Journal of Sleep Research最新文献_第8页

Decrease of excessive daytime sleepiness after shunt treatment for normal pressure hydrocephalus 正常压力脑积水分流治疗后白天过度嗜睡现象的减少

IF 4.4 3区医学 Q2 CLINICAL NEUROLOGY

Journal of Sleep Research

Pub Date : 2024-09-14 DOI: 10.1111/jsr.14333

Simon Lidén, Anna Lindam, Dan Farahmand, Anne‐Marie Landtblom, Katarina Laurell

SummarySleepiness and apathy are often reported in patients with normal pressure hydrocephalus. However, research on outcomes after shunt surgery has mainly focused on the classical triad symptoms, that is, gait, cognition, and bladder dysfunction. This study aimed to describe the effects of shunt treatment on excessive daytime sleepiness and whether there was a relation to changes in ventricular volume. Pre‐ and postsurgical excessive daytime sleepiness was investigated using the Epworth sleepiness scale in a sample of 32 patients with normal pressure hydrocephalus who underwent shunt surgery. Data were gathered before surgery and at 1, 2, and 3 months after surgery and with different settings of the shunt. In the total sample, the Epworth sleepiness scale improved by a median of 1.5 points at 1 month after surgery, p = 0.026. The improvement was predominately found in the group (n = 6) with high presurgical daytime sleepiness (Epworth sleepiness scale >12) (median = 12 points, p = 0.035) compared with a median change of 0 points (p = 0.47) in the group with Epworth sleepiness scale ≤12 (n = 26). Between the postsurgical follow‐ups, no further change in the Epworth sleepiness scale score was observed. The Epworth sleepiness scale score did not correlate with clinical tests nor with ventricular volume. Daytime sleepiness seems to be another domain of normal pressure hydrocephalus symptomatology in addition to the classical triad that is responsive to treatment, at least when pronounced. The Epworth sleepiness scale is a quick test to administer and could be a valuable addition to pre‐surgical screening for treatable symptoms.

摘要常压脑积水患者常有嗜睡和淡漠的报道。然而，有关分流手术后疗效的研究主要集中在经典的三联症状上，即步态、认知和膀胱功能障碍。本研究旨在描述分流治疗对白天过度嗜睡的影响，以及是否与脑室容量的变化有关。研究使用埃普沃思嗜睡量表对 32 名接受分流手术的正常压力脑积水患者进行了手术前和手术后白天过度嗜睡的调查。数据收集于手术前、手术后 1 个月、2 个月和 3 个月，并采用了不同的分流器设置。在所有样本中，埃普沃思嗜睡量表在术后 1 个月的中位数提高了 1.5 分，P = 0.026。这种改善主要出现在手术前白天嗜睡程度较高（爱普沃斯嗜睡量表>12）的组别（n=6）（中位数=12分，p=0.035），而爱普沃斯嗜睡量表≤12的组别（n=26）中位数变化为0分（p=0.47）。在术后随访期间，埃普沃思嗜睡量表评分没有进一步变化。埃普沃思嗜睡量表评分与临床测试和心室容积均无相关性。白天嗜睡似乎是正常压力脑积水症状中除传统三联征之外的另一个领域，至少在症状明显时对治疗有反应。埃普沃思嗜睡量表是一种快速的测试方法，可作为手术前筛查可治疗症状的重要补充。

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引用次数: 0

Respiratory safety of lemborexant in adult and elderly subjects with moderate‐to‐severe chronic obstructive pulmonary disease 在患有中度至重度慢性阻塞性肺病的成年和老年受试者中使用苯溴索的呼吸安全性

