bahammam by Ahmed S BaHammam
Journal of Clinical Sleep Medicine, 2025
This commentary builds upon Zhang et al.'s study on insomnia and cardiovascular diseases, offerin... more This commentary builds upon Zhang et al.'s study on insomnia and cardiovascular diseases, offering constructive insights to strengthen Mendelian randomization (MR) methodologies in sleep research. It highlights key methodological challenges, including high heterogeneity (I² >90%) and weak genetic instruments, which may undermine causal inferences. Educational recommendations include adopting robust analytical tools such as MR-Egger regression and sensitivity analyses (e.g., Steiger filtering), alongside subgroup analyses and standardized insomnia definitions to improve precision and reliability. The commentary underscores the importance of interdisciplinary collaboration between genetic epidemiologists and sleep specialists, fostering methodological rigor and advancing the understanding of sleep traits' causal relationships with health outcomes.
Annals of Thoracic Medicine, 2025
BACKGROUND:
This study aimed to examine the impact of the COVID-19 lockdown on adherence to cont... more BACKGROUND:
This study aimed to examine the impact of the COVID-19 lockdown on adherence to continuous positive airway pressure (CPAP) therapy among Saudi patients with obstructive sleep apnea (OSA). It also sought to assess the influence of demographic variables and comorbidities on CPAP adherence.
METHODS:
A prospective cohort study was conducted at the University Sleep Disorders Center at King Saud University Medical City. The study included 67 OSA patients who exclusively used CPAP for treatment across three distinct intervals prelockdown, during lockdown, and postlockdown. Adherence to CPAP therapy was objectively measured using “mask-on on-time monitoring” data from the CPAP machines.
RESULTS:
The study found a significant decrease in the number of days with CPAP usage during the lockdown period, which persisted postlockdown. Approximately half of the patients adhered to CPAP treatment throughout the three study intervals. The decrease in CPAP usage days during lockdown was particularly noticeable among patients younger than 50 and older than 65 years of age. The presence of comorbidities, body mass index, and sex did not significantly influence CPAP treatment adherence.
CONCLUSION:
The COVID-19 lockdown significantly impacted CPAP treatment adherence among OSA patients, with a decrease in adherence persisting postlockdown. This highlights the need for interventions to support CPAP adherence during challenging times such as a pandemic. Further research is needed to understand the long-term effects of the pandemic on CPAP therapy adherence.
Journal of Clinical Sleep medicine, 2025
Study Objectives: To develop a comprehensive Asian Adult Sleep Medicine Fellowship Training Curri... more Study Objectives: To develop a comprehensive Asian Adult Sleep Medicine Fellowship Training Curriculum to address the significant disparities in sleep medicine training across Asia, guided by the principle of "One Curriculum, Many Contexts," providing a standardized yet adaptable framework for sleep medicine education across the diverse healthcare landscapes of Asian countries
Methods: The curriculum development process involved a gap analysis, comprehensive literature review, and expert consensus through a modified RAND Appropriateness Method (RAM)/Delphi survey.
Results: The curriculum offers two flexible tracks: a one-year program (Track A) and a two-year program (Track B), accommodating varied educational pathways and healthcare system structures across Asia. Key features of the curriculum include detailed learning outcomes, competency-based educational content, and recommendations for teaching and learning activities. The assessment strategy incorporates summative and formative methods, with standard setting and program evaluation guidelines. The curriculum also provides recommendations for program accreditation, fellow-faculty ratios, and funding considerations.
Conclusions: The Asian Adult Sleep Medicine Fellowship Training Curriculum provides a standardized yet adaptable framework for sleep medicine education across diverse Asian healthcare landscapes. By emphasizing flexibility and customization while maintaining high training standards, the curriculum aims to bridge the gap in sleep medicine training across Asia, ultimately improving the quality of sleep healthcare and patient outcomes throughout the region.
Asian Society of Sleep Medicine, 2024
The Asian Adult Sleep Medicine Fellowship Training Curriculum (1st Edition, 2024) represents a co... more The Asian Adult Sleep Medicine Fellowship Training Curriculum (1st Edition, 2024) represents a comprehensive educational framework developed by the Asian Society of Sleep Medicine (ASSM) under the principle of "One Curriculum, Many Contexts." This curriculum provides a standardized yet adaptable approach to sleep medicine training across Asia, offering both one-year and two-year tracks to accommodate diverse healthcare systems. The curriculum encompasses detailed competency-based educational content, structured learning outcomes, and comprehensive assessment methodologies. It was developed through a systematic process involving gap analysis, expert consensus, and RAM/Delphi surveys, with contributions from leading sleep medicine specialists across Asia. The curriculum addresses seven major categories of sleep disorders and includes rotations in various subspecialties, ensuring comprehensive training in both clinical and technical aspects of sleep medicine. This framework was created in response to findings that only 32% of surveyed Asian countries recognize sleep medicine as an independent specialty, aiming to standardize and enhance sleep medicine education throughout Asia while maintaining flexibility for local adaptation. The curriculum provides detailed guidelines for program implementation, teaching methodologies, assessment strategies, and quality assurance measures, serving as a foundational document for establishing and improving sleep medicine training programs across Asian healthcare systems.
