Sleep Science最新文献

Objective: To compare the associations between sleep quality and body mass index (BMI), as well as excess weight status, in male and female subjects, while exploring potential mediating factors, including lifestyle and health-related variables.

Materials and methods: The present cross-sectional study analyzed data from 5,260 (29.7% male and 70.3% female) Brazilian adults collected through a virtual survey applied from 2023 to 2024. Sleep quality and duration were assessed using the Pittsburgh Sleep Quality Index (PSQI). The BMI was derived from self-reported weight and height, with excess weight defined as BMI > 24.9 kg/m ² . Associations were explored using multiple linear and logistic regression models, marginal probabilities for being overweight, and restricted cubic splines. Potential mediating variables were identified through mediation analysis.

Results: Among the female subjects, poor sleep quality (β = 0.46; 95%CI: 0.15-0.77) and short sleep duration (β = 0.62; 95%CI: 0.27-0.97) were associated with higher BMI and 21% of increased odds of excess weight after adjusting for all covariates (age, depression, chronic conditions, level of schooling, marriage status, smoking, alcohol consumption, screen time before bed, physical activity, diet quality, and whether dinner is the largest meal of the day). The mediation analysis showed that chronic conditions (20%), depression (16%), and diet quality (14%) mediated the total effect of poor sleep quality on BMI in female participants. Screen time before bed was the only significant mediator for short sleep duration, accounting for ∼ 5% of the total effect. No significant associations were found in male subjects.

Conclusion: Our findings highlight sex differences in the relationship between sleep and BMI, emphasizing the need for sex-specific approaches to sleep and weight management, focusing on health and lifestyle improvements.

While several therapeutic options for insomnia are currently available, they often require long-term use and come with certain disadvantages. Given insomnia's significant impact on health overall, more effective treatments are warranted. Here, we report two patients with moderate to severe insomnia whose symptoms significantly improved following the intravenous administration of ex vivo -expanded bone marrow-derived mesenchymal stem cells (MSC). The cases were 50-year-old and 38-year-old men with mild diabetes. They both developed insomnia several years ago and suffered from it despite taking some medications. We cultured their bone-marrow-derived MSCs and intravenously administered 1,5 × 10 ⁸ cells to each patient. After the treatment, the insomnia of both patients was drastically improved, while diabetes itself showed only mild improvement. Notably, their improvements were associated with an increase in plasma interleukin-4 levels. This is the first case report demonstrating the therapeutic effects of MSCs on insomnia.

Objective: To perform autonomic cardiovascular tests on patients with suspected OSA.

Materials and methods: In 2020, patients aged ≥18 years without difficult-to-control hypertension, cardiopathy, or pulmonary disease executed 6Hz deep breathing, 15-second Valsalva maneuver (40mmHg), and 5-minute active standing after the type 1 polysomnography at the Neurology (Federal University of São Paulo). The tests recorded blood pressure using beat-to-beat plethysmography, an electrocardiogram, and respiratory effort.

Results: Among the seventeen patients, ten had moderate OSA, and twelve were male. The mean age and disease duration were 52 and 14 years. Hypertension and obesity were frequent. They had mild autonomic symptom burden, mainly adrenergic sympathetic overactivity, and at least one-third of them had cardiovagal abnormalities.

Conclusion: A small sample of patients with untreated moderate-to-severe OSA had autonomic abnormalities in tests using beat-to-beat blood pressure. Sympathetic overdrive in long-term daytime was manifested as orthostatic hypertension. Emerging technologies contributed to diagnosing the OSA-related autonomic dysfunction beyond the polysomnographic approach.

Patients with REM sleep behavior disorder (RBD) enact their dreams, leading to enhanced dream recall. They report more negative emotions in their dreams, recall retrospective nightmares more frequently, and often experience more aggressive dreams. This study aims to understand dream characteristics in REM sleep behavior disorder using both retrospective and prospective measures in a controlled sleep laboratory setting to address possible recall biases in retrospective dream recall frequency. The sample comprises 102 iRBD-diagnosed patients (21 women, 81 men; M = 64.08, SD = 11.27) and 208 healthy controls (136 women, 72 men; M = 30.08, SD = 12.03), all undergoing identical procedures of two consecutive nights in the sleep laboratory, enabling a robust comparative examination of dream patterns. Retrospective assessments revealed a higher frequency of dream recall in patients with iRBD, while no significant difference was observed in prospective assessments. Nightmares were also reported more frequently in retrospective assessments in iRBD patients compared to healthy controls. Aggressive dream content was more frequent in patients with iRBD compared to controls, a future prospective diary study might clarify whether this heightened aggression in dreams is related to waking-life traits.

