María Florencia Angellotti, Sofía Grandval, Ileana Palma, Vanina Giovini, Verónica Jaritos, Gastón Diaz-Lapasini, Denise Carnevale, Juan Facundo Nogueira
Abstract Introduction Unattended Polysomnography (type 2 PSG) is a procedure for the diagnosis of sleep-disordered breathing (SDB). Published evidence on its performance and efficacy is limited. Available studies reveal a high rate of lost records that could limit its application. Objective To assess the efficacy of type 2 PSG and the rate of studies that must be repeated due to critical loss of signals. Methods prospective, descriptive study. Adult patients with suspected SDB were included. Unattended PSG was performed using portable equipment. 75 patients were connected at home and another 75 in the laboratory, without subsequent monitoring. Records were evaluated to determine the percentage of the night with adequate quality for each of the signals, considered as an evaluable signal for = 70% of the total recording time (TRT). The need to repeat the studies was also estimated. Results: 150 patients were recruited; 44% women; age 57.3 ± 15.4 years; BMI 29.4 ± 6.5. EEG and EOG signals were adequate in 149 records. Flow signal by pressure cannula was adequate in 146 and by thermistor in 67.8%. In only one study the signal of both effort bands were inadequate. Oximetry was lost in 4 cases. Ten tracings (6%) met the criteria for repetition; 8 hospital and 2 home. Conclusions Acceptable records were obtained in most unattended PSG studies, both at home and in the sleep laboratory. The rate of repetition of studies due to loss of signal was 6%, with failure in SaO2 or in flow signals being the main cause of the indication.
{"title":"Nocturnal Polysomnography without Technical Supervision in the Diagnosis of Respiratory Sleep Disorders, Diagnostic Performance of Home and Sleep Laboratory Studies","authors":"María Florencia Angellotti, Sofía Grandval, Ileana Palma, Vanina Giovini, Verónica Jaritos, Gastón Diaz-Lapasini, Denise Carnevale, Juan Facundo Nogueira","doi":"10.1055/s-0043-1772809","DOIUrl":"https://doi.org/10.1055/s-0043-1772809","url":null,"abstract":"Abstract Introduction Unattended Polysomnography (type 2 PSG) is a procedure for the diagnosis of sleep-disordered breathing (SDB). Published evidence on its performance and efficacy is limited. Available studies reveal a high rate of lost records that could limit its application. Objective To assess the efficacy of type 2 PSG and the rate of studies that must be repeated due to critical loss of signals. Methods prospective, descriptive study. Adult patients with suspected SDB were included. Unattended PSG was performed using portable equipment. 75 patients were connected at home and another 75 in the laboratory, without subsequent monitoring. Records were evaluated to determine the percentage of the night with adequate quality for each of the signals, considered as an evaluable signal for = 70% of the total recording time (TRT). The need to repeat the studies was also estimated. Results: 150 patients were recruited; 44% women; age 57.3 ± 15.4 years; BMI 29.4 ± 6.5. EEG and EOG signals were adequate in 149 records. Flow signal by pressure cannula was adequate in 146 and by thermistor in 67.8%. In only one study the signal of both effort bands were inadequate. Oximetry was lost in 4 cases. Ten tracings (6%) met the criteria for repetition; 8 hospital and 2 home. Conclusions Acceptable records were obtained in most unattended PSG studies, both at home and in the sleep laboratory. The rate of repetition of studies due to loss of signal was 6%, with failure in SaO2 or in flow signals being the main cause of the indication.","PeriodicalId":21848,"journal":{"name":"Sleep Science","volume":"57 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135249225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Maria de Lourdes Rabelo Guimarães, Milena Carvalho Tourino Ribeiro, Thiago Antunes da Silva Barbosa, Laila Gabriela de Figueiredo Costa, Patricia Souza Bastos
Abstract Objective to report a myotonic dystrophy type 1 (MD1) subject with obstructive sleep apnea syndrome treated with oral appliance. Methods A review of individual's history and records, associated with a photographic register of all diagnostic methods and literature research about the topic were done. Final Statements This case depicts the therapeutical choices disposable to treat subjects with obstructive sleep apnea and DM1. Although considered an uncommon treatment, the oral appliances, if well indicated in adequately selected cases, can satisfactorily improve respiratory parameters, symptoms and quality of life.
