The Role of Daytime Sleepiness in Psychosocial Outcomes After Treatment for Obstructive Sleep Apnea.

The role of daytime sleepiness in psychosocial outcomes after treatment for obstructive sleep apnea.

Sleep Disord. 2013; 2013: 140725
Lau EY, Eskes GA, Morrison DL, Rajda M, Spurr KF

We investigated the role of daytime sleepiness and sleep quality in psychosocial outcomes of patients with obstructive sleep apnea (OSA) treated with continuous positive airway pressure (CPAP). Thirty-seven individuals with moderate to severe OSA and compliant with CPAP treatment for at least 3 months were compared to 27 age- and education-matched healthy controls. The OSA group and the control group were studied with overnight polysomnography (PSG) and compared on measures of daytime sleepiness (Epworth Sleepiness Scale), sleep quality (Pittsburg Sleep Quality Index), mood (Beck Depression Inventory, Profile of Mood States), and functional outcomes (Functional Outcomes of Sleep Questionnaire). After CPAP treatment, the OSA group improved on sleep quality and sleepiness. As a group, they did not differ from controls on sleep architecture after CPAP. The OSA group also showed significant improvements in functional outcomes and was comparable to controls on mood and functional outcomes. Persistent difficulties included lowered activity level and residual sleepiness in some individuals. Sleepiness was found to be a significant predictor of mood and affective states, while both sleepiness and sleep quality predicted functional outcomes. These results highlight the importance of assessment and intervention targeting psychosocial functioning and sleepiness in individuals with OSA after treatment. HubMed – depression

Neurochemical Analysis of Primary Motor Cortex in Chronic Low Back Pain.

Brain Sci. 2012 Sep 1; 2(3): 319-331
Sharma NK, Brooks WM, Popescu AE, Vandillen L, George SZ, McCarson KE, Gajewski BJ, Gorman P, Cirstea CM

The involvement of the primary motor cortex (M1) in chronic low back pain (LBP) is a relatively new concept. Decreased M1 excitability and an analgesic effect after M1 stimulation have been recently reported. However, the neurochemical changes underlying these functional M1 changes are unknown. The current study investigated whether neurochemicals specific to neurons and glial cells in both right and left M1 are altered. N-Acetylaspartate (NAA) and myo-inositol (mI) were measured with proton magnetic resonance spectroscopy in 19 subjects with chronic LBP and 14 healthy controls. We also examined correlations among neurochemicals within and between M1 and relationships between neurochemical concentrations and clinical features of pain. Right M1 NAA was lower in subjects with LBP compared to controls (p = 0.008). Left M1 NAA and mI were not significantly different between LBP and control groups. Correlations between neurochemical concentrations across M1s were different between groups (p = 0.008). There were no significant correlations between M1 neurochemicals and pain characteristics. These findings provide preliminary evidence of neuronal depression and altered neuronalglial interactions across M1 in chronic LBP. HubMed – depression

Factors related to increasing trends in cigarette smoking of adolescent males in rural areas of Korea.

J Prev Med Public Health. 2013 May; 46(3): 139-46
Hong NS, Kam S, Kim KY

Cigarette smoking prevalence among adolescent males in rural areas of Korea has increased in recent years. The aim of this study was to explore the factors related to increasing trends in cigarette smoking among adolescent males living in rural areas.The raw data from the Korea Youth Risk Behavior Web-based Survey from 2006 to 2009 were used. Data were analyzed by using the method of complex survey data analysis considering complex sampling design. Multiple logistic regression models were used to explore the factors affecting cigarette smoking. We evaluated the linear time trends in the prevalence of factors that were related to current smoking status and the linear time trends in cigarette smoking in groups stratified by the exposure to each factor using logistic regression models. Finally, we examined the contributions of the factors to the time trends in cigarette smoking by adjusting for each of those factors in the baseline regression models and changes in the adjusted odds ratio by survey year.A statistically significant increasing trend in smoking was observed after adjusting for the factors affecting cigarette smoking. Significant factors related to cigarette use were perceived stress, experience with depression, current alcohol drinking, exposure to secondhand smoke, and academic performance. The factor related to increasing trends in cigarette smoking was academic performance.Stress about academic performance is an important factor affecting the increase in cigarette smoking among adolescent males in a rural area of Korea. HubMed – depression

Plasma Amyloid-? Peptides and Homocysteine in Depression in the Homebound Elderly.

N Am J Med Sci (Boston). 2010 Apr; 3(2): 61-67
Qiu WQ, Sun X, Mwamburi DM, Haker J, Lisle D, Rizal A, Lin YM, Qiao L, Summergrad P, Folstein M, Rosenberg I

Both plasma amyloid-? peptide 40 (A?40) and homocysteine (tHcy) are linked to vascular disease, which is related to depression in the elderly. We sought to study whether the relationship between tHcy and plasma A?40 differs in those with and without depression.In a cross-sectional study of 1058 homebound elders, vascular depression was defined as a score ? 16 on the Center for Epidemiological Studies Depression scale (CES-D) along with self-reported cardiovascular disease (CVD). Plasma A?40 and A?42, and serum tHcy and creatinine were measured.Elders with high tHcy had higher concentrations of plasma A?40 (median: 147.5 vs. 123.1 pg/ml, P < 0.0001) and A?42 (median: 20.2 vs. 16.6 pg/ml, P < 0.0001) than those with low tHcy. In elders with depression, the relationship between logarithm of plasma A?40 (LogA?40), but not LogA?42, and tHcy was significant (? = +0.010, SE = 0.004, P = 0.007); in contrast, this relationship was not observed in those without depression. Subjects with vascular depression had the highest concentration of tHcy (mean ± SD: 12.8 ± 4.6 vs. 11.7 ± 4.5 vs. 11.9 + 5.5, P = 0.008) compared to those without CVD and those without depression. Depressed subjects without CVD had the lowest concentration of plasma A?42 (median: 15.5 vs. 19.1 vs. 18.7, P = 0.01) compared to those with CVD and those without depression.Vascular depression, which is associated with tHcy and A?40 in blood, appears to be different from depression that is associated with low plasma A?42. This suggests that reducing tHcy and A?40 may be an adjunct treatment for vascular depression. HubMed – depression