Sleep Science最新文献

Introduction  The absence of standardized reporting for sleep medicine exams across different laboratories can lead to misinterpretation, diagnostic inconsistencies, and suboptimal treatment strategies. This document seeks to establish guidelines for the development of sleep study reports, covering recordings from studies of types 1 to 4, and represents the official position of Associação Brasileira do Sono (ABS; Brazilian Sleep Association) on the standardization of polysomnography (PSG) and cardiorespiratory polygraphies. Materials and Methods  The recommendations for the items to be reported in PSG records were developed by means of a Delphi study, comprised of two voting rounds. In each round, participants had to vote regarding the appropriateness of items to be reported in type-1 to -4 sleep studies, rating them as recommended , optional , or not recommended . The consensus threshold was set at 66% in each voting round, or 75% for the combined responses of recommended and optional . Results  The panel was comprised of 29 experts. After 2 voting rounds and subsequent deliberations by the steering committee, 352 items were included in the final set of recommendations. Consensus was achieved for 339 items (96.3%), of which 145 (41.2%) were classified as recommended , 154 as optional (43.8%), 35 as not recommended (9.9%), and 5 as not allowed (1.4%). No consensus was reached for 13 items (3.7%). The items recommended in this consensus are detailed in the main text. Conclusion  These guidelines provide comprehensive recommendations for reporting diagnostic tests in sleep medicine.

Introduction  The current document represents the official position of Associação Brasileira do Sono (ABS; Brazilian Sleep Association) on the application of different sleep studies and provides specific recommendations for the use of different types of polysomnography (PSG) and respiratory polygraphy. Materials and Methods  The present document was based on existing guidelines. The steering committee discussed its findings and developed recommendations and contraindications, which were refined in discussions with the advisory committee. Adaptations were made based on professional experience, pathophysiological knowledge, and theoretical reasoning, especially to cover topics not discussed in previous guidelines or to adapt recommendations to the context and current practices in Brazil. Results  A total of 55 recommendations were made, covering the following domains: professional requirements for the requisition and interpretation of sleep studies ( n  = 7); eligibility for different sleep studies ( n  = 9); diagnosis of sleep-disordered breathing (SDB; n  = 5); diagnosis of SDB in special conditions ( n  = 3); diagnosis of SDB in association with other sleep disorders and comorbidities ( n  = 3); sleep studies on the follow-up of patients with SDB ( n  = 9); sleep studies for positive air pressure titration ( n  = 3); diagnosis of other sleep disorders ( n  = 10); and sleep studies on other conditions ( n  = 6). Conclusion  The selection of the type of sleep study should be made carefully, considering resource constraints, clinical suspicion of moderate or severe obstructive sleep apnea (OSA), and individual patient needs, among other factors. It is crucial that health professionals receive appropriate training and board certification in sleep science, thus being able to determine the most suitable diagnostic method, understand their indications and limitations, and assure an accurate diagnosis for each patient.

Objective  To examine the association of evening eating clock time, its elapsed time to the midpoint of sleep (TEM), consumption of caffeine and sugary foods, and reporting dinner as the largest meal with sleep quality indicators and insomnia. Methods  Participants ( n  = 2,050;18-65y) were part of population-based research, with virtual data collection. Logistic regression models were fitted to assess differences in the ORs(95%CI) of sleep duration < 7 hours, sleep latency > 30 minutes, poor sleep quality, and insomnia (outcomes) with the evening diet-related variables. Linear regression analyses evaluated differences in sleep duration and latency associated with the same variables. Restricted cubic splines were used to study the shape of the association of eating event clock time and TEM with sleep duration and latency. Results  Each additional hour of evening eating clock time and of the TEM, respectively increased and decreased, the odds of sleep duration < 7/h [OR(95%CI):1.30(1.20,1.40); OR(95%CI):0.51(0.47,0.56)], sleep latency > 30min [OR(95%CI):1.14(1.07,1.22); 0.88(0.83,0.94)], poor sleep quality [OR(95%CI):1.21(1.13,1.30); 0.80(0.76,0.85)] and insomnia [OR(95%CI):1.12(1.04,1.20); 0.89(0.84,0.95)]. We found a dose-response association between evening eating (clock time and TEM) and sleep duration. The shortest latency was seen when evening eating was ∼20:00 and ∼7-8 hours before the midpoint of sleep. Participants who reported dinner as the largest meal and consumed caffeine and sugary foods/beverages after 18:00 presented higher odds of sleep duration < 7 hours, poor quality, and insomnia. Conclusions  Our findings indicate that an early-eating schedule has beneficial sleep effects and that it will be necessary to consider evening eating patterns and timing, along with the existing sleep and circadian hygiene, to improve sleep quality and circadian health.

