Sleep quality and duration are associated with the development of urologic symptoms like erectile dysfunction and lower urinary tract symptoms. Two studies presented at the American Urological Association meeting link sleep and urologic health:
1) A study of 870 men found those with erectile dysfunction were over twice as likely to be at high risk for obstructive sleep apnea. Risk increased with erectile dysfunction severity.
2) A longitudinal study of over 3,000 men and women found short sleep duration and poor sleep quality predicted later development of lower urinary tract symptoms, urinary incontinence, and nocturia. Improving sleep may benefit urologic health.
Background and objective: One of the diseases that increase the risk of seizures in the person is multiple sclerosis. Several studies have reported multiple sclerosis as a risk factor for seizure. This study was conducted to determine the frequency of seizure types in patients with Multiple Sclerosis (MS) referred to Alavi hospital in Ardebil city north-west of Iran.
Can brain atrophy measurement help us in monitoring MS progression in routine...MS Trust
This presentation by Dana Horáková, Department of Neurology and Centre of Clinical Neuroscience at the Charles University in Prague, looks at why and how we should measure brain atrophy.
It was presented at the MS Trust Annual Conference in November 2014.
Background and objective: One of the diseases that increase the risk of seizures in the person is multiple sclerosis. Several studies have reported multiple sclerosis as a risk factor for seizure. This study was conducted to determine the frequency of seizure types in patients with Multiple Sclerosis (MS) referred to Alavi hospital in Ardebil city north-west of Iran.
Can brain atrophy measurement help us in monitoring MS progression in routine...MS Trust
This presentation by Dana Horáková, Department of Neurology and Centre of Clinical Neuroscience at the Charles University in Prague, looks at why and how we should measure brain atrophy.
It was presented at the MS Trust Annual Conference in November 2014.
Prevalence of epilepsy, human and porcine cysticercosis in western KenyaILRI
Poster by A.C. Meyer, D. Sokhi, A. Ngugi, T. Solomon and E. Févre presented at the 64th annual meeting of the American Society of Tropical Medicine and Hygiene, Philadelphia, Pennsylvania, USA, 25-29 October 2015.
Rodger - Prostate cancer mortality outcomes and patterns of primary treatment...Cancer Council NSW
Prostate cancer mortality outcomes and patterns of primary treatment for Aboriginal men in New South Wales, Australia
BJU International http://onlinelibrary.wiley.com/doi/10.1111/bju.12899/abstract
ABSTRACT: Evaluation of morbidity profile among elderly people will help in the application of intervention to improve the health status of elderly. Communicable diseases do not show a fixed pattern of change with the age of man. However,non-communicable diseases like hypertension, Diabetes Mellitus ,musculoskeletal disorders,refractive errors, etc and their related complications become more prevalent in the elderly. Research showed that average number of morbidities per person was 2.77 among the elderly people of rural India. Elderly people are suffering from various physical,mental ,social and economical problems.It is essential to havegeriatric units with specialized professionals in the health care centres. Regular health check-up camps should be organized at old age homes. Insurance scheme should be implemented. Health problems of elderly should be tackled with psycho-social intervention. The present study was done to review the literature on geriatric morbidity. KEY WORDS: morbidity, geriatrics, review
There was a time when Man was the son of nature, interacting and part of the whole process of life. Then, as his fate, man progressed, invented, produced, flourished and finally prevailed on earth. He created artificial systems in which he lived, and at times seemed so close to being protected and safe from any natural phenomenal impact. Then he realized that his own creation, byproducts, beside his aggression against his own kind were being his enemy. In recent years, disasters increased in frequency, where grade 4 or more, hurricanes attacked the southern parts of the USA, as well in Asia. Large ice bergs cracked in Greenland, North and South poles, dissolving in the sea. There is an increase or rise of the Sea level, although it is few cms a year but it became a reality
https://crimsonpublishers.com/eaes/fulltext/EAES.000501.php
For more open access journals in Crimson Publishers
Please click on link: https://crimsonpublishers.com
For More Articles on Environmental Analysis & Ecology Studies
Please click on: https://crimsonpublishers.com/eaes/
A 40-year-old unmarried female presented with abnormal involuntary choreo-athetoid movements involving both upper limbs for 5 years along with features, such as bouts of disorientation, anxiety, personality changes, reckless behaviour, inappropriate laughter and progressive decline in the neurological status. On neurological examination, her speech was dysarthric with mild choreiform movements involving both upper limbs. She had MMSE score of 20/30. MRI scans of the brain plain T1- and T2-weighted axial and flair coronal images were obtained. It showed calcifications as hyper-intense lesions on T1W and hypo-intense T2W lesions in bilateral basal ganglion and bilateral dentate nuclei of cerebellum, that is consistent with Fahr's syndrome.
