Abstracts of 4th International Congress of WASM & 5th Conference of CSS / Sleep Medicine 12, Suppl. 1 (2011) S1–S130
with AutoPAP for 3 weeks. Based on AutoPAP results CPAP was initiated with planned follow-up. Results: Seventeen patients were evaluated (71% male, age = 48.6±8.87). Eleven patients had evidence of sleep apnea (AHI = 50.7±29.49). CPAP was initiated in 10 patients (pressure = 14±3.89 cmH2O). We assessed adherence in 8 patients (hrs/night = 3.59±1.58 on 67.6±26.43% of nights). Following consultation and workup, 8 patients returned for follow-up. Labor and professional costs were approximately $4,620. Since most PAP equipment given to patients was donated to us, our equipment costs were minimal. Lost equipment costs were approximately $1,500 - three of our AutoPAP devices were not returned. Expected revenue, had we been billing, would have been approximately $18,722. Conclusion: We believe it is feasible to provide sleep services at modest cost to an indigent population. We believe the cost is worth the beneﬁt derived. The most diﬃcult aspect of this program has been patient follow-up. This population is often highly mobile and diﬃcult to contact. Despite this, it would be of interest to see if this model could be replicated in other communities. Acknowledgements: We are grateful for the support of our equipment vendors and patients who donated equipment and supplies to our program.
SLEEP AND HEALTH-RELATED QUALITY OF LIFE IN SOUTH AUSTRALIAN YEAR 6-7 CHILDREN BEFORE AND AFTER A SLEEP EDUCATION PROGRAM
Sarah Blunden, Hayley Etherton, Gabrielle Rigney. University of South Australia, Australia Introduction and Objectives: Initial studies have indicated school-based sleep education programs (SEP) can increase sleep knowledge and outcomes within adolescent populations. Blunden (2007a & 2007b) found that sleep knowledge signiﬁcantly increased and Kira et al. (2010) found sleep duration signiﬁcantly improved (all p <0.05) following the ACES SEP. Whether this SEP can also improve health-related quality of life (HRQoL) is yet to be established. This project aims to improve children’s sleep duration, eﬃciency (time in bed minus time awake) and HRQoL by implementing a school-based SEP. Materials and Methods: This study is a randomised control trial. South Australian metropolitan schools (N=4) were randomly selected and assigned as either intervention or control groups. Participants (N=120, aged 11-12 years) will complete the Child Health Utility 9D (CHU9D) and those randomly selected (N=60) will also wear actigraphy monitors for one week to measure sleep duration and eﬃciency. Parents will complete a demographic questionnaire for their child. The SEP is teacher delivered and sessions run 1/week for four weeks with an optional ﬁfth week on relaxation available. Groups will be assessed at baseline and then 5-6 weeks later following the SEP. Data collection is ongoing. Between groups analysis will evaluate the effectiveness of the intervention. Results: It is expected that participants in the intervention groups will increase their overall sleep time and eﬃciency after the sleep education program. Subsequently, participants in the intervention groups will also report improved HRQoL. Conclusion: Should signiﬁcant improvements be found it would be recommended that sleep education programs be introduced into schools in order to improve student’s sleep and HRQoL in a simple and cost-effective manner.
