Harald Hrubos-Strøm

• Feng, Xin; Sigurdardottir, Fjola Dögg Hugberg; Arnardottir, Erna Sif; Dammen, Toril; Einvik, Gunnar & Korkalainen, Henri [Vis alle 15 forfattere av denne artikkelen] (2026). Association of major adverse cardiovascular events with the apnea-hypopnea index, desaturation severity parameters, and cardiac troponins in participants of the Akershus Sleep APnea cohort. Sleep. ISSN 0161-8105. 49(8). doi: 10.1093/sleep/zsag013. Fulltekst i vitenarkiv Vis sammendrag

  Study Objectives: To examine the prognostic value of the apnea-hypopnea index (AHI), desaturation severity parameters, and cardiac troponins alone and combined for major cardiovascular events (MACEs). Methods: MACE data were retrieved in 2021 from the Norwegian Patient Registry for 518 participants in the Akershus Sleep APnea (ASAP) cohort. Baseline polysomnography and fasting blood samples were collected between June 2006 and January 2008. Desaturation duration (DesDur) and severity (DesSev) were calculated using Automatic Blood Oxygen Saturation Analysis software. Cox regression models estimated hazard ratios (HRs) for MACE. Predictive properties of combining troponins and obstructive sleep apnea severity were calculated by comparing established clinical thresholds for cardiac troponin I (cTnI) and T (cTnT) with AHI clinical thresholds of ≥15 and ≥30, respectively. Results: High AHI, DesDur, DesSev, cTnI, and cTnT were associated with increased MACE risk. However, only cTnI independently predicted MACE after adjustment (HR: 1.74, 95% CI: 1.32–2.29). The HR for MACE was 2.68 (95% CI: 1.03–6.97) in patients with both high cTnI and AHI ≥30 events/h. Conclusion: In this 15-year follow-up, cTnI was independently associated with risk of MACE, whereas the AHI, desaturation parameters, and cTnT were not independent predictors. cTnI, especially when combined with AHI, was a stronger MACE predictor than cTnT. Provided our findings are validated in clinical obstructive sleep apnea populations, the measurement of cTnI may be considered for cardiovascular risk stratification.

• Gong, Siyi; Liu, Yaping; Huang, Bei; Chan, Ngan Yin; Partinen, Eemil & Benedict, Christian [Vis alle 29 forfattere av denne artikkelen] (2026). Association of Prodromal Parkinson's Disease-Like Features in Long COVID With Dream-Enactment Behaviours. Journal of Sleep Research. ISSN 0962-1105. doi: 10.1111/jsr.70371. Fulltekst i vitenarkiv Vis sammendrag

  Emerging evidence links COVID-19 to the predisposition of Parkinson's disease (PD). However, the relationship between long COVID and prodromal PD-like features remains unclear, particularly in long COVID participants with dream-enactment behaviours (DEBs) that may be suggestive of possible REM sleep behaviour disorder. This study aimed to quantify the burden of prodromal PD-like features in long COVID. This online survey (May–Nov 2021) across 16 countries/regions included 11,261 participants. Data on demographics, COVID-19 diagnosis, long COVID symptoms, sleep features and other typical prodromal PD-like features were collected. The likelihood ratio (LR) of prodromal PD was calculated as a proxy for each participant's overall burden of prodromal PD-like features, based on the 2019 Movement Disorder Society research criteria. Participants with long COVID (n = 1155) exhibited more symptoms suggestive of prodromal PD-like features, including DEBs, olfactory dysfunctions, constipation, excessive daytime sleepiness, postural dizziness, depression with/without anxiety, urinary dysfunctions, cognitive impairment and a higher LR of prodromal PD when compared to non-COVID-19 participants and COVID-19 recoverees. Long COVID was associated with a 73% higher burden of potential prodromal PD-like features (adjusted odds ratio [aOR] = 1.73, 95% confidence interval [CI] = 1.57–1.90). Among those with long COVID, emergence or exacerbation of post-infection DEBs further increased this burden by 38% (aOR = 1.38, 95% CI = 1.19–1.60). Our study suggested that long COVID is associated with an increased burden of prodromal PD-like features, which appears to be further enhanced with DEBs.

• Thorisdottir, K.; Leppänen, T.; Hrubos-Strøm, Harald; Richert, E.; Biedebach, L. & Jóhannsdóttir, K. R. [Vis alle 8 forfattere av denne artikkelen] (2025). Hypoxic Load and Average Oxygen‐Saturation During Sleep and Wake Are Associated With Cognitive Function in Obstructive Sleep Apnea. Journal of Sleep Research. ISSN 0962-1105. 35(1). doi: 10.1111/jsr.70136. Fulltekst i vitenarkiv Vis sammendrag

  Cognitive processes commonly affected by obstructive sleep apnea (OSA) are more strongly associated with hypoxic load parameters than the apnea‐hypopnea index (AHI). Additionally, lower SpO 2 during wake affects cognition, emphasising the need for concurrent assessment with sleep SpO 2 . This study examined which OSA severity parameters best predict cognitive performance and the role of wake SpO 2 . Sixty‐one participants (53% female), with an average age of 46.9 years (range 19–79), completed a three‐night self‐applied polysomnography (PSG) and a digital neurocognitive battery. Oxygen saturation‐based PSG parameters predicted immediate recall, vigilance, and processing speed, whereas the AHI did not. Greater hypoxic severity from 100% SpO 2 baseline was the strongest predictor of slower processing speed ( χ 2 (6) = 17.74, p  = 0.007) ( β  = −5.72, p  = 0.023). Lower average SpO 2 during sleep most strongly predicted immediate recall ( χ 2 (6) = 28.94, p  < 0.001) ( β  = 0.38, p  = 0.03) and vigilance ( χ 2 (6) = 16.72, p  = 0.010) ( β  = 0.15, p  = 0.002). Additionally, lower wake SpO 2 was associated with reduced vigilance performance. The results confirm the AHI's limitation in capturing OSA symptom severity and highlight the stronger associations between oxygen saturation‐based OSA parameters and cognitive abilities. Furthermore, we recommend incorporating wake SpO 2 measures in sleep research to gain a more comprehensive understanding of the relationship between SpO 2 and cognitive abilities.

• Sarkanen, Tomi; Merikanto, Ilona; Bjorvatn, Bjørn; Chung, Frances; Holzinger, Brigitte & Morin, Charles M. [Vis alle 29 forfattere av denne artikkelen] (2025). Long COVID as a risk factor for hypersomnolence and fatigue: insights from the 2nd International Covid Sleep Study Collaboration (ICOSS-2). Sleep Medicine. ISSN 1389-9457. 136. doi: 10.1016/j.sleep.2025.106764. Fulltekst i vitenarkiv Vis sammendrag

  Background Hypersomnolence, defined as excessive daytime sleepiness (EDS), excessive quantity of sleep (EQS), sleep inertia, and fatigue reduce quality of life. We assessed associations of the COVID-19 pandemic, infection without long-term sequalae (short COVID, SC), and long COVID (LC) on hypersomnolence and fatigue in a large population across different countries. Methods As part of an online questionnaire (ICOSS-2), we assessed EDS via the Epworth Sleepiness Scale (ESS), fatigue via Fatigue Severity Scale (FSS), and sleep duration at night and per 24 h. We also assessed the associations with EDS, sleep inertia, fatigue and napping by their frequencies, during the pandemic in COVID-negative, SC and LC participants. Results The final cohort comprised 13,656 participants (69.1 % women, 42.7 ± 16.6 years), with 12.4 % classified SC and 7.5 % LC. ESS scores were higher in LC (9.16, 95 % CI [8.78, 9.53]) compared to SC (7.26, [6.97, 7.55]) and COVID-negative (6.53, [6.43, 6.63]). LC also had higher odds of ESS>10 (OR 1.58, [1.18,2.09]). FSS scores were higher in LC (median 51, IQR 39–59) than SC (34, 25–44) and COVID-negative (35, 25–45), with LC having 2.22 higher odds of severe fatigue. LC cases also reported more EQS (≥10/24 h) than COVID-negative. Worsening of EDS, fatigue, sleep inertia, and napping was reported during pandemic to a greater extent in LC. Conclusions LC was associated with higher levels of hypersomnolence and fatigue than in SC or COVID-negative participants, highlighting the need for interventions and future research focusing on sleep symptoms and their relation to long-term health outcomes.

• Saavedra, Jose M.; Fridgeirsdottir, Katrin Y.; Murphy, Conor J.; Hrubos-Strøm, Harald & Arnardottir, Erna S. (2025). A Fully Replicable Exercise Program for Individuals with Sleep-Disordered Breathing: Protocol Design and Training Load Monitoring. Journal of Functional Morphology and Kinesiology. 10(3). doi: 10.3390/jfmk10030311. Fulltekst i vitenarkiv Vis sammendrag

  Objectives. The objectives of this study were (i) to design in detail an exercise program for individuals with sleep-disordered breathing (SDB) that would be reproducible, and (ii) to present a system for monitoring training load (volume × intensity) within such a program. Methods. A comprehensive exercise program was developed for individuals with SDB, detailing not only the session structure (warm-up, main part—circuit training and brisk walking—and cool-down) but also the specific exercises, training volume (actual exercise time excluding rest), intensity (Borg Rating of Perceived Exertion—RPE), and training load (calculated as time × RPE, in arbitrary units). This detailed program was previously implemented in a RCT (ISRCTN16974764). A comparison was also made between the planned and performed intensity, and training load through a paired t-test. Results. A fully replicable program was presented. No significant difference was found between the planned and performed training load (p = 0.482). When analyzed by week, a significant difference was found only for overestimation in weeks 9–12 (p < 0.001). Conclusions. In general terms, it can be concluded that a detailed exercise program was described for individuals with SDB. The program is reproducible in terms of content, training volume, intensity, and load. Moreover, the RPE proved to be a valid parameter for quantifying intensity, allowing for the integration of all parts of the session, as well as various types of content. The planned and performed programs (as quantified via participants’ RPE) matched appropriately. Therefore, this program can be reproduced and applied to this type of population.

