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P057 Exploring the ‘Pharmacist Role’ in Insomnia Management and Care Provision: A Scoping Review 探索“药师角色”在失眠管理和护理提供:一个范围审查
Pub Date : 2023-10-01 DOI: 10.1093/sleepadvances/zpad035.142
M Basheti, R Grunstein, C Gordon, B Saini
Abstract Background Insomnia is a highly burdensome sleep disorder, with a global prevalence of approximately thirty percent in adults. Given its impact on daily functioning and the role it plays in the development/progression of comorbid mental/physical disease, appropriate and timely management is essential. Pharmacists are at the forefront of the primary care workforce and given their expanding roles in healthcare, could aid in alleviating the burden of insomnia in the community by delivering adequate care. Objectives To describe the current and potential roles of pharmacists in insomnia care. Methods An extensive search of five databases (MEDLINE, EMBASE, SCOPUS, IPA, CINAHL) was conducted. Titles, abstracts, and full text articles were screened to identify relevant studies for review inclusion. Articles were reviewed and data extracted, analysed, and grouped categorically based on nature of care provided. Results Thirty studies met inclusion criteria. Insomnia management provision across these studies was divided categorically into 1) Screening/Assessment, 2) Pharmacological and non-pharmacological management provision, and 3) Deprescribing services. Regarding treatment provision, it was evident that pharmacological approaches remain the most common treatment modality adopted despite guidelines recommending behavioural therapy as first line. Overall, the results highlighted that provided with the adequate training and education, pharmacists have the potential to engage in insomnia screening, behavioural therapy and deprescribing services, improving overall insomnia management in primary care. Conclusion The outcomes of this review highlight a current gap in insomnia management practices carried out by pharmacists and provide evidence for improved roles when pharmacists are upskilled with specialised insomnia management education/training.
背景:失眠是一种高度繁重的睡眠障碍,全球成年人患病率约为30%。鉴于其对日常功能的影响及其在并发精神/身体疾病的发生/进展中所起的作用,适当和及时的管理至关重要。药剂师处于初级保健工作队伍的最前沿,鉴于他们在医疗保健中日益扩大的作用,可以通过提供适当的护理来帮助减轻社区失眠的负担。目的探讨药师在失眠护理中的现状和潜在作用。方法广泛检索MEDLINE、EMBASE、SCOPUS、IPA、CINAHL 5个数据库。筛选标题、摘要和全文文章,以确定纳入综述的相关研究。对文章进行回顾,并根据所提供护理的性质对数据进行提取、分析和分类。结果30项研究符合纳入标准。这些研究的失眠管理提供分为1)筛查/评估,2)药物和非药物管理提供,以及3)处方化服务。关于提供治疗,很明显,药理学方法仍然是采用的最常见的治疗方式,尽管指南建议将行为疗法作为第一线。总的来说,研究结果强调,在适当的培训和教育下,药剂师有潜力从事失眠筛查、行为治疗和处方服务,改善初级保健的整体失眠管理。结论本综述的结果突出了目前药剂师在失眠管理实践中的差距,并为通过专门的失眠管理教育/培训提高药剂师的技能提供了证据。
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引用次数: 0
P097 The Fate of Obstructive Sleep Apnea in Long-term 阻塞性睡眠呼吸暂停的长期预后
Pub Date : 2023-10-01 DOI: 10.1093/sleepadvances/zpad035.182
H Jang, J Lee, U Ryu, D Park, S Mun
Abstract Objective This study aims to investigate the relationships of the severity of OSA and the long-term results of OSA in untreated patients and to compare them with the results of OSA patients who were operated. Materials and Methods The study retrospectively analyzed medical records of 79 individuals who were diagnosed with OSA, who either underwent surgical treatment or received no treatment from 2009 to 2022. Among the patients who underwent polysomnography (PSG) twice, the patients were subdivided by mild, moderate, severe groups according to apnea-hypopnea index (AHI) and the changes in OSA severity over time were compared. Results This study included 43 patients (54%) who received no treatment and 36 patients (46%) who had undergone surgery including tonsillectomy with or without uvula or palatopharyngeal procedures. Among the untreated patients, there was no significant changes in AHI values over time for the overall group, the mild and severe subgroups, but the moderate group showed a significant increase in AHI values (p=0.017). Surgical treatment, specifically tonsillectomy, resulted in a significant decrease in AHI values compared to untreated patients, particularly within 36 months after the procedure (p=0.000). However, for patients with a follow-up period of more than 36 months, the difference in AHI values was not statistically significant between those who underwent tonsillectomy and those who did not. Conclusions Untreated moderate OSA patients show worsening of AHI values over time, highlighting the need for proactive treatment. Surgical intervention can reduce AHI values within 36 months but may lead to worsening of symptoms afterwards.