IF 4.4 3区医学 Q2 CLINICAL NEUROLOGY

Journal of Sleep Research

Pub Date : 2024-09-13 DOI: 10.1111/jsr.14334

Jocelyn Y. Cheng, Daniel Lorch, Nancy Hall, Margaret Moline

SummaryBecause some hypnotics worsen respiratory conditions, it was important to determine the respiratory safety of lemborexant, a competitive dual orexin‐receptor antagonist approved to treat adults with insomnia, in subjects with moderate‐to‐severe chronic obstructive pulmonary disease. E2006‐A001‐113 (Study 113; NCT04647383) was a multicentre, multiple‐dose, randomised, double‐blind, placebo‐controlled, two‐period crossover study in adult subjects with moderate or severe chronic obstructive pulmonary disease (per spirometry‐based Global Initiative for Chronic Obstructive Lung Disease [GOLD] criteria). Subjects (N = 30) were randomised to two treatment sequences comprising 8‐night treatment periods (washout ≥ 14 days) with lemborexant 10 mg or placebo. Peripheral oxygen saturation (SpO2; primary endpoint), apnea–hypopnea index, objective sleep parameters and sleep architecture measures were assessed after single (Day 1) and multiple (Day 8) doses. There was no significant difference in least‐squares mean SpO2 after a single dose of lemborexant (91.1%) versus placebo (91.5%). Although a statistically significant difference in SpO2 was observed after multiple doses (least‐squares mean: lemborexant, 91.3%; placebo, 90.8%) favouring lemborexant, this was not considered clinically meaningful. Apnea–hypopnea index was not significantly different between treatments after single or multiple doses. Total sleep time and total rapid eye movement sleep were significantly greater on Days 1 and 8 with lemborexant versus placebo. Treatment‐emergent adverse events were reported in five (16.7%) subjects when taking lemborexant and four (13.3%) subjects when taking placebo; treatment‐emergent adverse events were mostly mild. Lemborexant was well tolerated and did not adversely impact SpO2 or apnea–hypopnea index after single and multiple doses relative to placebo in subjects with moderate‐to‐severe chronic obstructive pulmonary disease.

摘要由于某些催眠药会加重呼吸系统疾病，因此必须确定lemborexant（一种获准用于治疗成人失眠症的竞争性双奥曲肽受体拮抗剂）在中度至重度慢性阻塞性肺病患者中的呼吸系统安全性。E2006-A001-113（研究 113；NCT04647383）是一项多中心、多剂量、随机、双盲、安慰剂对照、两阶段交叉研究，研究对象为患有中度或重度慢性阻塞性肺病（根据基于肺活量测定的全球慢性阻塞性肺病倡议 [GOLD] 标准）的成年受试者。受试者（N = 30）被随机分配到两个治疗序列，包括 8 夜治疗期（冲洗期≥ 14 天），分别服用 10 毫克的伦博雷沙坦或安慰剂。单次（第1天）和多次（第8天）用药后，对外周血氧饱和度（SpO2；主要终点）、呼吸暂停-低通气指数、客观睡眠参数和睡眠结构测量进行了评估。单次服用伦博雷沙坦（91.1%）与服用安慰剂（91.5%）后，最小二乘平均SpO2无明显差异。虽然在多次给药后观察到 SpO2 存在统计学意义上的显著差异（最小二乘法平均值：伦博罗司特，91.3%；安慰剂，90.8%），但这并不具有临床意义。单次或多次用药后，呼吸暂停-低通气指数在不同治疗之间没有显著差异。在第1天和第8天，总睡眠时间和总快速眼动睡眠时间明显多于安慰剂。服用伦博雷沙坦的受试者中有5人（16.7%）报告了治疗突发不良事件，服用安慰剂的受试者中有4人（13.3%）报告了治疗突发不良事件；治疗突发不良事件大多较轻。与安慰剂相比，中度至重度慢性阻塞性肺病患者在单次和多次服用伦博雷沙坦后耐受性良好，不会对SpO2或呼吸暂停-低通气指数产生不利影响。

