Browsing by Author "Karadeniz, D"

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    Body Mass Index and Sexual Dysfunction in Males and Females in a Population Study
    (KURE ILETISIM GRUBU A S) Karadag, H; Oner, O; Karaoglan, A; Orsel, S; Demir, AU; Firat, H; Karadeniz, D; Aksu, M; Ardic, S; Ucar, ZZ; Sevim, S; Yilmaz, H; Itil, O
    The association of obesity with sexual dysfunctions is complex and far from clear. Most former studies consisted of small samples and did not control several possible confounding factors. Our aim was to investigate the association of BMI with current sexual dysfunction in males and females in a nationally representative population sample after controlling for age, the presence of cardiovascular disorders, diabetes, hypertension, thyroid diseases, anxiety and depression and also menopause in women. The sample included a total of 4162 subjects (2081 females and 2081males). The most frequent sexual problem was premature ejaculation (8.8%) in males and hypoactive sexual desire disorder (13.9%) in females. Univariate analysis showed that hypoactive sexual desire and erectile dysfunction in males and hypoactive sexual desire, lack of pleasure from sexuality and sexual pain in females were associated with obesity. Multivariate analysis indicated that age was significantly associated with almost all types of sexual problems in both sexes. The risks of having no active sexual life, hypoactive sexual desire, lack of pleasure from sexuality and erectile dysfunction were higher in males with diabetes mellitus. Depression and anxiety were associated with all types of sexual problems in females and with no active sexual life, hypoactive sexual desire, erectile dysfunction and premature ejaculation in men. In both sexes BMI was not associated with sexual problems after the confounding factors were controlled. The association of obesity with sexual dysfunction might be mediated by other factors.
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    Prevalence of sleep disorders in the Turkish adult population epidemiology of sleep study
    (SPRINGER LONDON LTD) Demir, AU; Ardic, S; Firat, H; Karadeniz, D; Aksu, M; Ucar, ZZ; Sevim, S; Ozgen, F; Yilmaz, H; Itil, O; Peker, Y; Aygul, F; Kiran, S; Gelbal, S; Cepni, Z; Akozer, M
    Sleep disorders constitute an important public health problem. Prevalence of sleep disorders in Turkish adult population was investigated in a nationwide representative sample of 5021 Turkish adults (2598 women and 2423 men, response rate: 91%) by an interviewer-administered questionnaire. Insomnia was defined by the DSM-IV criteria, habitual snoring and risk for sleep-related breathing disorders (SDB) by the Berlin questionnaire, excessive daytime sleepiness (EDS) by the Epworth sleepiness scale score, and restless legs syndrome (RLS) by the complaints according to the International Restless Legs Syndrome Study Group criteria. Mean age of the participants was 40.7 +/- 15.1 (range 18 to 90) years. Prevalence rates (men/women) were insomnia 15.3% (10.5%/20.2%; P < 0.001), high probability of SDB 13.7% (11.1%/20.2%; P < 0.001), EDS 5.4% (5.0%/5.7%; P: 0.09), RLS 5.2% (3.0%/7.3%; P < 0.001). Aging and female gender were associated with higher prevalence of sleep disorders except for habitual snoring. Prevalence rates of the sleep disorders among Turkish adults based on the widely used questionnaires were close to the lower end of the previous estimates reported from different parts of the world. These findings would help for the assessment of the health burden of sleep disorders and addressing the risk groups for planning and implementation of health care.
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    Prevalence of insomnia and its clinical correlates in a general population in Turkey
    (WILEY) Benbir, G; Demir, AU; Aksu, M; Ardic, S; Firat, H; Itil, O; Ozgen, F; Yilmaz, H; Karadeniz, D
    AimThe prevalence of insomnia is influenced by environmental factors. This study aimed to investigate the prevalence of insomnia and its sociodemographic and clinical correlates in a general population-based survey in Turkey. MethodsThis population-based study included 4758 subjects among 5021 who participated in the Turkish Adult Population Epidemiology of Sleep Disorders study. Questionnaire items evaluating insomnia were adapted from the International Classification of Sleep Disorders II and the DSM-IV-TR. Subjects with restless legs syndrome were excluded. ResultsInsomnia was found to be associated with older age (18-24 years, 9.8%; 25-44 years, 11.7%; 45-64 years, 13.8%; 65 years or older, 13.9%), lower income level (<500 USD, 16.5%), time spent watching TV (6-8h or more, 18.4%), tea consumption in the evening (6 glasses, 14.5%) and smoking status (current and ex-smoker, both 14.2%) in multiple logistic regression analysis. In respect to other medical disorders, insomnia was significantly associated with the presence of hypertension, diabetes and heart diseases after the adjustment for relevant risk factors for each disease, across all age and sex groups. ConclusionsInsomnia is a major health problem in our population, affecting subjects in the working age group and those of lower socioeconomic status. It should especially be screened in patients with chronic diseases. A relatively low proportion of insomnia diagnosed as a sleep disorder suggests that this condition and its clinical correlates are possibly under-recognized.
