Journal of Sleep Research最新文献

Literature evidenced an association of maternal sleep disturbances and maternal obstructive sleep apnea with significant obstetric complications. Moreover, the maternal sleep disturbances effect on feto-placental circulation had not been extensively examined. Our objective is to explore the possible maternal sleep disturbances impact on the feto-placental indices evaluated through the Doppler study. A systematic review of the following databases was performed: PubMed, EMBASE, Cochrane Library and Google Scholar from the beginning to June 2024. Only studies that enrolled pregnant women with signs and symptoms of maternal sleep disturbances or obstructive sleep apnea diagnosis, which analysed the feto-placental Doppler parameters, were considered eligible (PROSPERO ID: CRD42024553926). We included a total of four studies with 1715 cases of pregnant women. Various instrumental and non-instrumental diagnostic methods were adopted for detection of maternal sleep disturbances. The ultrasound exam was performed mainly in the third trimester of pregnancies, and all the studies explored the uterine Doppler parameters. Only two studies explore the foetal Doppler parameters. Only one study disclosed that maternal sleep disturbances are related to altered uterine Doppler indices with probable placental dysfunction. This review did not evidence a significant influence of maternal sleep disturbances and obstructive sleep apnea on foetal Doppler indices. Moreover, one large prospective study showed a possible impact of maternal sleep disturbances on uterine Doppler with a potential impairment of the placentation function. Additional studies with detailed data and larger samples are needed to throw light on this relationship and its impact on the foetal outcomes.

Sleepiness-related errors are a leading cause of driving accidents, requiring drivers to effectively monitor sleepiness levels. However, there are inter-individual differences in driving performance after sleep loss, with some showing poor driving performance while others show minimal impairment. This research explored if there are differences in self-reported sleepiness and driving performance in healthy drivers who exhibited vulnerability or resistance to objective driving impairment following extended wakefulness. Thirty-two adults (female = 18, mean age = 33.0 ± 14.6 years) completed five × 60-min simulated drives across 29-hr of extended wakefulness. Subjective sleepiness (Karolinska Sleepiness Scale) and subjective driving performance ratings (nine-point Likert scale) were assessed at 10-min intervals while driving. Cluster analysis using simulator steering deviation and crash data categorised participants as vulnerable (n = 16) or resistant (n = 16) to driving impairments following extended wakefulness. No differences in self-ratings between the vulnerable and resistant groups were observed except during the last drive (25 hr awake), where the vulnerable group reported higher sleepiness (p = 0.008) and worse driving performance (p = 0.001) than the resistant group. For each 1-point increase on the Karolinska Sleepiness Scale and subjective driving scales, the vulnerable group showed about threefold greater steering impairment relative to resistant drivers. Although self-reported sleepiness and driving performance were correlated with objective driving performance, vulnerable drivers reported similar sleepiness and driving performance as resistant drivers. Thus, self-reported sleepiness and driving performance are not reliably sensitive to sleep loss effects on objective driving performance, which may impact the vulnerable driver's decisions to continue driving and delay engagement in countermeasures to reduce crash risk (e.g. napping), warranting further research.

The '6-h on/6-h off' shift pattern could potentially disrupt the physiological rhythms and cognitive performance of seafarers, attributed to its shorter and more frequent shifts. Conversely, light exposure has been demonstrated to enhance cognitive abilities and synchronise physiological processes. Therefore, we studied the fatigue, cognition, sleep and rhythm of seafarers with different shifts to determine how light can benefit their performance. A total of 16 seafarers participated in a 2 × 2 crossover study, which involved two shift types (Morning-Evening and Day-Night) and two lighting conditions (static lighting and dynamic lighting). Sleepiness, cognition and fatigue were assessed every 2 h during '6-h on' period, using the Karolinska Sleepiness Scale, psychomotor vigilance task, critical flicker frequency and visual analogue scale for fatigue. Sleep was monitored during '6-h off' period, core body temperature was continuously tracked for rhythm throughout the shift protocol. For the Day-Night shift, the static mode with stable higher illuminance than dynamic lighting significantly reduced sleepiness (p = 0.01), objective fatigue (p = 0.001), subjective fatigue (fatigue level [p = 0.004] and visual fatigue [p = 0.001]) during the night period, while increasing sleep duration during the day (6:00 a.m. to 12:00 p.m.) and delaying the rhythm. For the Morning-Evening shift, dynamic lighting with lower illuminance significantly increased sleep duration during the night (12:00 a.m. to 6:00 a.m.) without causing a significant difference in performance. Overall, static lighting is more suitable for Day-Night shift seafarers due to lower sleepiness, fatigue and longer daytime sleep duration, while dynamic lighting is more suitable for Morning-Evening shift seafarers due to longer night-time sleep duration. Therefore, different lighting patterns should be adopted for seafarers during different shifts.

