scholarly journals Increasing Risks of Suicide Attempt and Suicidal Drug Overdose After Head Trauma in Patients With Sleep-Disordered Breathing: A Population-Based Study

2020 ◽  
Vol 11 ◽  
Author(s):  
Dorji Harnod ◽  
Cheng-Li Lin ◽  
Tomor Harnod ◽  
Chia-Hung Kao
Keyword(s):  
Suicide Attempt ◽  
Head Trauma ◽  
Drug Overdose ◽  
Sleep Disordered Breathing ◽  
Population Based ◽  
Research Database ◽  
Hazard Ratios ◽  
Suicide Behaviors ◽  
Disordered Breathing

Objective: To determine the risks of suicide attempt (SA) and suicidal drug overdose (SDO) after head trauma in patients with sleep-disordered breathing (SDB) by using the National Health Insurance Research Database of Taiwan.Methods: We analyzed the data of patients aged ≥20 years who were diagnosed with SDB between 2000 and 2012. We further divided them into two cohorts [with admission for head injury (SBI) and without (SBN)], and we compared them against sex-, age-, comorbidity-, and index-date-matched healthy individuals. The adjusted hazard ratios (aHRs) and 95% confidence intervals of SA and SDO were calculated with adjustment of age, sex, and comorbidities.Results: Approximately 0.61% of patients among the overall 142,063 patients with SDB had SA, with 535 and 335 patients included in the SBN and SBI cohorts, respectively. Compared with patients with SBN, a significantly higher risk of SA was observed in patients with SBI (aHR = 2.22), especially in those aged under 50 years (aHR = 2.48). Notably, a SDO incidence of 1.20% was noted in patients with SDB, and the SBI cohort had a 1.81-fold higher risk for SDO when compared with the SBN cohort.Conclusion: The risks of subsequent SA and SDO are proportionally increased by the effects of head trauma with a moderating role of SDB, especially in those aged <50 years. SDB and head trauma can increase suicide behaviors individually and synergistically.

scholarly journals Differences in Incidence and Risks of Suicide Attempt and Suicidal Drug Overdose between Patients with Epilepsy with and without Comorbid Depression

2019 ◽  
Vol 16 (22) ◽  
pp. 4533
Author(s):  
Chi-Yu Lin ◽  
Tomor Harnod ◽  
Cheng-Li Lin ◽  
Wei-Chih Shen ◽  
Chia-Hung Kao
Keyword(s):  
Suicide Attempt ◽  
Drug Overdose ◽  
Research Database ◽  
Comorbid Depression ◽  
Hazard Ratios ◽  
Increased Risk ◽  
Crucial Information ◽  
The Government ◽  
Using Data ◽  
Patients With Epilepsy

Objective: To determine the differences in the incidences and risks of suicide attempt (SA) and suicidal drug overdose (SDO) between patients with epilepsy with and without comorbid depression by using data from Taiwan’s National Health Insurance Research Database. Methods: We analyzed data of patients (≥20 years) who had received epilepsy diagnoses between 2000 and 2012; the diagnosis date of epilepsy was defined as the index date. The epilepsy patients were divided into the cohorts, with and without comorbid depression, and compared against a cohort from the non-affected population. We calculated adjusted hazard ratios and the corresponding 95% confidence intervals for SA and SDO in the three cohorts after adjustment for age, sex, and comorbidities. Results: The incidences of SA and SDO in the cohort with epilepsy and depression were 42.9 and 97.4 per 10,000 person-years, respectively. The epilepsy with depression cohort had 21.3 times of SA risk; and 22.9 times of SDO risk than did the comparison cohort had a 6.03-fold increased risk of SA and a 2.56-fold increased risk of SDO than did the epilepsy patients without depression. Moreover, patients’ age <65 years, and female sex would further increase the risk of SA in patients with epilepsy and comorbid depression. Conclusion: Risks of SA and SDO in patients with epilepsy are proportionally increased when depression is coexisted. Our findings provide crucial information for clinicians and the government for suicide prevention and to question whether prescribing a large number of medications to patients with epilepsy and depression is safe.

scholarly journals Increased Risks of Suicide Attempt and Suicidal Drug Overdose Following Admission for Head Injury in Patients with Depression

2019 ◽  
Vol 16 (19) ◽  
pp. 3524 ◽  
Author(s):  
Harnod ◽  
Harnod ◽  
Lin ◽  
Shen ◽  
Kao
Keyword(s):  
Head Injury ◽  
Suicide Attempt ◽  
Drug Overdose ◽  
Comparison Group ◽  
Research Database ◽  
Hazard Ratios ◽  
Medicinal Substances ◽  
Taiwan National Health Insurance ◽  
Crucial Information

