Nature and Science of Sleep最新文献

Purpose: The psychomotor vigilance task (PVT) is one of the main methods to measure sustained vigilance/attention in sleep research. Vigilance is the main factor affecting daytime function in patients with narcolepsy type 1 (NT1). We aimed to quantify the negative effects of sleep-wake disorders on vigilance and investigate potential neural mechanisms.

Patients and methods: We compared data from 42 patients and 31 healthy controls, including sociodemographics, nighttime sleep quality (Pittsburgh Sleep Quality Index, PSQI), sleepiness (Epworth Sleepiness Scale, ESS), cognitive abilities (Montreal Cognitive Assessment, MoCA), emotional control (Barratt Impulsiveness Scale-11, BIS-11), depressive symptoms (Patient Health Questionnaire-9, PHQ-9), and PVT performance. PVT outcomes analyzed included number of lapses, reaction time (RT), variability in RT, and the slowest and fastest 10% of RTs. All patients were diagnosed with NT1 based on The International Classification of Sleep Disorders-Third Edition.

Results: Patients with NT1 had a significantly higher body mass index and longer duration of education than healthy controls. The patients also had a greater tendency for daytime sleepiness and poorer nighttime sleep quality, higher depression and impulsiveness scores, and more severe cognitive dysfunction. PVT performance was better in the healthy controls than in patients with NT1. We also noticed that emotional changes and the proportion of rapid eye movement sleep at night are related to PVT performance.

Conclusion: More severe sleepiness and an increased emotional burden could underlie the arousal and vigilance deficits seen in patients with NT1. We speculate that impaired vigilance in patients with NT1 is associated with abnormal brain function caused by a resource allocation imbalance related to hypothalamic orexin neuron damage, sleep inertia may also have a slight impact on this. Future studies should delve into this topic more deeply.

Objective: To investigate how attention is affected in children with obstructive sleep apnea (OSA) using the attention network test (ANT) combined with event-related potential (ERP) and time-frequency analysis.

Methods: Eighty-seven children aged 6-11 years with symptoms of snoring or mouth breathing during sleep were recruited from the Sleep Center of Beijing Children's Hospital from May to July, 2023. All participants completed the Mini-mental State Examination and Attention Deficit Hyperactivity Disorder rating scale. We acquired 32-lead electroencephalography (EEG) data while participants performed the ANT, followed by Polysomnography.

Results: Of the 87 children, 21 had no OSA, 49 had mild OSA, and 17 had moderate to severe (MS) OSA. Each group had similar questionnaire scores, similar response time and accuracy for the different ANT conditions. There are alterations in the processing of three separate components of the attentional network in children with OSA. The amplitude of the N3 component at the F_Z electrode in the MS OSA group was lower than that of the non-OSA and mild OSA groups (all P<0.05). In the executi control network phase, the energy of alpha band was higher in the MS OSA group than in the mild OSA group (Z=-2.624, P=0.026). The mean amplitude of the N3 component at the F_Z electrode was correlated with the obstructive apnea-hypopnea index (OAHI) (r=0.232, P=0.038).

Conclusion: Attention impairment was observed as a reduced N3 in the frontal area in the MS OSA group, which was correlated with the OAHI. However, questionnaire and behavioral performance did not differ significantly between groups. These findings suggest that the N3 amplitude is a sensitive neuroelectrophysiological marker of OSA-related cognitive impairment.

Background: Dexmedetomidine has been reported to improve postoperative sleep quality. However, the underlying mechanism remains unclear. This study aimed to investigate the effect of intraoperative dexmedetomidine infusion on postoperative sleep quality and changes in melatonin secretion in older patients undergoing elective thoracoscopic lung surgery.

Methods: A total of 126 older patients were randomly divided into two groups: dexmedetomidine group (Group D), which received continuous dexmedetomidine infusion at 0.3-0.5 µg/(kg·h) combined with propofol during surgery, and propofol group (Group P), which received propofol alone. The primary outcome was the postoperative sleep quality on the first postoperative night, assessed by the Richards-Campbell Sleep Questionnaire (RCSQ). Secondary outcomes included sleep quality scores on the second and third postoperative nights, melatonin concentrations postoperatively, and the incidence of delirium on the first and seventh postoperative days (discharge day).

Results: On the first postoperative night, Group D had a higher sleep quality score compared to Group P (57±11.4 vs 53±10.3; [95% CI, 1.1 to 8.7];P = 0.012), with no difference between the groups on the second and third postoperative nights. There was no statistically significant difference in the preoperative and postoperative night 3 urine 6-SMT concentrations between the two groups (P > 0.05); however, Group D had significantly higher urine 6-SMT concentrations on postoperative nights 1 and 2 compared to Group P (27 (24, 30) vs 21 (17, 24); [95% CI, -8.56 to -4.73]; P = 0.000. 28 (25, 30) vs 26 (21, 27); [95% CI, -4.37 to -1.65]; P = 0.000). There was no significant difference in the incidence of postoperative delirium between the two groups (P=0.65).

