Marcus McMahon, Jeremy Goldin, Elizabeth Susan Kealy, Darrel Joseph Wicks, Eugene Zilberg, Warwick Freeman, Behzad Aliahmad
Purpose: To investigate accuracy of the sleep staging algorithm in a new miniaturized home sleep monitoring device – Compumedics® Somfit. Somfit is attached to patient’s forehead and combines channels specified for a pulse arterial tonometry (PAT)-based home sleep apnea testing (HSAT) device with the neurological signals. Somfit sleep staging deep learning algorithm is based on convolutional neural network architecture. Patients and Methods: One hundred and ten participants referred for sleep investigation with suspected or preexisting obstructive sleep apnea (OSA) in need of a review were enrolled into the study involving simultaneous recording of full overnight polysomnography (PSG) and Somfit data. The recordings were conducted at three centers in Australia. The reported statistics include standard measures of agreement between Somfit automatic hypnogram and consensus PSG hypnogram. Results: Overall percent agreement across five sleep stages (N1, N2, N3, REM, and wake) between Somfit automatic and consensus PSG hypnograms was 76.14 (SE: 0.79). The percent agreements between different pairs of sleep technologists’ PSG hypnograms varied from 74.36 (1.93) to 85.50 (0.64), with interscorer agreement being greater for scorers from the same sleep laboratory. The estimate of kappa between Somfit and consensus PSG was 0.672 (0.002). Percent agreement for sleep/wake discrimination was 89.30 (0.37). The accuracy of Somfit sleep staging algorithm varied with increasing OSA severity – percent agreement was 79.67 (1.87) for the normal subjects, 77.38 (1.06) for mild OSA, 74.83 (1.79) for moderate OSA and 72.93 (1.68) for severe OSA. Conclusion: Agreement between Somfit and PSG hypnograms was non-inferior to PSG interscorer agreement for a number of scorers, thus confirming acceptability of electrode placement at the center of the forehead. The directions for algorithm improvement include additional arousal detection, integration of motion and oximetry signals and separate inference models for individual sleep stages.
Keywords: home sleep apnea testing, polysomnography, forehead electroencephalography, deep learning, interscorer agreement
{"title":"Performance Investigation of Somfit Sleep Staging Algorithm","authors":"Marcus McMahon, Jeremy Goldin, Elizabeth Susan Kealy, Darrel Joseph Wicks, Eugene Zilberg, Warwick Freeman, Behzad Aliahmad","doi":"10.2147/nss.s463026","DOIUrl":"https://doi.org/10.2147/nss.s463026","url":null,"abstract":"<strong>Purpose:</strong> To investigate accuracy of the sleep staging algorithm in a new miniaturized home sleep monitoring device – Compumedics® Somfit. Somfit is attached to patient’s forehead and combines channels specified for a pulse arterial tonometry (PAT)-based home sleep apnea testing (HSAT) device with the neurological signals. Somfit sleep staging deep learning algorithm is based on convolutional neural network architecture.<br/><strong>Patients and Methods:</strong> One hundred and ten participants referred for sleep investigation with suspected or preexisting obstructive sleep apnea (OSA) in need of a review were enrolled into the study involving simultaneous recording of full overnight polysomnography (PSG) and Somfit data. The recordings were conducted at three centers in Australia. The reported statistics include standard measures of agreement between Somfit automatic hypnogram and consensus PSG hypnogram.<br/><strong>Results:</strong> Overall percent agreement across five sleep stages (N1, N2, N3, REM, and wake) between Somfit automatic and consensus PSG hypnograms was 76.14 (SE: 0.79). The percent agreements between different pairs of sleep technologists’ PSG hypnograms varied from 74.36 (1.93) to 85.50 (0.64), with interscorer agreement being greater for scorers from the same sleep laboratory. The estimate of kappa between Somfit and consensus PSG was 0.672 (0.002). Percent agreement for sleep/wake discrimination was 89.30 (0.37). The accuracy of Somfit sleep staging algorithm varied with increasing OSA severity – percent agreement was 79.67 (1.87) for the normal subjects, 77.38 (1.06) for mild OSA, 74.83 (1.79) for moderate OSA and 72.93 (1.68) for severe OSA.<br/><strong>Conclusion:</strong> Agreement between Somfit and PSG hypnograms was non-inferior to PSG interscorer agreement for a number of scorers, thus confirming acceptability of electrode placement at the center of the forehead. The directions for algorithm improvement include additional arousal detection, integration of motion and oximetry signals and separate inference models for individual sleep stages.<br/><br/><strong>Keywords:</strong> home sleep apnea testing, polysomnography, forehead electroencephalography, deep learning, interscorer agreement<br/>","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141737089","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: Sleep-disordered breathing is more prevalent in individuals with allergic rhinitis (AR) than in those without AR. In addition to increased risk for sleep-disordered breathing, AR is associated with greater severity of obstructive sleep apnea (OSA) symptoms. The aim of this research study was to evaluate the association of multiple single nucleotide polymorphism (SNP) variations in AR with sleep- and breathing-related parameters in men with OSA. Methods: Men who had complained of snoring were consecutively enrolled in the Shanghai Sleep Health Study of Shanghai Sixth People’s Hospital from 2007 to 2018. After rigorous screening, 5322 men were included in the analysis. Anthropometric, fasting biochemical, and polysomnographic parameters, along with 27 AR-associated SNPs were analyzed. The associations between AR-related genetic polymorphisms and OSA were determined via linear, binary, and multinomial logistic regression analyses. Results: Rs12509403 had significantly positive associations with most sleep-breathing parameters. While the risk for OSA was increased by rs12509403, it was decreased by rs7717955 [odds ratio (OR) = 1.341, 95% confidence interval [CI] = 1.039– 1.732, P = 0.024; OR = 0.829, 95% CI = 0.715– 0.961, P = 0.013, respectively]. A graded increase in the risk of being in the highest quartile (Q4) vs the reference category (Q1) for sleep breathing indicators, especially REM-AHI and NREM-AHI, was identified by rs12509403 (OR = 1.496, 95% CI = 1.175– 1.904, P = 0.001; OR = 1.471, 95% CI = 1.151– 1.879, P < 0.001, respectively). Conclusion: The association of multiple AR SNPs with OSA-related hypoxia and sleep indices provides a genetic explanation for the higher AR susceptibility of OSA patients. Understanding the AR-related genetic underpinnings of OSA may lead to more personalized treatment approaches.
