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coeur et sommeil

Voici un aperçu des publications récentes liées au sommeil, parues ou en instance de parution et annoncées sur la base Pubmed.

- Le Journal of Atherosclerosis and Thrombosis publie une étude relative à l’incidence des apnées du sommeil obstructives, en fonction de leur degré de sévérité, sur l’agrégation plaquettaire.

- Une enquête publiée dans la revue Archives of gynecology and obstetrics  étudie l’impact des troubles respiratoires du sommeil sur l’issue fœtale et l’hypertension gestationnelle lors de la grossesse.

- La revue Clinics explore le sommeil  et le ronflement de l’enfant atteint de maladie cardiaque congénitale et attire l’attention sur la prévalence des troubles respiratoires du sommeil chez ces enfants et sur le handicap qu’ils représentent.

- La revue Frontiers in Biosciences souligne le système pervers liant rhinite allergique, troubles de l’humeur, sommeil et suicide à travers une revue de la littérature traitant notamment des phénomènes mécaniques et moléculaires impliqués dans la rhinite allergique et de leurs effets délétères sur le sommeil.

-La revue Behavioural brain research approfondit la connaissance des mécanismes en jeu dans la fabrication des "faux souvenirs". La reconnaissance du rôle du sommeil dans l’acte mnésique permet d’identifier deux modalités par lesquelles le sommeil affecte la mémorisation. D’une part, en ceci qu’il agit au niveau du processus de sédimentation de la trace mnésique et d’autre part, parce que le sommeil exerce une fonction régénérative, et influe ainsi sur le processus cognitif de recollection.

- La revue Population Health Management donne un aperçu des traitements existants pour l’insomnie de la personne âgée et insiste sur la nécessité d’une maitrise plus précise du ratio risques/bénéfices de certaines substances, compte tenu de la plus grande vulnérabilité de cette population, et de l’intérêt des approches non-pharmacologiques.
 

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 Journal of Atherosclerosis and Thrombosis. 2009 Dec 22. [Epub ahead of print]

Effects of Obstructive Sleep Apnea with Intermittent Hypoxia on Platelet Aggregability.

Oga T, Chin K, Tabuchi A, Kawato M, Morimoto T, Takahashi K, Handa T, Takahashi K, Taniguchi R, Kondo H, Mishima M, Kita T, Horiuchi H.

 

Department of Respiratory Care and Sleep Control Medicine, Graduate School of Medicine, Kyoto University.

Aim: Obstructive sleep apnea (OSA) is a risk factor for cardiovascular diseases. Platelets play key roles in the development of atherothrombosis. Several studies assessing platelet activation in patients with OSA have been published; however, there have been only a few studies with a small number of patients with OSA investigating platelet aggregability, which evaluates platelet aggregation more directly than the platelet activation status. We aimed to investigate the effects of OSA and nasal con-tinuous positive airway pressure (nCPAP) therapy, a well-established treatment for OSA, on platelet aggregability .Methods and Results: We examined 124 consecutive patients with snoring in whom the 3% oxygen desaturation index (3%ODI), a severity marker of OSA, and ADP- and collagen-induced platelet aggregability measured with the optical aggregometer were analyzed. ADP-induced platelet aggre-gability was increased more in patients with moderate-to-severe OSA (3%ODI>15) than in patients with non-to-mild OSA (p=0.029). In multiple linear models, 3%ODI significantly contributed to increased platelet aggregability induced by both ADP and collagen among 59 subjects with one or more risk factors for vascular diseases, such as smoking, hypertension, diabetes mellitus or hyperlip-idemia. In 23 patients treated by nCPAP, collagen-induced platelet aggregability was ameliorated on Day 90, compared to at the baseline. Conclusion: The severity of OSA significantly contributed to platelet aggregability, which was improved by nCPAP treatment partially at three months.

 

PMID: 20032579 [PubMed - as supplied by publisher

 

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Arch Gynecol Obstet. 2009 Dec 22. [Epub ahead of print]

Influence of self-reported snoring and witnessed sleep apnea on gestational hypertension and fetal outcome in pregnancy.

Ayr?m A, Keskin EA, Ozol D, Onaran Y, Y?ld?r?m Z, Kafali H.

 

Department of Gynecology and Obstetrics, Fatih University Faculty of Medicine, Ankara, Turkey.