[This corrects the article DOI: 10.1055/s-0044-1785522.].

Objective  To identify the factors related to sleep duration in 3-month-old infants. Materials and Methods  From 2021 to 2023, we conducted a cross-sectional study in the city of Araraquara, Brazil, involving 140 mothers and their respective 3-month-old infants. Maternal socioeconomic, demographic, obstetric, and nutritional characteristics, as well as nutritional and morbidity characteristics of the respective infants, were evaluated. Sleep duration was determined by the Brief Infant Sleep Questionnaire (BISQ). Multivariate linear regression analysis was used to assess the associations of maternal, newborn, and infant factors with sleep duration at three months. Results  The nighttime sleep duration of the infants was of 9 hours. There were negative associations between nighttime sleep duration and prone sleep position ( p  = 0.011), falling asleep between 8:30 pm and 11:00 pm ( p  = 0.032), falling asleep after 11:00 pm ( p  < 0.001), respiratory infection ( p  = 0.011), dermatitis ( p  = 0.002), and the presence of children under 9 years of age in the household ( p  = 0.013). Discussion  In the present study, factors such as infant morbidity, the presence of other children in the household, and sleeping habits were associated with a decrease in sleep duration in 3-month-old infants. Therefore, we emphasize the importance of early diagnosis of morbidity in the first months of life and of promoting healthy habits such as regulating the time to go to sleep, providing an adequate sleep environment, and other practices that help improve the quality and duration of sleep.

Objectives  To determine the feasibility for middle-aged and older adults to extend their time in bed by 2 h per night for 3 consecutive weeks. Other aims were to examine the effects of sleep extension on mood, cognitive performance, and cardiovascular health. Methods  Ten healthy middle-aged to older adults (9 women; M  = 65.20 ± 4.78 years) who reported regularly sleeping 6 to 8 h per night participated in a randomized controlled cross-over study: 3 weeks of both habitual sleep and extended sleep (1-week recovery between treatments). Participants were asked to spend 2 additional hours in bed per night during sleep extension. Cognitive (e.g., errors, response time), psychological (e.g., depression, anxiety, mood), and physiological measures (e.g., inflammation, glucose, triglycerides, blood pressure) were assessed. Results  Compared with habitual sleep, time in bed increased 81.63 ± 33.11 min and total sleep time increased 66.33 ± 28.64 min during sleep extension; these variables did not significantly change during baseline or the habitual sleep treatment. No significant treatment differences were found in the cognitive, psychological, or physiological measures. Discussion  Neither significant positive nor negative effects of sleep extension were found for any of the variables. In terms of feasibility, it was difficult for the participants to extend their time in bed and, subsequently, attain more sleep by the targeted amount. Sleep extension by a greater degree or longer period of times might be more likely to elicit positive or negative effects.

The absence or decrease in sleep time can affect different mechanisms associated with changes in body composition and physical exercise performance. However, it is unclear in the literature how chronically sleep-restricted individuals respond to strength training. Thus, this study aimed to evaluate the effects of reducing between one and two hours of recommended sleep time (7 hours) on the response to resistance training. The study included 12 subjects who slept on average 2 hours less than the recommended 7 hours per day (42 ± 8 years; 84.9 ± 11.6 kg; 27.9 ± 3.5 kg/m ² ; 6:17 ± 22 total sleep time/day and 5: 47 ± 29 sleep time/night) and 12 subjects with recommended sleep time (38 ± 11 years; 78.3 ± 9.5 kg; 25.1 ± 3.5 kg/m ² ; 7:47 ± 38 total sleep time/day and 7:16 ± 54 sleep time/night) and a control group (42 ± 7 years; 81 ± 12.2 kg; 26.2 ± 4.0 kg/m ² ; 7:30 ± 40 total sleep time/day and 7: 17 ± 51 sleep time/night) that did not perform resistance training. A total of 16 resistance training sessions were performed, 3 times a week (Sessions= 4 exercises; 2 sets; maximum repetitions to failure). The maximum number of repetitions, arm circumference, and arm muscle area increased, while triceps skinfold decreased after training in the experimental groups ( p  < 0.05), with no changes for the control group. There was no difference in muscle mass, body mass index, or sleep variables (sleep time, latency, efficiency) after the training period in either group (p> 0.05). Thus, the chronic 1-2-hour reduction in average recommended sleep time was not able to affect the positive effects of resistance training.