• Hansen, Diana Dobran; Tinbod, Unn; Feng, Xin; Dammen, Toril; Hrubos-Strøm, Harald & Skirbekk, Helge (2025). Orofacial Myofunctional Therapy for Patients with Obstructive Sleep Apnea—A Mixed Methods Study of Facilitators and Barriers to Treatment Adherence. International Journal of Orofacial Myology and Myofunctional Therapy (IJOM). ISSN 0735-0120. 51(2). doi: 10.3390/ijom51020006. Fulltekst i vitenarkiv Vis sammendrag

  Orofacial myofunctional therapy (OMT) for obstructive sleep apnea (OSA) is a promising, new treatment. We aimed to study patients’ experiences and adherence to OMT. Twelve patients with OSA were included in the study, and they engaged in OMT exercises three times daily for 12 weeks. Participants tracked their sleep and OMT exercise activities in an electronic diary. Exercise techniques were guided by a certified therapist. Patients’ experiences with OMT were assessed through semi-structured individual interviews conducted after a 12-week intervention, and the transcripts were analyzed using thematic analysis. The findings revealed an overarching theme that captured both facilitators of and barriers to OMT, organized into three subthemes: (1) motivation, (2) perceived support, and (3) perceived effects. Motivation was driven by a desire to improve general health and avoid continuous positive airway pressure treatment, and was supported by a sense of mastery and perceived effectiveness. Key facilitators included a trusting patient–therapist relationship, as well as developing routines and a sense of control. Barriers involved managing the comprehensive treatment protocol, insecurities around exercise execution and the potential impact of OMT, sickness burden, and previous negative healthcare experiences. These themes were supported by quantitative findings, which demonstrated high treatment adherence, while sleep data indicated modest individual improvements in subjective sleep quality and efficiency. By recognizing facilitators and barriers and addressing the individual differences among OSA patients, healthcare providers can better tailor their approach to meet diverse patient needs. This personalized approach, supported by emerging sleep improvements, may enhance patient engagement and improve adherence to OMT.

• Andersen, Silje Glenna; Sæterhagen, Henrik; Pacheco, André Pekkola; Pripp, Are Hugo; Hrubos-Strøm, Harald & Papageorgiou, Constantinos [Vis alle 8 forfattere av denne artikkelen] (2025). The effects of cognitive behavioral therapy for insomnia in patients with cardiovascular disease: a systematic review and meta-analysis. Journal of Clinical Sleep Medicine (JCSM). ISSN 1550-9389. 21(7), s. 1273–1284. doi: 10.5664/jcsm.11656. Fulltekst i vitenarkiv
• Bjorvatn, Bjørn; Merikanto, Ilona; Chung, Frances; Holzinger, Brigitte; Morin, Charles M. & Penzel, Thomas [Vis alle 30 forfattere av denne artikkelen] (2025). Sleep During Pandemic Times: Summary of Findings and Future Outlook Through the Lens of the International COVID Sleep Study (ICOSS). Journal of Sleep Research. ISSN 0962-1105. 34(5). doi: 10.1111/jsr.70076. Fulltekst i vitenarkiv Vis sammendrag

  To study the impact of the COVID-19 pandemic on sleep and circadian rhythms—two fundamental pillars for health—the collaboration International COVID-19 Sleep Study (ICOSS) was established. The present overview comprehensively discusses the findings from this collaboration. Involving sleep researchers across the globe, ICOSS used a harmonised questionnaire to cover changes in sleep and sleep disorders, as well as physical and mental health. Two survey waves were conducted, one in 2020 and another one in 2021. In ICOSS-1, a total of 26,539 people from 14 countries across four continents (Europe, Asia, North and South America) participated. In ICOSS-2, two more countries joined ICOSS, and 15,813 people participated. The focus in ICOSS-2 was on Long COVID. Participants accessed the widely disseminated online surveys in their native language. In the 20 papers published so far, the surveys have uncovered several novel findings, including how the pandemic impacted sleep patterns, the prevalence of sleep disorders, chronotype-based differences and sleep-immune system interactions. To the best of our knowledge, there is no other large-scale multinational study targeting the general population investigating the role of sleep and sleep disorders alongside a variety of psychological, biological, social and economic factors during the recent COVID-19 pandemic.

• Berezin, Linor; Waseem, Rida; Merikanto, Ilona; Benedict, Christian; Holzinger, Brigitte & Gennaro, Luigi De [Vis alle 27 forfattere av denne artikkelen] (2024). Habitual short sleepers with pre-existing medical conditions are at higher risk of Long COVID. Journal of Clinical Sleep Medicine (JCSM). ISSN 1550-9389. 20(1), s. 111–119. doi: 10.5664/JCSM.10818. Fulltekst i vitenarkiv
• Folkvord, Frans; Würth, Ana Roca-Umbert; Houten, Karlijn van; Liefveld, Aad R.; Carlson, Jim Ingebretsen & Bol, Nadine [Vis alle 26 forfattere av denne artikkelen] (2024). A systematic review on experimental studies about patient adherence to treatment. Pharmacology Research & Perspectives. 12(1). doi: 10.1002/prp2.1166. Fulltekst i vitenarkiv Vis sammendrag

  A better understanding of patients' adherence to treatment is a prerequisite to maximize the benefit of healthcare provision for patients, reduce treatment costs, and is a key factor in a variety of subsequent health outcomes. We aim to understand the state of the art of scientific evidence about which factors influence patients' adherence to treatment. A systematic literature review was conducted using PRISMA guidelines in five separate electronic databases of scientific publications: PubMed, PsycINFO (ProQuest), Cochrane library (Ovid), Google Scholar, and Web of Science. The search focused on literature reporting the significance of factors in adherence to treatment between 2011 and 2021, including only experimental studies (e.g., randomized controlled trials [RCT], clinical trials, etc.). We included 47 experimental studies. The results of the systematic review (SR) are grouped according to predetermined categories of the World Health Organization (WHO): socioeconomic, treatment, condition, personal, and healthcare-related factors. This review gives an actual overview of evidence-based studies on adherence and analyzed the significance of factors defined by the WHO classification. By showing the strength of certain factors in several independent studies and concomitantly uncovering gaps in research, these insights could serve as a basis for the design of future adherence studies and models.

• Howarth, Timothy P.; Sillanmäki, Saara; Karhu, Tuomas; Rissanen, Marika; Islind, Anna Sigridur & Hrubos-Strøm, Harald [Vis alle 10 forfattere av denne artikkelen] (2024). Nocturnal oxygen resaturation parameters are associated with cardiorespiratory comorbidities. Sleep Medicine. ISSN 1389-9457. 118, s. 101–112. doi: 10.1016/j.sleep.2024.03.047. Fulltekst i vitenarkiv Vis sammendrag

  Background There are strong associations between oxygen desaturations and cardiovascular outcomes. Additionally, oxygen resaturation rates are linked to excessive daytime sleepiness independent of oxygen desaturation severity. No studies have yet looked at the independent effects of comorbidities or medications on resaturation parameters. Methods The Sleep Heart Health Study data was utilised to derive oxygen saturation parameters from 5804 participants. Participants with a history of comorbidities or medication usage were compared against healthy participants with no comorbidity/medication history. Results 4293 participants (50.4% female, median age 64 years) were included in the analysis. Females recorded significantly faster resaturation rates (mean 0.61%/s) than males (mean 0.57%/s, p < 0.001), regardless of comorbidities. After adjusting for demographics, sleep parameters, and desaturation parameters, resaturation rate was reduced with hypertension (-0.09 (95% CI -0.16, -0.03)), myocardial infarction (-0.13 (95% CI -0.21, -0.04)) and heart failure (-0.19 (95% CI -0.33, -0.05)), or when using anti-hypertensives (-0.10 (95% CI -0.17, -0.03)), mental health medications (-0.18 (95% CI -0.27, -0.08)) or anticoagulants (-0.41 (95% CI -0.56, -0.26)). Desaturation to Resaturation ratio for duration was decreased with mental health (-0.21 (95% CI -0.34, -0.08)) or diabetic medications (-0.24 (95% CI -0.41, -0.07)), and desaturation to resaturation ratio for area decreased with heart failure (-0.25 (95% CI -0.42, -0.08)). Conclusions Comorbidities and medications significantly affect nocturnal resaturation parameters, independent of desaturation parameters. However, the causal relationship remains unclear. Further research can enhance our knowledge and develop more precise and safer interventions for individuals affected by certain comorbidities.

• Thorisdottir, K.; Hrubos-Strøm, Harald; Karhu, T.; Nikkonen, S.; Dammen, Toril & Nordhus, Inger Hilde [Vis alle 9 forfattere av denne artikkelen] (2024). Verbal memory is linked to average oxygen saturation during sleep, not the apnea-hypopnea index nor novel hypoxic load variables. Sleep Medicine. ISSN 1389-9457. 123, s. 29–36. doi: 10.1016/j.sleep.2024.08.028. Fulltekst i vitenarkiv Vis sammendrag

  Introduction: The apnea-hypopnea index (AHI) is the current diagnostic parameter for diagnosing and estimating the severity of obstructive sleep apnea (OSA). It is, however, poorly associated with the main clinical symptom of OSA, excessive daytime sleepiness, and with the often-seen cognitive decline among OSA patients. To better evaluate OSA severity, novel hypoxic load parameters have been introduced that consider the duration and depth of oxygen saturation drops associated with apneas or hypopneas. The aim of this paper was to compare novel hypoxic load parameters and traditional OSA parameters to verbal memory and executive function in OSA patients. Method: A total of 207 adults completed a one-night polysomnography at sleep laboratory and two neuropsychological assessments, the Rey Auditory Verbal Learning Test and Stroop test. Results: Simple linear regression analyses were used to evaluate independent associations between each OSA parameter and cognitive performance. Associations were found between immediate recall and arousal index, hypoxia <90 %, average SpO2 during sleep, and DesSev100+RevSev100. Total recall was associated with all OSA parameters, and no associations were found with the Stroop test. Subsequently, sex, age, and education were included as covariates in multiple linear regression analyses for each OSA parameter and cognitive performance. The main findings of the study were that average SpO2 during sleep was a significant predictor of total recall (p < .007, β = −.188) with the regression model explaining 21.2 % of performance variation. Average SpO2 during sleep was also a significant predictor of immediate recall (p < .022, β = −.171) with the regression model explaining 11.4 % of performance variation. Neither traditional OSA parameters nor novel hypoxic load parameters predicted cognitive performance after adjustment for sex, age, and education. Conclusion: The findings validate that the AHI is not an effective indicator of cognitive performance in OSA and suggest that average oxygen saturation during sleep may be the strongest PSG predictor of cognitive decline seen in OSA. The results also underline the importance of considering age when choosing neurocognitive tests, the importance of including more than one test for each cognitive domain as most tests are not pure measures of a single cognitive factor, and the importance of including tests that cover all cognitive domains as OSA is likely to have diffuse cognitive effects.

