Purpose: There is scarce evidence to support the effectiveness of faecal microbiota transplantation (FMT) in improving sleep among individuals with inflammatory bowel disease (IBD). Our study aimed to evaluate the effect of washed microbiota transplantation (WMT) (the new method of FMT) on the sleep of patients with IBD in short term. Patients and Methods: This prospective study was conducted as part of two interventional clinical trials (starting on February 2013 and expected to end on December 2025) and placed significant emphasis on evaluating sleep quality in patients with IBD. To measure subjective sleep, we used the Pittsburgh sleep quality index (PSQI). The primary endpoint was the PSQI score one month after WMT. Results: This stage study included 52 eligible patients evaluated by PSQI questionnaire who underwent WMT from January 2020 to March 2021 and 47 patients were enrolled for analysis. The age of the patients ranged from 13 to 60 years, with a mean of 33.4 years, and 57.4% (25/47) of the patients were male. The PSQI scores for all 47 patients one month after undergoing WMT were significantly lower (Cohen d = 0.59, p < 0.001) compared to the baseline. Moreover, baseline PSQI score was correlated with the difference value of the PSQI score before and after WMT (post-PSQI minus pre-PSQI) (r = 0.61, p < 0.05). Conclusion: The study suggests that WMT might be a helpful intervention for improving the sleep quality of patients with IBD, encouraging clinicians to consider its use in clinical practice for addressing poor sleep in IBD patients. Clinical Trial Registration: ClinicalTrials.gov; ID: NCT01793831, NCT01790061.
{"title":"Washed Microbiota Transplantation Improves the Sleep Quality in Patients with Inflammatory Bowel Disease","authors":"Qianqian Li, Yujie Liu, Zulun Zhang, Sheng Zhang, Xiao Ding, Faming Zhang","doi":"10.2147/nss.s460882","DOIUrl":"https://doi.org/10.2147/nss.s460882","url":null,"abstract":"<strong>Purpose:</strong> There is scarce evidence to support the effectiveness of faecal microbiota transplantation (FMT) in improving sleep among individuals with inflammatory bowel disease (IBD). Our study aimed to evaluate the effect of washed microbiota transplantation (WMT) (the new method of FMT) on the sleep of patients with IBD in short term.<br/><strong>Patients and Methods:</strong> This prospective study was conducted as part of two interventional clinical trials (starting on February 2013 and expected to end on December 2025) and placed significant emphasis on evaluating sleep quality in patients with IBD. To measure subjective sleep, we used the Pittsburgh sleep quality index (PSQI). The primary endpoint was the PSQI score one month after WMT.<br/><strong>Results:</strong> This stage study included 52 eligible patients evaluated by PSQI questionnaire who underwent WMT from January 2020 to March 2021 and 47 patients were enrolled for analysis. The age of the patients ranged from 13 to 60 years, with a mean of 33.4 years, and 57.4% (25/47) of the patients were male. The PSQI scores for all 47 patients one month after undergoing WMT were significantly lower (Cohen d = 0.59, p < 0.001) compared to the baseline. Moreover, baseline PSQI score was correlated with the difference value of the PSQI score before and after WMT (post-PSQI minus pre-PSQI) (r = 0.61, p < 0.05).<br/><strong>Conclusion:</strong> The study suggests that WMT might be a helpful intervention for improving the sleep quality of patients with IBD, encouraging clinicians to consider its use in clinical practice for addressing poor sleep in IBD patients.<br/><strong>Clinical Trial Registration:</strong> ClinicalTrials.gov; ID: NCT01793831, NCT01790061.<br/><br/><strong>Keywords:</strong> faecal microbiota transplantation, transendoscopic enteral tubing, sleep disorder, Crohn’s disease, ulcerative colitis, inflammatory bowel disease<br/>","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":"24 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141884631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jan Vagedes, Mohsen Sobh, Mohammad Oli Al Islam, Christian F Poets
Purpose: Clinical management decisions often rely on a patient’s SpO2 level and desaturation rate. Limitations include that measurements depend on the averaging time (AVT) used, which is particularly relevant to sleep medicine, but has yet received little attention. Methods: Cross-sectional review of studies reporting pulse oximeter saturation (SpO2) measurements published in 5 leading sleep medicine journals. All papers published between 2017 and 2023 reporting SpO2 measurements were screened regarding the AVT used. Results: Of 193 papers identified, 151 were included; of these, only 9 studies mentioned the AVT, 4 of these were published in one journal. The AVT ranged from zero (beat-to-beat-mode) to 10s, with 3s being used most often (33.3%), followed by 2s (22.2%). Conclusion: The AVT is only rarely mentioned in sleep medicine papers, despite its influence on sleep study results. Reported AVTs were heterogenous. Further research is warranted to set up guidelines for using or reporting the AVT.