Scientific Reports, 2024
The health advantages of Ramadan fasting, a time-restricted eating from dawn to dusk, have garner... more The health advantages of Ramadan fasting, a time-restricted eating from dawn to dusk, have garnered attention. Nevertheless, prior observational studies have found inconsistent findings because of challenges regulating variables such as sleep patterns, dietary habits, and physical activity. This study sought to investigate the impact of the Ramadan fasting model (RFM) on longevity and metabolic biomarkers in obese and non-obese rats. For 12 weeks, 48 male Wistar albino rats were separated into two groups and fed either a standard or a high-fat diet (HFD). During the final four weeks, rats in each group were separated into four subgroups to investigate the effect of RFM with/without training (on Treadmill) or glucose administration on the biomarkers of interest. The HFD groups subjected to RFM had significantly lower Insulin-like growth factor 1 (IGF-1) and mechanistic target of rapamycin (mTOR) serum, whereas AMPK, anti-inflammatory, and antioxidative stress serum levels were significantly higher. All groups reported decreased serum levels of Interleukin-6 (IL-6) and Tumor Necrosis Factor-alpha (TNF-α) compared to the HFD control group. Furthermore, the Real-Time Quantitative Polymerase Chain Reaction (RT-qPCR) results indicated a significant elevation in the TP53 gene expression in groups subjected to RFM. The data indicate that RFM can improve longevity and metabolic biomarkers and reduce pro-inflammation and oxidative stress. Also, RFM improves anti-inflammatory and antioxidant markers in HFD-induced obese rats.
Nature and Science of Sleep, 2024
Mendelian randomization (MR) has become an influential method for elucidating causal links betwee... more Mendelian randomization (MR) has become an influential method for elucidating causal links between sleep traits and disorders, and health outcomes. This article provides sleep medicine specialists with an overview of MR, emphasizing its applications and limitations in health research, particularly in the context of sleep research. The article addresses key challenges in conducting and interpreting MR studies on sleep, focusing on the core assumptions of relevance, exchangeability, and exclusion restriction. The importance of proper genetic instrument selection, bias mitigation, and cautious result interpretation is emphasized. Strategies are recommended to enhance the quality of MR studies in sleep medicine, including collaborations between MR experts and sleep specialists. The paper also explores sleep medicine-specific issues like analyzing binary traits and addressing heterogeneity in pooled analyses. Guidance is provided on transparent reporting of MR findings, stressing the need for comprehensive effect estimates, confidence intervals, and p-values. We conclude by advocating for rigorous MR implementation in sleep research to deepen our understanding of sleep-health relationships. By following best practices in study design, analysis, and reporting, researchers can reinforce the credibility and impact of MR findings in sleep medicine, ultimately improving patient care and public health strategies.
Journal of Clinical Sleep Medicine, 2024
Study Objectives: This study assessed the current state of sleep medicine accreditation and train... more Study Objectives: This study assessed the current state of sleep medicine accreditation and training in Asia by conducting a comprehensive survey across 29 Asian countries and regions facilitated by the Asian Society of Sleep Medicine to identify existing gaps and provide recommendations for future enhancements.
Methods: The Asian Society of Sleep Medicine Education Task Force Committee designed a survey to gather data on accreditation, education, and training standards in sleep medicine, including information on challenges in enhancing education in the field.
Results: With an 86% (25 countries/regions) response rate, the survey showed that sleep medicine is recognized as an independent specialty in just 9 countries/regions (36% of the countries/regions surveyed). Ten countries/regions have established sleep medicine training programs, with Japan and Saudi Arabia offering it as a distinct specialty. Significant disparities in training and accreditation standards were identified, with many countries/regions lacking formalized training and practice guidelines. The survey also revealed that most local sleep societies across Asia support the development of an Asian Sleep Medicine Training Curriculum led by the Asian Society of Sleep Medicine. However, several barriers significantly impede the establishment and development of sleep medicine training programs, including the scarcity of trained specialists and technologists and the absence of national accreditation for sleep medicine.
Conclusions: The survey highlights the need for standardized sleep medicine training and accreditation across Asia. Developing an Asian Sleep Medicine Training Curriculum and promoting Asian Society of Sleep Medicine accreditation guidelines are key recommendations. Implementing these strategies is essential for advancing sleep medicine as a widely recognized discipline throughout Asia.
Brain Science, 2024
Background/Objectives: Orthosomnia has become a concern in the field of sleep medicine. The purpo... more Background/Objectives: Orthosomnia has become a concern in the field of sleep medicine. The purpose of this cross-sectional study was to estimate the prevalence of orthosomnia in the general population. Methods: We collected data from 523 participants via the Generalized Anxiety Disorder Scale, Anxiety and Preoccupation about Sleep Questionnaire, and Athens Insomnia Scale. Additionally, we gathered information about participants’ use of commercial sleep-tracking wearable devices. Results: We developed a four-criteria algorithm to identify cases of orthosomnia: ownership of a wearable sleep-tracking device, AIS score ≥ 6, GAD-7 score ≤ 14, and APSQ score ≥ 40 or APSQ score ≥ 35 or APSQ score ≥ 30, for conservative, moderate, and lenient prevalence estimates, respectively. One hundred seventy-six (35.8%) (95% CI 34.6–40.1%) participants regularly used sleep-tracking devices. The prevalence rates of algorithm-identified orthosomnia in the study sample were: 16 participants (3.0%, 95% CI 1.6–4.5%), 45 participants (8.6%, 95% CI 6.2–11.0%), 73 participants (14.0%, 95% CI 10.9–16.9%) for the for conservative, moderate, and lenient prevalence estimates, respectively. Individuals with orthosomnia were not significantly different in terms of age and sex. The cases consistently had higher AIS scores than non-cases across all APSQ cutoffs, indicating more severe insomnia symptoms, with significant differences observed at each cutoff point. Conclusions: This study offers initial insights into the prevalence of orthosomnia within our sample at a specific time. The findings reveal notable rates of orthosomnia among individuals using sleep-tracking devices; however, we must acknowledge the limitations inherent in a cross-sectional design
Handbook of AI and Data Sciences for Sleep Disorders, 2024
Polysomnography (PSG) remains the gold standard diagnostic tool for sleep disorders, providing la... more Polysomnography (PSG) remains the gold standard diagnostic tool for sleep disorders, providing large volumes of raw data across various physiological signals such as brain activity, eye movement, muscle activity, and heart rate. This chapter focuses on the processes involved in extracting, exploring, and preprocessing PSG data for use in machine learning (ML) and deep learning (DL) applications. Preprocessing PSG data is critical to improving the performance of ML models by addressing issues like noise, missing values, and inconsistent formats.
