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  • 1. Arnardottir, E S
    et al.
    Thorleifsdottir, B
    Svanborg, Eva
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Clinical Neurophysiology. Östergötlands Läns Landsting, Reconstruction Centre, Department of Neurophysiology UHL.
    Gislason, T
    Decreased related sweating in CPAP treated OSA patients2006In: 18th Congress of European Sleep Research Society,2006, 2006, p. 200-201Conference paper (Other academic)
    Abstract [en]

       

  • 2.
    Arnardottir, Erna S I F
    et al.
    Landspitali University Hospital.
    Thorleifsdottir, Bjorg
    University of Iceland.
    Svanborg, Eva
    Linköping University, Department of Clinical and Experimental Medicine, Clinical Neurophysiology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Reconstruction Centre, Department of Neurophysiology UHL.
    Olafsson, Isleifur
    Landspitali University Hospital.
    Gislason, Thorarinn
    Landspitali University Hospital.
    Sleep-related sweating in obstructive sleep apnoea: association with sleep stages and blood pressure2010In: JOURNAL OF SLEEP RESEARCH, ISSN 0962-1105, Vol. 19, no 1, p. 122-130Article in journal (Refereed)
    Abstract [en]

    Pandgt;The aim of this study was to investigate sleep-related sweating as a symptom of obstructive sleep apnoea (OSA). Fifteen otherwise healthy male non-smoking patients with untreated moderate-to-severe OSA underwent polysomnography, including measurements of skin and core body temperature and electrodermal activity (EDA) as an objective indicator of sweating. Evening and morning blood pressure was measured as well as catecholamines in nocturnal urine. All measurements were repeated after 3 months on successful continuous positive airway pressure (CPAP) treatment. The untreated OSA subjects had a mean (+/- SD) apnoea-hypopnoea index of 45.3 +/- 3.9 and a mean EDA index during sleep of 131.9 +/- 22.4 events per hour. Patients with higher EDA indices had higher systolic blood pressure in the evening and morning (P = 0.001 and 0.006) and lower rapid eye movement (REM) sleep percentage (P = 0.003). The EDA index decreased significantly to 78.5 +/- 17.7 in the patients on CPAP treatment (P = 0.04). The decrease correlated with lower evening systolic and diastolic blood pressure (P = 0.05 and 0.006) and an increase in REM% (P = 0.02). No relationship was observed between EDA and skin or core body temperature, or to catecholamine levels in urine. OSA patients who experience sleep-related sweating may have increased blood pressure and decreased REM sleep compared with other OSA patients. CPAP treatment appears to lower blood pressure and increase REM sleep to a higher extent in these patients compared with other OSA patients.

  • 3.
    Broström, Anders
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Health Sciences, Nursing Science.
    Johansson, Peter
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Health Sciences, Cardiology . Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Albers, Jan
    City Hospital Ryhov.
    Wiberg, Jan
    City Hospital Ryhov.
    Svanborg, Eva
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Clinical Neurophysiology . Östergötlands Läns Landsting, Reconstruction Centre, Department of Neurophysiology UHL.
    Fridlund, Bengt
    Vaxjö University.
    6-month CPAP-treatment in a young male patient with severe obstructive sleep apnoea syndrome - A case study from the couples perspective2008In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 7, no 2, p. 103-112Article in journal (Refereed)
    Abstract [en]

    Background: Obstructive sleep apnoea syndrome (OSAS) is independently associated with an increased risk for hypertension and cardiovascular disease. Continuous positive airway pressure (CPAP) can reduce mortality and morbidity, but low compliance rates are seen. Aim: To explore and describe the experiences of CPAP-treatment in a young male patient with severe OSAS during a 6-month period from the couples perspective.

    Methods and the case: A single case study with a phenomenographic approach was employed. Diagnostic procedures of OSAS and initiation of treatment with Auto-CPAP, humidifier and a nasal mask were performed during 4 visits. Conceptions were collected at 4 different occasions during the 6-month period (before, and 2 weeks, 3 months, and 6 months after treatment initiation) by means of interviews with a 33-year old male patient and his female partner.

    Findings: Totally 17 different structural aspects were found to fluctuate during the 6-month period in relation to; influence of stressors, social reactions and adaptation to increase compliance.

    Conclusion: An increased knowledge about the influence of stressors, the social reactions, and the adaptation can help healthcare personnel to identify and better understand concerns of other patients and spouses during different time phases of the initial 6-month period of CPAP-treatment.

  • 4.
    Broström, Anders
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Nursing Science.
    Johansson, Peter
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Cardiology. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Albers, Jan
    Wiberg, Jan
    Svanborg, Eva
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Clinical Neurophysiology. Östergötlands Läns Landsting, Reconstruction Centre, Department of Neurophysiology UHL.
    Fridlund, Bengt
    P374 3-Month CPAP treatment in a young male patient with severe obstructive sleep apnoea syndrome - a qualitative case study from the couple´s perspective2006In: 8th World Congress on Sleep Apnea 27-30 September 2006,2006, 2006, p. 76-76Conference paper (Other academic)
  • 5.
    Broström, Anders
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Clinical Neurophysiology.
    Johansson, Peter
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Cardiology. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Kihl, J
    Forslund, P
    Dahlström, Ulf
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Cardiology. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Svanborg, Eva
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Clinical Neurophysiology. Östergötlands Läns Landsting, Reconstruction Centre, Department of Neurophysiology UHL.
    Fridlund, B G
    Depressive symptoms in patients with chronic heart failure - effects on insomnia, daytime sleepiness and health-related quality of life2006In: World Congress of Cardiology,2006, 2006, p. 224-224Conference paper (Other academic)
  • 6.
    Broström, Anders
    et al.
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Johansson, Peter
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Cardiology. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Strömberg, Anna
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Nursing Science.
    Albers, J
    County Hospital Ryhov.
    Mårtensson, Jan
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Svanborg, Eva
    Linköping University, Department of Clinical and Experimental Medicine, Clinical Neurophysiology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Reconstruction Centre, Department of Neurophysiology UHL.
    Obstructive sleep apnoea syndrome - Patients' perceptions of their sleep and its effects on their life situation2007In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 57, no 3, p. 318-327Article in journal (Refereed)
    Abstract [en]

    Title. Obstructive sleep apnoea syndrome - patients' perceptions of their sleep and its effects on their life situation Aim. This paper reports a descriptive study of how untreated patients with obstructive sleep apnoea syndrome perceived their sleep situation and how the syndrome affected their life situation. Background. Obstructive sleep apnoea syndrome is a prevalent problem independently associated with an increased risk for hypertension, cardiovascular disease, chronic heart failure and mortality. Increased consumption of healthcare resources can often be seen among patients over a long period of time since many have been undiagnosed and untreated. Methods. A phenomenographic approach was employed. Data were collected by interviews during 2005 with 20 purposively selected participants with untreated obstructive sleep apnoea syndrome. Findings. Participants described loud snoring, frequent awakenings, dyspnoea, frustration over nocturia, fear of dying during sleep and partners' anxiety about the apnoea, as being night-time effects of obstructive sleep apnoea syndrome. They described dry and sore throats, tiredness and daytime sleepiness, shame about falling asleep and snoring, thoughts about complications and depressed mood as daytime effects. Needs, such as increased alertness, improved ability to concentrate, improved relationship, adequate information as well as effective treatment, were described. Participants tried self-care strategies such as information-seeking about sleep disturbances and treatment, adapted sleeping routines, change of bedroom arrangements, adapted daily schedules, hyperactivity and avoidance of difficult situations. Conclusion. The perceived effects and needs, as well as tried self-care actions by the patients with obstructive sleep apnoea syndrome in this study, could be used to identify and evaluate concerns of other patients with obstructive sleep apnoea syndrome waiting for treatment. © 2007 The Authors.

