rates are higher and spike earlier than previously reported. Symptoms are dynamic, suggesting the need for early and continued vigilance in early childhood. Citation: Bonuck KA; Chervin RD; Cole TJ; Emond A; Henderson J; Xu L; Freeman K. Prevalence and persistence of sleep disordered breathing symptoms in young children: a 6-year population-based cohort study. SLEEP 2011;34(7):875-884. PMID:21731137

Prevalence of Sleep Related Symptoms in Four Latin American Cities

PubMed Central

Bouscoulet, Luis Torre; Vázquez-García, Juan Carlos; Muiño, Adriana; Márquez, Maria; López, Maria Victorina; de Oca, Maria Montes; Talamo, Carlos; Valdivia, Gonzalo; Pertuze, Julio; Menezes, Ana Maria B.; Pérez-Padilla, Rogelio

2008-01-01

Study Objectives: to estimate the prevalence of the most common sleep related symptoms (SRS) in the metropolitan areas of Mexico City, Montevideo (Uruguay), Santiago (Chile), and Caracas (Venezuela). Methods: The study consisted of a multistage cluster sampling of adults aged ≥ 40 years living in metropolitan areas. All participants completed a questionnaire on sleep related symptoms. Simplified respiratory polygraphy during sleep was conducted on 188 subjects from Mexico City. Obstructive sleep apnea syndrome was defined as Epworth Sleepiness Scale score ≥ 11 and respiratory disturbance index (RDI) ≥ 15 events/h; a cut-off of 15 was chosen because of its high sensitivity and specificity in association with the portable monitor used in the study. Results: The study included 4,533 subjects (1,062 in Mexico City, 941 in Montevideo, 1,173 in Santiago, and 1,357 in Caracas). Snoring was reported by 60.2% (95% CI 58.8% to 61.6%), excessive daytime sleepiness by 16.4% (15.3% to 17.5%), observed apneas by 12.3% (11.4% to 13.3%), insomnia by 34.7% (33.3% to 36%), sedative use by 15.1% (14.1% to 16.2%), daytime napping by 29.2% (27.7% to 30.6%), and a combination of snoring, sleepiness, and observed apneas by 3.4% (2.9% to 4%). Men had a higher frequency of snoring and daytime napping, whereas women reported more insomnia and sedative use. Prevalence of OSAS varied from 2.9% among subjects who denied snoring, excessive daytime sleepiness, and observed apneas, to 23.5% among those reporting these 3 symptoms. Conclusions: A high prevalence of sleep related symptoms and undiagnosed obstructive sleep apnea in Latin America was observed. Citation: Bouscoulet LT; Vázquez-García JC; Muiño A; Márquez M; López MV; Montes de Oca M; Talamo C; Valdivia G; Pertuze J; Menezes AMB; Pérez-Padilla R. Prevalence of Sleep Related Symptoms in Four Latin American Cities. J Clin Sleep Med 2008;4(6):579-585. PMID:19110888

The predictive value of polysomnography combined with quality of life for treatment decision of children with habitual snoring related to adenotonsillar hypertrophy.

PubMed

Zhao, Guoqiang; Li, Yanru; Wang, Xiaoyi; Ding, Xiu; Wang, Chunyan; Xu, Wen; Han, Demin

2018-06-01

Both surgical treatment and non-surgical treatment are suggested by clinicians for children with habitual snoring related to adenotonsillar hypertrophy; However, how should the decision be made remains unclear. The objective of this study was to investigate potential predictors for the treatment decision, i.e., surgical treatment vs wait and see in children with habitual snoring related to adenoidal and/or tonsillar hypertrophy. Children with complaints of snoring and/or apnea associated with adenotonsillar hypertrophy who received polysomnography (PSG) monitoring at our Hospital were recruited. After at least 6 months, the subjects were followed up and grouped according to whether or not they had received adenoidectomy and/or tonsillectomy (AT) execution. The heights, weights, as well as the quality of life (assessed using the obstructive sleep apnea-18 (OSA-18) quality of life questionnaire) and baseline PSG of the subjects were recorded and compared. Two logistic regressions were performed to reveal the factors influencing decision-making on conducting AT. A total of 509 children were finally included (345 males and 164 females). Among these children, 287 eventually received AT. Significant differences in age, scores for item 1 and 5 of the OSA-18, apnea-hypopnea index, obstructive apnea index, obstructive apnea-hypopnea index (OAHI), and Lowest arterial oxygen saturation (P < 0.05) were observed between groups. By multivariate logistic regression, the factors that influenced the surgical decision were identified as follows: age < 7 years (P = 0.008: odds ratio [OR] = 1.667, 95% confidence interval [CI] 1.140-2.438), score for item 5 of OSA-18 > 4 points (P = 0.042: OR = 1.489, 95% CI 1.014-2.212) and OAHI > 1/h (P = 0.044: OR = 1.579, 95% CI 1.013-2.463). School-age children aged < 7 years, with OAHI > 1/h and mouth breathing scored > 4 points were more likely to receive AT during the disease process and thus require increased attention.

Your Wake-Up Call

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... sleep comprise a broad range of problems, including sleep apnea, narcolepsy, insomnia, parasomnia, jet-lag syndrome, and disturbed ... health risks." Photo courtesy of NIH/NHLBI/NCSDR Sleep Apnea and Children Snoring is common in children and ...

Enlarged Adenoids (For Parents)

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... topic for: Parents Kids Teens Tonsils and Tonsillectomies Strep Throat Obstructive Sleep Apnea Preparing Your Child for Surgery ... the Operating Room? Snoring Tonsillitis All About Adenoids Strep Throat Enlarged Adenoids Tonsils and Tonsillectomies What's It Like ...

Guide to Understanding Your Sleep Study

MedlinePlus

... these numbers and alphabet soups, and a better comprehension of what they quantify and signify, here is ... constitute another sleep disorder. And yes, someone is listening to–though not measuring in decibels–your snoring, ...

Insufficient Sleep and Suicidality in Adolescents

PubMed Central

Lee, Yu Jin; Cho, Seong-Jin; Cho, In Hee; Kim, Seog Ju

2012-01-01

Study Objectives: To investigate the association between the behaviorally induced insufficient sleep and suicidality among adolescents. Design: A population-based, cross-sectional survey. Setting: General community. Participants: A sample of 8,530 students (grades 7-11) was recruited in the Republic of Korea. The participants were 8,010 students who completed all questionnaires. Intervention: N/A. Measurements: The survey included the Beck Scale for Suicidal Ideation (SSI), the Beck Depression Inventory (BDI), a modified Epworth Sleepiness Scale (ESS), and questionnaires about sleep (weekday/weekend sleep schedule/duration, insomnia and snoring). Results: Adolescents with behaviorally induced insufficient sleep syndrome (BISS) had higher SSI scores than those who slept ≥ 7 hours on weekdays, even after controlling for age, sex, and BDI score (F = 11.71, P < 0.001). After controlling for age and sex, longer weekend oversleep and shorter weekday sleep duration predicted a higher SSI score (β = 0.19, P < 0.001; β = 0.37, P < 0.001). The association between weekend oversleep and SSI score remained significant even after additionally controlling for BDI and ESS scores and presence of insomnia and snoring (β = 0.07, P < 0.01). Conclusion: BISS was found to be associated with increased suicidality. Weekend oversleep was associated with suicidality independently of depression, daytime sleepiness, snoring, and insomnia. The study findings suggest that chronic sleep restriction among adolescents may increase suicidal risk. Citation: Lee YJ; Cho SJ; Cho IH; Kim SJ. Insufficient sleep and suicidality in adolescents. SLEEP 2012;35(4):455-460. PMID:22467982

[Daytime tiredness correlated with nocturnal respiratory and arousal variables in patients with sleep apnea: polysomnographic and EEG mapping studies].

PubMed

Saletu, M; Hauer, C; Anderer, P; Saletu-Zyhlarz, G; Gruber, G; Oberndorfer, S; Mandl, M; Popovic, R; Saletu, B

2000-03-24

There is evidence that daytime tiredness is caused by apnea/hypopnea with oxygen desaturation and/or by sleep fragmentation due to arousals. The aim of this study was to investigate objective and subjective sleep and awakening quality and daytime vigilance--objectified by midmorning mapping of vigilance-controlled EEG (V-EEG)--in sleep apnea patients (N: 18), as compared with age- and sex-matched normal controls (N: 18) as well as to correlate nocturnal respiratory distress and arousals to daytime brain function. Statistical analyses demonstrated a deterioration in subjective and objective sleep and awakening quality in apnea patients. Midmorning V-EEG mapping in apnea patients exhibited less total power, more delta and theta, less alpha and beta activity, as well as a slower dominant frequency and centroid of the total activity compared to controls, which suggests a vigilance decrement. The Spearman rank correlation between 6 polysomnographically registered respiratory variables and 36 diurnal quantitative EEG measures demonstrated the following: the higher the apnea, apnea-hypopnea, snoring and desaturation indices and the lower the minimum and average low oxygen saturation, the more pronounced was diurnal tiredness. Eleven arousal measures based on ASDA criteria showed the following significant correlations: the higher the nocturnal arousal index and the more arousals due to hypopneas, the greater was daytime tiredness. On the other hand, the greater the average frequency change during arousals and the more spontaneous arousals, the better was daytime vigilance. Our findings show that, in contrast to the lengthy Multiple Sleep Latency (MSLT) and Maintenance of Wakefulness (MWT) tests which evaluate sleep pressure under resting conditions conducive to sleep, V-EEG mapping provides a brief objective measure of a sleep apnea patient's daytime tiredness under conditions of wakefulness more appropriate to reflect the patient's everyday life.

Snoring and Nasal Congestion

MedlinePlus

... treat the various causes of nasal congestion include: Topical nasal steroid spray Topical nasal antihistamine spray Oral antibiotic (in case of ... include more than just the decrease in oxygen levels at night during the apnea episodes. They also ...

Oral Appliances Therapy

MedlinePlus

... for travel Easy to care for How a Dentist Can Help: The First Visit Dentists work closely with physicians to treat snoring and sleep apnea. At your first visit, your dentist will talk to you about the benefits of ...

1. OVERALL VIEW SHOWING FACE OF CONCRETE GRAVITY DAM AND ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

1. OVERALL VIEW SHOWING FACE OF CONCRETE GRAVITY DAM AND FISH LADDER, LOOKING SOUTHWEST (UPSTREAM) FROM SNORE OPPOSITE FISH LADDER - Van Arsdale Dam, South Fork of Eel River, Ukiah, Mendocino County, CA

Periodic Limb Movement Disorder (PLMD) and Restless Legs Syndrome (RLS)

MedlinePlus

... Professional Version Sleep Disorders Overview of Sleep Snoring Insomnia and Excessive Daytime Sleepiness (EDS) Circadian Rhythm Sleep ... pressure when a person stands (orthostatic hypotension), and insomnia. Benzodiazepines: These drugs (such as clonazepam ) cause drowsiness, ...

Snore related signals processing in a private cloud computing system.

PubMed

Qian, Kun; Guo, Jian; Xu, Huijie; Zhu, Zhaomeng; Zhang, Gongxuan

2014-09-01

Snore related signals (SRS) have been demonstrated to carry important information about the obstruction site and degree in the upper airway of Obstructive Sleep Apnea-Hypopnea Syndrome (OSAHS) patients in recent years. To make this acoustic signal analysis method more accurate and robust, big SRS data processing is inevitable. As an emerging concept and technology, cloud computing has motivated numerous researchers and engineers to exploit applications both in academic and industry field, which could have an ability to implement a huge blue print in biomedical engineering. Considering the security and transferring requirement of biomedical data, we designed a system based on private cloud computing to process SRS. Then we set the comparable experiments of processing a 5-hour audio recording of an OSAHS patient by a personal computer, a server and a private cloud computing system to demonstrate the efficiency of the infrastructure we proposed.

The History of Sleep Surgery.

PubMed

Yaremchuk, Kathleen; Garcia-Rodriguez, Laura

2017-01-01

Snoring and the subsequent diagnosis of obstructive sleep apnea (OSA) was a life-threatening medical condition with no available treatment until the late 20th century. An early description of OSA was provided by Charles Dickens in his 1836 novel Pickwick Papers with the description of a "fat boy" who was thought to be lazy and always falling asleep but likely displayed hypersomnolence from OSA. It was not until 1976 that Ikematsu first described uvulopalatopharyngoplasty (UPPP) as an alternative surgical treatment of "snoring," with a reported cure rate of 81%. The only other surgical procedure for OSA was permanent tracheostomy, but patients suffered from social stigma from the visible stoma with skin flaps and complications such as tracheal granulomas and tracheitis. UPPP was introduced in the USA as an alternative to permanent tracheostomy by Fujita in 1981. Since then, multiple surgical approaches and combinations of approaches have surfaced, with variable success rates. © 2017 S. Karger AG, Basel.

The Effect of Breathing Exercises on the Nocturnal Enuresis in the Children with the Sleep-Disordered Breathing

PubMed Central

Khaleghipour, Shahnaz; Masjedi, Mohsen; Kelishadi, Roya

2013-01-01

Background The nocturnal enuresis is one of the most common complaints of childhood. Upper airway obstruction and nocturnal snoring affect the nocturnal enuresis in children. Objectives The aim of this study was to investigate the effects of breathing exercises on the nocturnal enuresis in the children with the sleep-disordered breathing. Patients and Methods This study was conducted in year of 2011 by a semi-experimental design with the control group among 40 children, aged 6 - 12 years, who had the nocturnal enuresis. Participants were examined based on the criteria of nocturnal enuresis, oral breathing, and nocturnal snoring. Subsequently, they were randomly assigned to the case and control groups. In the case group, the breathing exercises were performed for 45 minutes, and were pursued for four weeks in the morning following and prior to sleeping, and subsequently the arterial blood gases were measured and the frequency of enuresis and the respiratory rates (RR) were recorded. Results After intervention the means of PaCO2 and RR in the control group were significantly higher than the case group (P < 0.0001). Likewise, O2sat, PaO2 in the case group were higher than the control group (P < 0.0001). The nocturnal enuresis decreased significantly in the case group, compared to the control group (P < 0.0001). Conclusions This study suggests that the breathing exercises may reduce the frequency of nocturnal enuresis in the patients with the oral breathing and nocturnal snore. The clinical implications of these findings should be verified in the future longitudinal studies. PMID:24719691

A history of binge drinking during adolescence is associated with poorer sleep quality in young adult Mexican Americans and American Indians.

PubMed

Ehlers, Cindy L; Wills, Derek; Gilder, David A

2018-06-01

Binge drinking during adolescence is common, and adolescents and young adults with alcohol problems may also have sleep difficulties. However, few studies have documented the effects of a history of adolescent binge drinking on sleep in young adulthood in high-risk minority populations. To quantify sleep disturbance, as indexed by the Pittsburgh Sleep Quality Index (PSQI), in a sample of young adult Mexican American and American Indian men and women (18-30 years, n = 800) with and without a history of alcohol binge drinking during adolescence, controlling for age, gender, and race. Gender was found to affect PSQI responses with females reporting waking up at night, having more bad dreams, and later habitual bedtimes than males, and males reporting more problems with breathing and snoring. Increasing age was associated with snoring or coughing, less hours spent in bed, and later evening bedtimes. Race also influenced the PSQI with American Indians reporting longer sleep latencies and sleep durations, more hours spent in bed, and more trouble with coughing and snoring than Mexican Americans, and Mexican Americans reporting later bedtimes. A history of adolescent regular binge drinking was associated with longer sleep latencies, more problems with breathing, bad dreams, and an overall higher PSQI total score, when controlling for age, race, and gender. This report suggests, like what has been found in young adults in general population samples, that binge drinking during adolescence is associated with deleterious consequences on sleep quality in young adulthood in these high-risk and understudied ethnic groups.

Long-Term Cognitive and Behavioral Outcomes following Resolution of Sleep Disordered Breathing in Preschool Children.

PubMed

Biggs, Sarah N; Walter, Lisa M; Jackman, Angela R; Nisbet, Lauren C; Weichard, Aidan J; Hollis, Samantha L; Davey, Margot J; Anderson, Vicki; Nixon, Gillian M; Horne, Rosemary S C

2015-01-01

This study aimed to determine the long term effects of resolution of SDB in preschool children, either following treatment or spontaneous recovery, on cognition and behavior. Children diagnosed with SDB at 3-5y (N = 35) and non-snoring controls (N = 25), underwent repeat polysomnography (PSG) and cognitive and behavioral assessment 3 years following a baseline study. At follow-up, children with SDB were grouped into Resolved and Unresolved. Resolution was defined as: obstructive apnea hypopnea index (OAHI) ≤1 event/h; no snoring detected on PSG; and no parental report of habitual snoring. 57% (20/35) of children with SDB received treatment, with SDB resolving in 60% (12/20). 43% (15/35) were untreated, of whom 40% (6/15) had spontaneous resolution of SDB. Cognitive reduced between baseline and follow-up, however this was not related to persistent disease, with no difference in cognitive outcomes between Resolved, Unresolved or Control groups. Behavioral functioning remained significantly worse in children originally diagnosed with SDB compared to control children, regardless of resolution. Change in OAHI did not predict cognitive or behavioral outcomes, however a reduction in nocturnal arousals, irrespective of full resolution, was associated with improvement in attention and aggressive behavior. These results suggest that resolution of SDB in preschool children has little effect on cognitive or behavioral outcomes over the long term. The association between sleep fragmentation and behavior appears independent of SDB, however may be moderated by concomitant SDB. This challenges the assumption that treatment of SDB will ameliorate associated cognitive and behavioural deficits and supports the possibility of a SDB phenotype.

Remission and incidence of obstructive sleep apnea from middle childhood to late adolescence.

PubMed

Spilsbury, James C; Storfer-Isser, Amy; Rosen, Carol L; Redline, Susan

2015-01-01

To study the incidence, remission, and prediction of obstructive sleep apnea (OSA) from middle childhood to late adolescence. Longitudinal analysis. The Cleveland Children's Sleep and Health Study, an ethnically mixed, urban, community-based cohort, followed 8 y. There were 490 participants with overnight polysomnography data available at ages 8-11 and 16-19 y. Baseline participant characteristics and health history were ascertained from parent report and US census data. OSA was defined as an obstructive apnea- hypopnea index ≥ 5 or an obstructive apnea index ≥ 1. OSA prevalence was approximately 4% at each examination, but OSA largely did not persist from middle childhood to late adolescence. Habitual snoring and obesity predicted OSA in cross-sectional analyses at each time point. Residence in a disadvantaged neighborhood, African-American race, and premature birth also predicted OSA in middle childhood, whereas male sex, high body mass index, and history of tonsillectomy or adenoidectomy were risk factors among adolescents. Obesity, but not habitual snoring, in middle childhood predicted adolescent OSA. Because OSA in middle childhood usually remitted by adolescence and most adolescent cases were incident cases, criteria other than concern alone over OSA persistence or incidence should be used when making treatment decisions for pediatric OSA. Moreover, OSA's distinct risk factors at each time point underscore the need for alternative risk-factor assessments across pediatric ages. The greater importance of middle childhood obesity compared to snoring in predicting adolescent OSA provides support for screening, preventing, and treating obesity in childhood. © 2014 Associated Professional Sleep Societies, LLC.

[Effect of Continuous Positive Airway Pressure Treatment on Depression, Anxiety and Perceived Stress Levels in Patients with Obstructive Sleep Apnea Syndrome].

PubMed

Çelik, Mustafa; Sarıkaya, Yasin; Acar, Mustafa; Kalenderoğlu, Aysun; Doğan, Sedat; Kaskalan, Emin; Karataş, Mehmet

2016-01-01

The aim of this study is to determine the effects of continuous positive airway pressure (CPAP) treatment on depression, anxiety, and perceived stress levels and to identify factors predictive of treatment efficacy in patients with obstructive sleep apnea syndrome (OSAS). This study included 51 patients admitted to the Adiyaman University Medical School Otorhinolaryngology Department or Eskisehir Yunus Emre State Hospital between January and September 2014 with one or more complaints including snoring, excessive daytime sleepiness, or apnea witnessed by the partner. Diagnosis of OSAS was made by polysomnography and CPAP treatment was initiated. Depression levels were assessed in all study subjects using the Hospital Anxiety and Depression Scale (HADS) at the start of treatment and at 3 months. Anxiety levels were assessed using both the HADS and the State and Trait Anxiety Inventory (STAI), and perceived stress level was assessed using the Perceived Stress Questionnaire (PSQ). After CPAP treatment, we observed significant decreases in both the Depression and Anxiety Subscales of the HADS, in the Trait Anxiety subscale of the STAI, and in the PSQ. An evaluation of the initial parameters that predict improvements in these scales revealed that snoring time predicted decreases in all scale scores. In OSAS patients CPAP treatment has positive effects on psychological parameters like depression, anxiety, and perceived stress. We suggest that possible psychogenic benefits should be considered when deciding to start CPAP treatment, particularly in patients with pronounced and extended snoring who may also have social problems.

Sleep Disordered Breathing in Four Resource-Limited Settings in Peru: Prevalence, Risk Factors, and Association with Chronic Diseases

PubMed Central

Schwartz, Noah G.; Rattner, Adi; Schwartz, Alan R.; Mokhlesi, Babak; Gilman, Robert H.; Bernabe-Ortiz, Antonio; Miranda, J. Jaime; Checkley, William

2015-01-01

Study Objectives: Sleep disordered breathing (SDB) is a highly prevalent condition in high-income countries, with major consequences for cardiopulmonary health, public safety, healthcare utilization, and mortality. However, its prevalence and effect in low- and middle-income countries are less well known. We sought to determine the prevalence, risk factors, and comorbidities of SDB symptoms in four resource-limited settings. Design: Cross-sectional analysis of the CRONICAS Cohort, a population-based age- and sex-stratified sample. Setting: Four resource-limited settings in Peru varying in altitude, urbanization, and air pollution. Participants: There were 2,682 adults aged 35 to 92 y. Measurements and Results: Self-reported SDB symptoms (habitual snoring, observed apneas, Epworth Sleepiness Scale), sociodemographics, medical history, anthropometrics, spirometry, blood biomarkers were reported. We found a high prevalence of habitual snoring (30.2%, 95% confidence interval [CI] 28.5–32.0%), observed apneas (20.9%, 95% CI 19.4–22.5%) and excessive daytime sleepiness (18.6%, 95% CI 17.1–20.1%). SDB symptoms varied across sites; prevalence and adjusted odds for habitual snoring were greatest at sea level, whereas those for observed apneas were greatest at high altitude. In multivariable analysis, habitual snoring was associated with older age, male sex, body mass index (BMI), and higher socioeconomic status; observed apneas were associated with BMI; and excessive daytime sleepiness was associated with older age, female sex, and medium socioeconomic status. Adjusted odds of cardiovascular disease, depression, and hypertension and total chronic disease burden increased progressively with the number of SDB symptoms. A threefold increase in the odds of having an additional chronic comorbid disease (adjusted odds ratio 3.57, 95% CI 2.18–5.84) was observed in those with all three versus no SDB symptoms. Conclusions: Sleep disordered breathing symptoms were highly prevalent, varied widely across four resource-limited settings in Peru, and exhibited strong independent associations with chronic diseases. Citation: Schwartz NG, Rattner A, Schwartz AR, Mokhlesi B, Gilman RH, Bernabe-Ortiz A, Miranda JJ, Checkley W, CRONICAS Cohort Study Group. Sleep disordered breathing in four resource-limited settings in Peru: prevalence, risk factors, and association with chronic diseases. SLEEP 2015;38(9):1451–1459. PMID:25845694

Why does adenotonsillectomy not correct enuresis in all children with sleep disordered breathing?

PubMed

Kovacevic, Larisa; Wolfe-Christensen, Cortney; Lu, Hong; Toton, Monika; Mirkovic, Jelena; Thottam, Prasad J; Abdulhamid, Ibrahim; Madgy, David; Lakshmanan, Yegappan

2014-05-01

We analyzed the outcome of nocturnal enuresis after adenotonsillectomy in children with sleep disordered breathing. We also evaluated differences in demographic, clinical, laboratory and polysomnography parameters between responders and nonresponders after adenotonsillectomy. We prospectively evaluated children 5 to 18 years old diagnosed with sleep disordered breathing (snoring or obstructive sleep apnea syndrome) on polysomnography and monosymptomatic primary nocturnal enuresis requiring adenotonsillectomy to release upper airway obstruction. Plasma antidiuretic hormone and brain natriuretic peptide were measured preoperatively and 1 month postoperatively. Sleep studies were done in 46 children and 32 also underwent blood testing preoperatively and postoperatively. Mean ± SD patient age was 8.79 ± 2.41 years and the mean number of wet nights weekly was 6.39 ± 1.26. Polysomnography revealed obstructive sleep apnea syndrome in 71.7% of patients and snoring in 28.3%. After adenotonsillectomy 43.5% of patients became dry. Preoperative polysomnography findings indicated that responders, who were dry, had significantly more arousals and obstructive apnea episodes but fewer awakenings than nonresponders, who were wet. Significant increases in plasma antidiuretic hormone and significant decreases in plasma brain natriuretic peptide were seen in all children with no difference between responders and nonresponders. No difference between the groups was noted in age, gender, race, body mass index, constipation, preoperative number of wet nights weekly or type of sleep disordered breathing. Nocturnal enuresis resolved after adenotonsillectomy in almost half of the children with sleep disordered breathing. Those who became dry had more frequent arousal episodes caused by apnea events than those who remained wet. Copyright © 2014 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Mandibular Advancement Appliance for Obstructive Sleep Apnea Treatment.

PubMed

Kostrzewa-Janicka, J; Śliwiński, P; Wojda, M; Rolski, D; Mierzwińska-Nastalska, E

2017-01-01

A combination of abnormal anatomy and physiology of the upper airway can produce its repetitive narrowing during sleep, resulting in obstructive sleep apnea (OSA). Treatment of sleep-breathing disorder ranges from lifestyle modifications, upper airway surgery, continuous positive airway pressure (CPAP) to the use of oral appliances. A proper treatment selection should be preceded by thorough clinical and instrumental examinations. The type and number of specific oral appliances are still growing. The mandibular advancement appliance (MAA) is the most common type of a dental device in use today. The device makes the mandible protrude forward, preventing or minimizing the upper airway collapse during sleep. A significant variability in the patients' response to treatment has been observed, which can be explained by the severity of sleep apnea at baseline and duration of treatment. In some trials, patients with mild OSA show a similar treatment effect after the use of CPAP or MAA. It is worthwhile to give it a try with an oral appliance of MAA type in snoring, mild-to-moderate sleep apnea, and in individuals who are intolerant to CPAP treatment.

Validation of the Sonomat Against PSG and Quantitative Measurement of Partial Upper Airway Obstruction in Children With Sleep-Disordered Breathing.

PubMed

Norman, Mark B; Pithers, Sonia M; Teng, Arthur Y; Waters, Karen A; Sullivan, Colin E

2017-03-01

To validate the Sonomat against polysomnography (PSG) metrics in children and to objectively measure snoring and stertor to produce a quantitative indicator of partial upper airway obstruction that accurately reflects the pathology of pediatric sleep-disordered breathing (SDB). Simultaneous PSG and Sonomat recordings were performed in 76 children (46 male, age 5.8 ± 2.8, BMI = 18.5 ± 3.8 kg/m2). Sleep time, individual respiratory events and the apnea/hypopnea index (AHI) were compared. Obstructed breathing sounds were measured from the unobtrusive non-contact experimental device. There was no significant difference in total sleep time (TST), respiratory events or AHI values, the latter over-estimated by 0.3 events hr-1 by the Sonomat. Poor signal quality was minimal and gender, BMI, and body position did not adversely influence event detection. Obstructive and central events were classified correctly. The number of runs and duration of snoring (13 399 events, 20% TST) and stertor (5748 events, 24% TST) were an order of magnitude greater than respiratory events (1367 events, 1% TST). Many children defined as normal by PSG had just as many or more runs of snoring and stertor as those with mild, moderate and severe obstructive sleep apnea (OSA). The Sonomat accurately diagnoses SDB in children using current metrics. In addition, it permits quantification of partial airway obstruction that can be used to better describe pediatric SDB. Its non-contact design makes it ideal for use in children. © Sleep Research Society 2017. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

Sleep problems of adolescents: A detailed survey.

PubMed

Muluk, Nuray Bayar; Bulbul, Selda Fatma; Turğut, Mahmut; Ağirtaş, Gülşah

2015-06-01

We investigated the sleep problems and sleep habits of adolescents at three public primary schools and two high schools. Our study included 428 Turkish school children (244 girls and 184 boys). We used a questionnaire to determine the time they went to sleep at night; waking time in the morning; incidence of nightmares, snoring, daytime sleepiness, and intrafamilial physical trauma; concentration difficulty in class; and school success. The students were divided into age-related groups (group 1 = 11 to 13 years of age; group 2 = 14 to 15 years; group 3 = 16 to 18 years). The time they went to sleep was mostly between 10 and 11 p.m. in groups 1 and 2, and 11 to 12 p.m. in group 3. Difficulty in falling asleep was reported by 16.8 to 19.6% of the students in the three groups. Difficulty in waking up in the morning was reported by 12.7% of group 1, 16.0% of group 2, and 16.8% of group 3. Snoring was present in 12.1% of females and 22.0% of males. The occurrence of one nightmare in the preceding 3 months was reported by 11.3% of the students; 17.9% of the students reported having nightmares several times. Daytime sleepiness was present in 65.1%, and concentration difficulty was present in 56.8% of the students. We conclude that difficulty in falling asleep, snoring, and daytime sleepiness may be seen in adolescents who are in both primary and high schools. Watching inappropriate programs and movies on television and intrafamilial physical trauma may cause nightmares and sleeping problems in these adolescents. Students and families should be educated about the importance of sleep in academic performance. Countries' public health policies should address sleep problems and related educational activities.

A nationwide, cross-sectional survey on unusual sleep postures and sleep-disordered breathing-related symptoms in people with Down syndrome.

PubMed

Kuroda, H; Sawatari, H; Ando, S; Ohkusa, T; Rahmawati, A; Ono, J; Nishizaka, M; Hashiguchi, N; Matsuoka, F; Chishaki, A

2017-07-01

People with Down syndrome (DS) often have sleep-disordered breathing (SDB). Unusual sleep postures, such as leaning forward and sitting, are observed in people with DS. This study aimed to clarify the prevalence of unusual sleep postures and their relationships with SDB-related symptoms (SDB-RSs), such as snoring, witnessed apnoea, nocturnal awakening and excessive daytime sleepiness. A questionnaire, including demographic characteristics and the presence of unusual sleep postures, as well as SDB-RSs, was completed by 1149 parents of people with DS from Japan. Unusual sleep postures were recorded in 483 (42.0%) people with DS. These participants were significantly younger and had a history of low muscle tone more frequently than people without unusual sleep postures. In all ages, the leaning forward posture was more frequent than sitting. People with DS with unusual sleep postures suffered from SDB-RSs. Those who slept in the sitting posture had more frequent SDB-RSs than did those who slept with the leaning forward posture. Snoring, witnessed apnoea and nocturnal awakening were observed in 73.6, 27.2 and 58.2% of participants, respectively. Snoring increased with aging. Witnessed apnoea was more common in males and in those with hypothyroidism than in females and in those without hypothyroidism. Our study shows that there is a close relationship between unusual sleep postures and SDB-RSs. We recommend that all people with DS with unusual sleep postures should be checked for the presence of SDB. © 2017 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.

The influence of the lateral pharyngeal wall anatomy on snoring and sleep apnoea.

PubMed

Korhan, Ibrahim; Gode, Sercan; Midilli, Rasit; Basoglu, Ozen Kacmaz

2015-02-01

To elucidate the variations of the lateral pharyngeal wall anatomy on physical examination and to assess the clinical importance of the examination of the lateral pharyngeal wall on the presence and severity of obstructive sleep apnoea syndrome. The cross-sectional study was conducted at Ege University Medical School, Izmir, Turkey, between May 2010 and April 2011. The patients were divided into four equal groups: Group 1--snoring without apnoea (age 20-40); Group 2--snoring without apnoea (age 40-60); Group 3--apnoea-hypopnoea index < 5/hr; Group 4: apnoea-hypopnoea index > 30/hr. Calibrated oropharynx pictures were taken. Distance between palatoglossal and palatopharyngeal arches, height of palatoglossal and palatopharyngeal arches, uvula width, uvula length and distance between tonsils were measured. SPSS 17 was used for statistical analysis. Of the 80 patients in the study, 44 (55%) were men. Mean distance between palatopharyngeal and palatoglossal arches were 1.55 ± 0.34 cm and 2.70 ± 0.43 cm respectively. Mean height of palatopharyngeal and palatoglossal arches were 0.60 ± 0.21 cm and 1.37 ± 0.36 cm respectively (p > 0.05). Mean uvula width and uvula length were 0.80 ± 0.12cm and 1.25 ± 0.27 cm respectively (p > 0.05). Mean distance between tonsils was 2.24 ± 0.56 cm (p > 0.05). Distance between palatopharyngeal arches was significantly different between groups 3 and 4 (p < 0.05). Palatopharyngeal arch anatomy was found to be significantly associated with obstructive sleep apnoea syndrome severity, especially in patients with normal or small tonsil size. Patients with the palatopharyngeal arches, which narrow the oropharyngeal inlet more than the tonsils, should further be investigated with polysomnography.

Cough hypersensitivity in patients with obstructive sleep apnea hypopnea syndrome.

PubMed

Shi, Cuiqin; Liang, Siwei; Xu, Xianghuai; Chen, Qiang; Wang, Lan; Yu, Li; Lv, Hanjing; Qiu, Zhongmin

2018-02-16

The purpose of this study was to investigate cough hypersensitivity and its potential mechanisms in patients with obstructive sleep apnea hypopnea syndrome (OSAHS). Fifteen OSAHS patients, 12 simple snoring patients, and 15 healthy volunteers received cough sensitivity test and induced sputum cytology. Cough thresholds C2 and C5 (the minimum of capsaicin inducing ≥ 2 and ≥ 5 coughs, respectively), total cell count, cell differentials and the levels of bradykinin, histamine, prostaglandin E 2 , substance P, calcitonin gene-related peptide, pepsin, and interleukin-2 in the induced sputum detected by enzyme-linked immunosorbent assay were compared. The linear correlation between lgC2 and lgC5 and apnea hypopnea index, cell differentials, and inflammatory mediators in the induced sputum was calculated in OSAHS patients. OSAHS patients presented with a significant lower C2 and C5 (P < 0.01), increased lymphocyte but decreased macrophage and neutrophil proportions in the induced sputum (P < 0.01), and higher contents of substance P, calcitonin gene-related peptide and interleukin-2 (P < 0.01) but similar levels of bradykinin, pepsin, prostaglandin E 2 , and histamine (P > 0.05) in the supernatant of induced sputum, when compared with simple snoring patients and healthy volunteers. However, theses variable were comparable between simple snoring patients and healthy volunteers (P > 0.05). Finally, lgC2 or lgC5 was negatively related to apnea hypopnea index, lymphocyte percentage, and the levels of substance P, calcitonin gene-related peptide or interleukin-2 in the sputum (P < 0.01). There was a positive linear correlation between lymphocyte percentage and interleukin-2 level in the induced sputum (r = 0.63, P = 0.00). OSAHS patients have a predisposition of cough hypersensitivity associated with airway inflammation.

Sleep disorders in pregnancy and their association with pregnancy outcomes: a prospective observational study.

PubMed

Sharma, S K; Nehra, A; Sinha, S; Soneja, M; Sunesh, K; Sreenivas, V; Vedita, D

2016-03-01

Sleep disturbances such as insomnia, nocturnal awakenings, restless legs syndrome, habitual snoring, and excessive daytime sleepiness are frequent during pregnancy, and these have been linked to adverse maternal and fetal outcomes. A prospective observational study was performed in high-risk Indian pregnant women. We used modified Berlin questionnaire (MBQ), Pittsburgh sleep quality index (PSQI), International Restless Legs Syndrome Study Group 2011 criteria, and Epworth sleepiness scale to diagnose various sleep disorders, such as symptomatic OSA, poor sleep quality and insomnia, RLS, and excessive daytime sleepiness, respectively, in successive trimesters of pregnancy. Outcome variables of interest were development of gestational hypertension (GH), gestational diabetes mellitus (GDM), and cesarean delivery (CS); the Apgar scores; and low birth weight (LBW). The relationship between sleep disorders and outcomes was explored using logistic regression analysis. Outcome data were obtained in 209 deliveries. As compared to nonsnorers, women who reported snoring once, twice, and thrice or more had odds ratios for developing GH-4.0 (95 % CI 1.3-11.9), 1.5 (95 % CI 0.5-4.5), and 2.9 (95 % CI 1.0-8.2) and for undergoing CS-5.3 (95 % CI 1.7-16.3), 4.9 (95 % CI 1.8-13.1), and 5.1 (95 % CI 1.9-14.9), respectively. Pregnant women who were persistently positive on MBQ had increased odds for GH and CS. Snoring and high-risk MBQ in pregnant women are strong risk factors for GH and CS. In view of the significant morbidity and health care costs, simple screening of pregnant women with questionnaires such as MBQ may have clinical utility.

Incidence of Sleep Disorders Reported by Patients at UTHSC College of Dentistry: A Two-Year Follow-Up and Proposed Educational Program.

PubMed

Ivanoff, Chris S; Pancratz, Frank

2015-05-01

A 2011 study at one U.S. dental school found that patients were not routinely screened by dental students for obstructive sleep apnea and/or other related sleep disorders, nor were students being trained to screen. Consequently, the medical history questionnaire used in the clinic was updated to include five specific screening questions. The aim of this two-year follow-up study was to determine whether screening had improved at the school. A retrospective chart review of all patients (age 14-70+) in the third- and fourth-year dental clinics in 2012 and 2013 searched for "YES" responses to the five questions. Of 5,931 patients, 38% reported they snore or were told they snore. By age 50-59, their reports of snoring increased to 50%. About 5% reported incidents waking up choking. By age 50, between one-fifth and one-quarter indicated they woke up frequently during the night. One in six frequently felt overly tired during the daytime, often falling asleep. This problem was evenly reported by all age groups between ages 30 and 69. About half the patients reporting sleep problems also had hypertension and cardiovascular problems with an equal distribution between males and females. The results showed that updating the medical history form had dramatically improved screening for sleep-disordered breathing by these dental students. Though screening is neither a definitive diagnosis nor an attempt to distinguish among sleep disorders, the results correlate with national statistics. Screening is an important step to increase student awareness of this serious health trend as it prepares students to engage more constructively in its management and referral.

Prevalence, Awareness and Reporting of Symptoms of Obstructive Sleep Apnoea among Hospitalized Adult Patients in Nigeria: A Multicenter Study.

PubMed

Desalu, Olufemi; Onyedum, Cajetan; Sanya, Emmanuel; Fadare, Joseph; Adeoti, Adekunle; Salawu, Fatai; Oluyombo, Rotimi; Olamoyegun, Micheal; Fawale, Micheal; Gbadegesin, Babajide; Bello, Hamzat

2016-07-01

Obstructive sleep apnoea is the most common form of sleep-disordered breathing in adults and children. It is associated with many adverse health consequences. The objectives this study were to determine the prevalence, awareness and reporting of symptoms of obstructive sleep apnoea among hospitalized adult patients in Nigeria. This was a multicenter cross-sectional study involving 1420 adult patients admitted to general medical and surgical wards of selected hospitals from March to April 2013. A questionnaire embedded with Berlin questionnaire, Epworth sleepiness scale and questions on level of awareness and reporting of symptoms of sleep apnoea was used for data collection. One-third of the patients (33.4%) reported snoring, 16.3% had excessive daytime sleepiness, 10.0% experienced daytime fatigue, and 8.0% experienced drowsy driving. Approximately 5% reported witnessed apnoea and 18.0% had high risks for obstructive sleep apnoea. The frequency of high risk for sleep apnoea increased with age and declined after 65 years and also increased with the body mass index. Snoring, excessive daytime sleepiness and high risk for obstructive sleep apnoea were more common in patients with chronic medical conditions and who were admitted to the urban hospitals. The majority were not aware that snoring (77.3%) and excessive daytime sleepiness (65.8%) constitute a medical problem, and only 4.5% reported these symptoms to their doctors. The level of awareness and under-reporting of sleep apnoea symptoms are poor. The high prevalence of obstructive sleep apnoea symptoms from this study should form the basis for screening hospitalized patients with chronic medical condition across the country.

Patient's experience of treatment for sleep apnoea with a mandibular advancement splint.

PubMed

Bhamrah, Gurprit; Dhir, Arti; Cash, Alex; Ahmad, Sofia; Winchester, Lindsay J

2015-10-01

Obstructive sleep apnoea (OSA) is a well recognised clinical disorder in which there is narrowing and repeated collapse of the upper airway during sleep resulting in the cessation of breathing. Patients with mild to moderate sleep apnoea are often provided with mandibular advancement splint (MAS) therapy as a form of first line or definitive treatment. The aims of this audit were to evaluate patient satisfaction and success of MAS therapy. 93 patients diagnosed with sleep apnoea and suitable for a splint were recruited prospectively at Queen Victoria Hospital, East Grinstead between January 2009 and October 2010. A patient satisfaction questionnaire was developed by health professionals involved in the care of patients with sleep apnoea and assessed for face and content validity and reliability. Participants completed the questionnaire six weeks after the splint was fitted. 44% who previously experienced snoring now reported no snoring and 47% reported less snoring since wearing the MAS appliance. 69% reported complete resolution of sleep apnoea symptoms. 37% experienced aching teeth and 33% experienced having a dry throat when wearing the appliance. 86% of sleeping partners felt that their quality of sleep was improved following their partners treatment. The standards set for each criteria in this audit were met. MAS treatment has a key role to play in the management of obstructive sleep apnoea with high rates of patient satisfaction and the majority of patients partners reporting a significant improvement in their own and their partners sleep quality. Copyright © 2014 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

Parent versus teacher report of daytime behavior in snoring children.

PubMed

Kohler, Mark J; Kennedy, J D; Martin, A J; Lushington, K

2013-05-01

Problematic behavior is widely reported in children with sleep-disordered breathing (SDB). Daytime behavior is an important component in the evaluation of clinical history in SDB; however, there is a reliance on parental report alone, and it is unclear whether reports by teachers will aid diagnosis. We assessed sleep and behavior reported by both parents and teachers in 19 children with SDB and 27 non-snoring controls. All children were screened for prior diagnoses of other medical and/or behavior and learning disorders and underwent polysomnography and both parental and teacher assessment of behavior. Both parents and teachers report greater problematic behavior in SDB children, predominantly of an internalizing nature. Despite this consistency and moderate correlation between informants, the agreement between parent and teacher reports of individual child behavior was poor when assessed using Bland-Altman plots. Clinicians should be mindful that the behavioral history of a child being evaluated for SDB may vary depending on whether parent or teacher report is being discussed as this may influence clinical decision making.

[Methadone and sleep apnea syndrome].

PubMed

Durst, Philippe; Palazzolo, Jérôme; Peyrelong, Jean-Pierre; Berger, Michel; Chalabreysse, Michel; Billiard, Michel; Vialle, André

2005-03-01

Sleep apnea syndrome occurs when, during sleep, breathing stops for 10 seconds or longer, with an index of 5 times or more an hour. It is clinically characterized by loud snoring at night, continuous or interrupted by pauses followed by loud breathing. Sleep is fitful, broken by arousals, and yields little rest. There is daytime excessive sleepiness with repeated involuntary falling asleep, often unknown by the subject. In this article, we describe an observation of central sleep apnea syndrome in a female patient receiving an opiate replacement therapy. An analysis of the before and after methadone withdrawal polysomnograhic tracing was done for this patient. This diagnosis etiology and physiopathology are critically approached. Clinicians should be careful in treating induced sleep disorders in such patients. Prescribing benzodiazepines during an opiate withdrawal of the methadone type is not recommended when central apnea occurs.

A randomized cross over study comparing the efficacy of two mandibular advancement appliances in the treatment of mild-moderate obstructive sleep apnea.

PubMed

Al-Dharrab, Ayman

2017-11-01

To compare efficacy, side effects, patient compliance, and preference between two types of custom-made mandibular advancement appliances (MAAs) in the treatment of patients with mild to moderate obstructive sleep apnea (OSA). This prospective, randomized, crossover study of 12 patients with mild to moderate OSA compared a titratable and a non-titratable MAA. Each patient was fitted with both appliances in a random order with a washout period of two weeks. Efficacy, side effects, compliance, and preference were evaluated by a questionnaire. All patients underwent overnight home sleep recordings prior to and after the use of each appliance in order to objectively assess sleep quality in terms of the apnea and hypopnea index (AHI), snoring frequency and oxygen desaturation index. Treatment successes (relief of symptoms and/or reduction of AHI to <10/h) were reported with both types of appliances. No compliance failure was reported, and in most patients, the side effects were mild, and improved with time. Both types of oral appliances were effective treatments for patients with mild to moderate OSA, with fewer side effects and higher patient satisfaction.

Parental Report of Sleep Problems in Down Syndrome

ERIC Educational Resources Information Center

Breslin, J. H.; Edgin, J. O.; Bootzin, R. R.; Goodwin, J. L.; Nadel, L.

2011-01-01

Background: Children with Down syndrome (DS) suffer from sleep problems, including sleep maintenance problems, as well as snoring, and other symptoms of disordered breathing. To examine sleep in DS, we gave parents a questionnaire assessing their child's sleep. Materials and methods: The parents of 35 children with DS (mean age = 12.65 years,…

Nasal Involvement in Obstructive Sleep Apnea Syndrome

PubMed Central

Michels, Daniel de Sousa; Rodrigues, Amanda da Mota Silveira; Nakanishi, Márcio; Sampaio, André Luiz Lopes; Venosa, Alessandra Ramos

2014-01-01

Numerous studies have reported an association between nasal obstruction and obstructive sleep apnea syndrome (OSAS), but the precise nature of this relationship remains to be clarified. This paper aimed to summarize data and theories on the role of the nose in the pathophysiology of sleep apnea as well as to discuss the benefits of surgical and medical nasal treatments. A number of pathophysiological mechanisms can potentially explain the role of nasal pathology in OSAS. These include the Starling resistor model, the unstable oral airway, the nasal ventilatory reflex, and the role of nitric oxide (NO). Pharmacological treatment presents some beneficial effects on the frequency of respiratory events and sleep architecture. Nonetheless, objective data assessing snoring and daytime sleepiness are still necessary. Nasal surgery can improve the quality of life and snoring in a select group of patients with mild OSAS and septal deviation but is not an effective treatment for OSA as such. Despite the conflicting results in the literature, it is important that patients who are not perfectly adapted to CPAP are evaluated in detail, in order to identify whether there are obstructive factors that could be surgically corrected. PMID:25548569

Childhood obstructive sleep-disordered breathing: a clinical update and discussion of technological innovations and challenges.

PubMed

Halbower, Ann C; Ishman, Stacey L; McGinley, Brian M

2007-12-01

Childhood sleep-disordered breathing (SDB) has been known to be associated with health and cognitive impacts for more than a century, and yet our understanding of this disorder is in its infancy. Neuropsychological consequences in children with snoring or subtle breathing disturbances not meeting the traditional definition of sleep apnea suggest that "benign, or primary snoring" may be clinically significant, and that the true prevalence of SDB might be underestimated. There is no standard definition of SDB in children. The polysomnographic technology used in many sleep laboratories may be inadequate to diagnose serious but subtle forms of clinically important airflow limitation. In the last several years, advances in digital technology as well as new observational studies of respiratory and arousal patterns in large populations of healthy children have led to alternative views of what constitutes sleep-related breathing and arousal abnormalities that may refine our diagnostic criteria. This article reviews our knowledge of childhood SDB, highlights recent advances in technology, and discusses diagnostic and treatment strategies that will advance the management of children with pediatric SDB.

Obstructive Sleep Apnea Screening Using a Piezo-Electric Sensor

PubMed Central

2017-01-01

In this study, we propose a novel method for obstructive sleep apnea (OSA) detection using a piezo-electric sensor. OSA is a relatively common sleep disorder. However, more than 80% of OSA patients remain undiagnosed. We investigated the feasibility of OSA assessment using a single-channel physiological signal to simplify the OSA screening. We detected both snoring and heartbeat information by using a piezo-electric sensor, and snoring index (SI) and features based on pulse rate variability (PRV) analysis were extracted from the filtered piezo-electric sensor signal. A support vector machine (SVM) was used as a classifier to detect OSA events. The performance of the proposed method was evaluated on 45 patients from mild, moderate, and severe OSA groups. The method achieved a mean sensitivity, specificity, and accuracy of 72.5%, 74.2%, and 71.5%; 85.8%, 80.5%, and 80.0%; and 70.3%, 77.1%, and 71.9% for the mild, moderate, and severe groups, respectively. Finally, these results not only show the feasibility of OSA detection using a piezo-electric sensor, but also illustrate its usefulness for monitoring sleep and diagnosing OSA. PMID:28480645

Evaluation of effects of anterior palatoplasty operation on upper airway parameters in computed tomography in patients with pure snoring and obstructive sleep apnea syndrome.

PubMed

Selcuk, Adin; Ozer, Tulay; Esen, Erkan; Ozdogan, Fatih; Ozel, Halil Erdem; Yuce, Turgut; Caliskan, Sebla; Dasli, Sinem; Bilal, Nagihan; Genc, Gulden; Genc, Selahattin

2017-05-01

To investigate changes in upper airway volume parameters measured by computerized tomography scans in patients with surgically treated by anterior palatoplasty of whom having pure snoring and mild-moderate obstructive sleep apnea. A prospective study on consecutively anterior palatoplasty performed pure snoring and obstructive sleep apnea patients. Computerized tomography scans were obtained preoperatively and following anterior palatoplasty procedure to measure changes in upper airway volume. Patients underwent diagnostic drug induced sleep endoscopy to assess the site of obstruction. Preoperative and postoperative measurements were compared using student's t test and Chi-square test. Twenty-two patients (16 men and 6 women, age 48.22 ± 9.23, body mass index 25.85 ± 2.57) completed the trial. Anterior palatoplasty was associated with an increase in total upper airway volume from 4.81 ± 1.73 cm 3 before treatment to 6.57 ± 2.03 cm 3 after treatment (p < 0.005). Change in soft palate thickness did not vary significantly (p < 0.039). The mean soft palate length has changed from 4.13 ± 0.41 to 3.93 ± 0.51 cm (p < 0.001). The preoperative and postoperative measurements of cross-sectional areas and volumes all showed significant difference except velopharynx minimal lateral airway dimension. The operational procedure increased the total upper airway volume much more in men than in women (p < 0.05). Results of this study indicate that anterior palatoplasty operation appears to produce significant increase in upper airway volume and cross sectional area. It does not seem to have an effect on lateral airway dimension. Computerized tomography is a quick and noninvasive imaging technique that allows for quantitative assessment of the velopharyngeal patency changes.

Effect of reductions in biomass fuel exposure on symptoms of sleep apnea in children living in the peruvian andes: a preliminary field study.

PubMed

Castañeda, Jacqueline L; Kheirandish-Gozal, Leila; Gozal, David; Accinelli, Roberto A

2013-10-01

Multiple studies have evaluated the prevalence of sleep apnea in pediatric populations. Although environmental exposures to cigarette smoke (ECS) increase the risk of habitual snoring, no studies have thus far examined the potential contribution of indoor pollution in children. To determine the frequency of symptoms associated with sleep apnea in children exposed to traditional wood-burning stoves to open fire, and assess whether symptoms subside following implementation of improved less environmentally contaminating stoves. Residents of the communities of Chucllapampa, Sayhuapata, and Alparcuna in Cangallo province, department of Ayacucho, Peru were surveyed on two occasions within 12 months before and after the installation of an improved Inkawasi wood stove. The frequency of symptoms associated with sleep apnea was assessed in all children <15 years of age using a previously validated questionnaire. Parents of 59 children (62.7% males; mean age 7.76 ± 4.2 years) were interviewed representing >97% of the children in those small villages. The most common symptoms included nighttime awakenings, habitual snoring, repetitive movements during sleep, nasal congestion, and sore throat. After implementation of improved stoves in the homes, snoring (52.5% vs. 18.2%, P < 0.0001) nasal congestion (33.9% vs. 1.8%, P < 0.0001), behavioral hyperactivity (28.8% vs. 3.8%, P < 0.002), nighttime awakenings (42.4% vs. 1.7%, P < 0.0001), sore throat (38.2% vs. 5.5% P < 0.0001), breathing through the mouth during the day (33.9% vs. 1.8%, P < 0.001), daytime sleepiness (21.1% vs. 1.8%, P < 0.003), and falling asleep at school (14.6% vs. 0%, P < 0.03) were all significantly improved. Children exposed to traditional biomass fuel stoves had a higher frequency of symptoms related to sleep apnea, which decrease with improvements in biomass pollution. © 2012 Wiley Periodicals, Inc.

Efficacy of a Mandibular Advancement Appliance on Sleep Disordered Breathing in Children: A Study Protocol of a Crossover Randomized Controlled Trial.

PubMed

Idris, Ghassan; Galland, Barbara; Robertson, Christopher J; Farella, Mauro

2016-01-01

Sleep-Disordered Breathing (SDB) varies from habitual snoring to partial or complete obstruction of the upper airway and can be found in up to 10% of children. SDB can significantly affect children's wellbeing, as it can cause growth disorders, educational and behavioral problems, and even life-threatening conditions, such as cardiorespiratory failure. Adenotonsillectomy represents the primary treatment for pediatric SDB where adeno-tonsillar hypertrophy is indicated. For those with craniofacial anomalies, or for whom adenotonsillectomy or other treatment modalities have failed, or surgery is contra-indicated, mandibular advancement splints (MAS) may represent a viable treatment option. Whilst the efficacy of these appliances has been consistently demonstrated in adults, there is little information about their effectiveness in children. To determine the efficacy of mandibular advancement appliances for the management of SDB and related health problems in children. The study will be designed as a single-blind crossover randomized controlled trial with administration of both an "Active MAS" (Twin-block) and a "Sham MAS." Eligible participants will be children aged 8-12 years whose parents report they snore ≥3 nights per week. Sixteen children will enter the full study after confirming other inclusion criteria, particularly Skeletal class I or class II confirmed by lateral cephalometric radiograph. Each child will be randomly assigned to either a treatment sequence starting with the Active or the Sham MAS. Participants will wear the appliances for 3 weeks separated by a 2-week washout period. For each participant, home-based polysomnographic data will be collected four times; once before and once after each treatment period. The Apnea Hypopnea Index (AHI) will represent the main outcome variable. Secondary outcomes will include, snoring frequency, masseter muscle activity, sleep symptoms, quality of life, daytime sleepiness, children behavior, and nocturnal enuresis. In addition, blood samples will be collected to assess growth hormone changes. This study was registered in the Australian New Zealand Clinical Trials Registry (ANZCTR): [ACTRN12614001013651].

Sleep Disturbances, Quality of Life, and Ethnicity: The Sleep Heart Health Study

PubMed Central

Baldwin, Carol M.; Ervin, Ann-Margret; Mays, Mary Z.; Robbins, John; Shafazand, Shirin; Walsleben, Joyce; Weaver, Terri

2010-01-01

Study Objectives: To compare health-related quality of life (HR-QOL) across subgroups defined by sleep disturbances and ethnicity. Methods: Men (47%) and women (53%) Sleep Heart Health Study participants age 40 and older (N = 5237) underwent overnight polysomnography and completed self-report questionnaires on symptoms of sleep disturbances. The physical and mental composite scales (PCS and MCS) of the Medical Outcomes Study 36-item short form survey assessed HR-QOL and were compared to sleep data. Results: Participants self-identified as Caucasian/White (n = 4482, 86%), African American/Black (n = 490, 9%), or Hispanic/Mexican American (n = 265, 5%). The prevalence of obstructive sleep apnea (OSA) was 17%, frequent snoring was 34%, difficulty initiating or maintaining sleep (DIMS; insomnia symptoms) was 30%, and excessive daytime sleepiness (EDS) was 25%. African American participants with frequent snoring, insomnia symptoms, or EDS had significantly poorer physical health compared to Caucasians (p < 0.001). Hispanics with frequent snoring, insomnia symptoms, or EDS had significantly poorer mental health than Caucasian participants (p < 0.001). Neither PCS nor MCS scores differed significantly across ethnic subgroups for participants with moderate to severe OSA (respiratory disturbance index ≥ 15, 4% desaturation). Conclusions: Across ethnic/racial subgroups, sleep disturbances are associated with worse physical and better mental HR-QOL than the U.S. norm, but this relationship may be moderated by comorbid health conditions. This study replicates and extends prior research indicating differences among minority and non-minority participants and highlights the need for future studies of sleep disturbances with larger samples of minorities that control for comorbid health conditions. Citation: Baldwin CM; Ervin A; Mays MZ; Robbins J; Shafazand S; Walsleben J; Weaver T. Sleep disturbances, quality of life, and ethnicity: the sleep heart health study. J Clin Sleep Med 2010;6(2):176-183. PMID:20411696

Sex-Specific Prediction Models for Sleep Apnea From the Hispanic Community Health Study/Study of Latinos.

