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Resting-State EEG Microstates Dynamics Associated with Interindividual Vulnerability to Sleep Deprivation.
IF 3 2区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-12-05 eCollection Date: 2024-01-01 DOI: 10.2147/NSS.S485412
Zehui Liu, Tian Xie, Ning Ma

Purpose: Sleep deprivation can induce severe deficits in vigilant maintenance and alternation in large-scale networks. However, differences in the dynamic brain networks after sleep deprivation across individuals have rarely been investigated. In the present study, we used EEG microstate analysis to investigate the effects of sleep deprivation and how it differentially affects resting-state brain activity in different individuals.

Participants and methods: A total of 44 healthy adults participated in a within-participant design study involving baseline sleep and 24-hour sleep deprivation, with resting-state EEG recorded during wakefulness. The psychomotor vigilance task (PVT) was used to measure vigilant attention. Participants were median split as vulnerable or resilient according to their changes in the number of lapses between the baseline sleep and sleep deprivation conditions.

Results: Sleep deprivation caused decreases in microstates A, B, and D, and increases in microstate C. We also found increased transition probabilities of microstates C and D between each other, lower transition probabilities from microstates C and D to microstate B, and higher transition probabilities from microstates A and B to microstate C. Sleep-deprived vulnerable individuals showed decreased occurrence of microstate B and transition probability from microstate C to B after sleep deprivation, but not in resilient individuals.

Conclusion: The findings suggest that sleep deprivation critically affects dynamic brain-state properties and the differences in time parameters of microstates might be the underlying neural basis of interindividual vulnerability to sleep deprivation.

{"title":"Resting-State EEG Microstates Dynamics Associated with Interindividual Vulnerability to Sleep Deprivation.","authors":"Zehui Liu, Tian Xie, Ning Ma","doi":"10.2147/NSS.S485412","DOIUrl":"10.2147/NSS.S485412","url":null,"abstract":"<p><strong>Purpose: </strong>Sleep deprivation can induce severe deficits in vigilant maintenance and alternation in large-scale networks. However, differences in the dynamic brain networks after sleep deprivation across individuals have rarely been investigated. In the present study, we used EEG microstate analysis to investigate the effects of sleep deprivation and how it differentially affects resting-state brain activity in different individuals.</p><p><strong>Participants and methods: </strong>A total of 44 healthy adults participated in a within-participant design study involving baseline sleep and 24-hour sleep deprivation, with resting-state EEG recorded during wakefulness. The psychomotor vigilance task (PVT) was used to measure vigilant attention. Participants were median split as vulnerable or resilient according to their changes in the number of lapses between the baseline sleep and sleep deprivation conditions.</p><p><strong>Results: </strong>Sleep deprivation caused decreases in microstates A, B, and D, and increases in microstate C. We also found increased transition probabilities of microstates C and D between each other, lower transition probabilities from microstates C and D to microstate B, and higher transition probabilities from microstates A and B to microstate C. Sleep-deprived vulnerable individuals showed decreased occurrence of microstate B and transition probability from microstate C to B after sleep deprivation, but not in resilient individuals.</p><p><strong>Conclusion: </strong>The findings suggest that sleep deprivation critically affects dynamic brain-state properties and the differences in time parameters of microstates might be the underlying neural basis of interindividual vulnerability to sleep deprivation.</p>","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":"16 ","pages":"1937-1948"},"PeriodicalIF":3.0,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11626958/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142801788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Waiting for in-Lab Polysomnography May Unnecessarily Prolong Treatment Start in Patients with Moderate or Severe OSA at Home Sleep Apnea Testing.
IF 3 2区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-12-05 eCollection Date: 2024-01-01 DOI: 10.2147/NSS.S482614
Johannes Pordzik, Christopher Seifen, Katharina Ludwig, Christian Ruckes, Tilman Huppertz, Christoph Matthias, Haralampos Gouveris

Purpose: The gold standard in obstructive sleep apnea (OSA) diagnostics is nocturnal full-night polysomnography (PSG). Due to high costs and high time effort portable respiratory polygraphy (PG or home sleep apnea testing-HSAT) has been developed. In contrast to PG the PSG gains relevant further information concerning sleep stages, arousals and leg movements. However, the role of PG in the diagnostic of OSA remains largely undefined. The aim of this study was to investigate the difference of PG- and PSG- related metrics in OSA, to understand if there is a difference in PG and PSG-based treatment decision and show up the time between performed PG and PSG.