  • 7.
    Broström, Anders
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Nursing Science.
    Johansson, Peter
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Cardiology. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Strömberg, Anna
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Nursing Science.
    Albers, Jan
    Wiberg, Jan
    Mårtensson, Jan
    Svanborg, Eva
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Clinical Neurophysiology. Östergötlands Läns Landsting, Reconstruction Centre, Department of Neurophysiology UHL.
    Obstructive sleep apnea syndrome - Patient perceptions of their life situation before initiation of CPAP treatment2006In: 8th World Congress on Sleep Apnea 27-30 September, 2006,2006, 2006, p. 124-124Conference paper (Other academic)
  • 8.
    Broström, Anders
    et al.
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Nilsen, Per
    Linköping University, Department of Medicine and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Johansson, Peter
    Linköping University, Department of Medicine and Health Sciences, Cardiology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Ulander, Martin
    Linköping University, Department of Clinical and Experimental Medicine, Clinical Neurophysiology . Linköping University, Faculty of Health Sciences.
    Strömberg, Anna
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Svanborg, Eva
    Linköping University, Department of Clinical and Experimental Medicine, Clinical Neurophysiology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Reconstruction Centre, Department of Neurophysiology UHL.
    Fridlund, Bengt
    Jonköping University.
    Putative facilitators and barriers for adherence to CPAP treatment in patients with obstructive sleep apnea syndrome: A qualitative content analysis2010In: SLEEP MEDICINE, ISSN 1389-9457, Vol. 11, no 2, p. 126-130Article in journal (Refereed)
    Abstract [en]

    Introduction: Effective treatment of obstructive sleep apnea syndrome (OSAS) with continuous positive airway pressure (CPAP) can reduce morbidity and mortality, but adherence rates are low without a clear consensus Of causes. Objective: To explore the experiences of adherence to CPAP treatment in patients with OSAS. Methods: A qualitative content analysis was employed. Data were collected by in-depth interviews with 23 purposively selected patients. Results: Adherence to CPAP treatment was summarized according to "facilitators" and "barriers" to CPAP treatment. Facilitators for adherence, as described by the patients were a desire to avoid symptoms, knowledge about the risk for medical consequences, fear of negative social consequences and disturbing the sleep of significant others. Other facilitators were a positive attitude to CPAP treatment, trust in healthcare personnel, a sense of engagement from the spouse and a feeling of physical improvement. Barriers included experiencing practical problems, negative psychological effects of the equipment, and negative attitudes to the treatment. Other barriers were side-effects as well as insufficient support from healthcare personnel and the spouse. Conclusion: Adherence to CPAP treatment is a multifaceted problem including patient, treatment, condition, social and healthcare related factors. Knowledge about facilitators and barriers for adherence to CPAP treatment can be used in interventional Strategies.

  • 9.
    Broström, Anders
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences.
    Strömberg, Anna
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences.
    Mårtensson, Jan
    Jönköping.
    Ulander, Martin
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Clinical Neurophysiology.
    Harder, Lena
    Svanborg, Eva
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Clinical Neurophysiology. Östergötlands Läns Landsting, Reconstruction Centre, Department of Neurophysiology UHL.
    Association of Type D personality to perceived side effects and adherence in CPAP-treated patients with OSAS2007In: Journal of Sleep Research, ISSN 0962-1105, E-ISSN 1365-2869, Vol. 16, no 4, p. 439-447Article in journal (Refereed)
    Abstract [en]

    Continuous positive airway pressure (CPAP) is the treatment of choice for obstructive sleep apnoea syndrome (OSAS), but side effects are common and long-term adherence low. The Type D (distressed) personality is defined as a combination of negative affectivity and social inhibition. The association of Type D personality with adherence has not been studied in CPAP-treated patients with OSAS. This study aimed to describe the prevalence of Type D personality in OSAS patients with CPAP treatment longer than 6 months and the association with self-reported side effects and adherence. A cross-sectional descriptive design was used. A total of 247 OSAS patients with a mean use of CPAP treatment for 55 months (6-182 months) were included. Data collection was achieved by two questionnaires, the Type D scale 14 (DS14) (Type D personality), SECI (side effects of CPAP), as well as from medical records (clinical variables and objective adherence to CPAP treatment). Type D personality occurred in 30% of the patients with OSAS and significantly (P < 0.05-0.001) increased the perceived frequency and severity of a broad range of side effects. The objective adherence was significantly lower (P < 0.001) for OSAS patients with Type D compared to OSAS patients without Type D, both with regard to a mean use of 4 h per night and 85% of the self-rated sleep time per night. The additional effect of a Type D personality on perceived side effects and adherence to CPAP treatment found in this study could be used by healthcare personnel when evaluating patients waiting for treatment. © 2007 European Sleep Research Society.

  • 10.
    Broström, Anders
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Clinical Neurophysiology. Östergötlands Läns Landsting, Reconstruction Centre, Department of Neurophysiology UHL.
    Strömberg, Anna
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Nursing Science. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Ulander, Martin
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Clinical Neurophysiology.
    Fridlund, B
    Mårtensson, J
    Svanborg, Eva
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Clinical Neurophysiology. Östergötlands Läns Landsting, Reconstruction Centre, Department of Neurophysiology UHL.
    Informational needs, side effects and their consequences on adherence: A comparison between swedish healthcare professionals and CPAP-treated patients with obstructive sleep apnoea syndrome2007In: World Sleep 07,2007, 2007, p. 141-141Conference paper (Other academic)
    Abstract [en]

       

  • 11.
    Broström, Anders
    et al.
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Strömberg, Anna
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Ulander, Martin
    Linköping University, Department of Clinical and Experimental Medicine, Clinical Neurophysiology . Linköping University, Faculty of Health Sciences.
    Fridlund, Bengt
    Vaxjö University.
    Martensson, Jan
    Jönköping University.
    Svanborg, Eva
    Linköping University, Department of Clinical and Experimental Medicine, Clinical Neurophysiology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Reconstruction Centre, Department of Neurophysiology UHL.
    Perceived informational needs, side-effects and their consequences on adherence-A comparison between CPAP treated patients with OSAS and healthcare personnel2009In: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 74, no 2, p. 228-235Article in journal (Refereed)
    Abstract [en]

    Objective: To compare perceptions among continuous positive airway pressure (CPAP) treated patients with obstructive sleep apnoea syndrome (OSAS) and healthcare personnel with regard to informational needs, side-effects and their consequences on adherence.

    Methods: A cross-sectional descriptive design was used including 350 CPAP treated OSAS patients from three Swedish hospitals and 105 healthcare personnel from 26 Swedish hospitals. Data collection was performed using two questionnaires covering informational needs, side-effects and adherence to CPAP.

    Results: Both groups perceived all surveyed informational areas as very important. Patients perceived the possibilities to learn as significantly greater in all areas (p < 0.001) compared to healthcare personnel, and scored significantly higher regarding positive effects on adherence of information about pathophysiology (p < 0.05), self-care (p < 0.001) and troubleshooting (p < 0.01). A total of I I out of 15 surveyed side-effects were perceived to be more frequent by healthcare personnel (p < 0.01 - p < 0.001). They also scored all side-effects to cause greater problems and decrease the CPAP use to a greater extent (p < 0.001).

    Conclusion: Knowledge about these differences between patients and healthcare personnel regarding educational needs, side-effects and their effects on adherence can be important when designing educational programmes to increase CPAP adherence.

    Practice implications: Measurement of these parameters before, during and after educational programs are suggested.

  • 12.
    Broström, Anders
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Neurophysiology.
    Strömberg, Anna
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Nursing Science. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Ulander, Martin
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Clinical Neurophysiology.
    Mårtensson, J
    Svanborg, Eva
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Clinical Neurophysiology. Östergötlands Läns Landsting, Reconstruction Centre, Department of Neurophysiology UHL.
    Association of type D personality to perceived side effects and adherence in CPAP-treated patients with obstructive sleep apnoea syndrome2007In: World Sleep 07,2007, 2007, p. 142-142Conference paper (Other academic)
    Abstract [en]

      

  • 13.
    Edell-Gustafsson, Ulla
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Nursing Science.
    Carstensen, John
    Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Department of Health and Society, Tema Health and Society.
    Regestein, Quentin
    Swahn, Eva
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Cardiology. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Svanborg, Eva
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Clinical Neurophysiology. Östergötlands Läns Landsting, Reconstruction Centre, Department of Neurophysiology UHL.
    Hyperarousal, depression and quality of life - Validity and reliability of the Swedish version of the Hyperarousal Scale2006In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 20, no 1, p. 58-67Article in journal (Refereed)
    Abstract [en]

    Aim: Research focusing on hyperarousability in association with general sensitivity to stress has increased. This study aimed to: (i) describe values for self-reported hyperarousal behaviour traits, depression, sleeplessness behaviour and health-related quality of life [The Short Form 36 Health Survey Questionnaire (SF-36)] in a gender-stratified random sample from the Swedish population, and (ii) test the validity and reliability of the Swedish version of the Hyperarousal Behavioural Trait Scale (H-scale). Methods: In this study, 402 women and 391 men from Sweden were included. A test-retest study was performed on 297 subjects. Results: The total mean score on the H-scale was 29.5 (SD 10.0, 95% CI 28.8-30.2). Compared to men, women scored higher on the H-scale (total score, sub-scales and many items), whereas no evidence of an age trend was seen. The H-scale has proven to be a valid and reliable scale. Pearson's correlation coefficient showed similar magnitude and direction between the H-scale and the Zung's Self-rating Depression Scale, as between the H-scale and the Vicious Cycle of Sleeplessness Behaviour Scale, Vitality, Mental Health and the Mental Component Summary index on the SF-36 respectively. The Cronbach's alpha for the H-scale was 0.84 and estimated stability test-retest point of time varies between 0.73 and 0.80. Conclusions: This study indicates gender differences in response style in association with altered health-related quality of life. The H-scale is a valid and reliable self-reported scale for measuring hyperarousal behavioural trait research outcome in clinical practice. © 2006 Nordic College of Caring Science.

