PMCC PMCC

Search tips
Search criteria

Advanced
Results 1-9 (9)
 

Clipboard (0)
None

Select a Filter Below

Journals
Year of Publication
Document Types
1.  Diurnal Intermittent Fasting during Ramadan: The Effects on Leptin and Ghrelin Levels 
PLoS ONE  2014;9(3):e92214.
We aimed to assess the effect of Islamic intermittent fasting, during and outside of Ramadan, on plasma levels of leptin and ghrelin while controlling for several potential confounding variables. Eight healthy male volunteers with a mean age of 26.6±4.9 years reported to the sleep disorders center (SDC) at King Saud University on four occasions: 1) adaptation; 2) 4 weeks before Ramadan while performing Islamic fasting for 1 week (baseline fasting) (BLF); 3) 1 week before Ramadan (non-fasting baseline) (BL); and 4) during the second week of Ramadan while fasting. Plasma leptin and ghrelin levels were measured using enzyme-linked immunoassays at 22:00, 02:00, 04:00, 06:00, and 11:00. During BLF, there were significant reductions in plasma leptin concentrations at 22:00 and 02:00 compared with the baseline concentrations (at 22:00: 194.2±177.2 vs. 146.7±174.5; at 02:00: 203.8±189.5 vs. 168.1±178.1; p<0.05). During Ramadan, there was a significant reduction in plasma leptin levels at 22:00 (194.2±177.2 vs. 132.6±130.4, p<0.05). No significant difference in plasma ghrelin concentrations was detected during the BL, BLF, or Ramadan periods. Cosinor analyses of leptin and ghrelin plasma levels revealed no significant changes in the acrophases of the hormones during the three periods. The nocturnal reduction in plasma leptin levels during fasting may be the result of the changes in meal times during fasting.
doi:10.1371/journal.pone.0092214
PMCID: PMC3956913  PMID: 24637892
2.  Sleep medicine services in Saudi Arabia: The 2013 national survey 
Annals of Thoracic Medicine  2014;9(1):45-47.
BACKGROUND:
We conducted this national survey to quantitatively assess sleep medicine services in the Kingdom of Saudi Arabia (KSA) and to identify obstacles that specialists and hospitals face, precluding the establishment of this service.
MATERIALS AND METHODS:
A self-administered questionnaire was designed to collect the following: General information regarding each hospital, information regarding sleep medicine facilities (SFs), the number of beds, the number of sleep studies performed and obstacles to the establishment of SFs. The questionnaire and a cover letter explaining the study objectives were mailed and distributed by respiratory care practitioners to 32 governmental hospitals and 18 private hospitals and medical centers in the KSA.
RESULTS:
The survey identified 18 SFs in the KSA. The estimated per capita number of beds/year/100,000 people was 0.11 and the per capita polysomnography (PSG) rate was 18.0 PSG/year/100,000 people. The most important obstacles to the progress of sleep medicine in the KSA were a lack of trained sleep technologists and a lack of sleep medicine specialists.
CONCLUSION:
The sleep medicine services provided in the KSA have improved since the 2005 survey; however, these services are still below the level of service provided in developed countries. Organized efforts are needed to overcome the identified obstacles and challenges to the progress of sleep medicine in the KSA.
doi:10.4103/1817-1737.124444
PMCID: PMC3912688  PMID: 24551019
Polysomnography; quantitative assessment; sleep disorders center; sleep medicine service; sleep technologists
3.  Objective assessment of drowsiness and reaction time during intermittent Ramadan fasting in young men: a case-crossover study 
Background
Ramadan fasting and its attendant lifestyle changes induce changes in the circadian rhythm and in associated physiological and metabolic functions. Previous studies that have assessed psychomotor performance during Ramadan fasting have reported conflicting results. Therefore, we designed this study to objectively assess the effects of intermittent fasting during and outside Ramadan (to control for lifestyle changes) on drowsiness, blink total duration and mean reaction time (MRT) test while controlling for potential confounders.