PubMed

Shah, Neomi; Hanna, David B; Teng, Yanping; Sotres-Alvarez, Daniela; Hall, Martica; Loredo, Jose S; Zee, Phyllis; Kim, Mimi; Yaggi, H Klar; Redline, Susan; Kaplan, Robert C

2016-06-01

We developed and validated the first-ever sleep apnea (SA) risk calculator in a large population-based cohort of Hispanic/Latino subjects. Cross-sectional data on adults from the Hispanic Community Health Study/Study of Latinos (2008-2011) were analyzed. Subjective and objective sleep measurements were obtained. Clinically significant SA was defined as an apnea-hypopnea index ≥ 15 events per hour. Using logistic regression, four prediction models were created: three sex-specific models (female-only, male-only, and a sex × covariate interaction model to allow differential predictor effects), and one overall model with sex included as a main effect only. Models underwent 10-fold cross-validation and were assessed by using the C statistic. SA and its predictive variables; a total of 17 variables were considered. A total of 12,158 participants had complete sleep data available; 7,363 (61%) were women. The population-weighted prevalence of SA (apnea-hypopnea index ≥ 15 events per hour) was 6.1% in female subjects and 13.5% in male subjects. Male-only (C statistic, 0.808) and female-only (C statistic, 0.836) prediction models had the same predictor variables (ie, age, BMI, self-reported snoring). The sex-interaction model (C statistic, 0.836) contained sex, age, age × sex, BMI, BMI × sex, and self-reported snoring. The final overall model (C statistic, 0.832) contained age, BMI, snoring, and sex. We developed two websites for our SA risk calculator: one in English (https://www.montefiore.org/sleepapneariskcalc.html) and another in Spanish (http://www.montefiore.org/sleepapneariskcalc-es.html). We created an internally validated, highly discriminating, well-calibrated, and parsimonious prediction model for SA. Contrary to the study hypothesis, the variables did not have different predictive magnitudes in male and female subjects. Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

Clinical Practice Guideline for the Treatment of Obstructive Sleep Apnea and Snoring with Oral Appliance Therapy: An Update for 2015

PubMed Central

Ramar, Kannan; Dort, Leslie C.; Katz, Sheri G.; Lettieri, Christopher J.; Harrod, Christopher G.; Thomas, Sherene M.; Chervin, Ronald D.

2015-01-01

Introduction: Since the previous parameter and review paper publication on oral appliances (OAs) in 2006, the relevant scientific literature has grown considerably, particularly in relation to clinical outcomes. The purpose of this new guideline is to replace the previous and update recommendations for the use of OAs in the treatment of obstructive sleep apnea (OSA) and snoring. Methods: The American Academy of Sleep Medicine (AASM) and American Academy of Dental Sleep Medicine (AADSM) commissioned a seven-member task force. A systematic review of the literature was performed and a modified Grading of Recommendations Assessment, Development, and Evaluation (GRADE) process was used to assess the quality of evidence. The task force developed recommendations and assigned strengths based on the quality of the evidence counterbalanced by an assessment of the relative benefit of the treatment versus the potential harms. The AASM and AADSM Board of Directors approved the final guideline recommendations. Recommendations: We recommend that sleep physicians prescribe oral appliances, rather than no therapy, for adult patients who request treatment of primary snoring (without obstructive sleep apnea). (STANDARD) When oral appliance therapy is prescribed by a sleep physician for an adult patient with obstructive sleep apnea, we suggest that a qualified dentist use a custom, titratable appliance over non-custom oral devices. (GUIDELINE) We recommend that sleep physicians consider prescription of oral appliances, rather than no treatment, for adult patients with obstructive sleep apnea who are intolerant of CPAP therapy or prefer alternate therapy. (STANDARD) We suggest that qualified dentists provide oversight— rather than no follow-up—of oral appliance therapy in adult patients with obstructive sleep apnea, to survey for dental-related side effects or occlusal changes and reduce their incidence. (GUIDELINE) We suggest that sleep physicians conduct follow-up sleep testing to improve or confirm treatment efficacy, rather than conduct follow-up without sleep testing, for patients fitted with oral appliances. (GUIDELINE) We suggest that sleep physicians and qualified dentists instruct adult patients treated with oral appliances for obstructive sleep apnea to return for periodic office visits— as opposed to no follow-up—with a qualified dentist and a sleep physician. (GUIDELINE) Conclusions: The AASM and AADSM expect these guidelines to have a positive impact on professional behavior, patient outcomes, and, possibly, health care costs. This guideline reflects the state of knowledge at the time of publication and will require updates if new evidence warrants significant changes to the current recommendations. Citation: Ramar K, Dort LC, Katz SG, Lettieri CJ, Harrod CG, Thomas SM, Chervin RD. Clinical practice guideline for the treatment of obstructive sleep apnea and snoring with oral appliance therapy: an update for 2015. J Clin Sleep Med 2015;11(7):773–827. PMID:26094920

Obstructive Sleep Apnea Syndrome: From Phenotype to Genetic Basis

PubMed Central

Casale, M; Pappacena, M; Rinaldi, V; Bressi, F; Baptista, P; Salvinelli, F

2009-01-01

Obstructive sleep apnea syndrome (OSAS) is a complex chronic clinical syndrome, characterized by snoring, periodic apnea, hypoxemia during sleep, and daytime hypersomnolence. It affects 4-5% of the general population. Racial studies and chromosomal mapping, familial studies and twin studies have provided evidence for the possible link between the OSAS and genetic factors and also most of the risk factors involved in the pathogenesis of OSAS are largely genetically determined. A percentage of 35-40% of its variance can be attributed to genetic factors. It is likely that genetic factors associated with craniofacial structure, body fat distribution and neural control of the upper airway muscles interact to produce the OSAS phenotype. Although the role of specific genes that influence the development of OSAS has not yet been identified, current researches, especially in animal model, suggest that several genetic systems may be important. In this chapter, we will first define the OSAS phenotype, the pathogenesis and the risk factors involved in the OSAS that may be inherited, then, we will review the current progress in the genetics of OSAS and suggest a few future perspectives in the development of therapeutic agents for this complex disease entity. PMID:19794884

Mahalo, Kumu

ERIC Educational Resources Information Center

Pierpont, Katherine

2005-01-01

It had been a long 12-hour journey. As the passengers around us snored in slumber or pecked away at their laptops, we shifted in our seats for what seemed like the hundredth time and wondered (again, for what seemed like the hundredth time) if we were ever going to get to our destination. A low rumble issued from beneath our feet and finally, we…

When It Rains, It Pours

ERIC Educational Resources Information Center

Mills, Linda

2012-01-01

"It's raining, it's pouring, the old man is snoring!" "The itsy, bitsy spider crawled up the waterspout, down came the rain and washed the spider out. Out came the sun and dried up all the rain, and the itsy, bitsy spider went up the spout again." What do children's nursery rhymes have to do with the school library? The author begins by telling a…

Initial indication of treatment in 60 patients with sleep obstructive ventilatory disturbance.

PubMed

de Tarso Moura Borges, Paulo; Paschoal, Jorge Rizzato

2005-01-01

The author present a retrospective descriptive study of 60 patients with sleep obstructive ventilatory disturbance who have taken medical advice at the Centro Campinas de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço during a period of three years. All the patients have been examined after standardized protocol and decisions related to the treatment have been taken after systematic multidisciplinary discussion. clinical retrospective. The patients were distributed into two groups according to the proposal of surgical and non-surgical treatment. After so, they were studied according to the model of treatment proposed and the main propaedeutic findings: respiratory disturbance index (RDI), body mass index (BMI), cephalometric analysis and Müller maneuver. The main features were compared--isolated or in association--with the model of treatment proposed. Amongst several conclusions obtained, the most important were: surgical and non-surgical treatment were indicated almost in the same proportion for of snoring; surgical treatments were most indicated for snoring and Apnoea-Hipopnoea Syndrome, despite of its modality; RDI, BMI and cephalometric analysis and Müller maneuver had no influence at any therapeutic modality; the therapeutic decision was taken after standardized protocol and systematic multidisciplinary discussion, where each case was discussed individually.

Obstructive Sleep Apnea Screening Using a Piezo-Electric Sensor.

PubMed

Erdenebayar, Urtnasan; Park, Jong Uk; Jeong, Pilsoo; Lee, Kyoung Joung

2017-06-01

In this study, we propose a novel method for obstructive sleep apnea (OSA) detection using a piezo-electric sensor. OSA is a relatively common sleep disorder. However, more than 80% of OSA patients remain undiagnosed. We investigated the feasibility of OSA assessment using a single-channel physiological signal to simplify the OSA screening. We detected both snoring and heartbeat information by using a piezo-electric sensor, and snoring index (SI) and features based on pulse rate variability (PRV) analysis were extracted from the filtered piezo-electric sensor signal. A support vector machine (SVM) was used as a classifier to detect OSA events. The performance of the proposed method was evaluated on 45 patients from mild, moderate, and severe OSA groups. The method achieved a mean sensitivity, specificity, and accuracy of 72.5%, 74.2%, and 71.5%; 85.8%, 80.5%, and 80.0%; and 70.3%, 77.1%, and 71.9% for the mild, moderate, and severe groups, respectively. Finally, these results not only show the feasibility of OSA detection using a piezo-electric sensor, but also illustrate its usefulness for monitoring sleep and diagnosing OSA. © 2017 The Korean Academy of Medical Sciences.

[Sleep-disordered breathing in children].

PubMed

Cohen-Gogo, S; Do, Ngoc Thanh C; Levy, D; Métreau, J; Mornand, P; Parisot, P; Fauroux, B

2009-02-01

Sleep-disordered breathing (SDB) in children comprises a wide spectrum of symptoms ranging from primary snoring to obstructive sleep apnea (OSA). Twelve percent of children present primary snoring and 1-2% OSA. Polysomnography is the gold standard for diagnosis of SDB allowing the analysis of sleep stages, respiratory movements, airflow, and gas exchange. However, this test remains highly technical, expensive, and difficult to conduct; other simpler diagnostic methods are under evaluation. Recent studies highlight the frequency and importance of cognitive and behavioral disorders in children with SDB; both the age and the severity of the SDB seem to modulate in the expression of neurocognitive consequences. Local and systemic inflammation plays a key role in the physiopathology of SDB and its complications: OSA is a cardiovascular risk factor in childhood that could favor atheromatous complications later in life. Adenoidotonsillectomy is the treatment of choice, but anti-inflammatory therapies such as leukotriene receptor antagonists or nasal corticoids may be beneficial in mild SDB or in residual OSA after adenotonsillectomy. In case of failure, noninvasive ventilation by means of nasal continuous positive pressure will be necessary, aided by specialists. SDB and OSA are a public health problem, underlining the pivotal role of the pediatrician in preventing, diagnosing, and treating these frequent disorders.

Nasal Dilators (Breathe Right Strips and NoZovent) for Snoring and OSA: A Systematic Review and Meta-Analysis

PubMed Central

Malu, Omojo O.; Kram, Yoseph A.; Song, Sungjin A.; Tolisano, Anthony M.; Kushida, Clete A.

2016-01-01

Objective. To systematically review the international literature for studies evaluating internal (NoZovent) and external (Breathe Right Strips) nasal dilators as treatment for obstructive sleep apnea (OSA). Study Design. Systematic review with meta-analysis. Methods. Four databases, including PubMed/MEDLINE, were searched through September 29, 2016. Results. One-hundred twelve studies were screened, fifty-eight studies were reviewed, and fourteen studies met criteria. In 147 patients, the apnea-hypopnea index (AHI) was reported, and there was an improvement from a mean ± standard deviation (M ± SD) of 28.7 ± 24.0 to 27.4 ± 23.3 events/hr, p value 0.64. There was no significant change in AHI, lowest oxygen saturation, or snoring index in OSA patients when using nasal dilators. However, a subanalysis demonstrated a slight reduction in apnea index (AI) with internal nasal dilators (decrease by 4.87 events/hr) versus minimal change for external nasal dilators (increase by 0.64 events/hr). Conclusion. Although nasal dilators have demonstrated improved nasal breathing, they have not shown improvement in obstructive sleep apnea outcomes, with the exception of mild improvement in apnea index when internal nasal dilators were used. PMID:28070421

Hypersomnolence and Sleep-related Complaints in Metropolitan, Urban, and Rural Georgia

PubMed Central

Decker, Michael J.; Lin, Jin-Mann S.; Tabassum, Humyra

2009-01-01

Persistent daytime hypersomnolence is associated with significant morbidity and mortality, but its prevalence in the population has been poorly documented. This study sought to characterize the prevalence of persistent daytime hypersomnolence, difficulties initiating and maintaining sleep, unrefreshing sleep, snoring, and the presence of physician-diagnosed sleep disorders in metropolitan, urban, and rural US Georgia populations. Between September 2004 and July 2005, a total of 6,530 randomly selected well and unwell adults, identified by screening interviews of 10,837 households (contacted by random digit dialing), completed a detailed phone interview. Sixteen percent reported persistent problems staying awake during the day; 26% reported persistent problems falling asleep at night; 31% experienced problems sleeping through the night; 34% were bothered by unrefreshing sleep; and 33% reported that they snored. In spite of the high occurrence of reported persistent sleep problems, only 10% of the survey participants reported having been diagnosed with a sleep disorder. These study findings highlight the need for increased public and clinician awareness with respect to proactively indentifying signs and symptoms of sleep disorders, a better understanding of their adverse impact upon morbidity and mortality, and their negative impact upon socioeconomic and academic potential. PMID:19066308

Efficacy of Adjunct Sleep Interventions for PTSD

DTIC Science & Technology

2007-03-01

untreated severe PTSD, depression, of alcohol / substance use (n = 8), or sleep apnea (n = 4). Of the remaining 18 participants, all completed the...recommendations for further evaluation. Participants who endorsed symptoms consistent with sleep apnea (e.g., snoring, recalled or witnessed apneas , subjective...reported symptoms consistent with sleep apnea , screening sleep studies were conducted; 3 participants were excluded due to sig- nificant sleep apnea (AHI

Efficacy of a Mandibular Advancement Appliance on Sleep Disordered Breathing in Children: A Study Protocol of a Crossover Randomized Controlled Trial

PubMed Central

Idris, Ghassan; Galland, Barbara; Robertson, Christopher J.; Farella, Mauro

2016-01-01

Background: Sleep-Disordered Breathing (SDB) varies from habitual snoring to partial or complete obstruction of the upper airway and can be found in up to 10% of children. SDB can significantly affect children's wellbeing, as it can cause growth disorders, educational and behavioral problems, and even life-threatening conditions, such as cardiorespiratory failure. Adenotonsillectomy represents the primary treatment for pediatric SDB where adeno-tonsillar hypertrophy is indicated. For those with craniofacial anomalies, or for whom adenotonsillectomy or other treatment modalities have failed, or surgery is contra-indicated, mandibular advancement splints (MAS) may represent a viable treatment option. Whilst the efficacy of these appliances has been consistently demonstrated in adults, there is little information about their effectiveness in children. Aims: To determine the efficacy of mandibular advancement appliances for the management of SDB and related health problems in children. Methods/design: The study will be designed as a single-blind crossover randomized controlled trial with administration of both an “Active MAS” (Twin-block) and a “Sham MAS.” Eligible participants will be children aged 8–12 years whose parents report they snore ≥3 nights per week. Sixteen children will enter the full study after confirming other inclusion criteria, particularly Skeletal class I or class II confirmed by lateral cephalometric radiograph. Each child will be randomly assigned to either a treatment sequence starting with the Active or the Sham MAS. Participants will wear the appliances for 3 weeks separated by a 2-week washout period. For each participant, home-based polysomnographic data will be collected four times; once before and once after each treatment period. The Apnea Hypopnea Index (AHI) will represent the main outcome variable. Secondary outcomes will include, snoring frequency, masseter muscle activity, sleep symptoms, quality of life, daytime sleepiness, children behavior, and nocturnal enuresis. In addition, blood samples will be collected to assess growth hormone changes. Trial registration: This study was registered in the Australian New Zealand Clinical Trials Registry (ANZCTR): [ACTRN12614001013651]. PMID:27594841

Menopause is associated with self-reported poor sleep quality in women without vasomotor symptoms.

PubMed

Hung, Hao-Chang; Lu, Feng-Hwa; Ou, Horng-Yih; Wu, Jin-Shang; Yang, Yi-Ching; Chang, Chih-Jen

2014-08-01

The aim of this study was to investigate the relationship between menopause and self-reported sleep quality in Chinese women without vasomotor symptoms. Cross-sectional data were collected from a decoded database of the National Cheng Kung University Hospital. Menopause was defined as absence of menses for at least 12 months or a history of hysterectomy and oophorectomy. Self-reported sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). A higher global PSQI score indicates poorer self-reported sleep quality, and a global PSQI score greater than 5 differentiates poor sleepers from good sleepers. Of the 1,088 women recruited, 353 (32.4%) were in postmenopause status. Postmenopausal women had higher mean (SD) global PSQI scores (8.0 [3.3] vs. 6.1 [2.2], P < 0.001) and a greater prevalence of poor sleepers (73.1% vs. 60.8%, P < 0.001) compared with premenopausal women. Multivariate linear regression analysis showed that menopause (β = 1.532; 95% CI, 1.135 to 1.949; P < 0.001) and snoring (β = 0.764; 95% CI, 0.299 to 1.228; P = 0.001) were positively associated with global PSQI scores, whereas long sleep duration (β = -0.791; 95% CI, -1.113 to -0.468; P < 0.001) was negatively associated with global PSQI scores. Multivariate logistic regression analyses showed that menopause (odds ratio, 1.453; 95% CI, 1.030 to 2.051; P < 0.05), long sleep duration (odds ratio, 0.545; 95% CI, 0.418 to 0.710; P < 0.001), and snoring (odds ratio, 2.022; 95% CI, 1.312 to 3.116; P = 0.001) were independent predictors of poor sleepers. Postmenopausal women without vasomotor symptoms have significantly higher global PSQI scores and a higher risk of being poor sleepers than premenopausal women. In addition, menopause and snoring are associated with an increased risk of poor self-reported sleep quality independently of cardiometabolic factors and lifestyle, whereas long sleep duration is associated with a decreased risk of poor self-reported sleep quality.

Association between sleeping difficulty and type 2 diabetes in women.

PubMed

Li, Yanping; Gao, Xiang; Winkelman, John W; Cespedes, Elizabeth M; Jackson, Chandra L; Walters, Arthur S; Schernhammer, Eva; Redline, Susan; Hu, Frank B

2016-04-01

Sleeping difficulty has been associated with type 2 diabetes in some prior studies. Whether the observed associations are independent of health behaviours, other cardiovascular risk factors or other sleep disorders is unclear. We analysed data from 133,353 women without diabetes, cardiovascular disease and cancer at baseline in the Nurses' Health Study (NHS, 2000-2010) and the NHSII (2001-2011). Sleeping difficulty was assessed as having difficulty falling or staying asleep 'all of the time' or 'most of the time' at baseline (2000 in NHS and 2001 in NHSII). We documented 6,407 incident cases of type 2 diabetes during up to 10 years of follow-up. After adjustment for lifestyle factors at baseline, comparing women with and without sleeping difficulty, the multivariate-adjusted HR (95% CI) for type 2 diabetes was 1.45 (95% CI 1.33, 1.58), which changed to 1.22 (95% CI 1.12, 1.34) after further adjustment for hypertension, depression and BMI based on the updated repeated measurements. Women who reported all four sleep conditions (sleeping difficulty, frequent snoring, sleep duration ≤6 h and sleep apnoea in NHS or rotating shift work in NHSII) had more than a fourfold increased likelihood of type 2 diabetes (HR 4.17, 95% CI 2.93, 5.91). Sleeping difficulty was significantly associated with type 2 diabetes. This association was partially explained by associations with hypertension, BMI and depression symptoms, and was particularly strong when combined with other sleep disorders. Our findings highlight the importance of sleep disturbance in the development and prevention of type 2 diabetes.

Regional Brain Tissue Changes and Associations with Disease Severity in Children with Sleep Disordered Breathing.

PubMed

Horne, Rosemary S C; Roy, Bhaswati; Walter, Lisa M; Biggs, Sarah N; Tamanyan, Knarik; Weichard, Aidan; Nixon, Gillian M; Davey, Margot J; Ditchfield, Michael; Harper, Ronald M; Kumar, Rajesh

2017-12-15

Children with sleep-disordered breathing (SDB) exhibit behavioral, cognitive, and autonomic deficits, suggestive of neural injury. We assessed whether the tissue alterations resulted from acute or chronic processes, and if alterations correlated with disease severity. Brain tissue integrity was examined with mean diffusivity (MD) (3.0-Tesla scanner) in 20 non-snoring controls (mean age±sem, 12.2±0.6y; 10 male) and 18 children with SDB (12.3±0.7y; 11 male). Sleep, cognitive, and behavioral measures were compared between groups following overnight polysomnography using Student's t-tests. Whole-brain MD maps were realigned and averaged, normalized, smoothed, and compared between groups using ANCOVA (covariates; age, gender, and socioeconomic status). Partial correlations were calculated between whole-brain smoothed MD maps and obstructive apnea hypopnea indices (OAHI). Age, gender, and sleep variables did not differ between groups. The SDB group showed higher OAHI, body mass indices, and systolic blood pressure. Significantly reduced MD values (acute changes) appeared in the hippocampus, insula, thalamus, temporal and occipital cortices, and cerebellum, but were increased (chronic damage) in the frontal and prefrontal cortices in the SDB group over controls. Both positive and negative correlations appeared with extent of tissue changes and disease severity. Externalizing and Total Problem Behaviors were significantly higher in SDB children. Verbal, performance and total IQ scores trended lower, and behavioral scores trended higher. Pediatric SDB is accompanied by predominantly acute brain changes in areas that regulate autonomic, cognitive, and mood functions, and chronic changes in frontal cortices essential for behavioral control. Interventions need to be keyed to address acute vs chronic injury. © Sleep Research Society 2017. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

Microgravity reduces sleep-disordered breathing in humans.

PubMed

Elliott, A R; Shea, S A; Dijk, D J; Wyatt, J K; Riel, E; Neri, D F; Czeisler, C A; West, J B; Prisk, G K

2001-08-01

To understand the factors that alter sleep quality in space, we studied the effect of spaceflight on sleep-disordered breathing. We analyzed 77 8-h, full polysomnographic recordings (PSGs) from five healthy subjects before spaceflight, on four occasions per subject during either a 16- or 9-d space shuttle mission and shortly after return to earth. Microgravity was associated with a 55% reduction in the apnea-hypopnea index (AHI), which decreased from a preflight value of 8.3 +/- 1.6 to 3.4 +/- 0.8 events/h inflight. This reduction in AHI was accompanied by a virtual elimination of snoring, which fell from 16.5 +/- 3.0% of total sleep time preflight to 0.7 +/- 0.5% inflight. Electroencephalogram (EEG) arousals also decreased in microgravity (by 19%), and this decrease was almost entirely a consequence of the reduction in respiratory-related arousals, which fell from 5.5 +/- 1.2 arousals/h preflight to 1.8 +/- 0.6 inflight. Postflight there was a return to near or slightly above preflight levels in these variables. We conclude that sleep quality during spaceflight is not degraded by sleep-disordered breathing. This is the first direct demonstration that gravity plays a dominant role in the generation of apneas, hypopneas, and snoring in healthy subjects.

A unique complication of radiofrequency therapy to the tongue base

PubMed Central

Tornari, Chrysostomos; Wong, Gentle; Arora, Asit; Kotecha, Bhik

2015-01-01

Introduction Radiofrequency ablation treatment of the tongue base can be used either alone or as part of a multilevel approach in the treatment of snoring. This involves the generation of thermal energy around the circumvallate papillae of the tongue. Potential complications include ulceration, dysphagia, haematoma and abscess formation. Presentation of case We present the case of a 50-year-old patient who developed an anterior neck swelling following a second application of radiofrequency ablation therapy to the tongue base for snoring. This was secondary to an infection of a previously undiagnosed thyroglossal cyst. The patient made a full recovery following intravenous antibiotic therapy and ultrasound-guided needle aspiration. Discussion Thyroglossal tract remnants are thought to be present in seven percent of the adult population. An infection in a thyroglossal tract cyst has not previously been reported following radiofrequency ablation of the tongue base. Given the relatively high complication rate of tongue base radiofrequency ablation in some series, this complication may be under-recognised. Conclusion An infected thyroglossal tract cyst should be suspected in patients with anterior neck swellings following radiofrequency ablation therapy to the tongue base. We advise caution when performing this procedure on patients with known thyroglossal tract remnants though there is insufficient evidence to suggest that this procedure is contraindicated. PMID:25603484

Two-Dimensional Differential In-Gel Electrophoresis Proteomic Approaches Reveal Urine Candidate Biomarkers in Pediatric Obstructive Sleep Apnea

PubMed Central

Gozal, David; Jortani, Saeed; Snow, Ayelet B.; Kheirandish-Gozal, Leila; Bhattacharjee, Rakesh; Kim, Jinkwan; Capdevila, Oscar Sans

2009-01-01

Rationale: Sleep studies are laborious, expensive, inaccessible, and inconvenient for diagnosing obstructive sleep apnea (OSA) in children. Objectives: To examine whether the urinary proteome uncovers specific clusters that are differentially expressed in the urine of children with OSA. Methods: Two-dimensional differential in-gel electrophoresis (2D-DIGE) and mass spectrometry proteomics followed by validation with western blot of ELISA. Measurements and Main Results: Morning urine proteins from 60 children with polysomnographically confirmed OSA and from matched children with primary snoring (n = 30) and control subjects (n = 30) were assessed. A total of 16 proteins that are differentially expressed in OSA were identified, and 7 were confirmed by either immunoblots or ELISA. Among the latter, receiver–operator curve analyses of urinary concentrations of uromodulin, urocortin-3, orosomucoid-1, and kallikrein assigned favorable predictive properties to these proteins. Furthermore, combinatorial approaches indicated that the presence of values beyond the calculated cutoff concentrations for three or more of the proteins yielded a sensitivity of 95% and a specificity of 100%. Conclusions: Proteomic approaches reveal that pediatric OSA is associated with specific and consistent alterations in urinary concentrations of specific protein clusters. Future studies aiming to validate this approach as a screening method of habitually snoring children appears warranted. PMID:19797158

Lifestyle and oral facial disorders associated with sleep bruxism in children.

PubMed

Alencar, Nashalie Andrade de; Fernandes, Alline Birra Nolasco; Souza, Margareth Maria Gomes de; Luiz, Ronir Raggio; Fonseca-Gonçalves, Andréa; Maia, Lucianne Cople

2017-05-01

The aim of the study was to investigate the routine, sleep history, and orofacial disorders associated with children aged 3-7 years with nocturnal bruxism. Children (n = 66) were divided into groups of parent reported nocturnal bruxism (n = 34) and those without the disorder (n = 32). Data about the child's routine during the day, during sleep and awakening, headache frequency, temporomandibular joint (TMJ), and hearing impairments were obtained through interviews with parents/caregivers. Electromyography examination was used to assess the activity of facial muscles. Multiple logistic regression (MLR), chi-square test, and t-test analyses were performed. MLR revealed association of nightmares (p = 0.002; OR = 18.09) and snoring (p = 0.013; OR = 0.14) with bruxism. Variables related to awakening revealed an association with bruxism (p < 0.05). Parents of the main group (children with nocturnal bruxism) reported more complaints of orofacial pain, facial appearance, and headache occurrence (p < 0.05). Auditory and muscle disorders were not significant variables (p > 0.05). Nightmares and snoring are associated with nocturnal bruxism in children. Bruxism in children elicits consequences such as headache, orofacial pain, and pain related to awakening.

Abnormal afferent nerve endings in the soft palatal mucosa of sleep apnoics and habitual snorers.

PubMed

Friberg, D; Gazelius, B; Hökfelt, T; Nordlander, B

1997-07-23

Habitual snoring precedes obstructive sleep apnea (OSA), but the pathophysiological mechanisms behind progression are still unclear. The patency of upper airways depends on a reflexogen mechanism reacting on negative intrapharyngeal pressure at inspiration, probably mediated by mucosal receptors, i.e., via afferent nerve endings. Such nerves contain a specific nerve protein, protein-gene product 9.5 (PGP 9.5) and in some cases substance P (SP) and calcitonin gene-related (CGRP). Biopsies of the soft palatial mucosa were obtained from non-smoking men ten OSA patients, 11 habitual snorers and 11 non-snoring controls. The specimens were immunohistochemically analyzed for PGP 9.5, SP and CGRP. As compared to controls, an increased number of PGP-, SP- and CGRP-immunoreactive nerves were demonstrated in the mucosa in 9/10 OSA patients and 4/11 snorers, in addition to varicose nerve endings in the papillae and epithelium. Using double staining methodology, it could be shown that SP- and CGRP-like immunoreactivities (LIs) often coexisted in these fibres, as did CGRP- and PGP 9.5-LIs. The increased density in sensory nerve terminals are interpreted to indicate an afferent nerve lesion. Our results support the hypothesis of a progressive neurogenic lesion as a contributory factor to the collapse of upper airways during sleep in OSA patients.

Microgravity reduces sleep-disordered breathing in humans

NASA Technical Reports Server (NTRS)

Elliott, A. R.; Shea, S. A.; Dijk, D. J.; Wyatt, J. K.; Riel, E.; Neri, D. F.; Czeisler, C. A.; West, J. B.; Prisk, G. K.

2001-01-01

To understand the factors that alter sleep quality in space, we studied the effect of spaceflight on sleep-disordered breathing. We analyzed 77 8-h, full polysomnographic recordings (PSGs) from five healthy subjects before spaceflight, on four occasions per subject during either a 16- or 9-d space shuttle mission and shortly after return to earth. Microgravity was associated with a 55% reduction in the apnea-hypopnea index (AHI), which decreased from a preflight value of 8.3 +/- 1.6 to 3.4 +/- 0.8 events/h inflight. This reduction in AHI was accompanied by a virtual elimination of snoring, which fell from 16.5 +/- 3.0% of total sleep time preflight to 0.7 +/- 0.5% inflight. Electroencephalogram (EEG) arousals also decreased in microgravity (by 19%), and this decrease was almost entirely a consequence of the reduction in respiratory-related arousals, which fell from 5.5 +/- 1.2 arousals/h preflight to 1.8 +/- 0.6 inflight. Postflight there was a return to near or slightly above preflight levels in these variables. We conclude that sleep quality during spaceflight is not degraded by sleep-disordered breathing. This is the first direct demonstration that gravity plays a dominant role in the generation of apneas, hypopneas, and snoring in healthy subjects.

What sleep behaviors are associated with bruxism in children? A systematic review and meta-analysis.

PubMed

Guo, Huaqi; Wang, Tongxia; Li, Xuechao; Ma, Qiong; Niu, Xiaohong; Qiu, Jie

2017-12-01

The aim of this article was to assess the sleep behaviors that serve as risk factors related to bruxism in children ages 0 to 12 years by performing a systematic review and meta-analysis of published studies. Seven databases were searched to identify all peer-reviewed articles potentially relevant to the review. Data were pooled for random-effects modeling. Sleep risk factors related to bruxism in this age group are summarized using pooled odds ratios (ORs), 95% confidence intervals (CIs), and P values. Of 5637 initially identified articles, 14 met inclusion criteria. Study qualities of all case-control studies were high. Quality of cross-sectional studies was more variable. The pooled ORs, 95% CIs, and P values were as follows: snoring (2.86, 1.85-4.42, <0.0001), mouth breathing (1.51, 1.04-2.18, 0.029), restless sleep (2.31, 1.89-2.83, <0.0001), drooling (1.79, 1.07-2.97, 0.026), stomach position during sleep (1.70, 1.0-2.39, 0.003), and inadequate sleep time (2.56, 1.48-4.43, 0.001). Snoring, mouth breathing, restless sleep, drooling, stomach position during sleep, and lack of sleep were the risk factors related to bruxism in children.

Just a scary dream? A brief review of sleep terrors, nightmares, and rapid eye movement sleep behavior disorder.

PubMed

Haupt, Mark; Sheldon, Stephen H; Loghmanee, Darius

2013-10-01

The clinical spectrum of sleep disorders in children is broad, ranging from primary snoring and obstructive sleep apnea (OSA) syndrome to complex sleep-related behaviors and movement disorders. Although snoring and OSA typically receive significant attention and discussion, other biologically based sleep disorders are as common, if not more common, in children. A general pediatrician is frequently presented with the complaint of sleep talking, sleep walking, or abnormal movements during sleep. Even more alarming is the presentation of the child suddenly and explosively screaming during sleep. Such complaints fall under the category of parasomnias. Exclusive to sleep and wake-to-sleep transitions, these parasomnias include arousals with abnormal motor, behavioral, autonomic, or sensory symptoms. Parasomnias can be noticeably dissimilar in clinical manifestations, but most share biologic characteristics. Three parasomnias associated with loud vocalizations associated with sleep that can present to general practitioners include sleep terrors, nightmares, and rapid eye movement sleep behavior disorder (RBD). Although usually benign, these sleep disorders can be disruptive and even potentially dangerous to the patient and can often be threatening to quality of life. In this article, we describe the clinical features of some of these disorders and how to differentiate between their alarming presentations. Copyright 2013, SLACK Incorporated.

Association between sleeping difficulty and type 2 diabetes in women

PubMed Central

Li, Yanping; Gao, Xiang; Winkelman, John W.; Cespedes, Elizabeth M.; Jackson, Chandra L.; Walters, Arthur S.; Schernhammer, Eva; Redline, Susan; Hu, Frank B.

2017-01-01

AIMS/HYPOTHESIS Sleeping difficulty has been associated with type 2 diabetes in some prior studies. Whether the observed associations are independent of health behaviors, other cardiovascular risk factors, or other sleep disorders are unclear. METHODS We analyzed data from 133,353 women without diabetes, cardiovascular disease, and cancer at baseline in the Nurses’ Health Study (NHS, 2000–2010) and the NHSII (2001–2011). Sleeping difficulty was assessed as having difficulty falling or staying asleep “all of the time” or “most of the time” at baseline (2000 in NHS and 2001 in NHSII). RESULTS We documented 6,407 incident cases of type 2 diabetes during up to 10 years of follow-up. After adjustment for lifestyle factors at baseline, comparing women with and without sleeping difficulty, the multivariate-adjusted hazard ratio (HR, 95% confidence interval (CI)) for type 2 diabetes was 1.45 (95% CI 1.33, 1.58), which changed to 1.22 (95% CI 1.12, 1.34) after further adjustment for hypertension, depression and body mass index (BMI) based on the updated repeated measurements. Women who reported all four sleep conditions (sleeping difficulty, frequent snoring, sleep duration ≤6 hours, and sleep apnea in NHS or rotating shift work in NHSII) had more than 4-fold increased likelihood of type 2 diabetes (HR: 4.17, 95% CI 2.93, 5.91). CONCLUSIONS Sleeping difficulty was significantly associated with type 2 diabetes. This association was partially explained by associations with hypertension, BMI and depression symptoms, and was particularly strong when combined with other sleep disorders. Our findings highlight the importance of sleep disturbance in the development and prevention of type 2 diabetes. PMID:26818148

A Rare Cause of Obstructive Sleep Apnea Syndrome: Retropharyngeal Lipoma

PubMed Central

Dilek, Okan; Yilmaz, Cengiz; Gulek, Bozkurt; Akin, Mehmet Ali

2017-01-01

Lipoma is the most common benign mesenchymal neoplasm. About 16% of lipomas arise in the head and neck region, especially in the posterior neck. Large lipomas that originate from the retropharyngeal space may cause dyspnea, dysphagia, and snoring and occasionally may lead to obstructive sleep apnea syndrome (OSAS). Herein, we report a 45-year-old male patient with OSAS caused by a giant retropharyngeal lipoma with emphasis on CT findings. PMID:28912996

The adenoid as a key factor in upper airway infections.

PubMed

van Cauwenberge, P B; Bellussi, L; Maw, A R; Paradise, J L; Solow, B

1995-06-01

The adenoids (and the nasopharynx) play a key role in the normal functioning and in various pathologies of the upper respiratory tract. In this paper the role of adenoidal pathology and the beneficial effect of adenoidectomy in some upper respiratory tract and facial anomalies and diseases are discussed; otitis media with effusion, recurrent acute otitis media, sinusitis, snoring and sleep apnea and abnormal patterns in the midface growth and development.

Did Napoleon suffer from chronic rhonchopathy?

PubMed

Chouard, Claude-Henri

2017-04-01

If Napoleon had been treated, Europa would then have doubtless been different, and perhaps would not have known the last two World wars. This study plans to demonstrate that Napoleon very probably suffered from Chronic Rhonchopathy. Between 1983-1993, the author led their ENT department of CHU Saint-Antoine to contribute in the knowledge of chronic snoring and Obstructive Sleep Apneas Syndrome (OSAS), and to define the treatment of their consequences. As a result of these efforts, in Paris in 1987 the First International Congress on Chronic Rhonchopathy was organized. Obstructive Sleep Apnoea Syndrome (OSAS) is caused by anatomical and intermittent obstruction of the upper airway, which impedes passage of air to the lungs during sleep. Recent literature demonstrates that chronic snoring frequently precedes this obstruction by several years, and always accompanies this syndrome. All life long, there is a severity increasing continuum between more light snoring and more severe OSAS, i.e. Pickwick Syndrome. This continuum is described as a new disease called Chronic Rhonchopathy. This term was never discussed; since 2006, it has been implicitly recognized. Napoleon would sleep very little. He used to wake up in the night and then grasp the chance to work. Brief sleeping time in day repaired his fatigue. He also had a short and thick neck. In the last quarter of his life he had progressively suffered from obesity, daily involuntary sleepiness, and his intellectual capabilities had been undoubtedly decreasing. In the vast literature concerning Napoleon's behavior, the author brought together the clinical elements which could be due to this disease. This study looked for the morphological peculiarities of this OSAS in sculpture and painting, that had the Emperor as the model. Napoleon presented surely diurnal somnolence, asthenia, obesity, neck shortness, retrognatia, and nasal pathology. He did not suffer from these troubles while he was young. On the contrary, he took advantage of his multiple awakenings, doubtlessly due to apnea occurring during his paradoxical sleep, to deal with some of his main masterpieces, e.g. the French Code Civil. With age, the Emperor's chronic rhonchopathy became more severe. If he had benefitted of modern treatments, maybe Moskowa would not have been a French defeat and Waterloo would have been a victory for France.

Comparison of turbinoplasty surgery efficacy in patients with and without allergic rhinitis.

PubMed

Hamerschmidt, Rodrigo; Hamerschmidt, Rogério; Moreira, Ana Tereza Ramos; Tenório, Sérgio Bernardo; Timi, Jorge Rufno Ribas

2016-01-01

Turbinoplasty is a procedure that aims to reduce the size of the inferior turbinate through exuberant bone removal with high mucosal preservation. The procedure is recommended for patients with or without allergic rhinitis and those showing irreversible hypertrophy of inferior turbinates. To evaluate the efficacy of inferior turbinoplasty for obstructive and non-obstructive symptoms in patients with or without allergic rhinitis. Prospective study with 57 patients who underwent inferior turbinoplasty. They were evaluated for nasal obstruction, snoring, facial pressure, smell alterations, sneezing, nasal itching and runny nose symptoms, surgery time, and intraoperative bleeding. The last evaluation took place three months after surgery. Thirty-nine patients with allergic rhinitis and 18 without were assessed. Ninety days after surgery, 94.7% of patients showed degrees IV and V of breathing improvement; 89.5% showed moderate or complete improvement in snoring; all patients showed smell improvement (only one showed moderate improvement; all the others had full improvement); 95.5% experienced complete facial pressure improvement; and 89.7% showed moderate to complete improvement in nasal itching and runny nose symptoms, as well as in sneezing. The efficacy of inferior turbinoplasty was confirmed not only for obstructive symptoms, but also for non-obstructive symptoms in patients with and without allergic rhinitis. Copyright © 2015 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

[Changes of serum aminotransferase in children with obstructive sleep apnea hypopnea syndrome].

PubMed

Chen, Zhenjiang; Duo, Likun

2013-08-01

Obstructive sleep apnea hypopnea syndrome (OSAHS) and non-alcoholic fatty liver disease (NAFLD) are both strongly associated with obesity. Whether OSAHS is an independent risk factor for liver injury or not is uncertain. To assess the hypothesis that OSAHS is associated with liver injury independent of obesity. One hundred and thirty children with OSAHS and 77 children with primary snoring(PS) were enrolled. Polysomnography was performed. Body mass index (BMI), liver function tests, serum lipids, fasting plasma glucose (FPG), and insulin (INS) were measured. Seventeen children of OSAHS had elevated serum aminotransferase levels,while only 2 children of non-OSAHS had elevated serum aminotransferase in healthy control group (chi2 = 5.18, P < 0.05; OR = 5.64 CI 1.27-24.97). Fifteen children of obese had elevated serum aminotransferase levels, while only 4 children had elevated serum aminotransferase in non-obese group (chi2 = 4.58, P < 0.05; (OR = 1.97 CI 1.06-3.67). Seventy cases of obese children, 15 cases of elevated aminotransferase levels (21.4%), namely fatty liver patients, of these children, 14 had OSAHS (93.3%). In contrast, OSAHS was present in only 67.3% of obese children without elevated aminotransferase. OSAHS may be a risk factor for liver injury independent of obesity; Increased liver enzyme levels are frequently found in obese snoring children, particularly among those with OSAHS.

How do we recognize the child with OSAS?

PubMed

Joosten, Koen F; Larramona, Helena; Miano, Silvia; Van Waardenburg, Dick; Kaditis, Athanasios G; Vandenbussche, Nele; Ersu, Refika

2017-02-01

Obstructive sleep-disordered breathing includes a spectrum of clinical entities with variable severity ranging from primary snoring to obstructive sleep apnea syndrome (OSAS). The clinical suspicion for OSAS is most often raised by parental report of specific symptoms and/or abnormalities identified by the physical examination which predispose to upper airway obstruction (e.g., adenotonsillar hypertrophy, obesity, craniofacial abnormalities, neuromuscular disorders). Symptoms and signs of OSAS are classified into those directly related to the intermittent pharyngeal airway obstruction (e.g., parental report of snoring, apneic events) and into morbidity resulting from the upper airway obstruction (e.g., increased daytime sleepiness, hyperactivity, poor school performance, inadequate somatic growth rate or enuresis). History of premature birth and a family history of OSAS as well as obesity and African American ethnicity are associated with increased risk of sleep-disordered breathing in childhood. Polysomnography is the gold standard method for the diagnosis of OSAS but may not be always feasible, especially in low-income countries or non-tertiary hospitals. Nocturnal oximetry and/or sleep questionnaires may be used to identify the child at high risk of OSAS when polysomnography is not an option. Endoscopy and MRI of the upper airway may help to identify the level(s) of upper airway obstruction and to evaluate the dynamic mechanics of the upper airway, especially in children with combined abnormalities. Pediatr Pulmonol. 2017;52:260-271. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Associations of sleep bruxism with age, sleep apnea, and daytime problematic behaviors in children.

PubMed

Tachibana, M; Kato, T; Kato-Nishimura, K; Matsuzawa, S; Mohri, I; Taniike, M

2016-09-01

The aims of this study were to investigate the prevalence of sleep bruxism in children in Japan, and its relationships with sleep-related factors and daytime problematic behavior. Guardians of 6023 children aged 2-12 years completed the Japanese Sleep Questionnaire. Multiple regression analysis and structural equation modeling were performed. Sleep bruxism was reported in 21.0% children (n = 1263): the prevalence was highest in the age group of 5-7 years (27.4%). Multiple regression analysis showed that sleep bruxism had significant correlations with age 5-7 years (OR: 1.72; P < 0.0001), 'Moves a lot during sleep' (OR: 1.47; P < 0.0001), 'sleeps with mouth open' (OR: 1.56; P < 0.0001), and 'snores loudly' (OR: 1.80; P < 0.0001). In structural equation modeling, sleep bruxism had a significant but weak direct effect on daytime problematic behavior, while sleep bruxism significantly correlated with obstructive sleep apnea, which had a higher direct effect on daytime problematic behavior. Sleep bruxism was reported in 21.0% of Japanese children and had independent relationships with age, movements during sleep, and snoring. A comorbidity of sleep-disordered breathing might be related to daytime problematic behavior in children with sleep bruxism. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Usefulness and diagnostic value of the NEMA parameter combined with other selected bedside tests for prediction of difficult intubation.

PubMed

Torres, Kamil; Błoński, Marcin; Pietrzyk, Łukasz; Piasecka-Twaróg, Małgorzata; Maciejewski, Ryszard; Torres, Anna

2017-02-01

To assess the usefulness of the new NEMA (Neck Circumference Minus Acromion-Acromion Distance) parameter, in preoperative identification of patients' difficult intubation and compare it with other commonly used scales and tests. Prospective study. District Specialist Hospital of Lublin, Poland. Six hundreds twenty-nine patients underwent nonemergency surgical interventions. The NEMA parameter was confronted with: Modified Mallampati classification, TMD, RHTMD, NC, MPND, SMD, I-I D, A-AD, and medical history of difficult intubation and diagnosed obstructive sleep apnea syndrome or snoring. Higher medians of NEMA and Mallampati parameters were reported in patients with difficult intubation. AUC for Mallampati parameter was 0.733 while the NEMA parameter's AUC was 0.625. Sensitivity and specificity for Mallampati and NEMA parameter were respectively 0.79; 0.55 and 0.42; 0.75. Significantly higher MPN, RHTMD, Mallampati, and NEMA parameter were observed in patients in whom the BURP was used. Easy intubation occurs more frequently in patients with a history of OSAS or snoring than in those with difficult intubation. It seems that none of the known bedside tests for predicting difficult intubation have a discriminating power sufficient for clinicians. Our study draws attention to a novel parameter, called NEMA, which appears to be a strong predictor of DEI, especially in combination with the Mallampati scale. Copyright © 2016 Elsevier Inc. All rights reserved.

Sleep Duration, Snoring Prevalence, Obesity, and Behavioral Problems in a Large Cohort of Primary School Students in Japan.

PubMed

Sakamoto, Naoko; Gozal, David; Smith, Dale L; Yang, Limin; Morimoto, Noriko; Wada, Hiroo; Maruyama, Kotatsu; Ikeda, Ai; Suzuki, Yohei; Nakayama, Meiho; Horiguchi, Itsuko; Tanigawa, Takeshi

2017-03-01

Poor or short sleep and the presence of snoring indicative of sleep-disordered breathing (SDB) have been associated with behavioral problems in school-aged children. We examined the relationship between SDB, sleep duration, obesity risk, and behavioral characteristics in Japanese elementary school students using a large-scale survey. We conducted a cross-sectional study of children enrolled in all 46 public primary schools in Matsuyama city, Japan. The children's parents or guardians completed a questionnaire that covered sleep habits, presence of SDB risk, and behavioral characteristics. In total, 24 296 responses were received (90% response rate). After excluding incomplete responses, we analyzed complete datasets for 17 769 children. Mean sleep duration decreased with age, as did the prevalence of pediatric SDB. We found an increased risk for the presence of SDB and short sleep among overweight/obese children. With SDB or short sleep, we observed significantly increased odds of restless behaviors, fidgety behaviors, and poor concentration in school. Shorter sleep duration was associated with increased risk of obesity, and in turn, obesity increased SDB risk. Both short sleep duration and SDB risk were significantly associated with behavioral problems in school. © Sleep Research Society 2017. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

The effects of oral appliance therapy on occlusal function in patients with obstructive sleep apnea: a short-term prospective study.

PubMed

Otsuka, Ryo; Almeida, Fernanda Ribeiro; Lowe, Alan A

2007-02-01

The aim of this study was to objectively and prospectively assess whether oral appliances (OAs) alter occlusal function in patients treated for snoring or obstructive sleep apnea. The occlusal contact area (OCA) and bite force (Bf) of 12 patients who used OAs were measured with pressure-sensitive sheets in the morning and evening with the Dental Prescale Occluzer System. OCA and Bf were compared in each measurement period by using ANOVA. Percentage changes in the morning relative to the evening (OCA(M-E) and Bf(M-E)) were compared between the 2 periods by using the Wilcoxon signed rank test. Correlations between percentage changes in pretreatment and posttitration ((Pre-Post)OCA and (Pre-Post)Bf), age, and cephalometric variables were also assessed. Patients showed significant decreases in OCA and Bf when posttitration readings were compared with corresponding pretreatment measurements. OCA(M-E) and Bf(M-E) were significantly different between pretreatment and posttitration, suggesting that OCA and Bf tend to be smaller in the morning with OA use. (Pre-Post)Bf measured in the evening correlated with age. Effects on occlusal function after OA use were observed. These results suggest that practitioners should pay attention to the possible side effects of OAs on the dentition when treating patients with snoring or obstructive sleep apnea.

A Novel Approach to Prediction of Mild Obstructive Sleep Disordered Breathing in a Population-Based Sample: The Sleep Heart Health Study

PubMed Central

Caffo, Brian; Diener-West, Marie; Punjabi, Naresh M.; Samet, Jonathan

2010-01-01

This manuscript considers a data-mining approach for the prediction of mild obstructive sleep disordered breathing, defined as an elevated respiratory disturbance index (RDI), in 5,530 participants in a community-based study, the Sleep Heart Health Study. The prediction algorithm was built using modern ensemble learning algorithms, boosting in specific, which allowed for assessing potential high-dimensional interactions between predictor variables or classifiers. To evaluate the performance of the algorithm, the data were split into training and validation sets for varying thresholds for predicting the probability of a high RDI (≥ 7 events per hour in the given results). Based on a moderate classification threshold from the boosting algorithm, the estimated post-test odds of a high RDI were 2.20 times higher than the pre-test odds given a positive test, while the corresponding post-test odds were decreased by 52% given a negative test (sensitivity and specificity of 0.66 and 0.70, respectively). In rank order, the following variables had the largest impact on prediction performance: neck circumference, body mass index, age, snoring frequency, waist circumference, and snoring loudness. Citation: Caffo B; Diener-West M; Punjabi NM; Samet J. A novel approach to prediction of mild obstructive sleep disordered breathing in a population-based sample: the Sleep Heart Health Study. SLEEP 2010;33(12):1641-1648. PMID:21120126

Limitations of variable number of tandem repeat typing identified through whole genome sequencing of Mycobacterium avium subsp. paratuberculosis on a national and herd level.

PubMed

Ahlstrom, Christina; Barkema, Herman W; Stevenson, Karen; Zadoks, Ruth N; Biek, Roman; Kao, Rowland; Trewby, Hannah; Haupstein, Deb; Kelton, David F; Fecteau, Gilles; Labrecque, Olivia; Keefe, Greg P; McKenna, Shawn L B; De Buck, Jeroen

2015-03-08

Mycobacterium avium subsp. paratuberculosis (MAP), the causative bacterium of Johne's disease in dairy cattle, is widespread in the Canadian dairy industry and has significant economic and animal welfare implications. An understanding of the population dynamics of MAP can be used to identify introduction events, improve control efforts and target transmission pathways, although this requires an adequate understanding of MAP diversity and distribution between herds and across the country. Whole genome sequencing (WGS) offers a detailed assessment of the SNP-level diversity and genetic relationship of isolates, whereas several molecular typing techniques used to investigate the molecular epidemiology of MAP, such as variable number of tandem repeat (VNTR) typing, target relatively unstable repetitive elements in the genome that may be too unpredictable to draw accurate conclusions. The objective of this study was to evaluate the diversity of bovine MAP isolates in Canadian dairy herds using WGS and then determine if VNTR typing can distinguish truly related and unrelated isolates. Phylogenetic analysis based on 3,039 SNPs identified through WGS of 124 MAP isolates identified eight genetically distinct subtypes in dairy herds from seven Canadian provinces, with the dominant type including over 80% of MAP isolates. VNTR typing of 527 MAP isolates identified 12 types, including "bison type" isolates, from seven different herds. At a national level, MAP isolates differed from each other by 1-2 to 239-240 SNPs, regardless of whether they belonged to the same or different VNTR types. A herd-level analysis of MAP isolates demonstrated that VNTR typing may both over-estimate and under-estimate the relatedness of MAP isolates found within a single herd. The presence of multiple MAP subtypes in Canada suggests multiple introductions into the country including what has now become one dominant type, an important finding for Johne's disease control. VNTR typing often failed to identify closely and distantly related isolates, limiting the applicability of using this typing scheme to study the molecular epidemiology of MAP at a national and herd-level.

The eye in sleep apnea syndrome.

PubMed

Abdal, Helen; Pizzimenti, Joseph J; Purvis, Cheryl C

2006-03-01

Sleep apnea syndrome (SAS) is a disease characterized by recurrent complete or partial upper airway obstructions during sleep. The majority of patients with SAS demonstrate this obstruction either at the nasopharynx or the oropharynx. Risk factors for SAS include obesity, male gender, upper airway abnormalities, alcohol use, snoring, and neck girth of more than 17 in. in men or 16 in. in women. Reported ophthalmic findings in patients with SAS include floppy eyelid syndrome (FES), glaucoma, and non-arteritic anterior ischemic optic neuropathy (NAION).

A Map-Based Service Supporting Different Types of Geographic Knowledge for the Public

PubMed Central

Zhou, Mengjie; Wang, Rui; Tian, Jing; Ye, Ning; Mai, Shumin

2016-01-01

The internet enables the rapid and easy creation, storage, and transfer of knowledge; however, services that transfer geographic knowledge and facilitate the public understanding of geographic knowledge are still underdeveloped to date. Existing online maps (or atlases) can support limited types of geographic knowledge. In this study, we propose a framework for map-based services to represent and transfer different types of geographic knowledge to the public. A map-based service provides tools to ensure the effective transfer of geographic knowledge. We discuss the types of geographic knowledge that should be represented and transferred to the public, and we propose guidelines and a method to represent various types of knowledge through a map-based service. To facilitate the effective transfer of geographic knowledge, tools such as auxiliary background knowledge and auxiliary map-reading tools are provided through interactions with maps. An experiment conducted to illustrate our idea and to evaluate the usefulness of the map-based service is described; the results demonstrate that the map-based service is useful for transferring different types of geographic knowledge. PMID:27045314

A Map-Based Service Supporting Different Types of Geographic Knowledge for the Public.

PubMed

Zhou, Mengjie; Wang, Rui; Tian, Jing; Ye, Ning; Mai, Shumin

2016-01-01

The internet enables the rapid and easy creation, storage, and transfer of knowledge; however, services that transfer geographic knowledge and facilitate the public understanding of geographic knowledge are still underdeveloped to date. Existing online maps (or atlases) can support limited types of geographic knowledge. In this study, we propose a framework for map-based services to represent and transfer different types of geographic knowledge to the public. A map-based service provides tools to ensure the effective transfer of geographic knowledge. We discuss the types of geographic knowledge that should be represented and transferred to the public, and we propose guidelines and a method to represent various types of knowledge through a map-based service. To facilitate the effective transfer of geographic knowledge, tools such as auxiliary background knowledge and auxiliary map-reading tools are provided through interactions with maps. An experiment conducted to illustrate our idea and to evaluate the usefulness of the map-based service is described; the results demonstrate that the map-based service is useful for transferring different types of geographic knowledge.

Dream Content in Patients With Sleep Apnea: A Prospective Sleep Laboratory Study.