INTRODUCTION: Hormonal and physical changes during pregnancy are associated with some sleep-related breathing disorders (SRBD) such as snoring and sleep apnea, and SRBD are associated with recurrent episodes of oxyhemoglobin desaturation and increased sympathic activity. We aimed to search the incidence of self-reported snoring and witnessed apnea in the third trimester of pregnancy and to analyze their influence on fetal outcome and gestational hypertension (GH). METHODS: Two hundred pregnant women (group 1) during their stay for labor and 200 age-matched control women (group 2) were included in the study. All patients were asked to complete a detailed questionnaire that covers demographic features. We measured neck circumference and performed Epworth sleepiness scale (ESS) to determine excessive daytime sleepiness in all patients. RESULTS: The mean age was 27.4 +/- 6.7 and 26.3 +/- 5.8 for group 1 and 2, respectively. Habitual snoring was detected only in group 1 in 5 patients; 36 pregnant women and 7 control patients reported occasional snoring. Both habitual and occasional snoring was significantly observed to be increased in pregnancy. Witnessed sleep apnea was been observed only in 1 patient in group 1. The mean neck circumference was 37.4 +/- 3.2, 35.1 +/- 2.1 cm and ESS was 6.7 +/- 3.01, 5.1 +/- 2.1 for group 1 and 2, respectively (p < 0.05). There was no significant correlation between snoring and GH. There was no significant relationship between all investigated parameters and fetal outcome. We found that excessive weight gain during pregnancy is significantly associated with snoring. CONCLUSION: We concluded that, although pregnant women, especially who gain excessive weight during their pregnancy, significantly snore more than nonpregnant women, this did not affect fetal outcome.

PMID: 20033421 [PubMed - as supplied by publisher]

 

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Clinics (Sao Paulo). 2009;64(12):1205-10.

Sleep in infants with congenital heart disease.

Ykeda DS, Lorenzi-Filho G, Lopes AA, Alves RS.

 

Physiotherapy Department, Instituto do Coração, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo - São Paulo/SP, Brazil.

OBJECTIVES: To investigate hypoxia and sleep disordered breathing in infants with congenital heart disease. METHODS: Prospective study. In-hospital full polysomnography was performed on 14 infants with congenital heart disease, age 7 +/-1 months, and in 7 normal infants, age 10 +/-2 months. Congenital heart disease infants were classified as acyanotic (n=7) or cyanotic (n=7). RESULTS: Nutritional status, assessed by the Gomez classification and expressed as % weight for age, was 70 +/-7, 59 +/-11 and 94 +/-16 in the acyanotic, cyanotic congenital heart disease and control infants, respectively (p<0.001). The respiratory disturbance index (AHI, events per hour) was [median (25-75%)]: 2.5 (1.0-3.4), 2.4 (1.5-3.1) and 0.7 (0.7-0.9) in acyanotic, cyanotic CHD infants and controls, respectively (p=0.013). Almost all congenital heart disease infants (11 out of 14) and only one control infant had an AHI >1 event/hour. The minimum oxygen saturation was 79% (74-82), 73% (57-74) and 90% (90-91) in the acyanotic, cyanotic congenital heart disease infants and controls, respectively (p <0.001). The arousal index (events/hour) was similar among the three groups at 8.4 +/-2.4, 10.3 +/-8.7 and 6.5 +/-3, respectively (p=0.451). CONCLUSIONS: Infants with congenital heart disease frequently present with sleep-disordered breathing associated with oxygen desaturations but not arousals. Therefore, sleep may represent a significant burden to infants with congenital heart disease.

PMID: 20037709 [PubMed - in process]

 

 

 

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Front Biosci (Schol Ed). 2010 Jan 1;2:30-46.

Disturbed sleep: linking allergic rhinitis, mood and suicidal behavior.

Fang BJ, Tonelli LH, J Soriano J, Postolache TT.

Mood and Anxiety Program (MAP), Department of Psychiatry, University of Maryland School of Medicine, 685 West Baltimore Street MSTF Building Room 930, Baltimore, MD 21201 USA.

