New European guidelines for the accreditation of sleep medicine centres and more!

Abstract

Dear members of the ESRS,

Dear readers of JSR,

Welcome to the sixth edition of the Journal of Sleep Research in 2024, which will be published in December 2024.

This issue encompasses a variety of articles covering many facets of sleep medicine and sleep research.

Firstly, I would like to highlight the work by Hartley et al. (2024) who have provided us with a revision of the European guidelines for the accreditation of sleep medicine centres. The first such position paper was published in 2006, and therefore it is very timely that this update was written. In this paper, several levels of sleep medicine centres are suggested: Levels 1 and 2 would offer full diagnostic testing in a laboratory setting including polysomnography and other sophisticated diagnostic methods – this type of centre would usually be university based. Levels 3 and 4 would be ambulatory services, offering also polysomnography (Level 3) or polygraphy (Level 4). The paper outlines the role of the medical and paramedical teams, equipment and many other important issues for conducting proper sleep medicine according to our patients' needs.

Tse et al. (2024) from Oxford investigated whether single-component sleep restriction therapy may have a significant effect on depressive symptoms also, besides the well-known effects on sleep parameters in patients suffering from insomnia. To this end, a state of the art systematic review and meta-analysis on the relevant literature was conducted. Seven controlled and two uncontrolled trials met inclusion and exclusion criteria for the study, encompassing over 1100 patients with insomnia and some subclinical forms of depressive symptoms. Data analysis revealed that sleep restriction alone had a medium effect on depressive symptoms, apart from the effects on sleep. These promising data suggest to perform further trials encompassing patients with insomnia and clinical depression, to test whether also in this population depressed symptomatology will be reduced.

Meers et al. (2024) deal with a still widely neglected area, i.e. the relationships between sleep and emotion across the menstrual cycle. They studied 51 women aged from 18 to 35 years. Actigraphy and daily sleep/emotion diaries were collated over two menstrual cycles. Four phases of the menstrual cycle were compared with each other: peri-menstrual; mid-follicular; periovulatory; and mid-luteal. Relationships between menstrual phase, sleep parameters and emotions were estimated with multistep hierarchical linear modelling. Mean menstrual cycle length was 28.6 days. Interestingly, peri-menstrual phase predicted anger, but none of the other emotions; it also predicted total wake time at night measured subjectively and with actigraphy. Poor sleep during the peri-menstrual phase correlated with reduced positive emotions. The authors suggest that improving sleep during the peri-menstrual phase may have a positive impact on emotions during this phase and as such decrease depressive symptomatology.

Kendzerska et al. (2024) conducted a retrospective community-based study to elucidate the relationships between air pollution, weather and positive airway pressure treatment adherence. Data from over 8000 adults who had purchased a continuous positive airway pressure (CPAP) device between 2013 and 2017 in the Ottawa area could be analysed. Several parameters of weather and air pollution, derived from publicly available databases were connected with CPAP device usage times. It turned out that there were modest but significant correlations between CPAP adherence and measures of nitrogen oxide, fine particular matter and the air quality health index. With the increase of these measures, adherence decreased. Decreased PAP adherence was also described with increased temperature and decreased barometric pressure. So this study for the first time confirms that the weather and air pollution indeed may negatively influence adherence to PAP.