Methods
Eight healthy volunteers with a mean age of 25.3 ± 2.9 years and a mean body mass index (BMI) of 23.4 ± 3.2 kg/m2 reported to the sleep laboratory on four occasions for polysomnography (PSG) and drowsiness and psychomotor assessments as follows: 1) adaptation; 2) 4 weeks before Ramadan while performing the Islamic fasting for 1 week (baseline fasting) (BLF); 3) 1 week before Ramadan (non-fasting baseline) (BL); and 4) during the second week of Ramadan while fasting (Ramadan). OPTALERT™ was used to objectively assess daytime drowsiness using the Johns Drowsiness Scale (JDS), and blink total duration and a visual reaction time test were used to assess MRT.
Results
Rapid eye movement (REM) sleep percentage was significantly lower at BLF (17.7 ± 8.1%) and at Ramadan (18.6 ± 10.7%) compared with BL (25.6 ± 4.8%) (p < 0.05). There were no significant differences between JDS scores and blink total duration during the two test periods in BL, BLF and Ramadan. There were no significant changes in MRT during BL, BLF and Ramadan.
Conclusions
Under controlled conditions of fixed light/dark exposure, caloric intake, sleep/wake schedule and sleep quality, the Islamic intermittent fasting has no impact on drowsiness and vigilance as measured by the JDS, total blink duration and MRT.
doi:10.1186/1744-9081-9-32
PMCID: PMC3751553  PMID: 23937904
Ramadan; Fasting; REM sleep; Vigilance; Mean reaction time; Blink duration; Optalert; Johns Drowsiness Scale
4.  The effects of Ramadan fasting on sleep patterns and daytime sleepiness: An objective assessment 
Background:
Ramadan fasting and its associated lifestyle changes have been linked to changes in sleep and daytime sleepiness. This study was designed to assess the effects of Ramadan fasting on patterns of sleep and daytime sleepiness.
Methods:
The SenseWear Pro Armband™ was used to assess the duration and distribution of sleep in eight Muslim and eight non-Muslim volunteers during the last week of Shaaban [baseline (BL) and the first (R1) and second (R2) weeks of Ramadan (1430 H)]. OPTALERT™ was used to assess daytime drowsiness objectively using the John Drowsiness Scale (JDS) to assess sleepiness, and a visual reaction time test was used to assess mean reaction time (MRT).
Results:
The mean ages of Muslims and non-Muslims were 36.25 ± 4.46 and 34.75 ± 3.33 years, respectively. Although the start of work was delayed for Muslims from 0730 to 1000 hours, there was no change in working hours for non-Muslims. During Ramadan, bedtime and wake-up time were delayed, and there was a significant reduction in total sleep time for Muslims (5.91 ± 1.36 hours, 4.95 ± 1.46 hours, and 4.78 ± 1.36 hours during BL, R1, and R2, respectively, P < 0.001), but not for non-Muslims. JDS values in both Muslims and non-Muslims were normal at BL (1.70 ± 1.16 and 1.68 ± 1.07, respectively), and no changes occurred during Ramadan (R1 or R2), indicating no increase in daytime sleepiness. There were no significant changes in MRT during R1 and R2 from BL in either group.
Conclusion:
Although the sleep cycle of the studied sample shifted during Ramadan among fast observers, there was no objective evidence for increased sleepiness during fasting.
PMCID: PMC3724373  PMID: 23914215
Ramadan; fasting; sleep; sleepiness; vigilance
5.  Sleep estimation using BodyMedia's SenseWear™ armband in patients with obstructive sleep apnea 
Annals of Thoracic Medicine  2013;8(1):53-57.
OBJECTIVES:
We aimed to evaluate the validity of the BodyMedia's SenseWear™ Armband (BSA) device in estimating total sleep time (TST) in patients with obstructive sleep apnea (OSA).
METHODS:
Simultaneous overnight recordings of in-laboratory polysomnography (PSG) and BSA were performed on (1) 107 OSA patients (mean age of 45.2 ± 14.3 years, mean apnea hypopnea index of 43 ± 35.7/hr and (2) 30 controls matched with OSA patients for age and body mass index. An agreement analysis between the PSG and BSA scoring results was performed using the Bland and Altman method.
