Nature and Science of Sleep最新文献

Objective: To explore the characteristics of elderly patients with central sleep apnea (CSA).

Methods: This retrospective study divided 123 patients with CSA into elderly and non-elderly groups, and compared them in terms of demographic characteristics (age, BMI, etc), underlying diseases (hypertension, coronary heart disease, and cardiac arrhythmias, etc). and polysomnography parameters. Multiple linear regression analysis was conducted to investigate the potential risk factors of central apnea index (CAI).

Results: Compared with the non-elderly group, patients in the elderly group had lower body mass index, a higher proportion of comorbidities of coronary heart disease, arrhythmias, and diabetes, lower apnea-hypopnea index (AHI), obstructive apnea index (OAI) and oxygen desaturation index (ODI). CAI of the elderly group showed a trend higher than that of the non-elderly group with no statistical difference. However, the ratio of CAI to AHI in the elderly group was significantly higher (0.264 vs 0.154, P=0.003). True CSA was less prevalent than companion CSA in both groups. The results of multiple regression analysis indicated CAI was independently associated with age (β=0.256, P=0.005), OAI (β=-0.543, P<0.001), MAI (β=-0.267, P=0.005), ODI (β=0.538, P<0.001), heart failure (β=0.300, P<0.001).

Conclusion: CSA typically coexists with other types of sleep apnea. Elderly CSA patients have characteristics such as a lower BMI, and a milder decrease in blood oxygen saturation, along with higher prevalence of arrhythmia and coronary heart disease. Age may be a potential risk factor for CSA.

Background: White blood cell (WBC) and its subset counts are standard, inexpensive, direct markers of inflammation. Obstructive sleep apnea (OSA) is implicated in changes in inflammation markers, and sex differences are evident in both OSA and inflammation. It is unknown whether sex modulates the relationship between OSA severity and leukocyte measures.

Methods: 1222 patients (914 males, 308 females) underwent overnight laboratorial polysomnography and measurement of WBC and its subset (lymphocyte, neutrophil, monocyte) counts. Patients were divided into primary snoring and mild, moderate, and severe OSA groups, and differences in leukocyte parameters were analyzed separately by sex in multivariable analyses.

Results: In multiple regression models, higher apnea-hypopnea index (AHI) was independently associated with neutrophil counts only in men, and with higher total WBC, lymphocyte and monocyte counts both in women and men. Further ordinal logistic regression analysis revealed a significant association between AHI and total WBC (OR 1.87, 95% CI 1.09-3.23) and neutrophil (OR 1.77, 95% CI 1.02-3.07) counts in men only. Correlation analysis also revealed more robust relationships between leukocyte measures and cardiometabolic risk markers in men than in women.

Conclusion: This study provides novel data suggesting a significant association between neutrophil count and OSA severity only in men but not women. Similarly, the relationship between leukocyte parameters and cardiometabolic risk markers were more pronounced in men than women. Our findings suggest a sex-specific impact of OSA on leukocyte measures and on their relationship with indices of cardiometabolic risk.

Background: Continuous positive airway pressure (CPAP) is an effective treatment for obstructive sleep apnea (OSA), but its long-term efficacy is limited by poor patient adherence. This study aimed to develop and validate a predictive nomogram for CPAP non-adherence in patients with OSA.

Methods: This is a secondary analysis of a retrospective study. A cohort of 695 Danish patients with OSA were followed for 3 years after initiating CPAP therapy. Independently associated factors were evaluated using multivariate Cox regression, and then nomogram predicting adherence to CPAP use were constructed. The discrimination of the nomogram was assessed using receiver operating characteristic (ROC) curves, calibration curves and decision curve analysis (DCA).

Results: Pulmonary disease, oxygen desaturation index (ODI), Epworth Sleepiness Score (ESS) and severity of OSA were identified as predictors and incorporated into the nomogram. The nomogram demonstrated good discrimination with concordance index in training dataset (0.73, 95% CI: 0.69-0.78) and validation dataset (0.72, 95% CI: 0.66-0.79). ROC curve, calibration curve, and DCA indicated the nomogram had good clinical utility.

