Study Objectives: To validate a contact-free system designed to achieve maximal comfort during long-term sleep monitoring, together with high monitoring accuracy. Methods: We used a contact-free monitoring system (EarlySense, Ltd., Israel), comprising an under-the-mattress piezoelectric sensor and a smartphone application, to collect vital signs and analyze sleep. Heart rate (HR), respiratory rate (RR), body movement, and calculated sleep-related parameters from the EarlySense (ES) sensor were compared to data simultaneously generated by the gold standard, polysomnography (PSG). Subjects in the sleep laboratory underwent overnight technician-attended full PSG, whereas subjects at home were recorded for 1 to 3 nights with portable partial PSG devices. Data were compared epoch by epoch. Results: A total of 63 subjects (85 nights) were recorded under a variety of sleep conditions. Compared to PSG, the contact-free system showed similar values for average total sleep time (TST), % wake, % rapid eye movement, and % non-rapid eye movement sleep, with 96.1% and 93.3% accuracy of continuous measurement of HR and RR, respectively. We found a linear correlation between TST measured by the sensor and TST determined by PSG, with a coefficient of 0.98 (R = 0.87). Epoch-by-epoch comparison with PSG in the sleep laboratory setting revealed that the system showed sleep detection sensitivity, specificity, and accuracy of 92.5%, 80.4%, and 90.5%, respectively. Conclusions: TST estimates with the contact-free sleep monitoring system were closely correlated with the gold-standard reference. This system shows good sleep staging capability with improved performance over accelerometer-based apps, and collects additional physiological information on heart rate and respiratory rate.
Study Objectives: To evaluate the effects of pediatric epilepsy on sleep in parents of epileptic children. Methods: Cohort design in which the sleep quality of parents of epileptic children (POEC) and parents of nonepileptic children (PONEC) in the month preceding recruitment were compared using the self-administered Pittsburgh Sleep Quality Index (PSQI). Results: Mothers of epileptic children had a 7-fold occurrence of sleep disturbances when compared to mothers of non-epileptic children (OR = 6.66 CI 95% 1.10-70.08). The sleep characteristics that showed statistically signifi cant differences were: sleep duration, sleep continuity, and selfevaluation of sleep quality (p < 0.05 for all parameters). No signifi cant difference in sleep quality was found between fathers of epileptic children and fathers of nonepileptic children. Conclusions: Sleep disturbances are more common in mothers of epileptic children. The sleep quality of mothers to epileptic children should be considered in their comprehensive management, and if necessary, the sleep disturbance should be addressed. S C I E N T I F I C I N V E S T I g A T I O N SE pilepsy is one of the most common chronic clinical problems in the pediatric population, and appears in approximately 0.5% children. As in other chronic pediatric diseases, epilepsy has an appreciable negative impact on the quality of life in the family in general, and the parents in particular.1,2 Furthermore, epilepsy has unique characteristics that contribute to a prolonged adaptive diffi culty of the parent. This includes unpredictable stressful events, social stigma of the child and family, extended treatment regimen subject to frequent changes, and cognitive disturbances accompanying the disease and treatment. Previous research has shown that even in comparison with other chronic pediatric diseases, parents of children with epilepsy suffer from higher rates of stress, anxiety, and depression, which manifest in signifi cant impairment in social, familial, and personal parental functioning. 3,4 Despite the fact that there has been research investigating the effects on the lives of the parents in chronic pediatric disease in general and pediatric epilepsy in particular, there is insuffi cient data on the effects on the sleep quality of the parents, even though this impairment is liable to be accompanied by negative repercussions.Insomnia, which may be a symptom, a sign, or a primary disturbance, is currently defi ned only as a symptom, in the presence of ≥ 1 of 4 characteristics: diffi culty in falling asleep, involuntary early awakening, diffi culty in remaining continually asleep, and unrefreshing sleep. As a syndrome, sleep diffi culties must occur in association with a complaint of impaired daytime functioning (e.g., diminished vocational functioning) and in the presence of adequate opportunity to sleep.For the purpose of this project we decided to use the ICSD-2 general criteria for insomnia that do not specify a frequency and duration for the insomnia symptoms.5 Studies of the pathophys...
Context The rare syndrome of hypoparathyroidism, retardation, and dysmorphism (OMIM #241410) is caused by the mutated tubulin chaperone E (TBCE) gene. This gene encodes a critical protein in the microtubule assembly pathway. Objective To evaluate the endocrine profile of HRD patients. Methods The study used a retrospective analysis of a large cohort of patients in a single university medical center. Sixty-three patients were diagnosed with HRD during 1990–2019; 58 of them had an endocrine evaluation. Main outcome measures: We investigated somatic growth parameters, the prevalence of hypoglycemia, growth hormone deficiency, hypothyroidism, hypogonadism, and cortisol deficiency. Results All patients were born small for gestational age, and severe growth retardation was found in all patients with mean height SDS of -8.8 (range -5.1 to -15.1) and weight SDS -18 (range -5.1 to -61.2). Serum IGF-1 concentrations were very low among the 21 studied patients: -2.32 SDS (range -0.6 to -2.7). Four out of 14 (28%) investigated patients had growth hormone deficiency. 55% of patients were hospitalized due to symptomatic hypoglycemia. adrenal glucocorticoid insufficiency was diagnosed in 22% of those tested. 36% of patients had hypothyroidism. Both hypogonadotrophic and hypergonadotrophic hypogonadism were observed. The main MRI findings were small anterior pituitary gland, small hippocampus, brain atrophy, thin corpus callosum, Chiari type I malformation, and septo-optic dysplasia. Conclusion Multiple endocrine abnormalities are common in patients with HRD syndrome. Periodic Screening of thyroid and adrenal functions is recommended.
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