• Ghorvei, Mohammadreza; Karhu, Tuomas; Hietakoste, Salla; Ferreira-Santos, Daniela; Hrubos-Strøm, Harald & Islind, Anna Sigridur [Vis alle 10 forfattere av denne artikkelen] (2024). A comparative analysis of unsupervised machine-learning methods in PSG-related phenotyping. Journal of Sleep Research. ISSN 0962-1105. doi: 10.1111/jsr.14349. Fulltekst i vitenarkiv Vis sammendrag

  Obstructive sleep apnea is a heterogeneous sleep disorder with varying phenotypes. Several studies have already performed cluster analyses to discover various obstructive sleep apnea phenotypic clusters. However, the selection of the clustering method might affect the outputs. Consequently, it is unclear whether similar obstructive sleep apnea clusters can be reproduced using different clustering methods. In this study, we applied four well-known clustering methods: Agglomerative Hierarchical Clustering; K-means; Fuzzy C-means; and Gaussian Mixture Model to a population of 865 suspected obstructive sleep apnea patients. By creating five clusters with each method, we examined the effect of clustering methods on forming obstructive sleep apnea clusters and the differences in their physiological characteristics. We utilized a visualization technique to indicate the cluster formations, Cohen's kappa statistics to find the similarity and agreement between clustering methods, and performance evaluation to compare the clustering performance. As a result, two out of five clusters were distinctly different with all four methods, while three other clusters exhibited overlapping features across all methods. In terms of agreement, Fuzzy C-means and K-means had the strongest (κ = 0.87), and Agglomerative hierarchical clustering and Gaussian Mixture Model had the weakest agreement (κ = 0.51) between each other. The K-means showed the best clustering performance, followed by the Fuzzy C-means in most evaluation criteria. Moreover, Fuzzy C-means showed the greatest potential in handling overlapping clusters compared with other methods. In conclusion, we revealed a direct impact of clustering method selection on the formation and physiological characteristics of obstructive sleep apnea clusters. In addition, we highlighted the capability of soft clustering methods, particularly Fuzzy C-means, in the application of obstructive sleep apnea phenotyping.

• Thorshov, Thea Christine; Dammen, Toril; Moen, Anne; Einvik, Gunnar & Hrubos-Strøm, Harald (2024). Prevalence of insomnia and feasibility of a nurse-administered digital cognitive behavioural therapy two years after corona virus disease hospitalisation. Sleep Medicine. ISSN 1389-9457. 125, s. 108–113. doi: 10.1016/j.sleep.2024.11.028. Fulltekst i vitenarkiv Vis sammendrag

  Background Disturbed sleep is prevalent after corona virus disease (COVID-19). However, little is known of post infectious prevalence, course, predictors and treatment of chronic insomnia. Aim To estimate the prevalence of chronic insomnia three and twelve months after hospitalisation for COVID-19, to identify predictors of chronic insomnia, and to evaluate the feasibility of a nurse-administered digital cognitive behavioural therapy for insomnia (dCBTi) protocol. Method Patients hospitalised at Akershus University Hospital (Norway) for COVID-19 between February–June 2020 were eligible. The 94 patients that consented to participate were contacted by phone and interviewed with a modified DUKE structured interview three- and twelve months after discharge. Participants with chronic insomnia after twelve months were offered a nurse-administered dCBTi treatment protocol. Outcome measurements were sleep efficiency (SE) calculated by standard formulas (0-100 %) and the Bergen Insomnia Scale (BIS) (0-42). Results At three-month follow-up, 22 persons (23 %) fulfilled the diagnostic criteria for chronic insomnia. At twelve-month follow-up, 23 fulfilled the diagnostic criteria. The odds ratios for chronic insomnia after twelve months were 0.857 (0.742–0.989) for body mass index (BMI), and 0.239 (0.069–0.821) for male sex. Ten participated in the dCBTi feasibility study. Five completed the treatment protocol. SE improved, but not significantly. The BIS score improved significantly from 24 to 12 (p-value = 0.036). Conclusion Chronic insomnia remained stable three- and twelve months post COVID-19 hospitalisation. Female sex and low BMI were independent predictors of chronic insomnia twelve months post infection, but only 50 % of participants completed the protocol. Completers significantly reduced insomnia symptoms.

• Chen, Si-Jing; Morin, Charles M.; Ivers, Hans; Wing, Yun Kwok; Partinen, Markku & Merikanto, Ilona [Vis alle 28 forfattere av denne artikkelen] (2023). The association of insomnia with long COVID: An international collaborative study (ICOSS-II). Sleep Medicine. ISSN 1389-9457. 112, s. 216–222. doi: 10.1016/j.sleep.2023.09.034. Fulltekst i vitenarkiv
• Korkalainen, Henri; Kainulainen, Samu; Islind, Anna Sigridur; Óskarsdóttir, María; Strassberger, Christian & Nikkonen, Sami [Vis alle 19 forfattere av denne artikkelen] (2023). Review and perspective on sleep-disordered breathing research and translation to clinics. Sleep Medicine Reviews. ISSN 1087-0792. 73. doi: 10.1016/j.smrv.2023.101874. Fulltekst i vitenarkiv Vis sammendrag

  Sleep-disordered breathing, ranging from habitual snoring to severe obstructive sleep apnea, is a prevalent public health issue. Despite rising interest in sleep and awareness of sleep disorders, sleep research and diagnostic practices still rely on outdated metrics and laborious methods reducing the diagnostic capacity and preventing timely diagnosis and treatment. Consequently, a significant portion of individuals affected by sleep-disordered breathing remain undiagnosed or are misdiagnosed. Taking advantage of state-of-the-art scientific, technological, and computational advances could be an effective way to optimize the diagnostic and treatment pathways. We discuss state-of-the-art multidisciplinary research, review the shortcomings in the current practices of SDB diagnosis and management in adult populations, and provide possible future directions. We critically review the opportunities for modern data analysis methods and machine learning to combine multimodal information, provide a perspective on the pitfalls of big data analysis, and discuss approaches for developing analysis strategies that overcome current limitations. We argue that large-scale and multidisciplinary collaborative efforts based on clinical, scientific, and technical knowledge and rigorous clinical validation and implementation of the outcomes in practice are needed to move the research of sleep-disordered breathing forward, thus increasing the quality of diagnostics and treatment.

• Thorshov, Thea Christine; Øverby, Caroline Tonje; Hansen, Diana Dobran; Bong, Way Kiat; Skifjeld, Knut & Hurlen, Petter [Vis alle 9 forfattere av denne artikkelen] (2023). Experience with the use of a digital sleep diary in symptom management by individuals with insomnia -a pilot mixed method study. Sleep Medicine: X. 6. doi: 10.1016/j.sleepx.2023.100093. Fulltekst i vitenarkiv Vis sammendrag

  Background: Insomnia is the most common sleep disorder. The recommended treatment is cognitive behavioural therapy for insomnia (CBTi). A sleep diary is a core tool in CBTi. We have developed a digital sleep diary with a standardised feedback function. Aim: To study feasibility of the digital sleep diary in participants of the Akershus Sleep Apnea (ASAP) cohorts with difficulties falling asleep or maintaining sleep. To describe sleep diary engagement and explore experiences with the digital sleep diary with potential influences in insomnia symptom management. Material and methods: Twenty participants were recruited from the ASAP. All filled out a digital sleep diary up to 12 weeks. Treatment options provided were a self-help book (N = 11) or electroencephalography neurofeedback (N = 9) in addition to the sleep diary standardised feedback function. We collected quantitative data from the sleep diary reports and we sub-divided insomnia by sleep onset insomnia and non-sleep onset insomnia. Finally, we performed qualitative interviews. Results: The median number of entries to the sleep diary was 81 (25th quartile: 26, 75th quartile 84). In the qualitative analysis, we identified two main themes; “structure and overview” and “usability and digital features”. Conclusion: The sleep diary was found to be feasible when distributed in combination with a self-help book or electroencephalography neurofeedback. The qualitative results emphasised the importance of a timely graphical overview and visualisations of self-recorded sleep.

• Hrubos-Strøm, Harald; Bergqvist, Joel & Zou, Ding (2023). Longitudinal Management and a Decision-Aid Tool in Treatment-Resistant Sleep Apnea. Current Sleep Medicine Reports. doi: 10.1007/s40675-023-00257-6. Fulltekst i vitenarkiv
• Xue, Pei; Merikanto, Ilona; Chung, Frances; Morin, Charles M.; Espie, Colin & Bjorvatn, Bjørn [Vis alle 28 forfattere av denne artikkelen] (2023). Persistent short nighttime sleep duration is associated with a greater post-COVID risk in fully mRNA-vaccinated individuals. Translational Psychiatry. 13, s. 1–7. doi: 10.1038/s41398-023-02334-4. Fulltekst i vitenarkiv Vis sammendrag

  Short nighttime sleep duration impairs the immune response to virus vaccination, and long nighttime sleep duration is associated with poor health status. Thus, we hypothesized that short (<6 h) and long (>9 h) nighttime sleepers have a higher post-COVID risk than normal nighttime sleepers, despite two doses of mRNA vaccine (which has previously been linked to lower odds of long-lasting COVID-19 symptoms). Post-COVID was defined as experiencing at least one core COVID-19 symptom for at least three months (e.g., shortness of breath). Multivariate logistic regression adjusting for age, sex, BMI, and other factors showed in 9717 respondents (age span 18–99) that two mRNA vaccinations lowered the risk of suffering from post-COVID by about 21% (p < 0.001). When restricting the analysis to double-vaccinated respondents (n = 5918), short and long sleepers exhibited a greater post-COVID risk than normal sleepers (adjusted OR [95%-CI], 1.56 [1.29, 1.88] and 1.87 [1.32, 2.66], respectively). Among respondents with persistent sleep duration patterns during the pandemic compared to before the pandemic, short but not long sleep duration was significantly associated with the post-COVID risk (adjusted OR [95%-CI], 1.59 [1.24, 2.03] and 1.18 [0.70, 1.97], respectively). No significant association between sleep duration and post-COVID symptoms was observed in those reporting positive SARS-CoV-2 test results (n = 538). Our findings suggest that two mRNA vaccinations against SARS-CoV-2 are associated with a lower post-COVID risk. However, this protection may be less pronounced among those sleeping less than 6 h per night. Our findings warrant replication in cohorts with individuals with confirmed SARS-CoV-2 infection.