PubMed

Di Pauli, Franziska; Stefani, Ambra; Holzknecht, Evi; Brandauer, Elisabeth; Mitterling, Thomas; Holzinger, Brigitte; Högl, Birgit

2018-01-15

Few studies have addressed dreaming in patients with sleep apnea. We hypothesized that respiratory events and subsequent oxygen desaturation act as an important physiological trigger and may thus influence dream content in patients with a sleep-related breathing disorder. Seventy-six patients (28 women, mean age 54 years, range 20-82) who underwent polysomnography because of suspected sleep apnea participated in this study. Dream reports and dream questionnaires were collected immediately after first morning awakening, at 5:30 AM, at the sleep laboratory. Dream content analysis with respect to possible respiratory-related content was performed. Patients were stratified into primary snoring, mild, moderate, and severe sleep apnea groups. In 63 patients sleep apnea was diagnosed (mild n = 31, 49.2%, moderate n = 13, 20.6%, severe n = 19, 30.2%), and 13 subjects in whom a sleep-related breathing disorder was not confirmed were included as a control group with primary snoring. There was no significant difference in respiratory-related dream topics between patients and controls. Also, no influence of respiratory parameters measured during polysomnography on dream content was detectable. We failed to detect a difference in dream content between patients with sleep apnea and controls. Further studies are required to determine whether these results indicate that the incorporation of respiratory events into dreams is absent in patients with sleep apnea or represents a bias due to the collection of dream content in the early morning hours. © 2018 American Academy of Sleep Medicine

The Rematee Bumper Belt® positional therapy device for snoring and obstructive sleep apnea: Positional effectiveness in healthy subjects

PubMed Central

Matthews, Les; Fortier, Normand

2013-01-01

The present study was designed to investigate body position changes resulting from wearing a Rematee Bumper Belt (Rematee, Canada) during sleep. The majority of obstructive sleep apnea (OSA) patients will experience up to two times as many apneas and hypopneas while supine relative to lateral or prone body positions during sleep. It has been suggested that a positional therapy device could reduce the number of apneas and hypopneas in such patients. The present study was conducted to determine whether the Rematee Bumper Belt positional therapy device could prevent healthy subjects from sleeping in the supine position. Test subjects wore the belt for one to two nights. Each belt was equipped with an accelerometer that was used to measure the orientation of the belt relative to the horizontal plane. The results suggest that the belt creates an exclusion zone approximately 80° wide centred near the supine orientation, where subjects are effectively prevented to enter. Results of the present preliminary study suggests that the Rematee Bumper Belt positional therapy device is effective at limiting healthy subjects from sleeping in a supine position. The device appears to be most effective between 150° and 230°. A device with this capability may provide an inexpensive and potentially effective alternative treatment option for patients with OSA. This device has the capacity for reducing snoring and the apnea-hypopnea index in individuals with positional OSA. PMID:26078596

Position paper by Canadian dental sleep medicine professionals regarding the role of different health care professionals in managing obstructive sleep apnea and snoring with oral appliances

PubMed Central

Gauthier, Luc; Almeida, Fernanda; Arcache, Patrick; Ashton-McGregor, Catherine; Côté, David; Driver, Helen; Ferguson, Kathleen; Lavigne, Gilles; Martin, Philippe; Masse, Jean-François; Morisson, Florence; Pancer, Jeffrey; Samuels, Charles; Schachter, Maurice; Sériès, Frédéric; Sullivan, Glendon

2012-01-01

The present Canadian position paper contains recommendations for the management by dentists of sleep-disordered breathing in adults with the use of oral appliances (OAs) as a treatment option for snoring and obstructive sleep apnea (OSA). The recommendations are based on literature reviews and expert panel consensus. OAs offer an effective, first-line treatment option for patients with mild to moderate OSA who prefer an OA to continuous positive airway pressure (CPAP) therapy, or for severe OSA patients who cannot tolerate CPAP, are inappropriate candidates for CPAP or who have failed CPAP treatment attempts. The purpose of the present position paper is to guide interdisciplinary teamwork (sleep physicians and sleep dentists) and to clarify the role of each professional in the management of OA therapy. The diagnosis of OSA should always be made by a physician, and OAs should be fitted by a qualified dentist who is trained and experienced in dental sleep medicine. Follow-up assessment by the referring physician and polysomnography or sleep studies are required to verify treatment efficacy. The present article emphasizes the need for a team approach to OA therapy and provides treatment guidelines for dentists trained in dental sleep medicine. Many of the dentists and sleep physicians who contributed to the preparation of the present article are members of the Canadian Sleep Society and the authors reached a consensus based on the current literature. PMID:23061075

Maternal Sleep-Disordered Breathing.

PubMed

Pamidi, Sushmita; Kimoff, R John

2018-04-01

Emerging literature suggests that sleep-disordered breathing (SDB) worsens over the course of pregnancy and is associated with adverse maternal and fetal outcomes. Earlier studies, using mainly snoring as a surrogate marker for SDB, have shown an increase in the prevalence of SDB during pregnancy compared with that in the pregravid state. More recently, prospective observational studies in which the investigators ascertained SDB by using complete polysomnography have shown a prevalence ranging from approximately 17% to 45% in the third trimester. Pregnancy itself can be associated with daytime hypersomnolence, so complaints of increasing fatigue and sleepiness during pregnancy are not specific for SDB. Moreover, snoring in isolation also has relatively poor sensitivity and specificity as a screening tool for diagnosing maternal SDB. The indications for screening for SDB during routine obstetric prenatal visits are still unclear, but observational studies indicate that maternal SDB is linked with the development of adverse pregnancy outcomes, such as gestational hypertension and gestational diabetes mellitus. Some studies also have identified a relationship between maternal SDB and the delivery of infants who are small for gestational age. Aside from a few small interventional studies of CPAP in pregnant patients with gestational hypertension, little currently is known about whether treatment of SDB during pregnancy improves clinical outcomes for the mother and/or baby. Additional current knowledge gaps include elucidating underlying mechanisms of maternal SDB, determining optimal treatment strategies, and understanding the trajectory of SDB after delivery. Copyright © 2017. Published by Elsevier Inc.

Afternoon serum-melatonin in sleep disordered breathing.

PubMed

Ulfberg, J; Micic, S; Strøm, J

1998-08-01

To study afternoon serum-melatonin values in patients with sleep disordered breathing. Melatonin has a strong circadian rhythm with high values during the night-time and low values in the afternoon. Sleep disordered breathing may change the circadian rhythm of melatonin which may have diagnostic implications. The Sleep Laboratory, The Department of Internal Medicine, Avesta Hospital, Sweden, and the Department of Anaesthesiology, Glostrup University Hospital, Copenhagen, Denmark. We examined 60 consecutive patients admitted for sleep disordered breathing and 10 healthy non snoring controls. The patients underwent a sleep apnoea screening test having a specificity of 100% for the obstructive sleep apnoea syndrome (OSAS) using a combination of static charge sensitive bed and oximetry. Obstructive sleep apnoea syndrome was found in 49 patients, eight patients had borderline sleep disordered breathing (BSDB) and three patients were excluded due to interfering disease. Patients and controls had an afternoon determination of serum-melatonin. The Epworth Sleepiness Scale was used to score day-time sleepiness. In comparison with normal controls patients suffering from OSAS had significantly higher serum-melatonin levels in the afternoon. However, as a diagnostic test for OSAS in patients with sleep disordered breathing serum-melatonin showed a low sensitivity but a high specificity. The results indicate that breathing disorders during sleep in general affect pineal function. Sleep disordered breathing seems to disturb pineal function. Determination of afternoon serum-melatonin alone or together with a scoring of daytime sleepiness does not identify OSAS-patients in a heterogeneous population of patients complaining of heavy snoring and excessive daytime sleepiness.

Effect of an occlusal splint on sleep bruxism in children in a pilot study with a short-term follow up.

PubMed

Giannasi, Lilian Chrystiane; Santos, Israel Reis; Alfaya, Thays Almeida; Bussadori, Sandra Kalil; Franco de Oliveira, Luis Vicente

2013-10-01

The aim of the present study was to evaluate the effect of the use of an occlusal splint in children with bruxism in a pilot study with a short-term follow up. Seventeen children were recruited, only nine of whom formed the sample following the application of the inclusion criteria: presence of sleep bruxism for at least six months (based on parents' reports); presence of at least the first permanent molars; and no previous history of treatment involving an occlusal splint. The sample was submitted to a clinical exam. Other sleep problems were screened with the use of a sleep questionnaire filled out by parents before and after 90 days of occlusal splint usage. The children received a flat acrylic resin splint with full coverage of the occlusal surfaces to be worn in the maxilla. In children with erupting teeth, a space was created in the splint to allow normal eruption. After the 90-day period, the absence of sleep bruxism and sleep movements was noted in most of children. Moreover, snoring was reduced in nearly 50%, which raises a new issue to be investigated with regard to the pathophysiology of sleep bruxism. The use of an occlusal splint was effective in reducing the symptoms of sleep bruxism and other sleep problems. Further investigations should be carried out on the relationship between snoring and sleep bruxism in children. Copyright © 2013 Elsevier Ltd. All rights reserved.

Association of Sleep Apnea and Snoring With Incident Atrial Fibrillation in the Multi-Ethnic Study of Atherosclerosis

PubMed Central

Lin, Gen-Min; Colangelo, Laura A.; Lloyd-Jones, Donald M.; Redline, Susan; Yeboah, Joseph; Heckbert, Susan R.; Nazarian, Saman; Alonso, Alvaro; Bluemke, David A.; Punjabi, Naresh M.; Szklo, Moyses; Liu, Kiang

2015-01-01

The association between sleep apnea and atrial fibrillation (AF) has not been examined in a multiethnic adult population in prospective community-based studies. We prospectively (2000–2011) investigated the associations of physician-diagnosed sleep apnea (PDSA), which is considered more severe sleep apnea, and self-reported habitual snoring without PDSA (HS), a surrogate for mild sleep apnea, with incident AF in white, black, and Hispanic participants in the Multi-Ethnic Study of Atherosclerosis (MESA) who were free of clinical cardiovascular disease at baseline (2000–2002). Cox proportional hazards models were used to assess the associations, with adjustment for socioeconomic status, traditional vascular disease risk factors, race/ethnicity, body mass index, diabetes, chronic kidney disease, alcohol intake, and lipid-lowering therapy. Out of 4,395 respondents to a sleep questionnaire administered in MESA, 181 reported PDSA, 1,086 reported HS, and 3,128 reported neither HS nor PDSA (unaffected). Over an average 8.5-year follow-up period, 212 AF events were identified. As compared with unaffected participants, PDSA was associated with incident AF in the multivariable analysis, but HS was not (PDSA: hazard ratio = 1.76, 95% confidence interval: 1.03, 3.02; HS: hazard ratio = 1.02, 95% confidence interval: 0.72, 1.44). PDSA, a marker of more severe sleep apnea, was associated with higher risk of incident AF in this analysis of MESA data. PMID:25977516

Adjustable tongue advancement for obstructive sleep apnea: a pilot study.

PubMed

Hamans, Evert; Boudewyns, An; Stuck, Boris A; Baisch, Alexander; Willemen, Marc; Verbraecken, Johan; Van de Heyning, Paul

2008-11-01

Surgical treatment of obstructive sleep apnea (OSA) caused by hypopharyngeal collapse of the upper airway can be considered in patients who are intolerant to continuous positive airway pressure (CPAP). The present procedures addressing the hypopharynx are invasive and have substantial morbidity and limited efficacy. Ten patients (mean age, 44 years) with moderate to severe OSA, ie, an apnea-hypopnea index (AHI) between 15 and 50, with CPAP intolerance were included in a prospective, nonrandomized, multicenter study to evaluate the feasibility, safety, and efficacy of a novel tongue advancement procedure. The procedure consists of the implantation of a tissue anchor in the tongue base and an adjustment spool at the mandible. Titration of this tissue anchor results in advancement of the tongue and a patent upper airway. The mean AHI decreased from 22.8 at baseline to 11.8 at the 6-month follow-up (p = 0.007). The Epworth Sleepiness Scale score decreased from 11.4 at baseline to 7.7 at the 6-month follow-up (p = 0.094), and the snoring score decreased from 7.5 at baseline to 3.9 at the 6-month follow-up (p = 0.005). Four technical adverse events were noted, and 1 clinical adverse event occurred. Adjustable tongue advancement is a feasible and relatively safe way to reduce the AHI and snoring in selected patients with moderate to severe OSA and CPAP intolerance. Technical improvements and refinements to the procedure are ongoing.

Impaired memory consolidation in children with obstructive sleep disordered breathing

PubMed Central

Katz, Eliot S.; Kapur, Kush; Stickgold, Robert

2017-01-01

Memory consolidation is stabilized and even enhanced by sleep (and particularly by 12–15 Hz sleep spindles in NREM stage 2 sleep) in healthy children but it is unclear what happens to these processes when sleep is disturbed by obstructive sleep disordered breathing. This cross-sectional study investigates differences in declarative memory consolidation among children with primary snoring (PS) and obstructive sleep apnea (OSA) compared to controls. We further investigate whether memory consolidation group differences are associated with NREM stage 2 (N2) sigma (12–15 Hz) or NREM slow oscillation (0.5–1 Hz) spectral power bands. In this study, we trained and tested participants on a spatial declarative memory task with cued recall. Retest occurred after a period of daytime wake (Wake) or a night of sleep (Sleep) with in-lab polysomnography. 36 participants ages 5–9 years completed the protocol: 14 with OSA as defined by respiratory disturbance index (RDI) > 1/hour, 12 with primary snoring (PS) and 10 controls. OSA participants had poorer overall memory consolidation than controls across Wake and Sleep conditions [OSA: mean = -18.7% (5.8), controls: mean = 1.9% (7.2), t = -2.20, P = 0.04]. In contrast, PS participants and controls had comparable memory consolidation across conditions (t = 0.41; P = 0.38). We did not detect a main effect for condition (Sleep, Wake) or group x condition interaction on memory consolidation. OSA participants had lower N2 sigma power than PS (P = 0.03) and controls (P = 0.004) and N2 sigma power inversely correlated with percentage of time snoring on the study night (r = -0.33, P<0.05). Across all participants, N2 sigma power modestly correlated with memory consolidation in both Sleep (r = 0.37, P = 0.03) and Wake conditions (r = 0.44, P = 0.009). Further observed variable path analysis showed that N2 sigma power mediated the relationship between group and mean memory consolidation across Sleep and Wake states [Bindirect = 6.76(3.5), z = 2.03, P = 0.04]. NREM slow oscillation power did not correlate with memory consolidation. All results retained significance after controlling for age and BMI. In sum, participants with mild OSA had impaired memory consolidation and results were mediated by N2 sigma power. These results suggest that N2 sigma power could serve as biomarker of risk for cognitive dysfunction in children with sleep disordered breathing. PMID:29095855

Impaired memory consolidation in children with obstructive sleep disordered breathing.

PubMed

Maski, Kiran; Steinhart, Erin; Holbrook, Hannah; Katz, Eliot S; Kapur, Kush; Stickgold, Robert

2017-01-01

Memory consolidation is stabilized and even enhanced by sleep (and particularly by 12-15 Hz sleep spindles in NREM stage 2 sleep) in healthy children but it is unclear what happens to these processes when sleep is disturbed by obstructive sleep disordered breathing. This cross-sectional study investigates differences in declarative memory consolidation among children with primary snoring (PS) and obstructive sleep apnea (OSA) compared to controls. We further investigate whether memory consolidation group differences are associated with NREM stage 2 (N2) sigma (12-15 Hz) or NREM slow oscillation (0.5-1 Hz) spectral power bands. In this study, we trained and tested participants on a spatial declarative memory task with cued recall. Retest occurred after a period of daytime wake (Wake) or a night of sleep (Sleep) with in-lab polysomnography. 36 participants ages 5-9 years completed the protocol: 14 with OSA as defined by respiratory disturbance index (RDI) > 1/hour, 12 with primary snoring (PS) and 10 controls. OSA participants had poorer overall memory consolidation than controls across Wake and Sleep conditions [OSA: mean = -18.7% (5.8), controls: mean = 1.9% (7.2), t = -2.20, P = 0.04]. In contrast, PS participants and controls had comparable memory consolidation across conditions (t = 0.41; P = 0.38). We did not detect a main effect for condition (Sleep, Wake) or group x condition interaction on memory consolidation. OSA participants had lower N2 sigma power than PS (P = 0.03) and controls (P = 0.004) and N2 sigma power inversely correlated with percentage of time snoring on the study night (r = -0.33, P<0.05). Across all participants, N2 sigma power modestly correlated with memory consolidation in both Sleep (r = 0.37, P = 0.03) and Wake conditions (r = 0.44, P = 0.009). Further observed variable path analysis showed that N2 sigma power mediated the relationship between group and mean memory consolidation across Sleep and Wake states [Bindirect = 6.76(3.5), z = 2.03, P = 0.04]. NREM slow oscillation power did not correlate with memory consolidation. All results retained significance after controlling for age and BMI. In sum, participants with mild OSA had impaired memory consolidation and results were mediated by N2 sigma power. These results suggest that N2 sigma power could serve as biomarker of risk for cognitive dysfunction in children with sleep disordered breathing.

Polymorphisms in nitric oxide synthase and endothelin genes among children with obstructive sleep apnea.

PubMed

Chatsuriyawong, Siriporn; Gozal, David; Kheirandish-Gozal, Leila; Bhattacharjee, Rakesh; Khalyfa, Ahamed A; Wang, Yang; Sukhumsirichart, Wasana; Khalyfa, Abdelnaby

2013-09-06

Obstructive sleep apnea (OSA) is associated with adverse and interdependent cognitive and cardiovascular consequences. Increasing evidence suggests that nitric oxide synthase (NOS) and endothelin family (EDN) genes underlie mechanistic aspects of OSA-associated morbidities. We aimed to identify single nucleotide polymorphisms (SNPs) in the NOS family (3 isoforms), and EDN family (3 isoforms) to identify potential associations of these SNPs in children with OSA. A pediatric community cohort (ages 5-10 years) enriched for snoring underwent overnight polysomnographic (NPSG) and a fasting morning blood draw. The diagnostic criteria for OSA were an obstructive apnea-hypopnea Index (AHI) >2/h total sleep time (TST), snoring during the night, and a nadir oxyhemoglobin saturation <92%. Control children were defined as non-snoring children with AHI <2/h TST (NOSA). Endothelial function was assessed using a modified post-occlusive hyperemic test. The time to peak reperfusion (Tmax) was considered as the indicator for normal endothelial function (NEF; Tmax<45 sec), or ED (Tmax ≥ 45 sec). Genomic DNA from peripheral blood was extracted and allelic frequencies were assessed for, NOS1 (209 SNPs), NOS2 (122 SNPs), NOS3 (50 SNPs), EDN1 (43 SNPs), EDN2 (48 SNPs), EDN3 (14 SNPs), endothelin receptor A, EDNRA, (27 SNPs), and endothelin receptor B, EDNRB (23 SNPs) using a custom SNPs array. The relative frequencies of NOS-1,-2, and -3, and EDN-1,-2,-3,-EDNRA, and-EDNRB genotypes were evaluated in 608 subjects [128 with OSA, and 480 without OSA (NOSA)]. Furthermore, subjects with OSA were divided into 2 subgroups: OSA with normal endothelial function (OSA-NEF), and OSA with endothelial dysfunction (OSA-ED). Linkage disequilibrium was analyzed using Haploview version 4.2 software. For NOSA vs. OSA groups, 15 differentially distributed SNPs for NOS1 gene, and 1 SNP for NOS3 emerged, while 4 SNPs for EDN1 and 1 SNP for both EDN2 and EDN3 were identified. However, in the smaller sub-group for whom endothelial function was available, none of the significant SNPs was retained due to lack of statistical power. Differences in the distribution of polymorphisms among NOS and EDN gene families suggest that these SNPs could play a contributory role in the pathophysiology and risk of OSA-induced cardiovascular morbidity. Thus, analysis of genotype-phenotype interactions in children with OSA may assist in the formulation of categorical risk estimates.

Application of IS1311 locus 2 PCR-REA assay for the specific detection of 'Bison type' Mycobacterium avium subspecies paratuberculosis isolates of Indian origin.

PubMed

Singh, Ajay Vir; Chauhan, Devendra Singh; Singh, Abhinendra; Singh, Pravin Kumar; Sohal, Jagdip Singh; Singh, Shoor Vir

2015-01-01

Of the three major genotypes of Mycobacterium avium subspecies paratuberculosis (MAP), 'Bison type' is most prevalent genotype in the domestic livestock species of the country, and has also been recovered from patients suffering from Crohn's disease. Recently, a new assay based on IS1311 locus 2 PCR- restriction endonuclease analysis (REA) was designed to distinguish between 'Indian Bison type' and non-Indian genotypes. The present study investigated discriminatory potential of this new assay while screening of a panel of MAP isolates of diverse genotypes and from different geographical regions. A total of 53 mycobacterial isolates (41 MAP and 12 mycobacterium other than MAP), three MAP genomic DNA and 36 MAP positive faecal DNA samples from different livestock species (cattle, buffaloes, goat, sheep and bison) and geographical regions (India, Canada, USA, Spain and Portugal) were included in the study. The extracted DNA samples (n=92) were analyzed for the presence of MAP specific sequences (IS900, ISMav 2 and HspX) using PCR. DNA samples were further subjected to genotype differentiation using IS1311 PCR-REA and IS1311 L2 PCR-REA methods. All the DNA samples (except DNA from non-MAP mycobacterial isolates) were positive for all the three MAP specific sequences based PCRs. IS1311 PCR-REA showed that MAP DNA samples of Indian origin belonged to 'Bison type'. Whereas, of the total 19 non-Indian MAP DNA samples, 2, 15 and 2 were genotyped as 'Bison type', 'Cattle type' and 'Sheep type', respectively. IS1311 L2 PCR-REA method showed different restriction profiles of 'Bison type' genotype as compared to non-Indian DNA samples. IS1311 L2 PCR-REA method successfully discriminated 'Indian Bison type' from other non-Indian genotypes and showed potential to be future epidemiological tool and for genotyping of MAP isolates.

Sleep disturbances in Angelman syndrome: a questionnaire study.

PubMed

Bruni, Oliviero; Ferri, Raffaele; D'Agostino, Gaetana; Miano, Silvia; Roccella, Michele; Elia, Maurizio

2004-06-01

Only few studies are available on sleep disorders in Angelman syndrome (AS), a neurodevelopmental disorder with several behavior disturbances. The aim of this study was to determine the prevalence of sleep disorders in a relatively large group of AS subjects, compared to that of age-matched controls. Forty-nine consecutive parents of patients with AS (26 males and 23 females aged 2.3-26.2 years) were interviewed and filled out a comprehensive sleep questionnaire. Based on their genetic etiology, four groups were defined: deletion of chromosome 15q11-13 (25 subjects); methylation imprinting mutation (six subjects), UBE3A mutations (seven subjects) and paternal uniparental disomy (five subjects). In the remaining cases genetic testings were negative. A significantly high frequency of disorders of initiating and maintaining sleep, prolonged sleep latency, prolonged wakefulness after sleep onset, high number of night awakenings and reduced total sleep time were found in our AS patients, as compared to age-matched controls. We also found other types of sleep disorders, never reported before, such as enuresis, bruxism, sleep terrors, somnambulism, nocturnal hyperkinesia, and snoring. No differences were found between the four genetic aetiology groups. Moreover, we did not find important improvement of sleep disturbances from pre-pubertal to post-pubertal ages. Our data confirm the significant presence of sleep/wake rhythms fragmentation, peculiar of AS, and also demonstrate the presence of several other types of sleep disturbances in this syndrome.

Detailed maps of tropical forest types are within reach: forest tree communities for Trinidad and Tobago mapped with multiseason Landsat and multiseason fine-resolution imagery

Treesearch

Eileen H. Helmer; Thomas S. Ruzycki; Jay Benner; Shannon M. Voggesser; Barbara P. Scobie; Courtenay Park; David W. Fanning; Seepersad Ramnarine

2012-01-01

Tropical forest managers need detailed maps of forest types for REDD+, but spectral similarity among forest types; cloud and scan-line gaps; and scarce vegetation ground plots make producing such maps with satellite imagery difficult. How can managers map tropical forest tree communities with satellite imagery given these challenges? Here we describe a case study of...

New vegetation type map of India prepared using satellite remote sensing: Comparison with global vegetation maps and utilities

NASA Astrophysics Data System (ADS)

Roy, P. S.; Behera, M. D.; Murthy, M. S. R.; Roy, Arijit; Singh, Sarnam; Kushwaha, S. P. S.; Jha, C. S.; Sudhakar, S.; Joshi, P. K.; Reddy, Ch. Sudhakar; Gupta, Stutee; Pujar, Girish; Dutt, C. B. S.; Srivastava, V. K.; Porwal, M. C.; Tripathi, Poonam; Singh, J. S.; Chitale, Vishwas; Skidmore, A. K.; Rajshekhar, G.; Kushwaha, Deepak; Karnatak, Harish; Saran, Sameer; Giriraj, A.; Padalia, Hitendra; Kale, Manish; Nandy, Subrato; Jeganathan, C.; Singh, C. P.; Biradar, C. M.; Pattanaik, Chiranjibi; Singh, D. K.; Devagiri, G. M.; Talukdar, Gautam; Panigrahy, Rabindra K.; Singh, Harnam; Sharma, J. R.; Haridasan, K.; Trivedi, Shivam; Singh, K. P.; Kannan, L.; Daniel, M.; Misra, M. K.; Niphadkar, Madhura; Nagabhatla, Nidhi; Prasad, Nupoor; Tripathi, O. P.; Prasad, P. Rama Chandra; Dash, Pushpa; Qureshi, Qamer; Tripathi, S. K.; Ramesh, B. R.; Gowda, Balakrishnan; Tomar, Sanjay; Romshoo, Shakil; Giriraj, Shilpa; Ravan, Shirish A.; Behera, Soumit Kumar; Paul, Subrato; Das, Ashesh Kumar; Ranganath, B. K.; Singh, T. P.; Sahu, T. R.; Shankar, Uma; Menon, A. R. R.; Srivastava, Gaurav; Neeti; Sharma, Subrat; Mohapatra, U. B.; Peddi, Ashok; Rashid, Humayun; Salroo, Irfan; Krishna, P. Hari; Hajra, P. K.; Vergheese, A. O.; Matin, Shafique; Chaudhary, Swapnil A.; Ghosh, Sonali; Lakshmi, Udaya; Rawat, Deepshikha; Ambastha, Kalpana; Malik, Akhtar H.; Devi, B. S. S.; Gowda, Balakrishna; Sharma, K. C.; Mukharjee, Prashant; Sharma, Ajay; Davidar, Priya; Raju, R. R. Venkata; Katewa, S. S.; Kant, Shashi; Raju, Vatsavaya S.; Uniyal, B. P.; Debnath, Bijan; Rout, D. K.; Thapa, Rajesh; Joseph, Shijo; Chhetri, Pradeep; Ramachandran, Reshma M.

2015-07-01

A seamless vegetation type map of India (scale 1: 50,000) prepared using medium-resolution IRS LISS-III images is presented. The map was created using an on-screen visual interpretation technique and has an accuracy of 90%, as assessed using 15,565 ground control points. India has hitherto been using potential vegetation/forest type map prepared by Champion and Seth in 1968. We characterized and mapped further the vegetation type distribution in the country in terms of occurrence and distribution, area occupancy, percentage of protected area (PA) covered by each vegetation type, range of elevation, mean annual temperature and precipitation over the past 100 years. A remote sensing-amenable hierarchical classification scheme that accommodates natural and semi-natural systems was conceptualized, and the natural vegetation was classified into forests, scrub/shrub lands and grasslands on the basis of extent of vegetation cover. We discuss the distribution and potential utility of the vegetation type map in a broad range of ecological, climatic and conservation applications from global, national and local perspectives. We used 15,565 ground control points to assess the accuracy of products available globally (i.e., GlobCover, Holdridge's life zone map and potential natural vegetation (PNV) maps). Hence we recommend that the map prepared herein be used widely. This vegetation type map is the most comprehensive one developed for India so far. It was prepared using 23.5 m seasonal satellite remote sensing data, field samples and information relating to the biogeography, climate and soil. The digital map is now available through a web portal (http://bis.iirs.gov.in).

Looking for an old map

USGS Publications Warehouse

,

1996-01-01

Many people want maps that show an area of the United States as it existed many years ago. These are called historical maps, and there are two types. The most common type consists of special maps prepared by commercial firms to show such historical features as battle-fields, military routes, or the paths taken by famous travelers. Typically, these maps are for sale to tourists at the sites of historical events. The other type is the truly old map--one compiled by a surveyor or cartographer many years ago. Lewis and Clark, for example, made maps of their journeys into the Northwest Territories in 1803-6, and originals of some of these maps still exist.

Pediatric Home Sleep Apnea Testing

PubMed Central

Tan, Hui-Leng; Kheirandish-Gozal, Leila

2015-01-01

Pediatric OSA can result in significant neurocognitive, behavioral, cardiovascular, and metabolic morbidities. Prompt diagnosis and treatment are, therefore, of paramount importance. The current gold standard for diagnosis of OSA in children is in-laboratory polysomnography (PSG). Home sleep apnea testing has been considered as an alternative as it is potentially more cost effective, convenient, and accessible. This review concentrates mainly on the use of type 2 and 3 portable monitoring devices. The current evidence on the feasibility and diagnostic accuracy of home testing in the diagnosis of pediatric OSA was examined. Overall, the evidence in children is limited. Feasibility studies that have been performed have on the whole shown good results, with several reporting > 90% of their home recordings as meeting predetermined quality criteria regarding signal artifact and minimum recording time. The limited data comparing type 2 studies with in-laboratory PSG have shown no significant differences in respiratory parameters. The results pertaining to diagnostic accuracy of type 3 home sleep apnea testing devices are conflicting. Although more research is needed, home testing with at least a type 3 portable monitor offers a viable alternative in the diagnosis of otherwise healthy children with moderate to severe OSA, particularly in settings where access to polysomnography is scarce or unavailable. Of note, since most studies have been performed in habitually snoring healthy children, home sleep apnea testing may not be applicable to children with other comorbid conditions. In particular, CO2 monitoring is important in children in whom there is concern regarding nocturnal hypoventilation, such as children with neuromuscular disease, underlying lung disease, or obesity hypoventilation, and most home testing devices do not include a transcutaneous or end-tidal CO2 channel. PMID:26270608

Ordered versus Unordered Map for Primitive Data Types

DTIC Science & Technology

2015-09-01

mapped to some element. C++ provides two types of map containers within the standard template library, the std ::map and the std ::unordered_map...classes. As the name implies, the containers main functional difference is that the elements in the std ::map are ordered by the key, and the std ...unordered_map are not ordered based on their key. The std ::unordered_map elements are placed into “buckets” based on a hash value computed for their key

Non-Unitary Boson Mapping and Its Application to Nuclear Collective Motions

NASA Astrophysics Data System (ADS)

Takada, K.

First, the general theory of boson mapping for even-number many-fermion systems is surveyed. In order to overcome the confusion concerning the so-called unphysical or spurious states in the boson mapping, the correct concept of the unphysical states is precisely given in a clear-cut way. Next, a method to apply the boson mapping to a truncated many-fermion Hilbert space consisting of collective phonons is proposed, by putting special emphasis on the Dyson-type non-unitary boson mapping. On the basis of this method, it becomes possible for the first time to apply the Dyson-type boson mapping to analyses of collective motions in realistic nuclei. This method is also extended to be applicable to odd-number-fermion systems. As known well, the Dyson-type boson mapping is a non-unitary transformation and it gives a non-Hermitian boson Hamiltonian. It is not easy (but not impossible) to solve the eigenstates of the non-Hermitian Hamiltonian. A Hermitian treatment of this non-Hermitian eigenvalue problem is discussed and it is shown that this treatment is a very good approximation. Using this Hermitian treatment, we can obtain the normal-ordered Holstein-Primakoff-type boson expansion in the multi-collective-phonon subspace. Thereby the convergence of the boson expansion can be tested. Some examples of application of the Dyson-type non-unitary boson mapping to simplified models and realistic nuclei are also shown, and we can see that it is quite useful for analysis of the collective motions in realistic nuclei. In contrast to the above-mentioned ordinary type of boson mapping, which may be called a ``static'' boson mapping, the Dyson-type non-unitary selfconsistent-collective-coordinate method is discussed. The latter is, so to speak, a ``dynamical'' boson mapping, which is a dynamical extension of the ordinary boson mapping to be capable to include the coupling effects from the non-collective degrees of freedom selfconsistently. Thus all of the Dyson-type non-unitary boson mapping from A to Z is summarized in this paper.

National Park Service Vegetation Inventory Program, Cuyahoga Valley National Park, Ohio

USGS Publications Warehouse

Hop, Kevin D.; Drake, J.; Strassman, Andrew C.; Hoy, Erin E.; Menard, Shannon; Jakusz, J.W.; Dieck, J.J.

2013-01-01

The National Park Service (NPS) Vegetation Inventory Program (VIP) is an effort to classify, describe, and map existing vegetation of national park units for the NPS Natural Resource Inventory and Monitoring (I&M) Program. The NPS VIP is managed by the NPS Biological Resources Management Division and provides baseline vegetation information to the NPS Natural Resource I&M Program. The U.S. Geological Survey (USGS) Vegetation Characterization Program lends a cooperative role in the NPS VIP. The USGS Upper Midwest Environmental Sciences Center, NatureServe, and NPS Cuyahoga Valley National Park (CUVA) have completed vegetation classification and mapping of CUVA.Mappers, ecologists, and botanists collaborated to identify and describe vegetation types within the National Vegetation Classification Standard (NVCS) and to determine how best to map them by using aerial imagery. The team collected data from 221 vegetation plots within CUVA to develop detailed descriptions of vegetation types. Data from 50 verification sites were also collected to test both the key to vegetation types and the application of vegetation types to a sample set of map polygons. Furthermore, data from 647 accuracy assessment (AA) sites were collected (of which 643 were used to test accuracy of the vegetation map layer). These data sets led to the identification of 45 vegetation types at the association level in the NVCS at CUVA.A total of 44 map classes were developed to map the vegetation and general land cover of CUVA, including the following: 29 map classes represent natural/semi-natural vegetation types in the NVCS, 12 map classes represent cultural vegetation (agricultural and developed) in the NVCS, and 3 map classes represent non-vegetation features (open-water bodies). Features were interpreted from viewing color-infrared digital aerial imagery dated October 2010 (during peak leaf-phenology change of trees) via digital onscreen three-dimensional stereoscopic workflow systems in geographic information systems (GIS). The interpreted data were digitally and spatially referenced, thus making the spatial database layers usable in GIS. Polygon units were mapped to either a 0.5 ha or 0.25 ha minimum mapping unit, depending on vegetation type.A geodatabase containing various feature-class layers and tables shows the locations of vegetation types and general land cover (vegetation map), vegetation plot samples, verification sites, AA sites, project boundary extent, and aerial photographic centers. The feature-class layer and relate tables for the CUVA vegetation map provides 4,640 polygons of detailed attribute data covering 13,288.4 ha, with an average polygon size of 2.9 ha.Summary reports generated from the vegetation map layer show map classes representing natural/semi-natural types in the NVCS apply to 4,151 polygons (89.4% of polygons) and cover 11,225.0 ha (84.5%) of the map extent. Of these polygons, the map layer shows CUVA to be 74.4% forest (9,888.8 ha), 2.5% shrubland (329.7 ha), and 7.6% herbaceous vegetation cover (1,006.5 ha). Map classes representing cultural types in the NVCS apply to 435 polygons (9.4% of polygons) and cover 1,825.7 ha (13.7%) of the map extent. Map classes representing non-NVCS units (open water) apply to 54 polygons (1.2% of polygons) and cover 237.7 ha (1.8%) of the map extent.A thematic AA study was conducted of map classes representing natural/semi-natural types in the NVCS. Results present an overall accuracy of 80.7% (kappa index of 79.5%) based on data from 643 of the 647 AA sites. Most individual map-class themes exceed the NPS VIP standard of 80% with a 90% confidence interval.The CUVA vegetation mapping project delivers many geospatial and vegetation data products in hardcopy and/or digital formats. These products consist of an in-depth project report discussing methods and results, which include descriptions and a dichotomous key to vegetation types, map classification and map-class descriptions, and a contingency table showing AA results. The suite of products also includes a database of vegetation plots, verification sites, and AA sites; digital pictures of field sites; field data sheets; aerial photographic imagery; hardcopy and digital maps; and a geodatabase of vegetation types and land cover (map layer), fieldwork locations (vegetation plots, verification sites, and AA sites), aerial photographic index, project boundary, and metadata. All geospatial products are projected in Universal Transverse Mercator, Zone 17, by using the North American Datum of 1983. Information on the NPS VIP and completed park mapping projects are located on the Internet at and .

IntegratedMap: a Web interface for integrating genetic map data.

PubMed

Yang, Hongyu; Wang, Hongyu; Gingle, Alan R

2005-05-01

IntegratedMap is a Web application and database schema for storing and interactively displaying genetic map data. Its Web interface includes a menu for direct chromosome/linkage group selection, a search form for selection based on mapped object location and linkage group displays. An overview display provides convenient access to the full range of mapped and anchored object types with genetic locus details, such as numbers, types and names of mapped/anchored objects displayed in a compact scrollable list box that automatically updates based on selected map location and object type. Also, multilinkage group and localized map views are available along with links that can be configured for integration with other Web resources. IntegratedMap is implemented in C#/ASP.NET and the package, including a MySQL schema creation script, is available from http://cggc.agtec.uga.edu/Data/download.asp

[Obstructive sleep apnoea syndrome].

PubMed

García Castillo, Sergio; Hoyos Vázquez, María Del Perpetuo Socorro; Coloma Navarro, Ramón; Cruz Ruiz, Javier; Callejas González, Francisco Javier; Godoy Mayoral, Raúl; Tárraga López, Pedro Juan; Rodríguez Montes, José Antonio

2018-05-01

Obstructive sleep apnoea (OSA) is highly prevalent in children and a major public health problem. An attempt is made to determine the clinical and polysomnographic presentation of paediatric OSA in our area. Retrospective descriptive study of sleep tests conducted on children up to 14 years-old from 1999 to 2012 in the Sleep Unit of the University Hospital of Albacete. Age, gender, anthropometric, clinical data, indication and variables of sleep study, treatment, and outcomes were collected. The study included 234 children. OSA was found in 71.8%, with 42.3% moderate and 44.6% severe. The majority were male (60.7%) and the mean age 5 was years, of whom 78% were pre-school or school age. There was overweight/obesity in 44%, with 93.4% snoring, apnoea 84.5%, and 5.4% daytime sleepiness. There were 23 polysomnographies and 145 polygraphies, with a median apnoea/hypopnoea index (AHI) of 10, Sat.O2 minimum 84%, desaturation index 8, and mean sleep supine 53.65% and supine events 57.61%. Treatment was lifestyle modifications 29.2%, CPAP 6%, and surgery 42.9%. Improved snoring and/or apnoea 69.4%, and weight 32.4% of overweight/obesity children. Most of the studied children had a pathological AHI. Almost half were overweight/obese, and a high percentage had moderate-severe OSA. Most frequent treatment was surgery. The clinical outcome was favourable in almost 70%. Less than a third with OSA and overweight/obesity improved weight. Copyright © 2016 Asociación Española de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

The relationship between sleep problems and working memory in children born very preterm.

PubMed

McCann, Marie; Bayliss, Donna M; Anderson, Mike; Campbell, Catherine; French, Noel; McMichael, Judy; Reid, Corinne; Bucks, Romola S

2018-01-01

In two studies, the relationship between sleep and working memory performance was investigated in children born very preterm (i.e., gestation less than 32 weeks) and the possible mechanisms underlying this relationship. In Study 1, parent-reported measures of snoring, night-time sleep quality, and daytime sleepiness were collected on 89 children born very preterm aged 6 to 7 years. The children completed a verbal working memory task, as well as measures of processing speed and verbal storage capacity. Night-time sleep quality was found to be associated with verbal working memory performance over and above the variance associated with individual differences in processing speed and storage capacity, suggesting that poor sleep may have an impact on the executive component of working memory. Snoring and daytime sleepiness were not found to be associated with working memory performance. Study 2 introduced a direct measure of executive functioning and examined whether sleep problems would differentially impact the executive functioning of children born very preterm relative to children born to term. Parent-reported sleep problems were collected on 43 children born very preterm and 48 children born to term (aged 6 to 9 years). Problematic sleep was found to adversely impact executive functioning in the very preterm group, while no effect of sleep was found in the control group. These findings implicate executive dysfunction as a possible mechanism by which problematic sleep adversely impacts upon cognition in children born very preterm, and suggest that sleep problems can increase the cognitive vulnerability already experienced by many of these children.

Improved long-term autonomic function following resolution of sleep-disordered breathing in preschool-aged children.

PubMed

Walter, Lisa M; Biggs, Sarah N; Nisbet, Lauren C; Weichard, Aidan J; Hollis, Samantha L; Davey, Margot J; Anderson, Vicki; Nixon, Gillian M; Horne, Rosemary S C

2016-03-01

Sleep-disordered breathing (SDB) prevalence peaks in preschool children and is associated with deficits in cardiovascular functioning during sleep. No long-term studies have investigated the effects of SDB resolution in mitigating these outcomes. We hypothesized that following 3 years, normalization of alterations to heart rate (HR), pulse transit time (PTT), heart rate variability (HRV), and urinary catecholamines identified at the initial diagnosis would be associated with resolution of SDB. Forty-five children with SDB and 28 non-snoring controls underwent polysomnography at baseline (3-5 years) and follow-up (6-9 years). Children were classified into control, resolved, and unresolved SDB. Resolution was defined as an obstructive apnea-hypopnea index (OAHI) ≤1 event/h, no snoring on polysomnography (PSG), or indicated by parents. PTT is an inverse surrogate measure of blood pressure change. HRV was assessed using power spectral analysis. There was no change in PTT or HR between studies for any group. Our HRV data suggest reduced parasympathetic activity in children whose SDB resolved and increased parasympathetic activity in children whose SDB remained the same or worsened at follow-up. We identified a significant correlation between low frequency power and urinary dopamine and adrenaline levels at follow-up in the unresolved group, suggesting increased sympathetic activity in children with unresolved SDB. Our findings suggest an association between resolution of SDB and normalization of HRV in the long term in these preschool children and an augmented sympathetic activity in the children with residual SDB. This highlights the autonomic impact of SDB in young children and the importance of detection and treatment.

Spanish translation and cross-language validation of a sleep habits questionnaire for use in clinical and research settings.

PubMed

Baldwin, Carol M; Choi, Myunghan; McClain, Darya Bonds; Celaya, Alma; Quan, Stuart F

2012-04-15

To translate, back-translate and cross-language validate (English/Spanish) the Sleep Heart Health Study Sleep Habits Questionnaire for use with Spanish-speakers in clinical and research settings. Following rigorous translation and back-translation, this cross-sectional cross-language validation study recruited bilingual participants from academic, clinic, and community-based settings (N = 50; 52% women; mean age 38.8 ± 12 years; 90% of Mexican heritage). Participants completed English and Spanish versions of the Sleep Habits Questionnaire, the Epworth Sleepiness Scale, and the Acculturation Rating Scale for Mexican Americans II one week apart in randomized order. Psychometric properties were assessed, including internal consistency, convergent validity, scale equivalence, language version intercorrelations, and exploratory factor analysis using PASW (Version18) software. Grade level readability of the sleep measure was evaluated. All sleep categories (duration, snoring, apnea, insomnia symptoms, other sleep symptoms, sleep disruptors, restless legs syndrome) showed Cronbach α, Spearman-Brown coefficients and intercorrelations ≥ 0.700, suggesting robust internal consistency, correlation, and agreement between language versions. The Epworth correlated significantly with snoring, apnea, sleep symptoms, restless legs, and sleep disruptors) on both versions, supporting convergent validity. Items loaded on 4 factors accounted for 68% and 67% of the variance on the English and Spanish versions, respectively. The Spanish-language Sleep Habits Questionnaire demonstrates conceptual and content equivalency. It has appropriate measurement properties and should be useful for assessing sleep health in community-based clinics and intervention studies among Spanish-speaking Mexican Americans. Both language versions showed readability at the fifth grade level. Further testing is needed with larger samples.

Prevalence of obstructive sleep apnea among obese toddlers and preschool children.

PubMed

Bin-Hasan, Saadoun; Katz, Sherri; Nugent, Zoe; Nehme, Joy; Lu, Zihang; Khayat, Abdullah; Al-Saleh, Suhail; Amin, Reshma; Narang, Indra

2018-05-01

Obstructive sleep apnea (OSA) is a common disorder estimated at 1-5% in the school-aged children. With the obesity prevalence reaching staggering rates globally, OSA in obese adolescents is estimated to be 4-5-folds higher than their lean peers. There is a paucity of data regarding obesity-related OSA in children 6 years and less. This is particularly relevant as OSA is associated with neurocognitive deficits. The aim of this study is to evaluate the prevalence of OSA among obese toddlers and preschool children and further to determine what other factors may be associated with the presence of OSA. A retrospective study involving children ≤6 years, identified from two Canadian pediatric tertiary care centers who had an in-lab polysomnography (PSG). Obesity was defined by a BMI of > 95th percentile for age and gender or a z-score of > 2. OSA was diagnosed if the obstructive apnea-hypopnea index (OAHI) was greater than 2 events per hour. There were 60 participants included; the mean age was 4.4 years (standard deviation [SD] ± 1.7), mean BMI z-score was 3.0 (SD ± 1.2). Of these, 22/60 (36.6%) had OSA. Compared with the non-OSA group, the OSA group had a higher Epworth sleepiness score (p = 0.03) and were more likely to snore (p = 0.01). Young obese children should be assessed for OSA. A history of snoring and daytime sleepiness may be useful indicators to facilitate triage for a PSG, especially in resource-limited settings.

Oropharyngeal exercises in the treatment of obstructive sleep apnoea: our experience.

PubMed

Verma, Roshan K; Johnson J, Jai Richo; Goyal, Manoj; Banumathy, N; Goswami, Upendra; Panda, Naresh K

2016-12-01

Oropharyngeal exercises are new, non-invasive, cost effective treatment modality for the treatment of mild to moderate obstructive sleep apnoea. It acts by increasing the tone of pharyngeal muscles, is more physiological, and effects are long lasting. The aim of our present study was to evaluate the effect of oropharyngeal exercises in the treatment of mild to moderate obstructive sleep apnoea. Twenty patients of mild to moderate obstructive sleep apnoea syndrome (OSAS) were given oropharyngeal exercise therapy for 3 months divided into three phases in graded level of difficulty. Each exercise had to be repeated 10 times, 5 sets per day at their home. Oropharyngeal exercises were derived from speech-language pathology and included soft palate, tongue, and facial muscle exercises. Anthropometric measurements, snoring frequency, intensity, Epworth daytime sleepiness and Berlin sleep questionnaire, and full polysomnography were performed at baseline and at study conclusion. Body mass index (25.6 ± 3.1) did not change significantly at the end of the study period. There was significant reduction in the neck circumference (38.4 ± 1.3 to 37.8 ± 1.6) at the end of the study. Significant improvement was seen in symptoms of daytime sleepiness, witnessed apnoea, and snoring intensity. Significant improvement was also seen in sleep indices like minimum oxygen saturation, time duration of Sao2 < 90 %, sleep efficiency, arousal index, and total sleep time N3 stage of sleep at the end of study. Graded oropharyngeal exercise therapy increases the compliance and also reduces the severity of mild to moderate OSAS.

Sleep Symptoms, Race/Ethnicity, and Socioeconomic Position

PubMed Central

Grandner, Michael A.; Petrov, Megan E. Ruiter; Rattanaumpawan, Pinyo; Jackson, Nicholas; Platt, Alec; Patel, Nirav P.

2013-01-01

Study Objectives: Growing evidence indicates sleep is a major public health issue. Race/ethnicity and socioeconomics may contribute to sleep problems. This study assessed whether sleep symptoms were more prevalent among minorities and/or the socioeconomically disadvantaged. Design: Cross-sectional. Setting: Epidemiologic survey. Patients or Participants: 2007-2008 National Health and Nutrition Examination Survey (N = 4,081). Interventions: None. Measurements and Results: Sociodemographics included age, sex, race/ethnicity, marital status, and immigration. Socioeconomics included poverty, education, private insurance, and food insecurity. Sleep symptoms assessed were sleep latency > 30 min, difficulty falling asleep, sleep maintenance difficulties, early morning awakenings, non-restorative sleep, daytime sleepiness, snorting/gasping, and snoring. Decreased reported problems for most symptoms were found among minorities, immigrants, and lower education levels. In general, in fully adjusted models, long sleep latency was associated with female gender, being black/African American, lower education attainment, no private insurance, and food insecurity. Difficulty falling asleep, sleep maintenance difficulties, early morning awakenings, and non-restorative sleep were also associated with female gender and food insecurity. Daytime sleepiness was seen in female and divorced respondents. Snorting/gasping was more prevalent among male, other-Hispanic/Latino, and 9th- to 11th-grade-level respondents. Snoring was prevalent among male, other-Hispanic/Latino, less-educated, and food-insecure respondents. Conclusions: Sleep symptoms were associated with multiple sociodemographic and economic factors, though these relationships differed by predictor and sleep outcome. Also, reports depended on question wording. Citation: Grandner MA; Petrov MER; Rattanaumpawan P; Jackson N; Platt A; Patel NP. Sleep symptoms, race/ethnicity, and socioeconomic position. J Clin Sleep Med 2013;9(9):897-905. PMID:23997702

Blood pressure associated with sleep-disordered breathing in a population sample of children.

PubMed

Bixler, Edward O; Vgontzas, Alexandros N; Lin, Hung-Mo; Liao, Duanping; Calhoun, Susan; Fedok, Fred; Vlasic, Vukmir; Graff, Gavin

2008-11-01

The current criteria for sleep-disordered breathing (SDB) in children are not based on a clinically relevant outcome. The purpose of this study was to assess the association of blood pressure with SDB in a random sample of the local elementary school children (kindergarten through grade 5) using a 2-phased strategy. During phase 1, a brief questionnaire was completed for all of the children (N=5740) with a response rate of 78.5%. During phase 2, 700 randomly selected children from phase 1 with a response rate of 70.0% were assessed with a full polysomnograph and a history/physical, including an ECG; ear, nose, and throat; and pulmonary evaluation. We observed a significantly elevated systolic blood pressure associated with the apnea hypopnea index (AHI): AHI >or=1 (2.9 mm Hg); AHI >or=3 (7.1 mm Hg); and AHI >or=5 (12.9 mm Hg). The SDB and blood pressure association remained significant after adjusting for age, sex, race, body mass index percentile or waist circumference, sleep efficiency, percentage of rapid eye movement sleep, and snoring. In addition, older age, body mass index percentile, waist circumference, and snoring were significantly associated with blood pressure, independent of SDB. Based on these findings, our study suggests that SDB is significantly associated with higher levels of systolic blood pressure in children aged 5 to 12 years even after adjusting for the various confounding factors. Clinically, the data support the threshold of AHI >or=5 for the initiation of treatment for SDB. Additional research is indicated to assess the efficacy of SDB treatment on reducing blood pressure.

Characteristics of wake-up stroke.

PubMed

Tanimoto, Aki; Mehndiratta, Prachi; Koo, Brian B

2014-07-01

Wake-up stroke (WUS) accounts for up to 29.6% of ischemic strokes, but its mechanisms are poorly understood. The purpose of this study is to identify risk factors and characteristics of WUS. Seven-two ischemic strokes were classified as WUS or non-WUS. Collected were demographic information, medical history, cholesterol profile, and stroke characteristics including severity (National Institutes of Health Stroke Scale [NIHSS]) and mechanism (Trial of Org 10172 in Acute Stroke Treatment criteria). Subjects completed questionnaires screening for sleep apnea (Berlin questionnaire) and assessing sleep characteristics. There were 72 ischemic strokes, of which 28 WUS (38.9%). WUS and non-WUS patients were similar in regard to stroke risk factors. WUS patients tended to be African American and were significantly younger. WUS was significantly more likely to result from small-vessel disease mechanism (42.9% versus 14.0%; P=.006) and tended to be less severe WUS (NIHSS score 3 [1, 4] versus 4 [2, 11]; P=.13) than non-WUS. Groups did not differ in regard to scoring positively on the Berlin questionnaire, but WUS sufferers were more likely to snore frequently (90.5% versus 70.0%, P=.08). The lipid profile was significantly worse in WUS compared with non-WUS (low-density lipoprotein 124.6±38.4 versus 103.7±36.8; P=.03; cholesterol to high-density lipoprotein ratio 5.2±1.6 versus 4.3±1.6; P=.02). WUS is more likely to result from small-vessel disease mechanism. Poorer cholesterol profile and frequent snoring may contribute to WUS. Published by Elsevier Inc.

[Case of exploding head syndrome].

PubMed

Okura, Mutsumi; Taniguchi, Mitsutaka; Muraki, Hisae; Sugita, Hideko; Ohi, Motoharu

2010-01-01

Exploding head syndrome (EHS) attacks are characterized by the sensation of sudden loud banging noises, and are occasionally accompanied by the sensation of a flash light. Although these attacks in themselves are usually not painful, it is reported that EHS attacks may precede migraines and may be perceived as auras. A 53-year-old woman, with a 40-year history of fulgurating migraines, experienced 2 different types of EHS attacks. During most of the attacks, which were not painful, she heard sounds like someone yelling or cars passing by. Only 1 episode was accompanied with the sensation of a flash light and of sounds similar to those of an electrical short circuit. On the video-polysomnography, video-polysomnography showed 11 EHS attacks occurred during stage N1 and stage N2; these attacks were preceded by soft snoring. She also had moderate obstructive sleep apnea syndrome (Apnea Hypopnea Index: 16.7) for which an oral appliance was prescribed; the EHS attacks did not recur after this treatment. The pathophysiology of EHS is still unclear. A detailed analysis of PSG data may help in understanding the pathophysiology of this syndrome and also in the selection of therapeutic strategies.

Accurate and reproducible functional maps in 127 human cell types via 2D genome segmentation

PubMed Central

Hardison, Ross C.

2017-01-01

Abstract The Roadmap Epigenomics Consortium has published whole-genome functional annotation maps in 127 human cell types by integrating data from studies of multiple epigenetic marks. These maps have been widely used for studying gene regulation in cell type-specific contexts and predicting the functional impact of DNA mutations on disease. Here, we present a new map of functional elements produced by applying a method called IDEAS on the same data. The method has several unique advantages and outperforms existing methods, including that used by the Roadmap Epigenomics Consortium. Using five categories of independent experimental datasets, we compared the IDEAS and Roadmap Epigenomics maps. While the overall concordance between the two maps is high, the maps differ substantially in the prediction details and in their consistency of annotation of a given genomic position across cell types. The annotation from IDEAS is uniformly more accurate than the Roadmap Epigenomics annotation and the improvement is substantial based on several criteria. We further introduce a pipeline that improves the reproducibility of functional annotation maps. Thus, we provide a high-quality map of candidate functional regions across 127 human cell types and compare the quality of different annotation methods in order to facilitate biomedical research in epigenomics. PMID:28973456

Updating categorical soil maps using limited survey data by Bayesian Markov chain cosimulation.

PubMed

Li, Weidong; Zhang, Chuanrong; Dey, Dipak K; Willig, Michael R

2013-01-01

Updating categorical soil maps is necessary for providing current, higher-quality soil data to agricultural and environmental management but may not require a costly thorough field survey because latest legacy maps may only need limited corrections. This study suggests a Markov chain random field (MCRF) sequential cosimulation (Co-MCSS) method for updating categorical soil maps using limited survey data provided that qualified legacy maps are available. A case study using synthetic data demonstrates that Co-MCSS can appreciably improve simulation accuracy of soil types with both contributions from a legacy map and limited sample data. The method indicates the following characteristics: (1) if a soil type indicates no change in an update survey or it has been reclassified into another type that similarly evinces no change, it will be simply reproduced in the updated map; (2) if a soil type has changes in some places, it will be simulated with uncertainty quantified by occurrence probability maps; (3) if a soil type has no change in an area but evinces changes in other distant areas, it still can be captured in the area with unobvious uncertainty. We concluded that Co-MCSS might be a practical method for updating categorical soil maps with limited survey data.

Updating Categorical Soil Maps Using Limited Survey Data by Bayesian Markov Chain Cosimulation

PubMed Central

Dey, Dipak K.; Willig, Michael R.

2013-01-01

Updating categorical soil maps is necessary for providing current, higher-quality soil data to agricultural and environmental management but may not require a costly thorough field survey because latest legacy maps may only need limited corrections. This study suggests a Markov chain random field (MCRF) sequential cosimulation (Co-MCSS) method for updating categorical soil maps using limited survey data provided that qualified legacy maps are available. A case study using synthetic data demonstrates that Co-MCSS can appreciably improve simulation accuracy of soil types with both contributions from a legacy map and limited sample data. The method indicates the following characteristics: (1) if a soil type indicates no change in an update survey or it has been reclassified into another type that similarly evinces no change, it will be simply reproduced in the updated map; (2) if a soil type has changes in some places, it will be simulated with uncertainty quantified by occurrence probability maps; (3) if a soil type has no change in an area but evinces changes in other distant areas, it still can be captured in the area with unobvious uncertainty. We concluded that Co-MCSS might be a practical method for updating categorical soil maps with limited survey data. PMID:24027447

MAPPING SPATIAL ACCURACY AND ESTIMATING LANDSCAPE INDICATORS FROM THEMATIC LAND COVER MAPS USING FUZZY SET THEORY

EPA Science Inventory

This paper presents a fuzzy set-based method of mapping spatial accuracy of thematic map and computing several ecological indicators while taking into account spatial variation of accuracy associated with different land cover types and other factors (e.g., slope, soil type, etc.)...