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    THE REM-SLEEP RELATED CHARACTERISTICS OF NARCOLEPSY: A NATION-WIDE MULTI-CENTER STUDY IN TURKEY, THE REMCON STUDY
    (ELSEVIER) Akyildiz, UO; Tezer, I; Koç, G; Ismailogullari, S; Demir, AB; Kisabay, A; Sünter, G; Kara, KA; Berktas, DT; Sahin, A; Azman, F; Akçay, BD; Gök, DK; Yilmaz, H; Agan, K; Bekmezci, Y; Yetkin, S; Aksu, M; Karadeniz, D; Senel, GB
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    RISK OF OBSTRUCTIVE SLEEP APNEA IN THE TURKISH ADULT POPULATION
    (OXFORD UNIV PRESS INC) Ardic, S; Demir, A; Ucar, Z; Firat, H; Itil, O; Karadeniz, D; Aksu, M; Sevim, S; Yilmaz, H; Oktay, B
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    The REM-sleep-related characteristics of narcolepsy: a nation-wide multicenter study in Turkey, the REMCON study
    (ELSEVIER) Akyildiz, UO; Tezer, FI; Koc, G; Ismailogullari, S; Demir, AB; Ak, AK; Sunter, G; Kara, KA; Berktas, DT; Sahin, A; Azman, F; Akcay, BD; Gok, DK; Yilmaz, H; Agan, K; Bekmezci, Y; Yetkin, S; Aksu, M; Karadeniz, D; Senel, GB
    Introduction: Narcolepsy type 1 (NT1) is caused by hypocretin deficiency, the pathophysiology of narcolepsy type 2 (NT2) has not been delineated. Except for the hypocretin deficiency and cataplexy, all clinical and laboratory features used in the diagnosis of NT2 are identical to those used for NT1. The aim of this study was to assess the rapid eye movement (REM) sleep-related characteristics in the patients with narcolepsy; the characteristics of REM sleep in polysomnography (PSG) and multiple sleep latency test (MSLT) recordings, the quantification of REM sleep without atonia (RSWA) and atonia index, and the analysis of rapid eye movements (REMs) during REM sleep. Materials and methods: This study was planned by the Sleep Medicine Study Group of the Turkish Neurology Society, and conducted in 11 centers in eight cities in Turkey. The analysis of RSWA was analyzed by reviewing all REM sleep periods on nocturnal PSG and MSLT recordings per standard criteria. The total duration of the increased muscle tone during REM sleep in the chin and bilateral leg electromyography (EMG) recordings was calculated as RSWA index. The REMs index was also investigated the relation to the RSWA. Results: A total of 274 patients were involved; 147 patients (53.6%) were males and 127 patients (46.4%) were females; the mean age was 29.1 +/- 12.0 years. The diagnosis of NT1 was made in 166 patients (60.6%), and 108 patients (39.4%) were diagnosed as having NT2. The mean Epworth sleepiness scale score was significantly higher in patients with NT1 than the patients with NT2 (P = 0.001). The diagnosis of REM sleep behavior disorder (RBD) was made in 19.3% of the patients with NT1 versus in 2.8% of the patients with NT2 (P < 0.001). The percentage of SOREMP in PSG recordings was significantly higher in patients with NT1 (37.1%) than those with NT2 (18.9%, P = 0.001). MSLT showed that the mean sleep latency was shorter in patients with NT1 compared to those with NT2 (P < 0.001). The total duration of REMs on electrooculography recordings was also significantly higher in patients with RSWA in comparison with the patients without RSWA (P = 0.002). Total duration of REMs was significantly and positively correlated with the duration of RSWA on chin-EMG and leg-EMG recordings (P = 0.001). ROC analyses showed an RSWA index of >= 2% for the RSWA on chin-EMG with a sensitivity of 86.7% and a specificity of 71.3% (P < 0.001). The REMs index >= 20% was associated with the presence of RSWA with a sensitivity of 70.0% and a specificity of 57.1% (P = 0.008). Conclusions: In this nation-wide study, we identified for the first time that the increase in REMs density during REM sleep may be a major correlate of the RSWA. Significant positive correlations were demonstrated between the total duration of REMs on electrooculography recordings and the mean durations of RSWA in both chin and leg EMG recordings. A REMs index of >20% was demonstrated to have a moderate sensitivity and specificity in the diagnosis of RSWA. As observed in chin RSWA index, REMs index also showed a significantly high association with RBD, in comparison to RSWA per standard criteria. (C) 2022 Elsevier B.V. All rights reserved.