The chapter outlines a general workflow for PSG modeling, starting with problem definition, raw data collection, and exploration. It delves into essential preprocessing techniques, including data cleaning, dimensionality reduction, normalization, and segmentation. These steps ensure the data is transformed into a usable format for building and training ML models aimed at diagnosing sleep disorders like obstructive sleep apnea (OSA).
Moreover, the chapter highlights the role of DL models such as convolutional neural networks (CNN) and long short-term memory (LSTM) networks in learning from PSG data. It also emphasizes the importance of public datasets, which can serve as valuable resources for developing and benchmarking AI-driven diagnostic models.
Ultimately, this chapter serves as a comprehensive guide to the preprocessing steps that are vital for extracting meaningful insights from PSG data and improving the accuracy of AI-driven sleep disorder diagnoses.
Sleep and Breathing, 2024
Purpose Several studies have shown that aerobic exercise training improves obstructive sleep apne... more Purpose Several studies have shown that aerobic exercise training improves obstructive sleep apnea (OSA) severity. However, a dose-response relationship has never been shown. This study aimed to quantify any dose-response relationships between time spent per week in aerobic exercise and key sleep apnea outcomes. Methods Randomized controlled trials (RCT) were selected from literature search studying the effects of supervised aerobic exercise training on patients with OSA. Dose-response meta-analyses were performed, where the 'dose' was the total weekly duration of aerobic exercise training. Primary outcomes were apnea hypopnea index (AHI), cardiorespiratory fitness (maximum oxygen consumption or VO 2 peak) and Epworth Sleepiness Scale (ESS). Results Analysis of data from 11 RCTs showed a non-linear dose-response relationship between the total weekly duration of aerobic exercise training and mean differences in AHI. Maximum effects on AHI (-10.92 (95%CIs:-15.57;-6.27)) were observed when the weekly duration of aerobic exercise reached 100 min/week. Similar non-linear dose-response trend was observed in the mean differences in VO 2 peak. Studies in which aerobic exercise training lasted ≥ 12 weeks showed greater proportional changes in mean AHI differences with maximal effects reaching a peak at ∼ 70 min/week of aerobic exercise training. ESS and total weekly duration of aerobic exercise training showed a linear dose-response relationship based on 4 RCTs. Conclusions Based on these analyses, aerobic exercise training of 70-100 min/week over 3 or 5 days a week should be recommended as adjunctive treatment for patients with OSA.
BMC Infectious Diseases, 2024
Background Self-medication practices involve the use of medications without healthcare profession... more Background Self-medication practices involve the use of medications without healthcare professional requests. The threat of coronavirus disease 2019 (COVID-19) caused the practice of a fittest to survive action, with the assumption that something is better than nothing. Moreover, owing to the lack of effective treatment for COVID-19, the general public has shifted toward self-medication and symptomatic treatment, with approximately 80% of people stockpiling medication for use during the pandemic. Thus, this study aimed to assess the factors associated with self-medication practices during the COVID-19 pandemic crisis in southwestern Ethiopia. Methods A community-based cross-sectional study design was employed at selected drug retail outlets in southwestern Ethiopia for 415 community pharmacy clients from July 1, 2021, to September 1, 2021. Purposive sampling techniques were employed to select five drug retail outlets on the basis of high patient flows, and we took the study participants until the required quota allotted to each selected drug retail outlet had been filled. Bivariable and multivariable logistic regression analyses were employed to identify factors associated with self-medication. AORs with 95% CIs were used to report associations, and the level of significance was set at P < 0.05. Results: Self-medication was significantly associated with being female (AOR 3.51, 95% CI 1.04-12.41), having a college education or above (AOR 47, 95% CI 4.32-55.21), time wastage at public health facilities (AOR 2.71, 95% CI 3.47-5.21), being afraid of contracting COVID-19 (AOR 0.006, 95% CI 0.004-0.185), and having high fees at public health facility (AOR 0.006, 95% CI 0.004-0.185). The most frequently used medications to treat or prevent the COVID-19 pandemic were analgesics (42.4%) and cold medicines (29.5%). Headache (22.2%), fever (13.2%), respiratory infection (14.3%), and cold (21.4%) were the most frequently reported symptoms of the COVID-19 pandemic. Conclusion This study revealed high self-medication practices among study area residents during the COVID-19 pandemic. The primary reasons for self-medication in the context of COVID-19 are fear of the pandemic and time wastage at public health facilities. Therefore, special attention should be given to educating public and health care providers on the types of illnesses that can be self-diagnosed and self-treated and the types of drugs to be used for self-medication.
Journal of Education and Health Promotion, 2024
BACKGROUND:
There is limited data on sleep, physical activity, and health-related behaviors amon... more BACKGROUND:
There is limited data on sleep, physical activity, and health-related behaviors among the general public during Ramadan, particularly during the COVID-19 pandemic. This study aimed to assess the factors associated with sleep and physical activity changes among Nigerian Muslims during Ramadan fasting.
MATERIALS AND METHODS:
A nationwide web-based cross-sectional study was conducted among Nigerians aged ≥18 years who performed diurnal fasting during Ramadan. The target sample size was obtained using Fisher’s formula, and snowball sampling was employed. Adapted versions of the International Physical Activity Questionnaire Short Form and Copenhagen Psychosocial Questionnaire II were used to evaluate sleep and physical activity. Correlates of change in physical activity and sleep quality were assessed using logistic regression analysis.
