Despite varied classification systems, hypersomnolence disorders (or central disorders of hyperso... more Despite varied classification systems, hypersomnolence disorders (or central disorders of hypersomnolence) are a group of disorders with a common symptom of excessive daytime sleepiness. In addition to a thorough clinical interview and examination, the assessment of hypersomnolence may require clinical investigations such as polysomnography and the multiple sleep latency test. This chapter examines the disorders of hypersomnolence with an emphasis on their clinical features and treatment strategies. The authors discuss the four main types of hypersomnolence disorders, narcolepsy type 1, narcolepsy type 2, idiopathic hypersomnia and Kleine–Levin syndrome, as well as hypersomnia due to a medical disorder, medication, or substance use; a psychiatric disorder; and insufficient sleep syndrome. It also discusses the relationships between hypersomnolence and psychiatric disorders.
It has been suggested that distress secondary to isolation and fear can exert a more negative eff... more It has been suggested that distress secondary to isolation and fear can exert a more negative effect in the long-term than COVID-19 infection itself. This narrative review aims to provide a global view on the neuropsychiatric consequences of COVID-19 that can be ascribed to a number of factors ranging from the direct effect of infection, to the body’s responses against infection or to the psychological sequelae of social isolation, unemployment, and fear for one’s health and livelihood. Findings show that, with respect to the infection itself, the more severe the respiratory infection, the more likely are central nervous system (CNS) complications. Immune reactions to the infection may result in symptoms similar to chronic fatigue as well as neurocognitive deficits which last long after the infection is over. An increase in symptoms of depression, anxiety, and trauma-related stress may also follow upon economic fears and isolation from friends and family. The consequences of the pandemic are not limited to adults. Children learning remotely and away from classmates and routine activities may develop adjustment disorders, acute stress disorder, and a variety of manifestations of grief. A summary of case reports suggests that COVID-19-related stress, economic recession, and political unrest increase the risk of suicidal behaviors and acts of violence. However, it is not known whether manifestations of mental disorders all result from social causes, or whether some may be caused by CNS complications. In conclusion, COVID-19 leaves in its wake neuropsychiatric symptoms that result from several interrelated causes. We recommend a comprehensive approach while dealing with neuropsychiatric symptoms during the pandemic that includes all disease models i.e., biological, psychosocial, and economic in the causation as well as management.
Obstructive sleep apnea (OSA) is a breathing-related sleep disorder that is associated with subst... more Obstructive sleep apnea (OSA) is a breathing-related sleep disorder that is associated with substantial morbidity and disturbing quality of life. It is a systemic disorder that is associated with a wide range of comorbid abnormal behavioral symptomatology. OSA usually presents with snoring, daytime sleepiness, and choking attacks during sleep. However, the disorder may present with unusual presentations such as behavioral, psychiatric, and neurocognitive abnormalities, or abnormal movements disorders during sleep. Additionally, OSA may worsen comorbid psychiatric and behavioral disorders. Therefore, it is imperative for healthcare providers to have the knowledge and clinical skills to recognize the unusual presentation of OSA, particularly, changes in behavior, and to recognize the interaction between OSA and its comorbidities, which may affect behavior. This chapter discusses the association between OSA and psychiatric and behavioral disorders, which may influence the presentation of OSA.
Sleep and the circadian clock are intertwined and have persisted throughout history. The suprachi... more Sleep and the circadian clock are intertwined and have persisted throughout history. The suprachiasmatic nucleus (SCN) orchestrates sleep by controlling circadian (Process C) and homeostatic (Process S) activities. As a "hand" on the endogenous circadian clock, melatonin is critical for sleep regulation. Light serves as a cue for sleep/wake control by activating retino-recipient cells in the SCN and subsequently suppressing melatonin. Clock genes are the molecular timekeepers that keep the 24 h cycle in place. Two main sleep and behavioural disorder diagnostic manuals have now officially recognised the importance of these processes for human health and well-being. The body's ability to respond to daily demands with the least amount of effort is maximised by carefully timing and integrating all components of sleep and waking. In the brain, the organization of timing is essential for optimal brain physiology.
