Obstructive sleep apnea and objective sleep quality in non-dialyzed patients with chronic kidney disease: an ESADA study

Background: Altered sleep quality has been reported in chronic kidney disease (CKD). However, most studies focused on dialyzed patients or were based on subjective reports that did not consider possible coexistence of obstructive sleep apnea (OSA).Aim: To evaluate, with a case-control design, if objective sleep quality differs between patients with stage 3 CKD and subjects with normal estimated glomerular filtration rate (eGFR) independent of sleep disordered breathing.Methods: In the European Sleep Apnea Database (ESADA) cohort, 527 patients who had undergone full polysomnography and had an eGFR60.Results: CKD patients were slightly more obese, had worse sleep hypoxemia, and had more comorbidities than controls, including arterial hypertension, type 2 diabetes, and congestive heart failure. However, they did not differ from controls in any objective sleep parameter. When the sample was subdivided into three groups according to AHI tertiles, cases and controls were similar within each group. Total sleep time, sleep efficiency, % of stages N3 and R decreased, while stage N2 increased, with increasing OSA severity (all p60 and in patients with stage 3 CKD, objective sleep duration and quality did not differ, and changed in parallel with AHI. Previously reported poor sleep quality and duration in CKD may partly be due to a high prevalence of OSA.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Sleep and control of breathing Source Type: research

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This study describes the long-term comorbidity profile and treatment burden among people with HIV-1 infection.Methods: This retrospective study included Medicaid claims data from patients with ≥1 antiretroviral (ARV) claim between 2016 and 2017 (most recent claim defined the index date), ≥1 HIV diagnosis within 1 year before index, age ≥18 years at first HIV diagnosis and
Source: Current Medical Research and Opinion - Category: Research Tags: Curr Med Res Opin Source Type: research
Authors: Herring WJ, Ceesay P, Snyder E, Bliwise D, Budd K, Hutzelmann J, Stevens J, Lines C, Michelson D Abstract INTRODUCTION: We evaluated the clinical profile of the orexin receptor antagonist suvorexant for treating insomnia in patients with mild-to-moderate probable Alzheimer's disease (AD) dementia. METHODS: Randomized, double-blind, 4-week trial of suvorexant 10 mg (could be increased to 20 mg based on clinical response) or placebo in patients who met clinical diagnostic criteria for both probable AD dementia and insomnia. Sleep was assessed by overnight polysomnography in a sleep laboratory. The primar...
Source: The Journal of Alzheimers Association - Category: Psychiatry Tags: Alzheimers Dement Source Type: research
CONCLUSION: According to the high percentage of patients diagnosed with vision-threatening DR in this study, an early diagnosis of this complication of diabetes seems to be important. Teleophthalmology enhances patient accessibility to the healthcare system, making early diagnosis of DR easier, with a high degree of satisfaction among patients and healthcare professionals. PMID: 31941342 [PubMed - in process]
Source: Rural and Remote Health - Category: Rural Health Tags: Rural Remote Health Source Type: research
ConclusionsThis study provides important evidence for planners, urban designers, and policy makers on the significance of built environment, in general, and street network configuration, in particular, within home- and school-environments. One rule of thumb would be to design a well-connected street network with relatively denser connections and reduced direction changes within the neighbourhood – not only within a couple of blocks of homes and schools but also within their larger fabric (800–1600 mt buffers).
Source: Journal of Transport and Health - Category: Occupational Health Source Type: research
Publication date: Available online 16 January 2020Source: American Journal of Kidney DiseasesAuthor(s): Jelmer K. Humalda, Gerald Klaassen, Hanne de Vries, Yvette Meuleman, Lara C. Verschuur, Elisabeth J.M. Straathof, Gozewijn D. Laverman, Willem Jan W. Bos, Paul J.M. van der Boog, Karin M. Vermeulen, Olivier A. Blanson Henkemans, Wilma Otten, Martin H. de Borst, Sandra van Dijk, Gerjan J. Navis, P.J.M. van der Boog, S. van Dijk, G.J. Navis, J.K. Humalda (project coordination), G. KlaassenRationale &ObjectivePatients with chronic kidney disease (CKD) are particularly sensitive to dietary sodium. We evaluated a self-man...
Source: American Journal of Kidney Diseases - Category: Urology & Nephrology Source Type: research
We investigated whether family income gradients in obesity, overweight, and adiposity persist at geographic-level deprivation quintiles using a nationally representative cohort of UK adolescents. Data from 11,714 eligible adolescents from the sixth sweep o...
Source: SafetyLit - Category: International Medicine & Public Health Tags: Age: Adolescents Source Type: news
PURPOSE OF REVIEW: We sought to summarize recent evidence regarding optimal blood pressure (BP) treatment targets and antihypertensive regimen intensity for nursing home (NH) residents and similar older, complex patients with hypertension. RECENT FINDINGS:...
Source: SafetyLit - Category: International Medicine & Public Health Tags: Age: Elder Adults Source Type: news
ConclusionsMany elite and developing athletes visited pharmacies for medication supply and treatment of minor ailments. Doping regulatory agency websites were the most commonly used and trusted sources for medication information, although some athletes believed pharmacists could also contribute to their medication management. Future research should consider whether pharmacists are ready for a role in sports pharmacy.
Source: Journal of Science and Medicine in Sport - Category: Sports Medicine Source Type: research
ABSTRACT Objective: To describe a case of a male adolescent with symptomatic idiopathic intracranial hypertension (IIH) associated with obesity treated with bariatric surgery. Case description: A 16-year-and-6-month-old severely obese boy [weight: 133.6 kg; height: 1.74 m (Z score: +0.14); BMI: 44.1 kg/m2 (Z score: +4.4)], Tanner pubertal stage 5, presented biparietal, high-intensity, and pulsatile headaches, about five times per week, associated with nocturnal awakenings, and partial improvement with common analgesics, for three months. Ophthalmologic evaluation evidenced bilateral papilledema. Cranial computed tomography...
Source: Revista Paulista de Pediatria - Category: Pediatrics Source Type: research
CONCLUSIONS: Compliance with the 24-Hour Movement Guidelines was alarmingly low among Hong Kong adolescents. Meeting the PA recommendation or the combination of PA and sleep recommendations was associated with a healthier body weight in boys. PMID: 31945741 [PubMed - as supplied by publisher]
Source: Journal of Physical Activity and Health - Category: Sports Medicine Tags: J Phys Act Health Source Type: research
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