RESULTS:
Seven hundred and seventy individuals participated in the study. During Ramadan, 39.1% (95% confidence interval (CI): 35.6%–42.6%) reported decreased physical activity, and 56.6% (95% CI; 53.0%–60.2%) stated having self-reported good sleep. The independent correlates of physical activity were female sex (adjusted odds ratio (aOR):0.5, 95% CI: 0.4–0.8), having very good sleep (aOR: 0.4, 95% CI: 0.2–0.7), and obesity (aOR: 2.0, 95% CI: 1.1–3.7). In addition, factors associated with improved self-reported sleep quality were perceived good health state (aOR: 8.8, 95% CI: 1.1–72.4), sleeping 7–9 h per day (aOR: 5.5, 95% CI: 2.6–10.3), and sleeping for over 9 h per day (aOR: 4.6, 95% CI: 2.1–14.1).
CONCLUSIONS:
Although physical activity decreased by about a third, over half of the respondents lost weight and slept well during Ramadan. Strategies to include intermittent fasting in positive lifestyle changes could improve the health and well-being of the population.
Nature and Science of Sleep, 2024
Objective: We aimed to evaluate the effect of light–dark cycle alteration and soft drink consumpt... more Objective: We aimed to evaluate the effect of light–dark cycle alteration and soft drink consumption on the acceleration of type 1 diabetes mellitus (T1DM) development among non-obese diabetic (NOD) mice model.
Methods: We exposed female NOD and C57BL/6 mice from the age of 5 weeks to either adlib soft drink consumption and/or T20 light–dark cycle alteration until the development of diabetes, or the mice reached the age of 30 weeks. Each group consisted of 7– 15 mice. We monitored weight, length, blood glucose level, and insulin autoantibody (IAA) levels weekly.
Results: Out of 75 NOD and 22 C57BL/6 mice, 41 NOD mice developed diabetes, and 6 mice died between 7 and 8 weeks of age. The mean time to development of T1DM among NOD control mice was 20 weeks. The time to development of T1DM was accelerated by two weeks in the NOD mice exposed to light–dark cycle alteration, hazard ratio of 2.65,95th CI (0.70, 10.04) p = 0.15). The other groups developed T1DM, similar to the control group.
Conclusion: There was a trend toward earlier development of T1DM among NOD mice exposed to light–dark cycle alteration, but this difference was not statistically significant. Further studies are needed to confirm our findings using larger sample sizes and different animal species.
Chronobiology International, 2024
hronotype is an established concept designed to capture the internal clock’s phase in real-life c... more hronotype is an established concept designed to capture the internal clock’s phase in real-life conditions. It is vital in many aspects of daily life and can interfere considerably with numerous factors in a given population. Recognizing nonmodifiable and modifiable factors is crucial for identifying covariates of interest when studying the link between chronotype and health status. To date, chronotype and its related factors have not been extensively investigated. The present study aimed to explore the association of chronotypes with meal frequency, physical activity, and demographic factors among the Saudi population. This cross-sectional web-based questionnaire involved 1369 adults (aged 18 years and above) from the general public in Saudi Arabia and was conducted between March and May 2019. Chronotype was assessed using the reduced version of the original Horne and Ostberg morningness-eveningness questionnaire (MEQ). Meal frequencies and demographics data (age, gender, marital status, place of residence, educational level, employment status, income) were obtained. Physical activity level was also obtained using the international physical activity questionnaire. The MEQ scores group individuals into three categories: morning-type, neither-type, and evening-type. The neither-type individuals represented 41.6% (95% confidence interval [CI], 37.5% − 45.6%) of the study population, followed by the morning-type (34.1%; 95% [CI], 29.8% − 38.4%), then the evening-type (24.3%, 95% [CI], 19.6% − 28.9%). Chronotype was significantly associated with age, marital status, employment status and monthly income (All p < 0.05). Significant associations between chronotype with meal frequencies (number of meals per day, breakfast frequency, lunch frequency, and dinner frequency) and physical activity were also observed (All p < 0.05). This study highlights that meal frequencies and physical activity levels are associated with chronotype distribution. Furthermore, demographics, including age, marital status, employment status, and income, were associated with chronotype distribution.
Sleep Medicine Reviews, 2024
Primary snoring: Bridging gaps in management and research The editorial emphasizes the significan... more Primary snoring: Bridging gaps in management and research The editorial emphasizes the significance of developing a core outcome set and conducting network meta-analyses to compare intervention effectiveness. It also outlines key considerations for future research, including well-designed trials, comprehensive outcome assessment, and the incorporation of patient-centered factors. The editorial concludes by advocating for a multidisciplinary, evidence-based approach to optimize treatment outcomes for patients with primary snoring.
Annals of the American Thoracic Society, 2024
Sleep and Biological Rhythms, 2024
This mini-meta-analysis evaluated the internal consistency of the Anxiety and Preoccupation about... more This mini-meta-analysis evaluated the internal consistency of the Anxiety and Preoccupation about Sleep Questionnaire (APSQ) across existing studies to assess its potential as an orthosomnia (an obsessive preoccupation with achieving perfect sleep) screening tool. A systematic literature search identified four studies with 2,506 participants using English, Swedish, Turkish, and Arabic versions. Cronbach’s alpha ranged from 0.91 to 0.95 across studies. The APSQ demonstrated high overall internal consistency reliability (pooled Cronbach’s alpha of the entire ASPQ = 0.93, 95% CI 0.91–0.94), suggesting utility for screening orthosomnia symptoms. The pooled Cronbach’s alpha of the first and second factors of the ASPQ were: 0.91 (95% CI 0.89–0.93) and 0.87 (95% CI 0.84–0.89), respectively. APSQ demonstrated high overall internal consistency reliability; however, limited linguistic/cultural representation and significant heterogeneity across studies impact generalizability.