背景：患有过敏性鼻炎（AR）的人比没有过敏性鼻炎的人更容易出现睡眠呼吸障碍。除了增加睡眠呼吸障碍的风险外，过敏性鼻炎还与阻塞性睡眠呼吸暂停（OSA）症状的严重程度有关。本研究的目的是评估AR的多个单核苷酸多态性（SNP）变异与OSA男性患者的睡眠和呼吸相关参数的关联：2007年至2018年，上海市第六人民医院连续入组了上海市睡眠健康研究中主诉打鼾的男性。经过严格筛选，5322 名男性被纳入分析。研究人员分析了人体测量、空腹生化指标和多导睡眠图参数，以及27个与AR相关的SNPs。通过线性、二元和多项式逻辑回归分析确定了AR相关基因多态性与OSA之间的关联：结果：Rs12509403与大多数睡眠呼吸参数呈显著正相关。虽然rs12509403会增加OSA的风险，但rs7717955会降低OSA的风险[几率比（OR）=1.341，95%置信区间[CI]=1.039-1.732，P=0.024；OR=0.829，95%CI=0.715-0.961，P=0.013]。rs12509403发现，睡眠呼吸指标（尤其是REM-AHI和NREM-AHI）处于最高四分位数（Q4）与参考类别（Q1）的风险分级增加（OR = 1.496，95% CI = 1.175- 1.904，P = 0.001；OR = 1.471，95% CI = 1.151- 1.879，P <0.001）：多个AR SNP与OSA相关缺氧和睡眠指数的关联为OSA患者较高的AR易感性提供了遗传学解释。了解OSA与AR相关的遗传基础可能会带来更个性化的治疗方法。
{"title":"Multiple Allergic Rhinitis Single Nucleotide Polymorphism Variants are Associated with Sleep-Breathing Parameters in Men with Obstructive Sleep Apnea: A Large-Scale Study","authors":"Qiying Zeng, Wenjun Xue, Zhicheng Wei, Hangdong Shen, Huajun Xu, Huaming Zhu, Jian Guan, Hongliang Yi, Yunhai Feng, Xinyi Li, Haibo Ye","doi":"10.2147/nss.s456995","DOIUrl":"https://doi.org/10.2147/nss.s456995","url":null,"abstract":"<strong>Background:</strong> Sleep-disordered breathing is more prevalent in individuals with allergic rhinitis (AR) than in those without AR. In addition to increased risk for sleep-disordered breathing, AR is associated with greater severity of obstructive sleep apnea (OSA) symptoms. The aim of this research study was to evaluate the association of multiple single nucleotide polymorphism (SNP) variations in AR with sleep- and breathing-related parameters in men with OSA.<br/><strong>Methods:</strong> Men who had complained of snoring were consecutively enrolled in the Shanghai Sleep Health Study of Shanghai Sixth People’s Hospital from 2007 to 2018. After rigorous screening, 5322 men were included in the analysis. Anthropometric, fasting biochemical, and polysomnographic parameters, along with 27 AR-associated SNPs were analyzed. The associations between AR-related genetic polymorphisms and OSA were determined via linear, binary, and multinomial logistic regression analyses.<br/><strong>Results:</strong> Rs12509403 had significantly positive associations with most sleep-breathing parameters. While the risk for OSA was increased by rs12509403, it was decreased by rs7717955 [odds ratio (OR) = 1.341, 95% confidence interval [CI] = 1.039– 1.732, P = 0.024; OR = 0.829, 95% CI = 0.715– 0.961, P = 0.013, respectively]. A graded increase in the risk of being in the highest quartile (Q4) vs the reference category (Q1) for sleep breathing indicators, especially REM-AHI and NREM-AHI, was identified by rs12509403 (OR = 1.496, 95% CI = 1.175– 1.904, P = 0.001; OR = 1.471, 95% CI = 1.151– 1.879, P < 0.001, respectively).<br/><strong>Conclusion:</strong> The association of multiple AR SNPs with OSA-related hypoxia and sleep indices provides a genetic explanation for the higher AR susceptibility of OSA patients. Understanding the AR-related genetic underpinnings of OSA may lead to more personalized treatment approaches.<br/><br/>","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141737091","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}
Study Objectives: To evaluate the association between obstructive sleep apnea (OSA) and dry eye disease (DED) and analyze the impact of Continuous Positive Airway Pressure (CPAP) on DED. Methods: This is a retrospective population-based case-control study. Patients who underwent polysomnography in Taiwan from March 1, 2009, to March 1, 2020, were identified from the database of a sleep center. Patients who were diagnosed with keratoconjunctivitis sicca or tear film insufficiency were included. Patients without data from Schirmer’s test, lacking tear break-up time values, or with a history of refractive surgery, Sjögren’s syndrome, ocular injuries, or a disability in eyelid closure were excluded. All patients with DED enrolled had DED in both eyes. OSA severity between patients with and without DED was compared. Results: In total, 86 patients with DED and 86 age-matched patients without DED were enrolled. Significant differences in apnea-hypopnea index values (patients with DED: 29.1 ± 23.4, patients without DED: 17.9 ± 20.2, P < 0.001), OSA severity (P < 0.001), and lowest oxygen saturation (P = 0.040) between patients with and without DED were observed. A multivariate logistic regression model indicated that the use of CPAP was independently associated with DED after adjustments for OSA severity. Patients undergoing CPAP were at greater risk of developing DED than those not undergoing CPAP (Odds ratio: 3.93, 95% confidence interval: 1.47– 10.49, P = 0.006). Conclusion: OSA severity is associated with DED and might be attributed to the use of CPAP.