【摘要】目的探讨未经治疗的OSA患者的严重程度与长期预后的关系,并将其与手术治疗的OSA患者的预后进行比较。材料与方法本研究回顾性分析了2009年至2022年间79例被诊断为OSA的患者的医疗记录,这些患者要么接受了手术治疗,要么没有接受治疗。两次接受多导睡眠图(PSG)检查的患者,根据呼吸暂停低通气指数(AHI)将患者细分为轻度、中度、重度组,比较OSA严重程度随时间的变化。结果本研究包括43例(54%)未接受治疗的患者和36例(46%)接受了包括扁桃体切除术和小舌或腭咽手术的患者。在未经治疗的患者中,整体组、轻度和重度亚组的AHI值随时间没有显著变化,但中度组的AHI值显著升高(p=0.017)。与未经治疗的患者相比,手术治疗,特别是扁桃体切除术,导致AHI值显著下降,特别是在手术后36个月内(p=0.000)。然而,对于随访期超过36个月的患者,行扁桃体切除术与未行扁桃体切除术的患者AHI值差异无统计学意义。结论:未经治疗的中度OSA患者AHI值随着时间的推移而恶化,强调了积极治疗的必要性。手术干预可在36个月内降低AHI值,但术后可能导致症状恶化。
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引用次数: 0
O016 Caregivers’ Perspectives on the Sonomat as a Polysomnography Alternative in Children with Down syndrome [016]护理人员对sononomat作为唐氏综合症儿童多导睡眠仪替代方法的看法
Pub Date : 2023-10-01 DOI: 10.1093/sleepadvances/zpad035.016
K Sclip, A Collaro, J Chawla
Abstract Introduction Children with Down syndrome (DS) frequently require repeated polysomnography (PSG) to diagnose and monitor sleep disordered breathing (SDB). PSG set-up can be distressing for this population, who may struggle with sensor and lead application. The Sonomat, a non-invasive mattress overlay, has now been shown to accurately detect and profile SDB in this population. The aim of this study was to evaluate caregiver experiences of undertaking home Sonomat monitoring in their child with DS, compared to conventional lab PSG. Method Children with DS aged 2-17yrs undergoing a diagnostic PSG at the Queensland Children’s Hospital completed a PSG questionnaire about their child’s experience of this test. Those that also undertook home Sonomat monitoring completed a questionnaire about their experience of using the Sonomat in the home. Results Caregivers of fifty-one children with DS (median age 7yrs, 52% male) completed the PSG questionnaire and twenty-five completed the Sonomat questionnaire. 45% (n=51) of caregivers reported that in-lab PSG was ‘hard’ or ‘very hard’ for their child. 100% (n=25) of the caregivers rated their experience of using the Sonomat at home as good, very good or excellent. 88% (n=25) of caregivers felt that the Sonomat was their preferred option for monitoring in children with DS, as opposed to a traditional in-lab PSG. Conclusion In this study, the Sonomat was viewed favourably by caregivers of children with DS, and in the majority of instances was preferred to in-hospital PSG.