Background: The wide scope and spread of Coronavirus Disease 2019 (COVID-19) could lead to a true... more Background: The wide scope and spread of Coronavirus Disease 2019 (COVID-19) could lead to a true mental health disaster, especially in countries with high caseloads. Very few studies have assessed the impact on hospital staff. This study aimed to assess mental health changes in health-care workers (Northern Area Armed Forces Hospital-Kingdom of Saudi Arabia). Materials and Methods: This is a cross-sectional study. A survey questionnaire was designed and distributed among the participants, and the survey contained demographic questions and questions related to anxiety, worries, and fears, in addition to depressive symptoms and basic sleep profile. In addition, the psychological impacts, feelings, fears of developing COVID-19, and symptoms of posttraumatic stress disorder were assessed using the Impact of Events Scale-Revised (IES-R). Results: The mean age of the staff was 38.2 years. The examined staffs showed high levels of anxiety and depressive features: 19.3% had crying and depr...
Sleep is an essential physiological process, which profoundly affects a wide range of biological ... more Sleep is an essential physiological process, which profoundly affects a wide range of biological activities. It is now known that sleep supports myriad vital functions in the central nervous system. This includes neural plasticity, learning, memory, cognition and emotional regulation. Additionally, it affects basic processes such as cardiovascular, immunological and metabolic activity. Evidence from multiple lines of research has thus shown that good quality of sleep is essential for both survival and optimal functioning of life. Considerable evidence also supports the conclusion that even minimal dysfunctions in circadian regulation can significantly disrupt sleep and broadly affect body physiology. As a consequence, it is now appreciated that the therapy of sleep disorders is more complex than was once thought. At present, several clinical disciplines have recognized the significance of the biological clock in health and illness, and are incorporating this knowledge into treatment p...
ABSTRACT Social distancing, also referred to as physical distancing, means creating a safe distan... more ABSTRACT Social distancing, also referred to as physical distancing, means creating a safe distance of at least two meters (six feet) between yourself and others. This is a term popularized during the COVID-19 pandemic, as it is one of the most important measures to prevent the spread of this virus. However, the term ‘social distancing’ can be misleading, as it may imply that individuals should stop socializing. However, socializing in a safe context (i.e. over the phone, video-chat, etc.) is especially important during this time of crisis. Therefore, in this narrative review, we suggest the term ‘distant socializing’ as more apt expression, to promote physical distancing measures while also highlighting the importance of maintaining social bonds. Further, articles discussing the practice, implementation, measurement, and mental health effects of physical distancing are reviewed. Physical distancing is associated with psychiatric symptoms (such as anxiety and depression), suicidal ideation, and domestic violence. Further, unemployment and job insecurity have significantly increased during COVID-19, which may exacerbate these negative mental health effects. Governments, medical institutions, and public health bodies should therefore consider increasing mental health resources both during and after the pandemic, with a specific focus on frontline workers, COVID-19 survivors, and marginalized communities.
Metabolic syndrome (MS), initially described by Gerald Reaven in 1988 as "syndrome X" or "insulin... more Metabolic syndrome (MS), initially described by Gerald Reaven in 1988 as "syndrome X" or "insulin resistance syndrome, " is a collection of common irregularities, including resistance to insulin, impairment of glucose tolerance, central obesity, reduced high-density lipoprotein (HDL)-cholesterol levels, elevated triglycerides (TG), and hypertension. The condition reflects the sedentary lifestyle, over nutrition, and resultant excess adiposity
Background Various sleep disorders are reported to be frequent in end-stage renal disease (ESRD) ... more Background Various sleep disorders are reported to be frequent in end-stage renal disease (ESRD) patients on hemodialysis. This study aimed to assess the prevalence of sleep disorders and their correlates among hemodialysis patients. Methodology This cross-sectional study included 200 recruited ESRD patients on hemodialysis, who were assessed for sleep disorders by administering Pittsburgh sleep quality index, Berlin questionnaire and STOP-BANG for sleep apnea, and International restless legs syndrome study group rating scale. Results The mean age of the study sample was 51.7 ± 6 years. Most of the patients were males (66.2%), and 53.2% of participants were governmental employees. The prevalence of hypertension and diabetus were (53.7%, and 13.9% respectively). It was found that 62.2% of the sample were classified as poor sleepers. While 25.9% had EDS and 11.4% had RLS. Conclusion Sleep disorders are common but neglected in subjects on hemodialysis. Certain clinical correlates might negatively impact the severity of sleep disorders and thus worsen the dialysis efficiency. Early detection and treatment of sleep disorders in subjects with ESRD might improve the prognosis.