Patients and methods: 99 consecutive patients with existing outpatient performed PG and followed PSG in our tertiary care otorhinolaryngology department between February 2020 and December 2023 were retrospectively assessed. All patients were treatment-naive at the time of consultation. The time between performed outpatient PG and PSG was calculated. Furthermore, clinical baseline parameter and PG as well as PSG data were evaluated. All data were then blinded presented with relevant comorbid diseases to two experts in sleep medicine in our tertiary care centre to decide whether PAP therapy was indicated or not.

Results: Mean AHI was significantly higher in PSG (32.32 ± 22.78/h) compared to PG (22.60 ± 15.12/h) (p<0.001). Mean duration between performed PG and PSG was 194.99 ± 131.96 days (range between 37 and 842 days). Only in two patients PAP-therapy was indicated with PG results but not with PSG results. Only in one case PAP-therapy was not indicated with PG results but with PSG results.

Conclusion: These data suggest initiating OSA therapy based on PG results for patients with at least moderate OSA on PG, followed by a confirming PSG and a control PSG under treatment to avoid unnecessary prolongation of treatment start.

{"title":"Waiting for in-Lab Polysomnography May Unnecessarily Prolong Treatment Start in Patients with Moderate or Severe OSA at Home Sleep Apnea Testing.","authors":"Johannes Pordzik, Christopher Seifen, Katharina Ludwig, Christian Ruckes, Tilman Huppertz, Christoph Matthias, Haralampos Gouveris","doi":"10.2147/NSS.S482614","DOIUrl":"10.2147/NSS.S482614","url":null,"abstract":"<p><strong>Purpose: </strong>The gold standard in obstructive sleep apnea (OSA) diagnostics is nocturnal full-night polysomnography (PSG). Due to high costs and high time effort portable respiratory polygraphy (PG or home sleep apnea testing-HSAT) has been developed. In contrast to PG the PSG gains relevant further information concerning sleep stages, arousals and leg movements. However, the role of PG in the diagnostic of OSA remains largely undefined. The aim of this study was to investigate the difference of PG- and PSG- related metrics in OSA, to understand if there is a difference in PG and PSG-based treatment decision and show up the time between performed PG and PSG.</p><p><strong>Patients and methods: </strong>99 consecutive patients with existing outpatient performed PG and followed PSG in our tertiary care otorhinolaryngology department between February 2020 and December 2023 were retrospectively assessed. All patients were treatment-naive at the time of consultation. The time between performed outpatient PG and PSG was calculated. Furthermore, clinical baseline parameter and PG as well as PSG data were evaluated. All data were then blinded presented with relevant comorbid diseases to two experts in sleep medicine in our tertiary care centre to decide whether PAP therapy was indicated or not.</p><p><strong>Results: </strong>Mean AHI was significantly higher in PSG (32.32 ± 22.78/h) compared to PG (22.60 ± 15.12/h) (p<0.001). Mean duration between performed PG and PSG was 194.99 ± 131.96 days (range between 37 and 842 days). Only in two patients PAP-therapy was indicated with PG results but not with PSG results. Only in one case PAP-therapy was not indicated with PG results but with PSG results.</p><p><strong>Conclusion: </strong>These data suggest initiating OSA therapy based on PG results for patients with at least moderate OSA on PG, followed by a confirming PSG and a control PSG under treatment to avoid unnecessary prolongation of treatment start.</p>","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":"16 ","pages":"1881-1889"},"PeriodicalIF":3.0,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11626954/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142801789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Altered Density of Resting-State Long- and Short-Range Functional Connectivity in Patients with Moderate-to-Severe Obstructive Sleep Apnea.
IF 3 2区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-12-04 eCollection Date: 2024-01-01 DOI: 10.2147/NSS.S483030
Yumeng Liu, Huizhen Xin, Yongqiang Shu, Lifeng Li, Ting Long, Li Zeng, Ling Huang, Xiang Liu, Yingke Deng, Yu Zhu, Haijun Li, Dechang Peng

Purpose: This study is to evaluate the altered number of functional connection (s) in patients with obstructive sleep apnea (OSA) by functional connectivity density (FCD), to investigate its relationship with cognitive function, and to explore whether these features could be used to distinguish OSA from healthy controls (HCs).

Methods: Seventy-six OSA patients and 72 HCs were included in the analysis. All participants underwent resting-state functional magnetic resonance imaging scan. Subsequently, intergroup differences between long-and short-range FCD groups were obtained in the Matlab platform by using the degree centrality option with a 75 mm cutoff. The partial correlation analysis were used to assess the relationship between the altered FCD value and clinical assessments in OSA patients. The FCD values of the different brain regions were used as classification features to distinguish the two groups by support vector machine (SVM).