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引用次数: 0

The relationship between sleep and interoception 睡眠与内感知之间的关系

IF 4.4 3区医学 Q2 CLINICAL NEUROLOGY

Journal of Sleep Research

Pub Date : 2024-09-13 DOI: 10.1111/jsr.14337

Louisa G. Bynum, Ryan C. Brindle

SummaryThe present study aimed to characterise the relationship between sleep and interoception in two independent studies. Theoretical grounds for such a relationship include a weak relationship between subjectively‐ and objectively‐measured sleep, the covariance of sleep with pain, as well as the mass regulation of a number of visceral biological systems. In addition, such a relationship is often reflected in our language (i.e., ‘feeling’ tired). In both studies (Study 1: N = 118, 73% female, mean age 20.98 years; Study 2: N = 830, 49% female, mean age 38.04 years) sleep over the last month was self‐reported. Confidence in interoceptive accuracy, which is the precision with which a person can monitor visceral signals, was measured using the Interoceptive Accuracy Scale, while interoceptive attention, which is the dispositional tendency to attend to bodily signals, was measured using the Body Perception Questionnaire. Study 1 revealed a relationship between long sleep latency and low confidence in interoceptive accuracy (β = −0.222, p = 0.021) and poor sleep quality and less interoceptive attention (β = −0.226, p = 0.016). Study 2 replicated these results as well as made clear a more general pattern whereby poor sleep—characterised by short duration, poor quality, less efficiency, long latency, and more frequent nighttime awakenings—related to an interoceptive phenotype of less confidence in interoceptive accuracy and more interoceptive attention (all β ≥ 0.047, p ≤ 0.17). In conclusion, results from these two independent studies provide robust cross‐sectional evidence for associations between various dimensions of poor sleep and greater interoceptive attention, but less confidence in interoceptive accuracy.

摘要本研究旨在通过两项独立的研究来描述睡眠与内感知之间的关系。这种关系的理论依据包括主观测量的睡眠与客观测量的睡眠之间的微弱关系、睡眠与疼痛的协变关系以及对一些内脏生物系统的大规模调节。此外，这种关系还经常反映在我们的语言中（即 "感觉 "疲倦）。在这两项研究中（研究 1：N = 118，73% 为女性，平均年龄为 20.98 岁；研究 2：N = 830，49% 为女性，平均年龄为 38.04 岁），上个月的睡眠情况均为自我报告。研究人员使用 "内感知准确性量表 "测量内感知准确性信心，即一个人监测内脏信号的准确性；使用 "身体感知问卷 "测量内感知注意力，即关注身体信号的倾向性。研究 1 发现，睡眠潜伏期长与对感知间准确性的信心低（β = -0.222，p = 0.021）和睡眠质量差与感知间注意力低（β = -0.226，p = 0.016）之间存在关系。研究 2 复制了这些结果，并明确了一种更普遍的模式，即睡眠质量差--表现为持续时间短、质量差、效率低、潜伏期长和夜间觉醒次数多--与内感知表型有关，即对内感知准确性的信心较低和内感知注意力较强（全部 β ≥ 0.047，p ≤ 0.17）。总之，这两项独立研究的结果提供了强有力的横断面证据，证明睡眠不佳的各个层面与更高的内感知注意力之间存在关联，但对内感知准确性的信心较低。

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引用次数: 0

Associations between real‐life light exposure patterns and sleep behaviour in adolescents 现实生活中的光照模式与青少年睡眠行为之间的关系

IF 4.4 3区医学 Q2 CLINICAL NEUROLOGY

Journal of Sleep Research

Pub Date : 2024-09-11 DOI: 10.1111/jsr.14315

Luísa da Costa Lopes, Julia Ribeiro da Silva Vallim, Sergio Tufik, Fernando Louzada, Vânia D'Almeida