Conclusion: This study provided an effective nomogram for predicting CPAP non-adherence in OSA patients.

Purpose: The Pre-Sleep Arousal Scale (PSAS) is a well-recognized instrument utilized for measuring cognitive and somatic arousal before sleep. Although the PSAS is useful, an Arabic version of the scale has not yet been developed and validated. The current study aimed to translate the PSAS into Arabic language and evaluate its psychometric properties, such as reliability and validity, in an Arabic-speaking population.

Patients and methods: A cross-sectional survey was conducted with 438 participants who completed the Arabic version of the PSAS, along with other validated measures of insomnia, anxiety, and sleep effort.

Results: The results indicated that the Arabic version of the PSAS maintained the original scale's two-factor structure. The factor loadings for PSAS-Cognitive ranged from 0.57 to 0.75, and for PSAS-Somatic, from 0.45 to 0.70, with all loadings being statistically significant (p < 0.001). The Arabic version of the PSAS exhibited high internal consistency (McDonald's ω = 0.86; Cronbach's α = 0.86; Guttman's λ2 = 0.86; Greatest Lower Bound = 0.90) and test-retest reliability (ICC = 0.88) over two weeks. The PSAS demonstrated good concurrent and convergent validity. We documented significant large differences between individuals with "no insomnia" and those with "insomnia" symptoms across cognitive, somatic, and total pre-sleep arousal (all p <0.001). The insomnia group consistently scored higher scores for PSAP and its subscales.

Conclusion: These findings suggest that the Arabic version of the PSAS is a reliable and valid tool for assessing pre-sleep arousal in Arabic-speaking individuals.

Purpose: To describe the sleep habits (bedtime hours, waking hours, sleep duration) and to assess the prevalence of sleep disturbances (acute and chronic insomnia, insufficient sleep, perceived sleep debt) among French healthcare workers.

Participants and methods: Nurses and assistant nurses working in public hospitals from the Loire department at different work schedules (2x12h, 2x8h, fixed daytime, fixed nighttime) were asked about their socioprofessional and demographic information, their sleep habits and disturbances during night shifts, and the acceptability of a 20-min nap opportunity.

Results: A total of 297 healthcare workers completed the survey with 76% reporting a sleep debt with a lower prevalence for fixed nighttime workers (62%) and a higher prevalence for 2x12 h (84%) workers. The prevalence of acute insomnia was 76% with a significant difference between fixed nighttime (60%) and 2x12 h (82%); whereas the prevalence of chronic insomnia was 35% without any significant difference between working schedules. Moreover, 18% of healthcare workers reported excessive daytime sleepiness, while 13% admitted to using sleep medication at least once a week.

Conclusion: French healthcare workers reported poor sleep quality with a high prevalence of sleep debt, acute and chronic insomnia symptoms without an obvious impact of working schedules.

Background: Childhood obesity has become a global pandemic, leading to a range of diseases. Childhood obesity appears to be associated with an increased prevalence of sleep apnea syndrome. Sleep apnea is an inestimable risk factor for thrombosis, hypertension, cardiomyopathy and many other diseases. Therefore, exploring the relationship between childhood obesity and sleep apnea syndrome will help to understand the potential link between the two and provide research directions for future disease prevention and treatment. However, no studies have confirmed whether there is a causal relationship between childhood obesity and sleep apnea syndrome.

Methods: The IEU OpenGWAS project provided the GWAS-aggregated data for childhood obesity and sleep apnea syndrome. Inverse-variance weighted (IVW) was used as the main method to evaluate the causal relationship between childhood obesity and sleep apnea syndrome. Single nucleotide polymorphisms (SNPs) were regarded as instrumental variables, and the screening threshold was P <5.0×10^-6. Leave-one-out method was performed to confirm the robustness of the results.