Australia's mine sites are largely situated in remote locations and operate around the clock. Many shift workers fly to site, where they work 12-hr shifts and sleep in camp accommodation before they return home for the period rostered off work. Mining shift workers experience poor sleep, yet limited research is available on contributing factors. This study investigated, for the first time, the relationship between the sleep health and sleep hygiene in this population. A survey was disseminated to shift workers in the mining industry, utilising a cross-sectional study design. The Sleep Health Index and Sleep Hygiene Index questionnaires were used to evaluate their sleep health and sleep hygiene, respectively. In total, 470 shift workers (mean age [years]: 39 ± 12, mean body mass index [kg m^-2]: 28 ± 5) were included, which involved 132 females. Average scores for the Sleep Health Index and Sleep Hygiene Index were 76 ± 15 and 30 ± 7, respectively. Better sleep health was observed in shift workers with better sleep hygiene (β = -0.52, SE = 0.09 [-0.71, -0.34], p < 0.001). Differences in Sleep Health Index scores were found for individual Sleep Hygiene Index items related to "sleep regularity", "sleep environment", "mental health" and "time in bed extension". However, no differences in Sleep Health Index scores were found for items related to "caffeine, alcohol or nicotine consumption" or "exercise" close to bedtime and "bedtime activities" (p > 0.05 for all). These findings demonstrate a relationship between sleep hygiene and sleep health; therefore, it may be possible to improve the sleep of shift workers by improving their sleep hygiene.

Insomnia after acquired brain injury (ABI) is common and can negatively impact an individual's rehabilitation, recovery, and quality of life. The present study investigated the feasibility and preliminary efficacy of a Brief Behavioural Treatment for Insomnia (BBTI) in a community sample following ABI. Ten participants were recruited. Seven participants attended four weekly sessions of BBTI and kept a daily sleep diary. Participants completed a semi-structured sleep interview at baseline and self-report measures of sleep, anxiety, and depression pre- and post-treatment as well as a treatment acceptability questionnaire post-treatment. Follow-up data were collected at 1-, 2-, and 3-months post-treatment. Visual analyses of the data were performed on a case-by-case basis. Five of the seven participants (71%) no longer met the criteria for insomnia disorder on the Sleep Condition Indicator (SCI) post-treatment. Treatment effects on sleep outcomes were either maintained or augmented at follow-ups. BBTI was found to be well tolerated, as evidenced by the high overall retention rates (70%) and positive feedback on the treatment acceptability questionnaire. These results provide preliminary evidence of BBTI being both feasible to use and potentially efficacious in individuals with post-brain-injury insomnia. Larger-scale randomised controlled trials are needed to establish the effectiveness of BBTI following ABI.

Excessive daytime sleepiness (EDS) is a common complaint in the general population and is associated with cardiovascular disease and increased mortality. We aimed to investigate whether sleep duration is related to excessive daytime sleepiness in the general population, both in itself and in combination with other factors. We performed a cross-sectional analysis in the population-based Swedish CArdioPulmonary bioImage Study (SCAPIS) cohort (n = 27,976; 14,436 females; aged 50-64 years) to assess how sleep-related factors along with anthropometric, lifestyle, socioeconomic factors as well as somatic disease and psychological distress, were related with EDS assessed by the Epworth sleepiness scale (ESS). Analyses were performed using logistic regression modelling with EDS defined by an ESS score of ≥11 as the main outcome. Both short and long sleep duration were related to EDS with increasing ORs for decreasing sleep duration (7 h vs. reference (8 h): OR 1.2, 95% CI 1.02-1.3 to ≤4 h: 1.9; 1.4-2.5). In addition to sleep-related factors such as insomnia (1.3; 1.2-1.4), poor sleep quality (1.2; 1.04-1.4), snoring (1.5; 1.4-1.6), and nocturnal gastro-oesophageal reflux (1.5; 1.21-1.8), psychological distress showed a strong association with EDS. This included sadness/depression (1.2; 1.1-1.3), stress (some stress: 1.4; 1.1-1.7 to constant stress over 5 years: 1.7; 1.3-2.2), and self-rated "control in life" (lowest quartile: 1.7; 1.6-2.0). Daytime sleepiness is multifactorial and associated with both sleep duration and sleep quality. Strong associations were also established with factors related to psychological distress. Further research may investigate interventions targeting both sleep and psychological health to reduce daytime sleepiness at the societal level.

Positional obstructive sleep apnea, in which there is a ≥ 2:1 predominance of obstructive events in the supine position, is a sleep-disordered breathing phenotype with a targeted treatment in the form of positional device therapy. We sought to determine the prevalence of positional obstructive sleep apnea in a cohort of children prescribed continuous positive airway pressure therapy, ascertain risk factors for the condition, and determine the associated continuous positive airway pressure treatment adherence rate. A retrospective cohort study of all children > 2 years old from a single tertiary paediatric centre prescribed continuous positive airway pressure therapy over an 8-year period was conducted. Positional obstructive sleep apnea prevalence was established by analysing positional and respiratory event data from the participants' original diagnostic polysomnography. Continuous positive airway pressure therapy adherence was determined using data from machine download. Univariable and multivariable logistic regression modelling was used to determine participant demographic and clinical factors associated with positional obstruction. Positional obstructive sleep apnea (defined by Bignold's criteria modified for paediatric use) prevalence in the cohort of 237 analysed participants was 38%. Suboptimal continuous positive airway pressure adherence was noted in 30% of this group based on initial machine download, performed a median of 96 days post-treatment initiation. Higher age and lower obstructive apnea-hypopnea index were independent predictors of positional obstructive sleep apnea, whereas neurodevelopmental diagnosis, presence/absence of rapid eye movement-related obstructive sleep apnea, overweight/obesity status and history of adenoidectomy/adenotonsillectomy were not. For children, positional device therapy is a treatment option worthy of further consideration and research.