SummaryOne of the most striking changes in the regulation of sleep–wake behaviour during adolescence is circadian phase delay. Light exposure synchronises circadian rhythms, impacting sleep regulation, however, the influence of real‐life light exposure on sleep variations remains less clear. We aimed to describe the sleep and light exposure patterns of high school students with comparable schedules and socio‐economic backgrounds, and to evaluate whether there was any association between them, considering chronotype. We analysed five school days and two free days of actigraphy records, from 35 adolescents (24 female, mean age: 16.23 ± 0.60). The sample was described using the Sleep Regularity Index (SRI), chronotype (actigraphy MSFsc), and self‐reported diurnal preference (Morning/Evening Scale). Regression models were constructed to assess the impact of light exposure (daytime and nighttime) on subsequent sleep episodes; and to confirm whether the associations could be an indirect consequence of chronotype. Despite following similar routines, the SRI varied considerably (48.25 to 88.28). There was compatibility between the actigraphy proxy for chronotype and the self‐reported diurnal preference, extracted using the circadian rhythm scale for adolescents. Less light exposure during the day was associated with later sleep onset and shorter sleep duration. An increase of 100 lux in average daytime light exposure advance of 8.08 minutes in sleep onset and 7.16 min in sleep offset. When the regressions were controlled for chronotype, these associations persisted. These findings facilitate discussions regarding the behavioural aspect of the impact of real‐life light exposure on sleep and its potential as a target for interventions aiming to enhance adolescents’ sleep quality.

摘要青春期睡眠-觉醒行为调节中最显著的变化之一是昼夜节律相位延迟。光照可使昼夜节律同步，从而影响睡眠调节，然而，现实生活中的光照对睡眠变化的影响仍不太清楚。我们的目的是描述具有相似作息时间和社会经济背景的高中生的睡眠和光照模式，并在考虑昼夜节律的情况下评估两者之间是否存在关联。我们分析了 35 名青少年（24 名女性，平均年龄：16.23 ± 0.60）在校五天和空闲两天的行为记录。我们使用睡眠规律指数（SRI）、时序类型（动图 MSFsc）和自我报告的昼夜偏好（早/晚量表）对样本进行了描述。我们建立了回归模型，以评估光照（白天和夜间）对后续睡眠发作的影响，并确认这些关联是否可能是时序型的间接结果。尽管他们的作息时间相似，但 SRI 差异很大（从 48.25 到 88.28）。行为记录仪代表的时间型与使用青少年昼夜节律量表提取的自我报告的昼夜偏好之间具有兼容性。白天光照较少与睡眠开始时间较晚和睡眠持续时间较短有关。白天平均光照增加 100 勒克斯，睡眠开始时间提前 8.08 分钟，睡眠偏移时间提前 7.16 分钟。在对时间类型进行回归控制后，这些关联依然存在。这些发现有助于讨论现实生活中光线照射对睡眠的行为影响，以及将其作为旨在提高青少年睡眠质量的干预目标的潜力。

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引用次数: 0

Dream habits in a large cohort of preteens and their relation to sleep and nocturnal awakenings 大量青少年的做梦习惯及其与睡眠和夜间觉醒的关系

IF 4.4 3区医学 Q2 CLINICAL NEUROLOGY

Journal of Sleep Research

Pub Date : 2024-09-11 DOI: 10.1111/jsr.14339

Jean‐Baptiste Eichenlaub, Romain Bouet, Mathieu Pinelli, Sophie Portrat

SummaryThe present study examined dream habits, and their relation to sleep patterns, in 1151 preteens (597 boys; 554 girls; 11.31 ± 0.62 years old). Dream questionnaires assessed the frequency of dream recall, nightmare, and lucid dream, as well as the intensity of emotions experienced in dreams. Sleep variables included sleep duration and efficiency, but also different measurements of nocturnal awakenings. Among the preteens, 49.21% of them reported that they recalled dreams several times a week or almost every morning over the past few months. In addition, 52.00% of the preteens reported that they experienced nightmares, and 45.48% lucid dreams, less than once a month or never over the past few months. No gender differences were observed in dream variables. Nocturnal awakenings were linked to all dream variables, while sleep duration and sleep efficiency were related to nightmare frequency and emotions in dreams. Importantly, sleep duration and sleep efficiency were not associated with dream recall nor lucid dream frequency, with Bayesian analyses supporting the null hypothesis. These findings offer a comprehensive understanding of preteens’ dreams and their connection to key sleep aspects.