Conclusion: Continuous intraoperative infusion of dexmedetomidine can effectively improve sleep quality during the first postoperative night by promoting melatonin secretion over the first two postoperative nights.

Purpose: To investigate the effect of continuous erector spinae plane block (ESPB) on postoperative sleep in patients undergoing thoracoscopic lung lobe resection surgery.

Patients and methods: Eighty-six patients were randomly assigned into two groups: ESPB group (Group E) or control group (Group P). Group E received ESPB before induction, followed by continuous ESPB analgesia, while Group P received postoperative intravenous controlled analgesia. The Pittsburgh Sleep Quality Index (PSQI) questionnaire was used to assess postoperative sleep disturbance (PSD) on the postoperative day 3 (POD3). The St. Mary's Hospital Sleep Questionnaire (SMH) evaluated sleep quality on the day of surgery and postoperative day 1 (POD1) and postoperative day 2 (POD2). The Identity Consequence Fatigue Scale-10 (ICFS-10) was utilized to evaluate postoperative fatigue status. Numeric Rating Scale (NRS) scores at resting and coughing were recorded at extubation, 6 h, 24 h, 48 h, 72 h after surgery. Consumption of propofol, remifentanil, and remedial analgesics (bucinazine), hospital duration, occurrence of postoperative adverse reactions were documented. Interleukin-6 (IL-6) and interleukin-10 (IL-10) serum levels were measured before surgery, 12 h, 24 h, 48 h after surgery.

Results: The incidence of PSD in group E on POD3 was significantly lower than group P (75% vs 25%). Patients in group E had higher SMH scores than group P on the day of surgery and POD2. Compared with group P, the NRS scores of resting and coughing at all time points, remifentanil and bucinazine consumption, postoperative ICFS-10 scores, the incidence of nausea and vomiting, IL-6 serum levels in group E were significantly decreased. The IL-10 serum levels in group E were significantly higher than those in group P.

Conclusion: The continuous ESPB can improve postoperative sleep quality, alleviate pain, fatigue and inflammation, and reduce the incidence of postoperative nausea and vomiting.

Purpose: Later sleep timing is a key determinant of reduced sleep duration and quality in adolescents and is associated with negative mental and physical outcomes. However, little is known about adolescents' views on late bedtime. The study's purpose is to explore adolescents' perspectives on why they go to sleep late during school nights and what would help them to go to bed earlier.

Patients and methods: We conducted online semi-structured interviews with 24 adolescents aged 14-17 years as a part of the international HBSC (Health Behaviour in School-aged Children) study. The data were collected via individual and group interviews and analyzed using a combination of consensual qualitative research methodology and thematic analysis.

Results: School demands and leisure time activities, particularly online socialization with peers, have been identified as one of the main themes related to why adolescents go to sleep late. Adolescents reported difficulties managing these competing activities during the day after school, often postponing them until late at night and prioritizing them to sleep. Adolescents also mentioned bedtime distress as a barrier to falling asleep. However, some adolescents did not perceive late bedtime as a problem, but rather as a habit and personal choice. They reported that better time management, less homework, engagement in physical activity, parent-set bedtime, and less time spent online in the evening would help them to go to bed earlier.

Conclusion: Our findings suggest that interventions to improve sleep timing in adolescents should focus on reducing school pressure, building supportive social networks; strengthening adolescents' self-regulation skills; and enhancing parental involvement in establishing sleep and daily routines for their adolescents.

Purpose: Despite recent findings suggesting an altered gut microbiota in those suffering from insomnia disorder (ID), research into the gut microbiota, oral microbiota, serum metabolites, and their interactions in patients with ID is sparse.

Patients and methods: We collected a total of 114 fecal samples, 133 oral cavity samples and 20 serum samples to characterize the gut microbiota, oral microbiota and serum metabolites in a cohort of 76 ID patients (IDs) and 59 well-matched healthy controls (HCs). We assessed the microbiota as potentially biomarkers for ID for ID by 16S rDNA sequencing and elucidated the interactions involving gut microbiota, oral microbiota and serum metabolites in ID in conjunction with untargeted metabolomics.

Results: Gut and oral microbiota of IDs were dysbiotic. Gut and oral microbial biomarkers could be used to differentiate IDs from HCs. Eleven significantly altered serum metabolites, including adenosine, phenol, and phenol sulfate, differed significantly between groups. In multi-omics analyses, adenosine showed a positive correlation with genus_Lachnospira (p=0.029) and total sleep time (p=0.016). Additionally, phenol and phenol sulphate had a negative correlation with genus_Coprococcus (p=0.0059; p=0.0059) and a positive correlation with Pittsburgh Sleep Quality Index (p=0.006; p=0.006) and Insomnia Severity Index (p=0.021; p=0.021).