Allergic inflammation is associated with mood disorders, exacerbation of depression, and suicidal behavior. Mediators of inflammation modulate sleep , with Th1 cytokines promoting NREM sleep and increasing sleepiness and Th2 cytokines (produced during allergic inflammation) impairing sleep. As sleep impairment is a rapidly modifiable suicide risk factor strongly associated with mood disorders, we review the literature leading to the hypothesis that allergic rhinitis leads to mood and anxiety disorders and an increased risk of suicide via sleep impairment. Specifically, allergic rhinitis can impair sleep through mechanical (obstructive) and molecular (cytokine production) processes. The high prevalence of mood and anxiety disorders and allergy, the nonabating suicide incidence, the currently available treatment modalities to treat sleep impairment and the need for novel therapeutic targets for mood and anxiety disorders, justify multilevel efforts to explore disturbance of sleep as a pathophysiological link.

PMID: 20036927 [PubMed - in process]

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Behav Brain Res. 2009 Dec 22. [Epub ahead of print]

Sleep enhances false memories depending on general memory performance.

Diekelmann S, Born J, Wagner U.

Department of Neuroendocrinology, University of Luebeck, Ratzeburger Allee 160, Haus 50, 23538 Luebeck, Germany.

Memory is subject to dynamic changes, sometimes giving rise to the formation of false memories due to biased processes of consolidation or retrieval. Sleep is known to benefit memory consolidation through an active reorganization of representations whereas acute sleep deprivation impairs retrieval functions. Here, we investigated whether sleep after learning and sleep deprivation at retrieval enhance the generation of false memories in a free recall test. According to the Deese, Roediger, McDermott (DRM) false memory paradigm, subjects learned lists of semantically associated words (e.g., "night", "dark", "coal"...), lacking the strongest common associate or theme word (here: "black"). Free recall was tested after 9hours following a night of sleep, a night of wakefulness (sleep deprivation) or daytime wakefulness. Compared with memory performance after a retention period of daytime wakefulness, both post-learning nocturnal sleep as well as acute sleep deprivation at retrieval significantly enhanced false recall of theme words. However, these effects were only observed in subjects with low general memory performance. These data point to two different ways in which sleep affects false memory generation through semantic generalization: One acts during consolidation on the memory trace per se, presumably by active reorganization of the trace in the post-learning sleep period. The other is related to the recovery function of sleep and affects cognitive control processes of retrieval. Both effects are unmasked when the material is relatively weakly encoded. Copyright © 2009. Published by Elsevier B.V.

 

 PMID: 20035789 [PubMed - as supplied by publisher]

 

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Population Health Management. 2009 Dec;12(6):317-23.

Review of insomnia pharmacotherapy options for the elderly: implications for managed care.

Taylor SR, Weiss JS.

1 Geisinger Health System , Henry Hood Center, Geisinger Center for Health Research, Danville, Pennsylvania.

Abstract The prevalence of insomnia in the elderly is significant. If left untreated or inappropriately treated, insomnia may contribute to increased health care resource use. Therefore, better identification and management of insomnia is required for this patient population. The etiology and magnitude of insomnia due to changes in circadian rhythms, comorbid conditions, and pharmaceutical agents are not well documented, and the utilization of over-the-counter and non-Food and Drug Administration (FDA)-approved agents to induce sleep (including antihistamines and ethyl alcohol) have not been studied in a natural setting. Evaluating the actual type of insomnia remains much more art than science for the majority of patients and providers. Another issue to consider in this population involves the relationship between patient and physician and the traditional passive patient role. Nonpharmacologic approaches (ie, cognitive behavioral therapy) for insomnia management are effective and usually are first-line therapy. However, the challenges to implementing these approaches may limit their use, thus necessitating pharmacologic therapy. There are currently 3 FDA-approved drug classes for the treatment of insomnia: benzodiazepines, benzodiazepine receptor agonists, and melatonin receptor agonists. Although all agents in these classes are efficacious, benzodiazepines and benzodiazepine receptor agonists are associated with adverse events that must be considered when treating insomnia in the elderly. Melatonin agonists have a mechanism of action that regulates normal sleep-wake cycles and readjusts circadian rhythms, which may confer a better safety profile than traditional sedative-hypnotics that target gamma-aminobutyric acid receptors. Because the 3 currently approved drug classes for insomnia have similar efficacy, safety considerations should be of paramount importance for the elderly patient; however, additional data are needed to appropriately assess the risk-benefit ratios of each. (Population Health Management 2009;12:317-323).

 

PMID: 20038257 [PubMed - in process]

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Groupe Santé Sommeil

Le groupe médical Santé Sommeil a pour vocation de diagnostiquer et traiter les troubles du sommeil et de la veille chez l’adulte et l’enfant.