Keywords: pulse oximetry, averaging time, oxygen saturation, desaturation, SpO2, sleep medicine
{"title":"Averaging Times for Pulse Oximeter Measurements – A Review of Manuscripts Published in the Top Five Sleep Medicine Journals","authors":"Jan Vagedes, Mohsen Sobh, Mohammad Oli Al Islam, Christian F Poets","doi":"10.2147/nss.s460231","DOIUrl":"https://doi.org/10.2147/nss.s460231","url":null,"abstract":"<strong>Purpose:</strong> Clinical management decisions often rely on a patient’s SpO<sub>2</sub> level and desaturation rate. Limitations include that measurements depend on the averaging time (AVT) used, which is particularly relevant to sleep medicine, but has yet received little attention.<br/><strong>Methods:</strong> Cross-sectional review of studies reporting pulse oximeter saturation (SpO<sub>2</sub>) measurements published in 5 leading sleep medicine journals. All papers published between 2017 and 2023 reporting SpO<sub>2</sub> measurements were screened regarding the AVT used.<br/><strong>Results:</strong> Of 193 papers identified, 151 were included; of these, only 9 studies mentioned the AVT, 4 of these were published in one journal. The AVT ranged from zero (beat-to-beat-mode) to 10s, with 3s being used most often (33.3%), followed by 2s (22.2%).<br/><strong>Conclusion:</strong> The AVT is only rarely mentioned in sleep medicine papers, despite its influence on sleep study results. Reported AVTs were heterogenous. Further research is warranted to set up guidelines for using or reporting the AVT.<br/><br/><strong>Keywords:</strong> pulse oximetry, averaging time, oxygen saturation, desaturation, SpO<sub>2</sub>, sleep medicine<br/>","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":"24 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141884634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: The burden of cardiometabolic diseases (CMDs), defined as stroke, coronary artery disease, and diabetes mellitus, continues to pose a global challenge. Sleep duration has been linked to cardiovascular health. However, there is a lack of focused investigations on CMDs in underdeveloped areas of China. Purpose: This study aimed to examine the relationship between sleep duration and CMDs among residents from southwest China. Patients and Methods: This large cross-sectional study screened data from the National Key Research and Development Program (2018YFC1311400). Based on sleep duration reported through a standardized questionnaire, encompassing the sleep patterns of the past five years, participants were classified into three groups: < 6, 6– 8, > 8 hours. Baseline characteristics were compared, and Poisson regression models were used to assess the relationship between sleep duration and CMDs. Subgroup analysis was conducted based on age and gender. Results: This study included 28,908 participants with an average age of 65.6 ± 10.0 years, of whom 57.6% were female. The overall prevalence of CMDs was 22.6%. After multivariate adjustments, the prevalence ratios (PR) (95% CI) for CMDs across the three groups (6– 8h, < 6h and > 8h) were: reference, 1.140 (1.068– 1.218), 1.060 (0.961– 1.169) (P for trend =0.003), respectively. The subgroup analysis revealed that among older females, a longer sleep duration (> 8h) was also associated with an increased prevalence risk of CMDs, with PR 1.169 (1.001– 1.365) (p=0.049). Conclusion: A shorter sleep duration (< 6 hours) was associated with an increased risk of CMDs in the general population, while a longer sleep duration (> 8 hours) also raised the prevalence risk among older females.