{"title":"Associations Between Obstructive Sleep Apnea Syndrome, Dry Eye Disease, and CPAP Usage Among Taiwanese Patients: A Retrospective Analysis","authors":"Yuan-Kai Fu, Chi-chin Sun, Kuan-Jen Chen, Yu-Jr Lin, Chee-Jen Chang, Shu-Chen Chang, Ming-Hui Sun","doi":"10.2147/nss.s458245","DOIUrl":"https://doi.org/10.2147/nss.s458245","url":null,"abstract":"<strong>Study Objectives:</strong> To evaluate the association between obstructive sleep apnea (OSA) and dry eye disease (DED) and analyze the impact of Continuous Positive Airway Pressure (CPAP) on DED.<br/><strong>Methods:</strong> This is a retrospective population-based case-control study. Patients who underwent polysomnography in Taiwan from March 1, 2009, to March 1, 2020, were identified from the database of a sleep center. Patients who were diagnosed with keratoconjunctivitis sicca or tear film insufficiency were included. Patients without data from Schirmer’s test, lacking tear break-up time values, or with a history of refractive surgery, Sjögren’s syndrome, ocular injuries, or a disability in eyelid closure were excluded. All patients with DED enrolled had DED in both eyes. OSA severity between patients with and without DED was compared.<br/><strong>Results:</strong> In total, 86 patients with DED and 86 age-matched patients without DED were enrolled. Significant differences in apnea-hypopnea index values (patients with DED: 29.1 ± 23.4, patients without DED: 17.9 ± 20.2, <em>P</em> < 0.001), OSA severity (<em>P</em> < 0.001), and lowest oxygen saturation (<em>P</em> = 0.040) between patients with and without DED were observed. A multivariate logistic regression model indicated that the use of CPAP was independently associated with DED after adjustments for OSA severity. Patients undergoing CPAP were at greater risk of developing DED than those not undergoing CPAP (Odds ratio: 3.93, 95% confidence interval: 1.47– 10.49, <em>P</em> = 0.006).<br/><strong>Conclusion:</strong> OSA severity is associated with DED and might be attributed to the use of CPAP.<br/><br/><strong>Keywords:</strong> dry eye disease, obstructive sleep apnea, continuous positive airway pressure<br/>","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141745560","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}
Qiming Gan, Quanzhen Liu, Yanjuan Wu, Xiaofeng Zhu, Jingcun Wang, Xiaofen Su, Dongxing Zhao, Nuofu Zhang, Kang Wu
Purpose: Obstructive sleep apnea (OSA) had been associated with asthma in observational studies, but the effect of OSA on the onset of asthma in childhood or adulthood remains unclear, and the causal inferences have not been confirmed. This study aims to investigate the potential causal association between OSA with asthma, including different age-of-onset subtypes, providing reliable basis for the clinical treatment of OSA and asthma. Patients and Methods: Causality between OSA and asthma was assessed using a two-sample bi-directional Mendelian randomization (MR) analysis. OSA data were obtained from the FinnGen consortium R9, while asthma and its subtypes (adult-onset asthma, child-onset asthma, and moderate-to-severe asthma) were sourced from the IEU OpenGWAS project. The inverse-variance weighted (IVW) method was chosen as the primary analysis and was complemented by various sensitivity analyses. The MR-PRESSO outlier test was employed to systematically identify and remove outlier variants, mitigating heterogeneity and potential effects of horizontal pleiotropy. Results: The MR analyses provided evidence of genetically predicted OSA having a promoting effect on child-onset asthma (OR,1.49; 95% CI, 1.05– 2.11; P=0.025) and moderate-to-severe asthma (OR,1.03; 95% CI, 1.00– 1.06; P=0.046). However, no causal association between OSA with asthma and adult-onset asthma was observed. Conclusion: Our study revealed a causal association between OSA and child asthma, but not in adults. Moderate-to-severe asthma may have a potential promoting effect on OSA. These findings underscore the importance of age-specific considerations in managing asthma and suggests the need for personalized approaches in clinical practice.