• Matsui, Kentaro; Chung, Frances; Bjelajac, Adrijana Koscec; Merikanto, Ilona; Korman, Maria & Mota-Rolim, Sérgio [Vis alle 28 forfattere av denne artikkelen] (2023). Associations between changes in habitual sleep duration and lower self-rated health among COVID-19 survivors: findings from a survey across 16 countries/regions. BMC Public Health. 23. doi: 10.1186/s12889-023-17258-3. Fulltekst i vitenarkiv Vis sammendrag

  Background Self-rated health (SRH) is widely recognized as a clinically significant predictor of subsequent mortality risk. Although COVID-19 may impair SRH, this relationship has not been extensively examined. The present study aimed to examine the correlation between habitual sleep duration, changes in sleep duration after infection, and SRH in subjects who have experienced SARS-CoV-2 infection. Methods Participants from 16 countries participated in the International COVID Sleep Study-II (ICOSS-II) online survey in 2021. A total of 10,794 of these participants were included in the analysis, including 1,509 COVID-19 individuals (who reported that they had tested positive for COVID-19). SRH was evaluated using a 0-100 linear visual analog scale. Habitual sleep durations of < 6 h and > 9 h were defined as short and long habitual sleep duration, respectively. Changes in habitual sleep duration after infection of ≤ -2 h and ≥ 1 h were defined as decreased or increased, respectively. Results Participants with COVID-19 had lower SRH scores than non-infected participants, and those with more severe COVID-19 had a tendency towards even lower SRH scores. In a multivariate regression analysis of participants who had experienced COVID-19, both decreased and increased habitual sleep duration after infection were significantly associated with lower SRH after controlling for sleep quality (β = −0.056 and −0.058, respectively, both p < 0.05); however, associations between current short or long habitual sleep duration and SRH were negligible. Multinomial logistic regression analysis showed that decreased habitual sleep duration was significantly related to increased fatigue (odds ratio [OR] = 1.824, p < 0.01), shortness of breath (OR = 1.725, p < 0.05), diarrhea/nausea/vomiting (OR = 2.636, p < 0.01), and hallucinations (OR = 5.091, p < 0.05), while increased habitual sleep duration was significantly related to increased fatigue (OR = 1.900, p < 0.01). Conclusions Changes in habitual sleep duration following SARS-CoV-2 infection were associated with lower SRH. Decreased or increased habitual sleep duration might have a bidirectional relation with post-COVID-19 symptoms. Further research is needed to better understand the mechanisms underlying these relationships for in order to improve SRH in individuals with COVID-19.

• Sturludóttir, Jóna Elísabet; Sigurðardóttir, Sigríður; Serwatko, Marta; Arnardóttir, Erna S.; Hrubos-Strøm, Harald & Clausen, Michael Valur [Vis alle 9 forfattere av denne artikkelen] (2023). Deep learning for sleep analysis on children with sleep-disordered breathing: Automatic detection of mouth breathing events. Frontiers in Sleep. 2. doi: 10.3389/frsle.2023.1082996. Fulltekst i vitenarkiv
• Pahari, Purbanka; Korkalainen, Henri; Karhu, Tuomas; Rissanen, Marika; Arnardottir, Erna Sif & Hrubos-Strøm, Harald [Vis alle 10 forfattere av denne artikkelen] (2022). Obstructive sleep apnea-related intermittent hypoxaemia is associated with impaired vigilance. Journal of Sleep Research. ISSN 0962-1105. s. 1–9. doi: 10.1111/jsr.13803. Fulltekst i vitenarkiv Vis sammendrag

  Obstructive sleep apnea (OSA)-related intermittent hypoxaemia is a potential risk factor for different OSA comorbidities, for example cardiovascular disease. However, conflicting results are found as to whether intermittent hypoxaemia is associated with impaired vigilance. Therefore, we aimed to investigate how desaturation characteristics differ between the non-impaired vigilance and impaired vigilance patient groups formed based on psychomotor vigilance task (PVT) performance and compared with traditional OSA severity parameters. The study population comprised 863 patients with suspected OSA who underwent a PVT test before polysomnography. The conventional OSA parameters, for example, the apnea-hypopnea index, oxygen desaturation index, and arousal index were computed. Furthermore, the median desaturation area, fall area, recovery area, and desaturation depth were computed with the pre-event baseline reference and with reference to the 100% oxygen saturation level. Patients were grouped into best- and worst-performing quartiles based on the number of lapses in PVT (Q1: PVT lapses <5 and Q4: PVT lapses >36). The association between parameters and impaired vigilance was evaluated by cumulative distribution functions (CDFs) and binomial logistic regression. Based on the CDFs, patients in Q4 had larger desaturation areas, recovery areas, and deeper desaturations when these were referenced to 100% saturation compared with Q1. The odds ratio (OR) of the median desaturation area (OR = 1.56), recovery area (OR = 1.71), and depth (OR = 1.65) were significantly elevated in Q4 in regression models. However, conventional OSA parameters were not significantly associated with impaired vigilance (ORs: 0.79–1.09). Considering desaturation parameters with a 100% SpO2 reference in the diagnosis of OSA could provide additional information on the severity of OSA and related daytime vigilance impairment.

• Øverby, Caroline Tonje; Sutharshan, Prasanthy; Gulbrandsen, Pål; Dammen, Toril & Hrubos-Strøm, Harald (2022). Shared decision making: A novel approach to personalized treatment in obstructive sleep apnea. Sleep Medicine: X. 4. doi: 10.1016/j.sleepx.2022.100052. Fulltekst i vitenarkiv Vis sammendrag

  Study objectives i) To describe a novel approach of phenotyping by shared decision making (SDM) in obstructive sleep apnea (OSA) discharge consultations ii) to describe correlation between patient and observer based evaluations of SDM and iii) to describe treatment adherence. Methods Consecutive patients referred to the otorhinolaryngology department at Akershus University Hospital with suspected OSA between 2015 and 2016 participated. Patients with body mass index >30 were oversampled. Four male communication-trained doctors aged from 30 to 60 years participated. SDM was evaluated by modified content analysis and by the CollaboRATE self-report questionnaire and the “Observer OPTION (Young et al., 2008) [5]” rating scale. Positive airway pressure (PAP) treatment adherence and weight reduction was assessed by interview at six year follow-up. Results Eighteen consultations were video filmed. The content analysis revealed that the patient perspectives only briefly were explored. PAP was chosen by 17 of 18 patients. Median CollaboRATE questionnaire score was 29 (26, 30). Mean OPTION (Young et al., 2008) [5] score was 65.6 (SD 6.6, range 55–80). The correlation between SDM assessed by CollaboRATE self-report and by the “Observer OPTION (Young et al., 2008) [5]” rating scale was low (Pearson's r = 0.09). At follow up, 11 patients (64.7%) were PAP adherent and no one achieved 10% weight loss. Conclusions Despite a high degree of SDM compared to studies of non-OSA populations, the sub-optimal exploration of the patient perspective by communication-trained doctors precluded identification of patients willing to cope actively. SDM assessed by self-report and by a rating scale may represent two different constructs. PAP adherence was good.

• Merikanto, Ilona; Dauvilliers, Yves; Chung, Frances; Wing, Yun Kwok; Gennaro, Luigi de & Holzinger, Brigitte [Vis alle 25 forfattere av denne artikkelen] (2022). Sleep symptoms are essential features of long-COVID – Comparing healthy controls with COVID-19 cases of different severity in the international COVID sleep study (ICOSS-II). Journal of Sleep Research. ISSN 0962-1105. 32(1), s. 1–7. doi: 10.1111/jsr.13754. Fulltekst i vitenarkiv Vis sammendrag

  Large-scale, climate-induced synchrony in the productivity of fish populations is becoming more pronounced in the world's oceans. As synchrony increases, a population's “portfolio” of responses can be diminished, in turn reducing its resilience to strong perturbation. Here we argue that the costs and benefits of trait synchronization, such as the expression of growth rate, are context dependent. Contrary to prevailing views, synchrony among individuals could actually be beneficial for populations if growth synchrony increases during favorable conditions, and then declines under poor conditions when a broader portfolio of responses could be useful. Importantly, growth synchrony among individuals within populations has seldom been measured, despite well-documented evidence of synchrony across populations. Here, we used century-scale time series of annual otolith growth to test for changes in growth synchronization among individuals within multiple populations of a marine keystone species (Atlantic cod, Gadus morhua). On the basis of 74,662 annual growth increments recorded in 13,749 otoliths, we detected a rising conformity in long-term growth rates within five northeast Atlantic cod populations in response to both favorable growth conditions and a large-scale, multidecadal mode of climate variability similar to the East Atlantic Pattern. The within-population synchrony was distinct from the across-population synchrony commonly reported for large-scale environmental drivers. Climate-linked, among-individual growth synchrony was also identified in other Northeast Atlantic pelagic, deep-sea and bivalve species. We hypothesize that growth synchrony in good years and growth asynchrony in poorer years reflects adaptive trait optimization and bet hedging, respectively, that could confer an unexpected, but pervasive and stabilizing, impact on marine population productivity in response to large-scale environmental change.

• Arnardottir, Erna S.; Islind, Anna Sigridur; Óskarsdóttir, María; Ólafsdóttir, Kristín A.; August, Elias & Jónasdóttir, Lára [Vis alle 18 forfattere av denne artikkelen] (2022). The Sleep Revolution project: the concept and objectives. Journal of Sleep Research. ISSN 0962-1105. 31(4). doi: 10.1111/jsr.13630. Fulltekst i vitenarkiv Vis sammendrag

  Obstructive sleep apnea is linked to severe health consequences such as hypertension, daytime sleepiness, and cardiovascular disease. Nearly a billion people are estimated to have obstructive sleep apnea with a substantial economic burden. However, the current diagnostic parameter of obstructive sleep apnea, the apnea–hypopnea index, correlates poorly with related comorbidities and symptoms. Obstructive sleep apnea severity is measured by counting respiratory events, while other physiologically relevant consequences are ignored. Furthermore, as the clinical methods for analysing polysomnographic signals are outdated, laborious, and expensive, most patients with obstructive sleep apnea remain undiagnosed. Therefore, more personalised diagnostic approaches are urgently needed. The Sleep Revolution, funded by the European Union's Horizon 2020 Research and Innovation Programme, aims to tackle these shortcomings by developing machine learning tools to better estimate obstructive sleep apnea severity and phenotypes. This allows for improved personalised treatment options, including increased patient participation. Also, implementing these tools will alleviate the costs and increase the availability of sleep studies by decreasing manual scoring labour. Finally, the project aims to design a digital platform that functions as a bridge between researchers, patients, and clinicians, with an electronic sleep diary, objective cognitive tests, and questionnaires in a mobile application. These ambitious goals will be achieved through extensive collaboration between 39 centres, including expertise from sleep medicine, computer science, and industry and by utilising tens of thousands of retrospectively and prospectively collected sleep recordings. With the commitment of the European Sleep Research Society and Assembly of National Sleep Societies, the Sleep Revolution has the unique possibility to create new standardised guidelines for sleep medicine.