  • 14.
    Edell-Gustafsson, Ulla
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Nursing Science.
    Svanborg, Eva
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Clinical Neurophysiology. Östergötlands Läns Landsting, Reconstruction Centre, Department of Neurophysiology UHL.
    Swahn, Eva
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Cardiology. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    A gender perspective on sleeplessness behavior, effects of sleep loss, and coping resources in patients with stable coronary artery disease2006In: Heart & Lung, ISSN 0147-9563, E-ISSN 1527-3288, Vol. 35, no 2, p. 75-89Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: The primary aim of this study was to systematically compare perceived sleep quality, sleeplessness behavior, sense of mastery, self-esteem, depression, subjective health, and effects of sleep loss in men and women with stable coronary artery disease (CAD). Further aims were to determine possible predictors of poor sleep quality and sense of mastery, as well as the consequences of too little sleep. METHODS: Comparative-correlation and predictive design were used. Patients with a history of stable angina pectoris scheduled to undergo coronary angiography at Linköping University Hospital in Sweden were included. There were 47 women and 88 men (mean age 62.4 years) with CAD. Structured interviews using validated questionnaires covered sleep quality and sleep habits, effects of sleep loss, psychologic resources, and depression. RESULTS: Multiple stepwise regression analysis showed that sleeplessness behavior, depressed mood, female gender, and pharmacologic treatments with inflammation inhibitors significantly (P < .0001) accounted for the variance of poorer sleep quality. The analysis also showed that the following factors in descending order significantly accounted (P < .0001) for the outcome of sleep quality: inability to feel refreshed by sleep, difficulty in maintaining sleep, gastrointestinal problems, too little sleep, final morning awakening time, sleep onset latency, lying down because of daytime tiredness, and daytime physical tiredness. CONCLUSIONS: Compared with men, women with stable CAD may be especially at risk of experiencing poor sleep quality, even when sleeplessness behavior and pharmacologic treatments with inflammation inhibitors are controlled. It is also possible that they may be more at risk of depressed mood. Copyright © 2006 by Mosby, Inc.

  • 15.
    Edell-Gustafsson, Ulla
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Nursing Science.
    Svanborg, Eva
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Clinical Neurophysiology. Östergötlands Läns Landsting, Reconstruction Centre, Department of Neurophysiology UHL.
    Swahn, Eva
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Cardiology. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Psychological behavioural symptoms and sleep quality in patients with stable coronary artery disease2004In: Congress of the European Sleep Research Society,2004, 2004, p. 207-207Conference paper (Other academic)
  • 16.
    Edell-Gustafsson, Ulla
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Nursing Science.
    Swahn, Eva
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Cardiology. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Svanborg, Eva
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Clinical Neurophysiology. Östergötlands Läns Landsting, Reconstruction Centre, Department of Neurophysiology UHL.
    Hyperarousal behavioural trait, sufficient sleep index and health related qualtiy of life insomnia associated professional sleep societies (APSS)2005In: Associated Professional Sleep Societies APSS,2005, 2005Conference paper (Other academic)
  • 17.
    Engman, Maria
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine . Linköping University, Faculty of Health Sciences.
    Lindehammar, Hans
    Linköping University, Department of Clinical and Experimental Medicine, Clinical Neurophysiology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Reconstruction Centre, Department of Neurophysiology UHL.
    Wijma, Barbro
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Gynecology and Obstetrics in Linköping.
    Surface electromyography diagnostics in women with partial vaginismus with or without vulvar vestibulitis and in asymptomatic women2004In: Journal of Psychosomatic Obstetrics & Gynecology, ISSN 0167-482X, Vol. 25, no 3/4, p. 281-294Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to investigate to what extent women with superficial dyspareunia can be diagnosed for both partial vaginismus (PaV) and vulvar vestibulitis (VVS) and to discover to what extent surface electromyography (sEMG) of the pelvic floor muscles (PFM) can distinguish between women with PaV solely, PaV + VVS, and asymptomatic women. A total of 224 consecutive women with superficial dyspareunia were examined clinically for both PaV and VVS diagnoses. We examined 47 women with PaV ± VVS and 27 asymptomatic women with sEMG of the PFM. The results showed that 102/224 women with superficial dyspareunia and 33/47 women with PaV in the sEMG part of the study had both PaV and VVS. All women with VVS had vaginismus, while 42/224 had PaV but not VVS. sEMG measurements revealed no significant differences between the three groups of women (PaV solely, PaV + VVS, and asymptomatic). Almost half of the women with superficial dyspareunia referred to our clinic have both the diagnosis PaV and VVS. sEMG was not a method of any value to distinguish between women with PaV solely, PaV + VVS, or asymptomatic women. The increased tone found clinically in the PFM of women with PaV ± VVS may be of other origin than electrogenic contractions.

  • 18. Hagander, L
    et al.
    Harlid, R
    Svanborg, Eva
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Clinical Neurophysiology. Östergötlands Läns Landsting, Reconstruction Centre, Department of Neurophysiology UHL.
    Sensory nerve lesions in the oropharynx in obstructive sleep apnea2004In: 17th Congress of the European Sleep Research Society,2004, 2004, p. 299-299Conference paper (Other academic)
  • 19. Hagander, Louise
    et al.
    Harlid, Richard
    Svanborg, Eva
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Clinical Neurophysiology. Östergötlands Läns Landsting, Reconstruction Centre, Department of Neurophysiology UHL.
    Oropharyngeal vibration and thermal sensitivity in habitual snoring and obstructive sleep apnea2006In: 8th World Congress Sleep Apnea,2006, 2006, p. 46-46Conference paper (Other academic)
  • 20.
    Hagander, Louise
    et al.
    Karolinska Hospital.
    Harlid, Richard
    Fysiol Lab Stockholm.
    Svanborg, Eva
    Linköping University, Department of Clinical and Experimental Medicine, Clinical Neurophysiology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Reconstruction Centre, Department of Neurophysiology UHL.
    Quantitative Sensory Testing in the Oropharynx A Means of Showing Nervous Lesions in Patients With Obstructive Sleep Apnea and Snoring: A Means of Showing Nervous Lesions in Patients With Obstructive Sleep Apnea and Snoring2009In: CHEST, ISSN 0012-3692, Vol. 136, no 2, p. 481-489Article in journal (Refereed)
    Abstract [en]

    Background: It is not fully understood why habitual snoring frequently progresses to obstructive sleep apnea syndrome (OSAS). Vibrations per se may cause peripheral nerve lesions. Therefore, snoring vibrations could cause nervous lesions, leading to impaired reflex activation of dilating muscles at inspiration. In this study, the methodology for quantitative sensory testing in the oropharynx was developed, and the presence of sensory nerve lesions in patients with OSAS and snoring was evaluated. Methods: Vibration detection thresholds (VDTs) and/or cold detection thresholds (CDTs) were tested at the tonsillar pillars, tongue, lip, and finger in 23 nonsnoring individuals, 13 habitual snorers (apnea-hypopnea index [AHI] andlt; 10), and 31 patients with OSAS (AHI andgt; 20). Results: At tonsillar pillars, there were significant gender differences in both VDT and CDT, with women having lower thresholds. VDT showed no significant differences between any of the three groups when men only, were tested. Two nonsnoring control subjects could not detect vibrations at all. When both genders were tested, there was significant difference only between nonsnorers and patients with OSAS (p = 0.003). CDT showed significant differences between nonsnorers and snorers (p = 0.001) and also between nonsnorers and patients with OSAS (p andlt; 0.001), but not between snorers and patients with OSAS. CDT was easier to test than VDT with low variability in nonsnorers. Conclusions: CDT gave more discriminative results than VDT. Signs of sensory nervous lesions were present in the oropharynx of most patients with OSAS and some snorers, supporting the hypothesis of a progressive oropharyngeal nervous lesion. CDT testing could he a useful clinical method to evaluate the degree of oropharyngeal nervous lesions in patients who snore and in those with OSAS.