Journal of Clinical Sleep Medicine, 2024
STUDY OBJECTIVES:This study assessed the current state of sleep medicine accreditation and traini... more STUDY OBJECTIVES:This study assessed the current state of sleep medicine accreditation and training in Asia by conducting a comprehensive survey across 29 Asian countries and regions facilitated by the Asian Society of Sleep Medicine (ASSM) to identify existing gaps and provide recommendations for future enhancements.
METHODS:The ASSM Education Task Force Committee designed a survey to gather data on accreditation, education, and training standards in sleep medicine, including information on challenges in enhancing education in the field.
RESULTS:With an 86% (25 countries/regions) response rate, the survey showed that sleep medicine is recognized as an independent specialty in just nine countries/regions (36% of the countries/regions surveyed). Ten countries/regions have established sleep medicine training programs, with Japan and Saudi Arabia offering it as a distinct specialty. Significant disparities in training and accreditation standards were identified, with many countries/regions lacking formalized training and practice guidelines. The survey also revealed that most local sleep societies across Asia support the development of an Asian Sleep Medicine Training Curriculum led by the ASSM. However, several barriers significantly impede the establishment and development of sleep medicine training programs, including the scarcity of trained specialists and technologists and the absence of national accreditation for sleep medicine.
CONCLUSIONS:The survey highlights the need for standardized sleep medicine training and accreditation across Asia. Developing an Asian Sleep Medicine Training Curriculum and promoting ASSM accreditation guidelines are key recommendations. Implementing these strategies is essential for advancing sleep medicine as a widely recognized discipline throughout Asia.
Nature and Science of Sleep, 2024
Purpose: The COVID-19 pandemic affected the utilization of various healthcare services differenti... more Purpose: The COVID-19 pandemic affected the utilization of various healthcare services differentially. Sleep testing services utilization (STU), including Home Sleep Apnea Testing (HSAT) and Polysomnography (PSG), were uniquely affected. We assessed the effects of the pandemic on STU and its recovery using the Veterans Health Administration (VHA) data.
Patients and Methods: A retrospective cohort study from the VHA between 01/2019 and 10/2023 of veterans with age ≥ 50. We extracted STU data using Current Procedural Terminology codes for five periods based on STU and vaccination status: pre-pandemic (Pre-Pan), pandemic sleep test moratorium (Pan-Mor), and pandemic pre-vaccination (Pan-Pre-Vax), vaccination (Pan-Vax), and postvaccination (Pan-Post-Vax). We compared STU between intervals (Pre-Pan as the reference).
Results: Among 261,371 veterans (63.7± 9.6 years, BMI 31.9± 6.0 kg/m², 80% male), PSG utilization decreased significantly during Pan-Mor (− 56%), Pan-Pre-Vax (− 61%), Pan-Vax (− 42%), and Pan-Post-Vax (− 36%) periods all compared to Pre-Pan. HSAT utilization decreased significantly during the Pan-Mor (− 59%) and Pan-Pre-Vax (− 9%) phases compared to the Pre-Pan and subsequently increased during Pan-Vax (+6%) and Pan-Post-Vax (− 1%) periods. Over 70% of STU transitioned to HSAT, and its usage surged five months after the vaccine Introduction.
Conclusion: Sleep testing services utilization recovered differentially during the pandemic (PSG vs HSAT), including a surge in HSAT utilization post-vaccination.
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bahammam by Ahmed S BaHammam
This study aimed to examine the impact of the COVID-19 lockdown on adherence to continuous positive airway pressure (CPAP) therapy among Saudi patients with obstructive sleep apnea (OSA). It also sought to assess the influence of demographic variables and comorbidities on CPAP adherence.
METHODS:
A prospective cohort study was conducted at the University Sleep Disorders Center at King Saud University Medical City. The study included 67 OSA patients who exclusively used CPAP for treatment across three distinct intervals prelockdown, during lockdown, and postlockdown. Adherence to CPAP therapy was objectively measured using “mask-on on-time monitoring” data from the CPAP machines.
RESULTS:
The study found a significant decrease in the number of days with CPAP usage during the lockdown period, which persisted postlockdown. Approximately half of the patients adhered to CPAP treatment throughout the three study intervals. The decrease in CPAP usage days during lockdown was particularly noticeable among patients younger than 50 and older than 65 years of age. The presence of comorbidities, body mass index, and sex did not significantly influence CPAP treatment adherence.
CONCLUSION:
The COVID-19 lockdown significantly impacted CPAP treatment adherence among OSA patients, with a decrease in adherence persisting postlockdown. This highlights the need for interventions to support CPAP adherence during challenging times such as a pandemic. Further research is needed to understand the long-term effects of the pandemic on CPAP therapy adherence.
Methods: The curriculum development process involved a gap analysis, comprehensive literature review, and expert consensus through a modified RAND Appropriateness Method (RAM)/Delphi survey.
Results: The curriculum offers two flexible tracks: a one-year program (Track A) and a two-year program (Track B), accommodating varied educational pathways and healthcare system structures across Asia. Key features of the curriculum include detailed learning outcomes, competency-based educational content, and recommendations for teaching and learning activities. The assessment strategy incorporates summative and formative methods, with standard setting and program evaluation guidelines. The curriculum also provides recommendations for program accreditation, fellow-faculty ratios, and funding considerations.