{"title":"Obstructive Sleep Apnea Treatment with Oral Appliance in a Myotonic Dystrophy Type I Subject: A Case Report","authors":"Maria de Lourdes Rabelo Guimarães, Milena Carvalho Tourino Ribeiro, Thiago Antunes da Silva Barbosa, Laila Gabriela de Figueiredo Costa, Patricia Souza Bastos","doi":"10.1055/s-0043-1772817","DOIUrl":"https://doi.org/10.1055/s-0043-1772817","url":null,"abstract":"Abstract Objective to report a myotonic dystrophy type 1 (MD1) subject with obstructive sleep apnea syndrome treated with oral appliance. Methods A review of individual's history and records, associated with a photographic register of all diagnostic methods and literature research about the topic were done. Final Statements This case depicts the therapeutical choices disposable to treat subjects with obstructive sleep apnea and DM1. Although considered an uncommon treatment, the oral appliances, if well indicated in adequately selected cases, can satisfactorily improve respiratory parameters, symptoms and quality of life.","PeriodicalId":21848,"journal":{"name":"Sleep Science","volume":"108 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135249396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jordana Senff, Danielle Veiga Bonotto, Priscila Brenner Hilgenberg-Sydney, Aline Sebastiani, Rafaela Scariot, Lisa Yurie Oda
Abstract Introduction Sleep Bruxism (SB) is a common condition in childhood that can cause multiple consequences such as abnormal tooth wear, tensional headaches, masticatory muscle pain, or fatigue. The literature reports some interventions, however the treatment for SB in children is not well-established. Objectives A systematic review was performed to investigate the effectiveness of the treatments described for SB in children and adolescents: pharmacological and psychological treatments; behavioral guidelines; and dental approaches. Materials and methods Randomized clinical trials comparing different SB treatments with a control group were searched in the electronic databases PubMed, Scopus, Web of Science, Cochrane Library, and VHL until August 04, 2021. Two independent reviewers selected the studies, extracted the data, and assessed the risk of bias. After a two-phase selection process, 07 articles were selected. The methodology of the selected studies was analyzed using the Cochrane Risk of Bias Tool. The criteria used to qualify the studies were based on randomization, allocation, blinding of participants and evaluators, and analysis of results. Results The signs and symptoms of SB were reduced with pharmacotherapy (hydroxyzine/diazepam) and medicinal extracts (M. Officinalis), but with occlusal splints and physiotherapy, this improvement was not statistically significant when compared to control groups. Conclusion Some evidence of the efficacy of pharmacotherapy (hydroxyzine/diazepam) and medicinal extracts (M. Officinalis) was found. However, this systematic review is not enough to establish a protocol for the treatment of SB. Besides, the individualized management of SB in this population should be considered, emphasizing the management of risk factors.