• Eide, Per Kristian; Pripp, Are Hugo; Berge, Benedikte; Hrubos-Strøm, Harald; Ringstad, Geir & Valnes, Lars Magnus (2022). Altered glymphatic enhancement of cerebrospinal fluid tracer in individuals with chronic poor sleep quality. Journal of Cerebral Blood Flow and Metabolism. ISSN 0271-678X. 42(9), s. 1676–1692. doi: 10.1177/0271678X221090747. Fulltekst i vitenarkiv Vis sammendrag

  Chronic sleep disturbance is a risk factor for dementia disease, possibly due to impaired sleep-dependent clearance of toxic metabolic by-products. We compared enrichment of a cerebrospinal fluid (CSF) tracer within brain of patients reporting good or poor sleep quality, assessed by the Pittsburgh Sleep Quality Index (PSQI) questionnaire. Tracer enrichment in a selection of brain regions was assessed using multiphase magnetic resonance imaging up to 48 hours after intrathecal administration of the contrast agent gadobutrol (0.5 ml of 1 mmol/ml) serving as tracer. Tracer enrichment differed between patients with good (PSQI ≤5) and poor (PSQI >5) sleep quality in a cohort of non-dementia individuals (n = 44; age 42.3 ± 14.5 years), and in patients with the dementia subtype idiopathic normal pressure hydrocephalus (n = 24; age 71.0 ± 4.9 years). Sleep impairment was associated with increased CSF tracer enrichment in several brain regions. Cortical brain volume as well as entorhinal cortex thickness was reduced in the oldest cohort and was correlated with the severity of sleep disturbance and the degree of cortical tracer enrichment. We suggest chronic sleep disturbance is accompanied by altered glymphatic function along enlarged perivascular spaces.

• Sigurdardóttir, Fjóla Dögg; Øverby, Tonje Caroline; Nikkonen, Sami; Karhu, Tuomas; Dammen, Toril & Nordhus, Inger Hilde [Vis alle 14 forfattere av denne artikkelen] (2022). Novel oxygen desaturation parameters are associated with cardiac troponin I: Data from the Akershus Sleep Apnea Project. Journal of Sleep Research. ISSN 0962-1105. 31(5). doi: 10.1111/jsr.13581. Fulltekst i vitenarkiv Vis sammendrag

  Novel diagnostic markers for obstructive sleep apnea beyond the apnea–hypopnea index (AHI) have been introduced. There are no studies on their association with markers of subclinical myocardial injury. We assessed the association between novel desaturation parameters and elevated cardiac troponin I and T. Participants with polysomnography (498) from the Akershus Sleep Apnea study were divided into normal and elevated biomarker groups based on sex-specific concentration thresholds (cardiac troponin I: ≥4 ng/L for women, ≥6 ng/L for men; and cardiac troponin T: ≥7 ng/L for women, ≥8 ng/L for men). Severity of obstructive sleep apnea was evaluated with the AHI, oxygen desaturation index, total sleep time with oxygen saturation below 90% (T90), lowest oxygen saturation (Min SpO2%), and novel oxygen desaturation parameters: desaturation duration and desaturation severity. How the AHI and novel desaturation parameters predicted elevated cardiac troponin I and cardiac troponin T levels was assessed by the area under the curve (AUC). Based on multivariable-adjusted linear regression, the AHI (β = 0.004, p = 0.012), desaturation duration (β = 0.007, p = 0.004), and desaturation severity (β = 0.147, p = 0.002) were associated with cardiac troponin I levels but not cardiac troponin T. T90 was associated with cardiac troponin I (β = 0.006, p = 0.009) and cardiac troponin T (β = 0.005, p = 0.007). The AUC for the AHI 0.592 (standard error 0.043) was not significantly different from the AUC of T90 (SD 0.640, p = 0.08), desaturation duration 0.609 (SD 0.044, p = 0.42) or desaturation severity 0.616 (SD 0.043, p = 0.26) in predicting myocardial injury as assessed by cardiac troponin I. Oxygen desaturation parameters and the AHI were associated with cardiac troponin I levels but not cardiac troponin T levels. Novel oxygen desaturation parameters did not improve the prediction of subclinical myocardial injury compared to the AHI.

• Bjorvatn, Bjørn; Merikanto, Ilona; Reis, Catia; Korman, Maria; Bjelajac, Adrijana Koscec & Holzinger, Brigitte [Vis alle 22 forfattere av denne artikkelen] (2022). Shift workers are at increased risk of severe COVID-19 compared with day workers: Results from the international COVID sleep study (ICOSS) of 7141 workers. Chronobiology International. ISSN 0742-0528. doi: 10.1080/07420528.2022.2148182. Fulltekst i vitenarkiv Vis sammendrag

  The present study had two main aims. First, to investigate whether shift/night workers had a higher prevalence and severity of COVID-19 compared with day workers. Second, to investigate whether people regularly working in face-to-face settings during the pandemic exhibited a higher prevalence and severity of COVID-19 compared with those having no need to be in close contact with others at work. Data consisted of 7141 workers from 15 countries and four continents who participated in the International COVID Sleep Study-II (ICOSS-II) between May and December 2021. The associations between work status and a positive COVID-19 test and several indications of disease severity were tested with chi-square tests and logistic regressions adjusted for relevant confounders. In addition, statistical analyses were conducted for the associations between face-to-face work and COVID-19 status. Results showed that shift/night work was not associated with an increased risk of COVID-19 compared to day work. Still, shift/night workers reported higher odds for moderate to life-threatening COVID-19 (adjusted odds ratio (aOR) = 2.71, 95%-confidence interval = 1.23–5.95) and need for hospital care (aOR = 5.66, 1.89–16.95). Face-to-face work was associated with an increased risk of COVID-19 (aOR = 1.55, 1.12–2.14) but not with higher disease severity. In conclusion, shift/night work was not associated with an increased risk of COVID-19, but when infected, shift/night workers reported more severe disease. Impaired sleep and circadian disruption commonly seen among shift/night workers may be mediating factors. Working face-to-face increased the risk of COVID-19, likely due to increased exposure to the virus. However, face-to-face work was not associated with increased disease severity.

• Sigurdardóttir, Fjóla Dögg; Lyngbakken, Magnus; Hveem, Kristian; Hrubos-Strøm, Harald; Røsjø, Helge & Redline, Susan [Vis alle 7 forfattere av denne artikkelen] (2021). Insomnia symptoms and subclinical myocardial injury: Data from the Nord-Trøndelag Health (HUNT) study. Journal of Sleep Research. ISSN 0962-1105. 30(5). doi: 10.1111/jsr.13299. Fulltekst i vitenarkiv Vis sammendrag

  Insomnia symptoms are associated with increased risk of heart failure (HF) and cardiovascular (CV) mortality. We hypothesised that insomnia symptoms are cross-sectionally associated with increased cardiac troponin I (cTnI), a biomarker of subclinical myocardial injury, and that phenotyping by insomnia symptoms and cTnI enhances longitudinal risk stratification in the general population. In a population-based study, cTnI was measured in 8,398 participants (median age 49 years, 55% women), who had answered questionnaires regarding insomnia symptoms. Association between cTnI and insomnia symptoms was assessed by linear regression analysis for each response category of a sleep questionnaire. Insomnia symptoms were defined as having difficulty falling asleep almost every night, difficulty maintaining sleep almost every night, and/or non-restorative sleep once a week or more. The primary outcome measure was a composite endpoint of CV mortality or first admission for HF. In all, 844 participants reported insomnia symptoms, 585 (69%) were women. Those with insomnia symptoms had marginally, but significantly higher median cTnI than those without insomnia symptoms, (median [interquartile range] 3.4 [2.4–5.2] ng/L versus 3.2 [2.2–4.9] ng/L; p = .014), but there was no association between any insomnia symptom and cTnI in unadjusted linear regression models (β 0.06, 95% confidence interval [CI] −0.01 to 0.12). In adjusted analyses, participants with insomnia symptoms and increased cTnI were at increased risk of the composite endpoint (hazard ratio 1.71, 95% CI 1.04–2.79) compared to participants with insomnia symptoms and low cTnI. In the general population, insomnia symptoms are not associated with biochemical evidence of subclinical myocardial injury.

• Merikanto, Ilona; Dauvilliers, Yves; Chung, Frances; Holzinger, Brigitte; Gennaro, Luigi De & Wing, Yun Kwok [Vis alle 25 forfattere av denne artikkelen] (2021). Disturbances in sleep, circadian rhythms and daytime functioning in relation to coronavirus infection and Long-COVID - A multinational ICOSS study. Journal of Sleep Research. ISSN 0962-1105. doi: 10.1111/jsr.13542. Fulltekst i vitenarkiv
• Olafsson, Thorarinn Arnar; Steinsvik, Eivind Andreas Svaboe; Bachmann-Harildstad, Gregor & Hrubos-Strøm, Harald (2021). A validation study of an esophageal probe–based polygraph against polysomnography in obstructive sleep apnea. Sleep and Breathing. ISSN 1520-9512. 26(2), s. 575–584. doi: 10.1007/s11325-021-02374-4. Fulltekst i vitenarkiv Vis sammendrag

  Abstract Study objectives The aim of this study was to validate the automatically scored results of an esophageal probe–based polygraph system (ApneaGraph ® Spiro) against manually scored polysomnography (Nox A1, PSG) results. We compared the apnea–hypopnea index, oxygen saturation index, and respiratory disturbance index of the devices. Methods Consenting patients, referred for obstructive sleep apnea workup, were tested simultaneously with the ApneaGraph ® Spiro and Nox A1 ® polysomnograph. Each participant made one set of simultaneous registrations for one night. PSG results were scored independently. Apnea–hypopnea index, oxygen desaturation index, and respiratory disturbance index were compared using Pearson’s correlation and scatter plots. Sensitivity, specificity, and positive likelihood ratio of all indices at 5, 15, and 30 were calculated. Results A total of 83 participants had successful registrations. The apnea–hypopnea index showed sensitivity of 0.83, specificity of 0.95, and a positive likelihood ratio of 5.11 at an index cutoff of 15. At a cutoff of 30, the positive likelihood ratio rose to 31.43. The respiratory disturbance index showed high sensitivity (&gt; 0.9) at all cutoffs, but specificity was below 0.5 at all cutoffs. Scatterplots revealed overestimation in mild OSA and underestimation in severe OSA for all three indices. Conclusions The ApneaGraph ® Spiro performed acceptably when OSA was defined by an AHI of 15. The equipment overestimated mild OSA and underestimated severe OSA, compared to the PSG.