Background: Chronobiological changes have been detected in various physiological functions of pat... more Background: Chronobiological changes have been detected in various physiological functions of patients with breast cancer, suggesting dysregulation in the pineal gland and melatonin secretion. This study aimed to assess and measure serum melatonin levels preand postoperatively in patients who had been diagnosed for the first time with breast cancer. Methods: A sample of first-time breast cancer patients, consisting of 45 women aged 25-65 years, was evaluated and psychometric assessment was completed using the Beck Depression Inventory (BDI), Insomnia Severity Index (White, Weinberg et al) and the Epworth Sleepiness Scale (Cardoso, Spence et al). The Morningness-Eveningness questionnaire (MEQ) was used to assess the chronotype. Serum melatonin levels were measured by radioimmunoassay. Results: Morning and moderately morning chronotypes were prevalent among the sample (25%, 45.8%, respectively). The finding of a mean BDI score of 13.5±11.2 indicated that depressive symptoms were prevalent among the sample. Despite the finding that a mean of the participants apparently had no symptoms of daytime sleepiness (the mean and standard deviations of the ESS were 7.5±4.4), scores on the ISI (a mean of 16.7±SD 7.3) indicated that insomnia symptoms were prevalent in the sample. Melatonin levels showed an inverse relationship with insomnia severity as measured by the ISI and depression severity, as assessed by the BDI. The postoperative melatonin levels were higher than the preoperative levels. Additionally, the psychometric profile differed among various pathological types of breast cancer according to their hormone receptor profile. Conclusion: Serum melatonin levels correlated significantly with self-reported sleep quality and psychometric profiles of depression in the present sample of breast cancer patients. The melatonin assay, which is relatively easy to carry out, provided a convenient, objective measure of an important biological correlate of sleep quality and depression. This assay thus represented a confirmatory alternative to the self-report instruments, which may sometimes be unreliable. Future studies should further evaluate the utility of melatonin measures in psychiatric and sleep complaints of breast cancer patients.
The Egyptian Journal of Chest Diseases and Tuberculosis, 2018
Introduction Research into sleep practice of Egyptian youths is scanty and poorly disseminated, a... more Introduction Research into sleep practice of Egyptian youths is scanty and poorly disseminated, and therefore, relatively deficient data are available to put into practice. Adequate sleep practice is useful for both physical and mental health and improves the overall performance. It can also delay neurodegenerative changes in elderly. Aim The aim was to survey sleep practice and sleep-related problems among the Egyptian youths and to put the question of sleep education in practice. Participants and methods A cross-sectional study was conducted including 594 Egyptian youths randomly selected from university students and social club attendants in Mansoura, Egypt. An anonymous self-report questionnaire was prepared to elicit data on participants’ demography, sleep practice, and disorders. Results Of the 594 youths examined, 59.6, 29.5, and 12.1% reported insomnia, daily sleepiness, and sleep deprivation, respectively. Smoking was significantly associated with insomnia and high risk of obstructive sleep apnea. The median values for the time of getting into bed and sleep duration in working day and weekend were 1:00 a. m., 8 h, and 10 h, respectively. Approximately 50% reported afternoon naps with median duration of 2 h. Conclusion Sleep problems constitute a significant issue in youths. Sleep education and counseling for appropriate lifestyle and proper sleep practice may minimize the magnitude and effects of these problems.