摘要:睡眠磨牙症(Sleep brxism, SB)是儿童时期常见的一种疾病，可引起牙齿异常磨损、紧张性头痛、咀嚼肌疼痛或疲劳等多种后果。文献报道了一些干预措施，但是儿童SB的治疗还没有建立。目的:对儿童和青少年SB的治疗方法进行系统回顾，探讨治疗方法的有效性:药物和心理治疗;行为准则;还有牙科治疗。材料与方法在PubMed、Scopus、Web of Science、Cochrane Library和VHL等电子数据库中检索比较不同SB治疗方法与对照组的随机临床试验，检索截止日期为2021年8月4日。两名独立审稿人选择研究，提取数据，并评估偏倚风险。经过两阶段的筛选，07篇文章入选。所选研究的方法学采用Cochrane偏倚风险工具进行分析。用于确定研究资格的标准是基于随机化、分配、参与者和评估者的盲法以及结果分析。结果药物治疗(羟嗪/地西泮)和药用提取物(Officinalis)可减轻SB的体征和症状，但与对照组相比，咬合夹板和物理治疗的改善无统计学意义。结论药物治疗(羟嗪/地西泮)和药用提取物(Officinalis)有一定疗效。然而，本系统综述不足以建立SB的治疗方案。此外，应考虑对该人群SB的个体化管理，强调危险因素的管理。
{"title":"Childhood and Adolescents Sleep Bruxism Treatment: A Systematic Review","authors":"Jordana Senff, Danielle Veiga Bonotto, Priscila Brenner Hilgenberg-Sydney, Aline Sebastiani, Rafaela Scariot, Lisa Yurie Oda","doi":"10.1055/s-0043-1772826","DOIUrl":"https://doi.org/10.1055/s-0043-1772826","url":null,"abstract":"Abstract Introduction Sleep Bruxism (SB) is a common condition in childhood that can cause multiple consequences such as abnormal tooth wear, tensional headaches, masticatory muscle pain, or fatigue. The literature reports some interventions, however the treatment for SB in children is not well-established. Objectives A systematic review was performed to investigate the effectiveness of the treatments described for SB in children and adolescents: pharmacological and psychological treatments; behavioral guidelines; and dental approaches. Materials and methods Randomized clinical trials comparing different SB treatments with a control group were searched in the electronic databases PubMed, Scopus, Web of Science, Cochrane Library, and VHL until August 04, 2021. Two independent reviewers selected the studies, extracted the data, and assessed the risk of bias. After a two-phase selection process, 07 articles were selected. The methodology of the selected studies was analyzed using the Cochrane Risk of Bias Tool. The criteria used to qualify the studies were based on randomization, allocation, blinding of participants and evaluators, and analysis of results. Results The signs and symptoms of SB were reduced with pharmacotherapy (hydroxyzine/diazepam) and medicinal extracts (M. Officinalis), but with occlusal splints and physiotherapy, this improvement was not statistically significant when compared to control groups. Conclusion Some evidence of the efficacy of pharmacotherapy (hydroxyzine/diazepam) and medicinal extracts (M. Officinalis) was found. However, this systematic review is not enough to establish a protocol for the treatment of SB. Besides, the individualized management of SB in this population should be considered, emphasizing the management of risk factors.","PeriodicalId":21848,"journal":{"name":"Sleep Science","volume":"77 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135249399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Carolina Peña-Escudero, Sergio Priego-Fernández, Mario Caba, Juan Carlos Rodríguez-Alba, Aleph Alejandro Corona-Morales, Fabio García-García
Abstract Objective Nocturnal animals forage and eat during the night and sleep during the day. When food is available only for a short period during the day, animals develop a catabolic state and exhibit locomotor behavior before accessing food, termed food anticipatory activity. Consequently, there is a disruption in the sleep pattern. The present study aimed to explore how anticipatory arousal emerges under circadian exposure to a palatable meal (PM) and disrupts sleep architecture. Materials and Methods Adult male Wistar rats were implanted with electrodes for continuous sleep recording and housed under a light/dark 12/12-hour cycle with free access to food and water. After basal recordings, the rats had access to a PM during the light period for eight days. Results The anticipatory arousal started on the third day. On the eighth day, we found an increase in wake time and a decrease in the non-rapid eye movement sleep (NREMS) and rapid eye movement sleep (REMS) times 45 minutes before the PM compared with the basal recordings. The REMS transitions (events from NREMS to REMS) showed a significant reduction during the light period of the eighth day of PM. In contrast, the number of NREMS transitions (events from wakefulness to NREMS) remained unchanged. Conclusion The results suggest that palatable food induces a motivational timing that leads the rat to wake by altering the sleep quota.