Keywords: cardiometabolic disease, sleep duration, Southwest China
{"title":"Associations Between Sleep Duration and Cardiometabolic Diseases Among Residents in Southwest China","authors":"Jinxi Li, Yiduo Lu, Xuyun Zhang, Gang Liu","doi":"10.2147/nss.s466283","DOIUrl":"https://doi.org/10.2147/nss.s466283","url":null,"abstract":"<strong>Introduction:</strong> The burden of cardiometabolic diseases (CMDs), defined as stroke, coronary artery disease, and diabetes mellitus, continues to pose a global challenge. Sleep duration has been linked to cardiovascular health. However, there is a lack of focused investigations on CMDs in underdeveloped areas of China.<br/><strong>Purpose:</strong> This study aimed to examine the relationship between sleep duration and CMDs among residents from southwest China.<br/><strong>Patients and Methods:</strong> This large cross-sectional study screened data from the National Key Research and Development Program (2018YFC1311400). Based on sleep duration reported through a standardized questionnaire, encompassing the sleep patterns of the past five years, participants were classified into three groups: < 6, 6– 8, > 8 hours. Baseline characteristics were compared, and Poisson regression models were used to assess the relationship between sleep duration and CMDs. Subgroup analysis was conducted based on age and gender.<br/><strong>Results:</strong> This study included 28,908 participants with an average age of 65.6 ± 10.0 years, of whom 57.6% were female. The overall prevalence of CMDs was 22.6%. After multivariate adjustments, the prevalence ratios (PR) (95% CI) for CMDs across the three groups (6– 8h, < 6h and > 8h) were: reference, 1.140 (1.068– 1.218), 1.060 (0.961– 1.169) (<em>P <sub>for trend</sub></em> =0.003), respectively. The subgroup analysis revealed that among older females, a longer sleep duration (> 8h) was also associated with an increased prevalence risk of CMDs, with PR 1.169 (1.001– 1.365) (<em>p</em>=0.049).<br/><strong>Conclusion:</strong> A shorter sleep duration (< 6 hours) was associated with an increased risk of CMDs in the general population, while a longer sleep duration (> 8 hours) also raised the prevalence risk among older females.<br/><br/><strong>Keywords:</strong> cardiometabolic disease, sleep duration, Southwest China<br/>","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":"25 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141872949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Letter for the article Sleep Habits and Disturbances Among Tunisian Adults: A Cross-Sectional Online Survey
突尼斯成年人的睡眠习惯和干扰》一文的来信：横断面在线调查
{"title":"Sleep Habits and Disturbances Among Tunisian Adults: A Cross-Sectional Online Survey [Letter]","authors":"Imran Rauf","doi":"10.2147/nss.s487326","DOIUrl":"https://doi.org/10.2147/nss.s487326","url":null,"abstract":"Letter for the article Sleep Habits and Disturbances Among Tunisian Adults: A Cross-Sectional Online Survey","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":"76 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141864077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sitong Feng, Ziyao Wu, Sisi Zheng, Linrui Dong, Hongxiao Jia, Yanzhe Ning
Objective: The thalamus plays a critical role in attentional maintenance. Previous studies have revealed the dysfunction of the thalamus in attention decline after acute sleep deprivation (SD). However, the functional connectivity (FC) between the thalamus subregions and cortical regions underlying attentional impairment after acute SD remains unclear. Here, we aimed to probe the relationship between attentional function and the altered thalamocortical FC after acute SD. Methods: In this study, 25 healthy participants with regular sleep conducted an attentional network test and received a resting-state fMRI scan before and after 24 hours of SD. Then, we analyzed the FC between the thalamus and cerebrum and relationships with attentional function in the enrolled subjects. Results: Our results showed that the participants showed a significantly lower alerting effect, a higher executive effect, and lower accuracy after acute SD. Compared to the rested wakefulness state, we observed decreased FCs between the “somatosensory” thalamic seed and left frontal pole, right frontal pole, left middle temporal gyrus (posterior division), and right middle temporal gyrus (posterior division). Furthermore, the reduced FC between the right middle temporal gyrus and “somatosensory” thalamic seed was negatively associated with the change in orienting effect of the participants. Conclusion: Our findings reveal that the disrupted FC between thalamus subregions and cortical regions may contribute to impaired attention after SD.