摘要:唐氏综合征(DS)患儿经常需要重复多导睡眠图(PSG)来诊断和监测睡眠呼吸障碍(SDB)。PSG的设置对于这些人群来说可能是痛苦的,他们可能会与传感器和引线的应用作斗争。Sonomat是一种非侵入性床垫覆盖物,现已被证明可以准确地检测和分析这一人群的SDB。本研究的目的是评估与传统实验室PSG相比,对患有DS的儿童进行家庭索诺玛监测的护理经验。方法对在昆士兰儿童医院接受诊断性PSG检查的2-17岁DS患儿填写一份关于其对该测试体验的PSG问卷。那些也进行家庭索诺玛监测的人完成了一份关于他们在家中使用索诺玛的体验的问卷调查。结果51例退行性痴呆患儿(中位年龄7岁,男性占52%)完成了PSG问卷,25例完成了Sonomat问卷。45% (n=51)的护理人员报告说,实验室内的PSG对他们的孩子来说“困难”或“非常困难”。100% (n=25)的护理人员将他们在家中使用sononomat的体验评为良好、非常好或优秀。88% (n=25)的护理人员认为,与传统的实验室PSG相比,sononomat是他们监测DS儿童的首选选择。结论:在本研究中,索诺玛被退行性痴呆儿童的照顾者看好,在大多数情况下,索诺玛比住院PSG更受欢迎。
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引用次数: 0
O017 Real-World Utility of Overnight Oximetry for the Screening of Obstructive Sleep Apnoea in Children 夜间血氧仪在儿童阻塞性睡眠呼吸暂停筛查中的实际应用
Pub Date : 2023-10-01 DOI: 10.1093/sleepadvances/zpad035.017
C Hartnett, A Wilson, D Kilner, K Davies, N Slee, J Chawla, K Iyer, A Kevat
Abstract Obstructive sleep apnoea (OSA) is a common problem in children, and can result in developmental and cognitive complications if untreated. The gold-standard tool for diagnosis is polysomnography (PSG); however, it is an expensive and time-consuming test to undertake. Overnight oximetry has been suggested as a faster and cheaper alternative to PSG as it can be performed at home using limited, reusable equipment. This study aims to evaluate the effectiveness of a home oximetry service (implemented in response to extended waiting times for routine PSG) in reducing the time between patient referral and treatment. All patients who utilised the Queensland Children’s Hospital home oximetry service since its inception in 2021 (n=165) were compared to a historic group of patients who underwent PSG in 2018 (n=313). The time from request of the sleep-related study to definitive treatment (ENT surgery or continuous positive airway pressure trial) was significantly reduced (161 days for the HITH oximetry group vs 348 days for the comparable PSG group; p-value <0.02), and time from sleep study request to the report of results was significantly lower for patients in the oximetry group compared to those in the PSG group (12 days vs 86 days p-value <0.01). These results suggest that a home oximetry service can be effective in reducing the waiting time for patients diagnosed with OSA to receive treatment. Further research should examine larger sample sizes to confirm the study findings, investigate the health economic impacts of the service and explore patient/family perspectives.