{"title":"Effect of a Hedonic Stimulus on the Sleep Architecture of Male Wistar Rats","authors":"Carolina Peña-Escudero, Sergio Priego-Fernández, Mario Caba, Juan Carlos Rodríguez-Alba, Aleph Alejandro Corona-Morales, Fabio García-García","doi":"10.1055/s-0043-1773788","DOIUrl":"https://doi.org/10.1055/s-0043-1773788","url":null,"abstract":"Abstract Objective Nocturnal animals forage and eat during the night and sleep during the day. When food is available only for a short period during the day, animals develop a catabolic state and exhibit locomotor behavior before accessing food, termed food anticipatory activity. Consequently, there is a disruption in the sleep pattern. The present study aimed to explore how anticipatory arousal emerges under circadian exposure to a palatable meal (PM) and disrupts sleep architecture. Materials and Methods Adult male Wistar rats were implanted with electrodes for continuous sleep recording and housed under a light/dark 12/12-hour cycle with free access to food and water. After basal recordings, the rats had access to a PM during the light period for eight days. Results The anticipatory arousal started on the third day. On the eighth day, we found an increase in wake time and a decrease in the non-rapid eye movement sleep (NREMS) and rapid eye movement sleep (REMS) times 45 minutes before the PM compared with the basal recordings. The REMS transitions (events from NREMS to REMS) showed a significant reduction during the light period of the eighth day of PM. In contrast, the number of NREMS transitions (events from wakefulness to NREMS) remained unchanged. Conclusion The results suggest that palatable food induces a motivational timing that leads the rat to wake by altering the sleep quota.","PeriodicalId":21848,"journal":{"name":"Sleep Science","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135249054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Angus R. Teece, Martyn Beaven, Christos K. Argus, Nicholas Gill, Matthew W. Driller
Abstract Objective To evaluate the differences in subjective sleep quality, quantity, and behaviors among male and female elite rugby union athletes through two common sleep questionnaires. Materials and Methods A sample of 38 male and 27 female elite rugby union athletes filled out the Athlete Sleep Behavior Questionnaire (ASBQ) and the Pittsburgh Sleep Quality Index (PSQI). Global scores and individual items for each questionnaire were compared to assess differences between sexes. Results Male athletes reported significantly longer sleep duration (7 h 50 m ± 50 m versus 7h 12 m ± 58 m respectively; p ≤ 0.01; d = 0.70) and higher habitual sleep efficiency (88% versus 83% respectively; p < 0.05; d = 0.54) when compared with female athletes. Individual items of the ASBQ revealed significant differences between male and female athletes for five questions. Male athletes displayed higher instances of taking stimulants before training or competition and consuming alcohol within 4 hours of going to bed. Conversely, female athletes expressed greater thought or worry while in bed and a higher instance of training late at night. Discussion Male athletes displayed better self-reported sleep quality and quantity than female athletes; however, the present study highlighted that male and female elite rugby union athletes face specific challenges that differ. It appears that the differences observed between male and female elite rugby union athletes may be due to differing levels of professionalism or differences in training or competition schedules.
{"title":"Comparing Perceived Sleep Quality, Practices, and Behaviors of Male and Female Elite Rugby Union Athletes with the Use of Sleep Questionnaires","authors":"Angus R. Teece, Martyn Beaven, Christos K. Argus, Nicholas Gill, Matthew W. Driller","doi":"10.1055/s-0043-1772788","DOIUrl":"https://doi.org/10.1055/s-0043-1772788","url":null,"abstract":"Abstract Objective To evaluate the differences in subjective sleep quality, quantity, and behaviors among male and female elite rugby union athletes through two common sleep questionnaires. Materials and Methods A sample of 38 male and 27 female elite rugby union athletes filled out the Athlete Sleep Behavior Questionnaire (ASBQ) and the Pittsburgh Sleep Quality Index (PSQI). Global scores and individual items for each questionnaire were compared to assess differences between sexes. Results Male athletes reported significantly longer sleep duration (7 h 50 m ± 50 m versus 7h 12 m ± 58 m respectively; p ≤ 0.01; d = 0.70) and higher habitual sleep efficiency (88% versus 83% respectively; p < 0.05; d = 0.54) when compared with female athletes. Individual items of the ASBQ revealed