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Accepted Papers

Scientific Investigations

Obstructive Sleep Apnea in Children With Beckwith-Wiedemann Syndrome. 375-381.
Christopher M. Cielo, DO, MS1,2; Kelly A. Duffy, MPH3; Jesse A. Taylor, MD4,5; Carole L. Marcus, MBBCH1,2; Jennifer M. Kalish, MD, PhD2,3


Current Knowledge/Study Rationale: Infants and children with craniofacial abnormalities are disproportionately affected by obstructive sleep apnea (OSA). Many young children with Beckwith-Wiedemann syndrome (BWS) have macroglossia, but the prevalence and risk factors of OSA in this population is unknown.

Study Impact: OSA is highly prevalent in children with BWS who have macroglossia; infants younger than 6 months are at the greatest risk and those with more clinical BWS features have more severe OSA. Clinicians caring for children with BWS should have a high index of suspicion for OSA, regardless of the specific genetic or epigenetic changes present.

Eating Late Negatively Affects Sleep Pattern and Apnea Severity in Individuals With Sleep Apnea. 383-392.
Tássia do Vale Cardoso Lopes, PhD1; Matheus Eduardo Borba1; Raissa do Vale Cardoso Lopes, MSc2; Regina Mara Fisberg, PhD2; Samantha Lemos Paim, MSc1; Vinicius Vasconcelos Teodoro, PhD1; Ioná Zalcman Zimberg, PhD3; Cibele Aparecida Crispim, PhD1


Current Knowledge/Study Rationale: Several recent studies demonstrated that the timing of food intake and eating duration (interval between the first and last meal of the day), independent of energy intake, have a major role in obesity, which is a well-established leading risk factor for obstructive sleep apnea and sleep disorders.

Study Impact: Given the chronic diseases and sleep disturbance that patients with obesity and obstructive sleep apnea often have, methods to improve dietary patterns and metabolic health should be encouraged for these individuals to reduce apnea-hypopnea index and improve sleep architecture.

Sleep and the Risk of Chronic Kidney Disease: A Cohort Study. 393-400.
Yacong Bo, MSc1; Eng-kiong Yeoh, MBBS1; Cui Guo, MSc1; Zilong Zhang, PhD1; Tony Tam, PhD2; Ta-Chien Chan, PhD3,4; Ly-yun Chang, PhD5,6; Xiang Qian Lao, PhD1,7


Current Knowledge/Study Rationale: Increasing evidence suggests that a short sleep duration and poor sleep quality are associated with an increased risk of chronic kidney disease. However, information about the joint effects of sleep quality and duration on chronic kidney disease is limited.

Study Impact: Our study found an association of poor sleep with an increased risk of chronic kidney disease development. This finding underscores the need to consider sleep duration and sleep quality when developing strategies to improve sleep and thus prevent chronic kidney disease.

Autistic Traits Are Associated With Decreased Activity of Fast Sleep Spindles During Adolescence. 401-407.
Ilona Merikanto, PhD1,2,3; Liisa Kuula, PhD1; Tommi Makkonen, MSc1; Liisa Salmela, MSc1; Katri Räikkönen, PhD1; Anu-Katriina Pesonen, PhD1


Current Knowledge/Study Rationale: Sleep maintenance problems as well as imbalanced and lower level of synaptic connectivity are often associated with elevated autistic traits. Whether this reflects in changes in sleep spindle activity, which has a key function in sleep maintenance and synaptic plasticity, is essential. Accordingly, we examined the association between autistic traits and sleep spindle activity among healthy adolescents.

Study Impact: Our findings indicate that a higher level of autistic traits during adolescence associate with lower sleep spindle activity. Alterations in sleep microstructures and sleep-related brain plasticity are not restricted to diagnosed neuropsychiatric conditions.

Disconnection Between Self-Reported and Objective Cognitive Impairment in Obstructive Sleep Apnea. 409-415.
Katia Gagnon, BSc1,2; Andrée-Ann Baril, BSc1,3; Jacques Montplaisir, MD, PhD1,3; Julie Carrier, PhD1,4; Louis De Beaumont, PhD1,5; Caroline D'Aragon, BSc1; Sirin Chami, BSc1; Sandra Pelleieux, PhD6; Judes Poirier, PhD6,7; Serge Gauthier, MD8; Chantal Lafond, MD1; Jean-François Gagnon, PhD1,2; Nadia Gosselin, PhD1,4


Current Knowledge/Study Rationale: A relationship was recently established between obstructive sleep apnea (OSA) and dementia. To help clinicians identify patients at risk of progressing to dementia, we investigated whether reporting cognitive complaints are linked to objective cognitive impairment in late middle-aged and older individuals with OSA.