摘要本研究调查了 1151 名青少年（597 名男孩；554 名女孩；11.31 ± 0.62 岁）的做梦习惯及其与睡眠模式的关系。梦境问卷评估了梦境回忆、噩梦和清醒梦的频率，以及梦境中情感体验的强度。睡眠变量包括睡眠持续时间和效率，以及对夜间觉醒的不同测量。49.21% 的青少年表示，在过去几个月里，他们每周都会做几次梦，或者几乎每天早上都会做梦。此外，52.00% 的青少年表示他们在过去几个月中做过噩梦，45.48% 的青少年表示他们在过去几个月中每月少于一次或从未做过清晰的梦。在梦境变量方面没有观察到性别差异。夜醒与所有梦境变量有关，而睡眠时间和睡眠效率则与噩梦频率和梦境中的情绪有关。重要的是，睡眠时间和睡眠效率与梦境回忆和清醒梦频率无关，贝叶斯分析支持零假设。这些研究结果有助于全面了解青少年的梦境及其与主要睡眠方面的联系。

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引用次数: 0

Correction to ‘The future of JSR: Hybrid or Open Access publishing, and launch of a sister journal?’ 对"《联合期刊报告》的未来：混合出版还是开放获取出版，以及创办姊妹期刊？

IF 4.4 3区医学 Q2 CLINICAL NEUROLOGY

Journal of Sleep Research

Pub Date : 2024-09-11 DOI: 10.1111/jsr.14321

引用次数: 0

Early sleep apnea treatment in stroke (eSATIS) – a multicentre, randomised controlled, rater‐blinded, clinical trial: The association of post‐stroke cognition with sleep‐disordered breathing and its treatment 中风早期睡眠呼吸暂停治疗（eSATIS）--一项多中心、随机对照、评分者盲法临床试验：中风后认知与睡眠呼吸障碍及其治疗的关系

IF 4.4 3区医学 Q2 CLINICAL NEUROLOGY

Journal of Sleep Research

Pub Date : 2024-09-10 DOI: 10.1111/jsr.14296

Irina Filchenko, Simone B. Duss, Saskia Salzmann, Anne‐Kathrin Brill, Lyudmila Korostovtseva, Valeria Amelina, Sébastien Baillieul, Corrado Bernasconi, Markus H. Schmidt, Claudio L. A. Bassetti

SummarySleep‐disordered breathing (SDB) is linked to cognitive dysfunction. Although SDB is common in stroke patients, the impact of SDB and its early treatment on cognitive functioning after stroke remains poorly investigated. Therefore, we explored the association between SDB and post‐stroke cognitive functioning, including the impact of early SDB treatment with adaptive servo‐ventilation (ASV) on cognitive recovery from acute event to 3 months post‐stroke. We used data from two studies, which included ischaemic stroke patients (n = 131) and no‐stroke controls (n = 37) without SDB (apnea–hypopnea index, AHI <5/h) and with SDB (AHI≥20/h). Cognitive functioning was assessed within 7 days and 3 months post‐stroke in stroke patients, or at study inclusion in no‐stroke control group, respectively. Stroke patients with SDB were randomized to ASV treatment (ASV+) or usual care (ASV‐). Linear regression adjusted for main confounders assessed the impact of SDB and its treatment on cognitive recovery. The intention‐to‐treat analysis did not show significant associations of SDB ASV+ (n = 30) versus SDB ASV‐ (n = 29) with cognitive recovery. In an exploratory subanalysis, compliant SDB ASV+ (n = 14) versus SDB ASV‐ showed improvements with ASV in visual memory and cognitive flexibility. Combining the stroke and non‐stroke datasets, SDB (n = 85) versus no‐SDB (n = 83) was associated with deficits in visual memory and response inhibition independently of stroke. SDB ASV‐ versus no‐SDB (n = 51) was associated with less improvement in visual memory. There was no substantial evidence for benefits of intention‐to‐treat ASV on cognitive recovery. Exploratory analysis indicated that compliant ASV treatment could benefit visual memory and cognitive flexibility, whereas untreated SDB could contribute to a poor recovery of visual memory.