阻塞性睡眠呼吸暂停(OSA)是儿童的常见问题,如果不及时治疗,可导致发育和认知并发症。诊断的金标准工具是多导睡眠图(PSG);然而,这是一项昂贵且耗时的测试。过夜血氧仪被认为是一种更快、更便宜的替代PSG的方法,因为它可以在家中使用有限的、可重复使用的设备进行。本研究旨在评估家庭血氧测定服务(为应对常规PSG延长的等待时间而实施)在减少患者转诊和治疗之间的时间方面的有效性。自2021年昆士兰儿童医院家庭血氧仪服务成立以来,所有使用该服务的患者(n=165)与2018年接受PSG的历史患者组(n=313)进行了比较。从要求睡眠相关研究到最终治疗(耳鼻喉外科手术或持续气道正压试验)的时间显著缩短(HITH血氧仪组为161天,PSG组为348天;p值<0.02),血氧仪组患者从睡眠研究请求到报告结果的时间明显低于PSG组(12天vs 86天p值<0.01)。这些结果表明,家庭血氧测量服务可以有效地减少被诊断为阻塞性睡眠呼吸暂停的患者接受治疗的等待时间。进一步的研究应检查更大的样本量,以确认研究结果,调查该服务的健康经济影响,并探讨患者/家庭的观点。
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引用次数: 0
P096 The Effect of Moderate-Intensity Exercise on Sleep Quality and Quantity in Healthy Adult Males 中等强度运动对健康成年男性睡眠质量和睡眠量的影响
Pub Date : 2023-10-01 DOI: 10.1093/sleepadvances/zpad035.181
M Morrison, J Weakley, G Roach, C Sargent, D Miller, C Gardiner, S Halson
Abstract Introduction Acute exercise may have the ability to disrupt sleep in healthy adults. Given the popularity of afternoon exercise, it is important to determine how this affects sleep. Therefore, the aim of this study was to investigate the effect of afternoon moderate-intensity cycling exercise on objective and subjective sleep in healthy adult males. Methods To assess the effect of moderate-intensity afternoon exercise on sleep quality and quantity, 12 healthy adult males who were identified as good sleepers completed a repeated-measures, counter-balanced, crossover study design with two conditions (moderate-intensity aerobic exercise or no exercise). The exercise task involved cycling for 40 minutes at 70%HRmax and was completed ~15:30h. Polysomnography was used to measure sleep during a 9-h sleep opportunity (23:00h to 08:00h). Results There were no statistically significant differences in objective or subjective sleep between conditions. Exercise had a medium-sized effect on reducing total sleep time (mean ± SD; control 493.71 ± 12.59 mins vs exercise: 471.46 ± 55.19 mins; Cohen’s d: 0.56), sleep efficiency (mean ± SD; control 91.43 ± 2.33 % vs exercise: 87.31 ± 10.22 %; Cohen’s d: 0.56), and increasing REM onset latency (mean ± SD; control: 76.13 ± 45.10 mins vs exercise: 102.75 ± 46.85 mins; r: -0.33) (all p &gt; 0.05). Discussion Healthy adult males can complete afternoon moderate-intensity exercise without compromising subsequent sleep. Individual responses in objective sleep outcomes may vary after exercise.
急性运动可能会扰乱健康成年人的睡眠。鉴于下午运动的流行,确定它对睡眠的影响是很重要的。因此,本研究的目的是探讨下午中等强度自行车运动对健康成年男性客观和主观睡眠的影响。方法为评估中等强度下午运动对睡眠质量和时间的影响,12名睡眠良好的健康成年男性完成了两种条件(中等强度有氧运动和不运动)的重复测量、平衡、交叉研究设计。运动任务为以70%HRmax骑车40分钟,于15:30完成。多导睡眠仪用于测量9小时睡眠时间(23:00 - 08:00)的睡眠情况。结果两组患者主观、客观睡眠时间差异无统计学意义。运动对减少总睡眠时间有中等程度的影响(平均值±标准差;对照组493.71±12.59分钟vs运动471.46±55.19分钟;Cohen’SD: 0.56)、睡眠效率(mean±SD;对照组91.43±2.33% vs锻炼87.31±10.22%;Cohen’SD: 0.56), REM发作潜伏期增加(mean±SD;对照组:76.13±45.10分钟vs运动:102.75±46.85分钟;R: -0.33)(所有p >0.05)。健康的成年男性可以在不影响睡眠的情况下完成下午中等强度的运动。运动后个体对客观睡眠结果的反应可能有所不同。
{"title":"P096 The Effect of Moderate-Intensity Exercise on Sleep Quality and Quantity in Healthy Adult Males","authors":"M Morrison, J Weakley, G Roach, C Sargent, D Miller, C Gardiner, S Halson","doi":"10.1093/sleepadvances/zpad035.181","DOIUrl":"https://doi.org/10.1093/sleepadvances/zpad035.181","url":null,"abstract":"Abstract Introduction Acute exercise may have the ability to disrupt sleep in healthy adults. Given the popularity of afternoon exercise, it is important to determine how this affects sleep. Therefore, the aim of this study was to investigate the effect of afternoon moderate-intensity cycling exercise on objective and subjective sleep in healthy adult males. Methods To assess the effect