Map generation in unknown environments by AUKF-SLAM using line segment-type and point-type landmarks

NASA Astrophysics Data System (ADS)

Nishihta, Sho; Maeyama, Shoichi; Watanebe, Keigo

2018-02-01

Recently, autonomous mobile robots that collect information at disaster sites are being developed. Since it is difficult to obtain maps in advance in disaster sites, the robots being capable of autonomous movement under unknown environments are required. For this objective, the robots have to build maps, as well as the estimation of self-location. This is called a SLAM problem. In particular, AUKF-SLAM which uses corners in the environment as point-type landmarks has been developed as a solution method so far. However, when the robots move in an environment like a corridor consisting of few point-type features, the accuracy of self-location estimated by the landmark is decreased and it causes some distortions in the map. In this research, we propose AUKF-SLAM which uses walls in the environment as a line segment-type landmark. We demonstrate that the robot can generate maps in unknown environment by AUKF-SLAM, using line segment-type and point-type landmarks.

High Resolution Typing by Whole Genome Mapping Enables Discrimination of LA-MRSA (CC398) Strains and Identification of Transmission Events

PubMed Central

Bosch, Thijs; Verkade, Erwin; van Luit, Martijn; Pot, Bruno; Vauterin, Paul; Burggrave, Ronald; Savelkoul, Paul; Kluytmans, Jan; Schouls, Leo

2013-01-01

After its emergence in 2003, a livestock-associated (LA-)MRSA clade (CC398) has caused an impressive increase in the number of isolates submitted for the Dutch national MRSA surveillance and now comprises 40% of all isolates. The currently used molecular typing techniques have limited discriminatory power for this MRSA clade, which hampers studies on the origin and transmission routes. Recently, a new molecular analysis technique named whole genome mapping was introduced. This method creates high-resolution, ordered whole genome restriction maps that may have potential for strain typing. In this study, we assessed and validated the capability of whole genome mapping to differentiate LA-MRSA isolates. Multiple validation experiments showed that whole genome mapping produced highly reproducible results. Assessment of the technique on two well-documented MRSA outbreaks showed that whole genome mapping was able to confirm one outbreak, but revealed major differences between the maps of a second, indicating that not all isolates belonged to this outbreak. Whole genome mapping of LA-MRSA isolates that were epidemiologically unlinked provided a much higher discriminatory power than spa-typing or MLVA. In contrast, maps created from LA-MRSA isolates obtained during a proven LA-MRSA outbreak were nearly indistinguishable showing that transmission of LA-MRSA can be detected by whole genome mapping. Finally, whole genome maps of LA-MRSA isolates originating from two unrelated veterinarians and their household members showed that veterinarians may carry and transmit different LA-MRSA strains at the same time. No such conclusions could be drawn based spa-typing and MLVA. Although PFGE seems to be suitable for molecular typing of LA-MRSA, WGM provides a much higher discriminatory power. Furthermore, whole genome mapping can provide a comparison with other maps within 2 days after the bacterial culture is received, making it suitable to investigate transmission events and outbreaks caused by LA-MRSA. PMID:23805225

Predictive mapping of soil organic carbon in wet cultivated lands using classification-tree based models: the case study of Denmark.

PubMed

Bou Kheir, Rania; Greve, Mogens H; Bøcher, Peder K; Greve, Mette B; Larsen, René; McCloy, Keith

2010-05-01

Soil organic carbon (SOC) is one of the most important carbon stocks globally and has large potential to affect global climate. Distribution patterns of SOC in Denmark constitute a nation-wide baseline for studies on soil carbon changes (with respect to Kyoto protocol). This paper predicts and maps the geographic distribution of SOC across Denmark using remote sensing (RS), geographic information systems (GISs) and decision-tree modeling (un-pruned and pruned classification trees). Seventeen parameters, i.e. parent material, soil type, landscape type, elevation, slope gradient, slope aspect, mean curvature, plan curvature, profile curvature, flow accumulation, specific catchment area, tangent slope, tangent curvature, steady-state wetness index, Normalized Difference Vegetation Index (NDVI), Normalized Difference Wetness Index (NDWI) and Soil Color Index (SCI) were generated to statistically explain SOC field measurements in the area of interest (Denmark). A large number of tree-based classification models (588) were developed using (i) all of the parameters, (ii) all Digital Elevation Model (DEM) parameters only, (iii) the primary DEM parameters only, (iv), the remote sensing (RS) indices only, (v) selected pairs of parameters, (vi) soil type, parent material and landscape type only, and (vii) the parameters having a high impact on SOC distribution in built pruned trees. The best constructed classification tree models (in the number of three) with the lowest misclassification error (ME) and the lowest number of nodes (N) as well are: (i) the tree (T1) combining all of the parameters (ME=29.5%; N=54); (ii) the tree (T2) based on the parent material, soil type and landscape type (ME=31.5%; N=14); and (iii) the tree (T3) constructed using parent material, soil type, landscape type, elevation, tangent slope and SCI (ME=30%; N=39). The produced SOC maps at 1:50,000 cartographic scale using these trees are highly matching with coincidence values equal to 90.5% (Map T1/Map T2), 95% (Map T1/Map T3) and 91% (Map T2/Map T3). The overall accuracies of these maps once compared with field observations were estimated to be 69.54% (Map T1), 68.87% (Map T2) and 69.41% (Map T3). The proposed tree models are relatively simple, and may be also applied to other areas. Copyright 2010 Elsevier Ltd. All rights reserved.

Vegetation mapping of the Mond Protected Area of Bushehr Province (south-west Iran).

PubMed

Mehrabian, Ahmadreza; Naqinezhad, Alireza; Mahiny, Abdolrassoul Salman; Mostafavi, Hossein; Liaghati, Homan; Kouchekzadeh, Mohsen

2009-03-01

Arid regions of the world occupy up to 35% of the earth's surface, the basis of various definitions of climatic conditions, vegetation types or potential for food production. Due to their high ecological value, monitoring of arid regions is necessary and modern vegetation studies can help in the conservation and management of these areas. The use of remote sensing for mapping of desert vegetation is difficult due to mixing of the spectral reflectance of bright desert soils with the weak spectral response of sparse vegetation. We studied the vegetation types in the semiarid to arid region of Mond Protected Area, south-west Iran, based on unsupervised classification of the Spot XS bands and then produced updated maps. Sixteen map units covering 12 vegetation types were recognized in the area based on both field works and satellite mapping. Halocnemum strobilaceum and Suaeda fruticosa vegetation types were the dominant types and Ephedra foliata, Salicornia europaea-Suaeda heterophylla vegetation types were the smallest. Vegetation coverage decreased sharply with the increase in salinity towards the coastal areas of the Persian Gulf. The highest vegetation coverage belonged to the riparian vegetation along the Mond River, which represents the northern boundary of the protected area. The location of vegetation types was studied on the separate soil and habitat diversity maps of the study area, which helped in final refinements of the vegetation map produced.

Performance Analysis of Modified Accelerative Preallocation MAC Protocol for Passive Star-Coupled WDMA Networks

NASA Astrophysics Data System (ADS)

Yun, Changho; Kim, Kiseon

2006-04-01

For the passive star-coupled wavelength-division multiple-access (WDMA) network, a modified accelerative preallocation WDMA (MAP-WDMA) media access control (MAC) protocol is proposed, which is based on AP-WDMA. To show the advantages of MAP-WDMA as an adequate MAC protocol for the network over AP-WDMA, the channel utilization, the channel-access delay, and the latency of MAP-WDMA are investigated and compared with those of AP-WDMA under various data traffic patterns, including uniform, quasi-uniform type, disconnected type, mesh type, and ring type data traffics, as well as the assumption that a given number of network stations is equal to that of channels, in other words, without channel sharing. As a result, the channel utilization of MAP-WDMA can be competitive with respect to that of AP-WDMA at the expense of insignificantly higher latency. Namely, if the number of network stations is small, MAP-WDMA provides better channel utilization for uniform, quasi-uniform-type, and disconnected-type data traffics at all data traffic loads, as well as for mesh and ring-type data traffics at low data traffic loads. Otherwise, MAP-WDMA only outperforms AP-WDMA for the first three data traffics at higher data traffic loads. In the aspect of channel-access delay, MAP-WDMA gives better performance than AP-WDMA, regardless of data traffic patterns and the number of network stations.

CMap 1.01: a comparative mapping application for the internet

USDA-ARS?s Scientific Manuscript database

CMap is a web-based tool for displaying and comparing maps of any type and from any species. A user can compare an unlimited number of maps, view pair-wise comparisons of known correspondences, and search for maps or for features by name, species, type and accession. CMap is freely available, can ...

Increasing the availability of national mapping products.

USGS Publications Warehouse

Roney, J.I.; Ogilvie, B.C.

1981-01-01

A discussion of the means employed by the US Geological Survey to facilitate map usage, covering aspects of project Map Accessibility Program including special rolled and folded map packaging, new market testing, parks and campgrounds program, expanded map dealer program, new booklet-type State sales index and catalog and new USGS map reference code. The USGS is seen as the producer of a tremendous nation-wide inventory of topographic and related map products available in unprecedented types, formats and scales, and as endeavouring to increase access to its products. The new USGS map reference code is appended. -J.C.Stone

Sleep-disordered breathing: a survey of otolaryngologic practice at military hospitals.

PubMed

Davidson, T M; Do, K L

2000-11-01

We conducted a survey of otolaryngologists at all Veterans Administration and Department of Defense hospitals in the United States to ascertain the nature and scope of their treatment of sleep-disordered breathing. Questionnaire responses indicated that head and neck surgeons in military hospitals have a strong interest in the management of patients with snoring and sleep apnea. Because of the difficulty in obtaining timely sleep test results and the low number of referrals from physicians who perform such testing, many otolaryngologists expressed a desire to be able to perform their own sleep testing.

Quantifying Patterns of Smooth Muscle Motility in the Gut and Other Organs With New Techniques of Video Spatiotemporal Mapping

PubMed Central

Lentle, Roger G.; Hulls, Corrin M.

2018-01-01

The uses and limitations of the various techniques of video spatiotemporal mapping based on change in diameter (D-type ST maps), change in longitudinal strain rate (L-type ST maps), change in area strain rate (A-type ST maps), and change in luminous intensity of reflected light (I-maps) are described, along with their use in quantifying motility of the wall of hollow structures of smooth muscle such as the gut. Hence ST-methods for determining the size, speed of propagation and frequency of contraction in the wall of gut compartments of differing geometric configurations are discussed. We also discuss the shortcomings and problems that are inherent in the various methods and the use of techniques to avoid or minimize them. This discussion includes, the inability of D-type ST maps to indicate the site of a contraction that does not reduce the diameter of a gut segment, the manipulation of axis [the line of interest (LOI)] of L-maps to determine the true axis of propagation of a contraction, problems with anterior curvature of gut segments and the use of adjunct image analysis techniques that enhance particular features of the maps. PMID:29686624

National Park Service Vegetation Mapping Inventory Program: Appalachian National Scenic Trail vegetation mapping project

USGS Publications Warehouse

Hop, Kevin D.; Strassman, Andrew C.; Hall, Mark; Menard, Shannon; Largay, Ery; Sattler, Stephanie; Hoy, Erin E.; Ruhser, Janis; Hlavacek, Enrika; Dieck, Jennifer

2017-01-01

The National Park Service (NPS) Vegetation Mapping Inventory (VMI) Program classifies, describes, and maps existing vegetation of national park units for the NPS Natural Resource Inventory and Monitoring (I&M) Program. The NPS VMI Program is managed by the NPS I&M Division and provides baseline vegetation information to the NPS Natural Resource I&M Program. The U.S. Geological Survey Upper Midwest Environmental Sciences Center, NatureServe, NPS Northeast Temperate Network, and NPS Appalachian National Scenic Trail (APPA) have completed vegetation classification and mapping of APPA for the NPS VMI Program.Mappers, ecologists, and botanists collaborated to affirm vegetation types within the U.S. National Vegetation Classification (USNVC) of APPA and to determine how best to map the vegetation types by using aerial imagery. Analyses of data from 1,618 vegetation plots were used to describe USNVC associations of APPA. Data from 289 verification sites were collected to test the field key to vegetation associations and the application of vegetation associations to a sample set of map polygons. Data from 269 validation sites were collected to assess vegetation mapping prior to submitting the vegetation map for accuracy assessment (AA). Data from 3,265 AA sites were collected, of which 3,204 were used to test accuracy of the vegetation map layer. The collective of these datasets affirmed 280 USNVC associations for the APPA vegetation mapping project.To map the vegetation and land cover of APPA, 169 map classes were developed. The 169 map classes consist of 150 that represent natural (including ruderal) vegetation types in the USNVC, 11 that represent cultural (agricultural and developed) vegetation types in the USNVC, 5 that represent natural landscapes with catastrophic disturbance or some other modification to natural vegetation preventing accurate classification in the USNVC, and 3 that represent nonvegetated water (non-USNVC). Features were interpreted from viewing 4-band digital aerial imagery using digital onscreen three-dimensional stereoscopic workflow systems in geographic information systems (GIS). (Digital aerial imagery was collected each fall during 2009–11 to capture leaf-phenology change of hardwood trees across the latitudinal range of APPA.) The interpreted data were digitally and spatially referenced, thus making the spatial-database layers usable in GIS. Polygon units were mapped to either a 0.5-hectare (ha) or 0.25-ha minimum mapping unit, depending on vegetation type or scenario; however, polygon units were mapped to 0.1 ha for alpine vegetation.A geodatabase containing various feature-class layers and tables provide locations and support data to USNVC vegetation types (vegetation map layer), vegetation plots, verification sites, validation sites, AA sites, project boundary extent and zones, and aerial image centers and flight lines. The feature-class layer and related tables of the vegetation map layer provide 30,395 polygons of detailed attribute data covering 110,919.7 ha, with an average polygon size of 3.6 ha; the vegetation map coincides closely with the administrative boundary for APPA.Summary reports generated from the vegetation map layer of the map classes representing USNVC natural (including ruderal) vegetation types apply to 28,242 polygons (92.9% of polygons) and cover 106,413.0 ha (95.9%) of the map extent for APPA. The map layer indicates APPA to be 92.4% forest and woodland (102,480.8 ha), 1.7% shrubland (1866.3 ha), and 1.8% herbaceous cover (2,065.9 ha). Map classes representing park-special vegetation (undefined in the USNVC) apply to 58 polygons (0.2% of polygons) and cover 404.3 ha (0.4%) of the map extent. Map classes representing USNVC cultural types apply to 1,777 polygons (5.8% of polygons) and cover 2,516.3 ha (2.3%) of the map extent. Map classes representing nonvegetated water (non-USNVC) apply to 332 polygons (1.1% of polygons) and cover 1,586.2 ha (1.4%) of the map extent.

Association between symptoms and subtypes of attention-deficit hyperactivity disorder and sleep problems/disorders.

PubMed

Chiang, Huey-Ling; Gau, Susan Shur-Fen; Ni, Hsing-Chang; Chiu, Yen-Nan; Shang, Chi-Yung; Wu, Yu-Yu; Lin, Liang-Ying; Tai, Yueh-Ming; Soong, Wei-Tsuen

2010-12-01

This study aimed to investigate the association between attention-deficit hyperactivity disorder (ADHD) symptoms and subtypes, and sleep schedules, daytime inadvertent napping, and sleep problems/disorders in children and adolescents with and without ADHD. The sample included 325 patients with ADHD, aged 10-17 years [male: 81.5%; combined type (ADHD-C): 174; predominantly inattentive type (ADHD-I): 130; predominantly hyperactive-impulsive type (ADHD-HI): 21], and 257 children and adolescents without lifetime ADHD (non-ADHD). We conducted psychiatric interviews with the participants and their mothers before making the diagnoses of ADHD, other psychiatric disorders, and sleep problems or disorders. We also collected the medication treatment data and parent and teacher reports of ADHD symptoms. Multi-level models were used for data analyses controlling for sex, age, psychiatric comorbidities, and treatment with methylphenidate. The ADHD-C and ADHD-I groups had more daytime inadvertent napping. In general, the three subtypes were associated with increased rates of sleep problems/disorders. Specifically, ADHD-C rather than ADHD-I was associated with circadian rhythm problems, sleep-talking, nightmares (also ADHD-HI), and ADHD-I was associated with hypersomnia. The most-related sleep schedules and problems for inattention and hyperactivity-impulsivity were earlier bedtime, later rise time, longer nocturnal sleep, more frequent daytime napping, insomnia, sleep terrors, sleep-talking, snoring, and bruxism across informants. The findings imply that in addition to the dichotomous approach of ADHD and considering the psychiatric comorbid conditions, ADHD subtypes and symptom dimensions need to be considered in clinical practice and in the research regarding the association between ADHD and sleep problems/disorders. © 2010 European Sleep Research Society.

The association between sleep disordered breathing, academic grades, and cognitive and behavioral functioning among overweight subjects during middle to late childhood.

PubMed

Beebe, Dean W; Ris, M Douglas; Kramer, Megan E; Long, Elizabeth; Amin, Raouf

2010-11-01

(1) to determine the associations of sleep disordered breathing (SDB) with behavioral functioning, cognitive test scores, and school grades during middle- to late-childhood, an under-researched developmental period in the SDB literature, and (2) to clarify whether associations between SDB and school grades are mediated by deficits in cognitive or behavioral functioning. cross-sectional correlative study. Office/hospital, plus reported functioning at home and at school. 163 overweight subjects aged 10-16.9 years were divided into 4 groups based upon their obstructive apnea+hypopnea index (AHI) during overnight polysomnography and parent report of snoring: Moderate-Severe OSA (AHI > 5, n = 42), Mild OSA (AHI = 1-5, n = 58), Snorers (AHI < 1 + snoring, n = 26), and No SDB (AHI < 1 and nonsnoring, n = 37). inpatient overnight polysomnography, parent- and self-report of school grades and sleep, parent- and teacher-report of daytime behaviors, and office-based neuropsychological testing. The 4 groups significantly differed in academic grades and parent- and teacher-reported behaviors, particularly inattention and learning problems. These findings remained significant after adjusting for subject sex, race, socioeconomic status, and school night sleep duration. Associations with SDB were confined to reports of behavioral difficulties in real-world situations, and did not extend to office-based neuropsychological tests. Findings from secondary analyses were consistent with, but could not definitively confirm, a causal model in which SDB affects school grades via its impact on behavioral functioning. SDB during middle- to late-childhood is related to important aspects of behavioral functioning, especially inattention and learning difficulties, that may result in significant functional impairment at school.

Catathrenia (Nocturnal Groaning): A Social Media Survey and State-of-the-Art Review.

PubMed

Alonso, Jose; Camacho, Macario; Chhetri, Dinesh K; Guilleminault, Christian; Zaghi, Soroush

2017-04-15

Catathrenia is an underrecognized nocturnal vocalization phenomenon that can be a source of perplexity to patients, bed partners, and medical providers. Catathrenia is distinct from both sleep talking (a parasomnia with loud talking during sleep) and snoring (noise due to vibration of upper airway soft tissues related to variations in airway resistance). The objective of this review is to provide an evidence-based resource to help the practitioner reliably evaluate and manage patients with this condition. Data were gathered from: (1) PubMed, Scopus, Web of Science, and Google Scholar; and (2) catathrenia social media groups (Yahoo and Facebook). Data collected were (1) 15 case reports and 17 case series describing 191 patients with catathrenia; (2) questionnaires from 47 catathrenia subjects; (3) 5 audio files. Catathrenia is a noise produced during sleep (distinct from snoring) with identifiable harmonics, a computable main frequency, and high-decibel intensity that involves active adduction and vibration of the vocal cords during expiration. The quality of groaning in catathrenia is monotone, and often presents with a morose or sexual connotation, causing a significant social problem for patients. Although there is no association with risk of physical harm, catathrenia does present a significant disturbance to the bed partner and has been associated with subjective impairments to sleep quality, including unrefreshing sleep and fatigue. Polysomnography can be useful if performed properly to confirm the diagnosis and to evaluate for comorbid sleep disturbances, such as obstructive sleep apnea or parasomnia. Directions for further research could involve consideration of deep breathing exercises, yoga, meditation, or myofunctional therapy to help abate symptoms. © 2017 American Academy of Sleep Medicine

Assessment of a neck-based treatment and monitoring device for positional obstructive sleep apnea.

PubMed

Levendowski, Daniel J; Seagraves, Sean; Popovic, Djordje; Westbrook, Philip R

2014-08-15

A majority of patients diagnosed with obstructive sleep apnea are position dependent whereby they are at least twice as severe when sleeping supine (POSA). This study evaluated the accuracy and efficacy of a neck-worn device designed to limit supine sleep. The study included nightly measurements of snoring, sleep/wake, time supine, and the frequency and duration of feedback to monitor compliance. Thirty patients between ages 18 and 75 years, BMI ≤ 35 with an overall apnea-hypopnea index (AHI) ≥ 5 and an overall AHI ≥ 1.5 times the non-supine AHI, and an Epworth score ≥ 5 were prospectively studied. Subjective reports and polysomnography were used to assess efficacy resulting from 4 weeks of in-home supine-avoidance therapy and to measure device accuracy. From 363 polysomnography reports, 209 provided sufficient positional data to estimate one site's prevalence of positional OSA. In 83% of participants exhibiting > 50% reduction in overall AHI, the mean and median reductions were 69% and 79%. Significant reductions in the overall and supine AHI, apnea index, percent time SpO2 < 90%, and snoring contributed to significant improvements in stage N1 and N2 sleep, reductions in cortical arousals and awakenings, and improved depression scores. Supine position was under-detected by > 5% in 3% of cases. Sleep efficiency by neck actigraphy was within 10% of polysomnography in 87% of the studies when position feedback was delivered. The prevalence of POSA was consistently > 70% when the overall AHI was < 60. The neck position therapy device is accurate and effective in restricting supine sleep, improving AHI, sleep architecture and continuity, and monitoring treatment outcomes.

Obstructive Sleep Apnea Syndrome in Company Workers: Development of a Two-Step Screening Strategy with a New Questionnaire.

PubMed

Eijsvogel, Michiel M; Wiegersma, Sytske; Randerath, Winfried; Verbraecken, Johan; Wegter-Hilbers, Esther; van der Palen, Job

2016-04-15

To develop and evaluate a screening questionnaire and a two-step screening strategy for obstructive sleep apnea syndrome (OSAS) in healthy workers. This is a cross-sectional study of 1,861 employees comprising healthy blue- and white-collar workers in two representative plants in the Netherlands from a worldwide consumer electronic company who were approached to participate. Employees were invited to complete various sleep questionnaires, and undergo separate single nasal flow recording and home polysomnography on two separate nights. Of the 1,861 employees, 249 provided informed consent and all nasal flow and polysomnography data were available from 176 (70.7%). OSAS was diagnosed in 65 (36.9%). A combination of age, absence of insomnia, witnessed breathing stops, and three-way scoring of the Berlin and STOPBANG questionnaires best predicted OSAS. Factor analysis identified a six-factor structure of the resulting new questionnaire: snoring, snoring severity, tiredness, witnessed apneas, sleep quality, and daytime well-being. Subsequently, some questions were removed, and the remaining questions were used to construct a new questionnaire. A scoring algorithm, computing individual probabilities of OSAS as high, intermediate, or low risk, was developed. Subsequently, the intermediate risk group was split into low and high probability for OSAS, based on nasal flow recording. This two-step approach showed a sensitivity of 63.1%, and a specificity of 90.1%. Specificity is important for low prevalence populations. A two-step screening strategy with a new questionnaire and subsequent nasal flow recording is a promising way to screen for OSAS in a healthy worker population. Development and validation of a screening instrument for obstructive sleep apnea syndrome in healthy workers. Netherlands Trial Register (www.trailregister.nl), number: NTR2675. © 2016 American Academy of Sleep Medicine.

Airway assessment by volumetric computed tomography in snorers and subjects with obstructive sleep apnea in a Far-East Asian population (Chinese).

PubMed

Chen, Ning-Hung; Li, Kasey K; Li, Shia-Yu; Wong, Chao-Reng; Chuang, Ming-Lung; Hwang, Chung-Chi; Wu, Yao-Kaung

2002-04-01

To evaluate the airway dimension of simple snorers and subjects with obstructive sleep apnea (OSA) in a Far-East Asian population (Chinese). Prospective study of 117 near-consecutive patients evaluated for snoring and possible OSA from January 1998 to December 1998 in a sleep laboratory. Overnight polysomnography (PSG) was performed on all patients and the sleep parameters, including respiratory disturbance index (RDI), snoring index, minimal oxygen saturation (min O2), percentage of slow wave sleep (SWS), and rapid eye movement (REM) were recorded. Three-dimensional computerized tomography (CT) during awake periods was performed. The anteroposterior (AP) and the lateral distance of the retropalatal (RP) region in the oropharynx, the smallest area of RP, and retroglossal (RG) regions, and the total volume of the oropharynx were measured. Ninety-eight patients were diagnosed with OSA (mean RDI, 41.48 +/- 26.45 events per hour; min O2, 72.82 +/- 12.86%), whereas 19 were simple snorers. The AP and the lateral distance of the RP region, as well as the smallest area of the RP region, are significantly smaller in subjects with OSA. However, no differences in the RG region and the total volume of the oropharynx were found between the two groups. Linear regression analysis demonstrated that the lateral dimension and the smallest RP area in overweight subjects inversely correlated with the RDI, but only the AP dimension of the RP area was found to have an inverse correlation with the RDI in the underweight subjects. In Far-East Asians (Chinese), the RP airway was found to be the primary site of narrowing in subjects with OSA, and the narrowest RP area was inversely correlated with RDI. Furthermore, weight may influence the pattern of RP narrowing by contributing to lateral collapse.

Impact of night sleep duration on glycemic and triglyceride levels in Chinese with different glycemic status.

PubMed

Zheng, Yu; Wang, Anping; Pan, Changyu; Lu, Juming; Dou, Jingtao; Lu, Zhaohui; Ba, Jianming; Wang, Baoan; Mu, Yiming

2015-01-01

The aim of the present study was to assess the relationship between night sleep duration and glycemic and triglyceride (TG) levels among people with different glycemic status. In all, 18,121 subjects aged ≥40 years were enrolled in this cross-sectional study, including 4318 with impaired glucose regulation (IGR), 4225 with diabetes, and 9578 with normal glucose regulation (NGR). The IGR + diabetes and NGR groups were divided into three subgroups according to self-reported night sleep duration as follows: (i) <6 h; (ii) 6-9 h; and (iii) >9 h. The associations of sleep duration with HbA1c, fasting plasma glucose (FPG), 2-h post-load plasma glucose (PPG), and TG levels were examined. Long night sleep duration (>9 h) was associated with higher HbA1c, FPG, PPG, and TG levels compared with sleep duration of 6-9 h (P < 0.01 for all) in the IGR + diabetes group, but not in the NGR group. This association was adjusted for potential confounders, including body mass index and depressive symptoms, and remained significant even after adjusting for snoring. A significant interaction between sleep duration and TG or snoring was observed for HbA1c levels, which attenuated the sleep-HbA1c association in the IGR + diabetes group. However, no significant association was observed between short night sleep duration and HbA1c levels. Long night sleep duration is associated with higher HbA1c, FPG, PPG, and TG levels in IGR and diabetes patients, independent of potential confounders. This may be important in clinical management of IGR and diabetes patients. © 2014 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and Wiley Publishing Asia Pty Ltd.

Factors predictive of obstructive sleep apnea in patients undergoing pre-operative evaluation for bariatric surgery and referred to a sleep laboratory for polysomnography

PubMed Central

Duarte, Ricardo Luiz de Menezes; Magalhães-da-Silveira, Flavio José

2015-01-01

Objective: To identify the main predictive factors for obtaining a diagnosis of obstructive sleep apnea (OSA) in patients awaiting bariatric surgery. Methods: Retrospective study of consecutive patients undergoing pre-operative evaluation for bariatric surgery and referred for in-laboratory polysomnography. Eight variables were evaluated: sex, age, neck circumference (NC), BMI, Epworth Sleepiness Scale (ESS) score, snoring, observed apnea, and hypertension. We employed ROC curve analysis to determine the best cut-off value for each variable and multiple linear regression to identify independent predictors of OSA severity. Results: We evaluated 1,089 patients, of whom 781 (71.7%) were female. The overall prevalence of OSA-defined as an apnea/hypopnea index (AHI) ≥ 5.0 events/h-was 74.8%. The best cut-off values for NC, BMI, age, and ESS score were 42 cm, 42 kg/m2, 37 years, and 10 points, respectively. All eight variables were found to be independent predictors of a diagnosis of OSA in general, and all but one were found to be independent predictors of a diagnosis of moderate/severe OSA (AHI ≥ 15.0 events/h), the exception being hypertension. We devised a 6-item model, designated the NO-OSAS model (NC, Obesity, Observed apnea, Snoring, Age, and Sex), with a cut-off value of ≥ 3 for identifying high-risk patients. For a diagnosis of moderate/severe OSA, the model showed 70.8% accuracy, 82.8% sensitivity, and 57.9% specificity. Conclusions: In our sample of patients awaiting bariatric surgery, there was a high prevalence of OSA. At a cut-off value of ≥ 3, the proposed 6-item model showed good accuracy for a diagnosis of moderate/severe OSA. PMID:26578136

Obstructive sleep apnea: the most common secondary cause of hypertension associated with resistant hypertension.

PubMed

Pedrosa, Rodrigo P; Drager, Luciano F; Gonzaga, Carolina C; Sousa, Marcio G; de Paula, Lílian K G; Amaro, Aline C S; Amodeo, Celso; Bortolotto, Luiz A; Krieger, Eduardo M; Bradley, T Douglas; Lorenzi-Filho, Geraldo

2011-11-01

Recognition and treatment of secondary causes of hypertension among patients with resistant hypertension may help to control blood pressure and reduce cardiovascular risk. However, there are no studies systematically evaluating secondary causes of hypertension according to the Seventh Joint National Committee. Consecutive patients with resistant hypertension were investigated for known causes of hypertension irrespective of symptoms and signs, including aortic coarctation, Cushing syndrome, obstructive sleep apnea, drugs, pheochromocytoma, primary aldosteronism, renal parenchymal disease, renovascular hypertension, and thyroid disorders. Among 125 patients (age: 52±1 years, 43% males, systolic and diastolic blood pressure: 176±31 and 107±19 mm Hg, respectively), obstructive sleep apnea (apnea-hypopnea index: >15 events per hour) was the most common condition associated with resistant hypertension (64.0%), followed by primary aldosteronism (5.6%), renal artery stenosis (2.4%), renal parenchymal disease (1.6%), oral contraceptives (1.6%), and thyroid disorders (0.8%). In 34.4%, no secondary cause of hypertension was identified (primary hypertension). Two concomitant secondary causes of hypertension were found in 6.4% of patients. Age >50 years (odds ratio: 5.2 [95% CI: 1.9-14.2]; P<0.01), neck circumference ≥41 cm for women and ≥43 cm for men (odds ratio: 4.7 [95% CI: 1.3-16.9]; P=0.02), and presence of snoring (odds ratio: 3.7 [95% CI: 1.3-11]; P=0.02) were predictors of obstructive sleep apnea. In conclusion, obstructive sleep apnea appears to be the most common condition associated with resistant hypertension. Age >50 years, large neck circumference measurement, and snoring are good predictors of obstructive sleep apnea in this population.

Prevalence and risk factors for active convulsive epilepsy in rural northeast South Africa

PubMed Central

Wagner, Ryan G.; Ngugi, Anthony K.; Twine, Rhian; Bottomley, Christian; Kamuyu, Gathoni; Gómez-Olivé, F. Xavier; Connor, Myles D.; Collinson, Mark A.; Kahn, Kathleen; Tollman, Stephen; Newton, Charles R.

2014-01-01

Summary Rationale Epilepsy is among the most common neurological disorders worldwide. However, there are few large, population-based studies of the prevalence and risk factors for epilepsy in southern Africa. Methods From August 2008 to February 2009, as part of a multi-site study, we undertook a three-stage, population-based study, embedded within the Agincourt health and socio-demographic surveillance system, to estimate the prevalence and identify risk factors of active convulsive epilepsy (ACE) in a rural South African population. Results The crude prevalence of ACE, after adjusting for non-response and the sensitivity of the screening method, was 7.0/1,000 individuals (95%CI 6.4–7.6) with significant geographic heterogeneity across the study area. Being male (OR = 2.3; 95%CI 1.6–3.2), family history of seizures (OR = 4.0; 95%CI 2.0–8.1), a sibling with seizures (OR = 7.0; 95%CI 1.6–31.7), problems after delivery (OR = 5.9; 95%CI 1.2–24.6), and history of snoring (OR = 6.5; 95%CI 4.5–9.5) were significantly associated with ACE. For children, their mother's exposure to some formal schooling was protective (OR = 0.30; 95%CI 0.11–0.84) after controlling for age and sex. Human immunodeficiency virus was not found to be associated with ACE. Conclusions ACE is less frequent in this part of rural South Africa than other parts of sub-Saharan Africa. Improving obstetric services could prevent epilepsy. The relationship between snoring and ACE requires further investigation, as does the relative contribution of genetic and environmental factors to examine the increased risk in those with a family history of epilepsy. PMID:24582322

Prevalence and risk factors for active convulsive epilepsy in rural northeast South Africa.

PubMed

Wagner, Ryan G; Ngugi, Anthony K; Twine, Rhian; Bottomley, Christian; Kamuyu, Gathoni; Gómez-Olivé, F Xavier; Connor, Myles D; Collinson, Mark A; Kahn, Kathleen; Tollman, Stephen; Newton, Charles R

2014-05-01

Epilepsy is among the most common neurological disorders worldwide. However, there are few large, population-based studies of the prevalence and risk factors for epilepsy in southern Africa. From August 2008 to February 2009, as part of a multi-site study, we undertook a three-stage, population-based study, embedded within the Agincourt health and socio-demographic surveillance system, to estimate the prevalence and identify risk factors of active convulsive epilepsy (ACE) in a rural South African population. The crude prevalence of ACE, after adjusting for non-response and the sensitivity of the screening method, was 7.0/1,000 individuals (95% CI 6.4-7.6) with significant geographic heterogeneity across the study area. Being male (OR=2.3; 95% CI 1.6-3.2), family history of seizures (OR=4.0; 95% CI 2.0-8.1), a sibling with seizures (OR=7.0; 95% CI 1.6-31.7), problems after delivery (OR=5.9; 95% CI 1.2-24.6), and history of snoring (OR=6.5; 95% CI 4.5-9.5) were significantly associated with ACE. For children, their mother's exposure to some formal schooling was protective (OR=0.30; 95% CI 0.11-0.84) after controlling for age and sex. Human immunodeficiency virus was not found to be associated with ACE. ACE is less frequent in this part of rural South Africa than other parts of sub-Saharan Africa. Improving obstetric services could prevent epilepsy. The relationship between snoring and ACE requires further investigation, as does the relative contribution of genetic and environmental factors to examine the increased risk in those with a family history of epilepsy. Copyright © 2014 Elsevier B.V. All rights reserved.

Effect of Lifestyle Modification Using a Smartphone Application on Obesity With Obstructive Sleep Apnea: A Short-term, Randomized Controlled Study.

PubMed

Cho, Sung-Woo; Wee, Jee Hye; Yoo, Sooyoung; Heo, Eunyoung; Ryu, Borim; Kim, Yoojung; Lee, Joong Seek; Kim, Jeong-Whun

2018-01-30

To investigate the short-term effects of a lifestyle modification intervention based on a mobile application (app) linked to a hospital electronic medical record (EMR) system on weight reduction and obstructive sleep apnea (OSA). We prospectively enrolled adults (aged >20 years) with witnessed snoring or sleep apnea from a sleep clinic. The patients were randomized into the app user (n=24) and control (n=23) groups. The mobile app was designed to collect daily lifestyle data by wearing a wrist activity tracker and reporting dietary intake. A summary of the lifestyle data was displayed on the hospital EMR and was reviewed. In the control group, the lifestyle modification was performed as per usual practice. All participants underwent peripheral arterial tonometry (WatchPAT) and body mass index (BMI) measurements at baseline and after 4 weeks of follow-up. Age and BMI did not differ significantly between the two groups. While we observed a significant decrease in the BMI of both groups, the decrease was greater in the app user group (P <0.001). Apnea-hypopnea index, respiratory distress index, and oxygenation distress index did not change significantly in both groups. However, the proportion of sleep spent snoring at >45 dB was significantly improved in the app user group alone (P =0.014). In either group, among the participants with successful weight reduction, the apnea-hypopnea index was significantly reduced after 4 weeks (P =0.015). Multiple regression analyses showed that a reduction in the apnea-hypopnea index was significantly associated with BMI. Although a short-term lifestyle modification approach using a mobile app was more effective in achieving weight reduction, improvement in OSA was not so significant. Long-term efficacy of this mobile app should be evaluated in the future studies.

[Assessment of the validity and utility of the Beijing questionnaire as atool to evaluate for obstructive sleep apnea hypopnea syndrome].

PubMed

Wang, X T; Gao, L M; Xu, W; Ding, X

2016-10-20

Objective: To test the Beijing questionnaire as a means of identifying patients with obstructive sleep apnea hypopnea syndrome（OSAHS）. Method: The Beijing questionnaire is designed as an explorative tool consist of 11 questions for patients with obstructive sleep apnea hypopnea, and is targeted toward key symptoms include snoring, apneas, daytime sleepiness, hypertension and overweight. 1 336 female participants living in communities of age≥40 years and 198 male adult subjects visting clinics were given questionnaires. Finally, 59 female and 198 male subjects underwent sleep studies after factor analysis,reliability check,internal consistency study. The correlation analysis was performed between the scores from the Beijing questionnaire and the apnea-hypopnea index from inlaboratory polysomnography.Receiver operating characteristics were constructed to determine optimal sensitivity and specificity. Twenty-four male subjects were recorded in the sleep laberatory again after operative. Result: Factor analysis reduced 11 questions of scale to four common factors as we have designed: snoring,apneas,other symptoms,risk factors. Cronbach's α coefficient of scale reached 0.7.There were an acceptable level of testretest reliability(r=0.619, P <0.01).The apnea hypopnea indices were significantly correlated with their Beijing questionnaire scores( P <0.01).For wemen,an Beijing questionnaire scroe of 19.5 provided a sensitivity of 74.3% and a specificity of 62.5%.For men,an Beijing questionnaire scroe of 22.5 provided a sensitivity of 90.9% and a specificity of 54.5%. And the postoperative Beijing questionnaire scroes changed with the apnea hypopnea indices. Conclusion: This questionnaire has a good validity and reliability and appears to be valid and sensitive to clinical change. Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.

[A case of severe obstructive sleep apnea hypopnea syndrome with urinary and anal incontinence].

PubMed

Zhou, Li; Ouyang, Ruoyun; Chen, Ping; Luo, Hong; Liu, Hanmei; Liu, Guiqian

2018-03-28

A case of a young male patient, who came to the Second Xiangya Hospital, Central South University because of snoring for 10 years and nocturnal gatism for half month, was analyzed retrospectively. He was diagnosed as obstructive sleep apnea hypopnea syndrome (OSAHS) finally. The patient had been diagnosed and treated as stroke in the local hospital, while urinary and anal incontinence were not relieved. It was a dilemma for him to be properly diagnosed and treated. Polysomnography in our hospital revealed apnea hypopnea index (AHI) at 44.7 events/h, oxygen desaturation index (ODI) at 70.8 events/h and the longest apnea time at 185 seconds while the lowest blood oxygen saturation reduced to 31%. In addition, 413 events of apnea accounted for 61.2% of the sleep time and the minimal heart rate was 23 times/min. The patient was diagnosed as severe OSAHS with hypoxia metabolic brain disease, moderate pulmonary arterial hypertension, secondary polycythemia and obesity hypoventilation syndrome finally. He received the treatment of positive airway pressure non-invasive ventilator with an average pressure at 11.7 cmH2O with reduced AHI and increased blood oxygen saturation. The urinary and anal incontinence disappeared during the first night of treatment and it has been totally resolved so far. We considered that gatism was secondary to OSAHS with severe hypoxia resulted from attenuated regulation of primary defecation in the night. Physicians should pay attention to OSAHS when accepting obese patients with nocturnal incontinence, obvious daytime sleepiness and night snoring. Urinary and anal incontinence could be completely disappeared under therapy of positive airway pressure.

Sleep Complaints in the Adult Brazilian Population: A National Survey Based on Screening Questions

PubMed Central

Bittencourt, Lia Rita A.; Santos-Silva, Rogerio; Taddei, Jose A.; Andersen, Monica L.; de Mello, Marco T.; Tufik, Sergio

2009-01-01

Study Objectives: The aim of the current survey was to investigate the prevalence of sleep complaints in a randomized cluster sample of the Brazilian population. Methods: A 3-stage cluster sampling technique was utilized to randomly select Brazilian subjects older than 16 years, of both genders and all socioeconomic classes. The final sample of 2,110 subjects from 150 different cities was enough to estimate prevalence in the Brazilian population with a sampling error of ± 2%. Questions about sleep complaints were administered face-to-face by Instituto Datafolha interviewers on March 26 and 27, 2008. Data were expanded using a weighted variable. Results: Of all interviewed subjects, 63% reported at least one sleep related complaint. Sleep complaint prevalence increased with age and was similar among inhabitants of different Brazilian regions, as well as between metropolitan areas and smaller cities. Insomnia and nightmares were significantly more prevalent in women (40% and 25%, respectively), and snoring was more prevalent in men (35%). For sleep complaints with frequencies greater than 3 times per week, we found the following prevalence: 61% for snoring, 35% for insomnia, 17% for nightmares, 53% for leg kicking, and 37% for breathing pauses. Conclusions: Because sleep disorders are affect a high proportion of the population and are known to be correlated with decreased well-being and productivity, more detailed national surveys are necessary to provide relevant information to develop approaches to prevention and treatment. Citation: Bittencourt LRA; Santos-Silva R; Taddei JA; Andersen ML; de Mello MT; Tufik S. Sleep complaints in the adult brazilian population: a national survey based on screening questions. J Clin Sleep Med 2009;5(5):459-463. PMID:19961032

Clearcut mapping and forest type mapping in eastern forests with LANDSAT data

NASA Technical Reports Server (NTRS)

Sutherland, K.

1981-01-01

The development and use of signature packages which provide a forest type map and which identify clearcut areas is discussed. The type map divides the forest land into three categories: softwood, mixed wood, and hardwood. The user defines each of these categories and adjusts the signature package to fit his needs. Success in identifying clearcuts and their stage of regrowth was demonstrated in New Hampshire where clearcuts range in size from 5 to 100 acres with between 30 and 40 acres being the most common.

Low Altitude AVIRIS Data for Mapping Landform Types on West Ship Island, Mississippi

NASA Technical Reports Server (NTRS)

Spruce, Joseph; Otvos, Ervin; Giardino, Marco

2002-01-01

A chain of barrier islands provides protection against hurricanes and severe storms along the south and southeastern shores of the United States. Barrier island landform types can be spectrally similar and as small as a few meters across, making highly detailed maps difficult to produce. To determine whether high-resolution airborne hyperspectral imagery could provide detailed maps of barrier island landform types, we used low-altitude hyperspectral and multispectral imagery to map surface environments of West Ship Island, Mississippi. We employed 3.4-meter AVIRIS hyperspectral imagery acquired in July 1999 and 0.5-meter ADAR multispectral data acquired in November 1997. The data were co-registered to digital ortho aerial imagery, and the AVIRIS data was scaled to ground reflectance using ATREM software. Unsupervised classification of AVIRIS and ADAR data proceeded using ISODATA clustering techniques. The resulting landform maps were field-checked and compared to aerial photography and digital elevation maps. Preliminary analyses indicated that the AVIRIS classification mapped more landform types, while the ADAR-based map enabled smaller patches to be identified. Used together, these maps provided a means to assess landform distributions of West Ship Island before and after Hurricane Gorges. Classification accuracy is being addressed through photo-interpretation and field surveys of sample areas selected with stratified random sampling.

Low Altitude AVIRIS Data for Mapping Landform Types on West Ship Island, Mississippi

NASA Technical Reports Server (NTRS)

Spruce, Joseph; Otvos, Ervin; Giardino, Marco

2003-01-01

A chain of barrier islands provides protection against hurricanes and severe storms along the southern and southeastern shores of the Unites States. Barrier island landform types can be spectrally similar and as small as a few meters across, making highly detailed maps difficult to produce. To determine whether high-resolution airborne hyperspectral imagery could provide detailed maps of barrier island landform types, we used low-altitude hyperspectral and multispectral imagery to map surface environments of West Ship Island, Mississippi. We employed 3.4 meter AVIRIS hyperspectral imagery acquired in July 1999 and 0.5 meter ADAR multispectral data acquired in November 1997. The data were co-registered to digital ortho aerial imagery, and the AVIRIS data was scaled to ground reflectance using ATREM software. Unsupervised classification of AVIRIS and ADAR data proceeded using ISODATA clustering techniques. The resulting landform maps were field-checked and compared to aerial photography and digital elevation maps. Preliminary analyses indicated that the AVIRIS classification mapped more landform types, while the ADAR-based map enabled smaller patches to be identified. Used together, these maps provided a means to assess landform distributions of West Ship Island before and after Hurricane Georges. Classification accuracy is being assessed through photo-interpretation and field surveys of sample areas selected with stratified random sampling.

National Park Service Vegetation Mapping Inventory Program: Natchez Trace Parkway vegetation mapping project report

USGS Publications Warehouse

Hop, Kevin D.; Strassman, Andrew C.; Nordman, Carl; Pyne, Milo; White, Rickie; Jakusz, Joseph; Hoy, Erin E.; Dieck, Jennifer

2016-01-01

The National Park Service (NPS) Vegetation Mapping Inventory (VMI) Program is an effort to classify, describe, and map existing vegetation of national park units for the NPS Natural Resource Inventory and Monitoring (I&M) Program. The NPS VMI Program is managed by the NPS I&M Division and provides baseline vegetation information to the NPS Natural Resource I&M Program. The U.S. Geological Survey Upper Midwest Environmental Sciences Center, NatureServe, NPS Gulf Coast Network, and NPS Natchez Trace Parkway (NATR; also referred to as Parkway) have completed vegetation classification and mapping of NATR for the NPS VMI Program.Mappers, ecologists, and botanists collaborated to affirm vegetation types within the U.S. National Vegetation Classification (USNVC) of NATR and to determine how best to map them by using aerial imagery. Analyses of data from 589 vegetation plots had been used to describe an initial 99 USNVC associations in the Parkway; this classification work was completed prior to beginning this NATR vegetation mapping project. Data were collected during this project from another eight quick plots to support new vegetation types not previously identified at the Parkway. Data from 120 verification sites were collected to test the field key to vegetation associations and the application of vegetation associations to a sample set of map polygons. Furthermore, data from 900 accuracy assessment (AA) sites were collected (of which 894 were used to test accuracy of the vegetation map layer). The collective of all these datasets resulted in affirming 122 USNVC associations at NATR.To map the vegetation and open water of NATR, 63 map classes were developed. including the following: 54 map classes represent natural (including ruderal) vegetation types in the USNVC, 5 map classes represent cultural (agricultural and developed) vegetation types in the USNVC, 3 map classes represent nonvegetation open-water bodies (non-USNVC), and 1 map class represents landscapes that had received tornado damage a few months prior to the time of aerial imagery collection. Features were interpreted from viewing 4-band digital aerial imagery by means of digital onscreen three-dimensional stereoscopic workflow systems in geographic information systems. (The aerial imagery was collected during mid-October 2011 for the northern reach of the Parkway and mid-November 2011 for the southern reach of the Parkway to capture peak leaf-phenology of trees.) The interpreted data were digitally and spatially referenced, thus making the spatial-database layers usable in geographic information systems. Polygon units were mapped to either a 0.5 hectare (ha) or 0.25 ha minimum mapping unit, depending on vegetation type or scenario.A geodatabase containing various feature-class layers and tables present the locations of USNVC vegetation types (vegetation map), vegetation plot samples, verification sites, AA sites, project boundary extent, and aerial image centers. The feature-class layer and related tables for the vegetation map provide 13,529 polygons of detailed attribute data covering 21,655.5 ha, with an average polygon size of 1.6 ha; the vegetation map coincides closely with the administrative boundary for NATR.Summary reports generated from the vegetation map layer of the map classes representing USNVC natural (including ruderal) vegetation types apply to 12,648 polygons (93.5% of polygons) and cover 18,542.7 ha (85.6%) of the map extent for NATR. The map layer indicates the Parkway to be 70.5% forest and woodland (15,258.7 ha), 0.3% shrubland (63.0 ha), and 14.9% herbaceous cover (3,221.0 ha). Map classes representing USNVC cultural types apply to 678 polygons (5.0% of polygons) and cover 2,413.9 ha (11.1%) of the map extent.

Ada Integrated Environment III Computer Program Development Specification. Volume III. Ada Optimizing Compiler.

DTIC Science & Technology

1981-12-01

file.library-unit{.subunit).SYMAP Statement Map: library-file. library-unit.subunit).SMAP Type Map: 1 ibrary.fi le. 1 ibrary-unit{.subunit). TMAP The library...generator SYMAP Symbol Map code generator SMAP Updated Statement Map code generator TMAP Type Map code generator A.3.5 The PUNIT Command The P UNIT...Core.Stmtmap) NAME Tmap (Core.Typemap) END Example A-3 Compiler Command Stream for the Code Generator Texas Instruments A-5 Ada Optimizing Compiler

Low Altitude AVIRIS Data for Mapping Landform Types on West Ship Island, Mississippi

NASA Technical Reports Server (NTRS)

Spruce, Joseph; Otvos, Ervin; Giardino, Marco

2002-01-01

This paper presents a viewgraph presentation on low altitude AVIRIS data for mapping landform types on West Ship Island, Mississippi. The topics of discussion include: 1) Project background; 2) Mapping methods; 3) Examples of results; 4) Apparent trends; and 5) Final remarks.

Multiscale sampling of plant diversity: Effects of minimum mapping unit size

USGS Publications Warehouse

Stohlgren, T.J.; Chong, G.W.; Kalkhan, M.A.; Schell, L.D.

1997-01-01

Only a small portion of any landscape can be sampled for vascular plant diversity because of constraints of cost (salaries, travel time between sites, etc.). Often, the investigator decides to reduce the cost of creating a vegetation map by increasing the minimum mapping unit (MMU), and/or by reducing the number of vegetation classes to be considered. Questions arise about what information is sacrificed when map resolution is decreased. We compared plant diversity patterns from vegetation maps made with 100-ha, 50-ha, 2-ha, and 0.02-ha MMUs in a 754-ha study area in Rocky Mountain National Park, Colorado, United States, using four 0.025-ha and 21 0.1-ha multiscale vegetation plots. We developed and tested species-log(area) curves, correcting the curves for within-vegetation type heterogeneity with Jaccard's coefficients. Total species richness in the study area was estimated from vegetation maps at each resolution (MMU), based on the corrected species-area curves, total area of the vegetation type, and species overlap among vegetation types. With the 0.02-ha MMU, six vegetation types were recovered, resulting in an estimated 552 species (95% CI = 520-583 species) in the 754-ha study area (330 plant species were observed in the 25 plots). With the 2-ha MMU, five vegetation types were recognized, resulting in an estimated 473 species for the study area. With the 50-ha MMU, 439 plant species were estimated for the four vegetation types recognized in the study area. With the 100-ha MMU, only three vegetation types were recognized, resulting in an estimated 341 plant species for the study area. Locally rare species and keystone ecosystems (areas of high or unique plant diversity) were missed at the 2-ha, 50-ha, and 100-ha scales. To evaluate the effects of minimum mapping unit size requires: (1) an initial stratification of homogeneous, heterogeneous, and rare habitat types; and (2) an evaluation of within-type and between-type heterogeneity generated by environmental gradients and other factors. We suggest that at least some portions of vegetation maps created at a coarser level of resolution be validated at a higher level of resolution.

Common fixed point theorems for maps under a contractive condition of integral type

NASA Astrophysics Data System (ADS)

Djoudi, A.; Merghadi, F.

2008-05-01

Two common fixed point theorems for mapping of complete metric space under a general contractive inequality of integral type and satisfying minimal commutativity conditions are proved. These results extend and improve several previous results, particularly Theorem 4 of Rhoades [B.E. Rhoades, Two fixed point theorems for mappings satisfying a general contractive condition of integral type, Int. J. Math. Math. Sci. 63 (2003) 4007-4013] and Theorem 4 of Sessa [S. Sessa, On a weak commutativity condition of mappings in fixed point considerations, Publ. Inst. Math. (Beograd) (N.S.) 32 (46) (1982) 149-153].

Otorhinolaryngological aspects of sleep-related breathing disorders

PubMed Central

Virk, Jagdeep S.

2016-01-01

Snoring and obstructive sleep apnoea (OSA) are disorders within a wide spectrum of sleep-related breathing disorders (SRBD). Given the obesity epidemic, these conditions will become increasingly prevalent and continue to serve as a large economic burden. A thorough clinical evaluation and appropriate investigations will allow stratification of patients into appropriate treatment groups. A multidisciplinary team is required to manage these patients. Patient selection is critical in ensuring successful surgical and non-surgical outcomes. A wide range of options are available and further long term prospective studies, with standardised data capture and outcome goals, are required to evaluate the most appropriate techniques and long term success rates. PMID:26904262

Combined Orthodontic and Surgical Treatment in a 8-Years-Old Patient Affected By Severe Obstructive Sleep Apnea: A Case-Report.

PubMed

Gracco, Antonio; Bruno, Giovanni; de Stefani, Alberto; Ragona, Rosario Marchese; Mazzoleni, Sergio; Stellini, Edoardo

An eight-years-old girl showed a restless sleep with snoring and severe apnea episodes, a mandibular retrognathia, mouth breathing, maxillary transverse discrepancy, mandibular transverse discrepancy, moderate crowding and anterior open-bite. The CBCT showed an anterior collapse of the epiglottis. The treatment consisted in a rapid palatal expansion, an epiglottoplasty and a reduction of the tongue base. Polysomnography revealed that apnea-hypopnea index improved from 21,8 episodes/hr at the baseline to 0,6 episodes/hr, average oxygen saturation from 96,5% to 98,1%, oxygen desaturation events from 23,4 episodes/hr to 1/hr.

Sleep-Related Behaviors and Beliefs Associated With Race/Ethnicity in Women

PubMed Central

Grandner, Michael A.; Patel, Nirav P.; Jean-Louis, Girardin; Jackson, Nicholas; Gehrman, Philip R.; Perlis, Michael L.; Gooneratne, Nalaka S.

2013-01-01

Explore how social factors influence sleep, especially sleep-related beliefs and behaviors. Sleep complaints, sleep hygiene behaviors, and beliefs about sleep were studied in 65 black/African American and white/European American women. Differences were found for snoring and discrepancy between sleep duration and need. Sleep behaviors differed across groups for napping, methods for coping with sleep difficulties, and nonsleep behaviors in bed. Beliefs also distinguished groups, with differences in motivation for sleep and beliefs about sleep being important for health and functioning. These findings have important public health implications in terms of developing effective sleep education interventions that include consideration of cultural aspects. PMID:23862291

Digital Bedrock Compilation: A Geodatabase Covering Forest Service Lands in California

NASA Astrophysics Data System (ADS)

Elder, D.; de La Fuente, J. A.; Reichert, M.

2010-12-01

This digital database contains bedrock geologic mapping for Forest Service lands within California. This compilation began in 2004 and the first version was completed in 2005. Second publication of this geodatabase was completed in 2010 and filled major gaps in the southern Sierra Nevada and Modoc/Medicine Lake/Warner Mountains areas. This digital map database was compiled from previously published and unpublished geologic mapping, with source mapping and review from California Geological Survey, the U.S. Geological Survey and others. Much of the source data was itself compilation mapping. This geodatabase is huge, containing ~107,000 polygons and ~ 280,000 arcs. Mapping was compiled from more than one thousand individual sources and covers over 41,000,000 acres (~166,000 km2). It was compiled from source maps at various scales - from ~ 1:4,000 to 1:250,000 and represents the best available geologic mapping at largest scale possible. An estimated 70-80% of the source information was digitized from geologic mapping at 1:62,500 scale or better. Forest Service ACT2 Enterprise Team compiled the bedrock mapping and developed a geodatabase to store this information. This geodatabase supports feature classes for polygons (e.g, map units), lines (e.g., contacts, boundaries, faults and structural lines) and points (e.g., orientation data, structural symbology). Lookup tables provide detailed information for feature class items. Lookup/type tables contain legal values and hierarchical groupings for geologic ages and lithologies. Type tables link coded values with descriptions for line and point attributes, such as line type, line location and point type. This digital mapping is at the core of many quantitative analyses and derivative map products. Queries of the database are used to produce maps and to quantify rock types of interest. These include the following: (1) ultramafic rocks - where hazards from naturally occurring asbestos are high, (2) granitic rocks - increased erosion hazards, (3) limestone, chert, sedimentary rocks - paleontological resources (Potential Fossil Yield Classification maps), (4) calcareous rocks (cave resources, water chemistry), and (5) lava flows - lava tubes (more caves). Map unit groupings (e.g., belts, terranes, tectonic & geomorphic provinces) can also be derived from the geodatabase. Digital geologic mapping was used in ground water modeling to predict effects of tunneling through the San Bernardino Mountains. Bedrock mapping is used in models that characterize watershed sediment regimes and quantify anthropogenic influences. When combined with digital geomorphology mapping, this geodatabase helps to assess landslide hazards.