Results: Compared to HCs, OSA patients had decreased long-range FCD in the right superior frontal gyrus (SFG), right precuneus, and left middle frontal gyrus (MFG). Simultaneously, increased long-range FCD in the right cingulate gyrus (CG). Meanwhile, the short-range FCD were decreased in the right postcentral gyrus (PoCG), right SFG, left MFG, and right CG. The short-range FCD values of the right PoCG were correlated with the Montreal Cognitive Assessment scores in OSA patients. SVM analysis showed that FCD in differential brain regions could differentiate OSA patients from HCs.

Conclusion: Long- and short-range FCD values in different brain regions of OSA patients may be related to cognitive decline, and also be effective in distinguishing OSA patients from HCs. These findings provide new perspectives on neurocognition in OSA patients.

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引用次数: 0
Decreased Memory-Related Regional Cerebral Perfusion in Severe Obstructive Sleep Apnea with a Mild Cognitive Impairment During Wakefulness.
IF 3 2区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-12-03 eCollection Date: 2024-01-01 DOI: 10.2147/NSS.S481602
Xiangbo Yan, Wanqing Liu, Danyang Li, Qiang Huang, Jianlin Wu, Qing Zhang

Purpose: Previous studies have found that obstructive sleep apnea (OSA) can induce cognitive impairment (CI). However, the exact mechanisms of CI development in patients with OSA remains unclear. We investigated the neuropathological basis of CI development by examining changes in cerebral blood perfusion.

Patients and methods: Thirty-five patients with untreated OSA (15 with CI and 20 without CI [NCI]) and 15 good sleepers (GS) diagnosed using polysomnography were recruited. All participants underwent resting state brain scans in a Siemens 3.0 Tesla magnetic resonance imaging scanner with a pulsed arterial spin labeling sequence and completed a battery of neuropsychological tests.

Results: Compared to the regional cerebral blood flow (rCBF) values in the GS group, both the CI and NCI groups exhibited lower rCBF values in the bilateral inferior temporal, left lingual, and right medial and paracingulate gyri, as well as higher rCBF values in the bilateral middle frontal gyrus (p < 0.05 in all cases). Compared to the rCBF values in the NCI group, the CI group had lower rCBF values in the bilateral inferior temporal and left lingual gyri, and higher rCBF values in the right rectus and right middle orbital frontal gyri (p < 0.05 in all cases). In the CI group, rCBF values in the bilateral inferior temporal (right, p = 0.025; left, p = 0.005) and left lingual gyri (p = 0.018) were positively associated with the delayed memory scores, and rCBF values in the left inferior temporal gyrus positively correlated with the attention scores (p = 0.011).

Conclusion: Regions with abnormal perfusion in the NCI and CI groups were mostly memory-related. Blood perfusion in the bilateral inferior temporal and left lingual gyri decreased in the following order: GS > OSA-NCI > OSA-CI. These findings provide blood perfusion-level insights into the neuropathological basis of OSA-CI development.