  • 21.
    Hultcrantz, Elisabeth
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Oto-Rhiono-Laryngology and Head & Neck Surgery. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Reconstruction Centre, Department of ENT - Head and Neck Surgery UHL.
    Harder, Lena
    Linköping University, Department of Clinical and Experimental Medicine, Oto-Rhiono-Laryngology and Head & Neck Surgery. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Reconstruction Centre, Department of ENT - Head and Neck Surgery UHL.
    Loord, Helena
    Östergötlands Läns Landsting, Reconstruction Centre, Department of ENT - Head and Neck Surgery UHL.
    Käll, Lars-Göran
    Östergötlands Läns Landsting, Reconstruction Centre, Department of ENT - Head and Neck Surgery VHN.
    Ydreborg, Kjell
    ORL-Clinic, Ryhov Hospital, Jönköping.
    Wallberg, Staffan
    Linköping University, Department of Clinical and Experimental Medicine, Oto-Rhiono-Laryngology and Head & Neck Surgery. Linköping University, Faculty of Health Sciences.
    Svanborg, Eva
    Linköping University, Department of Clinical and Experimental Medicine, Clinical Neurophysiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Reconstruction Centre, Department of Neurophysiology UHL.
    Long-term effects of radiofrequency ablation of the soft palate on snoring.2010In: European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, ISSN 1434-4726, Vol. 267, no 1, p. 137-142Article in journal (Refereed)
    Abstract [en]

    The objective of the study was to evaluate short- and long-term effects of radiofrequency treatment of the soft palate on snoring. Twenty-nine patients with habitual snoring were studied prospectively and treated up to four times at 4-6 week intervals with an Ellman Surgitrone((R)). Electromyography (EMG) of m. palatoglossus was performed in ten patients. Patients and partners evaluated snoring, sleep quality and daytime sleepiness 1 week preoperatively, 6 months and 3-4 years postoperatively. Snoring was reduced postoperatively (P < 0.0001). Sleep time increased, daytime sleepiness was reduced, and the partners slept better after 6 months. However, 3-4 years postoperatively only 25% of patients were satisfied. Another 25% had received additional treatment. EMG was normal in 6/10 patients preoperatively. They all continued to snore postoperatively. Four patients had pathological EMGs; three were responders. In conclusion, radiofrequency treatment for snoring may lead to long-term improvement in one out of four cases. Pre-evaluation with EMG may predict the outcome.

  • 22.
    Johansson, A
    et al.
    Central Hospital Skovde.
    Swahn, Eva
    Linköping University, Department of Medicine and Health Sciences, Cardiology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Svanborg, Eva
    Linköping University, Department of Clinical and Experimental Medicine, Clinical Neurophysiology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Reconstruction Centre, Department of Neurophysiology UHL.
    Ejdeback, J
    Central Hospital Skovde.
    Edell-Gustafsson, Ulla
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Sleep quality, hyperarousal, and sleeplessness behaviour in patients with a previous history of myocardial infarction2008In: JOURNAL OF SLEEP RESEARCH,ISSN 0962-1105: Volume 17, 2008, Vol. 17, p. 176-176Conference paper (Refereed)
  • 23. Johansson, P
    et al.
    Alehagen, Urban
    Linköping University, Department of Medicine and Health Sciences, Cardiology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Svanborg, Eva
    Linköping University, Department of Clinical and Experimental Medicine, Clinical Neurophysiology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Reconstruction Centre, Department of Neurophysiology UHL.
    Dahlström, Ulf
    Linköping University, Department of Medicine and Health Sciences, Cardiology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Broström, Anders
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    SLEEP DISORDERED BREATHING IN AN ELDERLY COMMUNITY-LIVING POPULATION - RELATIONSHIP TO CARDIAC FUNCTION, INSOMNIA SYMPTOMS AND DAYTIME SLEEPINESS2009In: In Sleep Vol 32, 2009, Vol. 32, p. A213-A214Conference paper (Refereed)
  • 24.
    Johansson, Peter
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Cardiology. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Alehagen, Urban
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Cardiology. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Dahlström, Ulf
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Cardiology. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Svanborg, Eva
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Clinical Neurophysiology. Östergötlands Läns Landsting, Reconstruction Centre, Department of Neurophysiology UHL.
    Broström, Anders
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Clinical Neurophysiology.
    Prevalence of sleep disordered breathing, insomnia and daytime sleepiness in an elderly population - reports from the corokind study2006In: 18th Congress of the European Sleep research society,2006, 2006, p. 114-114Conference paper (Other academic)
  • 25.
    Johansson, Peter
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Cardiology. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Alehagen, Urban
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Cardiology. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Dahlström, Ulf
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Cardiology. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Svanborg, Eva
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Clinical Neurophysiology. Östergötlands Läns Landsting, Reconstruction Centre, Department of Neurophysiology UHL.
    Broström, Anders
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Nursing Science.
    Profile of elderly persons with sleep disordered breathing with and without insomnia2006In: 8th World Congress on Sleep Apnea 27-30 September, 2006,2006, 2006, p. 115-116Conference paper (Other academic)
  • 26.
    Johansson, Peter
    et al.
    Östergötlands Läns Landsting, Heart Centre, Department of Cardiology. Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Alehagen, Urban
    Linköping University, Department of Medicine and Health Sciences, Cardiology . Östergötlands Läns Landsting, Heart Centre, Department of Cardiology. Linköping University, Faculty of Health Sciences.
    Svanborg, Eva
    Linköping University, Department of Clinical and Experimental Medicine, Clinical Neurophysiology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Reconstruction Centre, Department of Neurophysiology UHL.
    Dahlström, Ulf
    Linköping University, Department of Medicine and Health Sciences, Cardiology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Broström, Anders
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Neurology. Linköping University, Faculty of Health Sciences.
    Sleep disordered breathing in an elderly community-living population - relationship to cardiac function, insomnia symptoms and daytime sleepiness2009Conference paper (Refereed)
  • 27.
    Johansson, Peter
    et al.
    Linköping University, Department of Medicine and Health Sciences, Cardiology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Alehagen, Urban
    Linköping University, Department of Medicine and Health Sciences, Cardiology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Svanborg, Eva
    Linköping University, Department of Clinical and Experimental Medicine, Clinical Neurophysiology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Reconstruction Centre, Department of Neurophysiology UHL.
    Dahlström, Ulf
    Linköping University, Department of Medicine and Health Sciences, Cardiology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Broström, Anders
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Sleep disordered breathing in an elderly community-living population: Relationship to cardiac function, insomnia symptoms and daytime sleepiness2009In: Sleep Medicine, ISSN 1389-9457, E-ISSN 1878-5506, Vol. 10, no 9, p. 1005-1011Article in journal (Refereed)
    Abstract [en]

    Introduction: The relationship between sleep disordered breathing (SDB), systolic function/heart failure in elderly people living in community has not been investigated, nor has insomnia and excessive daytime sleepiness (EDS).

    Aim: To describe the prevalence of SDB and its relationship to systolic function, the different insomnia symptoms as well as EDS.

    Method: 331 subjects (71-87 years) underwent echocardiographic examinations and sleep respiratory recordings. Questionnaires were used to evaluate insomnia symptoms and EDS.

    Results: Mild SDB (AHI 5-15), was found in 32%. Moderate SDB (AHI 15-30) occurred in 16%, and 7% had severe SDB (AHI >30). Median AHI was significantly higher (p<0.001) in those with mild impaired systolic function (AHI 11.7) and moderate impaired systolic function (AHI 10.9) compared to those with normal systolic function (AHI 5.0). Mild and moderate impaired systolic function was also independently associated to SDB as indicated by an AHI≥10. Concerning insomnia symptoms and EDS, only difficulties in initiating sleep correlated significantly (p<0.05) with AHI.

    Conclusion: SDB is common among the elderly and may be related to impaired systolic function/heart failure. However, detection of SDB in such population may be problematic since insomnia symptoms and EDS correlated poorly with SDB.