目的：在观察性研究中，阻塞性睡眠呼吸暂停（OSA）与哮喘有关，但OSA对儿童期或成年期哮喘发病的影响仍不清楚，因果推论也未得到证实。本研究旨在探讨OSA与哮喘（包括不同发病年龄亚型）之间的潜在因果关系，为OSA与哮喘的临床治疗提供可靠依据：采用双样本双向孟德尔随机分析法（MR）评估 OSA 与哮喘之间的因果关系。OSA数据来自FinnGen R9联盟，而哮喘及其亚型（成人发病型哮喘、儿童发病型哮喘和中重度哮喘）数据来自IEU OpenGWAS项目。我们选择了反方差加权法（IVW）作为主要分析方法，并辅以各种敏感性分析。采用MR-PRESSO离群检验系统地识别和移除离群变异，减轻异质性和水平多向性的潜在影响：MR分析表明，遗传预测的OSA对儿童初发哮喘（OR,1.49；95% CI,1.05-2.11；P=0.025）和中重度哮喘（OR,1.03；95% CI,1.00-1.06；P=0.046）有促进作用。然而，未观察到 OSA 与哮喘和成人哮喘之间存在因果关系：我们的研究表明，OSA 与儿童哮喘之间存在因果关系，但与成人无关。中重度哮喘可能对 OSA 有潜在的促进作用。这些发现强调了在管理哮喘时考虑特定年龄因素的重要性，并表明在临床实践中需要采取个性化的方法。
{"title":"The Causal Association Between Obstructive Sleep Apnea and Child-Onset Asthma Come to Light: A Mendelian Randomization Study","authors":"Qiming Gan, Quanzhen Liu, Yanjuan Wu, Xiaofeng Zhu, Jingcun Wang, Xiaofen Su, Dongxing Zhao, Nuofu Zhang, Kang Wu","doi":"10.2147/nss.s472014","DOIUrl":"https://doi.org/10.2147/nss.s472014","url":null,"abstract":"<strong>Purpose:</strong> Obstructive sleep apnea (OSA) had been associated with asthma in observational studies, but the effect of OSA on the onset of asthma in childhood or adulthood remains unclear, and the causal inferences have not been confirmed. This study aims to investigate the potential causal association between OSA with asthma, including different age-of-onset subtypes, providing reliable basis for the clinical treatment of OSA and asthma.<br/><strong>Patients and Methods:</strong> Causality between OSA and asthma was assessed using a two-sample bi-directional Mendelian randomization (MR) analysis. OSA data were obtained from the FinnGen consortium R9, while asthma and its subtypes (adult-onset asthma, child-onset asthma, and moderate-to-severe asthma) were sourced from the IEU OpenGWAS project. The inverse-variance weighted (IVW) method was chosen as the primary analysis and was complemented by various sensitivity analyses. The MR-PRESSO outlier test was employed to systematically identify and remove outlier variants, mitigating heterogeneity and potential effects of horizontal pleiotropy.<br/><strong>Results:</strong> The MR analyses provided evidence of genetically predicted OSA having a promoting effect on child-onset asthma (OR,1.49; 95% CI, 1.05– 2.11; P=0.025) and moderate-to-severe asthma (OR,1.03; 95% CI, 1.00– 1.06; P=0.046). However, no causal association between OSA with asthma and adult-onset asthma was observed.<br/><strong>Conclusion:</strong> Our study revealed a causal association between OSA and child asthma, but not in adults. Moderate-to-severe asthma may have a potential promoting effect on OSA. These findings underscore the importance of age-specific considerations in managing asthma and suggests the need for personalized approaches in clinical practice.<br/><br/><strong>Keywords:</strong> asthma, obstructive sleep apnea, Mendelian randomization, genetic<br/>","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141737093","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}
Response to Letter in regards to Beware of the Risk Factors for Pediatric Obstructive Sleep Apnea [Letter]
对有关 "警惕小儿阻塞性睡眠呼吸暂停的风险因素 "信件的回复[信件］
{"title":"Unravelling Pediatric Obstructive Sleep Apnea: Prevalence, Severity, and Associated Conditions [Response to Letter]","authors":"Qin Yang, Sandip Patil","doi":"10.2147/nss.s485728","DOIUrl":"https://doi.org/10.2147/nss.s485728","url":null,"abstract":"Response to Letter in regards to Beware of the Risk Factors for Pediatric Obstructive Sleep Apnea [Letter]","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141613974","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}
Jialin Gu, Hailan Wu, Wanjing Diao, Yi Ji, Jianyue Li, Jiege Huo
Objective: To examine potential factors affecting sleep duration and explore its association with the risk of mortality among adults in the United States. Methods: The study population consisted of adults aged 26 to 79 years who participated in the National Health and Nutrition Examination Survey (NHANES) conducted from 2007 to 2016. Sleep duration was classified into three categories: short (< 7 hours), optimal (7– 8 hours), and long (≥ 9 hours). The associations between sleep duration and both all-cause mortality and cause-specific mortality (including heart disease, tumors, cerebrovascular disease, and others) were examined in the overall population and subgroups using weighted Cox regression models. Dose-response associations between sleep duration and risk of all-cause mortality were explored using restricted cubic spline (RCS) analyses. Additionally, a multinomial logistic regression analysis was conducted to investigate potential factors that influence sleep duration in adults. Results: The study included a total of 24,141 subjects, with a population-weighted mean age of 48.93 years. Over 30% of the subjects exhibited unhealthy sleep habits. Fully adjusted models revealed that both short sleep duration (HR=1.169, 95% CI 1.027– 1.331) and long sleep duration (HR=1.286, 95% CI 1.08– 1.531), were associated with an increased risk of all-cause mortality. The RCS curves showed a U-shaped relationship between sleep duration and risk of all-cause mortality. Subgroup analyses showed a significant association between poor sleep patterns and all-cause mortality among adults aged 26– 64 years, males, and non-Hispanic whites. Furthermore, multinomial logistic regression identified several predictors associated with short and long sleep durations. Conclusion: Both short and long sleep duration are associated with an increased risk of all-cause mortality, with a U-shaped dose-response relationship. It is imperative to implement appropriate primary prevention strategies aimed at monitoring and providing health education to populations at risk of developing unhealthy sleep patterns.