The external validity of the Morningness-Eveningness Scale for Children was analysed via objective measures of skin temperature, light exposure and motor activity with the ambulatory circadian monitoring methodology. A total of 138 adolescents (57 boys and 81 girls) aged 12-13 years, who in addition to completing the Morningness-Eveningness Scale for Children to determine their circadian typology wore a wrist activity device (Kronowise 3.0; Kronohealth SL) during school days and a weekend, participated. Circadian parameters, such as mesor, amplitude and acrophase, were estimated for skin temperature, light exposure and motor activity, as were sleep parameters, such as risetime, bedtime and social jetlag. The results indicated that during the weekend E-type adolescents experienced later acrophases in temperature, light and activity than I-type and M-type adolescents did, whereas boys experienced earlier acrophases in temperature and activity. When school weekdays were compared with the weekend, there was a weekend delay in the acrophases of temperature (1:03), light exposure (2:03) and activity (3:15). The results obtained in this study provide external validity for applying the Morningness-Eveningness Scale for Children in the naturalistic context of high school while considering sex and type-of-day differences as important variables in chronopsychological studies.

Seasonality of excessive daytime sleepiness has been proposed, yet no research has specifically investigated its impact on daytime sleepiness and cataplexy in central disorders of hypersomnolence. This study examined seasonal variations in daytime sleepiness and cataplexy in narcolepsy type 1, narcolepsy type 2 and idiopathic hypersomnia. Patients included in the study were on stable pharmacological treatment, and participated in sleep medicine interviews to assess diurnal sleepiness and daytime napping and completed the Epworth Sleepiness Scale to assess excessive daytime sleepiness (Epworth Sleepiness Scale ≥ 10). Patients with narcolepsy type 1 also maintained a cataplexy diary. Evaluations were conducted in autumn, winter, spring and summer. The study included 29 patients with narcolepsy type 1, 16 patients with narcolepsy type 2 and 10 patients with idiopathic hypersomnia. Patients with narcolepsy type 1 and narcolepsy type 2 showed higher Epworth Sleepiness Scale scores in summer compared with other seasons, while patients with idiopathic hypersomnia showed no changes in excessive daytime sleepiness across the four seasons. Epworth Sleepiness Scale scores were higher in idiopathic hypersomnia patients compared to narcolepsy type 1 and narcolepsy type 2 patients in spring, autumn, and winter; conversely, in summer there were no differences in Epworth Sleepiness Scale scores among the three groups. No significant differences in Epworth Sleepiness Scale scores were noted between patients with narcolepsy type 1 and narcolepsy type 2 throughout the year. Furthermore, no seasonal effect on cataplexy frequency was found in patients with narcolepsy type 1. This study demonstrates that seasonality may influence daytime sleepiness in patients with narcolepsy type 1 and narcolepsy type 2 but not in patients with idiopathic hypersomnia, while cataplexy symptoms remain unaffected by seasonal changes. The underlying mechanisms linking excessive daytime sleepiness to seasonality have yet to be explored, though social factors and vacation time may contribute to increased excessive daytime sleepiness in narcolepsy.

This study aimed to improve our understanding of sleep problems as a comorbidity of hereditary deaf-blindness due to Usher syndrome type 2a. Fifteen patients with Usher syndrome type 2a with a conclusive genetic diagnosis and 15 unaffected controls participated in comprehensive sleep and activity assessments for 2 weeks, using the MotionWatch 8 actigraph and consensus sleep diary. Various sleep parameters including sleep opportunity window, sleep latency, sleep efficiency, and self-reported sleep quality were analysed. Non-parametric circadian rhythm analysis was performed to evaluate circadian rhythmicity. Additionally, regression analyses were conducted to study potential correlations between sleep parameters and patients' demographics and disease progression. Patients with Usher syndrome type 2a exhibited significantly longer sleep latency and lower self-reported sleep and rest quality compared with controls. Additionally, day-to-day variability of sleep efficiency and sleep latency were significantly higher in the patient population. Non-parametric circadian rhythm analysis revealed no significant differences in circadian rhythmicity. Regression analyses indicated that having Usher syndrome type 2a was a significant predictor of poor sleep outcomes. No clear correlations were found between the level of visual impairment and sleep parameters, suggesting that the negative effects of Usher syndrome type 2a on sleep manifest independently of the progressive visual impairment. These findings suggest that, while circadian sleep-wake rhythm remain intact, patients with Usher syndrome type 2a suffer from sleep disturbances that likely arise from factors beyond their progressive blindness. With sleep problems being a major risk factor for physical and mental health problems, we advocate that sleep problems should be recognized as a hallmark symptom of Usher syndrome type 2a, warranting in-depth research for potential targeted therapeutic interventions.