Several population-based studies across various geographical regions and ethnic groups have established a high prevalence of OSA. This epidemic of OSA is closely related to the obesity epidemic—an important public health related condition facing adults globally. In the United States in 2004, the estimated prevalence of adult obesity, classified as a body mass index (BMI) over 30 kg/m2, was more than 30% and the prevalence of extreme obesity (BMI > 40 kg/m2) was 2.8% in men and 6.7% in women [1]. Associated health care expenditures in obese individuals is 36% higher than normal weight persons, and it has been estimated that up to 7% of the annual health care expenditures is related to obesity [2,3]. Obesity is a well-recognized risk factor for a variety of medical conditions such as OSA, type 2 diabetes, cardiovascular diseases, hyperlipidemia, metabolic syndrome, and nonalcoholic fatty liver disease.

Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2727690/

The Food and Drug Administration has approved pitolisant (Wakix) for excessive daytime sleepiness among patients with narcolepsy, according to a release from the drug’s developer. Approval of this once-daily, selective histamine 3–receptor antagonist/inverse agonist was based on a pair of multicenter, randomized, double-blind, placebo-controlled studies that included a total of 261 patients. Patients in both studies experienced statistically significant improvements in excessive daytime sleepiness according to Epworth Sleepiness Scale scores.

Rates of adverse advents at or greater than 5% and more than double that of placebo included insomnia (6%), nausea (6%), and anxiety (5%). Patients with severe liver disease should not use pitolisant. Pitolisant has not been evaluated in patients under 18 years of age, and patients who are pregnant or planning to become pregnant are encouraged to enroll in a pregnancy exposure registry.

Source: https://www.mdedge.com/chestphysician/article/206754/sleep-medicine/fda-approves-wakix-excessive-daytime-sleepiness

Abstract

Aims

To investigate the association of estimated total daily sleep duration and daytime nap duration with deaths and major cardiovascular events.

Methods and results

We estimated the durations of total daily sleep and daytime naps based on the amount of time in bed and self-reported napping time and examined the associations between them and the composite outcome of deaths and major cardiovascular events in 116 632 participants from seven regions. After a median follow-up of 7.8 years, we recorded 4381 deaths and 4365 major cardiovascular events. It showed both shorter (≤6 h/day) and longer (>8 h/day) estimated total sleep durations were associated with an increased risk of the composite outcome when adjusted for age and sex. After adjustment for demographic characteristics, lifestyle behaviours and health status, a J-shaped association was observed. Compared with sleeping 6–8 h/day, those who slept ≤6 h/day had a non-significant trend for increased risk of the composite outcome [hazard ratio (HR), 1.09; 95% confidence interval, 0.99–1.20]. As estimated sleep duration increased, we also noticed a significant trend for a greater risk of the composite outcome [HR of 1.05 (0.99–1.12), 1.17 (1.09–1.25), and 1.41 (1.30–1.53) for 8–9 h/day, 9–10 h/day, and >10 h/day, Ptrend < 0.0001, respectively]. The results were similar for each of all-cause mortality and major cardiovascular events. Daytime nap duration was associated with an increased risk of the composite events in those with over 6 h of nocturnal sleep duration, but not in shorter nocturnal sleepers (≤6 h).

Conclusion

Estimated total sleep duration of 6–8 h per day is associated with the lowest risk of deaths and major cardiovascular events. Daytime napping is associated with increased risks of major cardiovascular events and deaths in those with >6 h of nighttime sleep but not in those sleeping ≤6 h/night.

Author:
Chuangshi Wang, Shrikant I Bangdiwala, Sumathy Rangarajan, Scott A Lear,Khalid F AlHabib, Viswanathan Mohan, Koon Teo, Paul Poirier, Lap Ah TSE, Zhiguang Liu, Annika Rosengren, Rajesh Kumar, Patricio Lopez-Jaramillo, Khalid Yusoff, Nahed Monsef,Vijayakumar Krishnapillai, Noorhassim Ismail, Pamela Seron, Antonio L Dans,Lanthé Kruger, Karen Yeates, Lloyd Leach, Rita Yusuf, Andres Orlandini, Maria Wolyniec,Ahmad Bahonar, Indu Mohan, Rasha Khatib, Ahmet Temizhan, Wei Li,Salim Yusuf

Source: https://academic.oup.com/eurheartj/article-abstract/40/20/1620/5229545