of moderate-intensity afternoon exercise on sleep quality and quantity, 12 healthy adult males who were identified as good sleepers completed a repeated-measures, counter-balanced, crossover study design with two conditions (moderate-intensity aerobic exercise or no exercise). The exercise task involved cycling for 40 minutes at 70%HRmax and was completed ~15:30h. Polysomnography was used to measure sleep during a 9-h sleep opportunity (23:00h to 08:00h). Results There were no statistically significant differences in objective or subjective sleep between conditions. Exercise had a medium-sized effect on reducing total sleep time (mean ± SD; control 493.71 ± 12.59 mins vs exercise: 471.46 ± 55.19 mins; Cohen’s d: 0.56), sleep efficiency (mean ± SD; control 91.43 ± 2.33 % vs exercise: 87.31 ± 10.22 %; Cohen’s d: 0.56), and increasing REM onset latency (mean ± SD; control: 76.13 ± 45.10 mins vs exercise: 102.75 ± 46.85 mins; r: -0.33) (all p &amp;gt; 0.05). Discussion Healthy adult males can complete afternoon moderate-intensity exercise without compromising subsequent sleep. Individual responses in objective sleep outcomes may vary after exercise.","PeriodicalId":21861,"journal":{"name":"SLEEP Advances","volume":"47 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136054282","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}
引用次数: 0
P071 Simple Vestibular-Occular Motor Assessment as a Predictor of Driving Performance Vulnerability following extended Wakefulness 简单前庭-眼运动评估作为长时间清醒后驾驶性能脆弱性的预测因子
Pub Date : 2023-10-01 DOI: 10.1093/sleepadvances/zpad035.156
C Dunbar, P Nguyen, A Guyett, K Nguyen, K Bickley, A Reynolds, M Hughes, H Scott, R Adams, L Lack, P Catcheside, J Cori, M Howard, C Anderson, N Lovato, A Vakulin
Abstract Introduction Driver fatigue is a significant contributor to road crashes, but identifying individuals at driving risk is challenging. We examined the potential of simple baseline vestibular ocular motor system (VOMS) assessment via virtual reality goggles to predict subsequent vulnerability to driving simulator impairment following extended wakefulness. Methods 49 individuals (Mean±SD Age 32.6±12.9, 45% Males) underwent 9hr baseline sleep opportunity followed by approximately ~29hrs extended wakefulness with five 60min driving assessments. Cluster analysis classified drivers into vulnerable (n=17) or resistant (n=32) groups based on their worst steering deviation and number of crashes from driving tests. Baseline VOMS were performed ~10mins prior to the first three drives (1, 7 and 13hrs of wakefulness). XGBoost machine learning model was trained using baseline VOMs features to predict vulnerable vs resistant groups from driving tests 4 and 5 (19 and 25hrs of wakefulness) Model performance was evaluated using 5-fold cross-validation approach using ROC analysis. Results XGBoost machine learning ranked all 70 VOMS metrics on their importance in predicting vulnerable vs resistant groups. Top 10 VOMs metrics assessed during baseline non-sleep deprived tests demonstrated a strong ability to predict the driver's performance following extended wakefulness, differentiating between the vulnerable vs resistant groups (AUC 0.73 [95%CI 0.61-0.83, p&lt;0.001]). Conclusion VOMs tests conducted at baseline holds promise for predicting future driving impairment. This approach has the potential to be highly valuable in determining an individual's fitness to drive. Future validation in independent samples, sleep disordered population and in-field on-road testing are needed to confirm these promising findings.