{"title":"Altered Functional Connectivity of the Thalamus Subregions Associated with Impaired Attention After Sleep Deprivation","authors":"Sitong Feng, Ziyao Wu, Sisi Zheng, Linrui Dong, Hongxiao Jia, Yanzhe Ning","doi":"10.2147/nss.s472323","DOIUrl":"https://doi.org/10.2147/nss.s472323","url":null,"abstract":"<strong>Objective:</strong> The thalamus plays a critical role in attentional maintenance. Previous studies have revealed the dysfunction of the thalamus in attention decline after acute sleep deprivation (SD). However, the functional connectivity (FC) between the thalamus subregions and cortical regions underlying attentional impairment after acute SD remains unclear. Here, we aimed to probe the relationship between attentional function and the altered thalamocortical FC after acute SD.<br/><strong>Methods:</strong> In this study, 25 healthy participants with regular sleep conducted an attentional network test and received a resting-state fMRI scan before and after 24 hours of SD. Then, we analyzed the FC between the thalamus and cerebrum and relationships with attentional function in the enrolled subjects.<br/><strong>Results:</strong> Our results showed that the participants showed a significantly lower alerting effect, a higher executive effect, and lower accuracy after acute SD. Compared to the rested wakefulness state, we observed decreased FCs between the “somatosensory” thalamic seed and left frontal pole, right frontal pole, left middle temporal gyrus (posterior division), and right middle temporal gyrus (posterior division). Furthermore, the reduced FC between the right middle temporal gyrus and “somatosensory” thalamic seed was negatively associated with the change in orienting effect of the participants.<br/><strong>Conclusion:</strong> Our findings reveal that the disrupted FC between thalamus subregions and cortical regions may contribute to impaired attention after SD.<br/><br/><strong>Keywords:</strong> sleep deprivation, fMRI, attention, thalamus, functional connectivity<br/>","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":"11 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141864078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Obstructive sleep apnea (OSA) patients commonly experience high rates of depression. This study aims to examine the oral microbiota characteristics of OSA and those with comorbid major depressive disorder (OSA+MDD) patients. Methods: Participants were enrolled from Aug 2022 to Apr 2023. Polysomnography, psychiatrist interviews, and scales were used to diagnose OSA and MDD. Oral samples were collected from participants by rubbing swabs on buccal mucosa, palate, and gums. Oral microbiota was analyzed via whole-genome metagenomics and bioinformatic analysis followed sequencing. Venous blood was drawn to detect plasma inflammatory factor levels. Results: The study enrolled 33 OSA patients, 28 OSA+MDD patients, and 28 healthy controls. Significant differences were found in 8 phyla, 229 genera, and 700 species of oral microbiota among the three groups. Prevotellaceae abundance in the OSA and OSA+MDD groups was significantly lower than that in healthy controls. Linear discriminant analysis effect size (LEfSe) analysis showed that Streptococcaceae and Actinobacteria were the characteristic oral microbiota of the OSA and OSA+MDD groups, respectively. KEGG analysis indicates 30 pathways were changed in the OSA and OSA+MDD groups compared with healthy controls, and 23 pathways were changed in the OSA group compared with the OSA+MDD group. Levels of IL-6 in the OSA+MDD group were significantly higher than in the healthy group, correlating positively with the abundance of Schaalia, Campylobacter, Fusobacterium, Alloprevotella, and Candidatus Nanosynbacter in the oral, as well as with Hamilton Anxiety Rating Scale and Hamilton Depression Rating Scale scores. Conclusion: Significant differences in oral microbiota populations and gene function were observed among the three groups. OSA patients were characterized by a decreased abundance of Prevotellaceae and an increased abundance of Streptococcaceae. OSA+MDD patients had an increased abundance of Actinobacteria. IL-6 might regulate the relationship between depression and the oral microbiota in OSA+MDD patients.
背景：阻塞性睡眠呼吸暂停（OSA）患者通常有较高的抑郁症发病率。本研究旨在检测 OSA 患者和合并重度抑郁症（OSA+MDD）患者的口腔微生物群特征：方法：从 2022 年 8 月至 2023 年 4 月招募参与者。采用多导睡眠图、精神科医生访谈和量表来诊断 OSA 和 MDD。用棉签擦拭参与者的口腔黏膜、上颚和牙龈，收集口腔样本。在测序后，通过全基因组元基因组学和生物信息分析对口腔微生物群进行分析。抽取静脉血检测血浆炎症因子水平：研究共纳入 33 名 OSA 患者、28 名 OSA+MDD 患者和 28 名健康对照组。结果发现，三组患者口腔微生物群的 8 个门、229 个属、700 个种存在显著差异。OSA组和OSA+MDD组的前胡科丰度明显低于健康对照组。线性判别分析效应大小（LEfSe）分析显示，链球菌属和放线菌属分别是OSA组和OSA+MDD组的特征性口腔微生物群。KEGG分析表明，与健康对照组相比，OSA组和OSA+MDD组有30条通路发生了变化，与OSA+MDD组相比，OSA组有23条通路发生了变化。OSA+MDD组的IL-6水平明显高于健康组，与口腔中的沙雷氏菌、弯曲杆菌、镰刀菌、异型伏特氏菌和纳米拟杆菌的丰度以及汉密尔顿焦虑评分量表和汉密尔顿抑郁评分量表的评分呈正相关：结论：三组患者的口腔微生物群和基因功能存在显著差异。OSA 患者的特点是普雷沃特氏菌（Prevotellaceae）数量减少，链球菌（Streptococcaceae）数量增加。OSA+MDD患者的放线菌数量增加。IL-6可能会调节OSA+MDD患者抑郁与口腔微生物群之间的关系。