RESULTS:
There was no significant difference in OSA patients between BSA and PSG with regard to TST, total wake time, and sleep efficiency. There was also no significant difference in the controls between BSA and PSG with regard to TST, total wake time, and sleep efficiency. Bland Altman plots showed strong agreement between TST, wake time, and sleep efficiency for both OSA and the controls. The intraclass correlation coefficients revealed perfect agreement between BSA and PSG in different levels of OSA severity and both genders.
CONCLUSION:
The current data suggest that BSA is a reliable method for determining sleep in patients with OSA when compared against the gold standard test (PSG). BSA can be a useful tool in determining sleep in patients with OSA and can be combined with portable sleep studies to determine TST.
doi:10.4103/1817-1737.105720
PMCID: PMC3573559  PMID: 23440703
Actigraphy; armband; polysomnography; portable monitoring; sleep apnea; sleep duration; sleep-disordered breathing; type 4 sleep study
6.  The relationship between sleep and wake habits and academic performance in medical students: a cross-sectional study 
BMC Medical Education  2012;12:61.
Background
The relationship between the sleep/wake habits and the academic performance of medical students is insufficiently addressed in the literature. This study aimed to assess the relationship between sleep habits and sleep duration with academic performance in medical students.
Methods
This study was conducted between December 2009 and January 2010 at the College of Medicine, King Saud University, and included a systematic random sample of healthy medical students in the first (L1), second (L2) and third (L3) academic levels. A self-administered questionnaire was distributed to assess demographics, sleep/wake schedule, sleep habits, and sleep duration. Daytime sleepiness was evaluated using the Epworth Sleepiness Scale (ESS). School performance was stratified as “excellent” (GPA ≥3.75/5) or “average” (GPA <3.75/5).
Results
The final analysis included 410 students (males: 67%). One hundred fifteen students (28%) had “excellent” performance, and 295 students (72%) had “average” performance. The “average” group had a higher ESS score and a higher percentage of students who felt sleepy during class. In contrast, the “excellent” group had an earlier bedtime and increased TST during weekdays. Subjective feeling of obtaining sufficient sleep and non-smoking were the only independent predictors of “excellent” performance.
Conclusion
Decreased nocturnal sleep time, late bedtimes during weekdays and weekends and increased daytime sleepiness are negatively associated with academic performance in medical students.
doi:10.1186/1472-6920-12-61
PMCID: PMC3419622  PMID: 22853649
Sleep; Sleep duration; Medical students; Academic performance; School
7.  Sleep architecture of consolidated and split sleep due to the dawn (Fajr) prayer among Muslims and its impact on daytime sleepiness 
Annals of Thoracic Medicine  2012;7(1):36-41.
BACKGROUND:
Muslims are required to wake up early to pray (Fajr) at dawn (approximately one and one-half hours before sunrise). Some Muslims wake up to pray Fajr and then sleep until it is time to work (split sleep), whereas others sleep continuously (consolidated sleep) until work time and pray Fajr upon awakening.
AIM:
To objectively assess sleep architecture and daytime sleepiness in consolidated and split sleep due to the Fajr prayer.
SETTING AND DESIGN:
A cross-sectional, single-center observational study in eight healthy male subjects with a mean age of 32.0 ± 2.4 years.
METHODS:
The participants spent three nights in the Sleep Disorders Center (SDC) at King Khalid University Hospital, where they participated in the study, which included (1) a medical checkup and an adaptation night, (2) a consolidated sleep night, and (3) a split-sleep night. Polysomnography (PSG) was conducted in the SDC following the standard protocol. Participants went to bed at 11:30 PM and woke up at 7:00 AM in the consolidated sleep protocol. In the split-sleep protocol, participants went to bed at 11:30 PM, woke up at 3:30 AM for 45 minutes, went back to bed at 4:15 AM, and finally woke up at 7:45 AM. PSG was followed by a multiple sleep latency test to assess the daytime sleepiness of the participants.
RESULTS:
There were no differences in sleep efficiency, the distribution of sleep stages, or daytime sleepiness between the two protocols.