User Guide for the Anvil Threat Cooridor Forecast Tool V2.4 for AWIPS

NASA Technical Reports Server (NTRS)

Barett, Joe H., III; Bauman, William H., III

2008-01-01

The Anvil Tool GUI allows users to select a Data Type, toggle the map refresh on/off, place labels, and choose the Profiler Type (source of the KSC 50 MHz profiler data), the Date- Time of the data, the Center of Plot, and the Station (location of the RAOB or 50 MHz profiler). If the Data Type is Models, the user selects a Fcst Hour (forecast hour) instead of Station. There are menus for User Profiles, Circle Label Options, and Frame Label Options. Labels can be placed near the center circle of the plot and/or at a specified distance and direction from the center of the circle (Center of Plot). The default selection for the map refresh is "ON". When the user creates a new Anvil Tool map with Refresh Map "ON, the plot is automatically displayed in the AWIPS frame. If another Anvil Tool map is already displayed and the user does not change the existing map number shown at the bottom of the GUI, the new Anvil Tool map will overwrite the old one. If the user turns the Refresh Map "OFF", the new Anvil Tool map is created but not automatically displayed. The user can still display the Anvil Tool map through the Maps dropdown menu* as shown in Figure 4.

Sleep duration, daytime napping, markers of obstructive sleep apnea and stroke in a population of southern China

PubMed Central

Wen, Ye; Pi, Fu-Hua; Guo, Pi; Dong, Wen-Ya; Xie, Yu-Qing; Wang, Xiang-Yu; Xia, Fang-Fang; Pang, Shao-Jie; Wu, Yan-Chun; Wang, Yuan-Yuan; Zhang, Qing-Ying

2016-01-01

Sleep habits are associated with stroke in western populations, but this relation has been rarely investigated in China. Moreover, the differences among stroke subtypes remain unclear. This study aimed to explore the associations of total stroke, including ischemic and hemorrhagic type, with sleep habits of a population in southern China. We performed a case-control study in patients admitted to the hospital with first stroke and community control subjects. A total of 333 patients (n = 223, 67.0%, with ischemic stroke; n = 110, 23.0%, with hemorrhagic stroke) and 547 controls were enrolled in the study. Participants completed a structured questionnaire to identify sleep habits and other stroke risk factors. Least absolute shrinkage and selection operator (Lasso) and multiple logistic regression were performed to identify risk factors of disease. Incidence of stroke, and its subtypes, was significantly associated with snorting/gasping, snoring, sleep duration, and daytime napping. Snorting/gasping was identified as an important risk factor in the Lasso logistic regression model (Lasso’ β = 0.84), and the result was proven to be robust. This study showed the association between stroke and sleep habits in the southern Chinese population and might help in better detecting important sleep-related factors for stroke risk. PMID:27698374

Comprehensive Insights in the Mycobacterium avium subsp. paratuberculosis Genome Using New WGS Data of Sheep Strain JIII-386 from Germany

PubMed Central

Möbius, Petra; Hölzer, Martin; Felder, Marius; Nordsiek, Gabriele; Groth, Marco; Köhler, Heike; Reichwald, Kathrin; Platzer, Matthias; Marz, Manja

2015-01-01

Mycobacterium avium (M. a.) subsp. paratuberculosis (MAP)—the etiologic agent of Johne’s disease—affects cattle, sheep, and other ruminants worldwide. To decipher phenotypic differences among sheep and cattle strains (belonging to MAP-S [Type-I/III], respectively, MAP-C [Type-II]), comparative genome analysis needs data from diverse isolates originating from different geographic regions of the world. This study presents the so far best assembled genome of a MAP-S-strain: Sheep isolate JIII-386 from Germany. One newly sequenced cattle isolate (JII-1961, Germany), four published MAP strains of MAP-C and MAP-S from the United States and Australia, and M. a. subsp. hominissuis (MAH) strain 104 were used for assembly improvement and comparisons. All genomes were annotated by BacProt and results compared with NCBI (National Center for Biotechnology Information) annotation. Corresponding protein-coding sequences (CDSs) were detected, but also CDSs that were exclusively determined by either NCBI or BacProt. A new Shine–Dalgarno sequence motif (5′-AGCTGG-3′) was extracted. Novel CDSs including PE-PGRS family protein genes and about 80 noncoding RNAs exhibiting high sequence conservation are presented. Previously found genetic differences between MAP-types are partially revised. Four of ten assumed MAP-S-specific large sequence polymorphism regions (LSPSs) are still present in MAP-C strains; new LSPSs were identified. Independently of the regional origin of the strains, the number of individual CDSs and single nucleotide variants confirms the strong similarity of MAP-C strains and shows higher diversity among MAP-S strains. This study gives ambiguous results regarding the hypothesis that MAP-S is the evolutionary intermediate between MAH and MAP-C, but it clearly shows a higher similarity of MAP to MAH than to Mycobacterium intracellulare. PMID:26384038

Contractive type non-self mappings on metric spaces of hyperbolic type

NASA Astrophysics Data System (ADS)

Ciric, Ljubomir B.

2006-05-01

Let (X,d) be a metric space of hyperbolic type and K a nonempty closed subset of X. In this paper we study a class of mappings from K into X (not necessarily self-mappings on K), which are defined by the contractive condition (2.1) below, and a class of pairs of mappings from K into X which satisfy the condition (2.28) below. We present fixed point and common fixed point theorems which are generalizations of the corresponding fixed point theorems of Ciric [L.B. Ciric, Quasi-contraction non-self mappings on Banach spaces, Bull. Acad. Serbe Sci. Arts 23 (1998) 25-31; L.B. Ciric, J.S. Ume, M.S. Khan, H.K.T. Pathak, On some non-self mappings, Math. Nachr. 251 (2003) 28-33], Rhoades [B.E. Rhoades, A fixed point theorem for some non-self mappings, Math. Japon. 23 (1978) 457-459] and many other authors. Some examples are presented to show that our results are genuine generalizations of known results from this area.

Response properties of single units in the dorsal nucleus of the lateral lemniscus of decerebrate cats.

PubMed

Davis, Kevin A; Lomakin, Oleg; Pesavento, Michael J

2007-09-01

The dorsal nucleus of the lateral lemniscus (DNLL) receives afferent inputs from many brain stem nuclei and, in turn, is a major source of inhibitory inputs to the inferior colliculus (IC). The goal of this study was to characterize the monaural and binaural response properties of neurons in the DNLL of unanesthetized decerebrate cat. Monaural responses were classified according to the patterns of excitation and inhibition observed in contralateral and ipsilateral frequency response maps. Binaural classification was based on unit sensitivity to interaural level differences. The results show that units in the DNLL can be grouped into three distinct types. Type v units produce contralateral response maps that show a wide V-shaped excitatory area and no inhibition. These units receive ipsilateral excitation and exhibit binaural facilitation. The contralateral maps of type i units show a more restricted I-shaped region of excitation that is flanked by inhibition. Type o maps display an O-shaped island of excitation at low stimulus levels that is bounded by inhibition at higher levels. Both type i and type o units receive ipsilateral inhibition and exhibit binaural inhibition. Units that produce type v maps have a low best frequency (BF), whereas type i and type o units have high BFs. Type v and type i units give monotonic rate-level responses for both BF tones and broadband noise. Type o units are inhibited by tones at high levels, but are excited by high-level noise. These results show that the DNLL can exert strong, differential effects in the IC.

Mapping forest types in Worcester County, Maryland, using LANDSAT data

NASA Technical Reports Server (NTRS)

Burtis, J., Jr.; Witt, R. G.

1981-01-01

The feasibility of mapping Level 2 forest cover types for a county-sized area on Maryland's Eastern Shore was demonstrated. A Level 1 land use/land cover classification was carried out for all of Worcester County as well. A June 1978 LANDSAT scene was utilized in a classification which employed two software packages on different computers (IDIMS on an HP 3000 and ASTEP-II on a Univac 1108). A twelve category classification scheme was devised for the study area. Resulting products include black and white line printer maps, final color coded classification maps, digitally enhanced color imagery and tabulated acreage statistics for all land use and land cover types.

Mapping a major QTL responsible for dwarf architecture in Brassica napus using a single-nucleotide polymorphism marker approach.

PubMed

Wang, Yankun; Chen, Wenjing; Chu, Pu; Wan, Shubei; Yang, Mao; Wang, Mingming; Guan, Rongzhan

2016-08-18

Key genes related to plant type traits have played very important roles in the "green revolution" by increasing lodging resistance and elevating the harvest indices of crop cultivars. Although there have been numerous achievements in the development of dwarfism and plant type in Brassica napus breeding, exploring new materials conferring oilseed rape with efficient plant types that provide higher yields is still of significance in breeding, as well as in elucidating the mechanisms underlying plant development. Here, we report a new dwarf architecture with down-curved leaf mutant (Bndwf/dcl1) isolated from an ethyl methanesulphonate (EMS)-mutagenized B. napus line, together with its inheritance and gene mapping, and pleiotropic effects of the mapped locus on plant-type traits. We constructed a high-density single-nucleotide polymorphism (SNP) map using a backcross population derived from the Bndwf/dcl1 mutant and the canola cultivar 'zhongshuang11' ('ZS11') and mapped the dwarf architecture with the down-curved leaf dominant locus, BnDWF/DCL1, in a 6.58-cM interval between SNP marker bins M46180 and M49962 on the linkage group (LG) C05 of B. napus. Further mapping with other materials derived from Bndwf/dcl1 narrowed the interval harbouring BnDWF/DCL1 to 175 kb in length and this interval contained 16 annotated genes. Quantitative trait locus (QTL) mappings with the backcross population for plant type traits, including plant height, branching height, main raceme length and average branching interval, indicated that the mapped QTLs for plant type traits were located at the same position as the BnDWF/DCL1 locus. This study suggests that the BnDWF/DCL1 locus is a major pleiotropic locus/QTL in B. napus, which may reduce plant height, alter plant type traits and change leaf shape, and thus may lead to compact plant architecture. Accordingly, this locus may have substantial breeding potential for increasing planting density.

Inter- and Intra-subtype genotypic differences that differentiate Mycobacterium avium subspecies paratuberculosis strains

PubMed Central

2012-01-01

Background Mycobacterium avium subspecies paratuberculosis (Map) is the aetiological agent of Johne’s disease or paratuberculosis and is included within the Mycobacterium avium complex (MAC). Map strains are of two major types often referred to as ‘Sheep’ or ‘S-type’ and ‘Cattle’ or ‘C-type’. With the advent of more discriminatory typing techniques it has been possible to further classify the S-type strains into two groups referred to as Type I and Type III. This study was undertaken to genotype a large panel of S-type small ruminant isolates from different hosts and geographical origins and to compare them with a large panel of well documented C-type isolates to assess the genetic diversity of these strain types. Methods used included Mycobacterial Interspersed Repetitive Units - Variable-Number Tandem Repeat analysis (MIRU-VNTR), analysis of Large Sequence Polymorphisms by PCR (LSP analysis), Single Nucleotide Polymorphism (SNP) analysis of gyr genes, Pulsed-Field Gel Electrophoresis (PFGE) and Restriction Fragment Length Polymorphism analysis coupled with hybridization to IS900 (IS900-RFLP) analysis. Results The presence of LSPA4 and absence of LSPA20 was confirmed in all 24 Map S-type strains analysed. SNPs within the gyr genes divided the S-type strains into types I and III. Twenty four PFGE multiplex profiles and eleven different IS900-RFLP profiles were identified among the S-type isolates, some of them not previously published. Both PFGE and IS900-RFLP segregated the S-type strains into types I and III and the results concurred with those of the gyr SNP analysis. Nine MIRU-VNTR genotypes were identified in these isolates. MIRU-VNTR analysis differentiated Map strains from other members of Mycobacterium avium Complex, and Map S-type from C-type but not type I from III. Pigmented Map isolates were found of type I or III. Conclusion This is the largest panel of S-type strains investigated to date. The S-type strains could be further divided into two subtypes, I and III by some of the typing techniques (IS900-RFLP, PFGE and SNP analysis of the gyr genes). MIRU-VNTR did not divide the strains into the subtypes I and III but did detect genetic differences between isolates within each of the subtypes. Pigmentation is not exclusively associated with type I strains. PMID:23164429

A nationwide cross-sectional study on congenital heart diseases and symptoms of sleep-disordered breathing among Japanese Down's syndrome people.

PubMed

Sawatari, Hiroyuki; Chishaki, Akiko; Nishizaka, Mari; Matsuoka, Fumio; Yoshimura, Chikara; Kuroda, Hiromi; Rahmawati, Anita; Hashiguchi, Nobuko; Miyazono, Mami; Ono, Junji; Ohkusa, Tomoko; Ando, Shin-Ichi

2015-01-01

It is well known that people with Down's syndrome (DS) frequently complicate with congenital heart diseases (CHDs). Patients with heart diseases often have sleep-disordered breathing as a co-morbidity (SDB) which worsens the heart diseases. However, the relationship between SDB and CHDs in DS people has not yet been fully elucidated. The aim of this study was to establish the association between SDB and CHDs in DS people using data from a large nationwide questionnaire survey in Japan. We conducted a cross-sectional questionnaire survey of a randomly selected sample of 2,000 DS people and their caregivers throughout Japan to examine the associations between observed signs of SDB and CHDs in DS people. The questionnaire included the presence of SDB symptoms (snoring, apnea, arousal, nocturia, and napping) and CHDs (the presence and types of CHDs). Of the 1,222 replies received from the caregivers, 650 reported complications of some type of CHDs. The observed apnea tended to be higher among DS people with CHDs than those without CHDs (OR=1.28, 95% CI=0.97-1.70, p=0.09). DS people with tetralogy of Fallot reported significantly more frequent apnea than those without CHDs (OR=3.10, 95% CI=1.36-7.05, p<0.01). SDB prevailed among DS people with severe CHDs, such as tetralogy of Fallot. Careful attention to the signs of SDB in such patients may lead to earlier clinical intervention removing the vicious cycle between SDB and CHDs.

Underdiagnosis of obstructive sleep apnoea syndrome in patients with type 2 diabetes in France: ENTRED 2007.

PubMed

Lecomte, P; Criniere, L; Fagot-Campagna, A; Druet, C; Fuhrman, C

2013-04-01

This study estimated the prevalence of symptoms evocative of obstructive sleep apneoa (OSA) in patients with type 2 diabetes and the proportion of those with evidence of a previous diagnosis or diagnostic procedure. In ENTRED 2007, 8926 people reimbursed for at least three antidiabetic agents within the last 12 months were randomly selected, and 3894 answered a self-administered questionnaire. Symptoms evocative of OSA were defined as frequent snoring with excessive daytime sleepiness and/or witnessed sleep apneoa. Patients were considered to have evidence of a previous diagnostic procedure if they reported an OSA diagnosis or had a sleep recording done, or if a sleep recording was found in the hospital discharge or medical claims database, or if they were currently being treated with nocturnal ventilation. The patients' mean age was 66 years. Around 8.5% reported being diagnosed with OSA, 4.2% were treated with nocturnal ventilation and 16% had symptoms evocative of OSA. Being male, obesity, high blood pressure, insulin treatment, living with a partner, lower educational level and financial difficulties were all associated with symptoms suggestive of OSA. Overall, 13% had evidence of a previous diagnostic procedure, and the rate was 35% among those with symptoms evocative of OSA. OSA is underdiagnosed in French diabetic patients, while the prevalence of symptoms is high. Only 13% of the study population and 35% of those with symptoms suggestive of OSA had benefited from a diagnostic procedure. It is of the utmost importance to better diagnose OSA in the diabetic population. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

An XML transfer schema for exchange of genomic and genetic mapping data: implementation as a web service in a Taverna workflow.

PubMed

Paterson, Trevor; Law, Andy

2009-08-14

Genomic analysis, particularly for less well-characterized organisms, is greatly assisted by performing comparative analyses between different types of genome maps and across species boundaries. Various providers publish a plethora of on-line resources collating genome mapping data from a multitude of species. Datasources range in scale and scope from small bespoke resources for particular organisms, through larger web-resources containing data from multiple species, to large-scale bioinformatics resources providing access to data derived from genome projects for model and non-model organisms. The heterogeneity of information held in these resources reflects both the technologies used to generate the data and the target users of each resource. Currently there is no common information exchange standard or protocol to enable access and integration of these disparate resources. Consequently data integration and comparison must be performed in an ad hoc manner. We have developed a simple generic XML schema (GenomicMappingData.xsd - GMD) to allow export and exchange of mapping data in a common lightweight XML document format. This schema represents the various types of data objects commonly described across mapping datasources and provides a mechanism for recording relationships between data objects. The schema is sufficiently generic to allow representation of any map type (for example genetic linkage maps, radiation hybrid maps, sequence maps and physical maps). It also provides mechanisms for recording data provenance and for cross referencing external datasources (including for example ENSEMBL, PubMed and Genbank.). The schema is extensible via the inclusion of additional datatypes, which can be achieved by importing further schemas, e.g. a schema defining relationship types. We have built demonstration web services that export data from our ArkDB database according to the GMD schema, facilitating the integration of data retrieval into Taverna workflows. The data exchange standard we present here provides a useful generic format for transfer and integration of genomic and genetic mapping data. The extensibility of our schema allows for inclusion of additional data and provides a mechanism for typing mapping objects via third party standards. Web services retrieving GMD-compliant mapping data demonstrate that use of this exchange standard provides a practical mechanism for achieving data integration, by facilitating syntactically and semantically-controlled access to the data.

An XML transfer schema for exchange of genomic and genetic mapping data: implementation as a web service in a Taverna workflow

PubMed Central

Paterson, Trevor; Law, Andy

2009-01-01

Background Genomic analysis, particularly for less well-characterized organisms, is greatly assisted by performing comparative analyses between different types of genome maps and across species boundaries. Various providers publish a plethora of on-line resources collating genome mapping data from a multitude of species. Datasources range in scale and scope from small bespoke resources for particular organisms, through larger web-resources containing data from multiple species, to large-scale bioinformatics resources providing access to data derived from genome projects for model and non-model organisms. The heterogeneity of information held in these resources reflects both the technologies used to generate the data and the target users of each resource. Currently there is no common information exchange standard or protocol to enable access and integration of these disparate resources. Consequently data integration and comparison must be performed in an ad hoc manner. Results We have developed a simple generic XML schema (GenomicMappingData.xsd – GMD) to allow export and exchange of mapping data in a common lightweight XML document format. This schema represents the various types of data objects commonly described across mapping datasources and provides a mechanism for recording relationships between data objects. The schema is sufficiently generic to allow representation of any map type (for example genetic linkage maps, radiation hybrid maps, sequence maps and physical maps). It also provides mechanisms for recording data provenance and for cross referencing external datasources (including for example ENSEMBL, PubMed and Genbank.). The schema is extensible via the inclusion of additional datatypes, which can be achieved by importing further schemas, e.g. a schema defining relationship types. We have built demonstration web services that export data from our ArkDB database according to the GMD schema, facilitating the integration of data retrieval into Taverna workflows. Conclusion The data exchange standard we present here provides a useful generic format for transfer and integration of genomic and genetic mapping data. The extensibility of our schema allows for inclusion of additional data and provides a mechanism for typing mapping objects via third party standards. Web services retrieving GMD-compliant mapping data demonstrate that use of this exchange standard provides a practical mechanism for achieving data integration, by facilitating syntactically and semantically-controlled access to the data. PMID:19682365

Identification of irrigated crop types from ERTS-1 density contour maps and color infrared aerial photography. [Wyoming

NASA Technical Reports Server (NTRS)

Marrs, R. W.; Evans, M. A.

1974-01-01

The author has identified the following significant results. The crop types of a Great Plains study area were mapped from color infrared aerial photography. Each field was positively identified from field checks in the area. Enlarged (50x) density contour maps were constructed from three ERTS-1 images taken in the summer of 1973. The map interpreted from the aerial photography was compared to the density contour maps and the accuracy of the ERTS-1 density contour map interpretations were determined. Changes in the vegetation during the growing season and harvest periods were detectable on the ERTS-1 imagery. Density contouring aids in the detection of such charges.

Estimation of vegetation-type areas by linear measurement

Treesearch

A.A. Hasel

1941-01-01

Maps are very useful in providing a picture of the location of vegetation types, but mapping as a method for determining type areas may be inadequate or costly. The measurement of vegetation type areas by means of line surveys is discussed in the following article, and the method is tested in connection with detailed studies on plots. The results indicate that the...

Comparative Effectiveness of Hierarchical, Flowchart and Spider Concept Mapping Strategies on Students' Performance in Chemistry

ERIC Educational Resources Information Center

Bamidele, E. F.; Oloyede, E. O.

2013-01-01

This study investigated the relative effectiveness of three types of concept maps (hierarchy, flowchart and spider) on the performance of students in Chemistry. This is with a view to find out which of the concept mapping types is more superior in enhancing students' performance in the numerical aspect of Chemistry. The pre-test, post-test…

Using object-oriented classification and high-resolution imagery to map fuel types in a Mediterranean region.

Treesearch

L. Arroyo; S.P. Healey; W.B. Cohen; D. Cocero; J.A. Manzanera

2006-01-01

Knowledge of fuel load and composition is critical in fighting, preventing, and understanding wildfires. Commonly, the generation of fuel maps from remotely sensed imagery has made use of medium-resolution sensors such as Landsat. This paper presents a methodology to generate fuel type maps from high spatial resolution satellite data through object-oriented...

Mapping landscape values: issues, challenges and lessons learned from fieldwork on the Olympic Peninsula, Washington

Treesearch

Diane T. Besser; Rebecca McLain; Lee K. Cerveny; Kelly Biedenweg; David Banis

2014-01-01

In order to inform natural resource policy and land management decisions, landscape values mapping (LVM) is increasingly used to collect data about the meanings that people attach to places and the activities associated with those places. This type of mapping provides geographically referenced data on areas of high density of values or associated with different types...

Regional Cerebral Blood Flow during Wakeful Rest in Older Subjects with Mild to Severe Obstructive Sleep Apnea.

PubMed

Baril, Andrée-Ann; Gagnon, Katia; Arbour, Caroline; Soucy, Jean-Paul; Montplaisir, Jacques; Gagnon, Jean-François; Gosselin, Nadia

2015-09-01

To evaluate changes in regional cerebral blood flow (rCBF) during wakeful rest in older subjects with mild to severe obstructive sleep apnea (OSA) and healthy controls, and to identify markers of OSA severity that predict altered rCBF. High-resolution (99m)Tc-HMPAO SPECT imaging during wakeful rest. Research sleep laboratory affiliated with a University hospital. Fifty untreated OSA patients aged between 55 and 85 years, divided into mild, moderate, and severe OSA, and 20 age-matched healthy controls. N/A. Using statistical parametric mapping, rCBF was compared between groups and correlated with clinical, respiratory, and sleep variables. Whereas no rCBF change was observed in mild and moderate groups, participants with severe OSA had reduced rCBF compared to controls in the left parietal lobules, left precentral gyrus, bilateral postcentral gyri, and right precuneus. Reduced rCBF in these regions and in areas of the bilateral frontal and left temporal cortex was associated with more hypopneas, snoring, hypoxemia, and sleepiness. Higher apnea, microarousal, and body mass indexes were correlated to increased rCBF in the basal ganglia, insula, and limbic system. While older individuals with severe obstructive sleep apnea (OSA) had hypoperfusion in the sensorimotor and parietal areas, respiratory variables and subjective sleepiness were correlated with extended regions of hypoperfusion in the lateral cortex. Interestingly, OSA severity, sleep fragmentation, and obesity correlated with increased perfusion in subcortical and medial cortical regions. Anomalies with such a distribution could result in cognitive deficits and reflect impaired vascular regulation, altered neuronal integrity, and/or undergoing neurodegenerative processes. © 2015 Associated Professional Sleep Societies, LLC.

Photographic technology development project: Timber typing in the Tahoe Basin using high altitude panoramic photography

NASA Technical Reports Server (NTRS)

Ward, J. F.

1981-01-01

Procedures were developed and tested for using KA-80A optical bar camera panoramic photography for timber typing forest land and classifying nonforest land. The study area was the south half of the Lake Tahoe Basin Management Unit. Final products from this study include four timber type map overlays on 1:24,000 orthophoto maps. The following conclusions can be drawn from this study: (1) established conventional timber typing procedures can be used on panoramic photography if the necessary equipment is available, (2) The classification and consistency results warrant further study in using panoramic photography for timber typing; and (3) timber type mapping can be done as fast or faster with panoramic photography than with resource photography while maintaining comparable accuracy.

Description and validation of an automated methodology for mapping mineralogy, vegetation, and hydrothermal alteration type from ASTER satellite imagery with examples from the San Juan Mountains, Colorado

USGS Publications Warehouse

Rockwell, Barnaby W.

2012-01-01

The efficacy of airborne spectroscopic, or "hyperspectral," remote sensing for geoenvironmental watershed evaluations and deposit-scale mapping of exposed mineral deposits has been demonstrated. However, the acquisition, processing, and analysis of such airborne data at regional and national scales can be time and cost prohibitive. The Advanced Spaceborne Thermal Emission and Reflection Radiometer (ASTER) sensor carried by the NASA Earth Observing System Terra satellite was designed for mineral mapping and the acquired data can be efficiently used to generate uniform mineral maps over very large areas. Multispectral remote sensing data acquired by the ASTER sensor were analyzed to identify and map minerals, mineral groups, hydrothermal alteration types, and vegetation groups in the western San Juan Mountains, Colorado, including the Silverton and Lake City calderas. This mapping was performed in support of multidisciplinary studies involving the predictive modeling of surface water geochemistry at watershed and regional scales. Detailed maps of minerals, vegetation groups, and water were produced from an ASTER scene using spectroscopic, expert system-based analysis techniques which have been previously described. New methodologies are presented for the modeling of hydrothermal alteration type based on the Boolean combination of the detailed mineral maps, and for the entirely automated mapping of alteration types, mineral groups, and green vegetation. Results of these methodologies are compared with the more detailed maps and with previously published mineral mapping results derived from analysis of high-resolution spectroscopic data acquired by the Airborne Visible/Infrared Imaging Spectrometer (AVIRIS) sensor. Such comparisons are also presented for other mineralized and (or) altered areas including the Goldfield and Cuprite mining districts, Nevada and the central Marysvale volcanic field, Wah Wah Mountains, and San Francisco Mountains, Utah. The automated mineral group mapping products described in this study are ideal for application to mineral resource and mineral-environmental assessments at regional and national scales.

Map scale effects on estimating the number of undiscovered mineral deposits

USGS Publications Warehouse

Singer, D.A.; Menzie, W.D.

2008-01-01

Estimates of numbers of undiscovered mineral deposits, fundamental to assessing mineral resources, are affected by map scale. Where consistently defined deposits of a particular type are estimated, spatial and frequency distributions of deposits are linked in that some frequency distributions can be generated by processes randomly in space whereas others are generated by processes suggesting clustering in space. Possible spatial distributions of mineral deposits and their related frequency distributions are affected by map scale and associated inclusions of non-permissive or covered geological settings. More generalized map scales are more likely to cause inclusion of geologic settings that are not really permissive for the deposit type, or that include unreported cover over permissive areas, resulting in the appearance of deposit clustering. Thus, overly generalized map scales can cause deposits to appear clustered. We propose a model that captures the effects of map scale and the related inclusion of non-permissive geologic settings on numbers of deposits estimates, the zero-inflated Poisson distribution. Effects of map scale as represented by the zero-inflated Poisson distribution suggest that the appearance of deposit clustering should diminish as mapping becomes more detailed because the number of inflated zeros would decrease with more detailed maps. Based on observed worldwide relationships between map scale and areas permissive for deposit types, mapping at a scale with twice the detail should cut permissive area size of a porphyry copper tract to 29% and a volcanic-hosted massive sulfide tract to 50% of their original sizes. Thus some direct benefits of mapping an area at a more detailed scale are indicated by significant reductions in areas permissive for deposit types, increased deposit density and, as a consequence, reduced uncertainty in the estimate of number of undiscovered deposits. Exploration enterprises benefit from reduced areas requiring detailed and expensive exploration, and land-use planners benefit from reduced areas of concern. ?? 2008 International Association for Mathematical Geology.

Isolation of Mycobacterium avium subspecies paratuberculosis from non-ruminant wildlife living in the sheds and on the pastures of Greek sheep and goats.

PubMed

Florou, M; Leontides, L; Kostoulas, P; Billinis, C; Sofia, M; Kyriazakis, I; Lykotrafitis, F

2008-05-01

This study aimed to: (1) investigate whether non-ruminant wildlife interfacing with dairy sheep and goats of four Greek flocks endemically infected with Mycobacterium avium subspecies paratuberculosis (MAP) harboured MAP and (2) genetically compare the strains isolated from the wildlife to those isolated from the small ruminants of these flocks. We cultured and screened, by polymerase chain reaction (PCR), pooled-tissue samples from 327 wild animals of 11 species for the MAP-specific IS900 insertion sequence. We also cultured faecal samples from 100 sheep or goats from each of the four flocks. MAP was detected in samples from 11 sheep, 12 goats, two mice, two rats, a hare and a fox. Only one rat had histopathological findings. Genetic typing categorized 21 isolates as cattle-type strains and two, from a house mouse and a goat respectively, as sheep-type strains; this is the first report of a rodent harbouring a sheep-type strain. The MAP types that were most frequently isolated amongst the sheep and goats of each flock were also the ones isolated from sympatric rodents; those isolated from the fox and hare also belonged to the predominant ruminant strains.

Cue-type manipulation dissociates two types of task set inhibition: backward inhibition and competitor rule suppression.

PubMed

Regev, Shirley; Meiran, Nachshon

2016-07-01

Backward inhibition (BI) reflects the suppression of a recently abandoned task set to allow for smooth transition to a new task even when the rules do not generate a response conflict. Competitor rule suppression (CRS) reflects the inhibition/suppression of irrelevant task rules when these rules generate a response conflict even if they have not recently been abandoned. We assessed whether BI and CRS are differentially affected by the difficulty in retrieving category-response mappings from memory. Retrieval demands were manipulated via the information provided by the task cues, which either indicated the relevant dimension (dimension cues; "color") or the relevant dimension with its category-to-key mapping (mapping cues; "red green", indicating that "red" and "green" go with the left/right responses, respectively). CRS was larger with dimension compared to mapping cues when cue-type varied between groups and was larger after trials involving dimension cues when cue-type varied on a trial-by-trial basis. In contrast, BI was not influenced by cue-type. These results suggest that task switching involve at least two distinct inhibitory processes, with CRS being related to the ease of retrieval of category-response mappings from memory.

Functions of the uvula and Z-pharyngoplasty.

PubMed

Mukai, S; Mukai, C; Nitta, M

2000-06-01

UPPP includes uvulotomy. The uvula works as the pilot for eating and swallowing. We performed an operation which left the uvula intact and opened the pharynx by Z-opening the palate, Z-pharyngoplasty (ZPP). Twenty-four patients were studied before and after ZPP. The results of the operations were satisfactory. No patients complained of symptoms after uvulectomy. As for the changes indicated by sleep monitoring, minimum SaO2 increased significantly (P = 0.0026), pulse rate decreased significantly (P = 0.0144), apnea index decreased significantly (P = 0.0392), snoring decreased (P = 0.064), and the amount of hours of sleep when SaO2 was over 95% increased (P = 0.0690) after ZPP.

Land use and land cover digital data from 1:250,000- and 1:100,000- scale maps

USGS Publications Warehouse

,

1990-01-01

The Earth Science Information Centers (ESIC) distribute digital cartographic/geographic data files produced by the U.S. Geological Survey (USGS) as part of the National Mapping Program. The data files are grouped into four basic types. The first type, called a Digital Line Graph (DLG), is line map information in digital form. These data files include information on planimetric base categories, such as transportation, hydrography, and boundaries. The second type, called a Digital Elevation Model (DEM), consists of a sampled array of elevations for ground positions that are usually at regularly spaced intervals. The third type, Land Use and Land Cover digital data, provide information on nine major classes of land use such as urban, agricultural, or forest as well as associated map data such as political units and Federal land ownership. The fourth type, the Geographic Names Information System, provides primary information for known places, features, and areas in the United States identified by a proper name.

Enhanced basal activation of mitogen-activated protein kinases in adipocytes from type 2 diabetes: potential role of p38 in the downregulation of GLUT4 expression.

PubMed

Carlson, Christian J; Koterski, Sandra; Sciotti, Richard J; Poccard, German Braillard; Rondinone, Cristina M

2003-03-01

Serine and threonine kinases may contribute to insulin resistance and the development of type 2 diabetes. To test the potential for members of the mitogen-activated protein (MAP) kinase family to contribute to type 2 diabetes, we examined basal and insulin-stimulated Erk 1/2, JNK, and p38 phosphorylation in adipocytes isolated from healthy and type 2 diabetic individuals. Maximal insulin stimulation increased the phosphorylation of Erk 1/2 and JNK in healthy control subjects but not type 2 diabetic patients. Insulin stimulation did not increase p38 phosphorylation in either healthy control subjects or type 2 diabetic patients. In type 2 diabetic adipocytes, the basal phosphorylation status of these MAP kinases was significantly elevated and was associated with decreased IRS-1 and GLUT4 in these fat cells. To determine whether MAP kinases were involved in the downregulation of IRS-1 and GLUT4 protein levels, selective inhibitors were used to inhibit these MAP kinases in 3T3-L1 adipocytes treated chronically with insulin. Inhibition of Erk 1/2, JNK, or p38 had no effect on insulin-stimulated reduction of IRS-1 protein levels. However, inhibition of the p38 pathway prevented the insulin-stimulated decrease in GLUT4 protein levels. In summary, type 2 diabetes is associated with an increased basal activation of the MAP kinase family. Furthermore, upregulation of the p38 pathway might contribute to the loss of GLUT4 expression observed in adipose tissue from type 2 diabetic patients.

Localizing National Fragmentation Statistics with Forest Type Maps

Treesearch

Kurt H. Riitters; John W. Coulston; James D. Wickham

2003-01-01

Fragmentation of forest types is an indicator of biodiversity in the Montreal Process, but the available national data permit assessment of only overall forestland fragmentation, not forest type fragmentation. Here we illustrate how to localize national statistics from the 2003 National Report on Sustainable Forests by combining state vegetation maps with national...

Computer-aided classification of forest cover types from small scale aerial photography

NASA Astrophysics Data System (ADS)

Bliss, John C.; Bonnicksen, Thomas M.; Mace, Thomas H.

1980-11-01

The US National Park Service must map forest cover types over extensive areas in order to fulfill its goal of maintaining or reconstructing presettlement vegetation within national parks and monuments. Furthermore, such cover type maps must be updated on a regular basis to document vegetation changes. Computer-aided classification of small scale aerial photography is a promising technique for generating forest cover type maps efficiently and inexpensively. In this study, seven cover types were classified with an overall accuracy of 62 percent from a reproduction of a 1∶120,000 color infrared transparency of a conifer-hardwood forest. The results were encouraging, given the degraded quality of the photograph and the fact that features were not centered, as well as the lack of information on lens vignetting characteristics to make corrections. Suggestions are made for resolving these problems in future research and applications. In addition, it is hypothesized that the overall accuracy is artificially low because the computer-aided classification more accurately portrayed the intermixing of cover types than the hand-drawn maps to which it was compared.

Motion induced second order temperature and y-type anisotropies after the subtraction of linear dipole in the CMB maps

NASA Astrophysics Data System (ADS)

Sunyaev, Rashid A.; Khatri, Rishi

2013-03-01

y-type spectral distortions of the cosmic microwave background allow us to detect clusters and groups of galaxies, filaments of hot gas and the non-uniformities in the warm hot intergalactic medium. Several CMB experiments (on small areas of sky) and theoretical groups (for full sky) have recently published y-type distortion maps. We propose to search for two artificial hot spots in such y-type maps resulting from the incomplete subtraction of the effect of the motion induced dipole on the cosmic microwave background sky. This dipole introduces, at second order, additional temperature and y-distortion anisotropy on the sky of amplitude few μK which could potentially be measured by Planck HFI and Pixie experiments and can be used as a source of cross channel calibration by CMB experiments. This y-type distortion is present in every pixel and is not the result of averaging the whole sky. This distortion, calculated exactly from the known linear dipole, can be subtracted from the final y-type maps, if desired.

Motion induced second order temperature and y-type anisotropies after the subtraction of linear dipole in the CMB maps

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sunyaev, Rashid A.; Khatri, Rishi, E-mail: sunyaev@mpa-garching.mpg.de, E-mail: khatri@mpa-garching.mpg.de

2013-03-01

y-type spectral distortions of the cosmic microwave background allow us to detect clusters and groups of galaxies, filaments of hot gas and the non-uniformities in the warm hot intergalactic medium. Several CMB experiments (on small areas of sky) and theoretical groups (for full sky) have recently published y-type distortion maps. We propose to search for two artificial hot spots in such y-type maps resulting from the incomplete subtraction of the effect of the motion induced dipole on the cosmic microwave background sky. This dipole introduces, at second order, additional temperature and y-distortion anisotropy on the sky of amplitude few μKmore » which could potentially be measured by Planck HFI and Pixie experiments and can be used as a source of cross channel calibration by CMB experiments. This y-type distortion is present in every pixel and is not the result of averaging the whole sky. This distortion, calculated exactly from the known linear dipole, can be subtracted from the final y-type maps, if desired.« less

Agricultural land cover mapping in the context of a geographically referenced digital information system. [Carroll, Macon, and Gentry Counties, Missouri

NASA Technical Reports Server (NTRS)

Stoner, E. R.

1982-01-01

The introduction of soil map information to the land cover mapping process can improve discrimination of land cover types and reduce confusion among crop types that may be caused by soil-specific management practices and background reflectance characteristics. Multiple dates of LANDSAT MSS digital were analyzed for three study areas in northern Missouri to produce cover types for major agricultural land cover classes. Digital data bases were then developed by adding ancillary data such as digitized soil and transportation network information to the LANDSAT-derived cover type map. Procedures were developed to manipulate the data base parameters to extract information applicable to user requirements. An agricultural information system combining such data can be used to determine the productive capacity of land to grow crops, fertilizer needs, chemical weed control rates, irrigation suitability, and trafficability of soil for planting.

Automatic categorization of land-water cover types of the Green Swamp, Florida, using Skylab multispectral scanner (S-192) data

NASA Technical Reports Server (NTRS)

Coker, A. E.; Higer, A. L.; Rogers, R. H.; Shah, N. J.; Reed, L. E.; Walker, S.

1975-01-01

The techniques used and the results achieved in the successful application of Skylab Multispectral Scanner (EREP S-192) high-density digital tape data for the automatic categorizing and mapping of land-water cover types in the Green Swamp of Florida were summarized. Data was provided from Skylab pass number 10 on 13 June 1973. Significant results achieved included the automatic mapping of a nine-category and a three-category land-water cover map of the Green Swamp. The land-water cover map was used to make interpretations of a hydrologic condition in the Green Swamp. This type of use marks a significant breakthrough in the processing and utilization of EREP S-192 data.

Geologic map of the Bobs Flat Quadrangle, Eureka County, Nevada

USGS Publications Warehouse

Peters, Stephen G.

2003-01-01

Map Scale: 1:24,000 Map Type: colored geologic map A 1:24,000-scale, full-color geologic map of the Bobs Flat Quadrangle in Eureka County with one cross section and descriptions of 28 geologic units. Accompanying text describes the geologic history and structural geology of the quadrangle.

An integrated approach for automated cover-type mapping of large inaccessible areas in Alaska

USGS Publications Warehouse

Fleming, Michael D.

1988-01-01

The lack of any detailed cover type maps in the state necessitated that a rapid and accurate approach to be employed to develop maps for 329 million acres of Alaska within a seven-year period. This goal has been addressed by using an integrated approach to computer-aided analysis which combines efficient use of field data with the only consistent statewide spatial data sets available: Landsat multispectral scanner data, digital elevation data derived from 1:250 000-scale maps, and 1:60 000-scale color-infrared aerial photographs.

Mapping Inhibitory Neuronal Circuits by Laser Scanning Photostimulation

PubMed Central

Ikrar, Taruna; Olivas, Nicholas D.; Shi, Yulin; Xu, Xiangmin

2011-01-01

Inhibitory neurons are crucial to cortical function. They comprise about 20% of the entire cortical neuronal population and can be further subdivided into diverse subtypes based on their immunochemical, morphological, and physiological properties1-4. Although previous research has revealed much about intrinsic properties of individual types of inhibitory neurons, knowledge about their local circuit connections is still relatively limited3,5,6. Given that each individual neuron's function is shaped by its excitatory and inhibitory synaptic input within cortical circuits, we have been using laser scanning photostimulation (LSPS) to map local circuit connections to specific inhibitory cell types. Compared to conventional electrical stimulation or glutamate puff stimulation, LSPS has unique advantages allowing for extensive mapping and quantitative analysis of local functional inputs to individually recorded neurons3,7-9. Laser photostimulation via glutamate uncaging selectively activates neurons perisomatically, without activating axons of passage or distal dendrites, which ensures a sub-laminar mapping resolution. The sensitivity and efficiency of LSPS for mapping inputs from many stimulation sites over a large region are well suited for cortical circuit analysis. Here we introduce the technique of LSPS combined with whole-cell patch clamping for local inhibitory circuit mapping. Targeted recordings of specific inhibitory cell types are facilitated by use of transgenic mice expressing green fluorescent proteins (GFP) in limited inhibitory neuron populations in the cortex3,10, which enables consistent sampling of the targeted cell types and unambiguous identification of the cell types recorded. As for LSPS mapping, we outline the system instrumentation, describe the experimental procedure and data acquisition, and present examples of circuit mapping in mouse primary somatosensory cortex. As illustrated in our experiments, caged glutamate is activated in a spatially restricted region of the brain slice by UV laser photolysis; simultaneous voltage-clamp recordings allow detection of photostimulation-evoked synaptic responses. Maps of either excitatory or inhibitory synaptic input to the targeted neuron are generated by scanning the laser beam to stimulate hundreds of potential presynaptic sites. Thus, LSPS enables the construction of detailed maps of synaptic inputs impinging onto specific types of inhibitory neurons through repeated experiments. Taken together, the photostimulation-based technique offers neuroscientists a powerful tool for determining the functional organization of local cortical circuits. PMID:22006064

Vegetation types on acid soils of Micronesia

Treesearch

Marjorie C. Falanruw; Thomas G.. Cole; Craig D. Whitesell

1987-01-01

The soils and vegetation of the Caroline high islands, Federated States of Micronesia, are being mapped by the U.S. Department of Agriculture's Forest Service and Soil Conservation Service. By the end of 1987, vegetation maps and reports on Kosrae, Pohnpei, Yap, four Truk Islands, and Palau are expected to be available. To compare soil types with vegetation types...

Mapping School Types in England

ERIC Educational Resources Information Center

Courtney, Steven J.

2015-01-01

The number and range of school types in England is increasing rapidly in response to a neoliberal policy agenda aiming to expand choice of provision as a mechanism for raising educational standards. In this paper, I seek to undertake a mapping of these school types in order to describe and explain what is happening. I capture this busy terrain…

USGS Maps

USGS Publications Warehouse

,

1994-01-01

Most USGS topographic maps use brown contours to show the shape and elevation of the terrain. Elevations are usually shown in feet, but on some maps they are in meters. Contour intervals vary, depending mainly on the scale of the map and the type of terrain.

A new world natural vegetation map for global change studies.

PubMed

Lapola, David M; Oyama, Marcos D; Nobre, Carlos A; Sampaio, Gilvan

2008-06-01

We developed a new world natural vegetation map at 1 degree horizontal resolution for use in global climate models. We used the Dorman and Sellers vegetation classification with inclusion of a new biome: tropical seasonal forest, which refers to both deciduous and semi-deciduous tropical forests. SSiB biogeophysical parameters values for this new biome type are presented. Under this new vegetation classification we obtained a consensus map between two global natural vegetation maps widely used in climate studies. We found that these two maps assign different biomes in ca. 1/3 of the continental grid points. To obtain a new global natural vegetation map, non-consensus areas were filled according to regional consensus based on more than 100 regional maps available on the internet. To minimize the risk of using poor quality information, the regional maps were obtained from reliable internet sources, and the filling procedure was based on the consensus among several regional maps obtained from independent sources. The new map was designed to reproduce accurately both the large-scale distribution of the main vegetation types (as it builds on two reliable global natural vegetation maps) and the regional details (as it is based on the consensus of regional maps).

Erectile Dysfunction and Sexual Hormone Levels in Men With Obstructive Sleep Apnea: Efficacy of Continuous Positive Airway Pressure.

PubMed

Zhang, Xiao-Bin; Lin, Qi-Chang; Zeng, Hui-Qing; Jiang, Xing-Tang; Chen, Bo; Chen, Xiao

2016-01-01

In this study, the prevalence of erectile dysfunction (ED) and serum sexual hormone levels were evaluated in men with obstructive sleep apnea (OSA). In these patients, the efficacy of continuous positive airway pressure (CPAP) was determined. The 207 men (mean age 44.0 ± 11.1 years) enrolled in the study were stratified within four groups based on their apnea-hypopnea index score: simple snoring (n = 32), mild OSA (n = 29), moderate OSA (n = 38), and severe OSA (n = 108). The International Index of Erectile Dysfunction-5 (IIEF-5) score was obtained from each patient, and blood samples for the analysis of sexual hormones (prolactin, luteotropin, follicle-stimulating hormone, estradiol, progestin, and testosterone) were drawn in the morning after polysomnography. The IIEF-5 test and serum sexual hormone measurements were repeated after 3 months of CPAP treatment in 53 men with severe OSA. The prevalence of ED was 60.6 % in OSA patients overall and 72.2 % in those with severe OSA. Compared with the simple snoring group, patients with severe OSA had significantly lower testosterone levels (14.06 ± 5.62 vs. 17.02 ± 4.68, p = .018) and lower IIEF-5 scores (16.33 ± 6.50 vs. 24.09 ± 1.94, p = .001). The differences in the other sexual hormones between groups were not significant. After 3 months of CPAP treatment, there were no significant changes in sexual hormone levels, but the IIEF-5 score had improved significantly (18.21 ± 4.05 vs. 19.21 ± 3.86, p = .001). Severe OSA patients have low testosterone concentration and high ED prevalence. IIEF-5 scores increased significantly after CPAP treatment, but there was no effect on serum testosterone levels.

Plasma radiofrequency preceded by pressure recording enhances success for treating sleep-related breathing disorders.

PubMed

Tvinnereim, Magne; Mitic, Svetislav; Hansen, Rolf K

2007-04-01

Sleep-related breathing disorders (SRBD) that cannot be treated conservatively are commonly treated using uvulopalatopharyngoplasty, although success rates are generally less than 70%. The purpose of this study was to assess a plasma-mediated radiofrequency (RF)-based coblation assisted upper airway procedure (CAUP) to treat SRBD patients determined to have obstruction localized to the upper (mid)-pharyngeal region. Prospective case series (n = 40). Six patients had socially bothersome snoring, and 34 patients had mild to moderate sleep apnea (apnea/hypopnea index [AHI] <20), with the primary level of obstruction (>50%) within the upper pharyngeal region as determined using whole night recordings, including airway pressure fluctuation monitoring (ApneaGraph, MRA-Medical Ltd, Gloucestershire, UK). CAUP consisted of making a lateral palatal incision, ablating three upward channels on each side of the midline (fan-shaped) into the soft palate using a plasma mediated RF-based device (ArthroCare Corporation, Austin, TX), and performing a partial uvulectomy. Clinical outcomes included the Epworth Sleepiness Scale (ESS), partner rating of snoring using a visual analogue scale (VAS), and night-time apnea and hypopnea events (AHI, hypopnea index [HI], apnea index [AI]). Patients were 28 to 68 (46 +/- 12) years old; 28 (70%) were male. Preoperatively, clinical assessment scores (median +/- interquartile range) were as follows: ESS (11.0 +/- 3.0), VAS (8.15 +/- 1.00), AHI (9.58 +/- 5.58), HI (9.00 +/- 5.29), AI (0.333 +/- 0.625). After CAUP, no postoperative scarring, fibrosis, or any other clinically significant side effects were observed. Postoperatively (9.1 +/- 1.5; 7-15 mo), ESS (4.0 +/- 1.0), VAS (2.70 +/- 1.38), AHI (3.75 +/- 2.92), HI (3.58 +/- 2.50), and AI (0.167 +/- 0.167) were significantly improved (P < .001). CAUP preceded by site-specific obstruction diagnosis using pressure recording is a well-tolerated outpatient treatment that is well suited for treating SRBD.

Catathrenia (Nocturnal Groaning): A Social Media Survey and State-of-the-Art Review

PubMed Central

Alonso, Jose; Camacho, Macario; Chhetri, Dinesh K.; Guilleminault, Christian; Zaghi, Soroush

2017-01-01

Study Objectives: Catathrenia is an underrecognized nocturnal vocalization phenomenon that can be a source of perplexity to patients, bed partners, and medical providers. Catathrenia is distinct from both sleep talking (a parasomnia with loud talking during sleep) and snoring (noise due to vibration of upper airway soft tissues related to variations in airway resistance). The objective of this review is to provide an evidence-based resource to help the practitioner reliably evaluate and manage patients with this condition. Methods: Data were gathered from: (1) PubMed, Scopus, Web of Science, and Google Scholar; and (2) catathrenia social media groups (Yahoo and Facebook). Results: Data collected were (1) 15 case reports and 17 case series describing 191 patients with catathrenia; (2) questionnaires from 47 catathrenia subjects; (3) 5 audio files. Conclusions: Catathrenia is a noise produced during sleep (distinct from snoring) with identifiable harmonics, a computable main frequency, and high-decibel intensity that involves active adduction and vibration of the vocal cords during expiration. The quality of groaning in catathrenia is monotone, and often presents with a morose or sexual connotation, causing a significant social problem for patients. Although there is no association with risk of physical harm, catathrenia does present a significant disturbance to the bed partner and has been associated with subjective impairments to sleep quality, including unrefreshing sleep and fatigue. Polysomnography can be useful if performed properly to confirm the diagnosis and to evaluate for comorbid sleep disturbances, such as obstructive sleep apnea or parasomnia. Directions for further research could involve consideration of deep breathing exercises, yoga, meditation, or myofunctional therapy to help abate symptoms. Citation: Alonso J, Camacho M, Chhetri DK, Guilleminault C, Zaghi S. Catathrenia (nocturnal groaning): a social media survey and state-of-the-art review. J Clin Sleep Med. 2017;13(4):613–622. PMID:28095968

Spanish Translation and Cross-Language Validation of a Sleep Habits Questionnaire for Use in Clinical and Research Settings

PubMed Central

Baldwin, Carol M.; Choi, Myunghan; McClain, Darya Bonds; Celaya, Alma; Quan, Stuart F.

2012-01-01

Study Objectives: To translate, back-translate and cross-language validate (English/Spanish) the Sleep Heart Health Study Sleep Habits Questionnaire for use with Spanish-speakers in clinical and research settings. Methods: Following rigorous translation and back-translation, this cross-sectional cross-language validation study recruited bilingual participants from academic, clinic, and community-based settings (N = 50; 52% women; mean age 38.8 ± 12 years; 90% of Mexican heritage). Participants completed English and Spanish versions of the Sleep Habits Questionnaire, the Epworth Sleepiness Scale, and the Acculturation Rating Scale for Mexican Americans II one week apart in randomized order. Psychometric properties were assessed, including internal consistency, convergent validity, scale equivalence, language version intercorrelations, and exploratory factor analysis using PASW (Version18) software. Grade level readability of the sleep measure was evaluated. Results: All sleep categories (duration, snoring, apnea, insomnia symptoms, other sleep symptoms, sleep disruptors, restless legs syndrome) showed Cronbach α, Spearman-Brown coefficients and intercorrelations ≥ 0.700, suggesting robust internal consistency, correlation, and agreement between language versions. The Epworth correlated significantly with snoring, apnea, sleep symptoms, restless legs, and sleep disruptors) on both versions, supporting convergent validity. Items loaded on 4 factors accounted for 68% and 67% of the variance on the English and Spanish versions, respectively. Conclusions: The Spanish-language Sleep Habits Questionnaire demonstrates conceptual and content equivalency. It has appropriate measurement properties and should be useful for assessing sleep health in community-based clinics and intervention studies among Spanish-speaking Mexican Americans. Both language versions showed readability at the fifth grade level. Further testing is needed with larger samples. Citation: Baldwin CM; Choi M; McClain DB; Celaya A; Quan SF. Spanish translation and cross-language validation of a Sleep Habits Questionnaire for use in clinical and research settings. J Clin Sleep Med 2012;8(2):137-146. PMID:22505858

Risk factors for chronic and recurrent otitis media-a meta-analysis.

PubMed

Zhang, Yan; Xu, Min; Zhang, Jin; Zeng, Lingxia; Wang, Yanfei; Zheng, Qing Yin

2014-01-01

Risk factors associated with chronic otitis media (COM) and recurrent otitis media (ROM) have been investigated in previous studies. The objective of this study was to integrate the findings and determine the possible risk factors for COM/ROM based on our meta-analysis. A comprehensive search of electronic bibliographic databases (PubMed, Embase, CNKI and Wanfang database) from 1964 to Dec 2012, as well as a manual search of references of articles, was performed. A total of 2971 articles were searched, and 198 full-text articles were assessed for eligibility; 24 studies were eligible for this meta-analysis. Regarding risk factors for COM/ROM, there were two to nine different studies from which the odds ratios (ORs) could be pooled. The presence of allergy or atopy increased the risk of COM/ROM (OR, 1.36; 95% CI, 1.13-1.64; P = 0.001). An upper respiratory tract infection (URTI) significantly increased the risk of COM/ROM (OR, 6.59; 95% CI, 3.13-13.89; P<0.00001). Snoring appeared to be a significant risk factor for COM/ROM (OR, 1.96; 95% CI, 1.78-2.16; P<0.00001). A patient history of acute otitis media (AOM)/ROM increased the risk of COM/ROM (OR, 11.13; 95% CI, 1.06-116.44; P = 0.04). Passive smoke significantly increased the risk of COM/ROM (OR, 1.39; 95% CI, 1.02-1.89 P = 0.04). Low social status appeared to be a risk factor for COM/ROM (OR, 3.82; 95% CI, 1.11-13.15; P = 0.03). Our meta-analysis identified reliable conclusions that allergy/atopy, URTI, snoring, previous history of AOM/ROM, Second-hand smoke and low social status are important risk factors for COM/ROM. Other unidentified risk factors need to be identified in further studies with critical criteria.

