Sleep Science最新文献

Introduction: Patients with nasal obstruction due to chronic rhinosinusitis with nasal polyposis may present with altered sleep quality. Data on this subject in the literature remains scarce.

Objectives: To evaluate changes in sleep quality and polysomnographic parameters among patients who underwent functional endoscopic sinus surgery for chronic rhinosinusitis with nasal polyposis.

Materials and methods: A systematic review was performed in three databases: PubMed, Cochrane, and Embase. The following keywords were used: chronic rhinosinusitis, nasal polyposis, sleep quality, and nasosinusal endoscopic surgery. Studies evaluating adults with nasal polyposis who underwent endoscopic nasosinusal surgery were selected. A meta-analysis was conducted to compare mean scores for polysomnographic and subjective variables from before to after the operation.

Results: A systematic review and meta-analysis of three studies were performed, only one of which was randomized. The total sample consisted of 64 patients. There was a decrease in the mean AHI score and improvements in mean and minimum saturation. The mean difference in percentage of stage N3 from before to after the operation was 1.12 with a 95% CI from -3.51 to 5.75, which was non-significant. There was a mean percentage increase in REM sleep duration and a decrease in PSQI scores, which were both statistically significant ( p  < 0.05).

Conclusion: There were improvements in the quality of sleep and duration of REM sleep after surgery, with no improvement in polysomnographic respiratory parameters.

Adolescence is a stage of development in which several social and biological parameters change drastically. Behavioral alterations are common during puberty, including the appearance of risk-taking behaviors such as substance use and unprotected sex, which can lead to unintended pregnancy. Of note, in addition to the inherent risks of pregnancy at a young age, sleep impairment and substance use are commonly seen in adolescents, even during pregnancy. The increased risk for the development of gestational diabetes, which has been linked to both sleep impairment and drug use, further complicates this scenario and deserves consideration among the scientific community and in the clinical setting. Therefore, in this commentary, we discuss the pathways connecting the risk of substance misuse, sleep impairment, and the development of gestational diabetes, a network that demonstrates the vulnerability of the pregnant teenage population. Future studies evaluating the complicating factors and modulators of pregnancy outcomes in these individuals are of the utmost importance.

Introduction: Despite significant advancements in sleep medicine, its integration into formal medical education remains uneven. While structured programs exist in some regions, a standardized framework for postgraduate education is notably lacking in Latin America. This study assesses the availability of sleep medicine training programs, how specialists gain expertise, and the current clinical practice across the region.

Methods: A descriptive, cross-sectional survey was conducted among Latin American sleep medicine specialists via a WhatsApp group of 443 professionals. The questionnaire covered formal education programs, training locations, and public and private healthcare coverage for sleep disorder treatments. Descriptive statistical analysis was performed.

Results: Seventy-four physicians from 11 Latin American countries participated. Only four countries-Mexico, Brazil, Argentina, and Chile-had formal postgraduate programs, leading many specialists to seek training abroad. Mexico was the most cited destination for further education. Public healthcare coverage varied: five countries provided sleep surgeries, while others did not, and CPAP device access was inconsistent. Private insurance generally did not cover sleep disorder treatments, including DISE, which was only covered in Argentina and Colombia with mixed responses.

Discussion: Significant disparities exist in sleep medicine education and healthcare access in Latin America. The lack of structured training limits local expertise development and increases reliance on international education. Raising awareness is a crucial step toward improving education and ensuring broader access to standardized sleep disorder care. Continued research is necessary to bridge existing gaps and enhance opportunities for specialized sleep medicine care.

This study aims to characterize dentists in Brazil who understand and practice Sleep Dentistry (SD), focusing on diagnosing and managing sleep-related breathing disorders (SRBD), such as snoring and obstructive sleep apnea. Our goal is to identify gaps in their training and emphasize the need to integrate dental sleep into the Brazilian system of education. We conducted a descriptive study with 161 Brazilian sleep dentists. Participants answered questionnaires with demographics, educational background, clinical experience, and perspectives on recognizing SD as a specialty. Our findings show that 57.8% of participants graduated from public universities. Many expressed a strong interest in receiving training on SD, highlighting difficulties in effectively managing SRBD. Additionally, they reported the importance of healthcare professionals in improving treatment outcomes for SRBD. This study highlights the need to incorporate sleep health education into dental training programs in Brazil. Aligning these educational improvements with the United Nations in promoting health and well-being, we urge policymakers to formally recognize SD as a key specialty, fostering stronger collaboration between dentists and physicians to enhance patient care and public health.

Introduction: Sleep quality is a subjective experience related to satisfaction and feelings after waking. Many menopausal women struggle to achieve adequate sleep, averaging less than 7 hours per night.

Objective: The purpose of this study was to identify unraveling the factors shaping sleep quality among postmenopausal women in Indonesia.

Methods: This research is a correlative descriptive study with a quantitative approach using a cross-sectional design. Determination of the sample in this study using the accidental sampling method ( n  = 256) in women aged ≥ 40 years in Indonesia with the Pittsburgh Sleep Quality Index (PSQI) questionnaire instrument to determine sleep quality. Depression Anxiety Stress Scale (DASS-21) to assess psychological factors, the Multidimensional Scale of Perceived Social Support (MSPSS) for social support, and the Menopause Rating Scale (MRS).