驾驶员疲劳是道路交通事故的重要因素,但识别处于驾驶风险中的个体是具有挑战性的。我们通过虚拟现实护目镜检测了简单基线前庭眼运动系统(VOMS)评估的潜力,以预测长时间清醒后驾驶模拟器损伤的后续脆弱性。方法49例受试者(平均±SD年龄32.6±12.9岁,男性45%)基线睡眠时间为9小时,延长清醒时间约29小时,并进行5次60min驾驶评估。聚类分析根据驾驶员的最大转向偏差和驾驶测试中的撞车次数,将驾驶员分为易受伤害(n=17)和抗受伤害(n=32)两组。基线VOMS在前三次驱动(清醒1、7和13小时)前约10分钟进行。使用基线VOMs特征对XGBoost机器学习模型进行训练,以预测驾驶测试4和5(清醒时间19和25小时)的易感组和抗性组。结果XGBoost机器学习对所有70个VOMS指标在预测弱势群体和抵抗群体中的重要性进行了排名。在基线非睡眠剥夺测试中评估的前10个VOMs指标显示出在长时间清醒后预测驾驶员表现的强大能力,区分了脆弱组和抵抗组(AUC 0.73 [95%CI 0.61-0.83, p<0.001])。结论在基线上进行的VOMs测试有望预测未来的驾驶障碍。这种方法在确定一个人的驾驶能力方面具有很高的价值。未来需要在独立样本、睡眠障碍人群和现场道路测试中进行验证,以证实这些有希望的发现。
{"title":"P071 Simple Vestibular-Occular Motor Assessment as a Predictor of Driving Performance Vulnerability following extended Wakefulness","authors":"C Dunbar, P Nguyen, A Guyett, K Nguyen, K Bickley, A Reynolds, M Hughes, H Scott, R Adams, L Lack, P Catcheside, J Cori, M Howard, C Anderson, N Lovato, A Vakulin","doi":"10.1093/sleepadvances/zpad035.156","DOIUrl":"https://doi.org/10.1093/sleepadvances/zpad035.156","url":null,"abstract":"Abstract Introduction Driver fatigue is a significant contributor to road crashes, but identifying individuals at driving risk is challenging. We examined the potential of simple baseline vestibular ocular motor system (VOMS) assessment via virtual reality goggles to predict subsequent vulnerability to driving simulator impairment following extended wakefulness. Methods 49 individuals (Mean±SD Age 32.6±12.9, 45% Males) underwent 9hr baseline sleep opportunity followed by approximately ~29hrs extended wakefulness with five 60min driving assessments. Cluster analysis classified drivers into vulnerable (n=17) or resistant (n=32) groups based on their worst steering deviation and number of crashes from driving tests. Baseline VOMS were performed ~10mins prior to the first three drives (1, 7 and 13hrs of wakefulness). XGBoost machine learning model was trained using baseline VOMs features to predict vulnerable vs resistant groups from driving tests 4 and 5 (19 and 25hrs of wakefulness) Model performance was evaluated using 5-fold cross-validation approach using ROC analysis. Results XGBoost machine learning ranked all 70 VOMS metrics on their importance in predicting vulnerable vs resistant groups. Top 10 VOMs metrics assessed during baseline non-sleep deprived tests demonstrated a strong ability to predict the driver's performance following extended wakefulness, differentiating between the vulnerable vs resistant groups (AUC 0.73 [95%CI 0.61-0.83, p&amp;lt;0.001]). Conclusion VOMs tests conducted at baseline holds promise for predicting future driving impairment. This approach has the potential to be highly valuable in determining an individual's fitness to drive. Future validation in independent samples, sleep disordered population and in-field on-road testing are needed to confirm these promising findings.","PeriodicalId":21861,"journal":{"name":"SLEEP Advances","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136054287","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}
引用次数: 0
O061 Maternal Circadian Disruption from Shift Work and the Impact on the timing of Melatonin in their Breast Milk 轮班工作对产妇昼夜节律的破坏及其对母乳中褪黑素分泌时间的影响
Pub Date : 2023-10-01 DOI: 10.1093/sleepadvances/zpad035.061
L Booker, D Wilson, J Spong, M Deacon-Crouch, K Lenz, T Skinner