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    Absenteeism and Delay to Work Due to Sleep Disorders in the Turkish Adult Population: A Questionnaire-Based National Survey
    (SAGE PUBLICATIONS INC) Firat, H; Yuceege, M; Kiran, S; Akgun, M; Demir, AU; Aksu, M; Ardic, S; Karadeniz, D; Ucar, ZZ; Sevim, S; Itil, O; Yilmaz, H
    Sleep problems may have negative effects on work-life balance, overall health, and safety. We aimed to investigate the association between sleep disorders and absenteeism and delay to work (being late or tardy) among the working adult population. The study was conducted by using data from a large survey of working adults who participated in the Turkish Adult Population Epidemiology of Sleep Study (TAPES) managed by Turkish Sleep Medicine Society (TSMS). Secondary analyses was employed to examine absenteeism and delay to work and their associations with sleep problems, including sleepiness by Epworth Sleepiness Scale (ESS), parasomnias, sleep apnea (by Berlin Questionnaire), sleep quality (by Pittsburgh Sleep Quality Index), and restless leg. History of any absenteeism and delay to work was observed in 276 (18%) and 443 (29%) out of 1,533 working adults, respectively. In the multivariate analyses, absenteeism was associated with younger age, female gender and poor sleep quality, while delay to work was associated with younger age, poor sleep quality, parasomnia, and sleepiness. In the presence of absenteeism and delay to work, sleep disorders including sleepiness, poor sleep quality, and parasomnia should be considered. Such evaluation may improve worker well-being and provide some additional benefits in terms of increasing productivity and lowering work-related costs.
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    Distinctive sleep complaints and polysomnographic findings in antibody subgroups of autoimmune limbic encephalitis
    (SPRINGER-VERLAG ITALIA SRL) Küçükali, CI; Yilmaz, V; Karadeniz, D; Akyildiz, UO; Algin, DI; Saritas, AS; Ak, AK; Demir, AB; Yilmaz, H; Domaç, FM; Elmali, AD; Hos, ÜD; Gözübatik-Çelik, RG; Kabeloglu, V; Bilgin, B; Berktas, DT; Türk, BG; Delil, S; Dilber, C; Öztürk, ST; Yeni, SN; Özkara,Ç; Aksu, M; Tüzün, E; Senel, GB
    Introduction Sleep disturbances are being increasingly recognized in association with autoimmune encephalitis (AIE). We investigated the prevalence of sleep-related symptoms and polysomnographic features of patients with AIE and the long-term outcomes in these patients in a multi-center, prospective study from Turkey.Methods We prospectively evaluated patients with definite AIE in a common database including demographics, AIE-related and sleep-related symptomatology. Maximum and latest modified Rankin scores (mRS) and Liverpool Outcome Score (LOS) were noted.Results Of 142 patients, 87 patients (61.3%) fulfilled the criteria for definite AIE (mean age, 46.8+18.8 years; 51.7% women; mean disease duration, 21.0+38.4 months). 78.9% of patients had at least one or more new onset or worsened sleep-related symptomatology: insomnia (55.3%), excessive daytime sleepiness (EDS, 28.0%), sleep apnea (18.7%), REM sleep behavior disorder (RBD, 17.3%), restless legs syndrome (10.7%) and oneiric stupor (9.3%). Sleep efficiency, N3 and REM sleep were decreased and N1 sleep was increased in patients with Ab[+] AIE. LOS points were highest in those with insomnia and sleep apnea, and lowest in those with EDS, RBD and oneiric stupor. RBD and sleep apnea were more common in anti-LG1 Ab[+] group than anti-NMDAR Ab[+] group. Index of periodic leg movements was highest in anti-LG1 Ab[+] group. Patients with EDS and oneiric stupor had more common memory problems. Maximum and latest mRS scores were positively correlated with EDS and oneiric stupor. EDS, RBD and oneiric stupor were negatively correlated with LOS points.Conclusion Our study emphasizes the presence and importance of early diagnosis of sleep disturbances in AIE in regard to their deteriorative influences on disease prognosis.
