Tomoko Yagi

• Ota Memorial Sleep Center

Daridorexant is a dual orexin receptor antagonist for the treatment of insomnia. We report results from the first two randomised, double‐blind clinical studies of daridorexant in Japanese subjects. In the Phase 1 study, daridorexant (10, 25, 50 mg) or placebo were administered in the morning for 4 days in 24 young (mean age 26.9 years) and 24 older...

Objective Polysomnography (PSG) is considered the gold standard for diagnosing obstructive sleep apnea syndrome (OSA) in children. However, many hospitals do not carry out PSG evaluations, and use out-of-center sleep test (OCST) devices for diagnosis instead. The aim of this study was to confirm the reliability of OCSTs for the diagnosis of pediatr...

The prevalence of sleep-disordered breathing (SDB) is reportedly very high. Among SDBs, the incidence of obstructive sleep apnea (OSA) is higher than previously believed, with patients having moderate-to-severe OSA accounting for approximately 20% of adult males and 10% of postmenopausal women not only in Western countries but also in Eastern count...

Objective Uvulopalatopharyngoplasty (UPPP) is performed as a surgical treatment at the oropharyngeal level for obstructive sleep apnea, but there are problems with variations in treatment effects and postoperative complications. Therefore, to improve those, we have devised and put into practice the so-called CWICKs, which is a modified version of b...

The prevalence of sleep disordered breathing (SDB) is reportedly very high. Among SDBs, the incidence of obstructive sleep apnea (OSA) is higher than previously believed, with patients having moderate-to-severe OSA accounting for approximately 20% of adult males and 10% of postmenopausal women not only in Western countries but also in Eastern count...

Background Pompe disease is an autosomal recessive disorder caused by deficiency of the acid α-glucosidase (GAA) enzyme. GAA deficiency induces progressive glycogen accumulation which leads to weakness of the respiratory muscle including the diaphragm. Pompe disease is one of the few myopathies, for which an established therapy is available. Thus,...

Introduction In Japan, the many of the patients are not able to access the specialized sleep medical facilities for overnight polysomnography(PSG) due to less availability and cost issues. Purpose of the study is to examine whether combination of video monitoring and other clinical examinations can reliably predict the severity of pediatric OSA com...

Introduction The use of information and communication technology (ICT) for sleep testing is mainly aimed at improving the accuracy of out-of-center sleep testing (OCST) by remote monitoring. In this study, as the first achievement in Japan, we report the results of our sleep medical clinic and hospital unit. For the diagnosis of sleep disorders, mo...

Introduction REM sleep behavior disorder (RBD), REM without atonia (RWA) and periodic limb movements in sleep (PLMS) are known as symptoms of Narcolepsy as it is listed in the International Classification of Sleep Disorders, third edition (ICSD3). The purpose of this study is to summarize polysomnographic findings and abnormal behavior related to R...

Recently, several new materials for mattresses have been introduced. Although some of these, such as low rebound (pressure-absorbing/memory foam) and high rebound mattresses have fairly different characteristics, effects of these mattresses on sleep have never been scientifically evaluated. In the current study, we have evaluated effects of a high...

(A) Changes in core body temperature during sleep in young (study I) and old (study II) subjects. Compared to the young subjects, the decline of the temperature of the old subjects was not obvious and mostly unchanged until the second half of the nocturnal sleep (p<0.01 by age group, p<0.01 by time, p<0.01 by age group x time, repeated measures ANO...

Amounts of slow wave sleep and sympathetic nerve activity (LF/HF values) in each 2-hour period slept in young (study I) and old (study II) subjects. (PDF)

Experimental design and schedule and bed materials used. Effects of a high rebound mattress topper (HR) on sleep and its associated physiology were compared to those of a low rebound mattress topper (LR) with a randomized single-blind cross over design. Bottom figures: HR (left two figs) and LR (light fig) mattress toppers used in the study. nPSG;...

Comparisons of sleep and sleep-related parameters between young (study I) and old (study II) subjects. SPT, total sleep period (sleep period time); TST, total sleep time; SL, sleep latency; SE1, sleep efficiency, SE2, sleep efficiency; VASS, visual analogue scale sleep; VASP, visual analogue scale performance; SSS, Stanford sleepiness scale; GH, gr...