Aims: To determine the risks of suicide attempt (SA) and suicidal drug overdose (SDO) following the admission for head injury of patients with depression. Design: We analyzed the NHIRD data of patients aged ≥20 years who had received depression diagnoses between 2000 and 2010. They were divided into cohorts of those with admission for head injury (DHI) and those without it (DWI) during the follow-up period and compared against a sex-, age-, comorbidity-, and index-date-matched cohort from the general population. Setting: The Taiwan National Health Insurance Research Database (NHIRD). Participants/Cases: We analyzed the NHIRD data of patients (≥20 years) who had received depression diagnoses between 2000 and 2010. Intervention(s): Regular interventions. Measurements: We calculated the adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) of SA and SDO in these cohorts after adjustment for age, sex, and comorbidities. Findings: Up to the end of 2011, our results revealed extremely high incidences of SA and SDO with 63.3 and 88.6 per 10,000 person-years, respectively, in the DHI cohort. The DHI cohort had a 37.4-times higher risk for SA and a 17.1-times higher risk for SDO compared with the comparison group and had aHRs of 14.4 and 16.3, respectively, for poisoning by medicinal substances and poisoning by tranquilizers compared with patients in the DWI cohort. Patients with DHI aged <50 years, of female sex, with high incomes, living in more urbanized areas, and without other comorbidities had extraordinarily higher risks for SA. Conclusions: The risks of SA and SDO were proportionally increased by head injury in patients with depression in Taiwan. Our findings provide crucial information to implement efficient suicide prevention strategies in the future.

scholarly journals Risk and Predisposing Factors for Suicide Attempts in Patients with Migraine and Status Migrainosus: A Nationwide Population-Based Study

2018 ◽  
Vol 7 (9) ◽  
pp. 269 ◽  
Author(s):  
Tomor Harnod ◽  
Cheng-Li Lin ◽  
Chia-Hung Kao
Keyword(s):  
Suicide Attempt ◽  
Suicide Attempts ◽  
Population Based ◽  
Research Database ◽  
Monthly Income ◽  
Government Officials ◽  
Population Based Study ◽  
Hazard Ratios ◽  
Comparison Cohort ◽  
Status Migrainosus

Objective: To investigate the risk and risk factors for suicide attempt by patients with regular migraines (RM) and status migrainosus (SM) in Taiwan. Methods: We analyzed a subset of the National Health Insurance Research Database of Taiwan and enrolled patients (≥20 years old) who had ever received a diagnosis of RM or SM between 2000 and 2012 in the RM and SM cohort. The SM cohort included 13,605 patients, the RM cohort had 21,485 patients, and the comparison cohort contained approximately four times that many patients. We calculated the adjusted hazard ratios and 95% confidence intervals (CI) for suicide attempts after adjusting for age, sex, monthly income, urbanization level, occupation, and comorbidities. Results: The SM cohort had a 1.81-fold risk of attempting suicide (95% CI = 1.14–2.89) compared to the comparison cohort. Other factors that predispose patients with SM to attempt suicide include the following: female sex, relatively young age (<50 years old), and low monthly income (<15,000 New Taiwan Dollars, approximately equivalent to 495 US Dollars). Additionally, the risk of attempting suicide only increased in patients who had been diagnosed with SM for longer than five years. Conclusion: SM is associated with a higher risk for suicide attempt in migraineurs in Taiwan. This finding is important to clinicians and government officials seeking to prevent patients from attempting suicide in Taiwan and other similar East Asian countries.

Abstract P105: Sleep Disordered Breathing and Cardiac Autonomic Modulation in Adolescents - Penn State Child Cohort (PSCC) Study

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Edward O Bixler ◽  
Fan He ◽  
Sol Rodriguez-Colon ◽  
Julio Fernandez-Mendoza ◽  
Alexandros Vgontzas ◽  
...  
Keyword(s):  
Heart Rate ◽  
Sleep Disordered Breathing ◽  
Population Based ◽  
Apnea Hypopnea Index ◽  
Autonomic Modulation ◽  
Rr Intervals ◽  
Cardiac Autonomic Modulation ◽  
The Mean ◽  
Frequency Power ◽  
Disordered Breathing

Objectives: To investigate the relationship between sleep disordered breathing (SDB) and cardiac autonomic modulation (CAM) in a population-based sample of adolescents. Methods: We used available data from 400 adolescents who completed the follow up examinations in the population-based PSCC study. 1-night polysomnography was used to assess apnea hypopnea index (AHI). AHI was used to define no-SDB (AHI<1), mild SDB (1≤AHI<5), and moderate SDB (AHI≥5). CAM was assessed by heart rate variability (HRV) analysis of beat-to-beat normal R-R intervals from a 39-hour high resolution Holter ECG. The HRV indices in frequency domain [high frequency power (HF), low frequency power (LF), and LF/HF ratio] and time domain [standard deviation of normal RR intervals (SDNN), and the square root of the mean squared difference of successive normal RR intervals (RMSSD), and heart rate (HR)] were calculated on a 30-minute basis (78 repeated measures). Mixed-effects models were used to assess the SDB and HRV relationship. Results: The mean age was 16.9 yrs (SD=2.19), with 54% male and 77% white. The mean (SD) AHI were 0.52 (0.26), 2.38 (1.03), and 12.27 (14.54) for no-, mild-, and moderate-SDB participants. The age, race, sex, and BMI percentile adjusted mean (SE) HRV indices across three SDB groups are presented in Table 1. In summary, sleep disordered breathing was associated with lower HRV and higher HR in this population-based adolescent sample, with a significant dose-response relationship. Conclusion: moderate SDB in adolescents is already associated with lower HRV, indicative of sympathetic activation and lower parasympathetic modulation, which has been associated with cardiac events in adults.