• McIntosh, Cameron; Clemm, Hege Synnøve Havstad; Sewry, Nicola; Hrubos-Strøm, Harald & Schwellnus, Martin P. (2021). Diagnosis and management of nasal obstruction in the athlete. A narrative review by subgroup B of the IOC Consensus Group on "Acute Respiratory Illness in the Athlete". Journal of Sports Medicine and Physical Fitness. ISSN 0022-4707. 61(8), s. 1144–1158. doi: 10.23736/S0022-4707.21.12821-X. Fulltekst i vitenarkiv Vis sammendrag

  Protection of the health of the athlete is required for high level sporting performance. Acute respiratory illness is the leading cause of illness and can compromise training and competition in athletes. To date the focus on respiratory health in athletes has largely been on acute upper respiratory infections and asthma/exercise induced bronchoconstriction (EIB), while nasal conditions have received less attention. The nose has several important physiological functions for the athlete. Nasal conditions causing obstruction to airflow can compromise respiratory health in the athlete, negatively affect quality of life and sleep, cause mouth breathing and ultimately leading to inadequate recovery and reduced exercise performance. Nasal obstruction can be broadly classified as structural (static or dynamic) or mucosal. Mucosal inflammation in the nose (rhinitis) is the most frequent cause of nasal obstruction and is reported to be higher in athletes (21-74%) than in the general population (20-25%). This narrative review provides the sport and exercise medicine physician with a clinical approach to the diagnosis and management of common nasal conditions that can cause nasal obstruction, ultimately leading to improved athlete health and better sports performance.

• Caspersen, Nina Faksvåg; Røsjø, Helge; Flyvbjerg, Allan; Bjerre, Mette; Randby, Anna & Hrubos-Strøm, Harald [Vis alle 8 forfattere av denne artikkelen] (2018). The association between circulating adiponectin levels, lung function and adiposity in subjects from the general population; data from the Akershus Sleep Apnea Project. BMC Pulmonary Medicine. 18(54). doi: 10.1186/s12890-018-0618-4. Fulltekst i vitenarkiv Vis sammendrag

  Background Circulating adiponectin (ADPN) levels are inversely associated with disease severity in patients with chronic obstructive pulmonary disease (COPD), while studies assessing the relationship between ADPN and lung function in subjects from the general population have shown diverging results. Accordingly, we hypothesized that ADPN would be associated with lung function in a population-based sample and tested how abdominal adiposity, metabolic syndrome, and systemic inflammation influenced this association. Methods We measured total ADPN in serum, forced vital capacity (FVC) and forced expiratory volume during the 1st second (FEV1) in 529 participants (median 50 years, 54.6% males) recruited from the general population. We assessed the association between ADPN and lung function by multivariate linear regression analyses and adjusted for age, gender, height, smoking habits, weight, body mass index, waist-hip ratio, metabolic syndrome, obstructive sleep apnoea (OSA) and C-reactive protein. Results The median (interquartile range) level of serum ADPN was 7.6 (5.4–10.4) mg/L. ADPN levels were positively associated with FVC % of predicted (beta 3.4 per SD adiponectin, p < 0.001)) in univariate linear regression analysis, but the association was attenuated in multivariate analysis (standardized beta 0.03, p = 0.573)). Among co-variates only WHR significantly attenuated the relationship. ADPN levels were also associated with FEV1% of predicted in bivariate analysis that adjusted for smoking (beta 1.4, p = 0.042)), but this association was attenuated and no longer significant in multivariate analysis (standardized beta -0.06, p = 0.254)). Conclusion In this population-based sample no association between ADPN and lung function was evident after adjustment for covariates related to adiposity.

• Varendh, Maria; Andersson, Morgan; Bjørnsdottir, Erla; Hrubos-Strøm, Harald; johannison, anders & Arnardóttir, Erna Sif [Vis alle 8 forfattere av denne artikkelen] (2018). Nocturnal nasal obstruction is frequent and reduces sleep quality in patients with obstructive sleep apnea. Journal of Sleep Research. ISSN 0962-1105. 27(4). doi: 10.1111/jsr.12631. Fulltekst i vitenarkiv
• Värendh, Maria; Andersson, Morgan; Björnsdóttir, Erla; Arnardóttir, Erna Sif; Gíslason, Þórarinn & Pack, Allan I. [Vis alle 9 forfattere av denne artikkelen] (2018). PAP treatment in patients with OSA does not induce long-term nasal obstruction. Journal of Sleep Research. ISSN 0962-1105. doi: 10.1111/jsr.12768. Fulltekst i vitenarkiv
• Pedersen, Maria; Ekstedt, Mirjam; Småstuen, Milada C; Wyller, Vegard Bruun Bratholm; Sulheim, Dag & Fagermoen, Frode Even [Vis alle 9 forfattere av denne artikkelen] (2017). Sleep-wake rhythm disturbances and perceived sleep in adolescent chronic fatigue syndrome. Journal of Sleep Research. ISSN 0962-1105. 26(5), s. 595–601. doi: 10.1111/jsr.12547. Fulltekst i vitenarkiv Vis sammendrag

  Chronic fatigue syndrome (CFS) is characterized by long-lasting, disabling and unexplained fatigue that is often accompanied by unrefreshing sleep. The aim of this cross-sectional study was to investigate sleep–wake rhythm and perceived sleep in adolescent CFS patients compared to healthy individuals. We analysed baseline data on 120 adolescent CFS patients and 39 healthy individuals included in the NorCAPITAL project. Activity measures from a uniaxial accelerometer (activPAL) were used to estimate mid-sleep time (mid-point of a period with sleep) and time in bed. Scores from the Karolinska Sleep Questionnaire (KSQ) were also assessed. The activity measures showed that the CFS patients stayed significantly longer in bed, had a significantly delayed mid-sleep time and a more varied sleep–wake rhythm during weekdays compared with healthy individuals. On the KSQ, the CFS patients reported significantly more insomnia symptoms, sleepiness, awakening problems and a longer sleep onset latency than healthy individuals. These results might indicate that disrupted sleep–wake phase could contribute to adolescent CFS; however, further investigations are warranted.

• Grøndahl, Pål; Hrubos-Strøm, Harald & Ekeberg, Øivind (2017). Sexsomnia – a forensic psychiatric challenge – a case report. Journal of Forensic Psychiatry & Psychology. ISSN 1478-9949. 28(4), s. 498–512. doi: 10.1080/14789949.2017.1301528. Fulltekst i vitenarkiv Vis sammendrag

  In rare penal cases, a defendant makes a claim that he or she was asleep at the time of an alleged crime. This article discusses a case of alleged sexsomnia where a man claimed that he had been asleep during a sexual encounter (rape) with a woman. The question that often arises during an investigation and in court is how complex a behaviour is someone able to perform and still be asleep? To assist the court in answering this question, forensic psychiatric experts may be appointed. But the experts were not present during the act and must therefore consider each case on the basis of the available information and existing research. This paper provides a brief overview of the research regarding sexsomnia. It will also discuss what kind of information is important to elaborate in these cases in order to clarify the premises for the experts? conclusions to the court.

• Värendh, M; Johannisson, A; Hrubos-Strøm, Harald & Andersson, M (2016). Sleep quality improves with endoscopic sinus surgery in patients with chronic rhinosinusitis and nasal polyposis. Rhinology. ISSN 0300-0729. doi: 10.4193/Rhin16.065. Fulltekst i vitenarkiv
• Omland, Torbjørn; Randby, Anna; Hrubos-Strøm, Harald; Røsjø, Helge & Einvik, Gunnar (2016). Relation of Erectile Dysfunction to Subclinical Myocardial Injury. American Journal of Cardiology. ISSN 0002-9149. 118(12), s. 1821–1825. doi: 10.1016/j.amjcard.2016.08.070. Fulltekst i vitenarkiv
• Skranes, Julia Brox; Einvik, Gunnar; Namtvedt, Silje Kjeka; Randby, Anna; Hrubos-Strøm, Harald & Brynildsen, Jon [Vis alle 10 forfattere av denne artikkelen] (2016). Biomarkers of cardiovascular injury and stress are associated with increased frequency of ventricular ectopy: A population-based study. BMC Cardiovascular Disorders. 16(1). doi: 10.1186/s12872-016-0407-z. Fulltekst i vitenarkiv Vis sammendrag

  Background Asymptomatic ventricular arrhythmias are common and associated with increased risk of cardiovascular mortality. Cardiac troponins, natriuretic peptides and C–reactive protein (CRP) are also predictive of adverse cardiovascular events in the general population, but limited information is available on the relationship between these biomarkers and ventricular ectopy in a community-based population. The objectives were to evaluate the associations between ventricular ectopic activity and N-terminal pro-B-type natriuretic peptide (NT-proBNP), high sensitivity-troponin I (hs-TnI) and hs-CRP in a community-based setting. Methods We performed a 24 h Holter-recording and blood sampling in 498 subjects. Premature ventricular complexes (PVC) were classified as frequent at >5/h and the presence of any bigeminy, trigeminy or non-sustained ventricular tachycardia were classified as complex ventricular ectopy. The associations between biomarkers and ventricular arrhythmias were investigated by univariate and multivariate logistic regression analyses. Results Frequent PVC’s and complex ventricular ectopy were detected in 46 (9%) and 47 (9%) participants respectively, and were associated with significantly (p < 0.001) higher concentrations of NT-proBNP and hs-TnI. The association between NT-proBNP and both frequent PVC’s (p = 0.020) and complex ventricular ectopy (p = 0.001) remained significant after adjusting for conventional risk markers in multivariate analyses. Conclusion Increased level of NT-proBNP was independently associated with ventricular ectopy, whereas no independent association was observed between hs-TnI and hs-CRP levels and ventricular ectopy in this community-based sample.