Amounts of slow wave sleep and sympathetic nerve activity (LF/HF values) in each 2-hour period slept with HR and LR in old subjects (study II). (PDF)

Introduction Obstructive sleep apnea (OSA) is a social problem that can lead to cardiovascular disease, traffic accidents resulting from daytime sleepiness and other effects due to sleep disordered breathing. Polysomnography (PSG) testing is necessary for the diagnosis of OSA at a professional medical facility but not all medical facilities can per...

Introduction According to ICDS-3 criteria, overnight polysomnography(PSG) is the gold standard tool for the diagnosis of pediatric obstructive sleep apnea(OSA) and adenotonsillectomy is the first line treatment for whom confirmed it. However, in Japan, the many of the patients are not able to access the specialized sleep medical facilities for PSG...

Introduction The phenomena of periodic cycles of vascular engorgement on the nasal cavity mucosa that alternate between right and left sides are termed the “nasal cycle.”It has been reported that nasal cycle duration during sleep is longer than in wakefulness by Kimura et al. They also reported that the reversal of cyclic phase during sleep(RCS) te...

Introduction Interrater reliability (IRR) of sleep stage scorings has an essential impact on the reading of polysomnographic studies (PSGs) for clinical trials. This is the first investigation on IRR for sleep stage scoring between experienced scorers from plural Japanese laboratories where the Japan Association of Polysomnographic Technologists (J...

Introduction CPAP and OA are typical conservative treatments for Obstructive Sleep Apnea (OSA), but decreased adherence can be a problem for using each device. Therefore, we suggest Sleep Surgery (SS) as an alternative treatment for OSA. SS is performed in two phases according to the Stanford protocol. Phase1 is performed on the soft tissues (nasal...

Introduction The phenomena of periodic cycles of vascular engorgement on the nasal cavity mucosa that alternate between right and left sides are termed the “nasal cycle(NC).” We have already reported that nasal cycle duration during sleep is longer than in wakefulness (Kimura et al. Laryngoscope, 123:20502055, 2013). And it is speculated that nasal...

This study was aimed to clarify the changes in Non-REM sleep by menstrual cycle using polysomnography with the Cyclic Alternating Pattern (CAP) analysis. The subjects were twelve healthy women having regular menstrual cycles (mean age: 29.5 ± 4.4 years old). As the results of our study, the conventional sleep parameters did not significantly differ...

We tried to improve the sleep assessment method from the accelerations (ACC) and RR interval variations (RRIV) thar were measured with newly developed small and light-weight wearable ECG and ACC measuring devices (M-BIT). We performed the simultaneous measurement of M-BIT and polygraph, and verified the validity of our ACC-based sleep/awake identif...

Obstructive sleep apnea (OSA) can be caused by obesity, craniofacial deformity, upper airway disease, aging, etc. Treatments for patients with OSA, such as weight loss, operations, nasal continuous positive airway pressure, and oral appliances may be used alone or in combination. According to previous reports, significant decrease of the apnea hypo...

Due to the busy lifestyles of people in developed countries, insufficient sleep has emerged as a central health issue in the general population. Objective home sleep monitoring is preferable for identifying sleep problems and improving sleep quality. Several instruments, most notably wrist actigraphy, have been used for this purpose. However, vario...

Introduction Recently, several new materials for mattresses become introduced. Although some of these, such as low rebound (or pressure-absorbing) and high rebound mattresses have fairly different characteristics, effects of these mattresses on sleep have never evaluated. In the current study, we have evaluated effects of airweave (a high rebound [...

Background and objectives: The phenomena of periodic cycles of vascular engorgement on the nasal cavity mucosa that alternate between right and left sides are termed the "nasal cycle." The physiologic mechanisms underlying this cycle have not been entirely clarified, even more so during sleep. In this study, we measured the periodic patterns of th...

