Sleep Science最新文献

Objective: To verify the feasibility of high-resolution oximeter plus actigraphy combined with a cloud-based algorithm for the detection of obstructive sleep apnea (OSA) in children with craniofacial anomalies.

Materials and methods: In the present prospective, cross-sectional study, we evaluated children previously submitted to primary surgical palate repair with a genetically confirmed diagnosis of Treacher Collins syndrome (TCS), non-syndromic Robin sequence (NSRS), or non-syndromic cleft palate (NSCP). The children underwent a clinical evaluation, had their anthropometric measures taken, and were submitted to OSA detection using high-resolution oximeter plus actigraphy combined with a cloud-based algorithm (Biologix Sleep Test, Biologix Sistemas S.A., São Paulo, SP, Brazil).

Results: In total, 64 children (TCS: n = 16; NSRS: n = 29; NSCP: n = 19) were included in the final analysis (mean age: 10 ± 2 years; 64% of female patients). The Biologix Sleep Test showed that 59 patients (92%) presented OSA according to the oxygen desaturation index (ODI): 36 (56%) were diagnosed with mild OSA, 19 (30%), with moderate OSA, and 4 (6%), with severe OSA. The high-resolution oximeter recording showed excellent signal quality in 94.53 ± 5.29% of the exams, with a success rate of exams on the first night of 90%. No significant difference was found in terms of ODI among the subgroups ( p  > 0.05). A significant relationship was observed between increased ODI with greater hypoxic burden and lower estimated sleep efficiency. The multiple linear regression analysis demonstrated a significant association between changes in total ODI with lower estimated sleep efficiency and sleep ODI.

Conclusion: High-resolution oximeter plus actigraphy combined with a cloud-based algorithm demonstrated adequate feasibility and applicability for OSA detection in children with craniofacial anomalies.

The scientific disciplines encompassing sleep, the immune system, and curcumin have garnered considerable interest due to their interconnectedness and potential implications for human health. Sleep is a crucial factor in maintaining optimal immune function, as it facilitates the release of cytokines, which are signaling molecules responsible for regulating immune responses. On the contrary, sleep deprivation has the potential of inhibiting immune function, thereby heightening the susceptibility to infection and disease. Curcumin, a naturally occurring polyphenol derived from the turmeric plant, has been observed to possess immunomodulatory characteristics through its ability to modulate the equilibrium between pro- and anti-inflammatory cytokines. It is worth noting that there is evidence suggesting that curcumin supplementation could enhance the quality of sleep. Scientific studies have indicated that curcumin supplementation has been associated with an increase in the duration of sleep and a decrease in wakefulness among individuals who are in good health. Additionally, curcumin supplementation has been found to enhance sleep quality and alleviate symptoms of depression in individuals diagnosed with major depressive disorder. The intricate interplay among sleep, the immune system, and curcumin is multifaceted, and scientific investigations indicate that curcumin may serve as a beneficial dietary adjunct to enhance immune function and optimize sleep quality. Nevertheless, additional investigation is required to fully comprehend the mechanisms through which curcumin alters the immune system and enhances sleep, as well as to ascertain the most effective dose and timing of curcumin supplementation.

Objective  To translate, cross-culturally adapt, and validate the Brazilian version of the Parkinson's Disease Sleep Scale-2 (PDSS-2/BR). Methods  This cross-sectional study addressed 80 patients with PD, and it was organized into two phases: 1) Translation and cross-cultural adaptation, which included 30 individuals in the scale's pretest stage and 2) Validation, when 50 individuals were assessed by the PDSS-2/BR, Pittsburgh Sleep Quality Index (PSQI), Parkinson's Disease Questionnaire-39 (PDQ-39), MDS-Unified Parkinson's Disease Rating Scale (MDS-UPDRS), and Hoehn and Yahr rating scale (HY); the PDSS-2/BR was retested 7 days later. The significance level was set at 5%. Results  The participants rated the PDSS-2/BR as having more than 90% comprehension. It also showed good reliability (Cronbach's alpha = 0.782) and excellent test-retest reliability (ICC _interrater  = 0.901; p  = 0.570; ICC _intrarater  = 0.905; p  = 0.116). Additionally, the scale showed good precision, with low standard error of measurement (SEM _inter  = 1.040; SEM _intra  = 0.908), and moderate to strong correlation with the PSQI, MDS-UPDRS, and PDQ-39 scales (rho = 0.46-0.74); only the HY scale showed no correlation. Discussion  The PDSS-2/BR is a reliable, precise, and valid instrument for evaluating sleep among Brazilian individuals with PD. Hence, it is expected to help researchers and clinicians improve the investigation of these symptoms, promoting early and assertive diagnoses and guiding the treatment and clinical management of this population.