Conclusion: Microbiota and serum metabolite changes in IDs are strongly correlated with clinical parameters, implying mechanistic links between altered bacteria, serum metabolites and ID. This study offers novel perspective into the interaction among gut microbiota, oral microbiota, and serum metabolites for ID.

Objective: The main purpose of this study is to evaluate the changes in sleep quality among patients with cirrhotic cardiomyopathy (CCM).

Methods: The study included liver cirrhosis patients aged 18-75 from Northern Jiangsu People's Hospital Affiliated to Yangzhou University and collected their clinical examination results to assess the clinical characteristics and related risk factors of patients with CCM.

Results: The study found that the onset of CCM was not related to the etiology of inducing cirrhosis. Pittsburgh Sleep Quality Index (PSQI) score (odds ratio (OR) = 13.476, 95% confidence interval (CI) = 1.514-119.923, P = 0.020), absolute GLS (OR = 0.328, 95% CI = 0.210-0.510, P < 0.001), and N-terminal pro-B-type natriuretic peptide (NT-proBNP) (OR = 1.050, 95% CI = 1.025-1.076, P < 0.001) were identified as independent risk factors for inducing CCM.

Conclusion: In patients with CCM, a decrease in sleep quality often occurs. When cirrhotic patients also have poor sleep quality, along with a decrease in absolute Global Left Ventricular Strain (GLS) levels and an increase in NT-proBNP levels, these factors may pose a higher risk for CCM development. However, further validation of these research findings is required in larger sample sizes.

Obstructive sleep apnea (OSA) has been reported to influence the ocular surface and may lead to dry eye disease (DED). Continuous positive airway pressure (CPAP) is the first-line conservative treatment for OSA. However, CPAP might also have mask-related side effects that could deteriorate DED simultaneously. This study investigated the impact of OSA on DED (Aim 1), and CPAP on DED (Aim 2). Five databases were searched for articles published up to May, 2024. OSA severity, CPAP usage, and DED parameters, including tear breakup time (TBUT), Schirmer test, Ocular Surface Disease Index (OSDI), and Corneal Fluorescence Staining Score (CFS), were analyzed. For Aim 1, the random-effects model was used for meta-analysis, and the leave-one-out method was used for sensitivity analysis. For Aim 2, a narrative synthesis with critical appraisal of the literature was performed. Eleven studies with 1,526 patients for Aim 1 and three studies with 180 patients for Aim 2 were included. For Aim 1, OSA patients had poorer dry eye profiles of TBUT, Schirmer test, and OSDI when compared to non-OSA patients. For Aim 2, it seemed that those wearing CPAP for less than half a year did not have enough improvement in dry eye status. Instead, those wearing CPAP for at least a year reached greater therapeutic effects for OSA and DED. We concluded that OSA patients may suffer from poorer dry eye condition compared to non-OSA patients. Besides, wearing CPAP for long enough duration (at least 1 year) seemed to have better improvement in DED.

Purpose: The purpose of this study was to look into the relationship between pre-sleep arousal state, sleep reactivity, and serum levels of neuroendocrine hormones (cortisol, copeptin, and corticotropin-releasing hormone) in patients with chronic insomnia disorders (CID), and whether the effects of sleep reactivity and pre-sleep arousal on insomnia are related to the levels of these neuroendocrine hormones.

Patients and methods: This study included 61 CID patients and 27 healthy controls (HC) whose base data were matched to those of the CID patients. The Pittsburgh Sleep Quality Index(PSQI), Pre-Sleep Arousal Scale (PSAS), and the Ford Insomnia Response to Stress Test (FIRST) were used to evaluate the participants' sleep, stress, and neuropsychological function. We measured the participants' serum concentration levels of cortisol, copeptin, and corticotropin-releasing hormone (CRH), using quantitative sandwich enzyme-linked immunosorbent assays.

Results: The CID group had significantly greater serum levels of copeptin, CRH, and cortisol, as well as higher FIRST and PSAS scores than the HC group. The partial correlation analysis revealed a substantial and positive association among cortisol, CRH, copeptin PSQI, PSAS, and FIRST after adjusting for sex, age, depression, and cognition. Principal component analysis showed that PSQI, FIRST, and PSAS, as well as cortisol, CRH, and copeptin, were all loaded on factor 1.

Conclusion: Patients with CID showed increased sleep reactivity and pre-sleep arousal, which correlated with serum levels of cortisol, copeptin, and CRH. Changes in neuroendocrine hormone levels may influence how pre-sleep arousal and sleep reactivity affect the development of insomnia.