{"title":"Whole-Genome Metagenomic Analysis of the Oral Microbiota in Patients with Obstructive Sleep Apnea Comorbid with Major Depressive Disorder","authors":"Jing Ye, Yunhui Lv, Hui Xie, Kun Lian, Xiufeng Xu","doi":"10.2147/nss.s474052","DOIUrl":"https://doi.org/10.2147/nss.s474052","url":null,"abstract":"<strong>Background:</strong> Obstructive sleep apnea (OSA) patients commonly experience high rates of depression. This study aims to examine the oral microbiota characteristics of OSA and those with comorbid major depressive disorder (OSA+MDD) patients.<br/><strong>Methods:</strong> Participants were enrolled from Aug 2022 to Apr 2023. Polysomnography, psychiatrist interviews, and scales were used to diagnose OSA and MDD. Oral samples were collected from participants by rubbing swabs on buccal mucosa, palate, and gums. Oral microbiota was analyzed via whole-genome metagenomics and bioinformatic analysis followed sequencing. Venous blood was drawn to detect plasma inflammatory factor levels.<br/><strong>Results:</strong> The study enrolled 33 OSA patients, 28 OSA+MDD patients, and 28 healthy controls. Significant differences were found in 8 phyla, 229 genera, and 700 species of oral microbiota among the three groups. Prevotellaceae abundance in the OSA and OSA+MDD groups was significantly lower than that in healthy controls. Linear discriminant analysis effect size (LEfSe) analysis showed that Streptococcaceae and Actinobacteria were the characteristic oral microbiota of the OSA and OSA+MDD groups, respectively. KEGG analysis indicates 30 pathways were changed in the OSA and OSA+MDD groups compared with healthy controls, and 23 pathways were changed in the OSA group compared with the OSA+MDD group. Levels of IL-6 in the OSA+MDD group were significantly higher than in the healthy group, correlating positively with the abundance of Schaalia, Campylobacter, Fusobacterium, Alloprevotella, and Candidatus Nanosynbacter in the oral, as well as with Hamilton Anxiety Rating Scale and Hamilton Depression Rating Scale scores.<br/><strong>Conclusion:</strong> Significant differences in oral microbiota populations and gene function were observed among the three groups. OSA patients were characterized by a decreased abundance of Prevotellaceae and an increased abundance of Streptococcaceae. OSA+MDD patients had an increased abundance of Actinobacteria. IL-6 might regulate the relationship between depression and the oral microbiota in OSA+MDD patients.<br/><br/>","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":"49 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141864079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Purpose: Wearable or non-contact, non-intrusive devices present a practical alternative to traditional polysomnography (PSG) for daily assessment of sleep quality. Physiological signals have been known to be nonlinear and nonstationary as the body adapts to states of rest or activity. By integrating more sophisticated nonlinear methodologies, the accuracy of sleep stage identification using such devices can be improved. This advancement enables individuals to monitor and adjust their sleep patterns more effectively without visiting sleep clinics. Patients and Methods: Six participants slept for three cycles of at least three hours each, wearing PSG as a reference, along with an Apple Watch, an actigraphy device, and a ballistocardiography (BCG) bed sensor. The physiological signals were processed with nonlinear methods and trained with a long short-term memory (LSTM) model to classify sleep stages. Nonlinear methods, such as return maps with advanced techniques to analyze the shape and asymmetry in physiological signals, were used to relate these signals to the autonomic nervous system (ANS). The changing dynamics of cardiac signals in restful or active states, regulated by the ANS, were associated with sleep stages and quality, which were measurable. Results: Approximately 73% agreement was obtained by comparing the combination of the BCG and Apple Watch signals against a PSG reference system to classify rapid eye movement (REM) and non-REM sleep stages. Conclusion: Utilizing nonlinear methods to evaluate cardiac dynamics showed an improved sleep quality detection with the non-intrusive devices in this study. A system of non-intrusive devices can provide a comprehensive outlook on health by regularly measuring sleeping patterns and quality over time, offering a relatively accessible method for participants. Additionally, a non-intrusive system can be integrated into a user’s or clinic’s bedroom environment to measure and evaluate sleep quality without negatively impacting sleep. Devices placed around the bedroom could measure user vitals over longer periods with minimal interaction from the user, representing their natural sleeping trends for more accurate health and sleep disorder diagnosis.
