18.12.2015

Thoughts from the XXII European Sleep Research Society Congress

Sleep, the main course in a life’s feast…
“Macbeth” William Shakespeare

 

ESRS Congress in Tallinn

The twenty-second congress of the European Sleep research Society was organised last September, in Tallinn. This event gathered over 1,500 delegates from all over the world. During the five-day congress, research results were submitted on sleep medicine basic research, diagnostics, treatment directions, as well as links between chronic sleep disorders and cardiovascular, metabolic, neurocognitive diseases. The author of this overview was most interested in the socioeconomic impact of sleep disorders, new treatment directions for sleep-related breathing disorders, and the neurocognitive consequences of sleep disorders.

 

Direct and indirect costs of sleep disorders to the medical system

Paul Jennum (Denmark) explained the socioeconomic impact of insomnia, OSA, central hypersomnia (narcolepsy, idiopathic hypersomnia), sleep deprivation, and restless feet syndrome on the medical system by indicating both indirect and direct costs for the medical system. Direct costs are primarily associated with going to the appointment of a primary level doctor, referrals to a specialist, using sleep-inducing medicine (prescription drugs and over-the-counter medicine). Indirect costs are missing work due to the inability to work, decreased efficiency, causing road accidents. Indirect and direct costs related to sleep disorders are comparable with the costs of other chronic diseases (hypertension, diabetes). Earlier research (Morin et al., 2009) on insomnia has shown that not treating insomnia turns out to be more expensive than treating insomnia. Insomnia is a concurrent sleep problem for many sleep apnoea patients.

 

Stimulation Therapy

The second generation nervus hypoglossus stimulation therapy was highlighted as a new treatment direction for sleep-related breathing disorders. Winfried J. Randerath (Germany) outlined the results of a comparative study that showed that the nervus hypoglossus stimulation therapy is successful in the treatment of mild to severe obstructive sleep apnoea with moderate obesity (BMI up to 32), decreasing the apnoea-hypopnea index to normal. When the stimulation therapy was cut off afterwards for one week, the apnoea-hypopnea index increased to the pre-treatment level, also involving symptoms typical to snoring and daytime sleep apnoea.

 

Treatment with Drugs

Jan Hedner’s (Sweden) lecture on “The Feasibility of Pharmacological Treatment of Sleep Apnoea” turned out to be intriguing. In addition to the PAP treatment, intra-oral devices, and surgical treatment, the pharmacological treatment of sleep apnoea is also researched. At the moment, the problem is insufficient research on the sleep apnoea phenotype, due to which doing appropriate animal tests and creating patient groups is difficult.

 

Daytime Sleepiness

The sleep centre of Bordeaux University focuses on researching the diagnostics and pharmacological treatment of a significant sleep apnoea symptom, daytime sleepiness. The researchers highlighted the subject of sleep disorders, especially excess daytime sleepiness and fatigue that causes neurocognitive disorders. Pierre Philip (France) referred to research results, based on which excess daytime sleepiness and fatigue should be assessed in a car driving simulation test, which would imitate a real driving situation as precisely as possible. The summary of another research from the same author refers to the efficient pharmacological treatment of patients with excess daytime sleepiness. The work of Pierre Philip’s research group indicates the importance of MWT (Maintenance of Wakefulness Test) for assessing excess daytime sleepiness and fatigue. This test can soon also be performed in Estonia.

 

Summary

The congress gave the opportunity to discuss different sleep-related research directions, such as the impact of sleep disorders on different groups among population: sleep-related breathing disorders in women, old people; impact of sleep disorders on Parkinson’s disease (the importance of early diagnostics of movement disorder during REM-sleep), in the early stages of Alzheimer’s; links between sleep disorders and malignant tumours. The next European Sleep Research Society’s Congress shall be organised in 2016, in Bologna.

The author of this article is Dr. Heisl Vaher.

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