{"title":"Decreased Memory-Related Regional Cerebral Perfusion in Severe Obstructive Sleep Apnea with a Mild Cognitive Impairment During Wakefulness.","authors":"Xiangbo Yan, Wanqing Liu, Danyang Li, Qiang Huang, Jianlin Wu, Qing Zhang","doi":"10.2147/NSS.S481602","DOIUrl":"10.2147/NSS.S481602","url":null,"abstract":"<p><strong>Purpose: </strong>Previous studies have found that obstructive sleep apnea (OSA) can induce cognitive impairment (CI). However, the exact mechanisms of CI development in patients with OSA remains unclear. We investigated the neuropathological basis of CI development by examining changes in cerebral blood perfusion.</p><p><strong>Patients and methods: </strong>Thirty-five patients with untreated OSA (15 with CI and 20 without CI [NCI]) and 15 good sleepers (GS) diagnosed using polysomnography were recruited. All participants underwent resting state brain scans in a Siemens 3.0 Tesla magnetic resonance imaging scanner with a pulsed arterial spin labeling sequence and completed a battery of neuropsychological tests.</p><p><strong>Results: </strong>Compared to the regional cerebral blood flow (rCBF) values in the GS group, both the CI and NCI groups exhibited lower rCBF values in the bilateral inferior temporal, left lingual, and right medial and paracingulate gyri, as well as higher rCBF values in the bilateral middle frontal gyrus (<i>p</i> < 0.05 in all cases). Compared to the rCBF values in the NCI group, the CI group had lower rCBF values in the bilateral inferior temporal and left lingual gyri, and higher rCBF values in the right rectus and right middle orbital frontal gyri (<i>p</i> < 0.05 in all cases). In the CI group, rCBF values in the bilateral inferior temporal (right, <i>p</i> = 0.025; left, <i>p</i> = 0.005) and left lingual gyri (<i>p</i> = 0.018) were positively associated with the delayed memory scores, and rCBF values in the left inferior temporal gyrus positively correlated with the attention scores (<i>p</i> = 0.011).</p><p><strong>Conclusion: </strong>Regions with abnormal perfusion in the NCI and CI groups were mostly memory-related. Blood perfusion in the bilateral inferior temporal and left lingual gyri decreased in the following order: GS > OSA-NCI > OSA-CI. These findings provide blood perfusion-level insights into the neuropathological basis of OSA-CI development.</p>","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":"16 ","pages":"1869-1880"},"PeriodicalIF":3.0,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11624665/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142801780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Effects of Tobacco Use on the Macrostructure and Microstructure of Sleep in Patients with OSA.
IF 3 2区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-11-29 eCollection Date: 2024-01-01 DOI: 10.2147/NSS.S480116
Wei Ji, Liyong Shi, Zhiqiang Ji, Zhihuang Zhao, Lianshun Lin, Xiali Wang, Jing Cheng, Xiaoyang Chen

Objective: Both tobacco use and obstructive apnea-hypopnea syndrome (OSA) can affect sleep, and it is speculated that tobacco use may further affect the sleep of those with OSA. Our primary objective is to clarify the associations between tobacco use and the macrostructure and microstructure of sleep in patients with OSA.

Methods: This retrospective study encompasses a cohort of 1017 patients who were hospitalized between January 2020 and January 2023 for the investigation of sleep disorders. Rigorous inclusion criteria were applied, and all patients underwent a comprehensive polysomnography (PSG) assessment and completed a Pittsburgh Sleep Quality Index (PSQI) questionnaire.

Results: Patients with OSA who concurrently used tobacco exhibited markedly inferior sleep quality than those who did not. Notably, there was no association between the degree of tobacco dependence and sleep quality. Those with OSA who used tobacco demonstrated a significant prolongation of stage 1 light sleep and a reduction of deep sleep duration (N3). In this group, those who demonstrated poor sleep quality had more pronounced alterations in light sleep stages with prolonged N1 and shortened N2 stages.

Conclusion: Our findings reveal a substantial reduction in sleep quality amongst OSA patients who also use tobacco, compared to those with OSA who do not use tobacco. The rate of poor sleep quality was not linearly associated with the level of tobacco dependence. Tobacco use was associated with alterations in both light and slow wave sleep in those with OSA. Importantly, the effects of tobacco dependence on sleep structure were more pronounced in those with more severe OSA.

{"title":"Effects of Tobacco Use on the Macrostructure and Microstructure of Sleep in Patients with OSA.","authors":"Wei Ji, Liyong Shi, Zhiqiang Ji, Zhihuang Zhao, Lianshun Lin, Xiali Wang, Jing Cheng, Xiaoyang Chen","doi":"10.2147/NSS.S480116","DOIUrl":"10.2147/NSS.S480116","url":null,"abstract":"<p><strong>Objective: </strong>Both tobacco use and obstructive apnea-hypopnea syndrome (OSA) can affect sleep, and it is speculated that tobacco use may further affect the sleep of those with OSA. Our primary objective is to clarify the associations between tobacco use and the macrostructure and microstructure of sleep in patients with OSA.</p><p><strong>Methods: </strong>This retrospective study encompasses a cohort of 1017 patients who were hospitalized between January 2020 and January 2023 for the investigation of sleep disorders. Rigorous inclusion criteria were applied, and all patients underwent a comprehensive polysomnography (PSG) assessment and completed a Pittsburgh Sleep Quality Index (PSQI) questionnaire.</p><p><strong>Results: </strong>Patients with OSA who concurrently used tobacco exhibited markedly inferior sleep quality than those who did not. Notably, there was no association between the degree of tobacco dependence and sleep quality. Those with OSA who used tobacco demonstrated a significant prolongation of stage 1 light sleep and a reduction of deep sleep duration (N3). In this group, those who demonstrated poor sleep quality had more pronounced alterations in light sleep stages with prolonged N1 and shortened N2 stages.</p><p><strong>Conclusion: </strong>Our findings reveal a substantial reduction in sleep quality amongst OSA patients who also use tobacco, compared to those with OSA who do not use tobacco. The rate of poor sleep quality was not linearly associated with the level of tobacco dependence. Tobacco use was associated with alterations in both light and slow wave sleep in those with OSA. Importantly, the effects of tobacco dependence on sleep structure were more pronounced in those with more severe OSA.</p>","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":"16 ","pages":"1849-1868"},"PeriodicalIF":3.0,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11615015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142780634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Research on Sleep Staging Based on Support Vector Machine and Extreme Gradient Boosting Algorithm.
IF 3 2区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-11-26 eCollection Date: 2024-01-01 DOI: 10.2147/NSS.S467111
Yiwen Wang, Shuming Ye, Zhi Xu, Yonghua Chu, Jiarong Zhang, Wenke Yu