目的：可穿戴或非接触、非侵入式设备是传统多导睡眠图（PSG）的实用替代品，可用于日常睡眠质量评估。众所周知，生理信号在人体适应休息或活动状态时是非线性和非稳态的。通过整合更复杂的非线性方法，可以提高使用此类设备识别睡眠阶段的准确性。这一进步能让个人在不去睡眠诊所的情况下更有效地监测和调整自己的睡眠模式：六名参与者在佩戴 PSG 作为参考的同时，还佩戴了 Apple Watch、动图设备和球心动图（BCG）床传感器，进行了三个周期的睡眠，每个周期至少三小时。生理信号采用非线性方法进行处理，并使用长短期记忆（LSTM）模型进行训练，以对睡眠阶段进行分类。非线性方法，如采用先进技术分析生理信号的形状和不对称的返回图，用于将这些信号与自律神经系统（ANS）联系起来。在自律神经系统的调节下，静息或活跃状态下心脏信号的动态变化与睡眠阶段和质量相关联，而睡眠阶段和质量是可以测量的：通过将 BCG 和 Apple Watch 信号组合与 PSG 参考系统进行比较，得出了约 73% 的一致性，从而对快速眼动（REM）和非快速眼动睡眠阶段进行了分类：利用非线性方法评估心脏动力学显示，本研究中的非侵入式设备提高了睡眠质量检测的效率。非侵入式设备系统可通过定期测量睡眠模式和睡眠质量，为参与者提供一种相对容易获得的方法，从而提供全面的健康展望。此外，非侵入式系统可以集成到用户或诊所的卧室环境中，在不对睡眠产生负面影响的情况下测量和评估睡眠质量。放置在卧室周围的设备可以在较长时间内测量用户的生命体征，而用户只需极少的互动，就能代表他们的自然睡眠趋势，从而更准确地诊断健康和睡眠障碍。
{"title":"Nonlinear Heart Rate Variability Analysis for Sleep Stage Classification Using Integration of Ballistocardiogram and Apple Watch","authors":"Dominic Jaworski, Edward J Park","doi":"10.2147/nss.s464944","DOIUrl":"https://doi.org/10.2147/nss.s464944","url":null,"abstract":"<strong>Purpose:</strong> Wearable or non-contact, non-intrusive devices present a practical alternative to traditional polysomnography (PSG) for daily assessment of sleep quality. Physiological signals have been known to be nonlinear and nonstationary as the body adapts to states of rest or activity. By integrating more sophisticated nonlinear methodologies, the accuracy of sleep stage identification using such devices can be improved. This advancement enables individuals to monitor and adjust their sleep patterns more effectively without visiting sleep clinics.<br/><strong>Patients and Methods:</strong> Six participants slept for three cycles of at least three hours each, wearing PSG as a reference, along with an Apple Watch, an actigraphy device, and a ballistocardiography (BCG) bed sensor. The physiological signals were processed with nonlinear methods and trained with a long short-term memory (LSTM) model to classify sleep stages. Nonlinear methods, such as return maps with advanced techniques to analyze the shape and asymmetry in physiological signals, were used to relate these signals to the autonomic nervous system (ANS). The changing dynamics of cardiac signals in restful or active states, regulated by the ANS, were associated with sleep stages and quality, which were measurable.<br/><strong>Results:</strong> Approximately 73% agreement was obtained by comparing the combination of the BCG and Apple Watch signals against a PSG reference system to classify rapid eye movement (REM) and non-REM sleep stages.<br/><strong>Conclusion:</strong> Utilizing nonlinear methods to evaluate cardiac dynamics showed an improved sleep quality detection with the non-intrusive devices in this study. A system of non-intrusive devices can provide a comprehensive outlook on health by regularly measuring sleeping patterns and quality over time, offering a relatively accessible method for participants. Additionally, a non-intrusive system can be integrated into a user’s or clinic’s bedroom environment to measure and evaluate sleep quality without negatively impacting sleep. Devices placed around the bedroom could measure user vitals over longer periods with minimal interaction from the user, representing their natural sleeping trends for more accurate health and sleep disorder diagnosis.<br/><br/><strong>Keywords:</strong> ballistocardiogram, wearable, heart rate variability, nonstationary signals<br/>","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":"28 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141776743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Prior research based on observations has furnished evidence that supports a connection between daytime napping and the prevalence of non-alcoholic fatty liver disease (NAFLD). Nevertheless, the question of whether this correlation is indicative of a causal link has not been definitively answered. Methods: We used meta-analysis and Mendelian randomization (MR) to synthesize genetic and observational data. A two-sample MR analysis was conducted, leveraging 105 single-nucleotide polymorphisms (SNPs) known to be associated with daytime napping patterns. Additionally, summary-level data pertaining to NAFLD outcomes were acquired from the comprehensive UK Biobank study. Network meta-analyses were employed to investigate the relationship between excessive daytime napping and NAFLD, while subgroup was also performed. Results: Significant associations were observed between daytime napping and NAFLD. The systematic review/meta-analysis uncovered a heightened risk of NAFLD development among individuals who engaged in daytime naps exceeding 30 minutes, when compared to those who did not nap(odds ratio [OR] = 1.32, 95% confidence interval [CI]: 1.05 to 1.66). Furthermore, MR analysis indicated that a genetic propensity towards longer daytime napping was significantly linked to an increased likelihood of NAFLD (OR = 2.26, 95% CI: 1.38 to 3.73). Conclusion: Daytime napping has been found to be causally related to a higher risk of NAFLD. Furthermore, across all participants, napping for an average duration over 30 minutes was linked to an elevated likelihood of NAFLD.