significant differences between male and female athletes for five questions. Male athletes displayed higher instances of taking stimulants before training or competition and consuming alcohol within 4 hours of going to bed. Conversely, female athletes expressed greater thought or worry while in bed and a higher instance of training late at night. Discussion Male athletes displayed better self-reported sleep quality and quantity than female athletes; however, the present study highlighted that male and female elite rugby union athletes face specific challenges that differ. It appears that the differences observed between male and female elite rugby union athletes may be due to differing levels of professionalism or differences in training or competition schedules.","PeriodicalId":21848,"journal":{"name":"Sleep Science","volume":"109 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135249063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Fabio García-García, Mario Eduardo Acosta-Hernández, Luis Beltrán-Parrazal, Juan Carlos Rodríguez-Alba
Abstract Neuroglobin (Ngb) is a protein expressed in the central and peripherical nervous systems of the vertebrate. The Ngb has different functions in neurons, including regulating O2 homeostasis, oxidative stress, and as a neuroprotector after ischemia/hypoxia events. The Ngb is a hemoprotein of the globin family, structurally like myoglobin and hemoglobin. Ngb has higher expression in the cortex, hypothalamus, thalamus, brainstem, and cerebellum in mammals. Interestingly, Ngb immunoreactivity oscillates according to the sleep-wake cycle and decreases after 24 hours of sleep deprivation, suggesting that sleep homeostasis regulates Ngb expression. In addition, Ngb expresses in brain areas related to REM sleep regulation. Therefore, in the present review, we discuss the potential role of the Ngb in the sleep-wake regulation of mammals.
{"title":"The Role of Neuroglobin in the Sleep-Wake Cycle","authors":"Fabio García-García, Mario Eduardo Acosta-Hernández, Luis Beltrán-Parrazal, Juan Carlos Rodríguez-Alba","doi":"10.1055/s-0043-1772806","DOIUrl":"https://doi.org/10.1055/s-0043-1772806","url":null,"abstract":"Abstract Neuroglobin (Ngb) is a protein expressed in the central and peripherical nervous systems of the vertebrate. The Ngb has different functions in neurons, including regulating O2 homeostasis, oxidative stress, and as a neuroprotector after ischemia/hypoxia events. The Ngb is a hemoprotein of the globin family, structurally like myoglobin and hemoglobin. Ngb has higher expression in the cortex, hypothalamus, thalamus, brainstem, and cerebellum in mammals. Interestingly, Ngb immunoreactivity oscillates according to the sleep-wake cycle and decreases after 24 hours of sleep deprivation, suggesting that sleep homeostasis regulates Ngb expression. In addition, Ngb expresses in brain areas related to REM sleep regulation. Therefore, in the present review, we discuss the potential role of the Ngb in the sleep-wake regulation of mammals.","PeriodicalId":21848,"journal":{"name":"Sleep Science","volume":"47 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135249237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Francine dos Santos Costa, Matheus dos Santos Fernandez, Ivan Freire da Silva-Junior, Sarah Arangurem Karam, Luiz Alexandre Chisini, Marília Leão Goettems
Abstract The aim of the present study was to examine the association regarding sleep bruxism (SB), depression, and stress in Brazilian university students. We conducted a cross-sectional study with a large-sample of university students (n = 2,089) in the city of Pelotas, Rio Grande do Sul, Southern Brazil. A self-administered questionnaire was sent to classrooms to evaluate socioeconomic and demographic characteristics. Possible SB was detected by self-report according to the International Consensus on The Assessment of Bruxism Criteria (2018). The Patient Health Questionnaire-9 and the Perceived Stress Scale were used to assess depression and stress symptoms respectively. Crude and adjusted Poisson regression analyses were performed. The prevalence of possible SB, high level of stress, and depressive symptoms in the sample were of 20.4%, 16.6%, and 16.6% respectively. Stress in female students was significantly associated with an increased prevalence of possible SB, but not in male students. Regarding depression, the prevalence of SB was 28% higher in students with depressive symptoms. Students with stress or depression had a 35% higher prevalence of SB than those without any symptoms. Conclusion The findings have shown that university students with stress and depressive symptoms were more likely to be detected with possible SB.