  • 28.
    Johansson, Peter
    et al.
    Linköping University, Department of Medicine and Health Sciences, Cardiology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Arestedt, Kristoffer
    University of Kalmar.
    Alehagen, Urban
    Linköping University, Department of Medicine and Health Sciences, Cardiology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Svanborg, Eva
    Linköping University, Department of Clinical and Experimental Medicine, Clinical Neurophysiology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Reconstruction Centre, Department of Neurophysiology UHL.
    Dahlström, Ulf
    Linköping University, Department of Medicine and Health Sciences, Cardiology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Broström, Anders
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Sleep disordered breathing, insomnia, and health related quality of life - A comparison between age and gender matched elderly with heart failure or without cardiovascular disease2010In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 9, no 2, p. 108-117Article in journal (Refereed)
    Abstract [en]

    Aims: The aims of this study are (I) to compare the prevalence of sleep disordered breathing (SDB) and insomnia between elderly with heart failure (HF) and age and gender matched elderly without cardiovascular disease (CVD), and (II) to examine the association between HF, SDB and insomnia, as well as their impact on health related quality of life (Hr-QoL). Methods: Three hundred and thirty-one elderly (71-87 years) community-living individuals underwent sleep recordings and echocardiography. Questionnaires assessed insomnia and Hr-QoL. Comparisons were made between age and gender matched individuals with HF (n=36) and without CVD (n=36). Results: The HF group had higher mean apnoea-hypopnoea index (17.6 vs. 6.3, pless than0.001). Moderate/severe SDB was found in 42% of those with HF vs. 8% in those without CVD (p=0.001). Those with HF had more difficulties maintaining sleep (DMS) (72% vs. 50%, p=0.05) and excessive daytime sleepiness (EDS) (25% vs. 8%, p=0.05) and scored worse Hr-QoL in five of eight SF-36 domains. In regression analysis SDB had no association to Hr-QoL. DMS associated to the physical-, and non restorative sleep to the mental domain of Hr-QoL. SDB had no correlations to insomnia or EDS. Conclusions: SDB, DMS and EDS are more common in elderly with HF. SDB is not an obvious cause for sleep complaints or poor Hr-QoL in elderly.

  • 29.
    Johansson, Peter
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Cardiology. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Broström, Anders
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Clinical Neurophysiology.
    Alehagen, Urban
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Cardiology. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Svanborg, Eva
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Clinical Neurophysiology. Östergötlands Läns Landsting, Reconstruction Centre, Department of Neurophysiology UHL.
    Dahlström, Ulf
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Cardiology. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Sleep disturbances, daytime sleepiness and depressive symptomatology in elderly. The corokind study2006In: 18th Congress of the European Sleep Research Society,2006, 2006, p. 114-114Conference paper (Other academic)
  • 30.
    Lindehammar, Hans
    Linköping University, Department of Clinical and Experimental Medicine, Clinical Neurophysiology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Reconstruction Centre, Department of Neurophysiology UHL.
    Hand strength in juvenile chronic arthritis: a two-year follow-up2003In: Acta Paediatrica, ISSN 0001-656X, Vol. 92, no 11, p. 1291-1296Article in journal (Refereed)
    Abstract [en]

    AIM: To describe changes in muscle strength in the hands of children with juvenile chronic arthritis (JCA) and to examine the relationship between muscle strength, presence of local arthritis and disease subtype.

    METHODS: Twenty children (10 girls and 10 boys) with JCA aged 7 to 18 y were followed for two years. Isometric muscle strength in wrist dorsiflexors and handgrip strength were measured repeatedly. The results were compared with reference values for the same methods. Arthritis severity in the hand was scored every third month. Nerve conduction velocities were measured twice.

    RESULTS: Seven out of 20 patients had initially low or decreasing strength in one or both of the two tests. Five out of 20 children had reduced strength (more than two standard deviations below the mean of the reference group) in at least one test. Four children showed a significant reduction in muscle strength in at least one test during the observation time. The greatest reduction in strength was measured in four children with polyarticular disease. These children also had local arthritis in the hand. A greater proportion of children with polyarthritis had low or decreasing strength compared with children with oligoarthritis. The same was true for children with active arthritis in the hand. Nerve conduction velocities were normal in all cases and did not change.

    CONCLUSION: The majority of children with JCA have normal strength in the hand. Some children, especially those with polyarthritis and hand arthritis, have reduced muscle strength in the hand. Risk factors for low or decreasing strength are polyarthritis and/or active arthritis in the hand.

  • 31.
    Lindehammar, Hans
    Linköping University, Department of Clinical and Experimental Medicine, Clinical Neurophysiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Reconstruction Centre, Department of Neurophysiology UHL.
    Muscle function in Juvenile Idiopathic Arthritis: A two-year follow-up2004Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    This is a study of muscle function in Juvenile Idiopathic Arthritis (JIA). Rheumatoid arthritis (RA) is a disease that primarily affects the synovial membrane of joints. Muscle weakness, atrophy and pain occur in adult RA. This may be a consequence of joint pain, stiffness and immobility. Muscle inflammation and neuropathy occur as complications in adults. Muscle function in JIA has been much less studied.

    The aim of the study was to examine whether muscle weakness and atrophy also occur in children with JIA.

    This was a longitudinal study over a two-year period, where muscle strength and thickness were measured repeatedly in a group of 20 children and teenagers with JIA. Muscle strength was measured using different methods and in several muscle groups. Muscle biopsies were obtained and nerve conduction velocity studies performed.

    The study concludes that, compared to healthy people, children and teenagers with JIA have as a group reduced muscle strength and muscle thickness. For most of these children and teenagers, muscle strength is only slightly lower than expected, but a few have marked muscle weakness. This is most apparent in patients with severe polyarthritis where the weakness seems to be widespread. Patients with isolated arthritis may also have greatly reduced strength and thickness of muscles near the inflamed joint.

    There is a risk of decreasing strength in patients with polyarthritis and in muscles near an active arthritis.

    Minor changes are common in muscle biopsies, and findings may indicate immunological activity in the muscles.

    Atrophy of type II fibres, as in adult RA, was not found in JIA.

    No patient had signs of neuropathy.

    List of papers
    1. Muscle function in Juvenile Chronic Arthritis
    Open this publication in new window or tab >>Muscle function in Juvenile Chronic Arthritis
    1995 (English)In: Journal of Rheumatology, ISSN 0315-162X, Vol. 22, no 6, p. 1159-1165Article in journal (Refereed) Published
    Abstract [en]

    OBJECTIVE. Muscle strength and thickness were studied in children with juvenile chronic arthritis (JCA) to evaluate their muscle function. METHODS. We studied voluntary isometric, isokinetic, and nonvoluntary isometric muscle strength, as well as muscle thickness, in 20 children with JCA. Thickness of the quadriceps muscle was measured by ultrasound. Results were compared with reference values for healthy children and a matched control group. RESULTS. Isometric muscle strength in knee extensors, elbow flexors, and wrist dorsiflexors was reduced in children with JCA. In muscles near an inflamed joint, the strength was 45-65% of expected value. In muscles without adjacent arthritis, the strength was slightly decreased (80-90% of expected value). Isometric and isokinetic strength in ankle dorsiflexors was reduced only in children with ankle arthritis. Nonvoluntary muscle strength in thumb adductors during electrical stimulation of the ulnar nerve was reduced in children with arthritis in the hand. Thickness of the quadriceps muscle was reduced both in children with and without knee arthritis (75 and 90% of expected). CONCLUSION. Children with JCA have reduced muscle strength and thickness, which is most pronounced in muscles near an inflamed joint.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-13644 (URN)
    Available from: 2004-05-27 Created: 2004-05-27 Last updated: 2009-08-19
    2. Measurement of Quadriceps Muscle Strength and Bulk in Juvenile Chronic Arthritis: A Prospective, Longitudinal, 2 Year Survey
    Open this publication in new window or tab >>Measurement of Quadriceps Muscle Strength and Bulk in Juvenile Chronic Arthritis: A Prospective, Longitudinal, 2 Year Survey
    1998 (English)In: Journal of Rheumatology, ISSN 0315-162X, Vol. 25, no 11, p. 2240-2248Article in journal (Refereed) Published
    Abstract [en]

    OBJECTIVE: In a prospective survey over a 2-year period we studied strength and bulk of the quadriceps muscle in the thighs of children with juvenile chronic arthritis (JCA). METHODS: Every third month for 2 years we measured isometric muscle strength in knee extensors with a hand-held dynamometer in 20 children with JCA. Ultrasound equipment was used to measure thigh muscle bulk. A joint evaluation was made using a standard severity score. The children had their ordinary medical treatment and physiotherapy during the observation period. RESULTS: Children with high severity scores in the knee or hip had least strength and muscle bulk. In the 4 children with the highest severity scores muscle strength was reduced to half of that expected. In 10 of the children there were clear variations in severity scores during the study period, for either better or worse. In these children an increase in the severity score correlated significantly with reduction in muscle strength and bulk (p < 0.05). The muscle strength and bulk changed in parallel in these children. Other factors, although not independent, such as polyarticular JCA, long duration of disease, and steroid treatment, also reduced muscle strength. CONCLUSION: The presence and intensity of local arthritis is one important factor affecting muscle function in JCA. Normal muscle strength and bulk is rapidly lost near an inflamed joint. It is difficult to maintain or achieve normal muscle function in the presence of active arthritis despite medical and physical treatment. We assume that the muscle weakness is in part caused by atrophy of the muscle, which is influenced by local arthritis.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-13645 (URN)
    Available from: 2004-05-27 Created: 2004-05-27 Last updated: 2009-08-19
    3. Hand strength in juvenile chronic arthritis: a two-year follow-up
    Open this publication in new window or tab >>Hand strength in juvenile chronic arthritis: a two-year follow-up
    2003 (English)In: Acta Paediatrica, ISSN 0001-656X, Vol. 92, no 11, p. 1291-1296Article in journal (Refereed) Published
    Abstract [en]

    AIM: To describe changes in muscle strength in the hands of children with juvenile chronic arthritis (JCA) and to examine the relationship between muscle strength, presence of local arthritis and disease subtype.