Prevalence of epilepsy, human and porcine cysticercosis in western KenyaILRI
Poster by A.C. Meyer, D. Sokhi, A. Ngugi, T. Solomon and E. Févre presented at the 64th annual meeting of the American Society of Tropical Medicine and Hygiene, Philadelphia, Pennsylvania, USA, 25-29 October 2015.
Rodger - Prostate cancer mortality outcomes and patterns of primary treatment...Cancer Council NSW
Prostate cancer mortality outcomes and patterns of primary treatment for Aboriginal men in New South Wales, Australia
BJU International http://onlinelibrary.wiley.com/doi/10.1111/bju.12899/abstract
ABSTRACT: Evaluation of morbidity profile among elderly people will help in the application of intervention to improve the health status of elderly. Communicable diseases do not show a fixed pattern of change with the age of man. However,non-communicable diseases like hypertension, Diabetes Mellitus ,musculoskeletal disorders,refractive errors, etc and their related complications become more prevalent in the elderly. Research showed that average number of morbidities per person was 2.77 among the elderly people of rural India. Elderly people are suffering from various physical,mental ,social and economical problems.It is essential to havegeriatric units with specialized professionals in the health care centres. Regular health check-up camps should be organized at old age homes. Insurance scheme should be implemented. Health problems of elderly should be tackled with psycho-social intervention. The present study was done to review the literature on geriatric morbidity. KEY WORDS: morbidity, geriatrics, review
There was a time when Man was the son of nature, interacting and part of the whole process of life. Then, as his fate, man progressed, invented, produced, flourished and finally prevailed on earth. He created artificial systems in which he lived, and at times seemed so close to being protected and safe from any natural phenomenal impact. Then he realized that his own creation, byproducts, beside his aggression against his own kind were being his enemy. In recent years, disasters increased in frequency, where grade 4 or more, hurricanes attacked the southern parts of the USA, as well in Asia. Large ice bergs cracked in Greenland, North and South poles, dissolving in the sea. There is an increase or rise of the Sea level, although it is few cms a year but it became a reality
https://crimsonpublishers.com/eaes/fulltext/EAES.000501.php
For more open access journals in Crimson Publishers
Please click on link: https://crimsonpublishers.com
For More Articles on Environmental Analysis & Ecology Studies
Please click on: https://crimsonpublishers.com/eaes/
A 40-year-old unmarried female presented with abnormal involuntary choreo-athetoid movements involving both upper limbs for 5 years along with features, such as bouts of disorientation, anxiety, personality changes, reckless behaviour, inappropriate laughter and progressive decline in the neurological status. On neurological examination, her speech was dysarthric with mild choreiform movements involving both upper limbs. She had MMSE score of 20/30. MRI scans of the brain plain T1- and T2-weighted axial and flair coronal images were obtained. It showed calcifications as hyper-intense lesions on T1W and hypo-intense T2W lesions in bilateral basal ganglion and bilateral dentate nuclei of cerebellum, that is consistent with Fahr's syndrome.
Brief Report: OSA Evaluations for the Anaesthesiologist, Surgeon, Surgery Centresemualkaira
This short report presents a scope of the medical condition of Obstructive Sleep Apnea (OSA). Current methods for assessment and
diagnosis of OSA are presented. Complications and potential death
from untreated OSA places the anesthesiologist, surgeon and surgical center in a risk situation. Factors related to the risk factors
and points toward resolution are presented.
IMPACT OF SLEEP DISORDER ON OVERALL HEALTH1IMPACT OF SLEEP DISO.docxsheronlewthwaite
IMPACT OF SLEEP DISORDER ON OVERALL HEALTH 1
IMPACT OF SLEEP DISORDER ON OVERALL HEALTH 5
Formatting style: Vancouver (Alhola & Polo-Kantola, 2007)
Impact of sleep disorder on overall health
Instructor:
BIO-317V
11/29/19
Abstract
Sleep disorders have several impacts on overall health. With the increase in sleep disorders over the last few years, there is a need to identify some of the most common causes of sleep disorders and if factors such as age, gender, ethnicity and social status may be considered as risk factors. Different studies have been done to determine the impacts of sleep disorders on an individual’s overall health. The central focus of this research is to review some of these studies, and come up with a conclusion that tends to bring out these health impacts that are associated with sleep disorders, particularly, sleep deprivation.