目的：研究影响睡眠时间的潜在因素，并探讨其与美国成年人死亡风险的关系：研究影响睡眠时间的潜在因素，并探讨其与美国成年人死亡风险的关系：研究对象包括参加2007年至2016年进行的美国国家健康与营养调查（NHANES）的26岁至79岁的成年人。睡眠时间分为三类：短时间（7小时以内）、最佳睡眠时间（7-8小时）和长时间（≥9小时）。利用加权 Cox 回归模型研究了总体人群和亚组人群的睡眠时间与全因死亡率和特定病因死亡率（包括心脏病、肿瘤、脑血管疾病和其他疾病）之间的关系。使用限制性立方样条曲线（RCS）分析探讨了睡眠时间与全因死亡风险之间的剂量-反应关系。此外，还进行了多项式逻辑回归分析，以研究影响成人睡眠时间的潜在因素：研究共纳入 24141 名受试者，人口加权平均年龄为 48.93 岁。超过 30% 的受试者有不健康的睡眠习惯。完全调整模型显示，睡眠时间短（HR=1.169，95% CI 1.027-1.331）和睡眠时间长（HR=1.286，95% CI 1.08-1.531）与全因死亡风险增加有关。RCS曲线显示睡眠时间与全因死亡风险之间呈U形关系。分组分析表明，在 26-64 岁的成年人、男性和非西班牙裔白人中，不良睡眠模式与全因死亡率之间存在显著关联。此外，多项式逻辑回归还发现了一些与睡眠时间长短相关的预测因素：结论：睡眠时间过短和过长都与全因死亡风险的增加有关，两者呈 "U "型剂量-反应关系。当务之急是实施适当的初级预防策略，对有可能形成不健康睡眠模式的人群进行监测并提供健康教育。 关键词：睡眠时间；死亡率；成人；关联；NHANES
{"title":"Association of Sleep Duration with Risk of All-Cause and Cause-Specific Mortality Among American Adults: A Population-Based Cohort Study","authors":"Jialin Gu, Hailan Wu, Wanjing Diao, Yi Ji, Jianyue Li, Jiege Huo","doi":"10.2147/nss.s469638","DOIUrl":"https://doi.org/10.2147/nss.s469638","url":null,"abstract":"<strong>Objective:</strong> To examine potential factors affecting sleep duration and explore its association with the risk of mortality among adults in the United States.<br/><strong>Methods:</strong> The study population consisted of adults aged 26 to 79 years who participated in the National Health and Nutrition Examination Survey (NHANES) conducted from 2007 to 2016. Sleep duration was classified into three categories: short (< 7 hours), optimal (7– 8 hours), and long (≥ 9 hours). The associations between sleep duration and both all-cause mortality and cause-specific mortality (including heart disease, tumors, cerebrovascular disease, and others) were examined in the overall population and subgroups using weighted Cox regression models. Dose-response associations between sleep duration and risk of all-cause mortality were explored using restricted cubic spline (RCS) analyses. Additionally, a multinomial logistic regression analysis was conducted to investigate potential factors that influence sleep duration in adults.<br/><strong>Results:</strong> The study included a total of 24,141 subjects, with a population-weighted mean age of 48.93 years. Over 30% of the subjects exhibited unhealthy sleep habits. Fully adjusted models revealed that both short sleep duration (HR=1.169, 95% CI 1.027– 1.331) and long sleep duration (HR=1.286, 95% CI 1.08– 1.531), were associated with an increased risk of all-cause mortality. The RCS curves showed a U-shaped relationship between sleep duration and risk of all-cause mortality. Subgroup analyses showed a significant association between poor sleep patterns and all-cause mortality among adults aged 26– 64 years, males, and non-Hispanic whites. Furthermore, multinomial logistic regression identified several predictors associated with short and long sleep durations.<br/><strong>Conclusion:</strong> Both short and long sleep duration are associated with an increased risk of all-cause mortality, with a U-shaped dose-response relationship. It is imperative to implement appropriate primary prevention strategies aimed at monitoring and providing health education to populations at risk of developing unhealthy sleep patterns.<br/><br/><strong>Keywords:</strong> sleep duration, mortality, adults, association, NHANES<br/>","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141588636","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}
Mingjun Gong, Min Sun, Yaqi Sun, Lijuan Jin, Shen Li
Objective: Using meta-analysis to comprehensively and quantitatively evaluate the impact of acute sleep deprivation on different sports performance of athletes, this study aims to provide scientific guidance for coaches in optimizing and adjusting training and competition arrangements. Methods: Establishing literature inclusion and exclusion criteria, we conducted searches in both Chinese and English databases. Using stata 14.0, we analyzed 75 indicators from 27 included literature, focusing on three aspects: the impact of acute sleep deprivation on overall athletic performance, the impact on sporting performance across various athletic abilities, and the disparities in athletic performance between morning and afternoon following acute sleep deprivation. Results: The effect size of acute sleep deprivation on overall athletic performance was − 0.56 (P< 0.05). Sub-analyses revealed effect sizes of − 0.23 (P< 0.05) for whole night sleep deprivation, − 1.17 (P< 0.05) for partial sleep deprivation at the end of the night, and − 0.25 (P> 0.05) for partial sleep deprivation in the beginning of the night. The effect sizes of acute sleep deprivation on high intensity intermittent exercise, skill control, speed, aerobic endurance, and explosive power indicators were − 1.57, − 1.06, − 0.67, − 0.54, and − 0.39 respectively (P< 0.05). The effect sizes of acute sleep deprivation on the overall athletic performance in the morning and afternoon were − 0.30, and − 1.11, respectively (P< 0.05). Conclusion: Acute sleep deprivation significantly impairs the overall athletic performance of athletes, with a more pronounced negative impact observed with partial sleep deprivation at the end of the night. Various types of exercise performance are adversely affected by acute sleep deprivation, with magnitude of impact ranking high intensity intermittent, skill control, speed, aerobic endurance, and explosive power. Following acute sleep deprivation, athletes’ overall sporting performance in the afternoon is inferior to that in the morning.