摘要睡眠呼吸障碍（SDB）与认知功能障碍有关。虽然 SDB 在脑卒中患者中很常见，但有关 SDB 及其早期治疗对脑卒中后认知功能的影响的研究仍然很少。因此，我们探讨了 SDB 与脑卒中后认知功能之间的关系，包括使用自适应伺服通气（ASV）早期治疗 SDB 对脑卒中急性期至卒中后 3 个月认知功能恢复的影响。我们使用了两项研究的数据，包括缺血性脑卒中患者（n = 131）和无脑卒中对照组（n = 37），其中无 SDB（呼吸暂停-低通气指数，AHI <5/h）和有 SDB（AHI≥20/h）。脑卒中患者的认知功能分别在脑卒中后 7 天和 3 个月内进行评估，无脑卒中对照组则在纳入研究时进行评估。患有 SDB 的脑卒中患者随机接受 ASV 治疗（ASV+）或常规护理（ASV-）。调整主要混杂因素后的线性回归评估了SDB及其治疗对认知恢复的影响。意向治疗分析结果显示，SDB ASV+（n = 30）与 SDB ASV-（n = 29）与认知恢复的关系并不显著。在一项探索性子分析中，SDB ASV+（n = 14）与 SDB ASV- 相比，ASV 改善了视觉记忆和认知灵活性。综合卒中和非卒中数据集，SDB（n = 85）与无 SDB（n = 83）在视觉记忆和反应抑制方面的缺陷与卒中无关。SDB ASV- 与无 SDB（n = 51）相比，视觉记忆的改善程度较低。没有大量证据表明意向性 ASV 对认知恢复有益。探索性分析表明，遵从 ASV 治疗可使视觉记忆和认知灵活性受益，而未经治疗的 SDB 可导致视觉记忆恢复不佳。

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引用次数: 0

REM sleep without atonia and neurocognitive function in isolated REM sleep behaviour disorder: Cross‐sectional and longitudinal study 孤立的快速眼动睡眠行为障碍患者的快速眼动睡眠（无失张力）和神经认知功能：横断面和纵向研究

IF 4.4 3区医学 Q2 CLINICAL NEUROLOGY

Journal of Sleep Research

Pub Date : 2024-09-10 DOI: 10.1111/jsr.14336

Sukhoon Kang, Jung Kyung Hong, Chan‐Hyung Kim, Ji Soo Kim, In‐Young Yoon

SummaryThis study investigated the relationship between rapid eye movement sleep without atonia and cognitive profiles in individuals diagnosed with isolated rapid eye movement sleep behaviour disorder, assesssing both cross‐sectional associations and their link to phenoconversion in a longitudinal follow‐up. Participants underwent video‐polysomnography, neurological examination, neuropsychological tests and structured interviews to confirm isolated rapid eye movement sleep behaviour disorder. Rapid eye movement sleep without atonia was manually scored using the Montreal method, and participants were categorized into either high or low electromyography activity groups, based on their tonic and phasic electromyography activities. The cross‐sectional study included 250 patients with isolated rapid eye movement sleep behaviour disorder, revealing that those with high tonic electromyography activity exhibited significantly lower scores in the constructional praxis recall than those with low tonic electromyography activity (p = 0.002). In the longitudinal study, 79 participants (63 isolated rapid eye movement sleep behaviour disorder and 16 phenoconversion), tracked for at least 5 years, demonstrated that high tonic electromyography activity (odds ratio: 6.14; 95% confidence interval: 1.23–30.60; p = 0.027) and lower performance on the Trail Making Test A (odds ratio: 0.23; 95% confidence interval: 0.11–0.70; p = 0.007) were associated with future phenoconversion. These results confirm the link between tonic electromyography activity and neurodegeneration in isolated rapid eye movement sleep behaviour disorder. Combining rapid eye movement sleep without atonia assessment with cognitive evaluation could serve as an early predictive marker for phenoconversion in clinical settings.