IntroductionObstructive sleep apnea (OSA) is a widely prevalent sleep-related breathing disorder,... more IntroductionObstructive sleep apnea (OSA) is a widely prevalent sleep-related breathing disorder, which leads to several life-threatening diseases. OSA has systemic effects on various organ systems. Untreated OSA is associated with long-term health consequences including hypertension, heart disease, diabetes, depression, metabolic disorders, and stroke. In addition, untreated OSA is reported to be associated with cognitive dysfunction, impaired productivity at the workplace and in an increased risk of motor vehicle accidents (MVAs) resulting in injury and fatality. Other consequences of OSA include, but are not limited to, impaired vigilance, daytime somnolence, performance deficits, morning headaches, mood disturbances, neurobehavioral impairments, and general malaise. Additionally, OSA has become an economic burden on most health systems all over the world. Many driving license regulations have been developed to reduce MVAs among OSA patients.MethodsStudies of the personal, societ...
This review describes the characteristics of a number of pathologies, which are considered from t... more This review describes the characteristics of a number of pathologies, which are considered from the point of view of chronobiology, that is, the way in which biological processes are expressed throughout the 24-hour day. This perspective is a relatively new way of thinking about disease and additionally about how to treat diseases. It has called attention to the importance of not only the quantity of a drug that is administered but also when it is administered. In addition, the review presents an overview of the emerging clinical strategies known as chronotherapeutics, that is, the effects of the daily scheduling of drug administration and the consequences of the activity and efficacy of therapies that are applied in this manner. This article also reviews innovative ways in which physicians are applying time-specified drug treatment (chronopharmacology) for sleep disorders. Here, we present a systematic description of chronopharmacology as well as definitions of key terms that, we b...
Despite varied classification systems, hypersomnolence disorders (or central disorders of hyperso... more Despite varied classification systems, hypersomnolence disorders (or central disorders of hypersomnolence) are a group of disorders with a common symptom of excessive daytime sleepiness. In addition to a thorough clinical interview and examination, the assessment of hypersomnolence may require clinical investigations such as polysomnography and the multiple sleep latency test. This chapter examines the disorders of hypersomnolence with an emphasis on their clinical features and treatment strategies. The authors discuss the four main types of hypersomnolence disorders, narcolepsy type 1, narcolepsy type 2, idiopathic hypersomnia and Kleine–Levin syndrome, as well as hypersomnia due to a medical disorder, medication, or substance use; a psychiatric disorder; and insufficient sleep syndrome. It also discusses the relationships between hypersomnolence and psychiatric disorders.
It has been suggested that distress secondary to isolation and fear can exert a more negative eff... more It has been suggested that distress secondary to isolation and fear can exert a more negative effect in the long-term than COVID-19 infection itself. This narrative review aims to provide a global view on the neuropsychiatric consequences of COVID-19 that can be ascribed to a number of factors ranging from the direct effect of infection, to the body’s responses against infection or to the psychological sequelae of social isolation, unemployment, and fear for one’s health and livelihood. Findings show that, with respect to the infection itself, the more severe the respiratory infection, the more likely are central nervous system (CNS) complications. Immune reactions to the infection may result in symptoms similar to chronic fatigue as well as neurocognitive deficits which last long after the infection is over. An increase in symptoms of depression, anxiety, and trauma-related stress may also follow upon economic fears and isolation from friends and family. The consequences of the pandemic are not limited to adults. Children learning remotely and away from classmates and routine activities may develop adjustment disorders, acute stress disorder, and a variety of manifestations of grief. A summary of case reports suggests that COVID-19-related stress, economic recession, and political unrest increase the risk of suicidal behaviors and acts of violence. However, it is not known whether manifestations of mental disorders all result from social causes, or whether some may be caused by CNS complications. In conclusion, COVID-19 leaves in its wake neuropsychiatric symptoms that result from several interrelated causes. We recommend a comprehensive approach while dealing with neuropsychiatric symptoms during the pandemic that includes all disease models i.e., biological, psychosocial, and economic in the causation as well as management.