Abstract Introduction Infants are not born with a circadian rhythm. Research shows that breast milk clearly exhibits a 24-hour pattern, with melatonin concentrations high during the evening and night but barely detectable in daytime milk. The presence and timing of melatonin in breast milk suggests that this hormone may help provide sleep timing information to infants, thereby supporting the development of their own circadian cycle. Currently, it is not known if disturbances of maternal circadian rhythm, such as shift work, impact the circadian rhythmicity of breastmilk. The aim of this study was to investigate whether maternal circadian disruption, from working night shift has an impact on melatonin timing in breastmilk. Methods A prospective repeated measures study design was undertaken to compare melatonin levels in breastmilk across shift types (day shift/non-workdays and night shifts). Four 10ml breastmilk samples were collected by participants the same time of the day, across five consecutive days. Results. A total of 11 mothers completed the study. Analysis is still ongoing but preliminary results show a potential difference in breastmilk melatonin between pre-night shift, night shift and post night shift, indicating a change in the circadian timing of the breastmilk. Discussion The findings from this study suggest that there is a potential effect from maternal circadian disruption from shift work on breast milk melatonin. This is an important first step in exploring the impact of maternal circadian misalignment disorders on breastmilk hormones and provides preliminary evidence that future research is needed in this area.
婴儿并非生来就有昼夜节律。研究表明,母乳明显呈现出24小时的模式,褪黑激素在晚上和晚上浓度很高,但在白天的母乳中几乎检测不到。母乳中褪黑素的存在和计时表明,这种激素可能有助于为婴儿提供睡眠时间信息,从而支持他们自己的昼夜节律周期的发展。目前,尚不清楚产妇昼夜节律的干扰,如轮班工作,是否会影响母乳的昼夜节律。这项研究的目的是调查夜班工作是否会影响母乳中褪黑激素的分泌。方法采用前瞻性重复测量研究设计,比较不同轮班类型(白班/非工作日和夜班)母乳中的褪黑激素水平。参与者在连续五天的时间内,每天同一时间收集四份10毫升的母乳样本。结果。共有11位母亲完成了这项研究。分析仍在进行中,但初步结果显示,夜班前、夜班和夜班后的母乳褪黑素可能存在差异,这表明母乳的昼夜节律发生了变化。本研究的结果表明,轮班工作对母乳褪黑素的母体昼夜节律中断有潜在影响。这是探索母体昼夜节律失调对母乳激素影响的重要的第一步,并为该领域未来的研究提供了初步证据。
{"title":"O061 Maternal Circadian Disruption from Shift Work and the Impact on the timing of Melatonin in their Breast Milk","authors":"L Booker, D Wilson, J Spong, M Deacon-Crouch, K Lenz, T Skinner","doi":"10.1093/sleepadvances/zpad035.061","DOIUrl":"https://doi.org/10.1093/sleepadvances/zpad035.061","url":null,"abstract":"Abstract Introduction Infants are not born with a circadian rhythm. Research shows that breast milk clearly exhibits a 24-hour pattern, with melatonin concentrations high during the evening and night but barely detectable in daytime milk. The presence and timing of melatonin in breast milk suggests that this hormone may help provide sleep timing information to infants, thereby supporting the development of their own circadian cycle. Currently, it is not known if disturbances of maternal circadian rhythm, such as shift work, impact the circadian rhythmicity of breastmilk. The aim of this study was to investigate whether maternal circadian disruption, from working night shift has an impact on melatonin timing in breastmilk. Methods A prospective repeated measures study design was undertaken to compare melatonin levels in breastmilk across shift types (day shift/non-workdays and night shifts). Four 10ml breastmilk samples were collected by participants the same time of the day, across five consecutive days. Results. A total of 11 mothers