摘要本研究调查了被诊断为孤立性眼球快速运动睡眠行为障碍的患者中，无失张力的眼球快速运动睡眠与认知特征之间的关系，评估了横断面关联及其与纵向随访中表型转换的联系。参与者接受了视频多导睡眠监测、神经系统检查、神经心理学测试和结构化访谈，以确认是否患有孤立性眼球快速运动睡眠行为障碍。采用蒙特利尔方法对无失神的快速眼动睡眠进行人工评分，并根据肌电图的强直性和相位性活动将参与者分为高肌电图活动组和低肌电图活动组。横断面研究纳入了250名孤立性快速眼动睡眠行为障碍患者，结果显示，强直性肌电活动高的患者在构思练习回忆中的得分明显低于强直性肌电活动低的患者（p = 0.002）。在纵向研究中，对79名参与者（63名孤立的快速眼动睡眠行为障碍患者和16名表型转换患者）进行了至少5年的追踪调查，结果表明，强直性肌电活动高（几率比：6.14；95%置信区间：1.23-30.60；p = 0.027）和在路径制作测试A中成绩较低（几率比：0.23；95%置信区间：0.11-0.70；p = 0.007）与未来的表型转换有关。这些结果证实，在孤立的快速眼动睡眠行为障碍中，强直性肌电图活动与神经变性之间存在联系。将快速眼动睡眠无张力评估与认知评估相结合，可作为临床表型转换的早期预测指标。

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引用次数: 0

Parasomnias and sleep-related movement disorders induced by drugs in the adult population: a review about iatrogenic medication effects. 药物在成年人群中诱发的副惊厥和睡眠相关运动障碍：关于药物先天性影响的综述。

IF 3.4 3区医学 Q2 CLINICAL NEUROLOGY

Journal of Sleep Research

Pub Date : 2024-09-07 DOI: 10.1111/jsr.14306

Sylvain Dumont, Vanessa Bloch, Agnès Lillo-Lelouet, Christine Le Beller, Pierre A Geoffroy, Marc Veyrier

Parasomnias and sleep-related movement disorders (SRMD) are major causes of sleep disorders and may be drug induced. The objective of this study was to conduct a systematic review of the literature to examine the association between drug use and the occurrence of parasomnias and SRMD. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for reporting systematic reviews, we searched PubMed databases between January 2020 and June 2023. The searches retrieved 937 records, of which 174 publications were selected for full-text screening and 73 drugs were identified. The most common drug-induced parasomnias were nightmares and rapid eye movement (REM) sleep behaviour disorders and sleepwalking. In terms of drug-induced SRMD, restless legs syndrome, periodic limb movement disorders (PLMD), and sleep-related bruxism were most frequent. Medications that inhibit noradrenergic, serotonergic, or orexin transmission could induce REM sleep (e.g., nightmares). Regarding sleepwalking, dysregulation of serotoninergic neurone activity is implicated. Antipsychotics are mentioned, as well as medications involved in the gamma-aminobutyric acid (GABA) pathway. A mechanism of desensitisation-autoregulation of GABA receptors on serotoninergic neurones is a hypothesis. SRMD and PLMD could involve medications disrupting the dopamine pathway (e.g., antipsychotics or opioids). Opioids would act on mu receptors and increase dopamine release. The role of adenosine and iron is also hypothesised. Regarding bruxism, the hypotheses raised involve dysregulation of mesocortical pathway or a downregulation of nigrostriatal pathway, related to medications involving dopamine or serotonin. Parasomnias are rarely identified in drug product labels, likely due to the recent classification of their diagnoses. An analysis of pharmacovigilance data could be valuable to supplement existing literature data.