{"title":"Excessive Daytime Napping Increases the Risk of Non-Alcoholic Fatty Liver Disease: A Meta-Analysis and a Mendelian Randomization Study","authors":"Xiuqi Qiao, Xiaoxia Wang, Lixin Guo, Qi Pan","doi":"10.2147/nss.s468444","DOIUrl":"https://doi.org/10.2147/nss.s468444","url":null,"abstract":"<strong>Background:</strong> Prior research based on observations has furnished evidence that supports a connection between daytime napping and the prevalence of non-alcoholic fatty liver disease (NAFLD). Nevertheless, the question of whether this correlation is indicative of a causal link has not been definitively answered.<br/><strong>Methods:</strong> We used meta-analysis and Mendelian randomization (MR) to synthesize genetic and observational data. A two-sample MR analysis was conducted, leveraging 105 single-nucleotide polymorphisms (SNPs) known to be associated with daytime napping patterns. Additionally, summary-level data pertaining to NAFLD outcomes were acquired from the comprehensive UK Biobank study. Network meta-analyses were employed to investigate the relationship between excessive daytime napping and NAFLD, while subgroup was also performed.<br/><strong>Results:</strong> Significant associations were observed between daytime napping and NAFLD. The systematic review/meta-analysis uncovered a heightened risk of NAFLD development among individuals who engaged in daytime naps exceeding 30 minutes, when compared to those who did not nap(odds ratio [OR] = 1.32, 95% confidence interval [CI]: 1.05 to 1.66). Furthermore, MR analysis indicated that a genetic propensity towards longer daytime napping was significantly linked to an increased likelihood of NAFLD (OR = 2.26, 95% CI: 1.38 to 3.73).<br/><strong>Conclusion:</strong> Daytime napping has been found to be causally related to a higher risk of NAFLD. Furthermore, across all participants, napping for an average duration over 30 minutes was linked to an elevated likelihood of NAFLD.<br/><br/>","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":"48 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141776788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: Poor sleep among young adults is prevalent, yet the mediating variables are largely understudied, and there is limited relevant work utilizing objective sleep measures. The present study investigated the mediating effects of perceived stress and rumination in the relationship between trait mindfulness and subjective and objective sleep quality in young adults. Methods: A total of 170 healthy adults (aged 18– 37, M = 20.8, SD = 2.9) self-reported on trait mindfulness, perceived stress, and rumination. The primary (N = 140) and secondary (N = 30) samples both completed the Pittsburgh Sleep Quality Index (PSQI) to assess subjective sleep quality. The secondary sample (N = 30) additionally provided sleep diaries, as well as wrist-worn actigraphy data for assessing objective sleep quality. A mediation analysis was conducted to assess the effect of trait mindfulness on sleep quality with perceived stress and rumination as mediators. Results: Trait mindfulness was positively associated with better subjective sleep quality; this was fully mediated by perceived stress, b = − 0.08, 95% CI [− .12, − 0.06]. Rumination was negatively associated with subjective sleep quality but did not mediate the relationship between trait mindfulness and sleep quality, b = − 0.01, 95% CI [− .03, 0.02]. Only trait mindfulness was correlated with diary-based sleep ratings, and none of the measures were associated with actigraphy-based sleep quality. Conclusion: This study indicates that perceived stress is an important mediator in the relationship between trait mindfulness and subjective sleep quality among young adults, rather than rumination. These findings have implications for mindfulness-based therapeutic approaches to address the high prevalence of sleep disorders among young adults, adding mechanistic detail to the literature.