• Engstrøm, Morten; Beiske, Kornelia Katalin; Hrubos-Strøm, Harald; Aarrestad, Sigurd & Sand, Trond (2015). Obstruktiv søvnapné. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 135(21), s. 1954–1956. doi: 10.4045/tidsskr.15.0392. Fulltekst i vitenarkiv Vis sammendrag

  Obstruktiv søvnapné er en meget sammensatt lidelse. Diagnostikk og patofysiologi varierer, mens behandlingstiltakene har vært mer ensartet – i form av kontinuerlig positivt luftveistrykk (CPAP) via en maske for å holde øvre luftveier åpne. En dypere forståelse av patofysiologien hos den enkelte vil kunne gi bedre tilpasset og mer effektiv behandling. Vi vil her oppsummere nyere kunnskap og mulige behandlingsmessige konsekvenser. Diagnosen obstruktiv søvnapné stilles ofte først etter flere år med symptomer. Nattlige symptomer som snorking og pustestopp under søvn observeres som regel av pasientens sengepartner, mens redusert dagtidsfunksjon grunnet søvnighet eller utmattelse kan være hovedproblemet for pasienten. «Bare snorking» og uttalt obstruktiv søvnapné er ytterpunkter på en kontinuerlig skala for søvnrelaterte obstruktive respirasjonsforstyrrelser (1), men kvantitative snorkedata rapporteres sjelden etter en søvnundersøkelse. Snorking er svært vanlig, men også noe vanskelig å kvantitere. Øvre luftveismotstandssyndrom (upper airway resistance syndrome, UARS) er en omdiskutert mellomtilstand som i 3. utgave av International Classification of Sleep Disorders er lagt inn under obstruktiv søvnapné (2).

• Einvik, Gunnar; Dammen, Toril; Namtvedt, Silje Kjeka; Hrubos-Strøm, Harald; Randby, Anna & Kristiansen, Håvard Anton [Vis alle 9 forfattere av denne artikkelen] (2014). Type D personality is associated with increased prevalence of ventricular arrhythmias in community-residing persons without coronary heart disease. European Journal of Preventive Cardiology (EJPC). ISSN 2047-4873. 21(5), s. 592–600. doi: 10.1177/2047487312462800. Fulltekst i vitenarkiv
• Einvik, Gunnar; Røsjø, Helge; Randby, Anna; Namtvedt, Silje Kjeka; Hrubos-Strøm, Harald & Brynildsen, Jon [Vis alle 8 forfattere av denne artikkelen] (2014). Severity of obstructive sleep apnea is associated with cardiac troponin I concentrations in a community-based sample: Data from the Akershus Sleep Apnea Project. Sleep. ISSN 0161-8105. 37(6), s. 1111–1116. doi: 10.5665/sleep.3772. Fulltekst i vitenarkiv
• Randby, Anna; Namtvedt, Silje Kjeka; Hrubos-Strøm, Harald; Einvik, Gunnar; Somers, Virend K. & Omland, Torbjørn (2013). Sex-Dependent Impact of OSA on Digital Vascular Function. Chest. ISSN 0012-3692. 144(3), s. 915–922. doi: 10.1378/chest.12-2283. Fulltekst i vitenarkiv
• Einvik, Gunnar; Flyvbjerg, Allan; Hrubos-Strøm, Harald; Randby, Anna; Frystyk, Jan & Mette, Bjerre [Vis alle 12 forfattere av denne artikkelen] (2013). Novel cardiovascular risk markers in depression: No association between depressive symptoms and osteoprotegerin or adiponectin in persons at high risk for sleep apnea. Journal of Affective Disorders. ISSN 0165-0327. 145(3), s. 400–404. doi: 10.1016/j.jad.2012.05.065. Fulltekst i vitenarkiv
• Hrubos-Strøm, Harald; Nordhus, Inger Hilde; Einvik, Gunnar; Randby, Anna; Omland, Torbjørn & Sundet, Kjetil Søren [Vis alle 8 forfattere av denne artikkelen] (2012). Obstructive sleep apnea, verbal memory, and executive function in a community-based high-risk population identified by the Berlin Questionnaire Akershus Sleep Apnea Project. Sleep and Breathing. ISSN 1520-9512. 16(1), s. 223–231. doi: 10.1007/s11325-011-0493-1. Fulltekst i vitenarkiv Vis sammendrag

  Purpose: Cognitive functions in community-dwelling adults at high risk of obstructive sleep apnea have not been described and nor are associations between cognitive functions and obstructive sleep apnea severity fully understood. The study aimed to describe verbal memory and executive function in community-dwelling adults identified by the Berlin Questionnaire and to investigate associations between these cognitive domains and different obstructive sleep apnea severity indicators. Methods: Among 29,258 age- and gender-stratified persons 30–65 years who received the Berlin Questionnaire by mail, 16,302 (55.7%) responded. From 654 randomly drawn respondents with BQ high risk who were approached for study participation, 290 participants (55.9% males, mean age 48.2 years) were included. Verbal memory was assessed by Rey Auditory Verbal Learning Test and executive function by Stroop test. Obstructive sleep apnea severity indicators were assessed by polysomnography. Results: Mean (standard deviation) verbal learning score was 42.0 (8.9), mean interference time was 31.1 (12.7), median (25th percentile, 75th percentile) apnea–hypopnea index was 7.7 (2.4–22.2), and mean average oxygen saturation was 94.3 (2.0). Verbal learning score was independently associated with average oxygen saturation (β = 0.721, p = 0.025) in multivariate linear regression models adjusted for putative confounders. Interference time was only related to OSA severity indicators in bivariate analyses. Conclusions: Verbal memory and executive function impairments were mild in community-dwelling adults at high risk of obstructive sleep apnea. Average oxygen saturation was the indicator of obstructive sleep apnea severity most strongly associated with cognitive function.

• Einvik, Gunnar; Vistnes, Maria; Hrubos-Strøm, Harald; Randby, Anna; Namtvedt, Silje Kjeka & Nordhus, Inger Hilde [Vis alle 9 forfattere av denne artikkelen] (2012). Circulating cytokine concentrations are not associated with major depressive disorder in a community-based cohort. General Hospital Psychiatry. ISSN 0163-8343. 34(3), s. 262–267. doi: 10.1016/j.genhosppsych.2012.01.017. Fulltekst i vitenarkiv
• Randby, Anna; Namtvedt, Silje Kjeka; Einvik, Gunnar; Hrubos-Strøm, Harald; Hagve, Tor-Arne & Somers, Virend K. [Vis alle 7 forfattere av denne artikkelen] (2012). Obstructive Sleep Apnea Is Associated With Increased High-Sensitivity Cardiac Troponin T Levels. Chest. ISSN 0012-3692. 142(3), s. 639–646. doi: 10.1378/chest.11-1779. Fulltekst i vitenarkiv
• Hrubos-Strøm, Harald; Einvik, Gunnar; Nordhus, Inger Hilde; Randby, Anna; Pallesen, Ståle & Moum, Torbjørn Åge [Vis alle 8 forfattere av denne artikkelen] (2012). Sleep apnoea, anxiety, depression and somatoform pain: a community-based high-risk sample. European Respiratory Journal. ISSN 0903-1936. 40(2), s. 400–407. doi: 10.1183/09031936.00111411. Fulltekst i vitenarkiv
• Einvik, Gunnar; Hrubos-Strøm, Harald; Randby, Anna; Nordhus, Inger Hilde; Somers, Virend K. & Omland, Torbjørn [Vis alle 7 forfattere av denne artikkelen] (2011). Major depressive disorder, anxiety disorders, and cardiac biomarkers in subjects at high risk of obstructive sleep apnea. Psychosomatic Medicine. ISSN 0033-3174. 73(5), s. 378–384. doi: 10.1097/PSY.0b013e318219e64e. Fulltekst i vitenarkiv
• Einvik, Gunnar; Dammen, Toril; Hrubos-Strøm, Harald; Namtvedt, Silje Kjeka; Randby, Anna & Kristiansen, Håvard Anton [Vis alle 9 forfattere av denne artikkelen] (2011). Prevalence of cardiovascular risk factors and concentration of C-reactive protein in Type D personality persons without cardiovascular disease. European Journal of Cardiovascular Prevention & Rehabilitation. ISSN 1741-8267. 18(3), s. 504–509. doi: 10.1177/1741826710389383. Fulltekst i vitenarkiv
• Hrubos-Strøm, Harald; Randby, Anna; Namtvedt, Silje Kjeka; Kristiansen, Håvard Anton; Einvik, Gunnar & Saltyte-Benth, Jurate [Vis alle 12 forfattere av denne artikkelen] (2011). A Norwegian population-based study on the risk and prevalence of obstructive sleep apnea. Journal of Sleep Research. ISSN 0962-1105. 20(1), s. 162–170. doi: 10.1111/j.1365-2869.2010.00861.x. Fulltekst i vitenarkiv
• Namtvedt, Silje Kjeka; Randby, Anna; Einvik, Gunnar; Hrubos-Strøm, Harald; Somers, VK & Røsjø, Helge [Vis alle 7 forfattere av denne artikkelen] (2011). Cardiac Arrhythmias in Obstructive Sleep Apnea (from the Akershus Sleep Apnea Project). American Journal of Cardiology. ISSN 0002-9149. 108(8), s. 1141–1146. doi: 10.1016/j.amjcard.2011.06.016. Fulltekst i vitenarkiv
• Hrubos-Strøm, Harald; Randby, Anna; Namtvedt, Silje Kjeka; Kristiansen, Håvard Anton; Einvik, Gunnar & Saltyte-Benth, Jurate [Vis alle 12 forfattere av denne artikkelen] (2010). A Norwegian population-based study on the risk and prevalence of obstructive sleep apnea. Journal of Sleep Research. ISSN 0962-1105. doi: 10.1111/j.1365-2869.2010.00861.x. Fulltekst i vitenarkiv

Se alle arbeider i NVA

• Hrubos-Strøm, Harald (2017). Sov Godt Råd og øvelser for deg som drømmer om bedre søvn. Kagge Forlag AS. ISBN 9788248919636. 143 s. Fulltekst i vitenarkiv

Se alle arbeider i NVA

• Jemterud, Torkild; Delsett, Lene Liebe; Røyne, Anja & Hrubos-Strøm, Harald (2025). Hvorfor får du dårlig ånde av å sove? - Abels tårn - NRK Radio. [Radio]. NRKP2. Fulltekst i vitenarkiv Vis sammendrag

  Sammen med et ekspertpanel gir tårndiktator Torkild Jemterud svar på alt du ikke visste du lurte på. Send oss dine spørsmål i appen NRKradio. Søk opp Abels tårn og trykk på snakkebobla

• Hrubos-Strøm, Harald; Hansen, Diana Dobran; Feng, Xin; Mäkinen, Hanna; Tinbod, Unn & Köster, Andres [Vis alle 12 forfattere av denne artikkelen] (2025). Effect of Orofacial Myofunctional Therapy with Auto-Monitoring on the Apnea–Hypopnea Index and Secondary Outcomes in Treatment-Naïve Patients with Mild to Moderate Obstructive Sleep Apnea (OMTaOSA): A Multicenter Randomized Controlled Trial Protocol. doi: 10.3390/ijom51020008. Fulltekst i vitenarkiv Vis sammendrag

  Background: The aim of this article is to describe the protocol of a large, multicenter randomized controlled trial evaluating the effects of orofacial myofunctional therapy with auto-monitoring (OMTa) versus auto-monitoring alone on obstructive sleep apnea (OSA) assessed by the apnea–hypopnea index and other pre-specified outcomes. Method: The OMTaOSA study protocol was registered at ClinicalTrials.gov (NCT06079073) in August 2023, and data collection ended in January 2025. One hundred and four participants with mild and moderate OSA were included. Randomization was conducted in a 1:1 ratio, using sex-stratified blocks. The intervention was a standardized protocol of OMT exercises previously shown to be effective, auto-monitoring with a Withings scan watch, and feedback from self-reports. Controls received watches and access to the same application without the exercise module. Sleep was measured over three nights at baseline and after three months. The sleep scorer and researchers evaluating other outcomes were blinded to the treatment allocation. Change in the apnea–hypopnea index was defined as the primary outcome. Secondary outcomes are published on Clinicaltrials.gov. Results: The results of the trial are still in preparation. Conclusions: By addressing the limitations of previous OMT studies, this trial may clarify the effectiveness of digitally delivered OMT for patients with mild to moderate OSA.