Results: The results showed that the proportion of menopausal women aged 50 to 72 years in Indonesia with poor sleep quality was 72.3%. Variables that significantly affect the sleep quality of menopausal women in bivariate analysis were age(OR = 2.898; 95%CI = 1.650-5.090; p  < 0.001), level of education(OR = 2.035; 95%CI = 1.115-3.713; p  = 0.019), anxiety level (OR = 2.027; 95%CI = 1.010-4.069; p  = 0.044), stress level (OR = 4.640; 95%CI = 2.573-8.368; p  < 0.001), social support(OR = 0.484; 95%CI = 0.273-0.860; p  = 0.013) and menopausal symptoms(OR = 4.596; 95%CI = 1.069-19.766; p  = 0.026). Then in multivariate analysis, stress level (OR = 6.075; 95%CI = 3.147- 11.727; p  < 0.001) was the most dominant factor affecting sleep quality.

Conclusion: It can be concluded that there were factors that significantly affected menopausal women, namely age, education level, anxiety level, stress level, social support, and menopausal symptoms with stress levels being the most dominating factor in menopausal women's sleep quality.

Introduction: Obstructive sleep apnea (OSA) involves recurrent upper airway obstructions during sleep, leading to fragmentation and oxygen desaturation. Vocal complaints and orofacial myofunctional changes are common, but few studies assess both aspects in diagnosed patients.

Objective: To assess vocal parameters and orofacial myofunctional conditions in adults diagnosed with OSA, comparing them to a control group at low risk for OSA.

Methods: Cross-sectional study. A convenience sample ( N  = 63) was included: 33 with OSA confirmed by polysomnography and 30 controls at low risk for OSA (STOP-BANG < 3 and no reported snoring in Stanford Snoring Scale), aged between 18-60 years. Assessments included perceptual-auditory analysis of voice quality (GRBASI scale, Vocal Symptom Scale (VSS), maximum phonation time (MPT) for vowels and s/z ratio) and orofacial myofunctional evaluation (OMES-E protocol). Participants who had received previous treatment or medical conditions affecting OSA, voice or orofacial function were excluded.

Results: OSA group showed significantly higher scores on VSS and lower scores on OMES-E protocol. They also displayed shorter MPT, worse performance in s/z ratio, reduced pneumophonoarticulatory coordination, and higher frequency of vocal alterations. The OSA group revealed mean apnea-hypopnea index of 45.80, indicates predominance of severe cases, as well as increased desaturation index.

Conclusion: Individuals with OSA exhibit impairments in both orofacial myofunctional and vocal parameters, with negative alterations observed in MPT speech rate, pneumophonoarticulatory coordination, and s/z ratio compared with subjects with no OSA complaints. These findings highlight the importance of evaluating vocal and orofacial aspects together in OSA.

Objective: This study investigated the relationship between hot flashes, menopausal symptoms, anxiety, depression, and insomnia in postmenopausal women with insomnia complaints.

Methods: A cross-sectional analysis was conducted with 71 postmenopausal women experiencing insomnia, divided into two groups based on the presence of vasomotor symptoms: 41 participants reported hot flashes in the past month, while 30 did not. All participants completed validated questionnaires, including the Blatt-Kupperman Menopausal Index, Menopause Rating Scale (MRS), Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), and Insomnia Severity Index (ISI).

Results: Women experiencing hot flashes showed a significant association between elevated anxiety levels and menopausal symptoms. Across the entire sample, anxiety levels strongly correlated with the severity of menopausal symptoms. Participants with hot flashes were more likely to be classified as having severe anxiety based on BAI results compared with those without vasomotor symptoms. However, no significant differences were found in depression or insomnia severity between the groups.

Conclusions: Vasomotor symptoms are associated with higher anxiety levels and more pronounced menopausal symptoms in postmenopausal women with insomnia complaints. These findings highlight the potential impact of hot flashes on emotional well-being and overall health during postmenopause.

Restless Legs Syndrome (RLS) represents a significant clinical challenge globally, with management varying by region due to differences in healthcare resources. The American Academy of Sleep Medicine (AASM) has established guidelines for the treatment of RLS;1 however, their applicability in Latin America is influenced by medication availability, healthcare infrastructure, and the specific characteristics of the region's health systems. The prevalence of RLS in Latin America shows substantial variability among countries. The American Association of Sleep Disorders (ALADS), explores diagnostic challenges, emphasizing the importance of evaluating iron status, which remains limited in many regions. Additionally, pharmacological treatment options are examined, highlighting the difficulty in accessing first-line therapies such as gabapentinoids, while dopamine agonists continue to be used despite the risk of symptom augmentation. The frequent use of benzodiazepines and the limited availability of opioids are also discussed. Alternative therapies, including lifestyle modifications and traditional medicine, are considered as complementary strategies in resource-limited settings. Finally, the need to adapt international guidelines to local realities and to promote research to optimize RLS management in Latin America is underscored.

Sleep-related breathing disorders (SRBDs) in children can lead to obstructive sleep apnea (OSA) in adulthood and sleep-related bruxism (SRB). Neuro occlusal rehabilitation and functional jaw orthopedics (NOR-FJO) show promise in addressing SRBDs and SRB to prevent OSA progression. However, consistent evidence for managing these conditions in children is lacking, highlighting the need for early intervention to mitigate long-term complications. The present article explores NOR-FJO's effects in preventing SRBDs and their progression to OSA. We report two cases of brothers with SRBD and SRB and the case of their father with OSA. The brothers, who had overjet and overbite, were treated with NOR-FJO. The third patient had a similar history in childhood, without treatment, and developed OSA, subsequently treated with a mandibular advancement device (MAD). Timely intervention for SRBDs is essential in preventing long-term health complications, and understanding treatment strategies is crucial for early intervention.