Risk Factors for Chronic and Recurrent Otitis Media–A Meta-Analysis

PubMed Central

Zhang, Yan; Xu, Min; Zhang, Jin; Zeng, Lingxia; Wang, Yanfei; Zheng, Qing Yin

2014-01-01

Risk factors associated with chronic otitis media (COM) and recurrent otitis media (ROM) have been investigated in previous studies. The objective of this study was to integrate the findings and determine the possible risk factors for COM/ROM based on our meta-analysis. A comprehensive search of electronic bibliographic databases (PubMed, Embase, CNKI and Wanfang database) from 1964 to Dec 2012, as well as a manual search of references of articles, was performed. A total of 2971 articles were searched, and 198 full-text articles were assessed for eligibility; 24 studies were eligible for this meta-analysis. Regarding risk factors for COM/ROM, there were two to nine different studies from which the odds ratios (ORs) could be pooled. The presence of allergy or atopy increased the risk of COM/ROM (OR, 1.36; 95% CI, 1.13–1.64; P = 0.001). An upper respiratory tract infection (URTI) significantly increased the risk of COM/ROM (OR, 6.59; 95% CI, 3.13–13.89; P<0.00001). Snoring appeared to be a significant risk factor for COM/ROM (OR, 1.96; 95% CI, 1.78–2.16; P<0.00001). A patient history of acute otitis media (AOM)/ROM increased the risk of COM/ROM (OR, 11.13; 95% CI, 1.06–116.44; P = 0.04). Passive smoke significantly increased the risk of COM/ROM (OR, 1.39; 95% CI, 1.02–1.89 P = 0.04). Low social status appeared to be a risk factor for COM/ROM (OR, 3.82; 95% CI, 1.11–13.15; P = 0.03). Our meta-analysis identified reliable conclusions that allergy/atopy, URTI, snoring, previous history of AOM/ROM, Second-hand smoke and low social status are important risk factors for COM/ROM. Other unidentified risk factors need to be identified in further studies with critical criteria. PMID:24466073

The Association Between Sleep Disordered Breathing, Academic Grades, and Cognitive and Behavioral Functioning Among Overweight Subjects During Middle to Late Childhood

PubMed Central

Beebe, Dean W.; Ris, M. Douglas; Kramer, Megan E.; Long, Elizabeth; Amin, Raouf

2010-01-01

Study Objectives: (1) to determine the associations of sleep disordered breathing (SDB) with behavioral functioning, cognitive test scores, and school grades during middle- to late-childhood, an under-researched developmental period in the SDB literature, and (2) to clarify whether associations between SDB and school grades are mediated by deficits in cognitive or behavioral functioning. Design: Cross-sectional correlative study. Setting: Office/hospital, plus reported functioning at home and at school. Participants: 163 overweight subjects aged 10-16.9 years were divided into 4 groups based upon their obstructive apnea+hypopnea index (AHI) during overnight polysomnography and parent report of snoring: Moderate-Severe OSA (AHI > 5, n = 42), Mild OSA (AHI = 1-5, n = 58), Snorers (AHI < 1 + snoring, n = 26), and No SDB (AHI < 1 and nonsnoring, n = 37). Measurements: Inpatient overnight polysomnography, parent- and self-report of school grades and sleep, parent- and teacher-report of daytime behaviors, and office-based neuropsychological testing. Results: The 4 groups significantly differed in academic grades and parent- and teacher-reported behaviors, particularly inattention and learning problems. These findings remained significant after adjusting for subject sex, race, socioeconomic status, and school night sleep duration. Associations with SDB were confined to reports of behavioral difficulties in real-world situations, and did not extend to office-based neuropsychological tests. Findings from secondary analyses were consistent with, but could not definitively confirm, a causal model in which SDB affects school grades via its impact on behavioral functioning. Conclusions: SDB during middle- to late-childhood is related to important aspects of behavioral functioning, especially inattention and learning difficulties, that may result in significant functional impairment at school. Citation: Beebe DW; Ris MD; Kramer ME; Long E; Amin R. The association between sleep disordered breathing, academic grades, and cognitive and behavioral functioning among overweight subjects during middle to late childhood. SLEEP 2010;33(11):1447-1456. PMID:21102986

Severity of OSAS, CPAP and cardiovascular events: A follow-up study.

PubMed

Baratta, Francesco; Pastori, Daniele; Fabiani, Mario; Fabiani, Valerio; Ceci, Fabrizio; Lillo, Rossella; Lolli, Valeria; Brunori, Marco; Pannitteri, Gaetano; Cravotto, Elena; De Vito, Corrado; Angelico, Francesco; Del Ben, Maria

2018-05-01

Previous studies suggested obstructive sleep apnoea syndrome (OSAS) as a major risk factor for incident cardiovascular events. However, the relationship between OSAS severity, the use of continuous positive airway pressure (CPAP) treatment and the development of cardiovascular disease is still matter of debate. The aim was to test the association between OSAS and cardiovascular events in patients with concomitant cardio-metabolic diseases and the potential impact of CPAP therapy on cardiovascular outcomes. Prospective observational cohort study of consecutive outpatients with suspected metabolic disorders who had complete clinical and biochemical workup including polysomnography because of heavy snoring and possible OSAS. The primary endpoint was a composite of major adverse cardiovascular and cerebrovascular events (MACCE). Median follow-up was 81.3 months, including 434 patients (2701.2 person/years); 83 had a primary snoring, 84 had mild, 93 moderate and 174 severe OSAS, respectively. The incidence of MACCE was 0.8% per year (95% confidence interval [CI] 0.2-2.1) in primary snorers and 2.1% per year (95% CI 1.5-2.8) for those with OSAS. A positive association was observed between event-free survival and OSAS severity (log-rank test; P = .041). A multivariable Cox regression analysis showed obesity (HR = 8.011, 95% CI 1.071-59.922, P = .043), moderate OSAS (vs non-OSAS HR = 3.853, 95% CI 1.069-13.879, P = .039) and severe OSAS (vs non-OSAS HR = 3.540, 95% CI 1.026-12.217, P = .045) as predictors of MACCE. No significant association was observed between CPAP treatment and MACCE (log-rank test; P = .227). Our findings support the role of moderate/severe OSAS as a risk factor for incident MACCE. CPAP treatment was not associated with a lower rate of MACCE. © 2018 Stichting European Society for Clinical Investigation Journal Foundation.

Associations between self-reported sleep duration and sleeping disorder with concentrations of fasting and 2-h glucose, insulin, and glycosylated hemoglobin among adults without diagnosed diabetes.

PubMed

Ford, Earl S; Wheaton, Anne G; Chapman, Daniel P; Li, Chaoyang; Perry, Geraldine S; Croft, Janet B

2014-07-01

There is limited information from population-based investigations of the associations between sleep duration and sleep disorders and parameters of glucose homeostasis. The objective of the present study was to examine cross-sectional associations between sleep duration and sleep disordered breathing with concentrations of insulin, fasting and 2-h glucose, and HbA1c. Data from 11 815 adults aged ≥20 years without diagnosed diabetes (5002 with an oral glucose tolerance test) from the National Health and Nutrition Examination Survey 2005-2010 were used. Information about sleep duration (2005-2010) and sleep apnea and sleep-disordered breathing (2005-2008) was obtained via questionnaire. An estimated 36.0% of participants reported sleeping ≤6 h/night, 62.0% reported sleeping 7-9 h/night, and 2.0% reported sleeping ≥10 h/night. In 2005-2008, 33.0% reported snoring ≥5 nights per week, 5.9% reported they snorted, gasped, or stopped breathing ≥5 nights/week, and 4.2% reported sleep apnea. Sleep duration was significantly associated with fasting concentrations of insulin and concentrations of HbA1c only in models that did not adjust for body mass index (BMI). Concentrations of fasting and 2-h glucose were significantly associated with sleep duration in models that adjusted only for age. Snoring frequency was positively associated with concentrations of insulin and HbA1c. Frequency of snorting or stopping breathing and sleep apnea status were associated with concentrations of insulin and of HbA1c only when BMI was not accounted for. In a representative sample of US adults, concentrations of insulin and HbA1c were significantly associated with short sleep duration, possibly mediated by BMI. Published 2013. This article is a U.S. Government work and is in the public domain in the USA.

Assessment of a Neck-Based Treatment and Monitoring Device for Positional Obstructive Sleep Apnea

PubMed Central

Levendowski, Daniel J.; Seagraves, Sean; Popovic, Djordje; Westbrook, Philip R.

2014-01-01

Study Objectives: A majority of patients diagnosed with obstructive sleep apnea are position dependent whereby they are at least twice as severe when sleeping supine (POSA). This study evaluated the accuracy and efficacy of a neck-worn device designed to limit supine sleep. The study included nightly measurements of snoring, sleep/wake, time supine, and the frequency and duration of feedback to monitor compliance. Methods: Thirty patients between ages 18 and 75 years, BMI ≤ 35 with an overall apnea-hypopnea index (AHI) ≥ 5 and an overall AHI ≥ 1.5 times the non-supine AHI, and an Epworth score ≥ 5 were prospectively studied. Subjective reports and polysomnography were used to assess efficacy resulting from 4 weeks of in-home supine-avoidance therapy and to measure device accuracy. From 363 polysomnography reports, 209 provided sufficient positional data to estimate one site's prevalence of positional OSA. Results: In 83% of participants exhibiting > 50% reduction in overall AHI, the mean and median reductions were 69% and 79%. Significant reductions in the overall and supine AHI, apnea index, percent time SpO2 < 90%, and snoring contributed to significant improvements in stage N1 and N2 sleep, reductions in cortical arousals and awakenings, and improved depression scores. Supine position was under-detected by > 5% in 3% of cases. Sleep efficiency by neck actigraphy was within 10% of polysomnography in 87% of the studies when position feedback was delivered. The prevalence of POSA was consistently > 70% when the overall AHI was < 60. Conclusions: The neck position therapy device is accurate and effective in restricting supine sleep, improving AHI, sleep architecture and continuity, and monitoring treatment outcomes. Citation: Levendowski DJ, Seagraves S, Popovic D, Westbrook PR. Assessment of a neck-based treatment and monitoring device for positional obstructive sleep apnea. J Clin Sleep Med 2014;10(8):863-871. PMID:25126032

New type of chimera and mutual synchronization of spatiotemporal structures in two coupled ensembles of nonlocally interacting chaotic maps

NASA Astrophysics Data System (ADS)

Bukh, Andrei; Rybalova, Elena; Semenova, Nadezhda; Strelkova, Galina; Anishchenko, Vadim

2017-11-01

We study numerically the dynamics of a network made of two coupled one-dimensional ensembles of discrete-time systems. The first ensemble is represented by a ring of nonlocally coupled Henon maps and the second one by a ring of nonlocally coupled Lozi maps. We find that the network of coupled ensembles can realize all the spatio-temporal structures which are observed both in the Henon map ensemble and in the Lozi map ensemble while uncoupled. Moreover, we reveal a new type of spatiotemporal structure, a solitary state chimera, in the considered network. We also establish and describe the effect of mutual synchronization of various complex spatiotemporal patterns in the system of two coupled ensembles of Henon and Lozi maps.

Feasibility study of geospatial mapping of chronic disease risk to inform public health commissioning

PubMed Central

Smith, Dianna; Mathur, Rohini; Robson, John; Greenhalgh, Trisha

2012-01-01

Objective To explore the feasibility of producing small-area geospatial maps of chronic disease risk for use by clinical commissioning groups and public health teams. Study design Cross-sectional geospatial analysis using routinely collected general practitioner electronic record data. Sample and setting Tower Hamlets, an inner-city district of London, UK, characterised by high socioeconomic and ethnic diversity and high prevalence of non-communicable diseases. Methods The authors used type 2 diabetes as an example. The data set was drawn from electronic general practice records on all non-diabetic individuals aged 25–79 years in the district (n=163 275). The authors used a validated instrument, QDScore, to calculate 10-year risk of developing type 2 diabetes. Using specialist mapping software (ArcGIS), the authors produced visualisations of how these data varied by lower and middle super output area across the district. The authors enhanced these maps with information on examples of locality-based social determinants of health (population density, fast food outlets and green spaces). Data were piloted as three types of geospatial map (basic, heat and ring). The authors noted practical, technical and information governance challenges involved in producing the maps. Results Usable data were obtained on 96.2% of all records. One in 11 adults in our cohort was at ‘high risk’ of developing type 2 diabetes with a 20% or more 10-year risk. Small-area geospatial mapping illustrated ‘hot spots’ where up to 17.3% of all adults were at high risk of developing type 2 diabetes. Ring maps allowed visualisation of high risk for type 2 diabetes by locality alongside putative social determinants in the same locality. The task of downloading, cleaning and mapping data from electronic general practice records posed some technical challenges, and judgement was required to group data at an appropriate geographical level. Information governance issues were time consuming and required local and national consultation and agreement. Conclusions Producing small-area geospatial maps of diabetes risk calculated from general practice electronic record data across a district-wide population was feasible but not straightforward. Geovisualisation of epidemiological and environmental data, made possible by interdisciplinary links between public health clinicians and human geographers, allows presentation of findings in a way that is both accessible and engaging, hence potentially of value to commissioners and policymakers. Impact studies are needed of how maps of chronic disease risk might be used in public health and urban planning. PMID:22337817

Mapping the seafloor geology offshore of Massachusetts

USGS Publications Warehouse

Barnhardt, Walter A.; Andrews, Brian D.

2006-01-01

Geologic and bathymetric maps help us understand the evolutionary history of the Massachusetts coast and the processes that have shaped it. The maps show the distribution of bottom types (for example, bedrock, gravel, sand, mud) and water depths over large areas of the seafloor. In turn, these two fundamental parameters largely determine the species of flora and fauna that inhabit a particular area. Knowledge of bottom types and water depths provides a framework for mapping benthic habitats and managing marine resources. The need for coastal–zone mapping to inform policy and management is widely recognized as critical for mitigating hazards, creating resource inventories, and tracking environmental changes (National Research Council, 2004; U.S. Commission on Ocean Policy, 2004).

MAPPING BATHYMETRY AND BOTTOM TYPE IN A SHALLOW ESTUARY

EPA Science Inventory

Bathymetry and bottom type are important in characterizing estuaries and their ecology but hard to map, especially in shallow estuaries. Acoustic backscattering was used to remotely sense these properties in the shallow Slocums River Estuary of Massachusetts. Acoustic pulses were...

Isolation of Mycobacterium avium subspecies paratuberculosis from non-ruminant wildlife living in the sheds and on the pastures of Greek sheep and goats

PubMed Central

FLOROU, M.; LEONTIDES, L.; KOSTOULAS, P.; BILLINIS, C.; SOFIA, M.; KYRIAZAKIS, I.; LYKOTRAFITIS, F.

2008-01-01

SUMMARY This study aimed to: (1) investigate whether non-ruminant wildlife interfacing with dairy sheep and goats of four Greek flocks endemically infected with Mycobacterium avium subspecies paratuberculosis (MAP) harboured MAP and (2) genetically compare the strains isolated from the wildlife to those isolated from the small ruminants of these flocks. We cultured and screened, by polymerase chain reaction (PCR), pooled-tissue samples from 327 wild animals of 11 species for the MAP-specific IS900 insertion sequence. We also cultured faecal samples from 100 sheep or goats from each of the four flocks. MAP was detected in samples from 11 sheep, 12 goats, two mice, two rats, a hare and a fox. Only one rat had histopathological findings. Genetic typing categorized 21 isolates as cattle-type strains and two, from a house mouse and a goat respectively, as sheep-type strains; this is the first report of a rodent harbouring a sheep-type strain. The MAP types that were most frequently isolated amongst the sheep and goats of each flock were also the ones isolated from sympatric rodents; those isolated from the fox and hare also belonged to the predominant ruminant strains. PMID:17578601

Radiometric age map of Aleutian Islands

USGS Publications Warehouse

Wilson, Frederic H.; Turner, D.L.

1975-01-01

This map includes published, thesis, and open-file radiometric data available to us as of June, 1975. Some dates are not plotted because of inadequate location data in the original references.The map is divided into five sections, based on 1:1,000,000 scale enlargements of the National Atlas maps of Alaska. Within each section (e.g., southeastern Alaska), radiometric dates are plotted and keyed to 1:250,000 scale quadrangles. Accompanying each map section is table 1, listing map numbers and the sample identification numbers used in DGGS Special Report 10: Radiometric Dates from Alaska-A 1975 Compilation”. The reader is referred to Special Report 10 for more complete information on location, rock type, dating method, and literature references for each age entry. A listing of dates in Special Report lo which require correction or deletion is included S table 2. Corrected and additional entries are listed in table 3. The listings in tables 2 and 3 follow the format of Special Report 10. Table 4 is a glossary of abbreviations used for quadrangle name, rock type, mineral dated, and type of dating method used.

Radiometric age map of southcentral Alaska

USGS Publications Warehouse

Wilson, Frederic H.; Turner, D.L.

1975-01-01

This map includes published, thesis, and open-file radiometric data available to us as of June, 1975. Some dates are not plotted because of inadequate location data in the original references.The map is divided into five sections, based on 1:1,000,000 scale enlargements of the National Atlas maps of Alaska. Within each section (e.g., southeastern Alaska), radiometric dates are plotted and keyed to 1:250,000 scale quadrangles. Accompanying each map section is table 1, listing map numbers and the sample identification numbers used in DGGS Special Report 10: Radiometric Dates from Alaska-A 1975 Compilation”. The reader is referred to Special Report 10 for more complete information on location, rock type, dating method, and literature references for each age entry. A listing of dates in Special Report lo which require correction or deletion is included S table 2. Corrected and additional entries are listed in table 3. The listings in tables 2 and 3 follow the format of Special Report 10. Table 4 is a glossary of abbreviations used for quadrangle name, rock type, mineral dated, and type of dating method used.

Radiometric age map of southwest Alaska

USGS Publications Warehouse

Wilson, Frederic H.; Turner, D.L.

1975-01-01

This map includes published, thesis, and open-file radiometric data available to us as of June, 1975. Some dates are not plotted because of inadequate location data in the original references.The map is divided into five sections, based on 1:1,000,000 scale enlargements of the National Atlas maps of Alaska. Within each section (e.g., southeastern Alaska), radiometric dates are plotted and keyed to 1:250,000 scale quadrangles. Accompanying each map section is table 1, listing map numbers and the sample identification numbers used in DGGS Special Report 10: Radiometric Dates from Alaska-A 1975 Compilation”. The reader is referred to Special Report 10 for more complete information on location, rock type, dating method, and literature references for each age entry. A listing of dates in Special Report lo which require correction or deletion is included S table 2. Corrected and additional entries are listed in table 3. The listings in tables 2 and 3 follow the format of Special Report 10. Table 4 is a glossary of abbreviations used for quadrangle name, rock type, mineral dated, and type of dating method used.

Radiometric age map of southeast Alaska

USGS Publications Warehouse

Wilson, Frederic H.; Turner, D.L.

1975-01-01

This map includes published, thesis, and open-file radiometric data available to us as of June, 1975. Some dates are not plotted because of inadequate location data in the original references.The map is divided into five sections, based on 1:1,000,000 scale enlargements of the National Atlas maps of Alaska. Within each section (e.g., southeastern Alaska), radiometric dates are plotted and keyed to 1:250,000 scale quadrangles. Accompanying each map section is table 1, listing map numbers and the sample identification numbers used in DGGS Special Report 10: Radiometric Dates from Alaska-A 1975 Compilation”. The reader is referred to Special Report 10 for more complete information on location, rock type, dating method, and literature references for each age entry. A listing of dates in Special Report lo which require correction or deletion is included S table 2. Corrected and additional entries are listed in table 3. The listings in tables 2 and 3 follow the format of Special Report 10. Table 4 is a glossary of abbreviations used for quadrangle name, rock type, mineral dated, and type of dating method used.

Radiometric age map of northern Alaska

USGS Publications Warehouse

Wilson, Frederic H.; Turner, D.L.

1975-01-01

This map includes published, thesis, and open-file radiometric data available to us as of June, 1975. Some dates are not plotted because of inadequate location data in the original references.The map is divided into five sections, based on 1:1,000,000 scale enlargements of the National Atlas maps of Alaska. Within each section (e.g., southeastern Alaska), radiometric dates are plotted and keyed to 1:250,000 scale quadrangles. Accompanying each map section is table 1, listing map numbers and the sample identification numbers used in DGGS Special Report 10: Radiometric Dates from Alaska-A 1975 Compilation”. The reader is referred to Special Report 10 for more complete information on location, rock type, dating method, and literature references for each age entry. A listing of dates in Special Report lo which require correction or deletion is included S table 2. Corrected and additional entries are listed in table 3. The listings in tables 2 and 3 follow the format of Special Report 10. Table 4 is a glossary of abbreviations used for quadrangle name, rock type, mineral dated, and type of dating method used.

Detection of serum antibodies cross-reacting with Mycobacterium avium subspecies paratuberculosis and beta-cell antigen zinc transporter 8 homologous peptides in patients with high-risk proliferative diabetic retinopathy.

PubMed

Pinna, Antonio; Masala, Speranza; Blasetti, Francesco; Maiore, Irene; Cossu, Davide; Paccagnini, Daniela; Mameli, Giuseppe; Sechi, Leonardo A

2014-01-01

MAP3865c, a Mycobacterium avium subspecies paratuberculosis (MAP) cell membrane protein, has a relevant sequence homology with zinc transporter 8 (ZnT8), a beta-cell membrane protein involved in Zn++ transportation. Recently, antibodies recognizing MAP3865c epitopes have been shown to cross-react with ZnT8 in type 1 diabetes patients. The purpose of this study was to detect antibodies against MAP3865c peptides in patients with high-risk proliferative diabetic retinopathy and speculate on whether they may somehow be involved in the pathogenesis of this severe retinal disorder. Blood samples were obtained from 62 type 1 and 80 type 2 diabetes patients with high-risk proliferative diabetic retinopathy and 81 healthy controls. Antibodies against 6 highly immunogenic MAP3865c peptides were detected by indirect ELISA. Type 1 diabetes patients had significantly higher rates of positive antibodies than controls. Conversely, no statistically significant differences were found between type 2 diabetes patients and controls. After categorization of type 1 diabetes patients into two groups, one with positive, the other with negative antibodies, we found that they had similar mean visual acuity (∼ 0.6) and identical rates of vitreous hemorrhage (28.6%). Conversely, Hashimoto's thyroiditis prevalence was 4/13 (30.7%) in the positive antibody group and 1/49 (2%) in the negative antibody group, a statistically significant difference (P = 0.016). This study confirmed that type 1 diabetes patients have significantly higher rates of positive antibodies against MAP/ZnT8 peptides, but failed to find a correlation between the presence of these antibodies and the severity degree of high-risk proliferative diabetic retinopathy. The significantly higher prevalence of Hashimoto's disease among type 1 diabetes patients with positive antibodies might suggest a possible common environmental trigger for these conditions.

Satellite Remote Sensing of Cropland Characteristics in 30m Resolution: The First North American Continental-Scale Classification on High Performance Computing Platforms

NASA Astrophysics Data System (ADS)

Massey, Richard

Cropland characteristics and accurate maps of their spatial distribution are required to develop strategies for global food security by continental-scale assessments and agricultural land use policies. North America is the major producer and exporter of coarse grains, wheat, and other crops. While cropland characteristics such as crop types are available at country-scales in North America, however, at continental-scale cropland products are lacking at fine sufficient resolution such as 30m. Additionally, applications of automated, open, and rapid methods to map cropland characteristics over large areas without the need of ground samples are needed on efficient high performance computing platforms for timely and long-term cropland monitoring. In this study, I developed novel, automated, and open methods to map cropland extent, crop intensity, and crop types in the North American continent using large remote sensing datasets on high-performance computing platforms. First, a novel method was developed in this study to fuse pixel-based classification of continental-scale Landsat data using Random Forest algorithm available on Google Earth Engine cloud computing platform with an object-based classification approach, recursive hierarchical segmentation (RHSeg) to map cropland extent at continental scale. Using the fusion method, a continental-scale cropland extent map for North America at 30m spatial resolution for the nominal year 2010 was produced. In this map, the total cropland area for North America was estimated at 275.2 million hectares (Mha). This map was assessed for accuracy using randomly distributed samples derived from United States Department of Agriculture (USDA) cropland data layer (CDL), Agriculture and Agri-Food Canada (AAFC) annual crop inventory (ACI), Servicio de Informacion Agroalimentaria y Pesquera (SIAP), Mexico's agricultural boundaries, and photo-interpretation of high-resolution imagery. The overall accuracies of the map are 93.4% with a producer's accuracy for crop class at 85.4% and user's accuracy of 74.5% across the continent. The sub-country statistics including state-wise and county-wise cropland statistics derived from this map compared well in regression models resulting in R2 > 0.84. Secondly, an automated phenological pattern matching (PPM) method to efficiently map cropping intensity was also developed in this study. This study presents a continental-scale cropping intensity map for the North American continent at 250m spatial resolution for 2010. In this map, the total areas for single crop, double crop, continuous crop, and fallow were estimated to be 123.5 Mha, 11.1 Mha, 64.0 Mha, and 83.4 Mha, respectively. This map was assessed using limited country-level reference datasets derived from United States Department of Agriculture cropland data layer and Agriculture and Agri-Food Canada annual crop inventory with overall accuracies of 79.8% and 80.2%, respectively. Third, two novel and automated decision tree classification approaches to map crop types across the conterminous United States (U.S.) using MODIS 250 m resolution data: 1) generalized, and 2) year-specific classification were developed. The classification approaches use similarities and dissimilarities in crop type phenology derived from NDVI time-series data for the two approaches. Annual crop type maps were produced for 8 major crop types in the United States using the generalized classification approach for 2001-2014 and the year-specific approach for 2008, 2010, 2011 and 2012. The year-specific classification had overall accuracies greater than 78%, while the generalized classifier had accuracies greater than 75% for the conterminous U.S. for 2008, 2010, 2011, and 2012. The generalized classifier enables automated and routine crop type mapping without repeated and expensive ground sample collection year after year with overall accuracies > 70% across all independent years. Taken together, these cropland products of extent, cropping intensity, and crop types, are significantly beneficial in agricultural and water use planning and monitoring to formulate policies towards global and North American food security issues.

Culture phenotypes and molecular characterization of Mycobacterium avium subsp. paratuberculosis isolates from small ruminants.

PubMed

Dimareli-Malli, Z; Mazaraki, K; Stevenson, K; Tsakos, P; Zdragas, A; Giantzi, V; Petridou, E; Heron, I; Vafeas, G

2013-08-01

In this study the suitability of different solid media was investigated for the isolation of Mycobacterium avium subsp. paratuberculosis (Map) in order to identify the optimum single or combination of media to permit the isolation of all strain types from small ruminants. A subset of these Map strains was then further characterized by molecular typing methods to assess the genetic diversity of Map strains in the study area (Northern Greece). Map strains were isolated from tissues and faeces of infected goats (n=52) and sheep (n=8) and were analysed for polymorphisms in IS1311 to classify the strain type as Type C or S. The study found that M7H11 supplemented with mycobactin j, OADC and new born calf serum (M7H11+Mj) is the best single choice of medium for the primary isolation of Map of both Type C and S from small ruminants. The combination of M7H11+Mj and Herrolds egg yolk medium supplemented with mycobactin j and sodium pyruvate allowed the detection of all Map isolates in this study. Nineteen Map isolates were characterised by pulsed-field gel electrophoresis and the isolates demonstrated significant genetic diversity. Twelve different SnaBI and 16 distinct SpeI profiles were detected of which 25 have not been described previously and are new profiles. The combination of both enzyme profiles gave 13 different multiplex profiles. Ten different multiplex profiles were detected in goats and three in sheep. One ovine isolate gave the same multiplex profile as a caprine isolate and two different profiles were found within a single goat herd. Copyright © 2013 Elsevier Ltd. All rights reserved.

Forest type mapping with satellite data

NASA Technical Reports Server (NTRS)

Dodge, A. G., Jr.; Bryant, E. S.

1976-01-01

Computer classification of data from Landsat, an earth-orbiting satellite, has resulted in measurements and maps of forest types for two New Hampshire counties. The acreages of hardwood and softwood types and total forested areas compare favorably with Forest Service figures for the same areas. These techniques have advantages for field application, particularly in states having forest taxation laws based on general productivity.

Developing Land Use Land Cover Maps for the Lower Mekong Basin to Aid SWAT Hydrologic Modeling

NASA Astrophysics Data System (ADS)

Spruce, J.; Bolten, J. D.; Srinivasan, R.

2017-12-01

This presentation discusses research to develop Land Use Land Cover (LULC) maps for the Lower Mekong Basin (LMB). Funded by a NASA ROSES Disasters grant, the main objective was to produce updated LULC maps to aid the Mekong River Commission's (MRC's) Soil and Water Assessment Tool (SWAT) hydrologic model. In producing needed LULC maps, temporally processed MODIS monthly NDVI data for 2010 were used as the primary data source for classifying regionally prominent forest and agricultural types. The MODIS NDVI data was derived from processing MOD09 and MYD09 8-day reflectance data with the Time Series Product Tool, a custom software package. Circa 2010 Landsat multispectral data from the dry season were processed into top of atmosphere reflectance mosaics and then classified to derive certain locally common LULC types, such as urban areas and industrial forest plantations. Unsupervised ISODATA clustering was used to derive most LULC classifications. GIS techniques were used to merge MODIS and Landsat classifications into final LULC maps for Sub-Basins (SBs) 1-8 of the LMB. The final LULC maps were produced at 250-meter resolution and delivered to the MRC for use in SWAT modeling for the LMB. A map accuracy assessment was performed for the SB 7 LULC map with 14 classes. This assessment was performed by comparing random locations for sampled LULC types to geospatial reference data such as Landsat RGBs, MODIS NDVI phenologic profiles, high resolution satellite data from Google Map/Earth, and other reference data from the MRC (e.g., crop calendars). LULC accuracy assessment results for SB 7 indicated an overall agreement to reference data of 81% at full scheme specificity. However, by grouping 3 deciduous forest classes into 1 class, the overall agreement improved to 87%. The project enabled updated LULC maps, plus more specific rice types were classified compared to the previous LULC maps. The LULC maps from this project should improve the use of SWAT for modeling hydrology in the LMB, plus improve water and disaster management in a region vulnerable to flooding, droughts, and anthropogenic change (e.g., from dam building and other LULC change).

Mapping pocket gopher burrow systems with expanding polyurethane foam

DOE Office of Scientific and Technical Information (OSTI.GOV)

Felthauser, M.; McInroy, D.

The impetus for this study arose from the need to isolate buried chemical and radioactive waste from burrowing animals. In a study of barrier materials that inhibit burrowing by pocket gophers (Thomomys spp.) into waste material, it was necessary to map tunnel systems as a function of depth and soil type. A method of mapping burrow systems was needed that would be economical, portable, useful in a variety of soil types, and give accurate, permanent records of burrow configurations. A method is described for injecting an expanding polyurethane foam to map burrow systems in situ.

Identification, definition and mapping of terrestrial ecosystems in interior Alaska

NASA Technical Reports Server (NTRS)

Anderson, J. H. (Principal Investigator)

1973-01-01

The author has identified the following significant results. The primary objective is to identify and analyze vegetation types in as great of detail as possible on ERTS-1 imagery and to classify and delineate them through mapping. This is basic to the identification, definition, and mapping of ecosystems. Major conclusions are: (1) the ERTS-1 system is useful for regional scale studies of broadly defined Alaskan vegetation types; (2) the resolution and spectral capabilities of ERTS-1 MSS imagery in photographic formats is adequate for certain phytecenologic purposes; and (3) preparation of an improved State vegetation map will be feasible.

Mapping wetlands on beaver flowages with 35-mm photography

USGS Publications Warehouse

Kirby, R.E.

1976-01-01

Beaver flowages and associated wetlands on the Chippewa National Forest, north-central Minnesota, were photographed from the ground and from the open side window of a small high-wing monoplane. The 35-mm High Speed Ektachrome transparencies obtained were used to map the cover-type associations visible on the aerial photographs. Nearly vertical aerial photos were rectified by projecting the slides onto a base map consisting ofcontrol points located by plane-table survey. Maps were prepared by tracing the recognizable stands of vegetation in the rectified projection at the desired map scale. Final map scales ranging from 1:260 to 1:571 permitted identification and mapping of 26 cover-type associations on 10 study flowages in 1971. This cover-mapping technique was economical and substituted for detailed ground surveys. Comparative data from 10 flowages were collected serially throughout the entire open-water season. Although developed for analysis of waterfowl habitat, the technique has application to other areas of wildlife management and ecological investigation.

Map showing structure of the Mississippi Valley Graben in the vicinity of New Madrid, Missouri

USGS Publications Warehouse

Wheeler, Russell L.; Rhea, Susan; Dart, Richard L.

1994-01-01

This is one of a series of five seismotectonic maps of the seismically active New Madrid area in southeast Missouri and adjacent parts of Arkansas, Kentucky, and Tennessee (table 1). We cannot legibly show all the seismotectonic data on a single map, therefore each of the five maps in this series groups a different type of related information. Rhea and others (1994) summarized the background and purpose of the seismotectonic map folio. The different types of data shown on this map are described in table 2. Except for a few exposed faults, all structures shown on the map are in Paleozoic sedimentary rocks of the midcontinent or underlying metamorphic and igneous basement rocks of presumed Precambrian age (Dart, 1992; Muehlberger, 1992). Edge of Mississippi Embayment, as shown on the map, marks the contact between gently dipping, exposed Paleozoic rocks to the northwest (Anderson and others, 1979) and unconformably overlying, flat or gently dipping Mesozoic and Cenozoic strata of the embayment to the southeast.

The possibility of clinical application of the solid state lasers: Nd:YAG, Ho:YAG, and Er:YAG in otolaryngology - head and neck surgery

NASA Astrophysics Data System (ADS)

Tomaszewska, M.; Kukwa, A.; Tulibacki, M.; Wójtowicz, P.; Olędzka, I.; Jeżewska, E.

2007-02-01

The purpose of this study was to summarize our experiences in clinical application of Nd:YAG, Ho:YAG and Er:YAG in otolaryngology- head and neck surgery. Choosing the laser type and parameters for the particular procedures was based on our previous research on tissue effects of those lasers. During the period of 1993-2006 we performed 3988 surgical procedures with the Nd:YAG laser. Over 87% of those were made for the nasal cavity pathologies as polyps, hyperplasia of inferior nasal turbinate, granulation tissue, postoperative adhesions, vascular malformations, under the local anesthesia conditions. In our experience Nd:YAG laser gives the possibility of good clinical control and low risk of side effects for disorders of high recurrence and frequent interventions necessity, as nasal polyps or respiratory papillomatosis. Nd:YAG assisted uvulopalatoplasty gives an interesting alternative for surgical procedures for snoring and slight/mild OSA-recognized patients. Due to its good hemostatic properties, it is a perfect tool for removal of the chemodectoma from meddle ear. During the period of 1995-2006 we performed 229 surgical procedures with the Ho:YAG laser, mostly for larynx pathologies (adhesion and scar tissue removal). In our experience Ho:YAG laser can serve as a precise laser knife for both soft and bony tissue. The ER:YAG laser still remain under clinical trial. Since 2001 year we performed 24 procedures of removing stone deposits from salivary glands. We believe it may become a promising method to cope with sialolithiasis which allows for glandule function preservation. All of the laser types mentioned above, can be easily coupled with endoscopes, what makes them available for all of the head and necklocalized disorders.

Petroleum systems of the San Joaquin Basin Province, California -- geochemical characteristics of oil types: Chapter 9 in Petroleum systems and geologic assessment of oil and gas in the San Joaquin Basin Province, California

USGS Publications Warehouse

Lillis, Paul G.; Magoon, Leslie B.

2007-01-01

New analyses of 120 oil samples combined with 139 previously published oil analyses were used to characterize and map the distribution of oil types in the San Joaquin Basin, California. The results show that there are at least four oil types designated MM, ET, EK, and CM. Most of the oil from the basin has low to moderate sulfur content (less than 1 weight percent sulfur), although a few unaltered MM oils have as much as 1.2 weight percent sulfur. Reevaluation of source rock data from the literature indicate that the EK oil type is derived from the Eocene Kreyenhagen Formation, and the MM oil type is derived, in part, from the Miocene to Pliocene Monterey Formation and its equivalent units. The ET oil type is tentatively correlated to the Eocene Tumey formation of Atwill (1935). Previous studies suggest that the CM oil type is derived from the Late Cretaceous to Paleocene Moreno Formation. Maps of the distribution of the oil types show that the MM oil type is restricted to the southern third of the San Joaquin Basin Province. The composition of MM oils along the southern and eastern margins of the basin reflects the increased contribution of terrigenous organic matter to the marine basin near the Miocene paleoshoreline. EK oils are widely distributed along the western half of the basin, and ET oils are present in the central and west-central areas of the basin. The CM oil type has only been found in the Coalinga area in southwestern Fresno County. The oil type maps provide the basis for petroleum system maps that incorporate source rock distribution and burial history, migration pathways, and geologic relationships between hydrocarbon source and reservoir rocks. These petroleum system maps were used for the 2003 U.S. Geological Survey resource assessment of the San Joaquin Basin Province.

Cognitive Mapping Techniques: Implications for Research in Engineering and Technology Education

ERIC Educational Resources Information Center

Dixon, Raymond A.; Lammi, Matthew

2014-01-01

The primary goal of this paper is to present the theoretical basis and application of two types of cognitive maps, concept map and mind map, and explain how they can be used by educational researchers in engineering design research. Cognitive mapping techniques can be useful to researchers as they study students' problem solving strategies…

Exploring the cellular basis of human disease through a large-scale mapping of deleterious genes to cell types.

PubMed

Cornish, Alex J; Filippis, Ioannis; David, Alessia; Sternberg, Michael J E

2015-09-01

Each cell type found within the human body performs a diverse and unique set of functions, the disruption of which can lead to disease. However, there currently exists no systematic mapping between cell types and the diseases they can cause. In this study, we integrate protein-protein interaction data with high-quality cell-type-specific gene expression data from the FANTOM5 project to build the largest collection of cell-type-specific interactomes created to date. We develop a novel method, called gene set compactness (GSC), that contrasts the relative positions of disease-associated genes across 73 cell-type-specific interactomes to map genes associated with 196 diseases to the cell types they affect. We conduct text-mining of the PubMed database to produce an independent resource of disease-associated cell types, which we use to validate our method. The GSC method successfully identifies known disease-cell-type associations, as well as highlighting associations that warrant further study. This includes mast cells and multiple sclerosis, a cell population currently being targeted in a multiple sclerosis phase 2 clinical trial. Furthermore, we build a cell-type-based diseasome using the cell types identified as manifesting each disease, offering insight into diseases linked through etiology. The data set produced in this study represents the first large-scale mapping of diseases to the cell types in which they are manifested and will therefore be useful in the study of disease systems. Overall, we demonstrate that our approach links disease-associated genes to the phenotypes they produce, a key goal within systems medicine.

Computer-aided analysis of Skylab scanner data for land use mapping, forestry and water resource applications

NASA Technical Reports Server (NTRS)

Hoffer, R. M.

1975-01-01

Skylab data were obtained over a mountainous test site containing a complex association of cover types and rugged topography. The application of computer-aided analysis techniques to the multispectral scanner data produced a number of significant results. Techniques were developed to digitally overlay topographic data (elevation, slope, and aspect) onto the S-192 MSS data to provide a method for increasing the effectiveness and accuracy of computer-aided analysis techniques for cover type mapping. The S-192 MSS data were analyzed using computer techniques developed at Laboratory for Applications of Remote Sensing (LARS), Purdue University. Land use maps, forest cover type maps, snow cover maps, and area tabulations were obtained and evaluated. These results compared very well with information obtained by conventional techniques. Analysis of the spectral characteristics of Skylab data has conclusively proven the value of the middle infrared portion of the spectrum (about 1.3-3.0 micrometers), a wavelength region not previously available in multispectral satellite data.

LAMMR world data base documentation support and demonstrations

NASA Technical Reports Server (NTRS)

Chin, R.; Beaudet, P.

1980-01-01

The primary purpose of the World Surface Map is to provide the LAMMR subsystem with world surface type classifications that are used to set up LAMMR LEVEL II process control. This data base will be accessed solely by the LAMMR subsystem. The SCATT and ALT subsystems will access the data base indirectly through the T sub b (Brightness Temperature) Data Bank, where the surface types were updated from a priori to current classification, and where the surface types were organized on an orbital subtrack basis. The single most important factor in the design of the World Surface Maps is the ease of access to the information while the complexity of generating these maps is of lesser importance because their generation is a one-time, off-line process. The World Surface Map provides storage of information with a resolution of 7 km necessary to set flags concerning the earth's features with a different set of maps for each month of the year.

Digital line graphs from 1:24,000-scale maps

USGS Publications Warehouse

,

1990-01-01

The Earth Science Information Centers (ESIC) distribute digital cartographic/geographic data files produced by the U.S. Geological Survey (USGS) as part of the National Mapping Program. Digital cartographic data flles are grouped into four basic types. The first of these, called a Digital Line . Graph (DLG), is line map information in digital form. These data files include information on planimetric base categories, such as transportation, hydrography, and boundaries. The second type, called a Digital Elevation Model (DEM), consists of a sampled array of elevations for a number of ground positions that are usually at regularly spaced intervals. The third type is Land Use and Land Cover digital data, which provides information on nine major classes of land use such as urban, agricultural, or forest as wen as associated map data such as political units and Federal land ownership. The fourth type, the Geographic Names Information System, provides primary information for all known places, features, and areas in the United States identified by a proper name.

Isostatic gravity map with simplified geology of the Los Angeles 30 x 60 minute quadrangle

USGS Publications Warehouse

Wooley, R.J.; Yerkes, R.F.; Langenheim, V.E.; Chuang, F.C.

2003-01-01

This isostatic residual gravity map is part of the Southern California Areal Mapping Project (SCAMP) and is intended to promote further understanding of the geology in the Los Angeles 30 x 60 minute quadrangle, California, by serving as a basis for geophysical interpretations and by supporting both geological mapping and topical (especially earthquake) studies. Local spatial variations in the Earth's gravity field (after various corrections for elevation, terrain, and deep crustal structure explained below) reflect the lateral variation in density in the mid- to upper crust. Densities often can be related to rock type, and abrupt spatial changes in density commonly mark lithologic boundaries. The map shows contours of isostatic gravity overlain on a simplified geology including faults and rock types. The map is draped over shaded-relief topography to show landforms.

A deer (subfamily Cervinae) genetic linkage map and the evolution of ruminant genomes.

PubMed Central

Slate, Jon; Van Stijn, Tracey C; Anderson, Rayna M; McEwan, K Mary; Maqbool, Nauman J; Mathias, Helen C; Bixley, Matthew J; Stevens, Deirdre R; Molenaar, Adrian J; Beever, Jonathan E; Galloway, Susan M; Tate, Michael L

2002-01-01

Comparative maps between ruminant species and humans are increasingly important tools for the discovery of genes underlying economically important traits. In this article we present a primary linkage map of the deer genome derived from an interspecies hybrid between red deer (Cervus elaphus) and Père David's deer (Elaphurus davidianus). The map is approximately 2500 cM long and contains >600 markers including both evolutionary conserved type I markers and highly polymorphic type II markers (microsatellites). Comparative mapping by annotation and sequence similarity (COMPASS) was demonstrated to be a useful tool for mapping bovine and ovine ESTs in deer. Using marker order as a phylogenetic character and comparative map information from human, mouse, deer, cattle, and sheep, we reconstructed the karyotype of the ancestral Pecoran mammal and identified the chromosome rearrangements that have occurred in the sheep, cattle, and deer lineages. The deer map and interspecies hybrid pedigrees described here are a valuable resource for (1) predicting the location of orthologs to human genes in ruminants, (2) mapping QTL in farmed and wild deer populations, and (3) ruminant phylogenetic studies. PMID:11973312

Lossless Compression of Classification-Map Data

NASA Technical Reports Server (NTRS)

Hua, Xie; Klimesh, Matthew

2009-01-01

A lossless image-data-compression algorithm intended specifically for application to classification-map data is based on prediction, context modeling, and entropy coding. The algorithm was formulated, in consideration of the differences between classification maps and ordinary images of natural scenes, so as to be capable of compressing classification- map data more effectively than do general-purpose image-data-compression algorithms. Classification maps are typically generated from remote-sensing images acquired by instruments aboard aircraft (see figure) and spacecraft. A classification map is a synthetic image that summarizes information derived from one or more original remote-sensing image(s) of a scene. The value assigned to each pixel in such a map is the index of a class that represents some type of content deduced from the original image data for example, a type of vegetation, a mineral, or a body of water at the corresponding location in the scene. When classification maps are generated onboard the aircraft or spacecraft, it is desirable to compress the classification-map data in order to reduce the volume of data that must be transmitted to a ground station.

Vegetation inventory, mapping, and classification report, Fort Bowie National Historic Site

USGS Publications Warehouse

Studd, Sarah; Fallon, Elizabeth; Crumbacher, Laura; Drake, Sam; Villarreal, Miguel

2013-01-01

A vegetation mapping and characterization effort was conducted at Fort Bowie National Historic Site in 2008-10 by the Sonoran Desert Network office in collaboration with researchers from the Office of Arid lands studies, Remote Sensing Center at the University of Arizona. This vegetation mapping effort was completed under the National Park Service Vegetation Inventory program which aims to complete baseline mapping inventories at over 270 national park units. The vegetation map data was collected to provide park managers with a digital map product that met national standards of spatial and thematic accuracy, while also placing the vegetation into a regional and even national context. Work comprised of three major field phases 1) concurrent field-based classification data collection and mapping (map unit delineation), 2) development of vegetation community types at the National Vegetation Classification alliance or association level and 3) map accuracy assessment. Phase 1 was completed in late 2008 and early 2009. Community type descriptions were drafted to meet the then-current hierarchy (version 1) of the National Vegetation Classification System (NVCS) and these were applied to each of the mapped areas. This classification was developed from both plot level data and censused polygon data (map units) as this project was conducted as a concurrent mapping and classification effort. The third stage of accuracy assessment completed in the fall of 2010 consisted of a complete census of each map unit and was conducted almost entirely by park staff. Following accuracy assessment the map was amended where needed and final products were developed including this report, a digital map and full vegetation descriptions. Fort Bowie National Historic Site covers only 1000 acres yet has a relatively complex landscape, topography and geology. A total of 16 distinct communities were described and mapped at Fort Bowie NHS. These ranged from lush riparian woodlands lining the ephemeral washes dominated by Ash (Fraxinus), Walnut (Juglans) and Hackberry (Celtis) to drier upland sites typical of desert scrub and semi-desert grassland communities. These shrublands boast a diverse mixture of shrubs, succulents and perennial grasses. In many places the vegetation could be seen to echo the history of the fort site, with management of shrub encroachment apparent in the grasslands and the paucity of trees evidence of historic cutting for timber and fire wood. Seven of the 16 vegetation types were ‘accepted’ types within the NVC while the others have been described here as specific to FOBO and have proposed status within the NVC. The map was designed to facilitate ecologically-based natural resources management and research. The map is in digital format within a geodatabase structure that allows for complex relationships to be established between spatial and tabular data, and makes accessing the product easy and seamless. The GIS format allows user flexibility and will also enable updates to be made as new information becomes available (such as revised NVC codes or vegetation type names) or in the event of major disturbance events that could impact the vegetation.

Myocutaneous sternocleidomastoid flap for reconstruction after the resection of a parapharyngeal heterotopic glioma in a child with cleft palate, and systematic review of parapharyngeal glial heterotopia.

PubMed

Prado-Calleros, Héctor M; Arrieta-Gómez, José R; Castillo-Ventura, Beatriz; Martínez, Sara Parraguirre; Jiménez-Gutiérrez, Carlos; Jiménez-Escobar, Irma

2016-02-01

We describe the surgery and reconstruction employed with a sternocleidomastoid myocutaneous flap for the treatment of a heterotopic glioma in a 2-year-old boy with incomplete palatal fissure who presented with dysphagia and snoring, in whom a lateral pharyngeal wall mass obstructing 60% of the airway was noted. Heterotopic gliomas are uncommonly reported in the parapharyngeal space and should be included in the differential diagnosis at this location in children. Parapharyngeal tumors present difficult diagnostic and management challenges; head and neck surgeons must be prepared not only for the resection but also for the reconstruction of these rare lesions. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Classification and spatial mapping of riparian habitat with applications toward management of streams impacted by nonpoint source pollution

NASA Astrophysics Data System (ADS)

Delong, Michael D.; Brusven, Merlyn A.

1991-07-01

Management of riparian habitats has been recognized for its importance in reducing instream effects of agricultural nonpoint source pollution. By serving as a buffer, well structured riparian habitats can reduce nonpoint source impacts by filtering surface runoff from field to stream. A system has been developed where key characteristics of riparian habitat, vegetation type, height, width, riparian and shoreline bank slope, and land use are classified as discrete categorical units. This classification system recognizes seven riparian vegetation types, which are determined by dominant plant type. Riparian and shoreline bank slope, in addition to riparian width and height, each consist of five categories. Classification by discrete units allows for ready digitizing of information for production of spatial maps using a geographic information system (GIS). The classification system was tested for field efficiency on Tom Beall Creek watershed, an agriculturally impacted third-order stream in the Clearwater River drainage, Nez Perce County, Idaho, USA. The classification system was simple to use during field applications and provided a good inventory of riparian habitat. After successful field tests, spatial maps were produced for each component using the Professional Map Analysis Package (pMAP), a GIS program. With pMAP, a map describing general riparian habitat condition was produced by combining the maps of components of riparian habitat, and the condition map was integrated with a map of soil erosion potential in order to determine areas along the stream that are susceptible to nonpoint source pollution inputs. Integration of spatial maps of riparian classification and watershed characteristics has great potential as a tool for aiding in making management decisions for mitigating off-site impacts of agricultural nonpoint source pollution.

Semisupervised GDTW kernel-based fuzzy c-means algorithm for mapping vegetation dynamics in mining region using normalized difference vegetation index time series

NASA Astrophysics Data System (ADS)

Jia, Duo; Wang, Cangjiao; Lei, Shaogang

2018-01-01

Mapping vegetation dynamic types in mining areas is significant for revealing the mechanisms of environmental damage and for guiding ecological construction. Dynamic types of vegetation can be identified by applying interannual normalized difference vegetation index (NDVI) time series. However, phase differences and time shifts in interannual time series decrease mapping accuracy in mining regions. To overcome these problems and to increase the accuracy of mapping vegetation dynamics, an interannual Landsat time series for optimum vegetation growing status was constructed first by using the enhanced spatial and temporal adaptive reflectance fusion model algorithm. We then proposed a Markov random field optimized semisupervised Gaussian dynamic time warping kernel-based fuzzy c-means (FCM) cluster algorithm for interannual NDVI time series to map dynamic vegetation types in mining regions. The proposed algorithm has been tested in the Shengli mining region and Shendong mining region, which are typical representatives of China's open-pit and underground mining regions, respectively. Experiments show that the proposed algorithm can solve the problems of phase differences and time shifts to achieve better performance when mapping vegetation dynamic types. The overall accuracies for the Shengli and Shendong mining regions were 93.32% and 89.60%, respectively, with improvements of 7.32% and 25.84% when compared with the original semisupervised FCM algorithm.

Forest Resource Information System (FRIS)

NASA Technical Reports Server (NTRS)

1983-01-01

The technological and economical feasibility of using multispectral digital image data as acquired from the LANDSAT satellites in an ongoing operational forest information system was evaluated. Computer compatible multispectral scanner data secured from the LANDSAT satellites were demonstrated to be a significant contributor to ongoing information systems by providing the added dimensions of synoptic and repeat coverage of the Earth's surface. Major forest cover types of conifer, deciduous, mixed conifer-deciduous and non-forest, were classified well within the bounds of the statistical accuracy of the ground sample. Further, when overlayed with existing maps, the acreage of cover type retains a high level of positional integrity. Maps were digitized by a graphics design system, overlayed and registered onto LANDSAT imagery such that the map data with associated attributes were displayed on the image. Once classified, the analysis results were converted back to map form as a cover type of information. Existing tabular information as represented by inventory is registered geographically to the map base through a vendor provided data management system. The notion of a geographical reference base (map) providing the framework to which imagery and tabular data bases are registered and where each of the three functions of imagery, maps and inventory can be accessed singly or in combination is the very essence of the forest resource information system design.

Preliminary investigation of Large Format Camera photography utility in soil mapping and related agricultural applications

NASA Technical Reports Server (NTRS)

Pelletier, R. E.; Hudnall, W. H.

1987-01-01

The use of Space Shuttle Large Format Camera (LFC) color, IR/color, and B&W images in large-scale soil mapping is discussed and illustrated with sample photographs from STS 41-6 (October 1984). Consideration is given to the characteristics of the film types used; the photographic scales available; geometric and stereoscopic factors; and image interpretation and classification for soil-type mapping (detecting both sharp and gradual boundaries), soil parent material topographic and hydrologic assessment, natural-resources inventory, crop-type identification, and stress analysis. It is suggested that LFC photography can play an important role, filling the gap between aerial and satellite remote sensing.

A THEOREM OF BOURGIN-YANG TYPE FOR \\mathbb{Z}_p^n-ACTION

NASA Astrophysics Data System (ADS)

Volovikov, A. Yu

1993-02-01

A theorem of Bourgin-Yang type is proved for maps of spaces with \\mathbb{Z}_p^n-action into manifolds. The results are applied to the problem of Knaster for maps of spheres into the line and the plane.Bibliography: 44 titles.

Fusion of pan-tropical biomass maps using weighted averaging and regional calibration data

NASA Astrophysics Data System (ADS)

Ge, Yong; Avitabile, Valerio; Heuvelink, Gerard B. M.; Wang, Jianghao; Herold, Martin

2014-09-01

Biomass is a key environmental variable that influences many biosphere-atmosphere interactions. Recently, a number of biomass maps at national, regional and global scales have been produced using different approaches with a variety of input data, such as from field observations, remotely sensed imagery and other spatial datasets. However, the accuracy of these maps varies regionally and is largely unknown. This research proposes a fusion method to increase the accuracy of regional biomass estimates by using higher-quality calibration data. In this fusion method, the biases in the source maps were first adjusted to correct for over- and underestimation by comparison with the calibration data. Next, the biomass maps were combined linearly using weights derived from the variance-covariance matrix associated with the accuracies of the source maps. Because each map may have different biases and accuracies for different land use types, the biases and fusion weights were computed for each of the main land cover types separately. The conceptual arguments are substantiated by a case study conducted in East Africa. Evaluation analysis shows that fusing multiple source biomass maps may produce a more accurate map than when only one biomass map or unweighted averaging is used.

Rapid Crop Cover Mapping for the Conterminous United States.

PubMed

Dahal, Devendra; Wylie, Bruce; Howard, Danny

2018-06-05

Timely crop cover maps with sufficient resolution are important components to various environmental planning and research applications. Through the modification and use of a previously developed crop classification model (CCM), which was originally developed to generate historical annual crop cover maps, we hypothesized that such crop cover maps could be generated rapidly during the growing season. Through a process of incrementally removing weekly and monthly independent variables from the CCM and implementing a 'two model mapping' approach, we found it viable to generate conterminous United States-wide rapid crop cover maps at a resolution of 250 m for the current year by the month of September. In this approach, we divided the CCM model into one 'crop type model' to handle the classification of nine specific crops and a second, binary model to classify the presence or absence of 'other' crops. Under the two model mapping approach, the training errors were 0.8% and 1.5% for the crop type and binary model, respectively, while test errors were 5.5% and 6.4%, respectively. With spatial mapping accuracies for annual maps reaching upwards of 70%, this approach demonstrated a strong potential for generating rapid crop cover maps by the 1 st of September.

Mapping the Oman Ophiolite using TM data

NASA Technical Reports Server (NTRS)

Abrams, Michael

1987-01-01

Ophiolite terrains, considered to be the onland occurrences of oceanic crust, host a number of types of mineral deposits: volcanogenic massive sulfides, podiform chromite, and asbestos. Thematic Mapper data for the Semail Ophiolite in Oman were used to separate and map ultramafic lithologies hosting these deposits, including identification of the components of the extrusive volcanic sequence, mapping of serpentinization due to various tectonic processes, and direct identification of gossans. Thematic Mapper data were found to be extremely effective for mapping in this terrain due to the excellent spatial resolution and the presence of spectral bands which allow separation of the pertinent mineralogically caused spectral features associated with the rock types of interest.

Three-Dimensional Gene Map of Cancer Cell Types: Structural Entropy Minimisation Principle for Defining Tumour Subtypes

PubMed Central

Li, Angsheng; Yin, Xianchen; Pan, Yicheng

2016-01-01

In this study, we propose a method for constructing cell sample networks from gene expression profiles, and a structural entropy minimisation principle for detecting natural structure of networks and for identifying cancer cell subtypes. Our method establishes a three-dimensional gene map of cancer cell types and subtypes. The identified subtypes are defined by a unique gene expression pattern, and a three-dimensional gene map is established by defining the unique gene expression pattern for each identified subtype for cancers, including acute leukaemia, lymphoma, multi-tissue, lung cancer and healthy tissue. Our three-dimensional gene map demonstrates that a true tumour type may be divided into subtypes, each defined by a unique gene expression pattern. Clinical data analyses demonstrate that most cell samples of an identified subtype share similar survival times, survival indicators and International Prognostic Index (IPI) scores and indicate that distinct subtypes identified by our algorithms exhibit different overall survival times, survival ratios and IPI scores. Our three-dimensional gene map establishes a high-definition, one-to-one map between the biologically and medically meaningful tumour subtypes and the gene expression patterns, and identifies remarkable cells that form singleton submodules. PMID:26842724

Detecting spatio-temporal changes in agricultural land use in Heilongjiang province, China using MODIS time-series data and a random forest regression model

NASA Astrophysics Data System (ADS)

Hu, Q.; Friedl, M. A.; Wu, W.