Sexsomnia is characterized by sexual behaviors ranging from masturbation, sexual sounds, and verbalizations, to touching and full sexual intercourse during NREM sleep, with subsequent amnesia. Autonomic activation occurs with sexual arousal. Sexsomnia has been described mostly in adult males and is still an underrecognized condition. Treatment is often effective but without current consensus. In a case now reported of an adolescent male with sexsomnia, which is rarely reported in the literature, a novel feature that is now first reported is defecation accompanying sexsomnia as a co-occurring autonomic disturbance during sleep.

Objective: To examine associations between polysomnography, muscle mass and strength, and daily life activity index (DLAI) in patients with sarcopenia.

Materials and methods: We measured polysomnography, muscle mass and strength, and DLAI in 16 patients with sarcopenia and 26 controls > 60 years old and then compared variables and correlations in the patients with sarcopenia.

Results: We found no differences in polysomnography between patients with sarcopenia and controls. Among patients with sarcopenia, latency to rapid eye-movement (REM) sleep was positively correlated with weight, REM %, and total sleep time was positively correlated with grip strength. Latency of REM sleep was negatively correlated with body mass index, NREM sleep, and apnea index was negatively correlated with grip strength. Daily life activity index correlated positively with grip strength.

Conclusion: Patients with sarcopenia showed significant correlations between polysomnography and weight, body mass index, and grip strength, suggesting a complex relationship involving sleep architecture, muscle function, and DLAI that deserves more research.

Objective: To analyze the association between sleep quality and chronic tinnitus.

Materials and methods: The present is a prospective observational cross-sectional study in which convenience sampling ( n  = 51) was used to assess individuals with chronic tinnitus at a specialized outpatient clinic in a tertiary referral hospital. The data collection tools included a demographics questionnaire, a sleep quality questionnaire (the Mini Sleep Questionnaire), a questionnaire to assess the impact of tinnitus (Tinnitus Handicap Inventory), and pure-tone audiometry. The data was analyzed using the student's t -test or analysis of variance (ANOVA), the Mann-Whitney or Kruskal-Wallis's test, and the Pearson's Chi-squared or Fisher's exact test.

Results: There was a predominance of women and middle-aged adults with bilateral tinnitus and hearing loss. The scores on the Tinnitus Handicap Inventory revealed that the tinnitus had a moderate to catastrophic impact on quality of life. Most participants classified themselves as having severe sleep difficulties on the Mini Sleep Questionnaire. Furthermore, patients with higher scores on the Tinnitus Handicap Inventory tended to show poor quality sleep patterns on the Mini Sleep Questionnaire. Regarding the association between sex and the scores on the Tinnitus Handicap Inventory, more men were severely handicapped, whereas more women were catastrophically handicapped. There was also a significant association between age group and hearing loss.

Conclusion: The data analysis revealed a significant association between sleep quality and tinnitus in the sample.

Introduction: Obstructive sleep apnea (OSA) affects nerve impulse transmission in the auditory pathway due to oxygen supply. Continuous positive airway pressure (CPAP) therapy improves oxygen levels, potentially alleviating sleepiness and enhancing central auditory pathway function.

Objective: To longitudinally evaluate the effect of CPAP on the degree of sleepiness, functional quality of sleep, and electrophysiological hearing responses of the central auditory pathways of patients with moderate to severe OSA.

Materials and methods: There were 31 adults (21 men and 10 women), aged 20 to 70 years, of which 18 were from the group with and 13 from the one without CPAP. All patients underwent three assessments: the first one performed immediately after CPAP prescription; the second, 3 months later; and the third, 6 months after the initial assessment. The Epworth Sleepiness Scale (ESS), the Functional Outcomes of Sleep Questionnaire-10 (FOSQ-10), auditory brainstem response (ABR), and long-latency auditory evoked potentials (LLAEP) were used for these assessments.

Results: The ESS did not detect any changes in excessive daytime sleepiness levels and the FOSQ-10 showed no improvement in either group. Analysis from ABR revealed a high proportion of altered results in both groups at the three assessment times. During the LLAEP, it was observed that the CPAP group exhibited reduced P2 latencies compared with the non-CPAP group in the second assessment. However, this improvement was not sustained in the subsequent assessment, possibly attributed to OSA-induced damage.

Conclusion: Treatment with CPAP for 6 months did not improve the degree of sleepiness, functional quality of sleep, or electrophysiological response of hearing, demonstrating that OSA can irreversibly harm the individual.