    METHODS: Twenty children (10 girls and 10 boys) with JCA aged 7 to 18 y were followed for two years. Isometric muscle strength in wrist dorsiflexors and handgrip strength were measured repeatedly. The results were compared with reference values for the same methods. Arthritis severity in the hand was scored every third month. Nerve conduction velocities were measured twice.

    RESULTS: Seven out of 20 patients had initially low or decreasing strength in one or both of the two tests. Five out of 20 children had reduced strength (more than two standard deviations below the mean of the reference group) in at least one test. Four children showed a significant reduction in muscle strength in at least one test during the observation time. The greatest reduction in strength was measured in four children with polyarticular disease. These children also had local arthritis in the hand. A greater proportion of children with polyarthritis had low or decreasing strength compared with children with oligoarthritis. The same was true for children with active arthritis in the hand. Nerve conduction velocities were normal in all cases and did not change.

    CONCLUSION: The majority of children with JCA have normal strength in the hand. Some children, especially those with polyarthritis and hand arthritis, have reduced muscle strength in the hand. Risk factors for low or decreasing strength are polyarthritis and/or active arthritis in the hand.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-13646 (URN)10.1080/08035250310006340 (DOI)
    Available from: 2004-05-27 Created: 2004-05-27 Last updated: 2009-08-19
    4. Muscle involvement in juvenile idiopathic arthritis
    Open this publication in new window or tab >>Muscle involvement in juvenile idiopathic arthritis
    2004 (English)In: Rheumatology, ISSN 1462-0324, Vol. 43, no 12, p. 1546-1554Article in journal (Refereed) Published
    Abstract [en]

    OBJECTIVE: An observational study of changes in muscle structure and the relation to muscle strength in juvenile idiopathic arthritis (JIA).

    METHODS: Fifteen children and teenagers (eight girls and seven boys) with JIA, aged 9-19 yr (mean age 16.1), were studied. Muscle biopsies were obtained from the anterior tibial muscle and were examined using histopathological and immunohistochemical methods. Muscle fibre types were classified and fibre areas measured. As markers of inflammation, the major histocompatibility complex (MHC) class I and class II and the membrane attack complex (MAC) were analysed. Results were compared with biopsies from the gastrocnemius muscle in 33 young (19-23 yr) healthy controls. Isometric and isokinetic muscle strengths were measured in ankle dorsiflexion. Strength was compared with reference values for healthy age-matched controls. Nerve conduction velocities were recorded in the peroneal and sural nerves.

    RESULTS: Four of the 15 muscle biopsies were morphologically normal. Eleven biopsies showed minor unspecific changes. Two of these also showed minor signs of inflammation. MHC class II expression was found in 4/15 patients, which was significantly more than in the healthy controls (P = 0.0143). The expression of MHC class I and MAC did not differ from that in the controls. The mean area of type I fibres was lower than that of type IIA fibres in 12/13 biopsies. Muscle strength was significantly reduced in the patient group. There was a significant positive correlation between muscle fibre area and muscle strength. Nerve conduction studies were normal in all cases.

    CONCLUSIONS: Changes in leg muscle biopsies appear to be common in children and teenagers with JIA. The presence of inflammatory cells in the muscle and expression of MHC class II on muscle fibres may be a sign of inflammatory myopathy. There are no findings of type II muscle fibre hypotrophy or neuropathy, as in adults with RA.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-13647 (URN)10.1093/rheumatology/keh381 (DOI)
    Available from: 2004-05-27 Created: 2004-05-27 Last updated: 2009-08-19
  • 32.
    Lindehammar, Hans
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Clinical Neurophysiology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Reconstruction Centre, Department of Neurophysiology UHL.
    Bäckman, Eva
    Linköping University, Department of Clinical and Experimental Medicine, Cell Biology. Linköping University, Faculty of Health Sciences.
    Muscle function in Juvenile Chronic Arthritis1995In: Journal of Rheumatology, ISSN 0315-162X, Vol. 22, no 6, p. 1159-1165Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE. Muscle strength and thickness were studied in children with juvenile chronic arthritis (JCA) to evaluate their muscle function. METHODS. We studied voluntary isometric, isokinetic, and nonvoluntary isometric muscle strength, as well as muscle thickness, in 20 children with JCA. Thickness of the quadriceps muscle was measured by ultrasound. Results were compared with reference values for healthy children and a matched control group. RESULTS. Isometric muscle strength in knee extensors, elbow flexors, and wrist dorsiflexors was reduced in children with JCA. In muscles near an inflamed joint, the strength was 45-65% of expected value. In muscles without adjacent arthritis, the strength was slightly decreased (80-90% of expected value). Isometric and isokinetic strength in ankle dorsiflexors was reduced only in children with ankle arthritis. Nonvoluntary muscle strength in thumb adductors during electrical stimulation of the ulnar nerve was reduced in children with arthritis in the hand. Thickness of the quadriceps muscle was reduced both in children with and without knee arthritis (75 and 90% of expected). CONCLUSION. Children with JCA have reduced muscle strength and thickness, which is most pronounced in muscles near an inflamed joint.

  • 33.
    Lindehammar, Hans
    et al.
    Linköping University, Department of Neuroscience and Locomotion. Linköping University, Department of Clinical and Experimental Medicine, Clinical Neurophysiology . Östergötlands Läns Landsting, Reconstruction Centre, Department of Neurophysiology UHL.
    Lindvall, Björn
    Linköping University, Department of Clinical and Experimental Medicine, Neurology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Neurology.
    Muscle involvement in juvenile idiopathic arthritis2004In: Rheumatology, ISSN 1462-0324, Vol. 43, no 12, p. 1546-1554Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: An observational study of changes in muscle structure and the relation to muscle strength in juvenile idiopathic arthritis (JIA).

    METHODS: Fifteen children and teenagers (eight girls and seven boys) with JIA, aged 9-19 yr (mean age 16.1), were studied. Muscle biopsies were obtained from the anterior tibial muscle and were examined using histopathological and immunohistochemical methods. Muscle fibre types were classified and fibre areas measured. As markers of inflammation, the major histocompatibility complex (MHC) class I and class II and the membrane attack complex (MAC) were analysed. Results were compared with biopsies from the gastrocnemius muscle in 33 young (19-23 yr) healthy controls. Isometric and isokinetic muscle strengths were measured in ankle dorsiflexion. Strength was compared with reference values for healthy age-matched controls. Nerve conduction velocities were recorded in the peroneal and sural nerves.

    RESULTS: Four of the 15 muscle biopsies were morphologically normal. Eleven biopsies showed minor unspecific changes. Two of these also showed minor signs of inflammation. MHC class II expression was found in 4/15 patients, which was significantly more than in the healthy controls (P = 0.0143). The expression of MHC class I and MAC did not differ from that in the controls. The mean area of type I fibres was lower than that of type IIA fibres in 12/13 biopsies. Muscle strength was significantly reduced in the patient group. There was a significant positive correlation between muscle fibre area and muscle strength. Nerve conduction studies were normal in all cases.

    CONCLUSIONS: Changes in leg muscle biopsies appear to be common in children and teenagers with JIA. The presence of inflammatory cells in the muscle and expression of MHC class II on muscle fibres may be a sign of inflammatory myopathy. There are no findings of type II muscle fibre hypotrophy or neuropathy, as in adults with RA.

