BACKGROUND & AIMS: :Obstructive sleep apnoea (OSA) is a complex disease entity strongly influenced by genetic factors, especially those that affect obesity and fat distribution, upper airway muscle tone, craniofacial morphology, ventilatory control and sleep, giving rise to the OSA phenotype. OSA can also be considered a metabolic syndrome which adversely affects multiple organ systems, especially the cardiovascular system and the brain. The most widely used clinical marker for the diagnosis of OSA is the apnoea-hypopnoea index, calculated by polysomnography. A percentage of 35 to 40% of its variance can be attributed to genetic factors. Therefore, the identification and elucidation of the genes implicated in the pathogenesis of OSA becomes a matter of extensive research and could lead to the development of therapeutic agents that can have a beneficial effect on the natural course of OSA.

背景与目标： 阻塞性睡眠呼吸暂停（OSA）是一种复杂的疾病实体，受到遗传因素的强烈影响，尤其是那些影响肥胖和脂肪分布，上呼吸道肌张力，颅面形态，通气控制和睡眠的因素，从而引起OSA表型。 OSA也可以被认为是一种代谢综合症，会对多种器官系统，尤其是心血管系统和大脑产生不利影响。用于诊断OSA的最广泛使用的临床指标是通过多导睡眠监测仪计算出的呼吸暂停-呼吸不足指数。其变异的35％至40％的百分比可归因于遗传因素。因此，鉴定和阐明与OSA发病机理有关的基因成为广泛研究的问题，并可能导致开发对OSA天然过程具有有益作用的治疗剂。

BACKGROUND & AIMS: BACKGROUND:Surveys of the population are commonly used to obtain information on health status. Increasingly, researchers are linking self-reported health status information to primary care consultation data. However, it is not known how participating in a health-related survey affects consultation behaviour. The objective of this study was to assess whether completion of a health-related questionnaire changes primary care consultation behaviour. METHODS:Participants were 3402 adults aged 50 and over from the general population in North Staffordshire, UK, who completed a health-related postal survey received in April 2003. The survey was predominantly about occurrence and severity of knee pain in the last year. Primary care attendance for the three months following response was compared to three control periods: i) the three months prior to the survey, ii) the same time period in the previous year and iii) the same time period in the following year. Comparisons were made on consultations for any problem, consultations for musculoskeletal disorders and consultations for knee problems. RESULTS:The percentage of subjects consulting for any condition was marginally higher for the three months directly after receipt of the questionnaire but the difference was only statistically significant in comparison to the three months before the survey (64% v. 62%, p = 0.05). There was little difference in consultation prevalence for musculoskeletal problems immediately after the survey compared to the three control periods. There was an increase of 37% in knee disorder consultations for the three months after the survey compared to the three months directly before the survey (p = 0.02). However, consultation prevalence for knee problems was identical for the three months after the survey to the same time periods in the years prior to and following the survey (both p = 0.94). CONCLUSION:The results from this study suggests that questionnaires related to physical health do not affect the standard consulting behaviour of patients, even for the symptom under investigation. This should reassure researchers who wish to link self-reported health status and medical care utilisation and clinicians whose patients are involved in such research.

背景与目标： 背景：人口调查通常用于获取有关健康状况的信息。研究人员越来越多地将自我报告的健康状况信息与初级保健咨询数据联系起来。但是，尚不清楚参与健康相关调查如何影响咨询行为。这项研究的目的是评估完成与健康有关的问卷是否会改变初级保健咨询的行为。
方法：参与者是来自英国北部斯塔福德郡（North Staffordshire）的3402名年龄在50岁以上的成年人，他们于2003年4月完成了一项与健康相关的邮政调查。该调查主要是关于去年膝盖疼痛的发生和严重程度。将响应后三个月的基层医疗出勤率与三个对照期进行比较：i）调查前三个月，ii）上一年的相同时期，iii）下一年的相同时期。对任何问题的咨询，肌肉骨骼疾病的咨询和膝盖问题的咨询进行了比较。
结果：在收到问卷后的三个月中，针对任何情况进行咨询的受试者的百分比略高，但与调查前的三个月相比，差异仅在统计上具有统计学意义（64％对62％，p = 0.05 ）。与三个对照期相比，调查后立即就骨骼肌肉问题进行咨询的患病率差异不大。与调查前三个月相比，调查后三个月的膝关节疾病咨询增加了37％（p = 0.02）。但是，膝关节问题的咨询患病率在调查后的三个月内与调查前后几年中的相同时间段相同（均为p = 0.94）。
结论：这项研究的结果表明，与身体健康相关的问卷不会影响患者的标准咨询行为，即使对于所调查的症状也是如此。这应该使希望将自我报告的健康状况和医疗利用联系起来的研究人员以及患者参与此类研究的临床医生得到保证。

BACKGROUND & AIMS: OBJECTIVE:The authors' goal was to test the hypothesis that the antidepressant effect of total sleep deprivation can be maintained by initially avoiding sleep during a supposedly "critical" time period in the early morning.

METHOD:They studied 33 inpatients with major depression, melancholic type, all of whom responded positively to total sleep deprivation. Twelve of the patients were men and 21 were women; their mean age was 46.7 years (SD = 13.7). After total sleep deprivation, the patients started a sleep schedule from 5:00 p.m. to 12:00 midnight, which then was shifted back by 1 hour each day until a sleep time of 11:00 p.m. to 6:00 a.m. was reached.

RESULTS:Twenty (61%) of the 33 patients who responded to total sleep deprivation with an improved state of mood maintained this improvement during sleep phase advance therapy. Drug-free and medicated patients did not differ from each other.

CONCLUSIONS:The rapid amelioration of mood observed with total sleep deprivation can be preserved with a succeeding phase shift of the sleep period.

背景与目标： 目的：作者的目标是检验以下假设：通过在清晨所谓的“关键”时间段内最初避免入睡，可以维持完全睡眠剥夺的抗抑郁作用。
< br> METHOD ：他们研究了33例重度抑郁，忧郁型抑郁症住院患者，所有患者对总睡眠不足的反应都积极。病人中有十二名是男性，二十一名是女性；他们的平均年龄为46.7岁（SD = 13.7）。在完全睡眠剥夺之后，患者从下午5:00开始睡眠计划。到午夜12:00，然后每天回移1小时，直到晚上11:00的睡眠时间。

结果：在对总睡眠剥夺有改善的情绪状态的33例患者中，有20例（61％）在睡眠阶段保持了这种改善提前治疗。无药和药物治疗的患者没有区别。

结论：随着睡眠时间的相移，可以保持完全睡眠剥夺所观察到的情绪快速改善。 。