• Jemterud, Torkild; Røine, Anja; Bøckman, Petter & Hrubos-Strøm, Harald (2022). Abels Tårn. [Radio]. NRK P2. Fulltekst i vitenarkiv
• Hrubos-Strøm, Harald (2021). Bidrag idrettsmedisinsk fagdag. Fulltekst i vitenarkiv
• Hrubos-Strøm, Harald (2021). Høstmøtet: CPAP i avtalepraksis? Fulltekst i vitenarkiv
• Hrubos-Strøm, Harald (2021). OROFACIAL MYOFUNCTIONAL THERAPY WITH AUTOFEEDBACK IN THE HORIZON 2020 SLEEP REVOLUTION PROJECT. Fulltekst i vitenarkiv
• Hrubos-Strøm, Harald (2021). Orofacial Myofunctional Therapy. Fulltekst i vitenarkiv
• Hrubos-Strøm, Harald (2021). Når samme søvnsymptom krever ulike behandlinger- seks grupper av søvnsykdommer. Fulltekst i vitenarkiv
• Simonsen, Michael & Hrubos-Strøm, Harald (2021). Vil utvikle persontilpasset behandling for søvnapné og kronisk insomni. [Journal]. Dagens Medisin. Fulltekst i vitenarkiv
• Pedersen, Pia; Hrubos-Strøm, Harald & Hantveit, Lina Elise (2021). Jeg får ikke sove... Fulltekst i vitenarkiv
• Hrubos-Strøm, Harald (2021). Persontilpasset behandling av obstruktiv søvnapné. Fulltekst i vitenarkiv
• moeller, Marc & Hrubos-Strøm, Harald (2020). "Munn- og Ansiktstrening mot snorking og søvnapné". Fulltekst i vitenarkiv
• Øverby, Tonje Caroline; Sutharshan, Prasanthy & Hrubos-Strøm, Harald (2020). Shared decision making and treatment adherence in patients diagnosed with obstructive sleep apnoea. Fulltekst i vitenarkiv
• Jemterud, Torkild; Bjorå, Charlotte Sletten; Kristiansen, Jostein Riiser & Hrubos-Strøm, Harald (2019). Abels tårn, Var Oumuamua et romskip? Har A og B-mennesker forskjellige søvnfaser? Hvordan vet trær når de skal skyte knopper? [TV]. NRK 2. Fulltekst i vitenarkiv
• Hrubos-Strøm, Harald (2019). Persontilpassede behandlingsvalg ved nydiagnostisert søvnapné. Fulltekst i vitenarkiv
• Hrubos-Strøm, Harald (2019). Participation in symposium "Technologies to support Communication". Fulltekst i vitenarkiv
• Hrubos-Strøm, Harald (2019). Symptoms and significance in patients referred With suspected sleep apnea. Fulltekst i vitenarkiv
• Hrubos-Strøm, Harald (2019). Førerkort og søvn-To års erfaring i klinikken. Fulltekst i vitenarkiv
• Hrubos-Strøm, Harald (2019). Symptoms and significance in patients referred With suspected sleep apnea. Fulltekst i vitenarkiv
• Olafsson, Thorarinn Arnar & Hrubos-Strøm, Harald (2019). A validation study of an esophageal based polygraph against manually scored polysomnography. Fulltekst i vitenarkiv
• Delsett, Lene Liebe; Samset, Bjørn Hallvard; Hrubos-Strøm, Harald & Jemterud, Torkild (2018). Abels tårn 6. november 2018. [TV]. NRK TV. Fulltekst i vitenarkiv
• Sætra, Marte Julie; Raklev, Are; Hrubos-Strøm, Harald & Jemterud, Torkild (2017). Abels Tårn. [Radio]. Ekko - NRK. Fulltekst i vitenarkiv
• Hrubos-Strøm, Harald (2016). Førerkortforskriften. Fulltekst i vitenarkiv
• Hrubos-Strøm, Harald (2015). Re: Er det overvekt eller vektfokus som er helseskadelig? Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 135(4), s. 309–310. doi: 10.4045/tidsskr.15.0140. Fulltekst i vitenarkiv
• Hammami, Amir; Langsrud, Solveig & Hrubos-Strøm, Harald (2015). Abels Tårn. [Radio]. EKKO, NRK P2. Fulltekst i vitenarkiv
• Engstrøm, Morten; Beiske, Kornelia Katalin; Hrubos-Strøm, Harald; Aarrestad, Sigurd & Sand, Trond (2015). Undersøkelse av obstruktiv respirasjonsforstyrrelse under søvn. 21(135), s. 1962–1964. doi: 10.4045/tidsskr.15.0391. Fulltekst i vitenarkiv
• Hrubos-Strøm, Harald & Einvik, Gunnar (2015). Nye helsekrav til førerkort – medisin med tvilsom effekt. Fulltekst i vitenarkiv
• Engstrøm, Morten; Beiske, Kornelia Katalin; Hrubos-Strøm, Harald; Aarrestad, Sigurd & Sand, Trond (2015). Investigation of obstructive respiratory disturbance during sleep. Fulltekst i vitenarkiv
• Hrubos-Strøm, Harald (2015). Disordered breathing and risk of traffic accidents? Experiences from the Akershus Sleep Apnoea Project (ASAP). Fulltekst i vitenarkiv
• Gardner, Benjamin; Broström, Anders; Nilsen, Per; Hrubos-Strøm, Harald; Ulander, Martin & Fridlund, Bengt [Vis alle 8 forfattere av denne artikkelen] (2014). From 'does it work?' to 'what makes it work?': The importance of making assumptions explicit when designing and evaluating behavioural interventions. European Journal of Cardiovascular Nursing. ISSN 1474-5151. 13(4), s. 292–294. doi: 10.1177/1474515114531688. Fulltekst i vitenarkiv
• Hrubos-Strøm, Harald; Omland, Torbjørn; Dammen, Toril & Nordhus, Inger Hilde (2011). AVERAGE OXYGEN SATURATION, VERBAL MEMORY AND EXECUTIVE FUNCTION IN A COMMUNITY-BASED HIGH RISK POPULATION IDENTIFIED BY THE BERLIN QUESTIONNAIRE. Fulltekst i vitenarkiv
• Hrubos-Strøm, Harald (2011). Pustestopp under søvn – akershus Søvnapné Prosjekt (ASAP). SØVN. ISSN 1891-5493. 3. årgang(2), s. 20–21. Fulltekst i vitenarkiv
• Skirbekk, Helge & Hrubos-Strøm, Harald (2010). TV-serien House. [TV]. Tidsskrift for Den norske legeforening. Fulltekst i vitenarkiv
• Skirbekk, Helge & Hrubos-Strøm, Harald (2010). Mistillit og manipulasjon hos dr. House. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. Fulltekst i vitenarkiv
• Skirbekk, Helge & Hrubos-Strøm, Harald (2010). Dr. House på pensum. Fulltekst i vitenarkiv
• Hrubos-Strøm, Harald; Nordhus, Inger Hilde; Dammen, Toril & Omland, Torbjørn (2010). A Norwegian population-based study on the risk and prevalence of obstructive sleep apnea - The Akershus sleep apnea project. Fulltekst i vitenarkiv
• Hrubos-Strøm, Harald; Dammen, Toril & Nordhus, Inger Hilde (2009). Neurocognitiv funksjon ved Obstruktiv Søvnapnè Syndrom. Fulltekst i vitenarkiv
• Hrubos-Strøm, Harald (2009). ”Your PhD and the road ahead”. Fulltekst i vitenarkiv
• Hrubos-Strøm, Harald (2009). The Akershus Sleep Apnea Project (ASAP). Fulltekst i vitenarkiv
• Hrubos-Strøm, Harald & Nordhus, Inger Hilde (2009). Sleeping with a machine: How can patient education improve adherence in patients with obstructive sleep apnea? Patient Education and Counseling. ISSN 0738-3991. 74(2), s. 133–134. doi: 10.1016/j.pec.2008.12.018. Fulltekst i vitenarkiv
• Hrubos-Strøm, Harald; Nordhus, Inger Hilde & Dammen, Toril (2009). Self-reported sleep quality, objective sleep, anxiety and depression in population derived subjects with high risk of Obstructive Sleep Apnea. Fulltekst i vitenarkiv
• Hrubos-Strøm, Harald (2009). Features of population based Obstructive Sleep Apnea (OSA). Fulltekst i vitenarkiv
• Hrubos-Strøm, Harald (2009). “Seminar of scientific writing”. Fulltekst i vitenarkiv
• Varendh, Maria; Andersson, Morgan & Hrubos-Strøm, Harald (2018). Nasal patency and sleep- Prevalence of obstruction, sleep disturbances, quality of life, and treatment. Lund University Open Access. Fulltekst i vitenarkiv
• Hrubos-Strøm, Harald & Dammen, Toril (2013). Obstructive Sleep Apnea in Community-Dwelling Adults. A Clinical-pidemiological Study. Akershus Sleep Apnea Project (ASAP). Akademisk Forlag. ISSN 9788282644044. Fulltekst i vitenarkiv

Se alle arbeider i NVA