Obstructive sleep apnea (OSA) is a breathing-related sleep disorder that is associated with subst... more Obstructive sleep apnea (OSA) is a breathing-related sleep disorder that is associated with substantial morbidity and disturbing quality of life. It is a systemic disorder that is associated with a wide range of comorbid abnormal behavioral symptomatology. OSA usually presents with snoring, daytime sleepiness, and choking attacks during sleep. However, the disorder may present with unusual presentations such as behavioral, psychiatric, and neurocognitive abnormalities, or abnormal movements disorders during sleep. Additionally, OSA may worsen comorbid psychiatric and behavioral disorders. Therefore, it is imperative for healthcare providers to have the knowledge and clinical skills to recognize the unusual presentation of OSA, particularly, changes in behavior, and to recognize the interaction between OSA and its comorbidities, which may affect behavior. This chapter discusses the association between OSA and psychiatric and behavioral disorders, which may influence the presentation of OSA.
Sleep and the circadian clock are intertwined and have persisted throughout history. The suprachi... more Sleep and the circadian clock are intertwined and have persisted throughout history. The suprachiasmatic nucleus (SCN) orchestrates sleep by controlling circadian (Process C) and homeostatic (Process S) activities. As a "hand" on the endogenous circadian clock, melatonin is critical for sleep regulation. Light serves as a cue for sleep/wake control by activating retino-recipient cells in the SCN and subsequently suppressing melatonin. Clock genes are the molecular timekeepers that keep the 24 h cycle in place. Two main sleep and behavioural disorder diagnostic manuals have now officially recognised the importance of these processes for human health and well-being. The body's ability to respond to daily demands with the least amount of effort is maximised by carefully timing and integrating all components of sleep and waking. In the brain, the organization of timing is essential for optimal brain physiology.
Background: The wide scope and spread of Coronavirus Disease 2019 (COVID-19) could lead to a true... more Background: The wide scope and spread of Coronavirus Disease 2019 (COVID-19) could lead to a true mental health disaster, especially in countries with high caseloads. Very few studies have assessed the impact on hospital staff. This study aimed to assess mental health changes in health-care workers (Northern Area Armed Forces Hospital-Kingdom of Saudi Arabia). Materials and Methods: This is a cross-sectional study. A survey questionnaire was designed and distributed among the participants, and the survey contained demographic questions and questions related to anxiety, worries, and fears, in addition to depressive symptoms and basic sleep profile. In addition, the psychological impacts, feelings, fears of developing COVID-19, and symptoms of posttraumatic stress disorder were assessed using the Impact of Events Scale-Revised (IES-R). Results: The mean age of the staff was 38.2 years. The examined staffs showed high levels of anxiety and depressive features: 19.3% had crying and depr...
Sleep is an essential physiological process, which profoundly affects a wide range of biological ... more Sleep is an essential physiological process, which profoundly affects a wide range of biological activities. It is now known that sleep supports myriad vital functions in the central nervous system. This includes neural plasticity, learning, memory, cognition and emotional regulation. Additionally, it affects basic processes such as cardiovascular, immunological and metabolic activity. Evidence from multiple lines of research has thus shown that good quality of sleep is essential for both survival and optimal functioning of life. Considerable evidence also supports the conclusion that even minimal dysfunctions in circadian regulation can significantly disrupt sleep and broadly affect body physiology. As a consequence, it is now appreciated that the therapy of sleep disorders is more complex than was once thought. At present, several clinical disciplines have recognized the significance of the biological clock in health and illness, and are incorporating this knowledge into treatment p...