{"title":"Effects of Acute Sleep Deprivation on Sporting Performance in Athletes: A Comprehensive Systematic Review and Meta-Analysis","authors":"Mingjun Gong, Min Sun, Yaqi Sun, Lijuan Jin, Shen Li","doi":"10.2147/nss.s467531","DOIUrl":"https://doi.org/10.2147/nss.s467531","url":null,"abstract":"<strong>Objective:</strong> Using meta-analysis to comprehensively and quantitatively evaluate the impact of acute sleep deprivation on different sports performance of athletes, this study aims to provide scientific guidance for coaches in optimizing and adjusting training and competition arrangements.<br/><strong>Methods:</strong> Establishing literature inclusion and exclusion criteria, we conducted searches in both Chinese and English databases. Using stata 14.0, we analyzed 75 indicators from 27 included literature, focusing on three aspects: the impact of acute sleep deprivation on overall athletic performance, the impact on sporting performance across various athletic abilities, and the disparities in athletic performance between morning and afternoon following acute sleep deprivation.<br/><strong>Results:</strong> The effect size of acute sleep deprivation on overall athletic performance was − 0.56 (<em>P</em>< 0.05). Sub-analyses revealed effect sizes of − 0.23 (<em>P</em>< 0.05) for whole night sleep deprivation, − 1.17 (<em>P</em>< 0.05) for partial sleep deprivation at the end of the night, and − 0.25 (<em>P</em>> 0.05) for partial sleep deprivation in the beginning of the night. The effect sizes of acute sleep deprivation on high intensity intermittent exercise, skill control, speed, aerobic endurance, and explosive power indicators were − 1.57, − 1.06, − 0.67, − 0.54, and − 0.39 respectively (<em>P</em>< 0.05). The effect sizes of acute sleep deprivation on the overall athletic performance in the morning and afternoon were − 0.30, and − 1.11, respectively (<em>P</em>< 0.05).<br/><strong>Conclusion:</strong> Acute sleep deprivation significantly impairs the overall athletic performance of athletes, with a more pronounced negative impact observed with partial sleep deprivation at the end of the night. Various types of exercise performance are adversely affected by acute sleep deprivation, with magnitude of impact ranking high intensity intermittent, skill control, speed, aerobic endurance, and explosive power. Following acute sleep deprivation, athletes’ overall sporting performance in the afternoon is inferior to that in the morning.<br/><br/><strong>Keywords:</strong> acute sleep deprivation, athletes, athletic ability, sporting performance, meta-analysis<br/>","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141566794","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}
Lingling Wang, Huiguo Liu, Ling Zhou, Pengdou Zheng, Hai Li, Huojun Zhang, Wei Liu
Abstract: Obstructive sleep apnea (OSA), a common sleep-disordered breathing condition, is characterized by intermittent hypoxia (IH) and sleep fragmentation and has been implicated in the pathogenesis and severity of nonalcoholic fatty liver disease (NAFLD). Abnormal molecular changes mediated by IH, such as high expression of hypoxia-inducible factors, are reportedly involved in abnormal pathophysiological states, including insulin resistance, abnormal lipid metabolism, cell death, and inflammation, which mediate the development of NAFLD. However, the relationship between IH and NAFLD remains to be fully elucidated. In this review, we discuss the clinical correlation between OSA and NAFLD, focusing on the molecular mechanisms of IH in NAFLD progression. We meticulously summarize clinical studies evaluating the therapeutic efficacy of continuous positive airway pressure treatment for NAFLD in OSA. Additionally, we compile potential molecular biomarkers for the co-occurrence of OSA and NAFLD. Finally, we discuss the current research progress and challenges in the field of OSA and NAFLD and propose future directions and prospects.