{"title":"Perceived Stress, but Not Rumination, Mediates the Relationship Between Trait Mindfulness and Sleep Quality in Young Adults","authors":"Jaimee K Miller, Simon L Evans","doi":"10.2147/nss.s447469","DOIUrl":"https://doi.org/10.2147/nss.s447469","url":null,"abstract":"<strong>Objective:</strong> Poor sleep among young adults is prevalent, yet the mediating variables are largely understudied, and there is limited relevant work utilizing objective sleep measures. The present study investigated the mediating effects of perceived stress and rumination in the relationship between trait mindfulness and subjective and objective sleep quality in young adults.<br/><strong>Methods:</strong> A total of 170 healthy adults (aged 18– 37, <em>M</em> = 20.8, <em>SD</em> = 2.9) self-reported on trait mindfulness, perceived stress, and rumination. The primary (<em>N</em> = 140) and secondary (<em>N</em> = 30) samples both completed the Pittsburgh Sleep Quality Index (PSQI) to assess subjective sleep quality. The secondary sample (<em>N</em> = 30) additionally provided sleep diaries, as well as wrist-worn actigraphy data for assessing objective sleep quality. A mediation analysis was conducted to assess the effect of trait mindfulness on sleep quality with perceived stress and rumination as mediators.<br/><strong>Results:</strong> Trait mindfulness was positively associated with better subjective sleep quality; this was fully mediated by perceived stress, <em>b</em> = − 0.08, 95% CI [− .12, − 0.06]. Rumination was negatively associated with subjective sleep quality but did not mediate the relationship between trait mindfulness and sleep quality, <em>b</em> = − 0.01, 95% CI [− .03, 0.02]. Only trait mindfulness was correlated with diary-based sleep ratings, and none of the measures were associated with actigraphy-based sleep quality.<br/><strong>Conclusion:</strong> This study indicates that perceived stress is an important mediator in the relationship between trait mindfulness and subjective sleep quality among young adults, rather than rumination. These findings have implications for mindfulness-based therapeutic approaches to address the high prevalence of sleep disorders among young adults, adding mechanistic detail to the literature.<br/><br/><strong>Keywords:</strong> mindfulness, perceived stress, rumination, sleep<br/>","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":"77 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141776789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: This study was conducted to investigate the bidirectional causal relationship between obstructive sleep apnea (OSA) and temporomandibular disorders (TMD). Methods: Using an online pooled dataset of genome-wide association studies (GWAS), a two-sample bi-directional Mendelian randomization (MR) method was implemented. Inverse variance weighting was used as the primary analyses approach, and other methods of MR Egger, weighted median method, MR-Egger, Simple mode, and Weighted mode analysis were conducted as supplements to evaluate the causal relationship between OSA and TMD with odds ratios (OR) and 95% confidence interval (CI). Furthermore, the Cochran Q, MR-Egger, and MR-PRESSO approaches were used to perform the heterogeneity test and multiple validity. Results: The general results of the forward MR analysis indicated that OSA had a significant causal influence on TMD (OR=1.241, 95% CI: 1.009– 1.526, P=0.041), but no significant correlation was observed in the reverse MR analysis (IVW: OR=0.975, 95% CI=0.918– 1.036, P=0.411). Conclusion: In summary, our research demonstrated a hereditary causative relationship between OSA and TMD, indicating that appropriate intervention is required for both prevention and treatment of TMD.
{"title":"Causal Relationship Between Obstructive Sleep Apnea and Temporomandibular Disorders: A Bidirectional Mendelian Randomization Analysis","authors":"Yu-Pei Wang, Hui-Xia Wei, Yuan-Yuan Hu, Yu-Ming Niu","doi":"10.2147/nss.s476277","DOIUrl":"https://doi.org/10.2147/nss.s476277","url":null,"abstract":"<strong>Objective:</strong> This study was conducted to investigate the bidirectional causal relationship between obstructive sleep apnea (OSA) and temporomandibular disorders (TMD).<br/><strong>Methods:</strong> Using an online pooled dataset of genome-wide association studies (GWAS), a two-sample bi-directional Mendelian randomization (MR) method was implemented. Inverse variance weighting was used as the primary analyses approach, and other methods of MR Egger, weighted median method, MR-Egger, Simple mode, and Weighted mode analysis were conducted as supplements to evaluate the causal relationship between OSA and TMD with odds ratios (OR) and 95% confidence interval (CI). Furthermore, the Cochran Q, MR-Egger, and MR-PRESSO approaches were used to perform the heterogeneity test and multiple validity.<br/><strong>Results:</strong> The general results of the forward MR analysis indicated that OSA had a significant causal influence on TMD (OR=1.241, 95% CI: 1.009– 1.526, P=0.041), but no significant correlation was observed in the reverse MR analysis (IVW: OR=0.975, 95% CI=0.918– 1.036, P=0.411).<br/><strong>Conclusion:</strong> In summary, our research demonstrated a hereditary causative relationship between OSA and TMD, indicating that appropriate intervention is required for both prevention and treatment of TMD.<br/><br/><strong>Keywords:</strong> Mendelian randomization analysis, obstructive sleep apnea, temporomandibular disorders<br/>","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":"39 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141754180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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