{"title":"Association Involving Possible Sleep Bruxism, Stress, and Depressive Symptoms in Brazilian University Students: A Cross-sectional Study","authors":"Francine dos Santos Costa, Matheus dos Santos Fernandez, Ivan Freire da Silva-Junior, Sarah Arangurem Karam, Luiz Alexandre Chisini, Marília Leão Goettems","doi":"10.1055/s-0043-1772808","DOIUrl":"https://doi.org/10.1055/s-0043-1772808","url":null,"abstract":"Abstract The aim of the present study was to examine the association regarding sleep bruxism (SB), depression, and stress in Brazilian university students. We conducted a cross-sectional study with a large-sample of university students (n = 2,089) in the city of Pelotas, Rio Grande do Sul, Southern Brazil. A self-administered questionnaire was sent to classrooms to evaluate socioeconomic and demographic characteristics. Possible SB was detected by self-report according to the International Consensus on The Assessment of Bruxism Criteria (2018). The Patient Health Questionnaire-9 and the Perceived Stress Scale were used to assess depression and stress symptoms respectively. Crude and adjusted Poisson regression analyses were performed. The prevalence of possible SB, high level of stress, and depressive symptoms in the sample were of 20.4%, 16.6%, and 16.6% respectively. Stress in female students was significantly associated with an increased prevalence of possible SB, but not in male students. Regarding depression, the prevalence of SB was 28% higher in students with depressive symptoms. Students with stress or depression had a 35% higher prevalence of SB than those without any symptoms. Conclusion The findings have shown that university students with stress and depressive symptoms were more likely to be detected with possible SB.","PeriodicalId":21848,"journal":{"name":"Sleep Science","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135249049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Introduction The clinical diagnosis of disorders of arousal (DOA) is based primarily on a clinical history including amnesia for episodes. The presence of amnesia means the patient cannot provide direct evidence. In a forensic setting, when the defendant has been charged criminally with violent actions or sexual related assaults allegedly during sleep, a sleepwalking defense may be presented. As opposed to clinical history, the prosecution generally focuses on the single episode of alleged DOA that resulted in the criminal charges against the defendant. The prosecution will argue that this episode of complex behavior was not consistent with a DOA. A past history of purported episodes is not proof that a recent single episode must be a DOA. However, most sleepwalking defenses rely heavily on standard clinical evaluations despite the fact they have no direct connection with the current criminally charged episode. The International Classification of Sleep Disorders (ICSD-3) General Diagnostic Criteria C for DOAs that states “limited or no associated cognition” should be present. Recent real time studies of DOAs have shown that during DOA episodes the prefrontal cortex (PRC) is deactivated while the motor cortex remains active. Conclusion The PFC is the location of almost all executive functions including inhibition, planning, memory, and many others. Thus, when the PFC is deactivated, these higher cognitive functions are not available. The presence of higher cognitive functions during an alleged episode of DOA would be inconsistent with a deactivated PFC and thus inconsistent with generally accepted brain activity during a NREM parasomnia. This would be direct evidence that the episode could not be a DOA but occurred during wakefulness. Clinical trial No.