Purpose: To develop a sleep-staging algorithm based on support vector machine (SVM) and extreme gradient boosting model (XB Boost) and evaluate its performance.

Methods: In this study, data features were extracted based on physiological significance, feature dimension reduction was performed through appropriate methods, and XG Boost classifier and SVM were used for classification. One hundred and twenty training sets and 80 test sets were randomly composed of the first 200 groups of data from the SHH1 database. The polysomnography (PSG) data of 20 real individuals in the clinic were selected as the experimental data. The C3 electroencephalogram (EEG), left and right electrooculogram (EOG), electromyogram (EMG), and other signals were analyzed. Finally, the stages were adjusted based on human sleep laws. The standard staging of the database and the doctor's diagnosis staging was used as the standard.

Results: The SHHS1 database test results were as follows: the average accuracy was 83.24%, the precision and recall of Stage Wake and Stage 2 NREM sleep (N2) were over 80%, and the precision, F1-Score and recall of Stage 3 NREM sleep (N3) and Rapid Eye Movement (REM) were more than 70%. The clinical data test results were as follows: the average accuracy rate was 76.37%; for Wake and N3, the precision reached 85%; for Wake, N2, and REM, the recall rate reached over 70%; for Wake, the F-1 Score reached over 90%.

Conclusion: This study shows that the sleep staging results of the algorithm for the database and clinical data were similar. The staging results meet the requirements at the medical level.

{"title":"Research on Sleep Staging Based on Support Vector Machine and Extreme Gradient Boosting Algorithm.","authors":"Yiwen Wang, Shuming Ye, Zhi Xu, Yonghua Chu, Jiarong Zhang, Wenke Yu","doi":"10.2147/NSS.S467111","DOIUrl":"10.2147/NSS.S467111","url":null,"abstract":"<p><strong>Purpose: </strong>To develop a sleep-staging algorithm based on support vector machine (SVM) and extreme gradient boosting model (XB Boost) and evaluate its performance.</p><p><strong>Methods: </strong>In this study, data features were extracted based on physiological significance, feature dimension reduction was performed through appropriate methods, and XG Boost classifier and SVM were used for classification. One hundred and twenty training sets and 80 test sets were randomly composed of the first 200 groups of data from the SHH1 database. The polysomnography (PSG) data of 20 real individuals in the clinic were selected as the experimental data. The C3 electroencephalogram (EEG), left and right electrooculogram (EOG), electromyogram (EMG), and other signals were analyzed. Finally, the stages were adjusted based on human sleep laws. The standard staging of the database and the doctor's diagnosis staging was used as the standard.</p><p><strong>Results: </strong>The SHHS1 database test results were as follows: the average accuracy was 83.24%, the precision and recall of Stage Wake and Stage 2 NREM sleep (N2) were over 80%, and the precision, F1-Score and recall of Stage 3 NREM sleep (N3) and Rapid Eye Movement (REM) were more than 70%. The clinical data test results were as follows: the average accuracy rate was 76.37%; for Wake and N3, the precision reached 85%; for Wake, N2, and REM, the recall rate reached over 70%; for Wake, the F-1 Score reached over 90%.</p><p><strong>Conclusion: </strong>This study shows that the sleep staging results of the algorithm for the database and clinical data were similar. The staging results meet the requirements at the medical level.</p>","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":"16 ","pages":"1827-1847"},"PeriodicalIF":3.0,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11611699/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142770595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Navigating Mendelian Randomization in Sleep Medicine: Challenges, Opportunities, and Best Practices. 引导睡眠医学中的孟德尔随机化:挑战、机遇和最佳实践。
IF 3 2区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-11-22 eCollection Date: 2024-01-01 DOI: 10.2147/NSS.S495411
Ahmed S BaHammam, Haitham Jahrami