Introduction
Sleep is considered as a biological process and it has regularly been essential for good life and optimal health (Wells & Vaughn, 2012). Sleep has been essential in controlling brain functioning, and even in other biological and systematic processes such as metabolism, regulation of appetite, and improving one’s immunity against a number of diseases, especially in children. Normally, a good sleep is associated by the duration of the sleep, the quality, and regularity among other factors. Although a number of studies, and even media, have covered the health benefits of sleep, more than 70 million individuals in the US are still suffering from sleep-related disorders, and moreover, in Europe, approximately 45 million people are also victims of these disorders. For instance, a study conferred that of all the car accidents that occur in the US, 20% are as a result of lack of enough sleep, or other disorders associated wit either too much sleep or lack of enough sleep (Palma et al., 2013).
There are a number of consequences that may arise as a result of sleep loss and other sleep-related disorders. As conveyed by Ming et al. (2011), the most common consequences that may be related to sleep include judgment errors, which may lead to disastrous events. On the other pedestal, some of the less visible consequences of sleep disorder include increased mortality and morbidity rate, car accidents and injuries, QoL, the well-being of the family, and utilization of healthcare services among the affected persons. Some of these consequences may arise a few minutes after having less hours of sleep, or too much sleep. However, there are some long-term impacts of sleep, for instance, obesity and hypertension. Sleeping for a longer duration enhances the body’s inactivity and this is greatly associated with obesity, which may also give chance to the development of hypertension and other cardiovascular complications. According to Ming et al. (2011), there are approximately 90-100 sleep disorders which may result from factors such as environmental factors, psychosocial issues, and ot ...
Sleep and dreams are taken for granted by those not affected by obstructive sleep apnea. Unfortunately in around 10 million population around the world, sleep is a nightly battle which leaves it‟s victims and their bed partners fatigued, stressed and much less healthy.
Untreated sleep apnea is one of the major public health issues we face in common. The emergence of dental sleep medicine as a safe and effective treatment brings hope for the millions of patients looking for alternatives to CPAP treatment.
Oral appliances used to date constitute a relatively heterogeneous group of devices for the treatment of sleep apnea and non-apneic snoring.
As dental professionals, we have a significant role to play in the early diagnosis, management and care of patients suffering from sleep apnea. Oral appliances play a major role in the non surgical management of OSA and have become the first line of treatment in almost all patients suffering from OSA.
The interplay between anatomic, functional, and neural factors that influence the upper airway patency during wakefulness and sleep is still unclear. Although the role played by the prosthodontists is still in its infancy, there is much to learn and understand in the rapidly evolving field of sleep medicine.
The growing interest of prosthodontists in sleep medicine has contributed immensely toward effective prevention and treatment of OSA and sleep Bruxism for each patient based on his/her individual requirement
Comparative Studies of Diabetes in Adult Nigerians Lipid Profile and Antioxid...YogeshIJTSRD
The study sought to determine the extent to which the usage of social media in the marketing of agricultural products in South West Nigeria can enhance farmers turnover. It employed the survey research design to collect data with the help of a structured questionnaire to elicit information from respondents selected from six 6 south western states. Research data were analysed using structural equation modelling. The results showed that the use of social media WhatsApp and Facebook in marketing of agricultural products significantly enhances farmers turnover. The managerial implication is that use of Whatsapp and Facebook in the marketing of agricultural products for the enhancement of farmers’ turnover was found to have significant influence on the enhancement in farmers’ turnover from agricultural products. Policy makers in government should provide the enabling environment for the telecommunication companies to enhance their reach by installing their facilities across the length and breadth of the country so that the network coverage will be strong at all times so that the benefits of social media usage will not be constrained. Egejuru, Leonard O | Akubugwo, Emmanuel I | Ugorji, Beatrice N "Comparative Studies of Diabetes in Adult Nigerians: Lipid Profile and Antioxidants Vitamins (A and C)" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-5 , August 2021, URL: https://www.ijtsrd.com/papers/ijtsrd45021.pdf Paper URL: https://www.ijtsrd.com/biological-science/biochemistry/45021/comparative-studies-of-diabetes-in-adult-nigerians-lipid-profile-and-antioxidants-vitamins-a-and-c/egejuru-leonard-o
Top 10 killers.H&HN Hospitals & Health Networks. Nov 2012 v86.docxedwardmarivel
Top 10 killers.