Study Impact: We found that, in the presence of objectively assessed cognitive deficits using neuropsychological tests, participants with OSA were less aware of their cognitive impairment compared to those in the mild/non-OSA group. Our results are useful for clinicians, because self-reports from patients with OSA regarding their cognitive functioning might not accurately reflect their actual cognitive status. Future longitudinal studies are needed to determine whether unawareness of cognitive impairments in OSA predicts dementia.

Effects of a Workplace-Based Sleep Health Program on Sleep in Members of the German Armed Forces. 417-429.
Cornelia Sauter, PhD1; Jens T. Kowalski, PhD2; Michael Stein, PhD2; Stefan Röttger, PhD2; Heidi Danker-Hopfe, PhD1


Current Knowledge/Study Rationale: Sleep health programs are rarely offered in workplaces, although the benefit of good sleep on physical and psychological health is unequivocal. The brief manual-based sleep health program presented here addressed persons with minor to moderate sleep impairments to improve sleep and prevent future sleep disorders.

Study Impact: This workplace-based group intervention was beneficial in improving objective and self-reported measures of sleep in members of the German Armed Forces. The program might increase health resilience by providing helpful strategies in the case of impaired sleep quality and strengthen self-efficacy.

Association Between Self-Reported Sleep Duration and Body Composition in Middle-Aged and Older Adults. 431-435.
Xiao Tan, PhD1; Olga E. Titova, PhD1; Eva Lindberg, MD, PhD2; Sölve Elmståhl, MD, PhD3; Lars Lind, MD, PhD4; Helgi B. Schiöth, PhD1; Christian Benedict, PhD1


Current Knowledge/Study Rationale: Healthy body composition is a key determinant of overall fitness and health, especially for middle-aged to older adults. However, the link between sleep duration and body composition has rarely been studied in older populations.

Study Impact: Short and long sleep were associated with lower fat-free mass and higher fat mass. Short and long sleep may therefore contribute to two common clinical phenotypes in middle-aged and older humans, ie, body adiposity and sarcopenia.

Polysomnography Reference Values in Healthy Newborns. 437-443.
Ameet S. Daftary, MBBS, MS1; Hasnaa E. Jalou, MD1; Lori Shively, RN1; James E. Slaven, MS2; Stephanie D. Davis, MD3


Current Knowledge/Study Rationale: Polysomnography (PSG) is increasingly used in the assessment of young infants, notably for airway obstruction. However, available reference data for PSG interpretation do not include newborns since procedural standardization by the AASM. Older reference values have used nonstandard methodology.

Study Impact: This study provides reference values in healthy newborns to assist with PSG interpretation and clinical decision making on major interventions at this vulnerable age.

Oral Health and Oral Health-Related Quality of Life in Children With Obstructive Sleep Apnea. 445-452.
Basma Tamasas, BDS, MS, PhD1,2; Travis Nelson, DDS, MSD, MPH3; Maida Chen, MD4,5


Current Knowledge/Study Rationale: Obstructive sleep apnea (OSA) is a known risk factor for poor oral health. Nevertheless, the oral health status of children with OSA is largely unknown.

Study Impact: Children with OSA have more caries, periodontal disease, and poorer oral health-related quality of life than children without reported sleep difficulties. To improve patient outcomes, medical providers should collaborate with dentists to evaluate, treat, and prevent oral diseases in children with OSA.

The Use of Computer Decision Support for Pediatric Obstructive Sleep Apnea Detection in Primary Care. 453-462.
Sarah M. Honaker, PhD1,2; Ashley Street, MS2; Ameet S. Daftary, MD, MS1; Stephen M. Downs, MD, MS2


Current Knowledge/Study Rationale: Many children with obstructive sleep apnea (OSA) do not receive timely diagnosis and treatment. This study describes the use of a computer decision support tool for universal OSA screening in two urban pediatric primary care clinics.

Study Impact: Almost 20% of children snored and three-fourths of snoring children met American Academy of Pediatrics criteria for an OSA referral. Findings raise questions about the appropriateness and feasibility of the current referral threshold.