Mendelian randomization (MR) has become an influential method for elucidating causal links between sleep traits and disorders, and health outcomes. This article provides sleep medicine specialists with an overview of MR, emphasizing its applications and limitations in health research, particularly in the context of sleep research. The article addresses key challenges in conducting and interpreting MR studies on sleep, focusing on the core assumptions of relevance, exchangeability, and exclusion restriction. The importance of proper genetic instrument selection, bias mitigation, and cautious result interpretation is emphasized. Strategies are recommended to enhance the quality of MR studies in sleep medicine, including collaborations between MR experts and sleep specialists. The paper also explores sleep medicine-specific issues like analyzing binary traits and addressing heterogeneity in pooled analyses. Guidance is provided on transparent reporting of MR findings, stressing the need for comprehensive effect estimates, confidence intervals, and p-values. We conclude by advocating for rigorous MR implementation in sleep research to deepen our understanding of sleep-health relationships. By following best practices in study design, analysis, and reporting, researchers can reinforce the credibility and impact of MR findings in sleep medicine, ultimately improving patient care and public health strategies.

孟德尔随机化(MR)已成为阐明睡眠特征和失调与健康结果之间因果联系的一种有影响力的方法。本文向睡眠医学专家概述了孟德尔随机化,强调了它在健康研究中的应用和局限性,尤其是在睡眠研究中的应用和局限性。文章探讨了开展和解释睡眠磁共振研究的主要挑战,重点是相关性、可交换性和排除限制等核心假设。文章强调了正确选择基因仪器、减少偏差和谨慎解释结果的重要性。文中推荐了提高睡眠医学磁共振研究质量的策略,包括磁共振专家与睡眠专家之间的合作。本文还探讨了睡眠医学的一些特定问题,如分析二元性状和解决汇总分析中的异质性问题。本文还就如何透明地报告磁共振研究结果提供了指导,强调了综合效应估计、置信区间和 p 值的必要性。最后,我们倡导在睡眠研究中严格实施 MR,以加深我们对睡眠与健康关系的理解。通过遵循研究设计、分析和报告方面的最佳实践,研究人员可以加强睡眠医学中 MR 研究结果的可信度和影响力,最终改善患者护理和公共卫生策略。
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引用次数: 0
Association Between the Weight-Adjusted Waist Index and OSA Risk: Insights from the NHANES 2017-2020 and Mendelian Randomization Analyses. 体重调整后腰围指数与 OSA 风险之间的关系:NHANES 2017-2020 和孟德尔随机分析的启示。
IF 3 2区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-11-19 eCollection Date: 2024-01-01 DOI: 10.2147/NSS.S489433
HanYu Wang, BoWen Yang, XiaoYu Zeng, ShiPeng Zhang, Yanjie Jiang, Lu Wang, Chao Liao

Background: Obesity is a significant risk factor for obstructive sleep apnea (OSA). The weight-adjusted-waist index (WWI) reflects weight-independent centripetal obesity. Our study aims to evaluate the relationship between WWI and OSA.

Methods: The data used in the current cross-sectional investigation are from the National Health and Nutrition Examination Survey (NHANES), which was carried out between 2017 and 2020. We utilized weighted multivariable-adjusted logistic regression to evaluate the relationship between WWI and the risk of OSA. In addition, we applied various analytical methods, including subgroup analysis, smoothing curve fitting, threshold effect analysis and the receiver operating characteristic (ROC) curve. To further explore the relationship, we conducted a MR study using genome-wide association study (GWAS) summary statistics. We performed the main inverse variance weighting (IVW) method along with other supplementary MR methods. In addition, a meta-analysis was conducted to provide an overall evaluation.

Results: WWI was positively related to OSA with the full adjustment [odds ratio (OR)=1.14, 95% confidence interval (95% CI): 1.06-1.23, P<0.001]. After converting WWI to a categorical variable by quartiles (Q1-Q4), compared to Q1 the highest WWI quartile was linked to an obviously increased likelihood of OSA (OR=1.26, 95% CI: 1.06-1.50. P=0.01). Subgroup analysis revealed the stability of the independent positive relationship between WWI and OSA. Smoothing curve fitting identified a saturation effect of WWI and OSA, with an inflection point of 11.62. In addition, WWI had the strongest prediction for OSA (AUC=0.745). Sensitivity analysis was performed to verify the significantly positive connection between WWI and stricter OSA (OR=1.18, 95% CI: 1.05-1.32, P=0.005). MR meta-analysis further supported our results (OR=2.11, 95% CI: 1.94-2.30, P<0.001). Sensitivity analysis confirmed the robustness and reliability of these findings.