H&HN Hospitals & Health Networks. Nov 2012 v86 i11 p68(1).
Full Text:COPYRIGHT 2012 Health Forum, Inc.
Here are the leading causes of death in the United States and the number of lives they took in 2010, based on preliminary data from the Centers for Disease Control and Prevention.
1. Heart disease (599,413)
2. Cancer (567,628)
3. Chronic lower respiratory diseases (137,353)
4. Stroke (cerebrovascular diseases) (128,842)
5. Accidents (unintentional injuries) (118,021)
6. Alzheimer's disease (79,003)
7. Diabetes (68,705)
8. Influenza and pneumonia (53,692)
9. Nephritis, nephrotic syndrome and nephrosis (48,935)
10. Intentional self-harm (suicide) (36,909)
Source: CDC/National Center for Health Statistics, 2012
Record Number: A311049240
CHOOSE ONE DISEASE AND DISCUSS IN 200-300 WORDS
CDC report provides snapshot of U.S. health.
Mary Ann Moon. Internal Medicine News. March 15, 2010 v43 i5 p64(1).
Full Text:COPYRIGHT 2010 International Medical News Group
The use of medical technology has grown dramatically over the last decade, according to the federal government's annual health report.
That's just one finding in the massive "Health, United States, 2009," a snapshot of Americans' health, which the Centers for Disease Control and Prevention compiles yearly as "an essential step in making sound health policy and setting research and program priorities."
This year's edition, the 33rd, includes a special section on medical technology, which includes procedures, tests, drugs, devices, and support systems such as computerized records. The principal findings in this section include:
* The use of MRI, CT, and PET imaging soared during the past decade. The number of such imaging studies either ordered or provided by physician offices and hospital outpatient departments more than tripled; those ordered or provided by emergency departments quadrupled.
* The rate of knee replacement surgery performed in patients aged 45 years and older rose 70% during the same interval, from 26 to 45 per 10,000 population. The rate of total hip replacement surgery increased by 33%, and that of partial hip replacements increased by 60%.
* The rate of angioplasty without stent placement declined by 80% during the past decade. Drug-eluting stents have rapidly replaced bare-metal stents and were used in 75% of angioplasties in 2006.
* The number of assisted reproductive technology cycles doubled during the past decade, with the fastest rate of growth occurring in women older than 40 (11% per year).
* The rate of outpatient upper endoscopies rose by 90%, and the rate of outpatient colonoscopy tripled during the same interval.
* The use of diabetes drugs among patients aged 45 and older increased approximately 50%, and that of statins soared 10-fold in the past decade.
* The percentage of people taking at least one prescription drug during the preceding month rose from 38% in the 1980s and 1990s to 47% in recent years. The percentage taking three or ...
JONAVolume 47, Number 1, pp 41-49Copyright B 2017 Wolters .docxvrickens
JONA
Volume 47, Number 1, pp 41-49
Copyright B 2017 Wolters Kluwer Health, Inc. All rights reserved.
T H E J O U R N A L O F N U R S I N G A D M I N I S T R A T I O N
The Effect of Reported Sleep,
Perceived Fatigue, and Sleepiness on
Cognitive Performance in a Sample of
Emergency Nurses
Lisa A. Wolf, PhD, RN, CEN, FAEN
Cydne Perhats, MPH
Altair Delao, MPH
Zoran Martinovich, PhD
OBJECTIVE: The aim of this study is to explore
the relationship between reported sleep, perceived
fatigue and sleepiness, and cognitive performance.
BACKGROUND: Although evidence suggests that
fatigue and sleepiness affect the provision of care in
inpatient units, there is a lack of research on the sleep
patterns of emergency nurses and the effects of dis-
turbed sleep and fatigue on their cognitive abilities
and susceptibility to medical errors.
METHODS: A quantitative correlational design was
used in this study; in each of 7 different statistical models,
zero-order relationships between predictors and the
dependent variable were examined with appropriate
inferential tests.