ABSTRACT Social distancing, also referred to as physical distancing, means creating a safe distan... more ABSTRACT Social distancing, also referred to as physical distancing, means creating a safe distance of at least two meters (six feet) between yourself and others. This is a term popularized during the COVID-19 pandemic, as it is one of the most important measures to prevent the spread of this virus. However, the term ‘social distancing’ can be misleading, as it may imply that individuals should stop socializing. However, socializing in a safe context (i.e. over the phone, video-chat, etc.) is especially important during this time of crisis. Therefore, in this narrative review, we suggest the term ‘distant socializing’ as more apt expression, to promote physical distancing measures while also highlighting the importance of maintaining social bonds. Further, articles discussing the practice, implementation, measurement, and mental health effects of physical distancing are reviewed. Physical distancing is associated with psychiatric symptoms (such as anxiety and depression), suicidal ideation, and domestic violence. Further, unemployment and job insecurity have significantly increased during COVID-19, which may exacerbate these negative mental health effects. Governments, medical institutions, and public health bodies should therefore consider increasing mental health resources both during and after the pandemic, with a specific focus on frontline workers, COVID-19 survivors, and marginalized communities.
Metabolic syndrome (MS), initially described by Gerald Reaven in 1988 as "syndrome X" or "insulin... more Metabolic syndrome (MS), initially described by Gerald Reaven in 1988 as "syndrome X" or "insulin resistance syndrome, " is a collection of common irregularities, including resistance to insulin, impairment of glucose tolerance, central obesity, reduced high-density lipoprotein (HDL)-cholesterol levels, elevated triglycerides (TG), and hypertension. The condition reflects the sedentary lifestyle, over nutrition, and resultant excess adiposity
Background Various sleep disorders are reported to be frequent in end-stage renal disease (ESRD) ... more Background Various sleep disorders are reported to be frequent in end-stage renal disease (ESRD) patients on hemodialysis. This study aimed to assess the prevalence of sleep disorders and their correlates among hemodialysis patients. Methodology This cross-sectional study included 200 recruited ESRD patients on hemodialysis, who were assessed for sleep disorders by administering Pittsburgh sleep quality index, Berlin questionnaire and STOP-BANG for sleep apnea, and International restless legs syndrome study group rating scale. Results The mean age of the study sample was 51.7 ± 6 years. Most of the patients were males (66.2%), and 53.2% of participants were governmental employees. The prevalence of hypertension and diabetus were (53.7%, and 13.9% respectively). It was found that 62.2% of the sample were classified as poor sleepers. While 25.9% had EDS and 11.4% had RLS. Conclusion Sleep disorders are common but neglected in subjects on hemodialysis. Certain clinical correlates might negatively impact the severity of sleep disorders and thus worsen the dialysis efficiency. Early detection and treatment of sleep disorders in subjects with ESRD might improve the prognosis.
Background: Chronobiological changes have been detected in various physiological functions of pat... more Background: Chronobiological changes have been detected in various physiological functions of patients with breast cancer, suggesting dysregulation in the pineal gland and melatonin secretion. This study aimed to assess and measure serum melatonin levels preand postoperatively in patients who had been diagnosed for the first time with breast cancer. Methods: A sample of first-time breast cancer patients, consisting of 45 women aged 25-65 years, was evaluated and psychometric assessment was completed using the Beck Depression Inventory (BDI), Insomnia Severity Index (White, Weinberg et al) and the Epworth Sleepiness Scale (Cardoso, Spence et al). The Morningness-Eveningness questionnaire (MEQ) was used to assess the chronotype. Serum melatonin levels were measured by radioimmunoassay. Results: Morning and moderately morning chronotypes were prevalent among the sample (25%, 45.8%, respectively). The finding of a mean BDI score of 13.5±11.2 indicated that depressive symptoms were prevalent among the sample. Despite the finding that a mean of the participants apparently had no symptoms of daytime sleepiness (the mean and standard deviations of the ESS were 7.5±4.4), scores on the ISI (a mean of 16.7±SD 7.3) indicated that insomnia symptoms were prevalent in the sample. Melatonin levels showed an inverse relationship with insomnia severity as measured by the ISI and depression severity, as assessed by the BDI. The postoperative melatonin levels were higher than the preoperative levels. Additionally, the psychometric profile differed among various pathological types of breast cancer according to their hormone receptor profile. Conclusion: Serum melatonin levels correlated significantly with self-reported sleep quality and psychometric profiles of depression in the present sample of breast cancer patients. The melatonin assay, which is relatively easy to carry out, provided a convenient, objective measure of an important biological correlate of sleep quality and depression. This assay thus represented a confirmatory alternative to the self-report instruments, which may sometimes be unreliable. Future studies should further evaluate the utility of melatonin measures in psychiatric and sleep complaints of breast cancer patients.