Conclusion: WWI was significantly associated with the risk of OSA, suggesting that WWI could potentially serve as a predictor for OSA.

背景:肥胖是阻塞性睡眠呼吸暂停(OSA)的重要风险因素。体重调整腰围指数(WWI)反映了与体重无关的向心性肥胖。我们的研究旨在评估 WWI 与 OSA 之间的关系:本次横断面调查使用的数据来自 2017 年至 2020 年间开展的美国国家健康与营养调查(NHANES)。我们利用加权多变量调整逻辑回归来评估WWI与OSA风险之间的关系。此外,我们还采用了多种分析方法,包括亚组分析、平滑曲线拟合、阈值效应分析和接收者操作特征曲线(ROC)。为了进一步探究两者之间的关系,我们利用全基因组关联研究(GWAS)的汇总统计进行了一项 MR 研究。我们采用了主要的逆方差加权(IVW)方法和其他辅助的 MR 方法。此外,我们还进行了荟萃分析,以提供总体评价:经全面调整后,WWI 与 OSA 呈正相关[几率比(OR)=1.14,95% 置信区间(95% CI):1.06-1.23,PP=0.01]。分组分析显示,WWI 与 OSA 之间的独立正相关关系具有稳定性。平滑曲线拟合确定了 WWI 与 OSA 的饱和效应,拐点为 11.62。此外,WWI 对 OSA 的预测能力最强(AUC=0.745)。敏感性分析证实,WWI 与更严格的 OSA 之间存在显著的正相关(OR=1.18,95% CI:1.05-1.32,P=0.005)。磁共振荟萃分析进一步支持了我们的结果(OR=2.11,95% CI:1.94-2.30,P=0.005):WWI与发生OSA的风险明显相关,表明WWI有可能成为OSA的预测因子。
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引用次数: 0
Predicting OSA Using Radiographs of the Airway Anatomy. 利用气道解剖的 X 光片预测 OSA。
IF 3 2区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-11-18 eCollection Date: 2024-01-01 DOI: 10.2147/NSS.S486432
Mengya Du, Yuqin Gui, Yu Guo, Jie Liu, Wenmin Deng, Jingyan Huang, Tianrun Liu, Xiangmin Zhang, Feng Pang

Objective: This study aims to analyze the tongue body shape and upper airway anatomical parameters in patients with Obstructive Sleep Apnea (OSA) and to explore the anatomical causes of OSA.

Methods: A total of 345 subjects participated in this study. Lateral pharyngeal images of the upper respiratory tract were captured in both normal and mandibular advancement states using X-ray plain film. Measurements were taken for the following parameters: Tongue Length, Tongue Thickness, Distance from the Mandibular Plane to the Hyoid, Soft Palate Length, Posterior Oropharyngeal Depth, Palatal Airway Space, Tongue Depth Space, and Mental Posterior Space. The correlation between the Apnea-Hypopnea Index (AHI) and these upper airway anatomical factors was analyzed using both univariate and multivariate analyses to develop a predictive model for OSA.

Results: The anatomical structure of the upper airway in patients with OSA is narrower compared to non-OSA individuals, and these patients exhibit a longer and thicker tongue. During mandibular advancement, the pharyngeal airway widens; however, the tongue length decreases while its thickness increases. Univariate correlation analysis revealed that the severity of OSA was significantly associated with tongue length, the ratio of tongue length to tongue thickness, the distance from the mandibular plane to the hyoid, soft palate length, and body mass index (BMI) in both the normal position and during mandibular advancement (p < 0.001). Multivariate linear analysis indicated that the severity of OSA is linked with the mandibular plane to hyoid distance in the normal position (MPH(N)) and BMI. A nomogram was utilized to develop a predictive model for OSA, achieving an area under the receiver operating characteristic curve of 0.838.

Conclusion: The pathogenesis of OSA is related to pharyngeal anatomy and tongue length in the state of mandibular advancement, which can be predicted by the measurement indexes of normal and anterior mandibular displacement lateral pharyngeal radiograph. This may potentially aid in early screening and diagnosis of OSA.