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    Prevalence and associated factors of sleep-disordered breathing in the Turkish adult population
    (SPRINGER LONDON LTD) Ardic, S; Demir, AU; Ucar, ZZ; Firat, H; Itil, O; Karadeniz, D; Aksu, M; Sevim, S; Yilmaz, H; Oktay, B
    Sleep disordered breathing (SDB) represents a major public health problem. We investigated the risk of SDB and associated factors in the Turkish adult population. We collected data by an interviewer-administered questionnaire in a nationwide representative sample of 5021 adults (2598 women, 2423 men) with a mean age of 40.7 years (SD:15.1) in 2010. High risk of SDB was defined as the positive response to at least two of the three categories in the Berlin questionnaire (BQ). High risk of SDB was found in 13.7% (men: 11.1%, women: 20.2%). High risk of SDB prevalence was not significantly different between the genders in the analysis stratified for BMI categories. Female gender, older age, lower level of education and smoking in the past were associated with high risk of SDB in the logistic regression analysis models adjusting for age and gender. After the adjustment for age, gender, smoking, BMI and educational status, high risk of SDB, and BQ Category 2 score were associated with previous hospitalization and cardiovascular diseases. Risk due to BQ Category 1 and BQ Category 2 was more than additive in the models for hypertension and heart disease for the age groups 4565 years and 65 years and over. Higher prevalence of SDB and obesity among women in our population should be addressed in further studies. Association between high risk of SDB and cardiovascular diseases, if confirmed, indicates the public health importance of screening for SDB symptoms.
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    Identification of the Variations in the CPT1B and CHKB Genes Along with the HLA-DQB1*06:02 Allele in Turkish Narcolepsy Patients and Healthy Persons
    (MARY ANN LIEBERT, INC) Cingoz, S; Agilkaya, S; Oztura, I; Eroglu, S; Karadeniz, D; Evlice, A; Altungoz, O; Yilmaz, H; Baklan, B
    Background: The HLA-DQB1*06:02 allele across all ethnic groups and the rs5770917 variation between CPT1B and CHKB genes in Japanese and Koreans are common genetic susceptibility factors for narcolepsy. This comprehensive genetic study sought to assess variations in CHKB and CPT1B susceptibility genes and HLA-DQB1*06:02 allele status in Turkish patients with narcolepsy and healthy persons. Methods: CHKB/CPT1B genes were sequenced in patients with narcolepsy (n=37) and healthy persons (n=100) to detect variations. The HLA-DQB1*06:02 allele status was determined by sequence specific polymerase chain reaction. Results: The HLA-DQB1*06:02 allele was significantly more frequent in narcoleptic patients than in healthy persons (p=2x10(-7)) and in patients with narcolepsy and cataplexy than in those without (p=0.018). The mean of the multiple sleep latency test, sleep-onset rapid eye movement periods, and frequency of sleep paralysis significantly differed in the HLA-DQB1*06:02-positive patients. rs5770917, rs5770911, rs2269381, and rs2269382 were detected together as a haplotype in three patients and 11 healthy persons. In addition to this haplotype, the indel variation (rs144647670) was detected in the 5 ' upstream region of the human CHKB gene in the patients and healthy persons carrying four variants together. Conclusion: This study identified a novel haplotype consisting of the indel variation, which had not been detected in previous studies in Japanese and Korean populations, and observed four single-nucleotide polymorphisms in CHKB/CPT1B. The study confirmed the association of the HLA-DQB1*06:02 allele with narcolepsy and cataplexy susceptibility. The findings suggest that the presence of HLA-DQB1*06:02 may be a predictor of cataplexy in narcoleptic patients and could therefore be used as an additional diagnostic marker alongside hypocretin.