Abstract P249: Incident Sleep-Disordered Breathing is Associated with Obesity: Penn State Child Cohort

Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Edward O Bixler ◽  
Alexandros N Vgontzas ◽  
Duanping Liao ◽  
Susan Calhoun ◽  
Julio Fernandez-Mendoza ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Sleep Disordered Breathing ◽  
Population Sample ◽  
Population Based ◽  
Penn State ◽  
Potential Risk Factors ◽  
State Child ◽  
Disordered Breathing

Objectives: To study the epidemiology of sleep-disordered breathing (SDB) in adolescents, which has received little attention. Methods: The Penn State Child Cohort (PSCC) is a representative general population sample of 700 children aged 5-12 years. Our preliminary results are based on an average 8 year follow up of the initial 300 prospective subjects (~43%) from this ongoing cohort study. A logistic regression was used to assess the association between potential risk factors and incident SDB. Results: The mean age at the 8-year follow up examination was 17.2 ± 0.1 years, with an average BMI percentile of 66.6 ± 1.6 and 56.5% boys. At baseline 1.5% of this subsample had SDB, defined by Apnea Hypopnia Index (AHI > 5 /hour). Surprisingly, there was no persistence of SDB. Eight-year incident SDB was 10.5%. The average AHI in those with incident SDB was 12.7 with a maximum of 92.4. Incident SDB was similar for girls (7.8%) and boys (12.7%). Those with SDB were older than those without (18.7 vs 17.0 years, P<0.001) and girls with SDB were older than boys with SDB (20.0 vs 18.0 years, P=0.002). Those with incident SDB tended to have a greater change in BMI percentile (8.2 vs 1.8, P = 0.143) during the follow up and slightly higher minority representation (25.8% vs 21.9%, P=0.655). A logistic regression model identified three variables that were associated with incident SDB, controlling for baseline AHI: age (OR = 1.5 (1.3, 1.9) P<0.001), male (OR= 2.5 (1.11,10.00) P=0.021), and [[Unable to Display Character: &#8710;]]BMIPCT (OR=1.2(1.02, 1.5) P=0.032). Conclusion: In this population based sample of adolescents, the 8-year incidence of SDB was high (10.5%), whereas childhood SDB did not persist into adolescence. Further, the results indicate that risk factors for incident SDB in adolescents are age, male and the development of obesity.

Sleep fragmentation and sleep-disordered breathing in individuals living close to main roads: results from a population-based study

2014 ◽  
Vol 15 (3) ◽  
pp. 322-328 ◽  
Author(s):  
M.W. Gerbase ◽  
J. Dratva ◽  
M. Germond ◽  
J.M. Tschopp ◽  
J.L. Pépin ◽  
...  
Keyword(s):  
Sleep Disordered Breathing ◽  
Population Based ◽  
Sleep Fragmentation ◽  
Population Based Study ◽  
Disordered Breathing

scholarly journals MinimallyInvasive Radiofrequency Surgery in Sleep-Disordered Breathing

Healthcare ◽  
2019 ◽  
Vol 7 (3) ◽  
pp. 97
Author(s):  
Ankit Patel ◽  
Bhik Kotecha
Keyword(s):  
Sleep Disordered Breathing ◽  
Sleep Apnoea ◽  
Long Term Outcomes ◽  
Sustained Improvement ◽  
Radiofrequency Surgery ◽  
Obstructive Sleep ◽  
Good Quality Research ◽  
Disordered Breathing

Sleep-disordered breathing encompasses a spectrum of conditions ranging from simple snoring to obstructive sleep apnoea (OSA). Radiofrequency surgery represents a relatively new technique available to surgeons involved in managing this condition. Its principal advantage relates to its minimally invasive nature resulting in a reduced morbidity when compared to traditional sleep surgery. The presence of good-quality research evaluating the long-term outcomes is currently scarce, although the short-term data is promising. Careful patient selection appears to be paramount in obtaining a sustained improvement. The role of radiofrequency surgery in sleep-disordered breathing has been reviewed.

scholarly journals The role of screening questionnaires in diagnosis of sleep-disordered breathing

2016 ◽  
Vol 22 (6) ◽  
pp. 629-637 ◽  
Author(s):  
A. A. Gortseva ◽  
M. V. Bochkarev ◽  
L. S. Korostovtseva ◽  
Y. V. Sviryaev
Keyword(s):  
Sleep Disordered Breathing ◽  
Screening Questionnaires ◽  
Disordered Breathing
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