2017-12-01

Accurate and timely information regarding the spatial distribution of crop types and their changes is essential for acreage surveys, yield estimation, water management, and agricultural production decision-making. In recent years, increasing population, dietary shifts and climate change have driven drastic changes in China's agricultural land use. However, no maps are currently available that document the spatial and temporal patterns of these agricultural land use changes. Because of its short revisit period, rich spectral bands and global coverage, MODIS time series data has been shown to have great potential for detecting the seasonal dynamics of different crop types. However, its inherently coarse spatial resolution limits the accuracy with which crops can be identified from MODIS in regions with small fields or complex agricultural landscapes. To evaluate this more carefully and specifically understand the strengths and weaknesses of MODIS data for crop-type mapping, we used MODIS time-series imagery to map the sub-pixel fractional crop area for four major crop types (rice, corn, soybean and wheat) at 500-m spatial resolution for Heilongjiang province, one of the most important grain-production regions in China where recent agricultural land use change has been rapid and pronounced. To do this, a random forest regression (RF-g) model was constructed to estimate the percentage of each sub-pixel crop type in 2006, 2011 and 2016. Crop type maps generated through expert visual interpretation of high spatial resolution images (i.e., Landsat and SPOT data) were used to calibrate the regression model. Five different time series of vegetation indices (155 features) derived from different spectral channels of MODIS land surface reflectance (MOD09A1) data were used as candidate features for the RF-g model. An out-of-bag strategy and backward elimination approach was applied to select the optimal spectra-temporal feature subset for each crop type. The resulting crop maps were assessed in two ways: (1) wall-to-wall pixel comparison with corresponding high spatial resolution reference maps; and (2) county-level comparison with census data. Based on these derived maps, changes in crop type, total area, and spatial patterns of change in Heilongjiang province during 2006-2016 were analyzed.

The use of TIMS for mapping different pahoehoe surfaces: Mauna Iki, Kilauea

NASA Technical Reports Server (NTRS)

Rowland, Scott K.

1992-01-01

S-type and p-type pahoehoe record different mechanisms and vigors of activity within an active flow field. There is some controversy about what these mechanisms are exactly, and this study was undertaken with the idea that an accurate map of the two surfaces within a pahoehoe flow field could be helpful in solving the problem. Thermal Infrared Multispectral Scanner (TIMS) allows discrimination between s-type and p-type pahoehoe, and this ability was used to map the two surface types on the Mauna Iki satellite shield (southwest rift zone, Kilauea Volcano). TIMS was previously used to discriminate a'a from pahoehoe as well as to determine relative age relationships of different flows. Although inter-flow variation was minor in the data published by these authors, a second goal presented is to understand such variations to better constrain intra-flow differences used for age dating.

Using remote sensing and GIS techniques to estimate discharge and recharge fluxes for the Death Valley regional groundwater flow system, USA

USGS Publications Warehouse

D'Agnese, F. A.; Faunt, C.C.; Turner, A.K.; ,

1996-01-01

The recharge and discharge components of the Death Valley regional groundwater flow system were defined by techniques that integrated disparate data types to develop a spatially complex representation of near-surface hydrological processes. Image classification methods were applied to multispectral satellite data to produce a vegetation map. The vegetation map was combined with ancillary data in a GIS to delineate different types of wetlands, phreatophytes and wet playa areas. Existing evapotranspiration-rate estimates were used to calculate discharge volumes for these area. An empirical method of groundwater recharge estimation was modified to incorporate data describing soil-moisture conditions, and a recharge potential map was produced. These discharge and recharge maps were readily converted to data arrays for numerical modelling codes. Inverse parameter estimation techniques also used these data to evaluate the reliability and sensitivity of estimated values.The recharge and discharge components of the Death Valley regional groundwater flow system were defined by remote sensing and GIS techniques that integrated disparate data types to develop a spatially complex representation of near-surface hydrological processes. Image classification methods were applied to multispectral satellite data to produce a vegetation map. This map provided a basis for subsequent evapotranspiration and infiltration estimations. The vegetation map was combined with ancillary data in a GIS to delineate different types of wetlands, phreatophytes and wet playa areas. Existing evapotranspiration-rate estimates were then used to calculate discharge volumes for these areas. A previously used empirical method of groundwater recharge estimation was modified by GIS methods to incorporate data describing soil-moisture conditions, and a recharge potential map was produced. These discharge and recharge maps were readily converted to data arrays for numerical modelling codes. Inverse parameter estimation techniques also used these data to evaluate the reliability and sensitivity of estimated values.

Using geologic maps and seismic refraction in pavement-deflection analysis

DOT National Transportation Integrated Search

1999-10-01

The researchers examined the relationship between three data types -- geologic maps, pavement deflection, and seismic refraction data -- from diverse geologic settings to determine whether geologic maps and seismic data might be used to interpret def...

X-ray microbeam three-dimensional topography for dislocation strain-field analysis of 4H-SiC

NASA Astrophysics Data System (ADS)

Tanuma, R.; Mori, D.; Kamata, I.; Tsuchida, H.

2013-07-01

This paper describes the strain-field analysis of threading edge dislocations (TEDs) and basal-plane dislocations (BPDs) in 4H-SiC using x-ray microbeam three-dimensional (3D) topography. This 3D topography enables quantitative strain-field analysis, which measures images of effective misorientations (Δω maps) around the dislocations. A deformation-matrix-based simulation algorithm is developed to theoretically evaluate the Δω mapping. Systematic linear calculations can provide simulated Δω maps (Δωsim maps) of dislocations with different Burgers vectors, directions, and reflection vectors for the desired cross-sections. For TEDs and BPDs, Δω maps are compared with Δωsim maps, and their excellent correlation is demonstrated. Two types of asymmetric reflections, high- and low-angle incidence types, are compared. Strain analyses are also conducted to investigate BPD-TED conversion near an epilayer/substrate interface in 4H-SiC.

Computer-generated mineral commodity deposit maps

USGS Publications Warehouse

Schruben, Paul G.; Hanley, J. Thomas

1983-01-01

This report describes an automated method of generating deposit maps of mineral commodity information. In addition, it serves as a user's manual for the authors' mapping system. Procedures were developed which allow commodity specialists to enter deposit information, retrieve selected data, and plot deposit symbols in any geographic area within the conterminous United States. The mapping system uses both micro- and mainframe computers. The microcomputer is used to input and retrieve information, thus minimizing computing charges. The mainframe computer is used to generate map plots which are printed by a Calcomp plotter. Selector V data base system is employed for input and retrieval on the microcomputer. A general mapping program (Genmap) was written in FORTRAN for use on the mainframe computer. Genmap can plot fifteen symbol types (for point locations) in three sizes. The user can assign symbol types to data items interactively. Individual map symbols can be labeled with a number or the deposit name. Genmap also provides several geographic boundary file and window options.

Fiber-dependent deautonomization of integrable 2D mappings and discrete Painlevé equations

NASA Astrophysics Data System (ADS)

Carstea, Adrian Stefan; Dzhamay, Anton; Takenawa, Tomoyuki

2017-10-01

It is well known that two-dimensional mappings preserving a rational elliptic fibration, like the Quispel-Roberts-Thompson mappings, can be deautonomized to discrete Painlevé equations. However, the dependence of this procedure on the choice of a particular elliptic fiber has not been sufficiently investigated. In this paper we establish a way of performing the deautonomization for a pair of an autonomous mapping and a fiber. Starting from a single autonomous mapping but varying the type of a chosen fiber, we obtain different types of discrete Painlevé equations using this deautonomization procedure. We also introduce a technique for reconstructing a mapping from the knowledge of its induced action on the Picard group and some additional geometric data. This technique allows us to obtain factorized expressions of discrete Painlevé equations, including the elliptic case. Further, by imposing certain restrictions on such non-autonomous mappings we obtain new and simple elliptic difference Painlevé equations, including examples whose symmetry groups do not appear explicitly in Sakai’s classification.

Application of remote sensing technology to land evaluation, planning utilization of land resources, and assessment of wildlife areas in eastern South Dakota

NASA Technical Reports Server (NTRS)

1975-01-01

A soils map for land evaluation in Potter County (Eastern South Dakota) was developed to demonstrate the use of remote sensing technology in the area of diverse parent materials and topography. General land use and soils maps have also been developed for land planning LANDSAT, RB-57 imagery, and USGS photographs are being evaluated for making soils and land use maps. LANDSAT fulfilled the requirements for general land use and a general soils map. RB-57 imagery supplemented by large scale black and white stereo coverage was required to provide the detail needed for the final soils map for land evaluation. Color infrared prints excelled black and white coverage for this soil mapping effort. An identification and classification key for wetland types in the Lake Dakota Plain was developed for June 1975 using color infrared imagery. Wetland types in the region are now being mapped via remote sensing techniques to provide a current inventory for development of mitigation measures.

Calculation of upper confidence bounds on proportion of area containing not-sampled vegetation types: An application to map unit definition for existing vegetation maps

Treesearch

Paul L. Patterson; Mark Finco

2011-01-01

This paper explores the information forest inventory data can produce regarding forest types that were not sampled and develops the equations necessary to define the upper confidence bounds on not-sampled forest types. The problem is reduced to a Bernoulli variable. This simplification allows the upper confidence bounds to be calculated based on Cochran (1977)....

Comparing Tactile Maps and Haptic Digital Representations of a Maritime Environment

ERIC Educational Resources Information Center

Simonnet, Mathieu; Vieilledent, Steephane; Jacobson, R. Daniel; Tisseau, Jacques

2011-01-01

A map exploration and representation exercise was conducted with participants who were totally blind. Representations of maritime environments were presented either with a tactile map or with a digital haptic virtual map. We assessed the knowledge of spatial configurations using a triangulation technique. The results revealed that both types of…

No clustering for linkage map based on low-copy and undermethylated microsatellites.

PubMed

Zhou, Yi; Gwaze, David P; Reyes-Valdés, M Humberto; Bui, Thomas; Williams, Claire G

2003-10-01

Clustering has been reported for conifer genetic maps based on hypomethylated or low-copy molecular markers, resulting in uneven marker distribution. To test this, a framework genetic map was constructed from three types of microsatellites: low-copy, undermethylated, and genomic. These Pinus taeda L. microsatellites were mapped using a three-generation pedigree with 118 progeny. The microsatellites were highly informative; of the 32 markers in intercross configuration, 29 were segregating for three or four alleles in the progeny. The sex-averaged map placed 51 of the 95 markers in 15 linkage groups at LOD > 4.0. No clustering or uneven distribution across the genome was observed. The three types of P. taeda microsatellites were randomly dispersed within each linkage group. The 51 microsatellites covered a map distance of 795 cM, an average distance of 21.8 cM between markers, roughly half of the estimated total map length. The minimum and maximum distances between any two bins was 4.4 and 45.3 cM, respectively. These microsatellites provided anchor points for framework mapping for polymorphism in P. taeda and other closely related hard pines.

Scoping of Flood Hazard Mapping Needs for Coos County, New Hampshire

DTIC Science & Technology

2006-01-01

Technical Partner DEM Digital Elevation Model DFIRM Digital Flood Insurance Rate Map DOQ Digital Orthophoto Quadrangle DOQQ Digital Ortho Quarter Quadrangle...color Digital Orthophoto Quadrangles (DOQs)). Remote sensing, base map information, GIS data (for example, contour data, E911 data, Digital Elevation...the feature types found on USGS topographic maps. More recently developed data were derived from digital orthophotos providing improved base map

Translating Research Reports into Educational Materials or How To Take a Neat Piece of Research and Turn It into a Curriculum.

ERIC Educational Resources Information Center

Brody, Michael J.

The rationale and procedures involved with the instructional strategies of concept mapping and Gowin's Vee Mapping are provided in this paper. Specific directives are outlined for building concept maps and vee maps. Examples of both types of these maps are given and explanations are offered on their form and use. Concepts and activities…

Geologic map of the Willow Creek Reservoir SE Quadrangle, Elko, Eureka, and Lander Counties, Nevada

USGS Publications Warehouse

Wallace, Alan R.

2003-01-01

Map Scale: 1:24,000 Map Type: colored geologic map A 1:24,000-scale, full-color geologic map of the Willow CreekReservoir 7.5-minute SE Quadrangle in Elko, Eureka, and LanderCounties, Nevada, with two cross sections and descriptions of 24 rock units. Accompanying text discusses the geology, paleogeography, and formation of the Ivanhoe Hg-Au district.

Change in land use in the Phoenix (1:250,000) Quadrangle, Arizona between 1970 and 1973: ERTS as an aid in a nationwide program for mapping general land use. [Phoenix Quadrangle, Arizona

NASA Technical Reports Server (NTRS)

Place, J. L.

1974-01-01

Changes in land use between 1970 and 1973 in the Phoenix (1:250,000 scale) Quadrangle in Arizona have been mapped using only the images from ERTS-1, tending to verify the utility of a standard land use classification system proposed for use with ERTS images. Types of changes detected have been: (1) new residential development of former cropland and rangeland; (2) new cropland from the desert; and (3) new reservoir fill-up. The seasonal changing of vegetation patterns in ERTS has complemented air photos in delimiting the boundaries of some land use types. ERTS images, in combination with other sources of information, can assist in mapping the generalized land use of the fifty states by the standard 1:250,000 quadrangles. Several states are already working cooperatively in this type of mapping.

High spatial resolution mapping of land cover types in a priority area for conservation in the Brazilian savanna

NASA Astrophysics Data System (ADS)

Ribeiro, F.; Roberts, D. A.; Hess, L. L.; Davis, F. W.; Caylor, K. K.; Nackoney, J.; Antunes Daldegan, G.

2017-12-01

Savannas are heterogeneous landscapes consisting of highly mixed land cover types that lack clear distinct boundaries. The Brazilian Cerrado is a Neotropical savanna considered a biodiversity hotspot for conservation due to its biodiversity richness and rapid transformation of its landscape by crop and pasture activities. The Cerrado is one of the most threatened Brazilian biomes and only 2.2% of its original extent is strictly protected. Accurate mapping and monitoring of its ecosystems and adjacent land use are important to select areas for conservation and to improve our understanding of the dynamics in this biome. Land cover mapping of savannas is difficult due to spectral similarity between land cover types resulting from similar vegetation structure, floristically similar components, generalization of land cover classes, and heterogeneity usually expressed as small patch sizes within the natural landscape. These factors are the major contributor to misclassification and low map accuracies among remote sensing studies in savannas. Specific challenges to map the Cerrado's land cover types are related to the spectral similarity between classes of land use and natural vegetation, such as natural grassland vs. cultivated pasture, and forest ecosystem vs. crops. This study seeks to classify and evaluate the land cover patterns across an area ranked as having extremely high priority for future conservation in the Cerrado. The main objective of this study is to identify the representativeness of each vegetation type across the landscape using high to moderate spatial resolution imagery using an automated scheme. A combination of pixel-based and object-based approaches were tested using RapidEye 3A imagery (5m spatial resolution) to classify the Cerrado's major land cover types. The random forest classifier was used to map the major ecosystems present across the area, and demonstrated to have an effective result with 68% of overall accuracy. Post-classification modification was performed to refine information to the major physiognomic groups of each ecosystem type. In this step, we used segmentation in eCognition, considering the random forest classification as input as well as other environmental layers (e.g. slope, soil types), which improved the overall classification to 75%.

Mesh versus bathtub - effects of flood models on exposure analysis in Switzerland

NASA Astrophysics Data System (ADS)

Röthlisberger, Veronika; Zischg, Andreas; Keiler, Margreth

2016-04-01

In Switzerland, mainly two types of maps that indicate potential flood zones are available for flood exposure analyses: 1) Aquaprotect, a nationwide overview provided by the Federal Office for the Environment and 2) communal flood hazard maps available from the 26 cantons. The model used to produce Aquaprotect can be described as a bathtub approach or linear superposition method with three main parameters, namely the horizontal and vertical distance of a point to water features and the size of the river sub-basin. Whereas the determination of flood zones in Aquaprotect is based on a uniform, nationwide model, the communal flood hazard maps are less homogenous, as they have been elaborated either at communal or cantonal levels. Yet their basic content (i.e. indication of potential flood zones for three recurrence periods, with differentiation of at least three inundation depths) is described in national directives and the vast majority of communal flood hazard maps are based on 2D inundation simulations using meshes. Apart from the methodical differences between Aquaprotect and the communal flood hazard maps (and among different communal flood hazard maps), all of these maps include a layer with a similar recurrence period (i.e. Aquaprotect 250 years, flood hazard maps 300 years) beyond the intended protection level of installed structural systems. In our study, we compare the resulting exposure by overlaying the two types of flood maps with a complete, harmonized, and nationwide dataset of building polygons. We assess the different exposure at the national level, and also consider differences among the 26 cantons and the six biogeographically unique regions, respectively. It was observed that while the nationwide exposure rates for both types of flood maps are similar, the differences within certain cantons and biogeographical regions are remarkable. We conclude that flood maps based on bathtub models are appropriate for assessments at national levels, while maps based on 2D simulations are preferable at sub-national levels.

Snake River Plain Geothermal Play Fairway Analysis - Phase 1 Raster Files

DOE Data Explorer

John Shervais

2015-10-09

Snake River Plain Play Fairway Analysis - Phase 1 CRS Raster Files. This dataset contains raster files created in ArcGIS. These raster images depict Common Risk Segment (CRS) maps for HEAT, PERMEABILITY, AND SEAL, as well as selected maps of Evidence Layers. These evidence layers consist of either Bayesian krige functions or kernel density functions, and include: (1) HEAT: Heat flow (Bayesian krige map), Heat flow standard error on the krige function (data confidence), volcanic vent distribution as function of age and size, groundwater temperature (equivalue interval and natural breaks bins), and groundwater T standard error. (2) PERMEABILTY: Fault and lineament maps, both as mapped and as kernel density functions, processed for both dilational tendency (TD) and slip tendency (ST), along with data confidence maps for each data type. Data types include mapped surface faults from USGS and Idaho Geological Survey data bases, as well as unpublished mapping; lineations derived from maximum gradients in magnetic, deep gravity, and intermediate depth gravity anomalies. (3) SEAL: Seal maps based on presence and thickness of lacustrine sediments and base of SRP aquifer. Raster size is 2 km. All files generated in ArcGIS.

An integrated molecular cytogenetic map of Cucumis sativus L. chromosome 2.

PubMed

Han, Yonghua; Zhang, Zhonghua; Huang, Sanwen; Jin, Weiwei

2011-01-27

Integration of molecular, genetic and cytological maps is still a challenge for most plant species. Recent progress in molecular and cytogenetic studies created a basis for developing integrated maps in cucumber (Cucumis sativus L.). In this study, eleven fosmid clones and three plasmids containing 45S rDNA, the centromeric satellite repeat Type III and the pericentriomeric repeat CsRP1 sequences respectively were hybridized to cucumber metaphase chromosomes to assign their cytological location on chromosome 2. Moreover, an integrated molecular cytogenetic map of cucumber chromosomes 2 was constructed by fluorescence in situ hybridization (FISH) mapping of 11 fosmid clones together with the cucumber centromere-specific Type III sequence on meiotic pachytene chromosomes. The cytogenetic map was fully integrated with genetic linkage map since each fosmid clone was anchored by a genetically mapped simple sequence repeat marker (SSR). The relationship between the genetic and physical distances along chromosome was analyzed. Recombination was not evenly distributed along the physical length of chromosome 2. Suppression of recombination was found in centromeric and pericentromeric regions. Our results also indicated that the molecular markers composing the linkage map for chromosome 2 provided excellent coverage of the chromosome.

Hippocampal participation in navigational map learning in young homing pigeons is dependent on training experience.

PubMed

Ioalè, P; Gagliardo, A; Bingman, V P

2000-02-01

The homing pigeon navigational map is perhaps one of the most striking examples of a naturally occurring spatial representation of the environment used to guide navigation. In a previous study, it was found that hippocampal lesions thoroughly disrupt the ability of young homing pigeons held in an outdoor aviary to learn a navigational map. However, since that study an accumulation of anecdotal data has hinted that hippocampal-lesioned young pigeons allowed to fly during their first summer could learn a navigational map. In the present study, young control and hippocampal-lesioned homing pigeons were either held in an outdoor aviary or allowed to fly during the time of navigational map learning. At the end of their first summer, the birds were experimentally released to test for navigational map learning. Independent of training experience, control pigeons oriented homeward during the experimental releases demonstrating that they learned a navigational map. Surprisingly, while the aviary-held hippocampal-lesioned pigeons failed to learn a navigational map as reported previously, hippocampal-lesioned birds allowed flight experience learned a navigational map indistinguishable from the two control groups. A subsequent experiment revealed that the navigational map learned by the three groups was based on atmospheric odours. The results demonstrate that hippocampal participation in navigational map learning depends on the type of experience a young bird pigeon has, and presumably, the type of navigational map learned.

Mineral Potential in India Using Airborne Visible/Infrared Imaging Spectrometer-Next Generation (AVIRIS-NG) Data

NASA Astrophysics Data System (ADS)

Oommen, T.; Chatterjee, S.

2017-12-01

NASA and the Indian Space Research Organization (ISRO) are generating Earth surface features data using Airborne Visible/Infrared Imaging Spectrometer-Next Generation (AVIRIS-NG) within 380 to 2500 nm spectral range. This research focuses on the utilization of such data to better understand the mineral potential in India and to demonstrate the application of spectral data in rock type discrimination and mapping for mineral exploration by using automated mapping techniques. The primary focus area of this research is the Hutti-Maski greenstone belt, located in Karnataka, India. The AVIRIS-NG data was integrated with field analyzed data (laboratory scaled compositional analysis, mineralogy, and spectral library) to characterize minerals and rock types. An expert system was developed to produce mineral maps from AVIRIS-NG data automatically. The ground truth data from the study areas was obtained from the existing literature and collaborators from India. The Bayesian spectral unmixing algorithm was used in AVIRIS-NG data for endmember selection. The classification maps of the minerals and rock types were developed using support vector machine algorithm. The ground truth data was used to verify the mineral maps.

Perfusion MR imaging detection of carcinoma arising from preexisting salivary gland pleomorphic adenoma by computer-assisted analysis of time-signal intensity maps

PubMed Central

Katayama, Ikuo; Eida, Sato; Fujita, Shuichi; Hotokezaka, Yuka; Sumi, Misa

2017-01-01

Tumor perfusion can be evaluated by analyzing the time-signal intensity curve (TIC) after dynamic contrast-enhanced (DCE) MR imaging. Accordingly, TIC profiles are characteristic of some benign and malignant salivary gland tumors. A carcinoma ex pleomorphic adenoma (CXPA) arises from a long-standing pleomorphic adenoma (PA) and has a distinctive prognostic risk depending on the tumor growth potential such as invasion beyond the preexisting capsule. Differentiating CXPA from PA can be very challenging. In this study, we have attempted to discriminate CXPA from PA based on a two-dimensional TIC mapping algorithm. TIC mapping analysis was performed on 8 patients with CXPA and 20 patients with PA after dynamic contrast-enhanced (DCE) MR imaging using a 1.5-T MR system. The TIC profiles obtained were automatically categorized into 5 types based on the enhancement ratio, maximum time, and washout ratio (Type 1 TIC with flat profile, Type 2 TIC with slow uptake, Type 3 TIC with rapid uptake and a low washout ratio, Type 4 TIC with rapid uptake and a high washout ratio, and Type 5 TIC not otherwise specific). The percentage tumor areas with each of the 5 TIC types were compared between CXPAs and PAs. Stepwise differentiation and cluster analysis using multiple TIC cut-off thresholds distinguished CXPAs from PAs with 75% sensitivity, 95% specificity, 86% accuracy, and 86% positive and 90% negative predictive values, when tumors with ≤1.1% Type 1 and ≥15% Type 4, or those with ≤1.1% Type 1, ≥78.1% Type 2, ≥16.1% Type 3, and <15% Type 4, or those with >1.1% Type 1, ≥78.1% Type 2, and ≥16.1% Type 3 areas were diagnosed as CXPAs. The overall TIC profiles predicted some aggressive CXPA growth patterns. These results suggest that stepwise differentiation based on TIC mapping is helpful in differentiating CXPAs from PAs. PMID:28531213

Spatial disaggregation of complex soil map units at regional scale based on soil-landscape relationships

NASA Astrophysics Data System (ADS)

Vincent, Sébastien; Lemercier, Blandine; Berthier, Lionel; Walter, Christian

2015-04-01

Accurate soil information over large extent is essential to manage agronomical and environmental issues. Where it exists, information on soil is often sparse or available at coarser resolution than required. Typically, the spatial distribution of soil at regional scale is represented as a set of polygons defining soil map units (SMU), each one describing several soil types not spatially delineated, and a semantic database describing these objects. Delineation of soil types within SMU, ie spatial disaggregation of SMU allows improved soil information's accuracy using legacy data. The aim of this study was to predict soil types by spatial disaggregation of SMU through a decision tree approach, considering expert knowledge on soil-landscape relationships embedded in soil databases. The DSMART (Disaggregation and Harmonization of Soil Map Units Through resampled Classification Trees) algorithm developed by Odgers et al. (2014) was used. It requires soil information, environmental covariates, and calibration samples, to build then extrapolate decision trees. To assign a soil type to a particular spatial position, a weighed random allocation approach is applied: each soil type in the SMU is weighted according to its assumed proportion of occurrence in the SMU. Thus soil-landscape relationships are not considered in the current version of DSMART. Expert rules on soil distribution considering the relief, parent material and wetlands location were proposed to drive the procedure of allocation of soil type to sampled positions, in order to integrate the soil-landscape relationships. Semantic information about spatial organization of soil types within SMU and exhaustive landscape descriptors were used. In the eastern part of Brittany (NW France), 171 soil types were described; their relative area in the SMU were estimated, geomorphological and geological contexts were recorded. The model predicted 144 soil types. An external validation was performed by comparing predicted with effectively observed soil types derived from available soil maps at scale of 1:25.000 or 1:50.000. Overall accuracies were 63.1% and 36.2%, respectively considering or not the adjacent pixels. The introduction of expert rules based on soil-landscape relationships to allocate soil types to calibration samples enhanced dramatically the results in comparison with a simple weighted random allocation procedure. It also enabled the production of a comprehensive soil map, retrieving expected spatial organization of soils. Estimation of soil properties for various depths is planned using disaggregated soil types, according to the GlobalSoilmap.net specifications. Odgers, N.P., Sun, W., McBratney, A.B., Minasny, B., Clifford, D., 2014. Disaggregating and harmonising soil map units through resampled classification trees. Geoderma 214, 91-100.

Modelling Multi Hazard Mapping in Semarang City Using GIS-Fuzzy Method

NASA Astrophysics Data System (ADS)

Nugraha, A. L.; Awaluddin, M.; Sasmito, B.

2018-02-01

One important aspect of disaster mitigation planning is hazard mapping. Hazard mapping can provide spatial information on the distribution of locations that are threatened by disaster. Semarang City as the capital of Central Java Province is one of the cities with high natural disaster intensity. Frequent natural disasters Semarang city is tidal flood, floods, landslides, and droughts. Therefore, Semarang City needs spatial information by doing multi hazard mapping to support disaster mitigation planning in Semarang City. Multi Hazards map modelling can be derived from parameters such as slope maps, rainfall, land use, and soil types. This modelling is done by using GIS method with scoring and overlay technique. However, the accuracy of modelling would be better if the GIS method is combined with Fuzzy Logic techniques to provide a good classification in determining disaster threats. The Fuzzy-GIS method will build a multi hazards map of Semarang city can deliver results with good accuracy and with appropriate threat class spread so as to provide disaster information for disaster mitigation planning of Semarang city. from the multi-hazard modelling using GIS-Fuzzy can be known type of membership that has a good accuracy is the type of membership Gauss with RMSE of 0.404 the smallest of the other membership and VAF value of 72.909% of the largest of the other membership.

California State Waters Map Series—Offshore of Fort Ross, California

USGS Publications Warehouse

Johnson, Samuel Y.; Dartnell, Peter; Golden, Nadine E.; Hartwell, Stephen R.; Erdey, Mercedes D.; Greene, H. Gary; Cochrane, Guy R.; Kvitek, Rikk G.; Manson, Michael W.; Endris, Charles A.; Dieter, Bryan E.; Watt, Janet T.; Krigsman, Lisa M.; Sliter, Ray W.; Lowe, Erik N.; Chin, John L.; Johnson, Samuel Y.; Cochran, Susan A.

2015-12-03

Potential marine benthic habitat types in the Offshore of Fort Ross map area include unconsolidated continental-shelf sediments, mixed continental-shelf substrate, and hard continental-shelf substrate. Rocky shelf outcrops and rubble are considered the primary habitat type for rockfish and lingcod, both of which are recreationally and commercially important species.

Mapping forest functional type in a forest-shrubland ecotone using SPOT imagery and predictive habitat distribution modelling

USGS Publications Warehouse

Assal, Timothy J.; Anderson, Patrick J.; Sibold, Jason

2015-01-01

The availability of land cover data at local scales is an important component in forest management and monitoring efforts. Regional land cover data seldom provide detailed information needed to support local management needs. Here we present a transferable framework to model forest cover by major plant functional type using aerial photos, multi-date Système Pour l’Observation de la Terre (SPOT) imagery, and topographic variables. We developed probability of occurrence models for deciduous broad-leaved forest and needle-leaved evergreen forest using logistic regression in the southern portion of the Wyoming Basin Ecoregion. The model outputs were combined into a synthesis map depicting deciduous and coniferous forest cover type. We evaluated the models and synthesis map using a field-validated, independent data source. Results showed strong relationships between forest cover and model variables, and the synthesis map was accurate with an overall correct classification rate of 0.87 and Cohen’s kappa value of 0.81. The results suggest our method adequately captures the functional type, size, and distribution pattern of forest cover in a spatially heterogeneous landscape.

Calculation of upper confidence bounds on not-sampled vegetation types using a systematic grid sample: An application to map unit definition for existing vegetation maps

Treesearch

Paul L. Patterson; Mark Finco

2009-01-01

This paper explores the information FIA data can produce regarding forest types that were not sampled and develops the equations necessary to define the upper confidence bounds on not-sampled forest types. The problem is reduced to a Bernoulli variable. This simplification allows the upper confidence bounds to be calculated based on Cochran (1977). Examples are...

Mapping coral and sponge habitats on a shelf-depth environment using multibeam sonar and ROV video observations: Learmonth Bank, northern British Columbia, Canada

NASA Astrophysics Data System (ADS)

Neves, Bárbara M.; Du Preez, Cherisse; Edinger, Evan

2014-01-01

Efforts to locate and map deep-water coral and sponge habitats are essential for the effective management and conservation of these vulnerable marine ecosystems. Here we test the applicability of a simple multibeam sonar classification method developed for fjord environments to map the distribution of shelf-depth substrates and gorgonian coral- and sponge-dominated biotopes. The studied area is a shelf-depth feature Learmonth Bank, northern British Columbia, Canada and the method was applied aiming to map primarily non-reef forming coral and sponge biotopes. Aside from producing high-resolution maps (5 m2 raster grid), biotope-substrate associations were also investigated. A multibeam sonar survey yielded bathymetry, acoustic backscatter strength and slope. From benthic video transects recorded by remotely operated vehicles (ROVs) six primary substrate types and twelve biotope categories were identified, defined by the primary sediment and dominant biological structure, respectively. Substrate and biotope maps were produced using a supervised classification mostly based on the inter-quartile range of the acoustic variables for each substrate type and biotope. Twenty-five percent of the video observations were randomly reserved for testing the classification accuracy. The dominant biotope-defining corals were red tree coral Primnoa pacifica and small styasterids, of which Stylaster parageus was common. Demosponges and hexactinellid sponges were frequently observed but no sponge reefs were observed. The substrate classification readily distinguished fine sediment, Sand and Bedrock from the other substrate types, but had greater difficulty distinguishing Bedrock from Boulders and Cobble. The biotope classification accurately identified Gardens (dense aggregations of sponges and corals) and Primnoa-dominated biotopes (67% accuracy), but most other biotopes had lower accuracies. There was a significant correspondence between Learmonth's biotopes and substrate types, with many biotopes strongly associated with only a single substrate type. This strong correspondence allowed substrate types to function as a surrogate for helping to map biotope distributions. Our results add new information on the distribution of corals and sponges at Learmonth Bank, which can be used to guide management at this location.

Hyers-Ulam stability of a generalized Apollonius type quadratic mapping

NASA Astrophysics Data System (ADS)

Park, Chun-Gil; Rassias, Themistocles M.

2006-10-01

Let X,Y be linear spaces. It is shown that if a mapping satisfies the following functional equation: then the mapping is quadratic. We moreover prove the Hyers-Ulam stability of the functional equation (0.1) in Banach spaces.

Receptor-like Molecules on Human Intestinal Epithelial Cells Interact with an Adhesion Factor from Lactobacillus reuteri.

PubMed

Matsuo, Yosuke; Miyoshi, Yukihiro; Okada, Sanae; Satoh, Eiichi

2012-01-01

A surface protein of Lactobacillus reuteri, mucus adhesion-promoting protein (MapA), is considered to be an adhesion factor. MapA is expressed in L. reuteri strains and adheres to piglet gastric mucus, collagen type I, and human intestinal epithelial cells such as Caco-2. The aim of this study was to identify molecules that mediate the attachment of MapA from L. reuteri to the intestinal epithelial cell surface by investigating the adhesion of MapA to receptor-like molecules on Caco-2 cells. MapA-binding receptor-like molecules were detected in Caco-2 cell lysates by 2D-PAGE. Two proteins, annexin A13 (ANXA13) and paralemmin (PALM), were identified by MALDI TOF-MS. The results of a pull-down assay showed that MapA bound directly to ANXA13 and PALM. Fluorescence microscopy studies confirmed that MapA binding to ANXA13 and PALM was colocalized on the Caco-2 cell membrane. To evaluate whether ANXA13 and PALM are important for MapA adhesion, ANXA13 and PALM knockdown cell lines were established. The adhesion of MapA to the abovementioned cell lines was reduced compared with that to wild-type Caco-2 cells. These knockdown experiments established the importance of these receptor-like molecules in MapA adhesion.

Factors affecting basket catheter detection of real and phantom rotors in the atria: A computational study.

PubMed

Martinez-Mateu, Laura; Romero, Lucia; Ferrer-Albero, Ana; Sebastian, Rafael; Rodríguez Matas, José F; Jalife, José; Berenfeld, Omer; Saiz, Javier

2018-03-01

Anatomically based procedures to ablate atrial fibrillation (AF) are often successful in terminating paroxysmal AF. However, the ability to terminate persistent AF remains disappointing. New mechanistic approaches use multiple-electrode basket catheter mapping to localize and target AF drivers in the form of rotors but significant concerns remain about their accuracy. We aimed to evaluate how electrode-endocardium distance, far-field sources and inter-electrode distance affect the accuracy of localizing rotors. Sustained rotor activation of the atria was simulated numerically and mapped using a virtual basket catheter with varying electrode densities placed at different positions within the atrial cavity. Unipolar electrograms were calculated on the entire endocardial surface and at each of the electrodes. Rotors were tracked on the interpolated basket phase maps and compared with the respective atrial voltage and endocardial phase maps, which served as references. Rotor detection by the basket maps varied between 35-94% of the simulation time, depending on the basket's position and the electrode-to-endocardial wall distance. However, two different types of phantom rotors appeared also on the basket maps. The first type was due to the far-field sources and the second type was due to interpolation between the electrodes; increasing electrode density decreased the incidence of the second but not the first type of phantom rotors. In the simulations study, basket catheter-based phase mapping detected rotors even when the basket was not in full contact with the endocardial wall, but always generated a number of phantom rotors in the presence of only a single real rotor, which would be the desired ablation target. Phantom rotors may mislead and contribute to failure in AF ablation procedures.

Factors affecting basket catheter detection of real and phantom rotors in the atria: A computational study

PubMed Central

Romero, Lucia; Rodríguez Matas, José F.; Berenfeld, Omer; Saiz, Javier

2018-01-01

Anatomically based procedures to ablate atrial fibrillation (AF) are often successful in terminating paroxysmal AF. However, the ability to terminate persistent AF remains disappointing. New mechanistic approaches use multiple-electrode basket catheter mapping to localize and target AF drivers in the form of rotors but significant concerns remain about their accuracy. We aimed to evaluate how electrode-endocardium distance, far-field sources and inter-electrode distance affect the accuracy of localizing rotors. Sustained rotor activation of the atria was simulated numerically and mapped using a virtual basket catheter with varying electrode densities placed at different positions within the atrial cavity. Unipolar electrograms were calculated on the entire endocardial surface and at each of the electrodes. Rotors were tracked on the interpolated basket phase maps and compared with the respective atrial voltage and endocardial phase maps, which served as references. Rotor detection by the basket maps varied between 35–94% of the simulation time, depending on the basket’s position and the electrode-to-endocardial wall distance. However, two different types of phantom rotors appeared also on the basket maps. The first type was due to the far-field sources and the second type was due to interpolation between the electrodes; increasing electrode density decreased the incidence of the second but not the first type of phantom rotors. In the simulations study, basket catheter-based phase mapping detected rotors even when the basket was not in full contact with the endocardial wall, but always generated a number of phantom rotors in the presence of only a single real rotor, which would be the desired ablation target. Phantom rotors may mislead and contribute to failure in AF ablation procedures. PMID:29505583

Mapping the EORTC QLQ-C30 onto the EQ-5D-3L: assessing the external validity of existing mapping algorithms.

PubMed

Doble, Brett; Lorgelly, Paula

2016-04-01

To determine the external validity of existing mapping algorithms for predicting EQ-5D-3L utility values from EORTC QLQ-C30 responses and to establish their generalizability in different types of cancer. A main analysis (pooled) sample of 3560 observations (1727 patients) and two disease severity patient samples (496 and 93 patients) with repeated observations over time from Cancer 2015 were used to validate the existing algorithms. Errors were calculated between observed and predicted EQ-5D-3L utility values using a single pooled sample and ten pooled tumour type-specific samples. Predictive accuracy was assessed using mean absolute error (MAE) and standardized root-mean-squared error (RMSE). The association between observed and predicted EQ-5D utility values and other covariates across the distribution was tested using quantile regression. Quality-adjusted life years (QALYs) were calculated using observed and predicted values to test responsiveness. Ten 'preferred' mapping algorithms were identified. Two algorithms estimated via response mapping and ordinary least-squares regression using dummy variables performed well on number of validation criteria, including accurate prediction of the best and worst QLQ-C30 health states, predicted values within the EQ-5D tariff range, relatively small MAEs and RMSEs, and minimal differences between estimated QALYs. Comparison of predictive accuracy across ten tumour type-specific samples highlighted that algorithms are relatively insensitive to grouping by tumour type and affected more by differences in disease severity. Two of the 'preferred' mapping algorithms suggest more accurate predictions, but limitations exist. We recommend extensive scenario analyses if mapped utilities are used in cost-utility analyses.

Use of landsat ETM+ SLC-off segment-based gap-filled imagery for crop type mapping

USGS Publications Warehouse

Maxwell, S.K.; Craig, M.E.

2008-01-01

Failure of the Scan Line Corrector (SLC) on the Landsat ETM+ sensor has had a major impact on many applications that rely on continuous medium resolution imagery to meet their objectives. The United States Department of Agriculture (USDA) Cropland Data Layer (CDL) program uses Landsat imagery as the primary source of data to produce crop-specific maps for 20 states in the USA. A new method has been developed to fill the image gaps resulting from the SLC failure to support the needs of Landsat users who require coincident spectral data, such as for crop type mapping and monitoring. We tested the new gap-filled method for a CDL crop type mapping project in eastern Nebraska. Scan line gaps were simulated on two Landsat 5 images (spring and late summer 2003) and then gap-filled using landscape boundary models, or segment models, that were derived from 1992 and 2002 Landsat images (used in the gap-fill process). Various date combinations of original and gap-filled images were used to derive crop maps using a supervised classification process. Overall kappa values were slightly higher for crop maps derived from SLC-off gap-filled images compared to crop maps derived from the original imagery (0.3–1.3% higher). Although the age of the segment model used to derive the SLC-off gap-filled product did not negatively impact the overall agreement, differences in individual cover type agreement did increase (−0.8%–1.6% using the 2002 segment model to −5.0–5.1% using the 1992 segment model). Classification agreement also decreased for most of the classes as the size of the segment used in the gap-fill process increased.

Verification of the WFAS Lightning Efficiency Map

Treesearch

Paul Sopko; Don Latham; Isaac Grenfell

2007-01-01

A Lightning Ignition Efficiency map was added to the suite of daily maps offered by the Wildland Fire Assessment System (WFAS) in 1999. This map computes a lightning probability of ignition (POI) based on the estimated fuel type, fuel depth, and 100-hour fuel moisture interpolated from the Remote Automated Weather Station (RAWS) network. An attempt to verify the...

Client-Side Image Maps: Achieving Accessibility and Section 508 Compliance

ERIC Educational Resources Information Center

Beasley, William; Jarvis, Moana

2004-01-01

Image maps are a means of making a picture "clickable", so that different portions of the image can be hyperlinked to different URLS. There are two basic types of image maps: server-side and client-side. Besides requiring access to a CGI on the server, server-side image maps are undesirable from the standpoint of accessibility--creating…

Try This: Collaborative Mind Mapping

ERIC Educational Resources Information Center

Mendelson, Melissa

2016-01-01

In this "Try This" article, students learn about collaborative mind mapping. A mind map is a type of graphic organizer that allows for short ideas to be written and linked to related ideas on a "map." A central idea is placed in the middle of the paper with related ideas connected to the central idea as well as to other ideas.…

USGS maps

USGS Publications Warehouse

,

2005-01-01

Discover a small sample of the millions of maps produced by the U.S. Geological Survey (USGS) in its mission to map the Nation and survey its resources. This booklet gives a brief overview of the types of maps sold and distributed by the USGS through its Earth Science Information Centers (ESIC) and also available from business partners located in most States. The USGS provides a wide variety of maps, from topographic maps showing the geographic relief and thematic maps displaying the geology and water resources of the United States, to special studies of the moon and planets.

Vegetation mapping from ERTS imagery of the Okavango Delta. [Botswana

NASA Technical Reports Server (NTRS)

Willamson, D. T.

1974-01-01

The Okavango is Botswana's major water resource. The present study has been specifically directed at mapping vegetation types within the delta and generally concerned with finding what information of value to plant and animal ecologists could be extracted from the imagery. To date it has been found that. (1) It is possible to map broad vegetation types from the imagery. (2) Imagery of the delta records the state of the system in a manner which will facilitate long-term studies of plant succession. (3) Phenological events can be detected. (4) The imagery can be used to detect and map wild fires. This will be useful in determining the role of fire in the ecology of the region. Using the imagery it is thus possible to map existing vegetation and monitor both short and long-term changes.

Fuel loads and fuel type mapping

USGS Publications Warehouse

Chuvieco, Emilio; Riaño, David; Van Wagtendonk, Jan W.; Morsdof, Felix; Chuvieco, Emilio

2003-01-01

Correct description of fuel properties is critical to improve fire danger assessment and fire behaviour modeling, since they guide both fire ignition and fire propagation. This chapter deals with properties of fuel that can be considered static in short periods of time: biomass loads, plant geometry, compactness, etc. Mapping these properties require a detail knowledge of vegetation vertical and horizontal structure. Several systems to classify the great diversity of vegetation characteristics in few fuel types are described, as well as methods for mapping them with special emphasis on those based on remote sensing images.

The Environmental Assessment and Management (TEAM) Guide; Rhode Island Supplement, Revised March 1998

DTIC Science & Technology

1998-03-01

Verify that Class I Landfills are located only in "till" areas as identified on the groundwater maps prepared by the U.S. Geological Survey and...are located in either "till" areas or "outwash" areas as identified on the groundwater maps prepared by the U.S. Geological Survey and are of the...groundwater maps prepared by the U.S. Geological Survey . Verify that Class I Landfills do not accept: - Type 6-Extremely Hazardous Waste - Type 2A--Highly

The Human Genome Initiative: First Steps.

ERIC Educational Resources Information Center

Newman, Alan R.

1990-01-01

Described is the basic biology involved in mapping chromosomes as presented at a symposium at a recent meeting of the American Chemical Association which focused on the Human Genome Initiative. Different types of gene maps and techniques used to produce gene maps are discussed. (CW)

Landslide inventory maps: New tools for an old problem

NASA Astrophysics Data System (ADS)

Guzzetti, Fausto; Mondini, Alessandro Cesare; Cardinali, Mauro; Fiorucci, Federica; Santangelo, Michele; Chang, Kang-Tsung

2012-04-01

Landslides are present in all continents, and play an important role in the evolution of landscapes. They also represent a serious hazard in many areas of the world. Despite their importance, we estimate that landslide maps cover less than 1% of the slopes in the landmasses, and systematic information on the type, abundance, and distribution of landslides is lacking. Preparing landslide maps is important to document the extent of landslide phenomena in a region, to investigate the distribution, types, pattern, recurrence and statistics of slope failures, to determine landslide susceptibility, hazard, vulnerability and risk, and to study the evolution of landscapes dominated by mass-wasting processes. Conventional methods for the production of landslide maps rely chiefly on the visual interpretation of stereoscopic aerial photography, aided by field surveys. These methods are time consuming and resource intensive. New and emerging techniques based on satellite, airborne, and terrestrial remote sensing technologies, promise to facilitate the production of landslide maps, reducing the time and resources required for their compilation and systematic update. In this work, we first outline the principles for landslide mapping, and we review the conventional methods for the preparation of landslide maps, including geomorphological, event, seasonal, and multi-temporal inventories. Next, we examine recent and new technologies for landslide mapping, considering (i) the exploitation of very-high resolution digital elevation models to analyze surface morphology, (ii) the visual interpretation and semi-automatic analysis of different types of satellite images, including panchromatic, multispectral, and synthetic aperture radar images, and (iii) tools that facilitate landslide field mapping. Next, we discuss the advantages and the limitations of the new remote sensing data and technology for the production of geomorphological, event, seasonal, and multi-temporal inventory maps. We conclude by arguing that the new tools will help to improve the quality of landslide maps, with positive effects on all derivative products and analyses, including erosion studies and landscape modeling, susceptibility and hazard assessments, and risk evaluations.

Seeing the soil through the net: an eye-opener on the soil map of the Flemish region (Belgium)

NASA Astrophysics Data System (ADS)

Dondeyne, Stefaan; Vanierschot, Laura; Langohr, Roger; Van Ranst, Eric; Deckers, Jozef; Oorts, Katrien

2017-04-01

A systematic soil survey of Belgium was conducted from 1948 to 1991. Field surveys were done at the detailed scale of 1:5000 with the final maps published at a 1:20,000 scale. The legend of these detailed soil maps (scale 1:20,000) has been converted to the 3rd edition of the international soil classification system 'World Reference Base for Soil Resources' (WRB). Over the last years, the government of the Flemish region made great efforts to make these maps, along with other environmental data, available to the general audience through the internet. The soil maps are widely used and consulted by researchers, teachers, land-use planners, environmental consultancy agencies and archaeologists. The maps can be downloaded and consulted in the viewer 'Visual Soil Explorer' ('Bodemverkenner'). To increase the legibility of the maps, we assembled a collection of photographs from soil profiles representing 923 soil types and 413 photos of related landscape settings. By clicking on a specific location in the 'Visual Soil Explorer', pictures of the corresponding soil type and landscape appear in a pop-up window, with a brief explanation about the soil properties. The collection of photographs of soil profiles cover almost 80% of the total area of the Flemish region, and include the 100 most common soil types. Our own teaching experience shows that these information layers are particular valuable for teaching soil geography and earth sciences in general. Overall, such visual information layers should contribute to a better interpretation of the soil maps and legacy soil data by serving as an eye-opener on the soil map to the wider community.

A new map of standardized terrestrial ecosystems of Africa

USGS Publications Warehouse

Sayre, Roger G.; Comer, Patrick; Hak, Jon; Josse, Carmen; Bow, Jacquie; Warner, Harumi; Larwanou, Mahamane; Kelbessa, Ensermu; Bekele, Tamrat; Kehl, Harald; Amena, Ruba; Andriamasimanana, Rado; Ba, Taibou; Benson, Laurence; Boucher, Timothy; Brown, Matthew; Cress, Jill J.; Dassering, Oueddo; Friesen, Beverly A.; Gachathi, Francis; Houcine, Sebei; Keita, Mahamadou; Khamala, Erick; Marangu, Dan; Mokua, Fredrick; Morou, Boube; Mucina, Ladislav; Mugisha, Samuel; Mwavu, Edward; Rutherford, Michael; Sanou, Patrice; Syampungani, Stephen; Tomor, Bojoi; Vall, Abdallahi Ould Mohamed; Vande Weghe, Jean Pierre; Wangui, Eunice; Waruingi, Lucy

2013-01-01

Terrestrial ecosystems and vegetation of Africa were classified and mapped as part of a larger effort and global protocol (GEOSS – the Global Earth Observation System of Systems), which includes an activity to map terrestrial ecosystems of the earth in a standardized, robust, and practical manner, and at the finest possible spatial resolution. To model the potential distribution of ecosystems, new continental datasets for several key physical environment datalayers (including coastline, landforms, surficial lithology, and bioclimates) were developed at spatial and classification resolutions finer than existing similar datalayers. A hierarchical vegetation classification was developed by African ecosystem scientists and vegetation geographers, who also provided sample locations of the newly classified vegetation units. The vegetation types and ecosystems were then mapped across the continent using a classification and regression tree (CART) inductive model, which predicted the potential distribution of vegetation types from a suite of biophysical environmental attributes including bioclimate region, biogeographic region, surficial lithology, landform, elevation and land cover. Multi-scale ecosystems were classified and mapped in an increasingly detailed hierarchical framework using vegetation-based concepts of class, subclass, formation, division, and macrogroup levels. The finest vegetation units (macrogroups) classified and mapped in this effort are defined using diagnostic plant species and diagnostic growth forms that reflect biogeographic differences in composition and sub-continental to regional differences in mesoclimate, geology, substrates, hydrology, and disturbance regimes (FGDC, 2008). The macrogroups are regarded as meso-scale (100s to 10,000s of hectares) ecosystems. A total of 126 macrogroup types were mapped, each with multiple, repeating occurrences on the landscape. The modeling effort was implemented at a base spatial resolution of 90 m. In addition to creating several rich, new continent-wide biophysical datalayers describing African vegetation and ecosystems, our intention was to explore feasible approaches to rapidly moving this type of standardized, continent-wide, ecosystem classification and mapping effort forward.

Integrating and mining the chromatin landscape of cell-type specificity using self-organizing maps.

PubMed

Mortazavi, Ali; Pepke, Shirley; Jansen, Camden; Marinov, Georgi K; Ernst, Jason; Kellis, Manolis; Hardison, Ross C; Myers, Richard M; Wold, Barbara J

2013-12-01

We tested whether self-organizing maps (SOMs) could be used to effectively integrate, visualize, and mine diverse genomics data types, including complex chromatin signatures. A fine-grained SOM was trained on 72 ChIP-seq histone modifications and DNase-seq data sets from six biologically diverse cell lines studied by The ENCODE Project Consortium. We mined the resulting SOM to identify chromatin signatures related to sequence-specific transcription factor occupancy, sequence motif enrichment, and biological functions. To highlight clusters enriched for specific functions such as transcriptional promoters or enhancers, we overlaid onto the map additional data sets not used during training, such as ChIP-seq, RNA-seq, CAGE, and information on cis-acting regulatory modules from the literature. We used the SOM to parse known transcriptional enhancers according to the cell-type-specific chromatin signature, and we further corroborated this pattern on the map by EP300 (also known as p300) occupancy. New candidate cell-type-specific enhancers were identified for multiple ENCODE cell types in this way, along with new candidates for ubiquitous enhancer activity. An interactive web interface was developed to allow users to visualize and custom-mine the ENCODE SOM. We conclude that large SOMs trained on chromatin data from multiple cell types provide a powerful way to identify complex relationships in genomic data at user-selected levels of granularity.

Integrating and mining the chromatin landscape of cell-type specificity using self-organizing maps

PubMed Central

Mortazavi, Ali; Pepke, Shirley; Jansen, Camden; Marinov, Georgi K.; Ernst, Jason; Kellis, Manolis; Hardison, Ross C.; Myers, Richard M.; Wold, Barbara J.

2013-01-01

We tested whether self-organizing maps (SOMs) could be used to effectively integrate, visualize, and mine diverse genomics data types, including complex chromatin signatures. A fine-grained SOM was trained on 72 ChIP-seq histone modifications and DNase-seq data sets from six biologically diverse cell lines studied by The ENCODE Project Consortium. We mined the resulting SOM to identify chromatin signatures related to sequence-specific transcription factor occupancy, sequence motif enrichment, and biological functions. To highlight clusters enriched for specific functions such as transcriptional promoters or enhancers, we overlaid onto the map additional data sets not used during training, such as ChIP-seq, RNA-seq, CAGE, and information on cis-acting regulatory modules from the literature. We used the SOM to parse known transcriptional enhancers according to the cell-type-specific chromatin signature, and we further corroborated this pattern on the map by EP300 (also known as p300) occupancy. New candidate cell-type-specific enhancers were identified for multiple ENCODE cell types in this way, along with new candidates for ubiquitous enhancer activity. An interactive web interface was developed to allow users to visualize and custom-mine the ENCODE SOM. We conclude that large SOMs trained on chromatin data from multiple cell types provide a powerful way to identify complex relationships in genomic data at user-selected levels of granularity. PMID:24170599

[Why is obstructive sleep apnea (OSA) a cardiovascular risk factor?].

PubMed

Koehler, U; Becker, H F; Gross, V; Reinke, C; Penzel, T; Schäfer, H; Vogelmeier, C

2003-12-01

Patients with obstructive sleep apnea (OSA) frequently suffer from cardiovascular diseases. Mechanisms like intrathoracic pressure variations, changes in blood gases (hypoxia), arousals and neurohumeral adaptation mechanisms, combined with breathing disorders are causing these cardiovascular sequelae. In particular repetitive hypoxemia and activation of the sympathetic nervous system have to be considered as stressors for the cardiovascular system. Special clinical findings should take OSA into consideration as a differential diagnosis. A systematic anamnesis with questions to daytime conditions (hypersomnia, decrease of performance), snoring and apneas while sleeping is easy to ascertain, and will lead to the correct diagnosis in more than 90% of cases. The extent and need for therapy should be assessed by three criteria: 1) daytime symptoms, 2) the extent of breathing disorder and 3) cardiovascular comorbidity.

Forest type mapping of the Interior West

Treesearch

Bonnie Ruefenacht; Gretchen G. Moisen; Jock A. Blackard

2004-01-01

This paper develops techniques for the mapping of forest types in Arizona, New Mexico, and Wyoming. The methods involve regression-tree modeling using a variety of remote sensing and GIS layers along with Forest Inventory Analysis (FIA) point data. Regression-tree modeling is a fast and efficient technique of estimating variables for large data sets with high accuracy...

Preliminary lithogeochemical map showing near-surface rock types in the Chesapeake Bay watershed, Virginia and Maryland

USGS Publications Warehouse

Peper, John D.; McCartan, Lucy; Horton, J. Wright; Reddy, James E.

2001-01-01

This preliminary experimental lithogeochemical map shows the distribution of rock types in the Virginia and Maryland parts of the Chesapeake Bay watershed. The map was produced digitally by classifying geologic-map units according to composition, mineralogy, and texture; rather than by age and stratigraphic relationships as shown on traditional geologic maps. This map differs from most lithologic maps in that the lithogeochemical unit classification distinguishes those rock units having key water-reactive minerals that may induce acid neutralization, or reduction, of hosted water at the weathering interface. The validity of these rock units, however, is independent of water chemistry, because the rock units are derived from geologic maps and rock descriptions. Areas of high soil carbon content, and sulfide metal deposits are also shown. Water-reactive minerals and their weathering reactions yield five lithogeochemical unit classes: 1) carbonate rock and calcareous rocks and sediments, the most acid-neutralizing; 2)carbonaceous-sulfidic rocks and sediments, oxygen-depleting and reducing; 3) quartzofeldspathic rocks and siliciclastic sediments, relatively weakly reactive with water; 4) mafic silicate rocks/sediments, oxygen consuming and high solute-load delivering; and, 5) the rarer calcareous-sulfidic (carbonaceous) rocks, neutralizing and reducing. Earlier studies in some parts of the map area have related solute loads in ground and stream waters to some aspects of bedrock lithology. More recent preliminary tests of relationships between four of the classes of mapped lithogeochemical units and ground water chemistry, in the Mid-Atlantic area using this map, have focused on and verified the nitrate-reducing and acid-neutralizing properties of some bedrock and unconsolidated aquifer rock types. Sulfide mineral deposits and their mine-tailings effects on waters are beginning to be studied by others. Additional testing of relationships among the lithogeochemical units and aspects of ground and surface water chemistry could help to refine the lithogeochemical classification, and this map. The testing could also improve the usefulness of the map for assessing aquifer reactivity and the transport properties of reactive contaminants such as acid rain, and nitrate from agricultural sources, in the Chesapeake Bay watershed.