Conclusions: The Asian Adult Sleep Medicine Fellowship Training Curriculum provides a standardized yet adaptable framework for sleep medicine education across diverse Asian healthcare landscapes. By emphasizing flexibility and customization while maintaining high training standards, the curriculum aims to bridge the gap in sleep medicine training across Asia, ultimately improving the quality of sleep healthcare and patient outcomes throughout the region.
Methods: The Asian Society of Sleep Medicine Education Task Force Committee designed a survey to gather data on accreditation, education, and training standards in sleep medicine, including information on challenges in enhancing education in the field.
Results: With an 86% (25 countries/regions) response rate, the survey showed that sleep medicine is recognized as an independent specialty in just 9 countries/regions (36% of the countries/regions surveyed). Ten countries/regions have established sleep medicine training programs, with Japan and Saudi Arabia offering it as a distinct specialty. Significant disparities in training and accreditation standards were identified, with many countries/regions lacking formalized training and practice guidelines. The survey also revealed that most local sleep societies across Asia support the development of an Asian Sleep Medicine Training Curriculum led by the Asian Society of Sleep Medicine. However, several barriers significantly impede the establishment and development of sleep medicine training programs, including the scarcity of trained specialists and technologists and the absence of national accreditation for sleep medicine.
Conclusions: The survey highlights the need for standardized sleep medicine training and accreditation across Asia. Developing an Asian Sleep Medicine Training Curriculum and promoting Asian Society of Sleep Medicine accreditation guidelines are key recommendations. Implementing these strategies is essential for advancing sleep medicine as a widely recognized discipline throughout Asia.
The chapter outlines a general workflow for PSG modeling, starting with problem definition, raw data collection, and exploration. It delves into essential preprocessing techniques, including data cleaning, dimensionality reduction, normalization, and segmentation. These steps ensure the data is transformed into a usable format for building and training ML models aimed at diagnosing sleep disorders like obstructive sleep apnea (OSA).
Moreover, the chapter highlights the role of DL models such as convolutional neural networks (CNN) and long short-term memory (LSTM) networks in learning from PSG data. It also emphasizes the importance of public datasets, which can serve as valuable resources for developing and benchmarking AI-driven diagnostic models.
Ultimately, this chapter serves as a comprehensive guide to the preprocessing steps that are vital for extracting meaningful insights from PSG data and improving the accuracy of AI-driven sleep disorder diagnoses.
There is limited data on sleep, physical activity, and health-related behaviors among the general public during Ramadan, particularly during the COVID-19 pandemic. This study aimed to assess the factors associated with sleep and physical activity changes among Nigerian Muslims during Ramadan fasting.
MATERIALS AND METHODS:
A nationwide web-based cross-sectional study was conducted among Nigerians aged ≥18 years who performed diurnal fasting during Ramadan. The target sample size was obtained using Fisher’s formula, and snowball sampling was employed. Adapted versions of the International Physical Activity Questionnaire Short Form and Copenhagen Psychosocial Questionnaire II were used to evaluate sleep and physical activity. Correlates of change in physical activity and sleep quality were assessed using logistic regression analysis.
RESULTS:
Seven hundred and seventy individuals participated in the study. During Ramadan, 39.1% (95% confidence interval (CI): 35.6%–42.6%) reported decreased physical activity, and 56.6% (95% CI; 53.0%–60.2%) stated having self-reported good sleep. The independent correlates of physical activity were female sex (adjusted odds ratio (aOR):0.5, 95% CI: 0.4–0.8), having very good sleep (aOR: 0.4, 95% CI: 0.2–0.7), and obesity (aOR: 2.0, 95% CI: 1.1–3.7). In addition, factors associated with improved self-reported sleep quality were perceived good health state (aOR: 8.8, 95% CI: 1.1–72.4), sleeping 7–9 h per day (aOR: 5.5, 95% CI: 2.6–10.3), and sleeping for over 9 h per day (aOR: 4.6, 95% CI: 2.1–14.1).
CONCLUSIONS:
Although physical activity decreased by about a third, over half of the respondents lost weight and slept well during Ramadan. Strategies to include intermittent fasting in positive lifestyle changes could improve the health and well-being of the population.
Methods: We exposed female NOD and C57BL/6 mice from the age of 5 weeks to either adlib soft drink consumption and/or T20 light–dark cycle alteration until the development of diabetes, or the mice reached the age of 30 weeks. Each group consisted of 7– 15 mice. We monitored weight, length, blood glucose level, and insulin autoantibody (IAA) levels weekly.
Results: Out of 75 NOD and 22 C57BL/6 mice, 41 NOD mice developed diabetes, and 6 mice died between 7 and 8 weeks of age. The mean time to development of T1DM among NOD control mice was 20 weeks. The time to development of T1DM was accelerated by two weeks in the NOD mice exposed to light–dark cycle alteration, hazard ratio of 2.65,95th CI (0.70, 10.04) p = 0.15). The other groups developed T1DM, similar to the control group.
Conclusion: There was a trend toward earlier development of T1DM among NOD mice exposed to light–dark cycle alteration, but this difference was not statistically significant. Further studies are needed to confirm our findings using larger sample sizes and different animal species.
METHODS:The ASSM Education Task Force Committee designed a survey to gather data on accreditation, education, and training standards in sleep medicine, including information on challenges in enhancing education in the field.
RESULTS:With an 86% (25 countries/regions) response rate, the survey showed that sleep medicine is recognized as an independent specialty in just nine countries/regions (36% of the countries/regions surveyed). Ten countries/regions have established sleep medicine training programs, with Japan and Saudi Arabia offering it as a distinct specialty. Significant disparities in training and accreditation standards were identified, with many countries/regions lacking formalized training and practice guidelines. The survey also revealed that most local sleep societies across Asia support the development of an Asian Sleep Medicine Training Curriculum led by the ASSM. However, several barriers significantly impede the establishment and development of sleep medicine training programs, including the scarcity of trained specialists and technologists and the absence of national accreditation for sleep medicine.