摘要：阻塞性睡眠呼吸暂停（OSA）是一种常见的睡眠呼吸障碍疾病，以间歇性缺氧（IH）和睡眠片段为特征，与非酒精性脂肪肝（NAFLD）的发病机制和严重程度有关。据报道，由 IH 介导的异常分子变化，如缺氧诱导因子的高表达，参与了异常病理生理状态，包括胰岛素抵抗、异常脂质代谢、细胞死亡和炎症，从而介导了非酒精性脂肪肝的发展。然而，IH 与非酒精性脂肪肝之间的关系仍有待全面阐明。在这篇综述中，我们讨论了 OSA 和 NAFLD 之间的临床相关性，重点研究了 IH 在 NAFLD 发展过程中的分子机制。我们仔细总结了评估持续气道正压治疗对 OSA 非酒精性脂肪肝疗效的临床研究。此外，我们还整理了 OSA 和 NAFLD 并发症的潜在分子生物标志物。关键词：间歇性缺氧；低氧诱导因子 1α；非酒精性脂肪肝；氧化应激；血脂异常；瘦素抵抗。
{"title":"Association of Obstructive Sleep Apnea with Nonalcoholic Fatty Liver Disease: Evidence, Mechanism, and Treatment","authors":"Lingling Wang, Huiguo Liu, Ling Zhou, Pengdou Zheng, Hai Li, Huojun Zhang, Wei Liu","doi":"10.2147/nss.s468420","DOIUrl":"https://doi.org/10.2147/nss.s468420","url":null,"abstract":"<strong>Abstract:</strong> Obstructive sleep apnea (OSA), a common sleep-disordered breathing condition, is characterized by intermittent hypoxia (IH) and sleep fragmentation and has been implicated in the pathogenesis and severity of nonalcoholic fatty liver disease (NAFLD). Abnormal molecular changes mediated by IH, such as high expression of hypoxia-inducible factors, are reportedly involved in abnormal pathophysiological states, including insulin resistance, abnormal lipid metabolism, cell death, and inflammation, which mediate the development of NAFLD. However, the relationship between IH and NAFLD remains to be fully elucidated. In this review, we discuss the clinical correlation between OSA and NAFLD, focusing on the molecular mechanisms of IH in NAFLD progression. We meticulously summarize clinical studies evaluating the therapeutic efficacy of continuous positive airway pressure treatment for NAFLD in OSA. Additionally, we compile potential molecular biomarkers for the co-occurrence of OSA and NAFLD. Finally, we discuss the current research progress and challenges in the field of OSA and NAFLD and propose future directions and prospects.<br/><br/><strong>Keywords:</strong> intermittent hypoxia, hypoxia-inducible factor 1 alpha, nonalcoholic fatty liver disease, oxidative stress, dyslipidemia, leptin resistance<br/>","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141566796","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}
Astri Budikayanti, Manfaluthy Hakim, Faradillah Mutiani, Sri Handayani, Nushrotul Lailiyya, Herlyani Khosama, Seilly Yunita Jehosua, Vivien Puspitasari, Pricilla Yani Gunawan, Yetty Hambarsari, Wardah Rahmatul Islamiyah, Abdul Gofir, Amelia Nur Vidyanti, Asnelia Devicaesaria, Rizka Ibonita, Herlina Suryawati, Rimawati Tedjasukmana
Background: Sleep disturbances are included in the six most commonly cited complaints in post-COVID-19 conditions. In order to find the optimal management approach and enhance Quality of Life (QoL), we intend to explore sleep disturbances that occur in post-COVID-19 conditions. Methods: This was a cross-sectional study conducted with interviews and questionnaires using the Pittsburgh Sleep Quality Index (PSQI) for assessing sleep quality, Insomnia Severity Index (ISI) for assessing insomnia, Epworth Sleepiness Scale (ESS) for assessing Excessive Daytime Sleepiness (EDS), STOP-BANG questionnaire for assessing Obstructive Sleep Apnea (OSA), and Short Form 36 (SF-36) for assessing QoL. We recruited respondents from several cities in Indonesia and performed an analysis to find the relationship between sleep disturbance and its association with QoL. Results: This study involved 757 respondents. They were predominantly female, with a median age of 39 years, no comorbidities, and had exhibited mild COVID-19 severity. Subjects with post-COVID-19 conditions experienced insomnia, poor sleep quality, normal sleepiness, and low risk of OSA. Sleep quality caused role limitations due to decreased physical and mental health. Insomnia caused role limitations due to emotional and social functioning problems. Meanwhile, OSA only affected physical functioning. Conclusion: Numerous aspects of patients’ QoL are affected by sleep disturbance in post-COVID-19 conditions. A comprehensive approach and coordinated care pathways must be effectively managed to improve QoL among individuals experiencing sleep disturbance.