RESULTS: Participants reported high levels of
sleepiness and chronic fatigue that impeded full
functioning both at work and at home.
CONCLUSIONS: Although high levels of self-reported
fatigue did not show any effects on cognitive function,
other factors in the environment may contribute to
delayed, missed, or inappropriate care. Further research
is indicated.
Studies of worker fatigue in the military and com-
mercial trucking industries1,2 suggest that long hours,
especially extending into overnight, can be hazardous
in terms of the potential for errors due to sleepiness
and reduced vigilance. Medical providers, both nurses
and physicians, are at risk because of the need for
around-the-clock coverage and the number and type
of decisions they must make in a given time span; in
1989, the Bell Commission Report cited sleep depri-
vation in medical house officers as a major contrib-
utor to the 1984 death of Libby Zion, an 18-year-old
who died at New York Hospital, leading to a restruc-
turing of the hours involved in medical residencies.3
The long (up to 36 hour) shifts of the medical resi-
dents in charge of her care and the consequences of
their fatigue on the decisions that were made were
cited as factors in her death. As a result of their inves-
tigation of the case, the Bell commission recommen-
ded limiting the work hours of medical residents to
less than 80 hours a week and no more than 24 hours
in a row, and subsequent research has led to similar
recommendations for the nursing workforce.4,5
Emergency care settings are chaotic environ-
ments, where there is high patient turnover, constantly
changing priorities and frequent changes in patient
condition. High demand work settings are associated
with increased fatigue, which can impair nurses_ at-
tentiveness and ability not only to recognize potential
errors they might commit but also to recognize and
mitigate the errors of others, inc ...
A Comparative Study of Anthropometric Characteristics and Blood Pressure betw...ijtsrd
Background Hypertension is a frequently encountered multifactorial disorder and its prevalence is reported to increase in postmenopausal females. Cardiovascular disease is the leading cause of death in women. Furthermore, there is evidence that hormonal changes also leads to anthropometric changes associated with hypertension.Aim - To compare the anthropometric measures and blood pressure of pre and post menopausal women and find the association between anthropometric measures and hypertension.Methodology - A comparative study was conducted on 50 pre and 50 post menopausal women. The sampling method was purposive sampling and conducted in Goyala Vihar of Delhi. The door to door survey was conducted and data was collected using kobo tool. The measurements of BP, weight, height, hip and waist circumference was done following the protocols. The data was analysed using SPSS software.Result and conclusion - The result was significant for all variables Age, Wt, BMI, HC, WC, WHR and BAI except Ht. Independent T test was used to compare. Correlation and regression depicted that age is the predictor for diastolic blood pressure in pre menopausal women and for post menopausal women age, Ht, Wt, BMI, WC and HC are predictor of diastolic blood pressure. Women in post menopausal stage were at high risk of HTN compared to pre menopausal women. Jyoti Yadav "A Comparative Study of Anthropometric Characteristics and Blood Pressure between Pre and Post - Menopausal Women in Poor Urban Area, Goyala Vihar, Delhi" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-7 | Issue-4, August 2023, URL: https://www.ijtsrd.com/papers/ijtsrd59641.pdf Paper Url:https://www.ijtsrd.com/other-scientific-research-area/other/59641/a-comparative-study-of-anthropometric-characteristics-and-blood-pressure-between-pre-and-post---menopausal-women-in-poor-urban-area-goyala-vihar-delhi/jyoti-yadav
1. EMBARGOED FOR RELEASE UNTIL SATURDAY, MAY 14, 2011 AT 2:00 P.M.
Contact: Wendy Waldsachs Isett, AUA
410-977-4770, wisett@AUAnet.org
STUDIES LINK QUALITY OF SLEEP TO ERECTILE DYSFUNCTION, OTHER UROLOGIC CONDITIONS
Washington, DC May 14, 2011 – Two studies that link the quality of sleep to the occurrence of erectile
dysfunction (ED) and other urologic conditions will be presented to reporters during a special press conference
at the Walter E. Washington Convention Center in Washington, DC, today, Sunday, May 14, at 2:00 p.m. during
the 2011 Annual Meeting of the American Urological Association (AUA). The session will be moderated by Kevin
McVary, MD.