{"title":"Forensic Evaluation of a Single Episode of a Disorder of Arousal in a Sleepwalking Defense: Cognitive Function Versus Prior Clinical History","authors":"Mark R. Pressman","doi":"10.1055/s-0043-1773787","DOIUrl":"https://doi.org/10.1055/s-0043-1773787","url":null,"abstract":"Abstract Introduction The clinical diagnosis of disorders of arousal (DOA) is based primarily on a clinical history including amnesia for episodes. The presence of amnesia means the patient cannot provide direct evidence. In a forensic setting, when the defendant has been charged criminally with violent actions or sexual related assaults allegedly during sleep, a sleepwalking defense may be presented. As opposed to clinical history, the prosecution generally focuses on the single episode of alleged DOA that resulted in the criminal charges against the defendant. The prosecution will argue that this episode of complex behavior was not consistent with a DOA. A past history of purported episodes is not proof that a recent single episode must be a DOA. However, most sleepwalking defenses rely heavily on standard clinical evaluations despite the fact they have no direct connection with the current criminally charged episode. The International Classification of Sleep Disorders (ICSD-3) General Diagnostic Criteria C for DOAs that states “limited or no associated cognition” should be present. Recent real time studies of DOAs have shown that during DOA episodes the prefrontal cortex (PRC) is deactivated while the motor cortex remains active. Conclusion The PFC is the location of almost all executive functions including inhibition, planning, memory, and many others. Thus, when the PFC is deactivated, these higher cognitive functions are not available. The presence of higher cognitive functions during an alleged episode of DOA would be inconsistent with a deactivated PFC and thus inconsistent with generally accepted brain activity during a NREM parasomnia. This would be direct evidence that the episode could not be a DOA but occurred during wakefulness. Clinical trial No.","PeriodicalId":21848,"journal":{"name":"Sleep Science","volume":"38 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135249045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Objective To identify sleep patterns and sleep behaviors in a group of infants and toddlers (0 to 36 months) in Iran. Methods Parents and caregivers of 602 infants and toddlers in Iran completed a Persian translation of the Brief Infant Sleep Questionnaire. To assess the differences among the age groups, non-parametric statistical approaches such as the Kruskal-Wallis and chi-square tests were employed. Results The infants and toddlers went to bed relatively late (22:30), and the median night awakening was 2 times (20 min). They most likely slept in the same room with their parents (55.5%), and commonly in the same bed (18.9%). They slept a median of 11.50 hours per day. A significant percentage of the parents felt that their child had moderate or severe sleep problems (22.4%). These children's sleep patterns had significant developmental changes, including decreased daytime sleep, reduced overall sleep, and increased sleep consolidation (reduced number and duration of night awakenings and increased overall sleep duration). The parents commonly used holding-and-rocking and bottle/breastfeeding to initiate infants' sleep and bottle/breastfeeding to resume their infants' sleep. Discussion These findings provide reference data for professionals to assess sleep in children under 3 years of age and also supply knowledge about common parenting practices related to a child's sleep. Cross-cultural comparisons using the findings can offer new insights into the practices and behaviors of parents concerning infant and toddler sleep.
{"title":"What is the Sleep Pattern of Infants and Toddlers in the Iranian Population? An Epidemiological Study","authors":"Amir Ali Mazandarani, Mahdi Zare Bahramabadi","doi":"10.1055/s-0043-1772804","DOIUrl":"https://doi.org/10.1055/s-0043-1772804","url":null,"abstract":"Abstract Objective To identify sleep patterns and sleep behaviors in a group of infants and toddlers (0 to 36 months) in Iran. Methods Parents and caregivers of 602 infants and toddlers in Iran completed a Persian translation of the Brief Infant Sleep Questionnaire. To assess the differences among the age groups, non-parametric statistical approaches such as the Kruskal-Wallis and chi-square tests were employed. Results The infants and toddlers went to bed relatively late (22:30), and the median night awakening was 2 times (20 min). They most likely slept in the same room with their parents (55.5%), and commonly in the same bed (18.9%). They slept a median of 11.50 hours per day. A significant percentage of the parents felt that their child had moderate or severe sleep problems (22.4%). These children's sleep patterns had significant developmental changes, including decreased daytime sleep, reduced overall sleep, and increased sleep consolidation (reduced number and duration of night awakenings and increased overall sleep duration). The parents commonly used holding-and-rocking and bottle/breastfeeding to initiate infants' sleep and bottle/breastfeeding to resume their infants' sleep. Discussion These findings provide reference data for professionals to assess sleep in children under 3 years of age and also supply knowledge about common parenting practices related to a child's sleep. Cross-cultural comparisons using the findings can offer new insights into the practices and behaviors of parents concerning infant and toddler sleep.","PeriodicalId":21848,"journal":{"name":"Sleep Science","volume":"57 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135249244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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