{"title":"The Impact of Post-COVID-19 Conditions on Sleep and Quality of Life in Indonesia: A Nationwide Cross-Sectional Study","authors":"Astri Budikayanti, Manfaluthy Hakim, Faradillah Mutiani, Sri Handayani, Nushrotul Lailiyya, Herlyani Khosama, Seilly Yunita Jehosua, Vivien Puspitasari, Pricilla Yani Gunawan, Yetty Hambarsari, Wardah Rahmatul Islamiyah, Abdul Gofir, Amelia Nur Vidyanti, Asnelia Devicaesaria, Rizka Ibonita, Herlina Suryawati, Rimawati Tedjasukmana","doi":"10.2147/nss.s456979","DOIUrl":"https://doi.org/10.2147/nss.s456979","url":null,"abstract":"<strong>Background:</strong> Sleep disturbances are included in the six most commonly cited complaints in post-COVID-19 conditions. In order to find the optimal management approach and enhance Quality of Life (QoL), we intend to explore sleep disturbances that occur in post-COVID-19 conditions.<br/><strong>Methods:</strong> This was a cross-sectional study conducted with interviews and questionnaires using the Pittsburgh Sleep Quality Index (PSQI) for assessing sleep quality, Insomnia Severity Index (ISI) for assessing insomnia, Epworth Sleepiness Scale (ESS) for assessing Excessive Daytime Sleepiness (EDS), STOP-BANG questionnaire for assessing Obstructive Sleep Apnea (OSA), and Short Form 36 (SF-36) for assessing QoL. We recruited respondents from several cities in Indonesia and performed an analysis to find the relationship between sleep disturbance and its association with QoL.<br/><strong>Results:</strong> This study involved 757 respondents. They were predominantly female, with a median age of 39 years, no comorbidities, and had exhibited mild COVID-19 severity. Subjects with post-COVID-19 conditions experienced insomnia, poor sleep quality, normal sleepiness, and low risk of OSA. Sleep quality caused role limitations due to decreased physical and mental health. Insomnia caused role limitations due to emotional and social functioning problems. Meanwhile, OSA only affected physical functioning.<br/><strong>Conclusion:</strong> Numerous aspects of patients’ QoL are affected by sleep disturbance in post-COVID-19 conditions. A comprehensive approach and coordinated care pathways must be effectively managed to improve QoL among individuals experiencing sleep disturbance.<br/><br/>","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141505966","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}
Jiaying Lao, Hang Tan, Yuyu Wu, Ting Ding, Xinqian Liu, Lanrong Sun, Xiyi Chen, Chongrong Zhu, Yiming Kang, Yu-Hsin Chen, Chonghui Tang, Fan Wang, Yanlong Liu
Objective: Cigarette smoking and low peripheral nitric oxide synthase (NOS) levels are strongly associated with sleep disorders. However, whether cerebrospinal fluid (CSF) NOS relates to sleep disorders and whether CSF NOS mediates the relationship between cigarette smoking and sleep disorders is unclear. Methods: We measured CSF levels of total NOS (tNOS) and its isoforms (inducible NOS [iNOS] and constitutive NOS [cNOS]) in 191 Chinese male subjects. We applied the Pittsburgh Sleep Quality Index (PSQI). Results: The PSQI scores of active smokers were significantly higher than those of non-smokers, while CSF tNOS, iNOS, and cNOS were significantly lower (all p < 0.001). CSF tNOS, iNOS, and cNOS were negatively associated with PSQI scores in the general population (all p < 0.001). Mediation analysis suggested that CSF tNOS, iNOS, and cNOS mediate the relationship between smoking and PSQI scores, and the indirect effect accounted for 78.93%, 66.29%, and 81.65% of the total effect, respectively. Conclusion: Cigarette smoking is associated with sleep disorders. Active smokers had significantly lower CSF levels of tNOS, iNOS, and cNOS. Furthermore, tNOS, iNOS, and cNOS mediate the relationship between cigarette smoking and sleep quality. This study provides insights into how cigarette smoke affects sleep disorders.
{"title":"Cerebrospinal Fluid Nitric Oxide Synthase is a Potential Mediator Between Cigarette Smoke Exposure and Sleep Disorders","authors":"Jiaying Lao, Hang Tan, Yuyu Wu, Ting Ding, Xinqian Liu, Lanrong Sun, Xiyi Chen, Chongrong Zhu, Yiming Kang, Yu-Hsin Chen, Chonghui Tang, Fan Wang, Yanlong Liu","doi":"10.2147/nss.s458294","DOIUrl":"https://doi.org/10.2147/nss.s458294","url":null,"abstract":"<strong>Objective:</strong> Cigarette smoking and low peripheral nitric oxide synthase (NOS) levels are strongly associated with sleep disorders. However, whether cerebrospinal fluid (CSF) NOS relates to sleep disorders and whether CSF NOS mediates the relationship between cigarette smoking and sleep disorders is unclear.<br/><strong>Methods:</strong> We measured CSF levels of total NOS (tNOS) and its isoforms (inducible NOS [iNOS] and constitutive NOS [cNOS]) in 191 Chinese male subjects. We applied the Pittsburgh Sleep Quality Index (PSQI).<br/><strong>Results:</strong> The PSQI scores of active smokers were significantly higher than those of non-smokers, while CSF tNOS, iNOS, and cNOS were significantly lower (all p < 0.001). CSF tNOS, iNOS, and cNOS were negatively associated with PSQI scores in the general population (all p < 0.001). Mediation analysis suggested that CSF tNOS, iNOS, and cNOS mediate the relationship between smoking and PSQI scores, and the indirect effect accounted for 78.93%, 66.29%, and 81.65% of the total effect, respectively.<br/><strong>Conclusion:</strong> Cigarette smoking is associated with sleep disorders. Active smokers had significantly lower CSF levels of tNOS, iNOS, and cNOS. Furthermore, tNOS, iNOS, and cNOS mediate the relationship between cigarette smoking and sleep quality. This study provides insights into how cigarette smoke affects sleep disorders.<br/><br/><strong>Keywords:</strong> cerebrospinal fluid nitric oxide synthase, cigarette smoking, Pittsburgh Sleep Quality Index, sleep disorders, mediation<br/>","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141524329","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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