Ryutaro Shirahama

Nocturnal enuresis and sleep disordered breathing in primary school children: Potential implications

The association between nocturnal enuresis (NE) and sleep disordered breathing (SDB) has been repeatedly reported, but has primarily been focused on clinical cohorts. The purpose of this study, was to assess whether SDB‐related symptoms such as snoring and unrefreshing sleep in the morning are associated with NE in a large‐scale community school‐based survey.

Harmonizing work with the treatment and prevention of sleep disordered breathing in commercial motor vehicle drivers: implications for health and productivity management

The desastrous traffic accidents to date have provided the relevance for promotion of harmonization of work with treatment and prevention of sleep disordered breathing (SDB) in transport sectors. SDB is highly prevalent in commercial motor vehicle (CMV) drivers and is one cause of cognitive impairment and consequent traffic accidents, potentially costing billions and leading to many deaths. Various screening, diagnostic, and therapeutic approaches, some well established, are explored in this paper. Although drivers with SDB need to be appropriately diagnosed and treated, some are reluctant to continue their treatment or never submit to screening because of a lack of information. Thus, CMV drivers need to be well informed and screened, in addition to being encouraged to continue the treatment. The harmonization of work with treatment and prevention aids these objectives, providing benefits not only for individual health but also for transport companies, and further being an essential step towards uptake of “health and productivity management” in the transport sectors.

Association Between Heart Rate Variability and Home Blood Pressure: The Toon Health Study

BACKGROUNDnAlthough blood pressure (BP) is regulated by the autonomic nervous system, it is not fully understood how autonomic activity affects BP at home in the general population.nnnMETHODSnSubjects were enrolled from 2009 to 2012 and included 1,888 men and women aged 30-79 years. We measured casual BP in the morning during health checkups and asked participants to monitor BP at home twice in the morning and evening for 1 week. The mean of the two measurements of mean arterial pressure (MAP) was calculated. Five-minute recordings of the pulse wave from a fingertip sensor were used to determine the following indices of heart rate variability (HRV): standard deviation of normal-to-normal RR intervals (SDNN), root mean square of successive differences in RR intervals (RMSSD), high frequency (HF) power, low frequency (LF) power, and LF/HF.nnnRESULTSnSex- and age-adjusted means of casual MAP, and morning and evening MAP at home were significantly different among quartiles of SDNN, RMSSD, and HF. When further adjusted for smoking, alcohol drinking, medication for hypertension, diabetes, sleeping hours, snoring, and mental health status, the associations were somewhat attenuated. Inverse relationships were found between the means of morning home MAP, and RMSSD (P = 0.02) and HF (P = 0.051) after adjustment for confounders. The association between MAP and RMSSD, or MAP and HF was evident in individuals <65 years old.nnnCONCLUSIONnLow HF and RMSSD, which reflect impaired parasympathetic nervous system activity, were associated with increased home MAP in the morning rather than in the evening.