Results: IVW analysis confirmed a causal relationship between genetic susceptibility to childhood obesity and an increased risk of sleep apnea syndrome [odds ratio (OR)=1.12, 95% confidence interval (CI): 1.02-1.23, P=0.016]. However, two-sample MR results also showed no causal relationship between genetic susceptibility to sleep apnea syndrome and an increased risk of childhood obesity (OR=1.50, 95% CI: 0.95-2.38, P=0.083). The intercept of MR-Egger regression was close to 0, which implies that there are no confounding factors in the analysis to affect the results of two-sample MR analysis. The leave-one-out results show that the bidirectional two-sample MR analysis results were robust.

Conclusion: There is a causal relationship between genetic susceptibility to childhood obesity and increased risk of sleep apnea syndrome. People with a history of childhood obesity should pay more attention to physical examination to early prevention and management of sleep apnea syndrome.

Purpose: This study aims to investigate the impact of anesthetic methods on the occurrence of postoperative sleep disorders in elderly patients following their discharge from the hospital for 3 months.

Patients and methods: This retrospective observational cohort study included elderly patients aged >60 years who had undergone general and regional anesthesia from 1 June 2023 to 31 December 2023. These patients were then assessed for sleep by telephone callback using the Athens Insomnia Scale after discharge from the hospital three months later. The duration of pain and sleep disturbance experienced by patients following discharge was also recorded.

Results: Following propensity score matching, 308 individuals were included in the study (154 in the GA group and 154 in the RA group). Compared with general anesthesia (11.7%), regional anesthesia (5.2%) reduced the prevalence of sleep disorders in elderly patients after discharge from the hospital. However, the duration of sleep disturbance and pain exhibited no statistically significant difference between the two groups (p=0.818; p=0.211).

Conclusion: Regional anesthesia was associated with a reduction in the incidence of sleep disorders in elderly patients after discharge from the hospital for 3 months.

Background: Sleep disorders and low grip strength often co-occur clinically and are geriatric symptoms that cause significant socioeconomic burden. Previous observational studies have found an association between sleep behaviors and grip strength, but the causal relationship remains unclear.

Purpose: With the Mendelian randomization (MR) approach, the study aimed to determine the causal association between sleep traits (sleep duration, insomnia, daytime napping, sleep-wake disorders, chronotype) and low grip strength.

Methods: The study used genetic variants from the genome-wide association study (GWAS) archived in UK Biobank and FinnGen. We assessed the potential causal relationship between sleep behaviors and grip strength using inverse variance weighting (IVW), weighted median (WM), and MR-Egger. Additionally, we performed sensitivity analyses using Cochran's Q test, MR Egger Intercept test, funnel plots, and leave-one-out method.

Results: We found that sleep duration is causally negatively associated with low grip strength (OR = 0.618, 95% CI = 0.424-0.900, P = 0.012). Sleep-wake disorders have a positive association with low grip strength (OR = 1.018, 95% CI = 1.002-1.034, P = 0.029). Reversely, high low grip strength risk was causally associated with increased daytime napping (OR = 1.018, 95% CI = 1.004-1.032, P = 0.011).

Conclusion: The study revealed causal associations between sleep duration, sleep-wake disorders, and low grip strength. Understanding their relationship helps in early clinical intervention to improve the life quality of the elderly.

Sepsis is defined as life-threatening organ injury induced by infection, with high incidence and mortality. Sleep disorder is prevalent in septic patients and approximately 50% of patients with sepsis may develop atypical sleep patterns, but many of them may have been underdiagnosed by physicians. Sleep disorders and sepsis exhibit a close bidirectional relationship, with each condition significantly influencing the other. Conversely, sleep deprivation, sleep dysrhythmia and sleep fragmentation have been shown to impact the outcome of sepsis. This review endeavors to offer a comprehensive understanding of the intricate mechanisms that underpin the interplay between sepsis and sleep disorders, in addition to exploring potential clinical intervention strategies that could enhance outcomes for patients suffering from sepsis.