The Egyptian Journal of Chest Diseases and Tuberculosis, 2018
Introduction Research into sleep practice of Egyptian youths is scanty and poorly disseminated, a... more Introduction Research into sleep practice of Egyptian youths is scanty and poorly disseminated, and therefore, relatively deficient data are available to put into practice. Adequate sleep practice is useful for both physical and mental health and improves the overall performance. It can also delay neurodegenerative changes in elderly. Aim The aim was to survey sleep practice and sleep-related problems among the Egyptian youths and to put the question of sleep education in practice. Participants and methods A cross-sectional study was conducted including 594 Egyptian youths randomly selected from university students and social club attendants in Mansoura, Egypt. An anonymous self-report questionnaire was prepared to elicit data on participants’ demography, sleep practice, and disorders. Results Of the 594 youths examined, 59.6, 29.5, and 12.1% reported insomnia, daily sleepiness, and sleep deprivation, respectively. Smoking was significantly associated with insomnia and high risk of obstructive sleep apnea. The median values for the time of getting into bed and sleep duration in working day and weekend were 1:00 a. m., 8 h, and 10 h, respectively. Approximately 50% reported afternoon naps with median duration of 2 h. Conclusion Sleep problems constitute a significant issue in youths. Sleep education and counseling for appropriate lifestyle and proper sleep practice may minimize the magnitude and effects of these problems.
IntroductionObstructive sleep apnea (OSA) is a widely prevalent sleep-related breathing disorder,... more IntroductionObstructive sleep apnea (OSA) is a widely prevalent sleep-related breathing disorder, which leads to several life-threatening diseases. OSA has systemic effects on various organ systems. Untreated OSA is associated with long-term health consequences including hypertension, heart disease, diabetes, depression, metabolic disorders, and stroke. In addition, untreated OSA is reported to be associated with cognitive dysfunction, impaired productivity at the workplace and in an increased risk of motor vehicle accidents (MVAs) resulting in injury and fatality. Other consequences of OSA include, but are not limited to, impaired vigilance, daytime somnolence, performance deficits, morning headaches, mood disturbances, neurobehavioral impairments, and general malaise. Additionally, OSA has become an economic burden on most health systems all over the world. Many driving license regulations have been developed to reduce MVAs among OSA patients.MethodsStudies of the personal, societ...
This review describes the characteristics of a number of pathologies, which are considered from t... more This review describes the characteristics of a number of pathologies, which are considered from the point of view of chronobiology, that is, the way in which biological processes are expressed throughout the 24-hour day. This perspective is a relatively new way of thinking about disease and additionally about how to treat diseases. It has called attention to the importance of not only the quantity of a drug that is administered but also when it is administered. In addition, the review presents an overview of the emerging clinical strategies known as chronotherapeutics, that is, the effects of the daily scheduling of drug administration and the consequences of the activity and efficacy of therapies that are applied in this manner. This article also reviews innovative ways in which physicians are applying time-specified drug treatment (chronopharmacology) for sleep disorders. Here, we present a systematic description of chronopharmacology as well as definitions of key terms that, we b...
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Papers by Nevin F W Zaki