  • 34.
    Lindehammar, Hans
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Clinical Neurophysiology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Reconstruction Centre, Department of Neurophysiology UHL.
    Sandstedt, P.
    Measurement of Quadriceps Muscle Strength and Bulk in Juvenile Chronic Arthritis: A Prospective, Longitudinal, 2 Year Survey1998In: Journal of Rheumatology, ISSN 0315-162X, Vol. 25, no 11, p. 2240-2248Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: In a prospective survey over a 2-year period we studied strength and bulk of the quadriceps muscle in the thighs of children with juvenile chronic arthritis (JCA). METHODS: Every third month for 2 years we measured isometric muscle strength in knee extensors with a hand-held dynamometer in 20 children with JCA. Ultrasound equipment was used to measure thigh muscle bulk. A joint evaluation was made using a standard severity score. The children had their ordinary medical treatment and physiotherapy during the observation period. RESULTS: Children with high severity scores in the knee or hip had least strength and muscle bulk. In the 4 children with the highest severity scores muscle strength was reduced to half of that expected. In 10 of the children there were clear variations in severity scores during the study period, for either better or worse. In these children an increase in the severity score correlated significantly with reduction in muscle strength and bulk (p < 0.05). The muscle strength and bulk changed in parallel in these children. Other factors, although not independent, such as polyarticular JCA, long duration of disease, and steroid treatment, also reduced muscle strength. CONCLUSION: The presence and intensity of local arthritis is one important factor affecting muscle function in JCA. Normal muscle strength and bulk is rapidly lost near an inflamed joint. It is difficult to maintain or achieve normal muscle function in the presence of active arthritis despite medical and physical treatment. We assume that the muscle weakness is in part caused by atrophy of the muscle, which is influenced by local arthritis.

  • 35. Lorr, D
    et al.
    Wren, Joakim
    Linköping University, The Institute of Technology. Linköping University, Department of Mechanical Engineering, Applied Thermodynamics and Fluid Mechanics.
    Loyd, Dan
    Linköping University, The Institute of Technology. Linköping University, Department of Mechanical Engineering, Applied Thermodynamics and Fluid Mechanics.
    Svanborg, Eva
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Clinical Neurophysiology. Östergötlands Läns Landsting, Reconstruction Centre, Department of Neurophysiology UHL.
    Temperature changes in different locations of the body in conjunction with sleep2004In: 17th Congress of the European Sleep Research Society,2004, 2004Conference paper (Refereed)
  • 36.
    Lorr, David
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Clinical Neurophysiology.
    Harder, Henrik
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Oto-Rhiono-Laryngology and Head & Neck Surgery. Östergötlands Läns Landsting, Reconstruction Centre, Department of ENT - Head and Neck Surgery UHL.
    Harder, Lena
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Oto-Rhiono-Laryngology and Head & Neck Surgery. Östergötlands Läns Landsting, Reconstruction Centre, Department of ENT - Head and Neck Surgery UHL.
    Broström, Anders
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Nursing Science.
    Svanborg, Eva
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Clinical Neurophysiology. Östergötlands Läns Landsting, Reconstruction Centre, Department of Neurophysiology UHL.
    Blood flow changes during obstuctive apnoeas can be estimated by using thermal measurements2007In: World Sleep 07,2007, 2007, p. 133-133Conference paper (Other academic)
  • 37.
    Sunnergren, Ola
    et al.
    Ryhov County Hospital.
    Broström, Anders
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Svanborg, Eva
    Linköping University, Department of Clinical and Experimental Medicine, Clinical Neurophysiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Reconstruction Centre, Department of Neurophysiology UHL.
    How should sensory function in the oropharynx be tested? Cold thermal testing; a comparison of the methods of levels and limits2010In: Clinical Neurophysiology, ISSN 1388-2457, E-ISSN 1872-8952, Vol. 121, no 11, p. 1886-1889Article in journal (Refereed)
    Abstract [en]

    Objective: Several studies indicate an upper airway peripheral neuropathy in obstructive sleep apnea syndrome (OSAS). The sensation of cold, as measured by cold detection thresholds (CDT), in the oropharynx has been shown to be compromised in patients with sleep apnea and, to a lesser extent, habitual snoring. To reveal whether this neuropathy is part of the pathogenetic process of OSAS, longitudinal studies of snorers are needed. The objective of the present study was to establish the test-retest repeatability for the two most commonly used thermal testing methods: the reaction time exclusive method of levels (MLE) and the method of limits (MLI). Methods: Forty non-snoring subjects were tested at the soft palate and the lip at two separate occasions (mean interval 45 days) using a Medoc TSA - 2001 equipment with an intra-oral thermode. Results: With MLE mean CDTs were lower for both the lip and soft palate than with MLI. However, MLI showed a better test-retest repeatability (r = 2.2 vs. 2.6) for the soft palate. Conclusions: MLI should be used in longitudinal studies. The performance of this method is also faster. Significance: We have established a quick, safe and reliable method suitable for longitudinal studies of peripheral neuropathy in sleep apnea pathogenesis.

  • 38.
    Sunnergren, Ola
    et al.
    Ear, Nose and Throat Clinic, Ryhov County Hospital, Jönköping.
    Broström, Anders
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Svanborg, Eva
    Linköping University, Department of Clinical and Experimental Medicine, Clinical Neurophysiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Reconstruction Centre, Department of Neurophysiology UHL.
    Positional sensitivity as a confounder in diagnosis of severity of obstructive sleep apnea2013In: Sleep and Breathing, ISSN 1520-9512, E-ISSN 1522-1709, Vol. 17, no 1, p. 173-179Article in journal (Refereed)
    Abstract [en]

    Purpose: The apnea–hypopnea index (AHI) is used to grade obstructive sleep apnea (OSA) into mild, moderate, and severe forms. Obstructive events are most common in the supine position. The amount of supine sleep thus influences total AHI. Our aim was to determine the prevalence of position-dependent OSA (POSA) and its relation to OSA severity classification as recommended by the American Academy of Sleep Medicine (AASM).

    Methods: Two hundred sixty-five subjects were recruited from primary care hypertension clinics. Whole-night respiratory recordings were performed to determine the AHI in the supine and non-supine positions, respectively. POSA was defined as supine AHI twice the non-supine AHI with supine AHI ≥5.

    Results: Fifty-three percent had POSA, 22% had non-position-dependent OSA, and 25% had normal respiration. By AASM classification, 81 subjects did not have OSA, but 42% of them had some degree of obstruction when supine, and 5 subjects would have been classified as moderate–severe if they had only slept supine. Conversely, of the 53 classified as mild OSA, 30% would have changed to a more severe classification if they had exclusively slept supine.

    Conclusions: POSA was common both in subjects that by AASM classification had OSA as well as those without. The severity of OSA, as defined by AASM, could be dependent on supine time in a substantial amount of subjects

  • 39.
    Sunnergren, Ola
    et al.
    Ryhov County Hospital.
    Broström, Anders
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Svanborg, Eva
    Linköping University, Department of Clinical and Experimental Medicine, Clinical Neurophysiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Reconstruction Centre, Department of Neurophysiology UHL.
    Soft Palate Sensory Neuropathy in the Pathogenesis of Obstructive Sleep Apnea2011In: The Laryngoscope, ISSN 0023-852X, E-ISSN 1531-4995, Vol. 121, no 2, p. 451-456Article in journal (Refereed)
    Abstract [en]

    Objectives/Hypothesis: In general, obstructive sleep apnea (USA) seems to be a progressive disorder whose pathogenesis is not fully understood. One hypothesis is that long-standing snoring vibrations cause a local neuropathy in the upper airway, which predisposes to obstructive events during sleep. The aim of this study was to investigate sensory function in the upper airway in a cohort of subjects comprising nonsnorers, snorers, and untreated subjects with USA, and to correlate data to apnea-hypopnea index (AHI) and duration of snoring. Study Design: Cross-sectional cohort study. Methods: Subjects were recruited from primary care hypertension clinics. Whole-night respiratory recordings were performed to determine presence and degree of USA. Three groups were formed based on AHI and snoring history: 1) nonsnorers (n = 25); 2) snorers, AHI andlt; 10 (n = 32); 3) USA subjects, AHI andgt;= 10 (n = 33). Quantitative cold sensory testing of the soft palate and lip was used to assess neuropathy. Results: There were no significant differences concerning lip sensory function between groups. Nonsnorers showed significantly lower thresholds for cold (i.e., better sensitivity) in the soft palate compared to both other groups (P andlt; .01). Snorers had lower thresholds than USA subjects (P andlt; .05). There were significant correlations (P andlt; .01) between decreased sensory function and AHI (r(s) = .41) and to duration of snoring (r(s) = .47). Conclusions: The degree of sensory neuropathy in the upper airway correlates with degree of obstructive sleep disorder. Our results strengthen the hypothesis that snoring vibrations may cause a neuropathy in the upper airway, which contributes to the progression and development of USA.