Erectile Dysfunction Is Independently Associated With Sleep Apnea In A Large Population Of Middle-Aged
Men (#1325): In the largest study to date demonstrating the relationship between obstructive sleep apnea
(OSA) and erectile dysfunction, researchers from Mount Sinai Medical Center in New York evaluated 870
consecutively enrolled men in the ongoing Law Enforcement Cardiac Screening program (LECS), a subset of the
World Trade Center Medical Monitoring and Treatment Program. Patients who scored positive on the Berlin
Questionnaire (a widely used survey for OSA) were defined to be at high risk for OSA. ED was assessed by use of
the International Index of Erectile Function -5 (IIEF-5), and was defined as IIEF of less than 22. A multivariate,
binary logistic regression was performed to adjust for age, history of cardiovascular disease, systolic blood
pressure, diabetes, smoking and body mass index (BMI).
The mean age of the patients in the study population was 47.3 years, with a mean BMI of 30.2. Sixty-three
percent of the patients screened positive for OSA, 5.6 percent had a history of diabetes, and 29 percent had a
smoking history. After adjusting for age and comorbidities, the patients with ED were more than twice more
likely to have OSA than their normal counterparts. The likelihood of having OSA increased as the severity of
erectile dysfunction increased, suggesting that men with this condition should also be screened for OSA.
Sleep Predicts The Development Of Urologic Symptoms In A Longitudinal Study (#57): Sleep is a modifiable risk
factor that precedes certain urologic conditions (urinary incontinence [UI], lower urinary tract symptoms [LUTS]
and nocturia) in men and women, perhaps operating through inflammatory and other pathways, according to a
study by researchers at New England Research Institutes Inc. in Watertown, MA.
In the prospective cohort analyses of 1,610 men and 2, 535 women who completed the baseline and follow-up
phases of the Boston Area Community Health (BACH) survey, researchers followed the subjects for five years,
assessing sleep disturbance and the development of urologic symptoms. Baseline short sleep duration (men
only) was defined as sleeping fewer than five hours per night, and sleep quality was defined as having restless
sleep in the past week. LUTS were assessed using the AUA Symptom Index, urinary incontinence was defined as
weekly urine leakage, and nocturia was defined as needing to urinate more than two times per night after falling
asleep.
2. Incidence of LUTS among men (8 percent) and women (13 percent) was strongly related to short sleep duration
among men and restless sleep among men and women. Incidences of UI and nocturia were associated with
restless sleep among women but not men.
“We know that proper amounts of sleep and quality of sleep can impact a wide range of health conditions
including erectile function and lower urinary tract symptoms,” said AUA spokesperson Kevin T. McVary, MD.
“These data may help us better assess how helping patients modify their sleep patterns may help improve their
health and overall quality of life.”
NOTE TO REPORTERS: Experts are available to discuss this study outside normal briefing times. To arrange an
interview with an expert, please contact the AUA Communications Office at the number above or e-mail
Communications@AUAnet.org.
About the American Urological Association: Founded in 1902 and headquartered near Baltimore, Maryland, the American
Urological Association is the pre-eminent professional organization for urologists, with more than 17,000 members
throughout the world. An educational nonprofit organization, the AUA pursues its mission of fostering the highest standards
of urologic care by carrying out a wide variety of programs for members and their patients.
###
3. 1325
ERECTILE DYSFUNCTION IS INDEPENDENTLY ASSOCIATED WITH SLEEP APNEA IN A LARGE POPULATION OF
MIDDLE-AGED MEN
Boback Berookhim, Mary Ann McLaughlin, Mark Woodward, Rupa Iyengar, Simonette Sawit, Cynara Maceda
Jacqueline Moline, Natan Bar-Chama, New York, NY
INTRODUCTION AND OBJECTIVES: Obstructive sleep apnea (OSA) is a common condition, which has been
recently associated with erectile dysfunction (ED). A number of different mechanisms have been proposed to
describe this association, including endothelial dysfunction and nocturnal hypoxemia. The Berlin Questionnaire
is the most widely used questionnaire for OSA, with published sensitivity up to 86% and specificity of 87%
(Netzer NC, 1999, Ahmadi N, 2008). We aim to describe an independent association between patients with ED
and those at risk for OSA as assessed by the Berlin Questionnaire.
METHODS: We evaluated 870 consecutively enrolled men in the ongoing Law Enforcement Cardiac Screening
program (LECS), a subset of the World Trade Center Medical Monitoring and Treatment Program. Patients who
scored positive on the Berlin Questionnaire were defined to be at high risk for OSA. ED was assessed by use of
the International Index of Erectile Function -5 (IIEF-5), and was defined as IIEF < 22. A multivariate, binary logistic
regression was performed to adjust for age, history of cardiovascular disease, systolic blood pressure, diabetes,
smoking and body mass index (BMI).