In this open‐label study using final evaluator blinding, the efficacy of yokukansan (YKS) was evaluated in six psychophysiological insomnia patients using the cyclic alternating pattern (CAP) method. YKS had no influence on objective sleep parameters by the Rechtschaffen & Kales method, but the CAP rate and CAP cycle frequency decreased significant...

By definition, insomnia entails a subjective component relating to the perception of poor sleep, which may and may not be supported by objective evaluation of sleep. Although polysomnography (PSG) is the objective method that provides a comprehensive measurement of sleep and is essential in diagnosing many sleep disorders, it is not usually necessa...

Though complex sleep apnea syndrome (compSAS) has recently been recognized as a new category of sleep apnea syndrome, its prevalence has not been determined, especially in Japan. Hence, we surveyed the prevalence of compSAS in Japan from the data of 4582 patients at eight sleep institutes who were diagnosed with obstructive SAS (apnea–hypopnea inde...

A placebo-controlled randomized crossover study to investigate the effects of zolpidem on sleep stability in Japanese insomniac patients was performed using the cyclic alternating pattern (CAP) rate, a polysomnographic marker that reflects sleep instability. Seventeen patients (5 M and 12 F, mean age: 40.4+/-13.6 years) who met the International Cl...

Influence of fragrance on the heart rate and R-R interval (RRI) variation (RRV) in male and female university students were studied. High and low frequency elements from the RRI, recorded for short duration, were classified by a newly programmed computer. A two-dimensional trajectory of heart rate variation (X-axis: RRV, Y-axis: heart rate, beats p...

Abstract  The aim of the present paper was to clarify the factors influencing subjective daytime sleepiness in patients with obstructive sleep apnea syndrome (OSAS). Subjects included 230 adult male OSAS patients aged 20–73 years. Single and multiple linear regression analyses were performed to estimate the association between the Epworth Sleepines...

Overnight polysomnography (PSG) is indispensable for diagnosis of obstructive sleep apnea hypopnea syndrome. However, studies on interscorer agreement on PSG scoring between laboratories are few. The purpose of this study was to examine the reliability of interscorer agreement on PSG scoring among 16 sleep laboratories in Japan. We found a relative...

We examined the efficiency of upper airway structural changes in uvulopalatopharyngoplasty and/or tonsillectomy on central chemosensitivity, and whether the outcome of such surgeries can be predicted by the central chemosensitivity in obstructive sleep apnea-hypopnea syndrome (OSAHS) patients. In 11 patients with OSAHS group, the average of the hyp...

We investigated factors of daytime sleepiness in 22 middle-aged male patients with sleep apnea syndrome (SAS) using the Epworth sleepiness scale (ESS) and polysomnography. The subjects were classified into two groups according to ESS score as follows; low ESS group: ESS score < 10, and high ESS group; ESS score > or = 10. ESS score was significantl...

We evaluated the rate of automobile accidents and daytime sleepiness using the Epworth sleepiness scale (ESS) in 44 patients with obstructive sleep apnea syndrome (OSAS). We defined the automobile accident score as a sum of two points for every one automobile accident and one point for every near-miss accident. Automobile accidents and near-misses...

The purpose of the present study is to determine whether electrocardiographic QRS voltage criteria with ST-T change is useful in the diagnosis of left ventricular hypertrophy (LVH) using echocardiography. One hundred men including 59 with hypertension (HT), 9 with hypertrophic cardiomyopathy (HCM), and 32 without any cardiovascular disease were enr...

We examined relationships between mitral valve prolapse (MVP) and circadian rhythm of autonomic activity using spectral analysis of heart rate variability and echocardiography in 31 normal women. The heart rate variability was calculated from 24-hour ambulatory electrocardiogram by Fourier transformation. The power spectra were quantified at 0.04-0...

We evaluated the usefulness of a combination of QRS voltage and the pattern of ST-T abnormality in the electrocardiographic diagnosis of left ventricular hypertrophy (LVH) in 100 middle-aged men: 32 normals, 59 with hypertension (HT), and 9 with hypertrophic cardiomyopathy (HCM) with evidence of LVH (RV5 or RV6 > or = 2.6 mV, SV1 + RV5 or SV1 + RV6...