A new vegetation map of the western Seward Peninsula, Alaska, based on ERTS-1 imagery

NASA Technical Reports Server (NTRS)

Anderson, J. H.; Belon, A. E. (Principal Investigator)

1973-01-01

The author has identified the following significant results. A reconstituted, simulated color-infrared ERTS-1 image covering the western Seward Peninsula was prepared and it is used for identifying and mapping vegetation types by direct visual examination. The image, NASA ERTS E-1009-22095, was obtained approximately at 1110 hours, 165 degrees WMT on August 1, 1972. Seven major colors are identified. Four of these are matched with units on existing vegetation maps: bright red - shrub thicket; light gray-red - upland tundra; medium gray-red - coastal coastal wet tundra; gray - alpine barrens. The three colors having no map equivalents are tentatively interpreted as follows: pink - grassland tundra; dark gray-red - burn scars; light orange-red - senescent vegetation. A vegetation map, drawn by tracing on an acetate overlay of the image is presented. Significantly more information is depicted than on existing maps with regards to vegetation types and their areal distribution. Furthermore the preparation of the new map from ERTS-1 imagery required little time relative to conventional methods and extent of areal coverage.

Functional Maps of Mechanosensory Features in the Drosophila Brain.

PubMed

Patella, Paola; Wilson, Rachel I

2018-04-23

Johnston's organ is the largest mechanosensory organ in Drosophila. It contributes to hearing, touch, vestibular sensing, proprioception, and wind sensing. In this study, we used in vivo 2-photon calcium imaging and unsupervised image segmentation to map the tuning properties of Johnston's organ neurons (JONs) at the site where their axons enter the brain. We then applied the same methodology to study two key brain regions that process signals from JONs: the antennal mechanosensory and motor center (AMMC) and the wedge, which is downstream of the AMMC. First, we identified a diversity of JON response types that tile frequency space and form a rough tonotopic map. Some JON response types are direction selective; others are specialized to encode amplitude modulations over a specific range (dynamic range fractionation). Next, we discovered that both the AMMC and the wedge contain a tonotopic map, with a significant increase in tonotopy-and a narrowing of frequency tuning-at the level of the wedge. Whereas the AMMC tonotopic map is unilateral, the wedge tonotopic map is bilateral. Finally, we identified a subregion of the AMMC/wedge that responds preferentially to the coherent rotation of the two mechanical organs in the same angular direction, indicative of oriented steady air flow (directional wind). Together, these maps reveal the broad organization of the primary and secondary mechanosensory regions of the brain. They provide a framework for future efforts to identify the specific cell types and mechanisms that underlie the hierarchical re-mapping of mechanosensory information in this system. Copyright © 2018 Elsevier Ltd. All rights reserved.

Virtual screening filters for the design of type II p38 MAP kinase inhibitors: a fragment based library generation approach.

PubMed

Badrinarayan, Preethi; Sastry, G Narahari

2012-04-01

In this work, we introduce the development and application of a three-step scoring and filtering procedure for the design of type II p38 MAP kinase leads using allosteric fragments extracted from virtual screening hits. The design of the virtual screening filters is based on a thorough evaluation of docking methods, DFG-loop conformation, binding interactions and chemotype specificity of the 138 p38 MAP kinase inhibitors from Protein Data Bank bound to DFG-in and DFG-out conformations using Glide, GOLD and CDOCKER. A 40 ns molecular dynamics simulation with the apo, type I with DFG-in and type II with DFG-out forms was carried out to delineate the effects of structural variations on inhibitor binding. The designed docking-score and sub-structure filters were first tested on a dataset of 249 potent p38 MAP kinase inhibitors from seven diverse series and 18,842 kinase inhibitors from PDB, to gauge their capacity to discriminate between kinase and non-kinase inhibitors and likewise to selectively filter-in target-specific inhibitors. The designed filters were then applied in the virtual screening of a database of ten million (10⁷) compounds resulting in the identification of 100 hits. Based on their binding modes, 98 allosteric fragments were extracted from the hits and a fragment library was generated. New type II p38 MAP kinase leads were designed by tailoring the existing type I ATP site binders with allosteric fragments using a common urea linker. Target specific virtual screening filters can thus be easily developed for other kinases based on this strategy to retrieve target selective compounds. Copyright © 2012 Elsevier Inc. All rights reserved.

Multimap formation in visual cortex

PubMed Central

Jain, Rishabh; Millin, Rachel; Mel, Bartlett W.

2015-01-01

An extrastriate visual area such as V2 or V4 contains neurons selective for a multitude of complex shapes, all sharing a common topographic organization. Simultaneously developing multiple interdigitated maps—hereafter a “multimap”—is challenging in that neurons must compete to generate a diversity of response types locally, while cooperating with their dispersed same-type neighbors to achieve uniform visual field coverage for their response type at all orientations, scales, etc. Previously proposed map development schemes have relied on smooth spatial interaction functions to establish both topography and columnar organization, but by locally homogenizing cells' response properties, local smoothing mechanisms effectively rule out multimap formation. We found in computer simulations that the key requirements for multimap development are that neurons are enabled for plasticity only within highly active regions of cortex designated “learning eligibility regions” (LERs), but within an LER, each cell's learning rate is determined only by its activity level with no dependence on location. We show that a hybrid developmental rule that combines spatial and activity-dependent learning criteria in this way successfully produces multimaps when the input stream contains multiple distinct feature types, or in the degenerate case of a single feature type, produces a V1-like map with “salt-and-pepper” structure. Our results support the hypothesis that cortical maps containing a fine mixture of different response types, whether in monkey extrastriate cortex, mouse V1 or elsewhere in the cortex, rather than signaling a breakdown of map formation mechanisms at the fine scale, are a product of a generic cortical developmental scheme designed to map cells with a diversity of response properties across a shared topographic space. PMID:26641946

Augmented Affordances Support Learning: Comparing the Instructional Effects of the Augmented Reality Sandbox and Conventional Maps to Teach Topographic Map Skills

ERIC Educational Resources Information Center

Richardson, R. Thomas; Sammons, Dotty; Del-Parte, Donna

2018-01-01

This study compared learning performance during and following AR and non-AR topographic map instruction and practice Two-way ANOVA testing indicated no significant differences on a posttest assessment between map type and spatial ability. Prior learning activity results revealed a significant performance difference between AR and non-AR treatment…

Mapping human environment connections on the Olympic Peninsula: an atlas of landscape values

Treesearch

R. McLain; L. Cerveny; Paul M. Montesano; André Beaudoin; Guoqing Sun; Hans-Erik Andersen; Michael A. Wulder; S. Rohdy

2015-01-01

The advent of computerized mapping has greatly expanded the ability of land managers to map many aspects of ecological systems, such as tree species, soil types, wildlife habitat, air quality, and water conditions. Mapping the social and cultural aspects of ecological systems, however, has proved much more challenging. This atlas uses the Olympic Peninsula in western...

Land cover

USGS Publications Warehouse

Jorgenson, Janet C.; Joria, Peter C.; Douglas, David C.; Douglas, David C.; Reynolds, Patricia E.; Rhode, E.B.

2002-01-01

Documenting the distribution of land-cover types on the Arctic National Wildlife Refuge coastal plain is the foundation for impact assessment and mitigation of potential oil exploration and development. Vegetation maps facilitate wildlife studies by allowing biologists to quantify the availability of important wildlife habitats, investigate the relationships between animal locations and the distribution or juxtaposition of habitat types, and assess or extrapolate habitat characteristics across regional areas.To meet the needs of refuge managers and biologists, satellite imagery was chosen as the most cost-effective method for mapping the large, remote landscape of the 1002 Area.Objectives of our study were the following: 1) evaluate a vegetation classification scheme for use in mapping. 2) determine optimal methods for producing a satellite-based vegetation map that adequately met the needs of the wildlife research and management objectives; 3) produce a digital vegetation map for the Arctic Refuge coastal plain using Lands at-Thematic Mapper(TM) satellite imagery, existing geobotanical classifications, ground data, and aerial photographs, and 4) perform an accuracy assessment of the map.

Special-Status Plant Species Surveys and Vegetation Mapping at Lawrence Livermore National Laboratory

DOE Office of Scientific and Technical Information (OSTI.GOV)

Preston, R E

This report presents the results of Jones & Stokes special-status plant surveys and vegetation mapping for the University of California, Lawrence Livermore National Laboratory (LLNL). Special-status plant surveys were conducted at Site 300 in April to May 1997 and in March to April 2002. Eight special-status plants were identified at Site 300: large-flowered fiddleneck, big tarplant, diamond-petaled poppy, round-leaved filaree, gypsum-loving larkspur, California androsace, stinkbells, and hogwallow starfish. Maps identifying the locations of these species, a discussion of the occurrence of these species at Site 300, and a checklist of the flora of Site 300 are presented. A reconnaissance surveymore » of the LLNL Livermore Site was conducted in June 2002. This survey concluded that no special-status plants occur at the Livermore Site. Vegetation mapping was conducted in 2001 at Site 300 to update a previous vegetation study done in 1986. The purpose of the vegetation mapping was to update and to delineate more precisely the boundaries between vegetation types and to map vegetation types that previously were not mapped. The vegetation map is presented with a discussion of the vegetation classification used.« less

An expanded map of vegetation communities at Big Muddy National Fish and Wildlife Refuge

USGS Publications Warehouse

Struckhoff, Matthew A.

2013-01-01

In 2012, a map of vegetation communities on Big Muddy National Fish and Wildlife Refuge was expanded based on interpretation of aerial photographs and field data. National Agricultural Imagery Program aerial photographs were used to identify distinct communities on previously unmapped refuge units and newly acquired parcels. Newly mapped polygons were then visited to adjust map boundaries, classify communities according to the National Vegetation Classification System, and quantify the abundance of dominant species and non-native, invasive species of concern to the refuge and other resource management agencies along the Missouri River. The expanded map now covers 6,136 hectares representing 33 community types, including 6 previously unmapped types. The full map includes 1,113 polygons, of which 627 are new, 21 are updated from the 2009 mapping effort, and 465 are unchanged from 2009. Mortality of primarily cottonwood stems, because of growing-season floods between 2008 and 2011, has reduced foliar cover of woody stems and created more open wooded communities. In herbaceous communities, dominance by herbaceous old fields has increased due to the inclusion of refuge units dominated by lands in recent agricultural production in the expanded map. Wetland community abundance has increased slightly due to recent flooding.

Sea ice type maps from Alaska synthetic aperture radar facility imagery: An assessment

NASA Technical Reports Server (NTRS)

Fetterer, Florence M.; Gineris, Denise; Kwok, Ronald

1994-01-01

Synthetic aperture radar (SAR) imagery received at the Alaskan SAR Facility is routinely and automatically classified on the Geophysical Processor System (GPS) to create ice type maps. We evaluated the wintertime performance of the GPS classification algorithm by comparing ice type percentages from supervised classification with percentages from the algorithm. The root mean square (RMS) difference for multiyear ice is about 6%, while the inconsistency in supervised classification is about 3%. The algorithm separates first-year from multiyear ice well, although it sometimes fails to correctly classify new ice and open water owing to the wide distribution of backscatter for these classes. Our results imply a high degree of accuracy and consistency in the growing archive of multiyear and first-year ice distribution maps. These results have implications for heat and mass balance studies which are furthered by the ability to accurately characterize ice type distributions over a large part of the Arctic.

Vegetation, plant biomass, and net primary productivity patterns in the Canadian Arctic

NASA Astrophysics Data System (ADS)

Gould, W. A.; Raynolds, M.; Walker, D. A.

2003-01-01

We have developed maps of dominant vegetation types, plant functional types, percent vegetation cover, aboveground plant biomass, and above and belowground annual net primary productivity for Canada north of the northern limit of trees. The area mapped covers 2.5 million km2 including glaciers. Ice-free land covers 2.3 million km2 and represents 42% of all ice-free land in the Circumpolar Arctic. The maps combine information on climate, soils, geology, hydrology, remotely sensed vegetation classifications, previous vegetation studies, and regional expertise to define polygons drawn using photo-interpretation of a 1:4,000,000 scale advanced very high resolution radiometer (AVHRR) color infrared image basemap. Polygons are linked to vegetation description, associated properties, and descriptive literature through a series of lookup tables in a graphic information systems (GIS) database developed as a component of the Circumpolar Arctic Vegetation Map (CAVM) project. Polygons are classified into 20 landcover types including 17 vegetation types. Half of the region is sparsely vegetated (<50% vegetation cover), primarily in the High Arctic (bioclimatic subzones A-C). Whereas most (86%) of the estimated aboveground plant biomass (1.5 × 1015 g) and 87% of the estimated above and belowground annual net primary productivity (2.28 × 1014 g yr-1) are concentrated in the Low Arctic (subzones D and E). The maps present more explicit spatial patterns of vegetation and ecosystem attributes than have been previously available, the GIS database is useful in summarizing ecosystem properties and can be easily updated and integrated into circumpolar mapping efforts, and the derived estimates fall within the range of current published estimates.

Molecular epidemiology of Mycobacterium avium subspecies paratuberculosis in ruminants in different parts of India.

PubMed

Sonawane, Ganesh G; Narnaware, Shirish D; Tripathi, Bhupendra N

2016-03-01

Paratuberculosis is an economically important, chronic, and incurable disease in ruminants, caused by Mycobacterium avium subspecies paratuberculosis (MAP). Understanding the genetic variability of MAP strains is important in diagnosis, epidemiological investigation, and the formation of strategies for prevention and control of the disease. In the present study, a total of 61 MAP isolates obtained from different parts and species of India were typed using IS1311 polymerase chain reaction-restriction endonuclease analysis (PCR-REA) to analyze the genetic difference(s), if any, between them and the host adaptation. Based on PCR-REA results, bison B type was detected in 54 (87%) MAP isolates obtained from cattle, sheep, and goats. Of these, 19 were from sheep of the Rajasthan (n=17) and Bareilly (n=2), North India regions, 28 were from cattle of Chennai, South India (n=3), Bareilly, North India (n=3), and Nagpur, West India (n=22), and seven goat isolates from Bareilly, North India region. The 'C' type strain was detected in only seven cattle isolates obtained from the Bareilly region. The study revealed that in India, bison B-type MAP strains were prevalent in most of the ruminant species. These results have important epidemiological implications with regard to control and prevention of paratuberculosis in India. Copyright © 2015 Asian African Society for Mycobacteriology. Published by Elsevier Ltd. All rights reserved.

Rapid crop cover mapping for the conterminous United States

USGS Publications Warehouse

Dahal, Devendra; Wylie, Bruce K.; Howard, Daniel

2018-01-01

Timely crop cover maps with sufficient resolution are important components to various environmental planning and research applications. Through the modification and use of a previously developed crop classification model (CCM), which was originally developed to generate historical annual crop cover maps, we hypothesized that such crop cover maps could be generated rapidly during the growing season. Through a process of incrementally removing weekly and monthly independent variables from the CCM and implementing a ‘two model mapping’ approach, we found it viable to generate conterminous United States-wide rapid crop cover maps at a resolution of 250 m for the current year by the month of September. In this approach, we divided the CCM model into one ‘crop type model’ to handle the classification of nine specific crops and a second, binary model to classify the presence or absence of ‘other’ crops. Under the two model mapping approach, the training errors were 0.8% and 1.5% for the crop type and binary model, respectively, while test errors were 5.5% and 6.4%, respectively. With spatial mapping accuracies for annual maps reaching upwards of 70%, this approach demonstrated a strong potential for generating rapid crop cover maps by the 1st of September.

Use of satellite imagery for wildland resource evaluation in the Great Basin

NASA Technical Reports Server (NTRS)

Tueller, P. T. (Principal Investigator)

1973-01-01

The author has identified the following significant results. Most major vegetation types of Nevada have been mapped with success. The completed set of mosaic overlays will be more accurate and detailed than previous maps compiled by various State and Federal agencies due to the excellent vantage point that ERTS-1 data affords. This new vegetation type map will greatly aid resource agencies in their daily work. Such information as suitable grazing areas, wildlife habitat, forage production, and approximate wildland production potentials can be inferred from such a map. There has been some success in detecting vegetational changes with the use of ERTS-1 MSS imagery, but exposure differences have somewhat confounded the results. Future plans include work to solve this problem.

Integrating gravity and magnetic field data to delineate structurally controlled gold mineralization in the Sefwi Belt of Ghana

NASA Astrophysics Data System (ADS)

Konadu Amoah, Bernard; Dadzie, Isaac; Takyi-Kyeremeh, Kwaku

2018-08-01

Gravity and magnetic surveys were used to delineate potential gold mineralization zones in the Sefwi belt of Ghana. The study area is an intrusive dominated area that hosts pockets of small scale mining operations locally referred to as Galamsey. These Galamsey operations are not guided by a scientific approach to back the trend of gold mineralization which is conventionally mined. The study aimed at mapping lithological units, structural setting and relating Galamsey sites to delineate potential zones of gold mineralization. A Scintrex CG5 gravimeter and GEM’s Overhauser magnetometer were used for gravity and magnetic data acquisition respectively. The magnetic data were corrected and enhancing filters such as reduction to the pole (RTP), analytical signal and first vertical derivative were applied using Oasis montaj 7.1. Gravity data were also reduced to the geoid using the Oasis montaj software to produce a complete Bouguer anomaly map. The regional/residual separation technique produced a residual gravity map. The RTP and analytical signal filters from the magnetic data and residual gravity anomaly map from the gravity data helped in mapping belt type (Dixcove) Birimian granitoids and mafic intrusive unit, interpreted as gabbro. The first vertical derivative filter was useful in mapping NE/SW minor faults and crosscutting dykes largely concentrated in the belt type Birimian granitoids. All the three mapped Galamsey sites fell on a minor fault and are associated with the belt type granitoids which were used in delineating four potential zones of gold mineralization.

A fully traits-based approach to modeling global vegetation distribution.

PubMed

van Bodegom, Peter M; Douma, Jacob C; Verheijen, Lieneke M

2014-09-23

Dynamic Global Vegetation Models (DGVMs) are indispensable for our understanding of climate change impacts. The application of traits in DGVMs is increasingly refined. However, a comprehensive analysis of the direct impacts of trait variation on global vegetation distribution does not yet exist. Here, we present such analysis as proof of principle. We run regressions of trait observations for leaf mass per area, stem-specific density, and seed mass from a global database against multiple environmental drivers, making use of findings of global trait convergence. This analysis explained up to 52% of the global variation of traits. Global trait maps, generated by coupling the regression equations to gridded soil and climate maps, showed up to orders of magnitude variation in trait values. Subsequently, nine vegetation types were characterized by the trait combinations that they possess using Gaussian mixture density functions. The trait maps were input to these functions to determine global occurrence probabilities for each vegetation type. We prepared vegetation maps, assuming that the most probable (and thus, most suited) vegetation type at each location will be realized. This fully traits-based vegetation map predicted 42% of the observed vegetation distribution correctly. Our results indicate that a major proportion of the predictive ability of DGVMs with respect to vegetation distribution can be attained by three traits alone if traits like stem-specific density and seed mass are included. We envision that our traits-based approach, our observation-driven trait maps, and our vegetation maps may inspire a new generation of powerful traits-based DGVMs.

Digital line graphs from 1:100,000-scale maps

USGS Publications Warehouse

,

1989-01-01

The National Cartographic Information Center (NCIC) distributes digital cartographic/geographic data files produced by the U.S. Geological Survey (USGS) as part of the National Mapping Program. Digital cartographic data files may be grouped into four basic types. The first of these, called a Digital Line Graph (DLG), is line map information in digital form. These data files include information on planimetric base categories, such as transportation, hydrography, and boundaries. The second form, called a Digital Elevation Model (OEM), consists of a sampled array of elevations for ground positions that are usually, but not always, at regularly spaced intervals. The third type is Land Use and Land Cover digital data, which provides information on nine major classes of land use such as urban, agricultural, or forest as well as associated map data such as political units and Federal land ownership. The fourth type, the Geographic Names Information System, provides primary information for known places, features, and areas in the United States identified by a proper name.

Visualized analysis of mixed numeric and categorical data via extended self-organizing map.

PubMed

Hsu, Chung-Chian; Lin, Shu-Han

2012-01-01

Many real-world datasets are of mixed types, having numeric and categorical attributes. Even though difficult, analyzing mixed-type datasets is important. In this paper, we propose an extended self-organizing map (SOM), called MixSOM, which utilizes a data structure distance hierarchy to facilitate the handling of numeric and categorical values in a direct, unified manner. Moreover, the extended model regularizes the prototype distance between neighboring neurons in proportion to their map distance so that structures of the clusters can be portrayed better on the map. Extensive experiments on several synthetic and real-world datasets are conducted to demonstrate the capability of the model and to compare MixSOM with several existing models including Kohonen's SOM, the generalized SOM and visualization-induced SOM. The results show that MixSOM is superior to the other models in reflecting the structure of the mixed-type data and facilitates further analysis of the data such as exploration at various levels of granularity.

Neighborhood size of training data influences soil map disaggregation

USDA-ARS?s Scientific Manuscript database

Soil class mapping relies on the ability of sample locations to represent portions of the landscape with similar soil types; however, most digital soil mapping (DSM) approaches intersect sample locations with one raster pixel per covariate layer regardless of pixel size. This approach does not take ...

Mapping the Climate of Puerto Rico, Vieques and Culebra.

Treesearch

CHRISTOPHER DALY; E. H. HELMER; MAYA QUINONES

2003-01-01

Spatially explicit climate data contribute to watershed resource management, mapping vegetation type with satellite imagery, mapping present and hypothetical future ecological zones, and predicting species distributions. The regression based Parameter-elevation Regressions on Independent Slopes Model (PRISM) uses spatial data sets, a knowledge base and expert...

Is "poor sleep" too vague a concept for rational treatment?

PubMed

Declerck, A C

1994-01-01

Poor sleep is a common complaint, accounting for 4-5% of all general practitioner consultations. Disorders of initiating sleep are overrated by patients compared with disorders of maintaining sleep, despite the greater effect of the latter on daytime performance. There is frequently a discrepancy between subjective observations and objective measurements of sleep. General practitioners should pay attention to sleep disorders lasting more than three weeks and should bear in mind that poor sleep is a symptom, the underlying cause of which needs to be determined. Good coordination of endogenous biorhythms and external life and working circumstances can positively influence sleeping patterns. Sleep onset latency determines the amount of deep sleep and, thus, the duration and stability of core sleep. General practitioners usually prescribe a single type of benzodiazepine drug with a half-life of 5-10 h for sleep disorders. Such drugs cause the patient to fall asleep quickly, to have a considerable period of uninterrupted sleep with little waking and to wake in the morning with a subjective feeling of having slept well. A number of less desirable changes can occur, however, that may produce, for example, anxiety dreams, increased snoring and sleep apnoea periods at night, and weakness of muscles during the day. The third generation of hypnotic agents produce less undesirable changes than the second generation. Zolpidem (an imidazoypridine), one such agent, seems to provide an effective treatment for insomnia without inducing undesirable side-effects.

Receptor-like Molecules on Human Intestinal Epithelial Cells Interact with an Adhesion Factor from Lactobacillus reuteri

PubMed Central

MATSUO, Yosuke; MIYOSHI, Yukihiro; OKADA, Sanae; SATOH, Eiichi

2012-01-01

A surface protein of Lactobacillus reuteri, mucus adhesion-promoting protein (MapA), is considered to be an adhesion factor. MapA is expressed in L. reuteri strains and adheres to piglet gastric mucus, collagen type I, and human intestinal epithelial cells such as Caco-2. The aim of this study was to identify molecules that mediate the attachment of MapA from L. reuteri to the intestinal epithelial cell surface by investigating the adhesion of MapA to receptor-like molecules on Caco-2 cells. MapA-binding receptor-like molecules were detected in Caco-2 cell lysates by 2D-PAGE. Two proteins, annexin A13 (ANXA13) and paralemmin (PALM), were identified by MALDI TOF-MS. The results of a pull-down assay showed that MapA bound directly to ANXA13 and PALM. Fluorescence microscopy studies confirmed that MapA binding to ANXA13 and PALM was colocalized on the Caco-2 cell membrane. To evaluate whether ANXA13 and PALM are important for MapA adhesion, ANXA13 and PALM knockdown cell lines were established. The adhesion of MapA to the abovementioned cell lines was reduced compared with that to wild-type Caco-2 cells. These knockdown experiments established the importance of these receptor-like molecules in MapA adhesion. PMID:24936355

Predicting temperate forest stand types using only structural profiles from discrete return airborne lidar

NASA Astrophysics Data System (ADS)

Fedrigo, Melissa; Newnham, Glenn J.; Coops, Nicholas C.; Culvenor, Darius S.; Bolton, Douglas K.; Nitschke, Craig R.

2018-02-01

Light detection and ranging (lidar) data have been increasingly used for forest classification due to its ability to penetrate the forest canopy and provide detail about the structure of the lower strata. In this study we demonstrate forest classification approaches using airborne lidar data as inputs to random forest and linear unmixing classification algorithms. Our results demonstrated that both random forest and linear unmixing models identified a distribution of rainforest and eucalypt stands that was comparable to existing ecological vegetation class (EVC) maps based primarily on manual interpretation of high resolution aerial imagery. Rainforest stands were also identified in the region that have not previously been identified in the EVC maps. The transition between stand types was better characterised by the random forest modelling approach. In contrast, the linear unmixing model placed greater emphasis on field plots selected as endmembers which may not have captured the variability in stand structure within a single stand type. The random forest model had the highest overall accuracy (84%) and Cohen's kappa coefficient (0.62). However, the classification accuracy was only marginally better than linear unmixing. The random forest model was applied to a region in the Central Highlands of south-eastern Australia to produce maps of stand type probability, including areas of transition (the 'ecotone') between rainforest and eucalypt forest. The resulting map provided a detailed delineation of forest classes, which specifically recognised the coalescing of stand types at the landscape scale. This represents a key step towards mapping the structural and spatial complexity of these ecosystems, which is important for both their management and conservation.

Integration of new geologic mapping and satellite-derived quartz mapping yields insights into the structure of the Roberts Mountains allochthon applicable to assessments for concealed Carlin-type gold deposits

USGS Publications Warehouse

Holm-Denoma, Christopher S.; Hofstra, Albert H.; Rockwell, Barnaby W.; Noble, Paula J.

2012-01-01

Geologic mapping and remote sensing across north-central Nevada enable recognition of a thick sheet of Middle and Upper Ordovician Valmy Formation quartzite that structurally overlies folded and faulted Ordovician through Devonian stratigraphic units of the Roberts Mountains allochthon. In the northern Independence Mountains and nearby Double Mountain area, the Valmy Formation is in fault contact with Ordovician through Silurian, predominantly clastic, sedimentary rocks of the Roberts Mountains allochthon that were deformed prior to, or during, emplacement of the Valmy thrust sheet. Similar structural relations are recognized discontinuously for 200 kilometers along the strike of the Roberts Mountains allochthon in mapping guided by regional remote-sensing-based (ASTER) quartz maps. Overall thicknesses of deformed Roberts Mountains allochthon units between the base of the Valmy and the top of underlying carbonate rocks that host large Carlin-type gold deposits varies on the order of hundreds of meters but is not known to exceed 700 meters. The base of the Valmy thrust sheet is a complimentary datum in natural resource exploration and mineral resource assessment for concealed Carlin-type gold deposits.

Discovery of Type II Inhibitors of TGFβ-Activated Kinase 1 (TAK1) and Mitogen-Activated Protein Kinase Kinase Kinase Kinase 2 (MAP4K2)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tan, Li; Nomanbhoy, Tyzoon; Gurbani, Deepak

Here, we developed a pharmacophore model for type II inhibitors that was used to guide the construction of a library of kinase inhibitors. Kinome-wide selectivity profiling of the library resulted in the identification of a series of 4-substituted 1H-pyrrolo[2,3-b]pyridines that exhibited potent inhibitory activity against two mitogen-activated protein kinases (MAPKs), TAK1 (MAP3K7) and MAP4K2, as well as pharmacologically well interrogated kinases such as p38α (MAPK14) and ABL. Further investigation of the structure–activity relationship (SAR) resulted in the identification of potent dual TAK1 and MAP4K2 inhibitors such as 1 (NG25) and 2 as well as MAP4K2 selective inhibitors such as 16more » and 17. Some of these inhibitors possess good pharmacokinetic properties that will enable their use in pharmacological studies in vivo. Lastly, a 2.4 Å cocrystal structure of TAK1 in complex with 1 confirms that the activation loop of TAK1 assumes the DFG-out conformation characteristic of type II inhibitors.« less

Discovery of Type II Inhibitors of TGFβ-Activated Kinase 1 (TAK1) and Mitogen-Activated Protein Kinase Kinase Kinase Kinase 2 (MAP4K2)

PubMed Central

2015-01-01

We developed a pharmacophore model for type II inhibitors that was used to guide the construction of a library of kinase inhibitors. Kinome-wide selectivity profiling of the library resulted in the identification of a series of 4-substituted 1H-pyrrolo[2,3-b]pyridines that exhibited potent inhibitory activity against two mitogen-activated protein kinases (MAPKs), TAK1 (MAP3K7) and MAP4K2, as well as pharmacologically well interrogated kinases such as p38α (MAPK14) and ABL. Further investigation of the structure–activity relationship (SAR) resulted in the identification of potent dual TAK1 and MAP4K2 inhibitors such as 1 (NG25) and 2 as well as MAP4K2 selective inhibitors such as 16 and 17. Some of these inhibitors possess good pharmacokinetic properties that will enable their use in pharmacological studies in vivo. A 2.4 Å cocrystal structure of TAK1 in complex with 1 confirms that the activation loop of TAK1 assumes the DFG-out conformation characteristic of type II inhibitors. PMID:25075558

Discovery of Type II Inhibitors of TGFβ-Activated Kinase 1 (TAK1) and Mitogen-Activated Protein Kinase Kinase Kinase Kinase 2 (MAP4K2)

DOE PAGES

Tan, Li; Nomanbhoy, Tyzoon; Gurbani, Deepak; ...

2014-07-17

Here, we developed a pharmacophore model for type II inhibitors that was used to guide the construction of a library of kinase inhibitors. Kinome-wide selectivity profiling of the library resulted in the identification of a series of 4-substituted 1H-pyrrolo[2,3-b]pyridines that exhibited potent inhibitory activity against two mitogen-activated protein kinases (MAPKs), TAK1 (MAP3K7) and MAP4K2, as well as pharmacologically well interrogated kinases such as p38α (MAPK14) and ABL. Further investigation of the structure–activity relationship (SAR) resulted in the identification of potent dual TAK1 and MAP4K2 inhibitors such as 1 (NG25) and 2 as well as MAP4K2 selective inhibitors such as 16more » and 17. Some of these inhibitors possess good pharmacokinetic properties that will enable their use in pharmacological studies in vivo. Lastly, a 2.4 Å cocrystal structure of TAK1 in complex with 1 confirms that the activation loop of TAK1 assumes the DFG-out conformation characteristic of type II inhibitors.« less

Map of distribution of six forest ownership types in the conterminous United States

Treesearch

Jaketon H. Hewes; Brett J. Butler; Greg C. Liknes; Mark D. Nelson; Stephanie A. Snyder

2014-01-01

This map depicts the spatial distribution of ownership types across forest land in the conterminous United States circa 2009. The distribution is derived, in part, from Forest Inventory and Analysis (FIA) data that are collected at a sample intensity of approximately one plot per 2400 ha across the United States (U.S. Forest Service 2012). Ownership categories were...

Effects of Various Types of Situps on Integrated MAP's of the Abdominal Musculature.

ERIC Educational Resources Information Center

Noble, Larry

The electrical activity of the abdominal muscles was tested during situps to determine the effect upon integrated muscle action potential (MAP). The following types of situps were used in testing 18 college males: (1) trunk curls; (2) AAHPER situp; (3) YMCA situp; (4) modified AAHPER situp; and (5) modified YMCA situp. All situps were performed…

Mapping of volcanic units at Alba Patera, Mars

NASA Technical Reports Server (NTRS)

Cattermole, Peter

1987-01-01

Detailed photogeologic mapping of Alba Patera, Northern Tharsis, was completed and a geologic map prepared. This was supplemented by a series of detailed volcanic flow maps and used to study the morphometry of different flow types and analyze the way in which the behavior of the volcano has changed with time and also the manner in which flow fields developed in different sectors of the structure.

A Mapping from the Human Factors Analysis and Classification System (DOD-HFACS) to the Domains of Human Systems Integration (HSI)

DTIC Science & Technology

2009-11-01

Equation Chapter 1 Section 1 A MAPPING FROM THE HUMAN FACTORS ANALYSIS AND CLASSIFICATION SYSTEM (DOD...OMB control number. 1. REPORT DATE NOV 2009 2. REPORT TYPE 3. DATES COVERED 4. TITLE AND SUBTITLE A Mapping from the Human Factors Analysis ...7 The Human Factors Analysis and Classification System .................................................. 7 Mapping of DoD

Domestic well locations and populations served in the contiguous U.S.: 1990

USGS Publications Warehouse

Johnson, Tyler; Belitz, Kenneth

2017-01-01

We estimate the location and population served by domestic wells in the contiguous United States in two ways: (1) the “Block Group Method” or BGM, uses data from the 1990 census, and (2) the “Road-Enhanced Method” or REM, refines the locations by using a buffer expansion and shrinkage technique along roadways to define areas where domestic wells exist. The fundamental assumption is that houses (and therefore domestic wells) are located near a named road. The results are presented as two nationally-consistent domestic-well population datasets.While both methods can be considered valid, the REM map is more precise in locating domestic wells; the REM map has a smaller amount of spatial bias (Type 1 and Type 2 errors nearly equal vs biased in Type 1), total error (10.9% vs 23.7%), and distance error (2.0 km vs 2.7 km), when comparing the REM and BGM maps to a calibration map in California. However, the BGM map is more inclusive of all potential locations for domestic wells. Independent domestic well datasets from the USGS, and the States of MN, NV, and TX show that the BGM captures about 5 to 10% more wells than the REM.One key difference between the BGM and the REM is the mapping of low density areas. The REM reduces areas mapped as low density by 57%, concentrating populations into denser regions. Therefore, if one is trying to capture all of the potential areas of domestic-well usage, then the BGM map may be more applicable. If location is more imperative, then the REM map is better at identifying areas of the landscape with the highest probability of finding a domestic well. Depending on the purpose of a study, a combination of both maps can be used.

A Lithology Based Map Unit Schema For Onegeology Regional Geologic Map Integration

NASA Astrophysics Data System (ADS)

Moosdorf, N.; Richard, S. M.

2012-12-01

A system of lithogenetic categories for a global lithological map (GLiM, http://www.ifbm.zmaw.de/index.php?id=6460&L=3) has been compiled based on analysis of lithology/genesis categories for regional geologic maps for the entire globe. The scheme is presented for discussion and comment. Analysis of units on a variety of regional geologic maps indicates that units are defined based on assemblages of rock types, as well as their genetic type. In this compilation of continental geology, outcropping surface materials are dominantly sediment/sedimentary rock; major subdivisions of the sedimentary category include clastic sediment, carbonate sedimentary rocks, clastic sedimentary rocks, mixed carbonate and clastic sedimentary rock, colluvium and residuum. Significant areas of mixed igneous and metamorphic rock are also present. A system of global categories to characterize the lithology of regional geologic units is important for Earth System models of matter fluxes to soils, ecosystems, rivers and oceans, and for regional analysis of Earth surface processes at global scale. Because different applications of the classification scheme will focus on different lithologic constituents in mixed units, an ontology-type representation of the scheme that assigns properties to the units in an analyzable manner will be pursued. The OneGeology project is promoting deployment of geologic map services at million scale for all nations. Although initial efforts are commonly simple scanned map WMS services, the intention is to move towards data-based map services that categorize map units with standard vocabularies to allow use of a common map legend for better visual integration of the maps (e.g. see OneGeology Europe, http://onegeology-europe.brgm.fr/ geoportal/ viewer.jsp). Current categorization of regional units with a single lithology from the CGI SimpleLithology (http://resource.geosciml.org/201202/ Vocab2012html/ SimpleLithology201012.html) vocabulary poorly captures the lithologic character of such units in a meaningful way. A lithogenetic unit category scheme accessible as a GeoSciML-portrayal-based OGC Styled Layer Description resource is key to enabling OneGeology (http://oneGeology.org) geologic map services to achieve a high degree of visual harmonization.

Methodology to assess and map the potential development of forest ecosystems exposed to climate change and atmospheric nitrogen deposition: A pilot study in Germany.

PubMed

Schröder, Winfried; Nickel, Stefan; Jenssen, Martin; Riediger, Jan

2015-07-15

A methodology for mapping ecosystems and their potential development under climate change and atmospheric nitrogen deposition was developed using examples from Germany. The methodology integrated data on vegetation, soil, climate change and atmospheric nitrogen deposition. These data were used to classify ecosystem types regarding six ecological functions and interrelated structures. Respective data covering 1961-1990 were used for reference. The assessment of functional and structural integrity relies on comparing a current or future state with an ecosystem type-specific reference. While current functions and structures of ecosystems were quantified by measurements, potential future developments were projected by geochemical soil modelling and data from a regional climate change model. The ecosystem types referenced the potential natural vegetation and were mapped using data on current tree species coverage and land use. In this manner, current ecosystem types were derived, which were related to data on elevation, soil texture, and climate for the years 1961-1990. These relations were quantified by Classification and Regression Trees, which were used to map the spatial patterns of ecosystem type clusters for 1961-1990. The climate data for these years were subsequently replaced by the results of a regional climate model for 1991-2010, 2011-2040, and 2041-2070. For each of these periods, one map of ecosystem type clusters was produced and evaluated with regard to the development of areal coverage of ecosystem type clusters over time. This evaluation of the structural aspects of ecological integrity at the national level was added by projecting potential future values of indicators for ecological functions at the site level by using the Very Simple Dynamic soil modelling technique based on climate data and two scenarios of nitrogen deposition as input. The results were compared to the reference and enabled an evaluation of site-specific ecosystem changes over time which proved to be both, positive and negative. Copyright © 2015 Elsevier B.V. All rights reserved.

Identification of phenological stages and vegetative types for land use classification

NASA Technical Reports Server (NTRS)

Mckendrick, J. D. (Principal Investigator)

1973-01-01

The author has identified the following significant results. Classification of digital data for mapping Alaskan vegetation has been compared to ground truth data and found to have accuracies as high as 90%. These classifications are broad scale types as are currently being used on the Major Ecosystems of Alaska map prepared by the Joint Federal-State Land Use Planning Commission for Alaska. Cost estimates for several options using the ERTS-1 digital data to map the Alaskan land mass at the 1:250,000 scale ranged between $2.17 to $1.49 per square mile.

Autism and Equine-Assisted Interventions: A Systematic Mapping Review

ERIC Educational Resources Information Center

McDaniel Peters, B. Caitlin; Wood, Wendy

2017-01-01

This systematic mapping review mapped current knowledge of equine-assisted interventions for people with autism to help guide future practice and research. Thirty-three studies including children and adolescents with autism, 3 of which confirmed diagnoses, were reviewed. Five types of equine-assisted activities were identified across 25 studies,…

Concept Mapping for Critical Thinking: Efficacy, Timing, & Type

ERIC Educational Resources Information Center

Harris, Charles M.; Zha, Shenghua

2017-01-01

Many college students are not progressing in the development of their critical thinking skills. Concept mapping is a technique for facilitating validation of one's critical thinking by graphically depicting the structure of complex concepts. Each of our three studies of concept mapping involved approximately 240 students enrolled in four sections…

The influence of snoring, mouth breathing and apnoea on facial morphology in late childhood: a three-dimensional study

PubMed Central

Al Ali, Ala; Richmond, Stephen; Popat, Hashmat; Playle, Rebecca; Pickles, Timothy; Zhurov, Alexei I; Marshall, David; Rosin, Paul L; Henderson, John; Bonuck, Karen

2015-01-01

Objective To explore the relationship between the prevalence of sleep disordered breathing (SDB) and face shape morphology in a large cohort of 15-year-old children. Design Observational longitudinal cohort study Setting Avon Longitudinal Study of Parents and Children (ALSPAC), South West of England. Participants Three-dimensional surface laser scans were taken for 4784 white British children from the ALSPAC during a follow-up clinic. A total of 1724 children with sleep disordered breathing (SDB) and 1862 healthy children were identified via parents’ report of sleep disordered symptoms for their children. We excluded from the original cohort all children identified as having congenital abnormalities, diagnoses associated with poor growth and children with adenoidectomy and/or tonsillectomy. Main outcome measures Parents in the ALSPAC reported sleep disordered symptoms (snoring, mouth breathing and apnoea) for their children at 6, 18, 30, 42, 57, 69 and 81 months. Average facial shells were created for children with and without SDB in order to explore surface differences. Results Differences in facial measurements were found between the children with and without SDB throughout early childhood. The mean differences included an increase in face height in SDB children of 0.3 mm (95% CI −0.52 to −0.05); a decrease in mandibular prominence of 0.9° (95% CI −1.30 to −0.42) in SDB children; and a decrease in nose prominence and width of 0.12 mm (95% CI 0.00 to 0.24) and 0.72 mm (95% CI −0.10 to −0.25), respectively, in SDB children. The odds of children exhibiting symptoms of SDB increased significantly with respect to increased face height and mandible angle, but reduced with increased nose width and prominence. Conclusions The combination of a long face, reduced nose prominence and width, and a retrognathic mandible may be diagnostic facial features of SBD that may warrant a referral to specialists for the evaluation of other clinical symptoms of SDB. PMID:26351193

The influence of snoring, mouth breathing and apnoea on facial morphology in late childhood: a three-dimensional study.

PubMed

Al Ali, Ala; Richmond, Stephen; Popat, Hashmat; Playle, Rebecca; Pickles, Timothy; Zhurov, Alexei I; Marshall, David; Rosin, Paul L; Henderson, John; Bonuck, Karen

2015-09-08

To explore the relationship between the prevalence of sleep disordered breathing (SDB) and face shape morphology in a large cohort of 15-year-old children. Observational longitudinal cohort study Avon Longitudinal Study of Parents and Children (ALSPAC), South West of England. Three-dimensional surface laser scans were taken for 4784 white British children from the ALSPAC during a follow-up clinic. A total of 1724 children with sleep disordered breathing (SDB) and 1862 healthy children were identified via parents' report of sleep disordered symptoms for their children. We excluded from the original cohort all children identified as having congenital abnormalities, diagnoses associated with poor growth and children with adenoidectomy and/or tonsillectomy. Parents in the ALSPAC reported sleep disordered symptoms (snoring, mouth breathing and apnoea) for their children at 6, 18, 30, 42, 57, 69 and 81 months. Average facial shells were created for children with and without SDB in order to explore surface differences. Differences in facial measurements were found between the children with and without SDB throughout early childhood. The mean differences included an increase in face height in SDB children of 0.3 mm (95% CI -0.52 to -0.05); a decrease in mandibular prominence of 0.9° (95% CI -1.30 to -0.42) in SDB children; and a decrease in nose prominence and width of 0.12 mm (95% CI 0.00 to 0.24) and 0.72 mm (95% CI -0.10 to -0.25), respectively, in SDB children. The odds of children exhibiting symptoms of SDB increased significantly with respect to increased face height and mandible angle, but reduced with increased nose width and prominence. The combination of a long face, reduced nose prominence and width, and a retrognathic mandible may be diagnostic facial features of SBD that may warrant a referral to specialists for the evaluation of other clinical symptoms of SDB. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Respiratory symptoms, sleep-disordered breathing and biomarkers in nocturnal gastroesophageal reflux.

PubMed

Emilsson, Össur Ingi; Benediktsdóttir, Bryndís; Ólafsson, Ísleifur; Cook, Elizabeth; Júlíusson, Sigurður; Björnsson, Einar Stefán; Guðlaugsdóttir, Sunna; Guðmundsdóttir, Anna Soffía; Mirgorodskaya, Ekaterina; Ljungström, Evert; Arnardóttir, Erna Sif; Gíslason, Þórarinn; Janson, Christer; Olin, Anna-Carin

2016-09-20

Nocturnal gastroesophageal reflux (nGER) is associated with respiratory symptoms and sleep-disordered breathing (SDB), but the pathogenesis is unclear. We aimed to investigate the association between nGER and respiratory symptoms, exacerbations of respiratory symptoms, SDB and airway inflammation. Participants in the European Community Respiratory Health Survey III in Iceland with nGER symptoms (n = 48) and age and gender matched controls (n = 42) were studied by questionnaires, exhaled breath condensate (EBC), particles in exhaled air (PEx) measurements, and a home polygraphic study. An exacerbation of respiratory symptoms was defined as an episode of markedly worse respiratory symptoms in the previous 12 months. Asthma and bronchitis symptoms were more common among nGER subjects than controls (54 % vs 29 %, p = 0.01; and 60 % vs 26 %, p < 0.01, respectively), as were exacerbations of respiratory symptoms (19 % vs 5 %, p = 0.04). Objectively measured snoring was more common among subjects with nGER than controls (snores per hour of sleep, median (IQR): 177 (79-281) vs 67 (32-182), p = 0.004). Pepsin (2.5 ng/ml (0.8-5.8) vs 0.8 ng/ml (0.8-3.6), p = 0.03), substance P (741 pg/ml (626-821) vs 623 pg/ml (562-676), p < 0.001) and 8-isoprostane (3.0 pg/ml (2.7-3.9) vs 2.6 pg/ml (2.2-2.9), p = 0.002) in EBC were higher among nGER subjects than controls. Albumin and surfactant protein A in PEx were lower among nGER subjects. These findings were independent of BMI. In a general population sample, nGER is associated with symptoms of asthma and bronchitis, as well as exacerbations of respiratory symptoms. Also, nGER is associated with increased respiratory effort during sleep. Biomarker measurements in EBC, PEx and serum indicate that micro-aspiration and neurogenic inflammation are plausible mechanisms.

Identifying patients at high risk for obstructive sleep apnoea syndrome in Nigeria: A multicentre observational study.

PubMed

Desalu, Olufemi O; Onyedum, Cajetan C; Adeoti, Adekunle O; Fadare, Joseph O; Sanya, Emmanuel O; Fawale, Michael B; Bello, Hamzat A

2017-06-01

Obstructive sleep apnoea is associated with significant health consequences. A significant proportion of hospitalized patients at risk for obstructive sleep apnoea were never identified and referred for polysomnography for diagnosis. The objective of this study was to determine the factors associated with high risk for obstructive sleep apnoea and use it to identify patients at risk for the condition in tertiary hospitals in Nigeria. This was a multicentre observational study of adult patients hospitalized in three selected hospitals from 15th January to 17th March 2015. Berlin questionnaire and Epworth sleepiness scale were used to assess for obstructive sleep apnoea risk and excessive daytime sleepiness respectively. Additional questions on traditional risk factors for obstructive sleep apnoea were also obtained. Nine hundred and twenty-six patients were recruited into the study. Respondents' mean age was 44.3 years ± 15.2years, 486 (52.5%) were females and 556 (60.0%) had one or more medical co-morbidity and none of the patients had a previous diagnosis of obstructive sleep apnoea. Factors that were independently associated with high risk for obstructive sleep apnoea include systemic hypertension(aOR-10.33;95%: CI 6.42-16.61), obesity(aOR-7.87;95% CI: 4.33-14.29); excessive daytime sleepiness (aOR-3.77;95% CI :2.28-6.22), tobacco smoking (aOR-2.99;95% CI: 1.76-5.07), snoring in a first-degree relative (aOR-1.83;95% CI: 1.19-2.81); and the use of sedative (aOR-1.82;95% CI: 1.06-3.15). This study shows that patients with systemic hypertension, obesity, excessive daytime sleepiness, history of smoking, snoring in a first-degree relative and use of sedatives are at high risk of obstructive sleep apnoea. None of the patients at high risk had a previous diagnosis of sleep apnoea by a physician, highlighting the diagnostic challenges of this condition. The results of this study will assist health care professionals in early identification of individuals at risk of obstructive sleep apnoea and subsequent referral for a sleep study.

CPAP for Prevention of Cardiovascular Events in Obstructive Sleep Apnea.

PubMed

McEvoy, R Doug; Antic, Nick A; Heeley, Emma; Luo, Yuanming; Ou, Qiong; Zhang, Xilong; Mediano, Olga; Chen, Rui; Drager, Luciano F; Liu, Zhihong; Chen, Guofang; Du, Baoliang; McArdle, Nigel; Mukherjee, Sutapa; Tripathi, Manjari; Billot, Laurent; Li, Qiang; Lorenzi-Filho, Geraldo; Barbe, Ferran; Redline, Susan; Wang, Jiguang; Arima, Hisatomi; Neal, Bruce; White, David P; Grunstein, Ron R; Zhong, Nanshan; Anderson, Craig S

2016-09-08

Obstructive sleep apnea is associated with an increased risk of cardiovascular events; whether treatment with continuous positive airway pressure (CPAP) prevents major cardiovascular events is uncertain. After a 1-week run-in period during which the participants used sham CPAP, we randomly assigned 2717 eligible adults between 45 and 75 years of age who had moderate-to-severe obstructive sleep apnea and coronary or cerebrovascular disease to receive CPAP treatment plus usual care (CPAP group) or usual care alone (usual-care group). The primary composite end point was death from cardiovascular causes, myocardial infarction, stroke, or hospitalization for unstable angina, heart failure, or transient ischemic attack. Secondary end points included other cardiovascular outcomes, health-related quality of life, snoring symptoms, daytime sleepiness, and mood. Most of the participants were men who had moderate-to-severe obstructive sleep apnea and minimal sleepiness. In the CPAP group, the mean duration of adherence to CPAP therapy was 3.3 hours per night, and the mean apnea-hypopnea index (the number of apnea or hypopnea events per hour of recording) decreased from 29.0 events per hour at baseline to 3.7 events per hour during follow-up. After a mean follow-up of 3.7 years, a primary end-point event had occurred in 229 participants in the CPAP group (17.0%) and in 207 participants in the usual-care group (15.4%) (hazard ratio with CPAP, 1.10; 95% confidence interval, 0.91 to 1.32; P=0.34). No significant effect on any individual or other composite cardiovascular end point was observed. CPAP significantly reduced snoring and daytime sleepiness and improved health-related quality of life and mood. Therapy with CPAP plus usual care, as compared with usual care alone, did not prevent cardiovascular events in patients with moderate-to-severe obstructive sleep apnea and established cardiovascular disease. (Funded by the National Health and Medical Research Council of Australia and others; SAVE ClinicalTrials.gov number, NCT00738179 ; Australian New Zealand Clinical Trials Registry number, ACTRN12608000409370 .).

Sleep habits and road traffic accident risk for Iranian occupational drivers.

PubMed

Ebrahimi, Mohammad Hossein; Sadeghi, Masoumeh; Dehghani, Mohsen; Niiat, Khosro Sadegh

2015-01-01

The aim of this study is to assess the sleep quality and sleep disorders (prevalence of obstructive sleep apnea and sleepiness) among occupational drivers in Iran and to determine which demographic factors and occupational habits are linked to road traffic accidents. In this analytic cross-sectional study 556 occupational road drivers from Shahroud city (in the northeast of Iran) participated, upon a prior verbal informed consent, during 2013-2014. The Pittsburgh Sleep Quality Index (PSQI) standard questionnaire that scored on 7 point scale, the 8-item Epworth Sleepiness Scale (ESS) questionnaire and the 8-question STOP-Bang questionnaire along with demographic information and occupational data were used. To explore the independent factors associated with odds of poor sleep quality and road accident, multiple logistic regression models were used. Prevalence of previous road accidents, sleepiness while driving, and obstructive sleep apnea scored ≥ 3 in the study, and drivers accounted for 23.8%, 29%, and 24.8%, respectively. The global mean score of sleep quality and excessive sleepiness score were 5.2 and 4.8, respectively. The main factors related to the odds of poor sleep quality were snoring (odds ratio (OR) = 2.34; 95% confidence interval (CI): 1.15-4.77), smoking (OR = 2.12; 95% CI: 1.15-3.97), and driving times in a day (OR = 1.12; 95% CI: 1.03-1.21). The Epworth Sleepiness Scale (OR = 1.13; 95% CI: 1.07-1.23) and suffering from apnea (OR = 4.89; 95% CI: 1.07-23.83) were the best predictors for odds (increased risk) of road accidents. A considerable proportion of Iranian drivers had records of road accidents; poor sleep quality, sleepiness while driving, and sleep disorder breathing (obstructive sleep apnea - OSA). Snoring, smoking, driving time in a day, excessive sleepiness, and presumably apnea increase the odds of poor sleep quality and road traffic accident for Iranian occupational drivers. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

Expression and Organization of Geographic Spatial Relations Based on Topic Maps

NASA Astrophysics Data System (ADS)

Liang, H. J.; Wang, H.; Cui, T. J.; Guo, J. F.

2017-09-01

Spatial Relation is one of the important components of Geographical Information Science and Spatial Database. There have been lots of researches on Spatial Relation and many different spatial relations have been proposed. The relationships among these spatial relations such as hierarchy and so on are complex and this brings some difficulties to the applications and teaching of these spatial relations. This paper summaries some common spatial relations, extracts the topic types, association types, resource types of these spatial relations using the technology of Topic Maps, and builds many different relationships among these spatial relations. Finally, this paper utilizes Java and Ontopia to build a topic map among these common spatial relations, forms a complex knowledge network of spatial relations, and realizes the effective management and retrieval of spatial relations.

Database of the Geologic Map of North America - Adapted from the Map by J.C. Reed, Jr. and others (2005)

USGS Publications Warehouse

Garrity, Christopher P.; Soller, David R.

2009-01-01

The Geological Society of America's (GSA) Geologic Map of North America (Reed and others, 2005; 1:5,000,000) shows the geology of a significantly large area of the Earth, centered on North and Central America and including the submarine geology of parts of the Atlantic and Pacific Oceans. This map is now converted to a Geographic Information System (GIS) database that contains all geologic and base-map information shown on the two printed map sheets and the accompanying explanation sheet. We anticipate this map database will be revised at some unspecified time in the future, likely through the actions of a steering committee managed by the Geological Society of America (GSA) and staffed by scientists from agencies including, but not limited to, those responsible for the original map compilation (U.S. Geological Survey, Geological Survey of Canada, and Woods Hole Oceanographic Institute). Regarding the use of this product, as noted by the map's compilers: 'The Geologic Map of North America is an essential educational tool for teaching the geology of North America to university students and for the continuing education of professional geologists in North America and elsewhere. In addition, simplified maps derived from the Geologic Map of North America are useful for enlightening younger students and the general public about the geology of the continent.' With publication of this database, the preparation of any type of simplified map is made significantly easier. More important perhaps, the database provides a more accessible means to explore the map information and to compare and analyze it in conjunction with other types of information (for example, land use, soils, biology) to better understand the complex interrelations among factors that affect Earth resources, hazards, ecosystems, and climate.

Mapping croplands, cropping patterns, and crop types using MODIS time-series data

NASA Astrophysics Data System (ADS)

Chen, Yaoliang; Lu, Dengsheng; Moran, Emilio; Batistella, Mateus; Dutra, Luciano Vieira; Sanches, Ieda Del'Arco; da Silva, Ramon Felipe Bicudo; Huang, Jingfeng; Luiz, Alfredo José Barreto; de Oliveira, Maria Antonia Falcão

2018-07-01

The importance of mapping regional and global cropland distribution in timely ways has been recognized, but separation of crop types and multiple cropping patterns is challenging due to their spectral similarity. This study developed a new approach to identify crop types (including soy, cotton and maize) and cropping patterns (Soy-Maize, Soy-Cotton, Soy-Pasture, Soy-Fallow, Fallow-Cotton and Single crop) in the state of Mato Grosso, Brazil. The Moderate Resolution Imaging Spectroradiometer (MODIS) normalized difference vegetation index (NDVI) time series data for 2015 and 2016 and field survey data were used in this research. The major steps of this proposed approach include: (1) reconstructing NDVI time series data by removing the cloud-contaminated pixels using the temporal interpolation algorithm, (2) identifying the best periods and developing temporal indices and phenological parameters to distinguish croplands from other land cover types, and (3) developing crop temporal indices to extract cropping patterns using NDVI time-series data and group cropping patterns into crop types. Decision tree classifier was used to map cropping patterns based on these temporal indices. Croplands from Landsat imagery in 2016, cropping pattern samples from field survey in 2016, and the planted area of crop types in 2015 were used for accuracy assessment. Overall accuracies of approximately 90%, 73% and 86%, respectively were obtained for croplands, cropping patterns, and crop types. The adjusted coefficients of determination of total crop, soy, maize, and cotton areas with corresponding statistical areas were 0.94, 0.94, 0.88 and 0.88, respectively. This research indicates that the proposed approach is promising for mapping large-scale croplands, their cropping patterns and crop types.