Introduction  At high altitudes, hypobaric hypoxia leads to central apneas in both healthy adults and patients with obstructive sleep apnea. This condition correlates with intermittent desaturation and disruption of sleep. Materials and Methods  The clinical case of a patient evaluated during a sleep medicine outpatient consultation at the Fundación Neumológica Colombiana (Bogotá, Colombia, 2,600 masl) is reported. Case Study  We present a 64-year-old male patient living in a high-altitude city, who was an aircrew member and was on continuous positive airway pressure (CPAP) therapy for severe obstructive sleep apnea (OSA). The patient had symptoms and central apneas only when he slept at high altitudes. Other causes of central apnea were ruled out, and these events were corrected with the administration of supplemental oxygen. Altitude-associated central apnea is a common disorder that can occur at altitudes higher than 1,600 m above sea level. Currently, the first-line treatments are acetazolamide and oxygen supplementation. Conclusions  Changes in altitude should be considered in patients with OSA in PAP therapy, as it can occur in many occupations and in recreational travels.

Craniofacial phenotyping methods are pivotal in understanding and diagnosing pediatric obstructive sleep apnea (OSA). However, the lack of standardized methods often leads to inconsistencies, hindering the reliability and validity of quantitative analyses in this field. This systematic review aims to evaluate existing craniofacial phenotyping methodologies and their key parameters to propose standardization measures to enhance the reliability and validity of future quantitative analyses on this topic. A comprehensive search of electronic databases was conducted following PRISMA guidelines, resulting in the inclusion of 13 studies. Data extraction focused on the types of phenotyping methods and the parameters or measurements used. Our findings revealed a variation in the phenotyping techniques and a wide array of parameters used across studies, highlighting the need for standardization. The authors proposed a framework of parameters for future evaluation of craniofacial morphologies of pediatric OSA. By standardizing the assessment of these craniofacial morphologies, future research efforts can ensure consistency, facilitating more reliable and valid quantitative analyses in this critical area of study.

Objective: To evaluate whether a patch-type wearable temperature sensor (CALERA Research) could determine the circadian phase of core body temperature (CBT) in a manner like a rectal probe.

Objective: Sixteen participants (27 ± 11 years, 8 males and 8 females) wore an actigraph and CALERA Research sensor on the chest region for 3-5 days in a real-world setting. Simultaneous rectal temperature measurements were performed during the nocturnal sleep period. The midpoints of the nocturnal decrease in CBT (CBT _trough ) were used as the circadian phase marker. We analyzed 60 pairs of CBT _trough . The reliability and agreement of the CBT _trough from the two devices were analyzed using the intraclass correlation coefficient (ICC) and the concordance correlation coefficient (CCC). The Bland-Altman analysis was used to quantify the limit of agreement of CBT _trough between the devices.

Objective: The ICC of 0.96 (95%CI: 0.93-0.98) and CCC of 0.96 (95%CI: 0.93-0.97) values indicated excellent reliability and substantial agreement, respectively. The mean bias was 0.16 hours (95%LoA: -0.76-1.07 hours). The mean CBT _trough comparison was 5.9 ± 1.6 hours in the CALERA Research sensor and 5.8 ± 1.7 hours in the rectal probe.

Conclusion: The difference in the CBT _trough between the two devices was about ± 1.0 hour which would be an acceptable range for determining the CBT _trough . We suggest that the CALERA Research sensor could be a useful tool for reasonably estimating the circadian phase of CBT _trough and providing a surrogate for a rectal probe.

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.

Objective  Snoring is often perceived as a simple social nuisance, whereas it can be a telltale sign of serious respiratory diseases. The present study aimed to determine the prevalence of self-reported habitual snoring and to identify its associated factors. Materials and Methods  This cross-sectional study surveyed 815 individuals about their medical history, anthropometric characteristics, and lifestyle using a questionnaire. Results  The prevalence of self-reported habitual snoring in our sample was 29.2%. Variables independently associated with snoring were advanced age ( p  = 0.008), asthma ( p  = 0.003), sleepiness ( p  < 0.001), hyperthyroidism ( p  = 0.006), smoking ( p  < 0.001), diabetes ( p  = 0.010), and abdominal obesity ( p  = 0.007). Conclusion  This survey has highlighted the importance of snoring in an Arab-African context, to bring more awareness to this respiratory disorder and to understand that a simple snore can be a silent cry of an organism in need of help.