研究目的本研究旨在分析阻塞性睡眠呼吸暂停(OSA)患者的舌体形状和上气道解剖学参数,并探讨 OSA 的解剖学原因:方法:共有 345 名受试者参与了这项研究。使用 X 光平片拍摄正常和下颌前突状态下的上呼吸道侧面咽部图像。对以下参数进行了测量:舌长、舌厚、下颌平面到舌骨的距离、软腭长度、口咽后深度、腭气道间隙、舌深间隙和舌后间隙。通过单变量和多变量分析,分析了呼吸暂停-高通气指数(AHI)与这些上气道解剖因素之间的相关性,从而建立了 OSA 的预测模型:结果:与非 OSA 患者相比,OSA 患者的上气道解剖结构更狭窄,而且这些患者的舌头更长、更厚。在下颌骨前移过程中,咽部气道变宽,但舌头长度减少,厚度增加。单变量相关分析表明,OSA 的严重程度与正常位置和下颌前突时的舌长、舌长与舌厚之比、下颌平面到舌骨的距离、软腭长度和体重指数(BMI)均有显著相关性(P < 0.001)。多变量线性分析表明,OSA的严重程度与正常体位时下颌平面到舌骨的距离(MPH(N))和体重指数有关。利用提名图建立了一个 OSA 预测模型,其接收器操作特征曲线下面积为 0.838:OSA的发病机制与下颌前突状态下的咽部解剖结构和舌长度有关,可以通过正常和下颌前突侧位咽部X光片的测量指标进行预测。这可能有助于 OSA 的早期筛查和诊断。
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引用次数: 0
Sleep Disruption Impairs Sustained Attention in Food-Restricted Rats Using a Food-Reinforced Rodent Psychomotor Vigilance Test. 使用食物强化啮齿动物精神运动警觉性测试干扰睡眠会损害限食大鼠的持续注意力
IF 3 2区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-11-09 eCollection Date: 2024-01-01 DOI: 10.2147/NSS.S475672
Catherine M Davis, Victoria Elizabeth Elliott, Joan Smith

Purpose: Sleep disruption (SD) impairs sustained attention, and impairment is quantified with the psychomotor vigilance test (PVT) in humans. In rats, food restriction attenuates SD's effects on sustained attention, limiting translation of rodent vigilance tests. The goal of the current study was to determine if a rodent PVT (rPVT) requiring high baseline performance using food restriction and reinforcement is sensitive to the effects of SD.

Methods: Male Long-Evans rats (n=4) were trained on the rPVT using food reinforcement. Once baseline acquisition criteria were achieved, rats experienced acute SD using an automated sweep bar that moved across the home cage. Rats were tested in the rPVT the day following SD to assess performance-impairing effects.

Results: SD significantly increased lapses, and this effect was specific to shorter response-stimulus intervals. Decreased percent correct responses and increased slow reaction times were also found. These data suggest that many of the performance-impairing effects of SD are not attenuated by food restriction in this procedure.

Conclusion: The rPVT is sensitive to the performance impairing effects of SD in food restricted rats, a common methodology used to train and maintain performance on operant behavioral tests. Thus, food restriction does not appear to attenuate the effects of SD in all attention-related behavioral procedures.

目的:睡眠中断(SD)会损害持续注意力,而这种损害可通过人类的精神运动警觉性测试(PVT)进行量化。在大鼠中,食物限制会减弱睡眠中断对持续注意力的影响,从而限制了啮齿类警觉性测试的转化。本研究的目的是确定使用食物限制和强化的啮齿类警觉性测试(rPVT)要求较高的基线表现是否对SD的影响敏感:方法:使用食物强化训练雄性 Long-Evans 大鼠(n=4)的 rPVT。大鼠达到基线习得标准后,使用在笼子中移动的自动扫荡杆对其进行急性自毁训练。在SD后的第二天对大鼠进行rPVT测试,以评估对表现的影响:结果:自毁明显增加了失误率,而且这种影响只针对较短的反应-刺激间隔。此外,还发现正确反应百分比下降,反应迟缓时间增加。这些数据表明,在这一过程中,食物限制并不能减弱自毁行为对成绩的许多影响:rPVT对限食大鼠的SD表现损害效应很敏感,而SD是一种用于训练和维持操作行为测试表现的常用方法。因此,在所有与注意力相关的行为过程中,食物限制似乎并不能减弱自毁效应。
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引用次数: 0
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