SLEEP COMPLAINTS AND QUALITY OF LIFE IN GYNECOLOGICAL CANCER PATIENTS
Marta Gonçalves 1 , Rita Cruz 2 , Susana Almeida 3 , Rui Mota-Cardoso 4. 1 Instituto do Sono, Portugal; 2 Porto Universuty Medical Faculty and Hospital de São João, Portugal; 3 Porto University Medical Faculty and Portuguese Institute of Oncology, Portugal; 4 Porto University Medical Faculty, Portugal Introduction and Objectives: Women diagnosed with gynecological cancer often present with sleep complaints. Moreover, it has been suggested by previous work that these type of complaints are strongly correlated with uncontrolled pain. Sleep disturbance can inﬂuence patient’s well-being self-awareness and quality of life, and we can anticipate a clinically relevant impact in a vulnerable population experiencing pain and distress. Furthermore, it may be helpful to know if sleep complaints precede or follow the diagnosis or treatment stage of illness in order to better inform
management. The objectives of this study are to assess gynecological cancer patients’ views about sleep and quality of life at the ﬁrst gynecologic consultation in a central hospital. Materials and Methods: Cross-sectional study. Sample of 36 women presenting to their ﬁrst appointment in a central hospital gynecological cancer outpatients clinic, recruited consecutively. Individual brief interviews were performed. Two self-completion questionnaires were used: EORTC-QLQ 30 scale for quality of life and Pittsburg Sleep Quality Index (PSQI). Results: Population’s age and education years (mean + SD) were 57+19,33 and 6,1 +3,7 respectively. Fifty percent reported fairly bad or very bad sleep quality (mean PSQI component 1 =1,44+0,9) and 30% were on sleep enhancing medication. Sample’s mean sleep eﬃciency was 75,6%+23%. The more distressful sleep disturbances were having to get out of bed to use the bathroom (component 5 question b score mean = 2,19+1,2) and pain (component 5 question i score mean= 1,58+1,4). PSQI total score mean was 9,3+4,9. Global health status’ mean was fair. Conclusion: Pain and sleep disturbance are common complaints in women presenting with gynecological cancer. Future follow-up cohort studies might help to clarify how these complaints progress and which patients may beneﬁt from early intervention.
SLEEP IN MIGRAINE AND TENSION TYPE HEADACHE IN CHILDREN: PRELIMINARY STUDY
Marcin Zarowski 1 , Monika Cieslik 1 , Marta Studzinska 1 , Arkadiusz Garczyk 1 , Barbara Steinborn 2 . 1 Polysomnography and Sleep Research Unit, Department of Developmental Neurology, Poznan University of Medical Sciences, Poznan, Poland, Poland; 2 Select, Poland Introduction and Objectives: A relationship between migraine headaches and sleep disturbances has been suggested in both adults and children. Clinical studies performed in adult populations indicate that certain headache types may be related to speciﬁc sleep stages, but there is a lack of research examining the relationship between primary headache and sleep in children. The aim of the study was to evaluate sleep disturbances in children with migraine and tension type headache (TTH). Materials and Methods: We evaluated nocturnal polysomnography (PSG) in 20 Migraine children and 11 TTH subjects. PSG records were manually scored. We used Fast Fourier Transformation to deconstruct EEG signals into primary frequency bands of beta, alpha, theta, and delta frequency domains. We analyzed central EEGs (C3-A2) and occipital EEGs (O2-A1) in ﬁrst episodes of N1, N2, N3 and REM sleep. Epochs containing artifact were removed. The spectral power of each frequency domain for each sleep state was compared between Migraine and TTH children. Results: On Sleep Macrostructure, sleep latency was signiﬁcantly longer in children with migraine (19.2min) than in TTH (11.6min) (p=0.048), N2 latency was longer in migraine (21.6min) than in TTH (13.0min) (p=0.028). The REM sleep latency was signiﬁcantly shorter in children with migraine (100.4min) than in TTH (153.2min) (p=0.011). The children with migraine had a mean of 5 REM periods vs. 4 periods in TTH. In persons with Migraine, theta power was signiﬁcantly higher in REM sleep, than in TTH patients. In central EEGs migraine children had 22.0% theta power vs. 14.5% for TTH children. In occipital EEGs migraine children had 18.9% theta power vs. 12.6% for TTH children. Conclusion: It is necessary to conduct further research on a larger group of patients with headaches in order to better correlate the prevalence of sleep disorder symptoms with the type of primary headache and daytime functioning.
SYMPTOMS CLUSTER IN PERSONS WITH MULTIPLE SCLEROSIS AND THEIR IMPACT ON SLEEP DISORDERS
Shahnaz Shahrbanian 1 , Nancy Mayo 1 , Pierre Duquette 2 , Ayse Kuspinar 1 , Shang Yuan Teng 1 . 1 McGill University, Canada; 2 Hôpital Notre-Dame du CHUM, Canada Introduction and Objectives: Multiple sclerosis (MS) is one of the most common neurological disabling conditions among young adults. Patients with MS often experience several concurrent symptoms, called a cluster symptom, which is believed in comparison to a single symptom, to have a stronger effect on disease consequences such as sleep disturbance. The objective of this study was to examine the existence of symptom cluster of