RESULTS: The mean age of the patients in the study population was 47.3 years, with a mean BMI of 30.2. 63% of
patients screened positive for OSA, 5.6% of patients had a history of diabetes, and 29% had a smoking history.
After adjusting for age and comorbidities, patients with ED were more than twice as likely to have OSA than
their normal counterparts (OR 2.15, 95% confidence interval 1.42 ? 3.26, p = 0.0003). The likelihood of having
OSA increased as the severity of ED increased (Wilcoxon test, p= 0.0005) (see figure 1).
Normal Erectile Mild ED Mild to
Moderate ED Severe ED
Function (IIEF > (IIEF 17- Moderate ED
(IIEF 8-11) (IIEF < 8)
22) 21) (IIEF 12-16)
Percent of
patients at high 59% 72% 79% 83% 88%
risk for OSA
CONCLUSIONS: On multivariate analysis, ED is independently associated with patients at high risk for OSA, and
the risk of having OSA increased as the severity of ED increased. This is the largest study to date demonstrating
this relationship, and verifies recently published data (Budweiser, 2009). Given these findings, this study
suggests that men with ED should also be screened for OSA .
Source of Funding: The New York Fraternal Order of Police through the Charity Fund of the NY Office of the
Attorney General.
4. 57
SLEEP PREDICTS THE DEVELOPMENT OF UROLOGIC SYMPTOMS IN A LONGITUDINAL STUDY
Andre B. Araujo, Rebecca S. Piccolo, John B. McKinlay, Watertown, MA
INTRODUCTION AND OBJECTIVES: Current thinking regarding the association between urologic symptoms and
sleep implicitly assumes that the two are linked uni-directionally, i.e., that urologic symptoms (urinary
incontinence (UI), lower urinary tract symptoms (LUTS), and nocturia) lead to sleep disturbance in men and
women. However, it is highly plausible that sleep disturbance, which is associated with obesity and systemic
inflammation, leads to the development of urologic symptoms. We tested whether sleep predicts the
development of UI, LUTS, and nocturia in a longitudinal study.
METHODS: Prospective cohort analyses of 1,610 men and 2,535 women who completed the baseline (2002-05)
and follow-up (2006-10) phases of the Boston Area Community Health (BACH) survey, a population-based
random sample survey. Subjects were followed for approximately 5 years for the development of urologic
symptoms. Baseline short sleep duration (men only) was defined as sleeping < 5 h per night, and sleep quality
was defined as having restless sleep in the past week. Moderate-to-severe LUTS was defined by American
Urological Association Symptom Index ?8, urinary incontinence was defined as weekly urine leakage, and
nocturia was defined as 2+ urinations at night after falling asleep. Sex-specific logistic regression models of
incidence among those without UI, LUTS, and nocturia at baseline yielded odds ratios (OR) and 95% confidence
intervals (CI) that were adjusted for age, race/ethnicity, diabetes, heart disease, alcohol use, physical activity
and anti-depressant use (at baseline). Further adjustments were made for baseline body mass index (BMI) and
baseline C-reactive protein (CRP) levels to test for mediation of associations.
RESULTS: The mean age at baseline was 48 y. Short sleep duration was present in 18% of men, and restless sleep
in 34% of men and 42% of women. Incidence of LUTS among men (8%) and women (13%) was strongly related
to short sleep duration among men (OR: 1.97, 95% CI: 1.02, 3.78) and restless sleep among men (OR: 2.03, 95%
CI: 1.26, 3.28) and women (OR: 1.66, 95% CI: 1.10, 2.49). Incident UI (OR: 1.78, 95%: 1.06, 2.96) and nocturia
(OR: 1.90, 95%: 1.26-2.88) were associated with restless sleep among women but not men. Findings persisted
with adjustment for BMI and CRP, but OR estimates were considerably altered with adjustment for CRP.
CONCLUSIONS: This study identified sleep as a novel and modifiable risk factor that precedes urologic symptoms
in men and women, perhaps operating through inflammatory and other pathways.
Source of Funding: This study was supported by award number U01DK056842 from the National Institute of
Diabetes and Digestive and Kidney Disorders.