CONCLUSION:
No differences were detected in sleep architecture or daytime sleepiness in the consolidated and split-sleep schedules when the total sleep duration was maintained.
doi:10.4103/1817-1737.91560
PMCID: PMC3277040  PMID: 22347349
Consolidated sleep; daytime sleepiness; Fajr prayer; sleep architecture; split sleep
8.  Assessment of sleep patterns, energy expenditure and circadian rhythms of skin temperature in patients with acute coronary syndrome 
Summary
Background
There is no simple and practical way to monitor sleep patterns in patients in acute care units. We designed this study to assess sleep patterns, energy expenditure and circadian rhythms of patients’ skin temperature in the coronary care unit (CCU) utilizing a new portable device.
Material/Methods
The SenseWear Armband (SWA) was used to record sleep duration, distribution over 24 hr, energy expenditure and the circadian rhythms of skin temperature in 46 patients with acute coronary syndrome (ACS) for the first 24 hr in the CCU and upon transfer to the ward. An advanced analysis was used to extract and compare data associated with the above variables in the two settings.
Results
Patients in the CCU had a reduced night’s sleep duration (5.6±2.2 hr) with more frequent and significantly shorter night sessions (p=0.015) than patients in the ward. Energy expenditure and METs (metabolic equivalents of a task) were significantly lower in the CCU than in the ward. However, the midline-estimating statistic of rhythm (MESOR) and acrophase for skin temperature did not exhibit any significant difference between the two settings.
Conclusions
Patients with ACS have sleep fragmentation and shorter nocturnal sleep duration in the CCU compared to the ward. On the other hand, there was no difference in the circadian rhythms of skin temperature between patients in the CCU and the general wards.
doi:10.12659/MSM.881851
PMCID: PMC3539555  PMID: 21709634
acute coronary syndrome; acute myocardial infarction; circadian rhythm; sleep; energy expenditure; temperature
9.  Sleep medicine education and knowledge among medical students in selected Saudi Medical Schools 
BMC Medical Education  2013;13:133.
Background
Limited information is available regarding sleep medicine education worldwide. Nevertheless, medical education has been blamed for the under-recognition of sleep disorders among physicians. This study was designed to assess the knowledge of Saudi undergraduate medical students about sleep and sleep disorders and the prevalence of education on sleep medicine in medical schools as well as to identify the obstacles to providing such education.
Methods
We surveyed medical schools that were established more than 10 years ago, asking fourth- and fifth-year medical students (men and women) to participate. Seven medical schools were selected. To assess knowledge on sleep and sleep disorders, we used the Assessment of Sleep Knowledge in Medical Education (ASKME) Survey, which is a validated 30-item questionnaire. The participants were separated into two groups: those who scored ≥60% and those who scored <60%. To assess the number of teaching hours dedicated to sleep medicine in the undergraduate curricula, the organizers of the major courses on sleep disorders were contacted to obtain the curricula for those courses and to determine the obstacles to education.
Results
A total of 348 students completed the survey (54.9% male). Among the participants, 27.7% had a specific interest in sleep medicine. More than 80% of the study sample had rated their knowledge in sleep medicine as below average. Only 4.6% of the respondents correctly answered ≥60% of the questions. There was no difference in the scores of the respondents with regard to university, gender, grade-point average (GPA) or student academic levels. Only five universities provided data on sleep medicine education. The time spent teaching sleep medicine in the surveyed medical schools ranged from 0-8 hours with a mean of 2.6 ±2.6 hours. Identified obstacles included the following: (1) sleep medicine has a lower priority in the curriculum (53%) and (2) time constraints do not allow the incorporation of sleep medicine topics in the curriculum (47%).
Conclusions
Medical students in the surveyed institutions possess poor knowledge regarding sleep medicine, which reflects the weak level of education in this field of medicine. To improve the recognition of sleep disorders among practicing physicians, medical schools must provide adequate sleep medicine education.
doi:10.1186/1472-6920-13-133
PMCID: PMC3849688  PMID: 24070217
Sleep medicine; Education; ASKME survey; Medical schools; Medical students; Knowledge

Results 1-9 (9)