Free Objective Relationship Between Sleep Apnea and Frequency of Snoring Assessed by Machine Learning. 463-470.
Hisham Alshaer, MD, PhD1; Richard Hummel, MASc2; Monique Mendelson, PhD2; Travis Marshal, BAHSc2; T. Douglas Bradley, MD3,4


Current Knowledge/Study Rationale: Snoring, along with other symptoms, is routinely used in screening tools for sleep apnea. It is often thought that the more prominent the snoring, the worse the sleep apnea. Most studies that examined this notion relied on self-reporting of snoring. Objective quantification of snoring and its relationship to the presence and severity of sleep apnea have not been thoroughly investigated.

Study Impact: This is the first study to deploy advanced techniques for accurate determination of snoring frequency. Snoring frequency was found to have a modest predictive value for sleep apnea and a tenuous relation with its severity. Our findings suggest that assessment of snoring alone is probably of limited usefulness in screening for obstructive or central sleep apnea, and it should be more appropriately combined with assessment of other features of sleep apnea, such as daytime sleepiness.

Free The Presence of Snoring as Well as its Intensity Is Underreported by Women. 471-476.
Roi Westreich, MD, PhD1,2; Aya Gozlan-Talmor, MD2; Shahar Geva-Robinson, MD2; Tal Schlaeffer-Yosef, MD2; Tzachi Slutsky, MD2; Efrat Chen-Hendel, MD, MPH2; Dana Braiman, MD2; Yehonatan Sherf, MD, MPH2; Natan Arotsker, MD2; Yasmeen Abu-Fraiha, MD2; Liat Waldman-Radinsky, MD2; Nimrod Maimon, MD, MHA1,2


Current Knowledge/Study Rationale: In women with symptoms of sleep-disordered breathing, sleep apnea is less likely to be diagnosed and treated than in men. The presence of snoring is one of the main symptoms searched for by clinicians who are screening for obstructive sleep apnea.

Study Impact: This study showed that although no objective difference in snoring intensity was found between women and men, there was a significant discrepancy in self-reported volume of snoring. Compared to men, women reported snoring less often and described it as milder. This difference may be one of the barriers preventing women from reaching sleep clinics and sleep laboratories for polysomnography.

Longitudinal Sleep Outcomes in Neonates With Pierre Robin Sequence Treated Conservatively. 477-482.
Zarmina Ehsan, MD1; Christopher Kurian, MS2; K. Nicole Weaver, MD3; Brian S. Pan, MD4; Guixia Huang, MS5; Md M. Hossain, PhD5; Narong Simakajornboon, MD6


Current Knowledge/Study Rationale: Although Pierre Robin sequence (PRS) is a major cause of neonatal obstructive sleep apnea (OSA), most studies have focused on surgical management outcomes. The natural evolution of severe OSA over the first 2 years of life is not well understood.

Study Impact: This study reports on the largest cohort of symptomatically treated neonates with PRS and moderate to severe OSA, showing improvement in OSA over the first 2 years of life. These results help inform providers regarding the natural history of OSA in neonates with PRS and may affect risk stratification and medical decision making in this population.

Emerging Technologies

Sleep Parameter Assessment Accuracy of a Consumer Home Sleep Monitoring Ballistocardiograph Beddit Sleep Tracker: A Validation Study. 483-487.
Jarno Tuominen, MA1; Karoliina Peltola, MA1; Tarja Saaresranta, MD, PhD2,3; Katja Valli, PhD1,4

Review Articles

Sleep Disturbances in Patients With Coronary Heart Disease: A Systematic Review. 489-504.
Michael Tilling Madsen, MD, PhD1,2; Chenxi Huang, MD1; Graziella Zangger, MHS3; Ann Dorthe Olsen Zwisler, MD, PhD3; Ismail Gögenur, MD, DMSc1

Case Reports

Sexsomnia in an Adolescent. 505-507.
Jose B. Contreras, MD1; Jarrett Richardson, MD1,2; Suresh Kotagal, MD1,3
A Novel c.676_677insG PHOX2B Mutation in Congenital Central Hypoventilation Syndrome. 509-513.
Guodong Ye, PhD1,2,3; Daxiong Han, PhD4; Yu Jiang, MS1; Zengge Wang, MS1; Yulin Zhou, PhD1; Xinzhu Lin, BS5; Weiwei Chen, MS2; Maoli Chen, MS2; Jianxiong Xu, MS2; Yanyan Yang, MS6; Qiwei Guo, MS1
Central Sleep Apnea With Sodium Oxybate in a Pediatric Patient. 515-517.
Arezou Heshmati, MD

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2017 Impact Factor: 3.396
5-Year Impact Factor: 4.216
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