副惊厥和睡眠相关运动障碍（SRMD）是睡眠障碍的主要原因，也可能是药物诱发的。本研究的目的是对文献进行系统性回顾，研究药物使用与寄生虫症和 SRMD 发生之间的关联。根据《系统综述和元分析首选报告项目》（Preferred Reporting Items for Systematic Reviews and Meta-Analyses）的系统综述报告指南，我们在 2020 年 1 月至 2023 年 6 月期间检索了 PubMed 数据库。搜索共检索到 937 条记录，其中 174 篇出版物被选中进行全文筛选，并确定了 73 种药物。最常见的药物诱发的寄生虫是噩梦、快速眼动（REM）睡眠行为障碍和梦游。在药物诱发的SRMD方面，不宁腿综合征、周期性肢体运动障碍（PLMD）和睡眠相关磨牙症最为常见。抑制去甲肾上腺素能、血清素能或奥曲肽传导的药物可诱发快速眼动睡眠（如噩梦）。在梦游方面，血清素能神经元活动失调也与此有关。抗精神病药物以及涉及γ-氨基丁酸（GABA）途径的药物也被提及。血清素能神经元上的 GABA 受体的脱敏-自动调节机制是一种假设。SRMD 和 PLMD 可能涉及干扰多巴胺通路的药物（如抗精神病药物或阿片类药物）。阿片类药物会作用于μ受体，增加多巴胺的释放。此外，还假设腺苷和铁也能发挥作用。关于磨牙症，所提出的假设涉及中脑皮层通路的失调或黑质通路的失调，这与涉及多巴胺或血清素的药物有关。副交感神经亢进症很少在药品标签上标明，这可能是由于最近对其诊断进行了分类。对药物警戒数据的分析可能对补充现有文献数据很有价值。

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引用次数: 0

Objective and subjective measurement of sleep in people who use substances: Emerging evidence and recommendations from a systematic review. 对药物使用者睡眠情况的客观和主观测量：系统综述中的新证据和建议。

IF 3.4 3区医学 Q2 CLINICAL NEUROLOGY

Journal of Sleep Research

Pub Date : 2024-09-05 DOI: 10.1111/jsr.14330

Heather E Webber, Jessica C Badawi, Joy M Schmitz, Jin H Yoon, Douglas J Calvillo, Cabrina I Becker, Scott D Lane

People who use substances commonly experience sleep disruptions, affecting the regulation of physical and mental health, and presenting a significant barrier to treatment success. Sleep impairments are noted in all phases of substance use; however, differences between subjective versus objective methods used to measure sleep quality have been reported. While polysomnography is the gold-standard for sleep measurement, recent advances in actigraphy may help address the discordance between subjective and objective sleep reports. This systematic review examined emerging evidence (2016-present) for sleep impairment in people who use substances, with the twofold goal of: (1) identifying whether sleep outcomes vary across substance type (alcohol, nicotine, cannabis, cocaine, methamphetamine and opioids); and (2) contrasting results from subjective and objective measures. While some differences between subjective and objective sleep were noted, there was overwhelming evidence of clinically relevant sleep impairment in people who use alcohol, nicotine, cocaine, methamphetamine and opioids, with less consistent results for cannabis. Gaps in the literature are identified and future recommendations are presented, including utilization of common methodological frameworks, identification of mechanisms, and closer examination of sleep across stages of substance use and the interconnection between sleep and return to use.

使用药物的人通常会出现睡眠障碍，影响身心健康的调节，成为治疗成功的一大障碍。使用药物的各个阶段都会出现睡眠障碍；然而，据报道，用于测量睡眠质量的主观方法与客观方法之间存在差异。虽然多导睡眠图是睡眠测量的黄金标准，但最近在动图方面取得的进展可能有助于解决主观和客观睡眠报告之间不一致的问题。本系统综述研究了关于药物使用者睡眠障碍的新证据（2016 年至今），其双重目标是：（1）确定不同药物类型（酒精、尼古丁、大麻、可卡因、甲基苯丙胺和阿片类药物）的睡眠结果是否存在差异；（2）对比主观和客观测量结果。虽然注意到主观和客观睡眠之间存在一些差异，但有大量证据表明，使用酒精、尼古丁、可卡因、甲基苯丙胺和阿片类药物的人存在临床相关的睡眠障碍，而大麻的结果则不太一致。报告指出了文献中的不足之处，并提出了未来的建议，包括利用共同的方法框架、确定机制、更仔细地研究使用药物的各个阶段的睡眠情况以及睡眠与重新使用药物之间的相互联系。

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