Ravi Gupta

Publications (45) View all

• Article: Sleep-stage-independent obstructive sleep apnea: an unidentified group?

  Ravi Gupta, Vivekananda Lahan, Girish Sindhwani
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  ABSTRACT: Our clinical experience suggested existence of a third group, stage-independent-OSA besides two known groups: REM-dependent-OSA and NREM-dependent-OSA. This study was planned to compare the characteristics of this group with the other two. All the subjects undergoing diagnostic video-polysomnographies with AHI >5/h were included in this study. Based upon the ratio of AHI during REM and NREM sleep, various groups were formed. REM-dependent-OSA was defined as AHI-REM/AHI-NREM >2; all other subjects were included in Not-REM-dependent-OSA (A-1 analysis). This group was further bifurcated into two groups: Non-REM-dependent OSA (NREM-dependent-OSA) where AHI-NREM/AHI-REM >2 and remaining subjects were included in the sleep-stage-independent-OSA group (A-2 analysis). SPSS v 17.0 was used to calculate independent sample t test (A-1 analysis) and Kruskall-Wallis test (A-2 analysis). Using A-1 approach, REM-dependent-OSA group was found to be suffering from mild-moderate OSA (90 %). REM-dependent OSA group had lower AHI-NREM (P < 0.001; 95 % CI 22.11-36.81) and lower AHI-total (P < 0.001; 95 % CI 15.39-30.73). Surprisingly, AHI-REM and DI-REM were not significantly different between these groups. A-2 analysis showed that overall, REM-dependent-OSA had lowest AHI-total while the stage-independent group had highest (P < 0.001). However, on analysis of REM-dependent-OSA, it was found that few of the subjects from this group had severe OSA (AHI-total > 30/h). The NREM-AHI increased linearly as we moved from REM-dependent-OSA to stage-independent-OSA with a significant difference across groups (P < 0.001). However, similar trend was not observed for AHI-REM. This study showed that a third group, sleep-stage-independent-OSA also exists when OSA is classified according to the proportion of apnea across sleep stages. This classification partially corresponds with the severity of illness.
  Neurological Sciences 01/2013; · 1.32 Impact Factor
• Article: Prevalence of restless leg syndrome in subjects with depressive disorder.

  Ravi Gupta, Vivekananda Lahan, Deepak Goel
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  ABSTRACT: Restless legs syndrome (RLS) is known to be associated with depression. We hypothesized that RLS in depression is linked to the severity, duration, and frequency of depressive episodes. Subjects fulfilling DSM-IV-TR criteria of depressive disorders were included in this study after seeking informed consent. Using structured interview of MINI-Plus their demographic data and history were recorded. Severity of depression was assessed with the help of HAM-D. Insomnia was diagnosed following ICSD-2 criteria. RLS was diagnosed according to IRLSSG criteria. Descriptive statistics, Chi-square test, independent sample t test and MANOVA were computed with the help of SPSS v 17.0. RLS was reported by 31.48% of sample. There was no gender difference in prevalence of RLS (X(2) =0.46; P=0.33). There was no difference in the age , total duration of depressive illness and number of depressive episodes between RLS and non-RLS groups (F=0.44; P=0.77; Wilk's Lambda=0.96). The HAM-D score was higher in the non-RLS group (P=0.03). Onset of RLS symptoms was not related to onset of depressive symptoms. RLS is prevalent in depressive disorder. However, onset of RLS is unrelated to age and number or duration of depressive disorders.
  Indian Journal of Psychiatry 01/2013; 55(1):70-3.
• Article: Restlessness in right upper limb as sole presentation of restless legs syndrome.

  Ravi Gupta, Vivekananda Lahan, Deepak Goel
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  ABSTRACT: Restless legs syndrome (RLS) rarely affects the upper limb during the initial course of disease. We present a patient who complained of symptoms suggesting RLS in the right upper limb as the sole manifestation of illness. Bilateral cervical ribs and depression were co-incidental findings. Patient responded well to dopaminergic therapy.
  Journal of neurosciences in rural practice. 01/2013; 4(1):78-80.
• Article: Subjective sleep problems in young women suffering from premenstrual dysphoric disorder.

  Ravi Gupta, Vivekananda Lahan, Savita Bansal
  North American journal of medical sciences. 11/2012; 4(11):593-5.
• Article: Primary headaches in restless legs syndrome patients.

  Ravi Gupta, Vivekananda Lahan, Deepak Goel
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  ABSTRACT: Earlier studies conducted among migraineurs have shown an association between migraine and restless legs syndrome (RLS). We chose RLS patients and looked for migraine to exclude sample bias. 99 consecutive subjects of idiopathic RLS were recruited from the sleep clinic during four months period. Physician diagnosis of headache and depressive disorder was made with the help of ICHD-2 and DSM-IV-TR criteria, respectively. Sleep history was gathered. Severity of RLS and insomnia was measured using IRLS (Hindi version) and insomnia severity index Hindi version, respectively. Chi-square test, one way ANOVA and t-test were applied to find out the significance. Primary headache was seen in 51.5% cases of RLS. Migraine was reported by 44.4% subjects and other types of 'primary headaches' were reported by 7.1% subjects. Subjects were divided into- RLS; RLS with migraine and RLS with other headache. Females outnumbered in migraine subgroup (χ(2)=16.46, P<0.001). Prevalence of depression (χ(2)=3.12, P=0.21) and family history of RLS (χ(2)=2.65, P=0.26) were not different among groups. Severity of RLS (P=0.22) or insomnia (P=0.43) were also similar. Migraine is frequently found in RLS patients in clinic based samples. Females with RLS are prone to develop migraine. Depression and severity of RLS or insomnia do not affect development of headache.
  Annals of Indian Academy of Neurology 08/2012; 15(Suppl 1):S104-8. · 0.93 Impact Factor