  • 40.
    Svanborg, Eva
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Clinical Neurophysiology. Östergötlands Läns Landsting, Reconstruction Centre, Department of Neurophysiology UHL.
    Impact of obstructive apnea syndrome on upper airway respiratory muscles2005In: Respiratory Physiology & Neurobiology, ISSN 1569-9048, E-ISSN 1878-1519, Vol. 147, no 2-3 SPEC. ISS., p. 263-272Article in journal (Refereed)
    Abstract [en]

    This article reviews studies of upper airway muscles in humans, with emphasis on muscle fiber structural and electrophysiological changes observed in patients with obstructive sleep apnea syndrome (OSAS). The concept of OSAS as a progressive disease is discussed and also possible causes. These include local nervous lesions in the upper airway, both motor and sensory. Previous muscle biopsy studies have given evidence for motor neuron lesions such as, e.g., the phenomenon of type grouping in histological sections. New data obtained with concentric needle EMG recordings from the palatopharyngeus muscles are also presented. In 10/12 OSAS patients there were typical findings indicating motor neuropathy (reduced EMG activity at maximal voluntary effort, long and polyphasic motor-unit potentials and, in two cases, spontaneous denervation activity), whereas such findings were only present in 3/15 patients with habitual snoring. This supports the hypothesis that progression from habitual snoring to the clinical disease of OSAS could be attributed to peripheral neurogenic lesions. © 2005 Elsevier B.V. All rights reserved.

  • 41.
    Svanborg, Eva
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Clinical Neurophysiology. Östergötlands Läns Landsting, Reconstruction Centre, Department of Neurophysiology UHL.
    Sömnbrist - farligt för både kropp och själ2007In: SERiP, ISSN 1400-9013, Vol. 14Article in journal (Other (popular science, discussion, etc.))
  • 42.
    Svanborg, Eva
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Clinical Neurophysiology. Östergötlands Läns Landsting, Reconstruction Centre, Department of Neurophysiology UHL.
    Sömnproblem vid Parkinsons sjukdom2003In: Nya perspektiv på Parkinsons sjukdom V,2003, Pfizer AB , 2003, p. 16-18Conference paper (Other academic)
  • 43.
    Svanborg, Eva
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Clinical Neurophysiology. Östergötlands Läns Landsting, Reconstruction Centre, Department of Neurophysiology UHL.
    Upper Airway Muscles in Obstructive Respiratory Sleep Disorders2006In: Sleep Apnea: current diagnosis and treatment / [ed] Winfried J. Randerath, Bernd M. Sanner, Virend K. Somers., Basel: Karger , 2006, 1, p. 113-117Chapter in book (Other academic)
    Abstract [en]

    In the face of the rapid developments in sleep medicine, this book seeks to present the current knowledge in the pathophysiology, clinical presentation, diagnosis, and treatment of sleep apnea. New physiological approaches to modeling sleep and recent pathophysiologic findings in upper airway mechanics as well as the importance of inflammatory and oxidative processes and the underlying genetic aspects are discussed to open up new avenues of investigation for better understanding and improved therapeutic options. Besides the well-known CPAP therapy, chapters describe novel therapeutic methods that are currently under investigation and highlight their future prospects, limitations as well as recommendations for practice. The influence of breathing disturbances on the cardiovascular system during sleep is significant. Reviews of central sleep apnea and of cardiovascular complications of sleep-disordered breathing therefore play an important role in this edition. Some of the chapters are dedicated to specific aspects in children, in the elderly and in pregnancy and receive special attention as sleep apnea is relevant to all ages. The excellent contributions to this volume will be stimulating reading to pneumologists, sleep and ENT specialists, neurologists, dental surgeons, cardiologists, obstetricians, general practitioners as well as public health specialists

  • 44.
    Svanborg, Eva
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Clinical Neurophysiology. Östergötlands Läns Landsting, Reconstruction Centre, Department of Neurophysiology UHL.
    Viktigt utreda nattlig obstruktiv andning hos barn2006In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 103, p. 2215-2216Article in journal (Other academic)
    Abstract [en]

      

  • 45.
    Svanborg, Eva
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Clinical Neurophysiology. Östergötlands Läns Landsting, Reconstruction Centre, Department of Neurophysiology UHL.
    Hagander, L
    Harlid, R
    Harder, Lena
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Oto-Rhiono-Laryngology and Head & Neck Surgery. Östergötlands Läns Landsting, Reconstruction Centre, Department of ENT - Head and Neck Surgery UHL.
    Hultcrantz, Elisabeth
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Oto-Rhiono-Laryngology and Head & Neck Surgery. Östergötlands Läns Landsting, Reconstruction Centre, Department of ENT - Head and Neck Surgery UHL.
    Haraldsson, P
    Evidence of local nervous lesions in the upper airway of osas-patients and habitual snorers; muscular and sensory testing2007In: World Sleep 07,2007, 2007, p. 134-135Conference paper (Other academic)
  • 46.
    Svanborg, Eva
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Clinical Neurophysiology. Östergötlands Läns Landsting, Reconstruction Centre, Department of Neurophysiology UHL.
    Hagander, Louise
    Can snoring cause sleep apnea by causing local nervous lesions in the oropharynx? An EMG-study2006In: 8th World Congress on Sleep Apnea 27-30 September 2006,2006, 2006Conference paper (Other academic)
  • 47.
    Svanborg, Eva
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Clinical Neurophysiology. Östergötlands Läns Landsting, Reconstruction Centre, Department of Neurophysiology UHL.
    Hagander, Louise
    Haraldsson, P
    Harder, Lena
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Clinical Neurophysiology. Östergötlands Läns Landsting, Reconstruction Centre, Department of ENT - Head and Neck Surgery UHL.
    Hultcrantz, Elisabeth
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Oto-Rhiono-Laryngology and Head & Neck Surgery. Östergötlands Läns Landsting, Reconstruction Centre, Department of ENT - Head and Neck Surgery UHL.
    Electromyographic findings in the upper airway of patients with obstructive sleep apnea an snoring2006In: 8th World Congress Sleep Apnea,2006, 2006, p. 112-112Conference paper (Other academic)
    Abstract [en]

      

  • 48.
    Svanborg, Eva
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Clinical Neurophysiology. Östergötlands Läns Landsting, Reconstruction Centre, Department of Neurophysiology UHL.
    Harder, Lena
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Clinical Neurophysiology. Östergötlands Läns Landsting, Reconstruction Centre, Department of Neurophysiology UHL.
    Sarberg, Maria
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Obstetrics and gynecology. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Gynecology and Obstetrics in Linköping.
    Broström, Anders
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Clinical Neurophysiology. Östergötlands Läns Landsting, Reconstruction Centre, Department of Neurophysiology UHL.
    Josefsson, Ann
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Obstetrics and gynecology. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Gynecology and Obstetrics in Linköping.
    Development of snoring during pregnancy. Relationship to blood pressure increases and pre-eclampsia2007In: World Sleep 07,2007, 2007, p. 111-111Conference paper (Other academic)
  • 49.
    Svanborg, Eva
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Clinical Neurophysiology. Östergötlands Läns Landsting, Reconstruction Centre, Department of Neurophysiology UHL.
    Harder, Lena
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Oto-Rhiono-Laryngology and Head & Neck Surgery. Östergötlands Läns Landsting, Reconstruction Centre, Department of ENT - Head and Neck Surgery UHL.
    Sarberg, Maria
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Obstetrics and gynecology. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Gynecology and Obstetrics in Linköping.
    Josefsson, Ann
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Obstetrics and gynecology. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Gynecology and Obstetrics in Linköping.
    Development of restless legs syndrome during pregnancy. Relationship to snoring and edemas2007In: World Sleep 07,2007, 2007, p. 177-177Conference paper (Other academic)
  • 50.
    Svanborg, Eva
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Clinical Neurophysiology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Reconstruction Centre, Department of Neurophysiology UHL.
    Harder, Lena
    Linköping University, Department of Clinical and Experimental Medicine, Oto-Rhiono-Laryngology and Head & Neck Surgery . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Reconstruction Centre, Department of ENT - Head and Neck Surgery UHL.
    Sarberg, Maria
    Linköping University, Department of Clinical and Experimental Medicine, Obstetrics and gynecology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Gynecology and Obstetrics in Linköping.
    Josefsson, Ann
    Linköping University, Department of Clinical and Experimental Medicine, Obstetrics and gynecology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Gynecology and Obstetrics in Linköping.
    Harder, Henrik
    Linköping University, Department of Clinical and Experimental Medicine, Oto-Rhiono-Laryngology and Head & Neck Surgery . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Reconstruction Centre, Department of ENT - Head and Neck Surgery UHL.
    Broström, Anders
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    SNORING DURING PREGNANCY AND ITS RELATION TO PRE-ECLAMPSIA2009In: In Sleep, vol 32, 2009, Vol. 32, p. A219-A219Conference paper (Refereed)
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