CONCLUSIONS:The survey highlights the need for standardized sleep medicine training and accreditation across Asia. Developing an Asian Sleep Medicine Training Curriculum and promoting ASSM accreditation guidelines are key recommendations. Implementing these strategies is essential for advancing sleep medicine as a widely recognized discipline throughout Asia.
Patients and Methods: A retrospective cohort study from the VHA between 01/2019 and 10/2023 of veterans with age ≥ 50. We extracted STU data using Current Procedural Terminology codes for five periods based on STU and vaccination status: pre-pandemic (Pre-Pan), pandemic sleep test moratorium (Pan-Mor), and pandemic pre-vaccination (Pan-Pre-Vax), vaccination (Pan-Vax), and postvaccination (Pan-Post-Vax). We compared STU between intervals (Pre-Pan as the reference).
Results: Among 261,371 veterans (63.7± 9.6 years, BMI 31.9± 6.0 kg/m², 80% male), PSG utilization decreased significantly during Pan-Mor (− 56%), Pan-Pre-Vax (− 61%), Pan-Vax (− 42%), and Pan-Post-Vax (− 36%) periods all compared to Pre-Pan. HSAT utilization decreased significantly during the Pan-Mor (− 59%) and Pan-Pre-Vax (− 9%) phases compared to the Pre-Pan and subsequently increased during Pan-Vax (+6%) and Pan-Post-Vax (− 1%) periods. Over 70% of STU transitioned to HSAT, and its usage surged five months after the vaccine Introduction.
Conclusion: Sleep testing services utilization recovered differentially during the pandemic (PSG vs HSAT), including a surge in HSAT utilization post-vaccination.
This study aimed to examine the impact of the COVID-19 lockdown on adherence to continuous positive airway pressure (CPAP) therapy among Saudi patients with obstructive sleep apnea (OSA). It also sought to assess the influence of demographic variables and comorbidities on CPAP adherence.
METHODS:
A prospective cohort study was conducted at the University Sleep Disorders Center at King Saud University Medical City. The study included 67 OSA patients who exclusively used CPAP for treatment across three distinct intervals prelockdown, during lockdown, and postlockdown. Adherence to CPAP therapy was objectively measured using “mask-on on-time monitoring” data from the CPAP machines.
RESULTS:
The study found a significant decrease in the number of days with CPAP usage during the lockdown period, which persisted postlockdown. Approximately half of the patients adhered to CPAP treatment throughout the three study intervals. The decrease in CPAP usage days during lockdown was particularly noticeable among patients younger than 50 and older than 65 years of age. The presence of comorbidities, body mass index, and sex did not significantly influence CPAP treatment adherence.
CONCLUSION:
The COVID-19 lockdown significantly impacted CPAP treatment adherence among OSA patients, with a decrease in adherence persisting postlockdown. This highlights the need for interventions to support CPAP adherence during challenging times such as a pandemic. Further research is needed to understand the long-term effects of the pandemic on CPAP therapy adherence.
Methods: The curriculum development process involved a gap analysis, comprehensive literature review, and expert consensus through a modified RAND Appropriateness Method (RAM)/Delphi survey.
Results: The curriculum offers two flexible tracks: a one-year program (Track A) and a two-year program (Track B), accommodating varied educational pathways and healthcare system structures across Asia. Key features of the curriculum include detailed learning outcomes, competency-based educational content, and recommendations for teaching and learning activities. The assessment strategy incorporates summative and formative methods, with standard setting and program evaluation guidelines. The curriculum also provides recommendations for program accreditation, fellow-faculty ratios, and funding considerations.
Conclusions: The Asian Adult Sleep Medicine Fellowship Training Curriculum provides a standardized yet adaptable framework for sleep medicine education across diverse Asian healthcare landscapes. By emphasizing flexibility and customization while maintaining high training standards, the curriculum aims to bridge the gap in sleep medicine training across Asia, ultimately improving the quality of sleep healthcare and patient outcomes throughout the region.
Methods: The Asian Society of Sleep Medicine Education Task Force Committee designed a survey to gather data on accreditation, education, and training standards in sleep medicine, including information on challenges in enhancing education in the field.
Results: With an 86% (25 countries/regions) response rate, the survey showed that sleep medicine is recognized as an independent specialty in just 9 countries/regions (36% of the countries/regions surveyed). Ten countries/regions have established sleep medicine training programs, with Japan and Saudi Arabia offering it as a distinct specialty. Significant disparities in training and accreditation standards were identified, with many countries/regions lacking formalized training and practice guidelines. The survey also revealed that most local sleep societies across Asia support the development of an Asian Sleep Medicine Training Curriculum led by the Asian Society of Sleep Medicine. However, several barriers significantly impede the establishment and development of sleep medicine training programs, including the scarcity of trained specialists and technologists and the absence of national accreditation for sleep medicine.
Conclusions: The survey highlights the need for standardized sleep medicine training and accreditation across Asia. Developing an Asian Sleep Medicine Training Curriculum and promoting Asian Society of Sleep Medicine accreditation guidelines are key recommendations. Implementing these strategies is essential for advancing sleep medicine as a widely recognized discipline throughout Asia.
The chapter outlines a general workflow for PSG modeling, starting with problem definition, raw data collection, and exploration. It delves into essential preprocessing techniques, including data cleaning, dimensionality reduction, normalization, and segmentation. These steps ensure the data is transformed into a usable format for building and training ML models aimed at diagnosing sleep disorders like obstructive sleep apnea (OSA).