The present study used four different methods to estimate fatigue. Forty-seven volunteers (45 men and 2 women), 41.3 ± 7.5 years old, truck operators for 11.5 ± 6.0 years, were included. All participants accepted the invitation to be included in the study. Actigraphy and core temperature were evaluated. The 5-minute psychomotor vigilance test, the Karolinksa Sleepiness Scale (KSS), and the postural assessment using the Light Sonometer™ (Belo Horizonte, Minas Gerais, Brazil) were performed. Fatigue prediction was performed using the Fatigue Avoidance Scheduling Tool (FAST) program. In response to the Pittsburgh Sleep Quality Index (PSQI), 51.06% had good sleep quality and 48.94% had poor sleep quality with an average efficiency of 81.6%. In response to the actigraphy, workers slept an average of 7.2 hours a day with 93.5% efficiency. The workers' core body temperature (CBT) cosinor analysis showed a preserved circadian curve. Core body temperature showed differences between the 6 hours worked in each shift. Similarly, the light sound level meter showed lower risk scores for fatigue in day shifts. Only the variable of the fastest 10% of the Psychomotor Vigilance Test (PVT) showed worse results, while no significant differences were observed by the KSS. The risk analysis by FAST showed a strong influence of the circadian factor. In conclusion, each method has positive and negative points, and it is up to the evaluator/manager to identify the method that best suits the purpose of the evaluation, as well as the local culture and conditions. We recommend using different methods of risk assessment and management in combination with fatigue prediction by Sonometer as well as carrying out assessments, which enable researchers to estimate performance and fatigue throughout the working day, since these may change over the duration of the working day.

Introduction  Portable respiratory monitoring (PM) has been used to diagnose obstructive sleep apnea (OSA) in the general population. However, its validation in patients with both OSA and chronic obstructive pulmonary disease (COPD), remains unclear. Objective  The aim of the study was to validate PM for the diagnosis of OSA in patients with COPD. Materials and Methods  In this crossectional study, COPD patients were submitted simultaneously to polysomnography (PSG) and PM. Moreover, the risk for OSA was verified by the Berlin, NoSAS, and STOP-BANG questionnaires. Sensitivity, specificity, positive predictive value, and negative predictive value for PM were calculated for the cutoff points of the hypopnea apnea index (AHI) of 5, 15, and 30 events/hour, as well as for the questionnaires. The Bland-Altman test and correlation analyses between the AHI of the PSG and PM were performed. Results  A total of 103 patients were evaluated (age 67.5 ± 9.9 years, 60% men). The STOP-BANG questionnaire had the highest sensitivity for OSA diagnosis, at 94.4% (72.7-99.9%). The sensitivity of PM decreased (87.0, 66.7, and 44.4%), and the specificity increased 40.0, 78.6, and 100.0%) as the AHI cutoff point increased from 5, 15, and 30. The Bland-Altman test indicated good limits of agreement (AHI = 5.5 ± 11.7 events/hour). Therefore, the AHI results of the PM showed a strong and positive correlation with those of the PSG (r = 0.70, p  < 0.0001). Conclusion  The PM test can be a useful tool for OSA diagnosis in patients with COPD.

Objective  To evaluate which condition of sleep debt has a greater negative impact on insulin resistance: sleep deprivation for 24 hours or 4 hours of sleep restriction for 4 nights. Materials and Methods  In total, 28 healthy male subjects aged 18 to 40 years were recruited and randomly allocated to two groups: sleep deprivation (SD) and sleep restriction (SR). Each group underwent two conditions: regular sleep (11 pm to 7 am ) and total sleep deprivation for 24 hours (SD); regular sleep (11 pm to 7 am ) and 4 nights of sleep restriction (SR) (1 am to 5 am ). The oral glucose tolerance test (OGTT) was performed, and baseline glucose, insulin, free fatty acids (FFAs), and cortisol were measured. In addition, the area under the curve (AUC) for glucose and insulin, the homeostasis model assessment of insulin resistance (HOMA-IR), and the Matsuda Index (Insulin Sensitivity Index, ISI) were calculated. Results  Glucose and insulin had a similar pattern between groups, except at the baseline, when insulin was higher in the sleep debt condition of the SR when compared with the SD ( p  < 0.01). In the comparison between regular sleep and sleep debt, the SD had a higher insulin AUC ( p  < 0.01) and FFAs ( p  = 0.03) after sleep deprivation, and insulin and the insulin AUC increased ( p  < 0.01 for both), while the ISI decreased ( p  = 0.02) after sleep restriction in the SR. In baseline parameters covariate by the condition of regular sleep, insulin ( p  = 0.02) and the HOMA-IR ( p  < 0.01) were higher, and cortisol ( p  = 0.04) was lower after sleep restriction when compared with sleep deprivation. Conclusion  Sleep restriction for 4 consecutive nights is more detrimental to energy metabolism because of the higher insulin values and insulin resistance compared with an acute period of sleep deprivation of 24 hours.