Moreover, the chapter highlights the role of DL models such as convolutional neural networks (CNN) and long short-term memory (LSTM) networks in learning from PSG data. It also emphasizes the importance of public datasets, which can serve as valuable resources for developing and benchmarking AI-driven diagnostic models.
Ultimately, this chapter serves as a comprehensive guide to the preprocessing steps that are vital for extracting meaningful insights from PSG data and improving the accuracy of AI-driven sleep disorder diagnoses.
There is limited data on sleep, physical activity, and health-related behaviors among the general public during Ramadan, particularly during the COVID-19 pandemic. This study aimed to assess the factors associated with sleep and physical activity changes among Nigerian Muslims during Ramadan fasting.
MATERIALS AND METHODS:
A nationwide web-based cross-sectional study was conducted among Nigerians aged ≥18 years who performed diurnal fasting during Ramadan. The target sample size was obtained using Fisher’s formula, and snowball sampling was employed. Adapted versions of the International Physical Activity Questionnaire Short Form and Copenhagen Psychosocial Questionnaire II were used to evaluate sleep and physical activity. Correlates of change in physical activity and sleep quality were assessed using logistic regression analysis.
RESULTS:
Seven hundred and seventy individuals participated in the study. During Ramadan, 39.1% (95% confidence interval (CI): 35.6%–42.6%) reported decreased physical activity, and 56.6% (95% CI; 53.0%–60.2%) stated having self-reported good sleep. The independent correlates of physical activity were female sex (adjusted odds ratio (aOR):0.5, 95% CI: 0.4–0.8), having very good sleep (aOR: 0.4, 95% CI: 0.2–0.7), and obesity (aOR: 2.0, 95% CI: 1.1–3.7). In addition, factors associated with improved self-reported sleep quality were perceived good health state (aOR: 8.8, 95% CI: 1.1–72.4), sleeping 7–9 h per day (aOR: 5.5, 95% CI: 2.6–10.3), and sleeping for over 9 h per day (aOR: 4.6, 95% CI: 2.1–14.1).
CONCLUSIONS:
Although physical activity decreased by about a third, over half of the respondents lost weight and slept well during Ramadan. Strategies to include intermittent fasting in positive lifestyle changes could improve the health and well-being of the population.
Methods: We exposed female NOD and C57BL/6 mice from the age of 5 weeks to either adlib soft drink consumption and/or T20 light–dark cycle alteration until the development of diabetes, or the mice reached the age of 30 weeks. Each group consisted of 7– 15 mice. We monitored weight, length, blood glucose level, and insulin autoantibody (IAA) levels weekly.
Results: Out of 75 NOD and 22 C57BL/6 mice, 41 NOD mice developed diabetes, and 6 mice died between 7 and 8 weeks of age. The mean time to development of T1DM among NOD control mice was 20 weeks. The time to development of T1DM was accelerated by two weeks in the NOD mice exposed to light–dark cycle alteration, hazard ratio of 2.65,95th CI (0.70, 10.04) p = 0.15). The other groups developed T1DM, similar to the control group.
Conclusion: There was a trend toward earlier development of T1DM among NOD mice exposed to light–dark cycle alteration, but this difference was not statistically significant. Further studies are needed to confirm our findings using larger sample sizes and different animal species.
METHODS:The ASSM Education Task Force Committee designed a survey to gather data on accreditation, education, and training standards in sleep medicine, including information on challenges in enhancing education in the field.
RESULTS:With an 86% (25 countries/regions) response rate, the survey showed that sleep medicine is recognized as an independent specialty in just nine countries/regions (36% of the countries/regions surveyed). Ten countries/regions have established sleep medicine training programs, with Japan and Saudi Arabia offering it as a distinct specialty. Significant disparities in training and accreditation standards were identified, with many countries/regions lacking formalized training and practice guidelines. The survey also revealed that most local sleep societies across Asia support the development of an Asian Sleep Medicine Training Curriculum led by the ASSM. However, several barriers significantly impede the establishment and development of sleep medicine training programs, including the scarcity of trained specialists and technologists and the absence of national accreditation for sleep medicine.
CONCLUSIONS:The survey highlights the need for standardized sleep medicine training and accreditation across Asia. Developing an Asian Sleep Medicine Training Curriculum and promoting ASSM accreditation guidelines are key recommendations. Implementing these strategies is essential for advancing sleep medicine as a widely recognized discipline throughout Asia.
Patients and Methods: A retrospective cohort study from the VHA between 01/2019 and 10/2023 of veterans with age ≥ 50. We extracted STU data using Current Procedural Terminology codes for five periods based on STU and vaccination status: pre-pandemic (Pre-Pan), pandemic sleep test moratorium (Pan-Mor), and pandemic pre-vaccination (Pan-Pre-Vax), vaccination (Pan-Vax), and postvaccination (Pan-Post-Vax). We compared STU between intervals (Pre-Pan as the reference).
Results: Among 261,371 veterans (63.7± 9.6 years, BMI 31.9± 6.0 kg/m², 80% male), PSG utilization decreased significantly during Pan-Mor (− 56%), Pan-Pre-Vax (− 61%), Pan-Vax (− 42%), and Pan-Post-Vax (− 36%) periods all compared to Pre-Pan. HSAT utilization decreased significantly during the Pan-Mor (− 59%) and Pan-Pre-Vax (− 9%) phases compared to the Pre-Pan and subsequently increased during Pan-Vax (+6%) and Pan-Post-Vax (− 1%) periods. Over 70% of STU transitioned to HSAT, and its usage surged five months after the vaccine Introduction.
Conclusion: Sleep testing services utilization recovered differentially during the pandemic (PSG vs HSAT), including a surge in HSAT utilization post-vaccination.