completed the study. Analysis is still ongoing but preliminary results show a potential difference in breastmilk melatonin between pre-night shift, night shift and post night shift, indicating a change in the circadian timing of the breastmilk. Discussion The findings from this study suggest that there is a potential effect from maternal circadian disruption from shift work on breast milk melatonin. This is an important first step in exploring the impact of maternal circadian misalignment disorders on breastmilk hormones and provides preliminary evidence that future research is needed in this area.","PeriodicalId":21861,"journal":{"name":"SLEEP Advances","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136054378","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}
引用次数: 0
P029 Comparing the Impact of General Strength Conditioning and Motor Control Manual Therapy on Sleep Quality in Adults with Chronic Low Back Pain: A Randomised Controlled Trial 比较一般力量训练和运动控制手法治疗对成人慢性腰痛患者睡眠质量的影响:一项随机对照试验
Pub Date : 2023-10-01 DOI: 10.1093/sleepadvances/zpad035.114
G Vincent, E Craige, D Belavy, J Ford, C Miller, L Main, A Hahne, S Ferguson, P Owen
Abstract Introduction There is strong evidence indicating interactions between sleep and chronic low back pain (CLBP). However, evidence on the effect of exercise training (first-line treatment for CLBP), especially of specific modes of exercise training, on sleep is limited. This study aimed to investigate the effect of two exercise-based interventions (general strength and conditioning [GSC] and motor control and manual therapy [MCMT]) on sleep quality in adults with CLBP. Methods We conducted a two-group parallel (1:1), randomised controlled trial. Forty adults (mean age [SD]: 34.7 [6.1] years) with CLBP were randomised to receive either GSC (n=20) or MCMT (n=20) for 6 months. Sleep quality and its sub-components (e.g., sleep disturbance, sleep duration) were measured by the Pittsburgh Sleep Quality Index (PSQI). Analysis employed an intention-to-treat approach and group-by-time effects were assessed with mixed linear effect models. Results Both GSC (PSQI mean change [95%CI]: -1.58 [-2.70, -0.46] points) and MCMT (-1.61 [ 2.79, -0.43]) improved sleep quality at 6 months, but no group-by-time effect was detected (β [95%CI]: 0.03 [-1.60, 1.65]). For sleep quality sub-components, GSC improved daytime dysfunction (-0.33 [-0.65, -.0.01]), but led to a small decline in sleep efficiency (0.06 [0.01, 0.10]). MCMT improved sleep disturbance ( 0.31 [-0.55, -0.07]). Conclusion Both GSC and MCMT improved sleep quality, although neither intervention appeared superior. Sleep disturbance was improved in the MCMT group and daytime dysfunction was improved in the GSC group. Future studies would benefit from including a true control, objective sleep measures, and investigation of potential mediators.
有强有力的证据表明睡眠与慢性腰痛(CLBP)之间存在相互作用。然而,关于运动训练(CLBP的一线治疗),特别是特定运动训练模式对睡眠的影响的证据有限。本研究旨在探讨两种基于运动的干预措施(一般力量和调节[GSC]和运动控制和手动治疗[MCMT])对CLBP成人睡眠质量的影响。方法采用两组平行(1:1)随机对照试验。40名患有CLBP的成年人(平均年龄[SD]: 34.7[6.1]岁)被随机分配接受GSC (n=20)或MCMT (n=20),为期6个月。采用匹兹堡睡眠质量指数(PSQI)测量睡眠质量及其子成分(如睡眠障碍、睡眠持续时间)。分析采用意向治疗方法,按时间分组效应采用混合线性效应模型进行评估。结果GSC (PSQI平均变化[95%CI]: -1.58[-2.70, -0.46]点)和MCMT(-1.61[2.79, -0.43]点)均能改善6个月时的睡眠质量,但未发现组间效应(β [95%CI]: 0.03[-1.60, 1.65])。对于睡眠质量子成分,GSC改善了白天功能障碍(-0.33[-0.65,- 0.0.01]),但导致睡眠效率小幅下降(0.06[0.01,0.10])。MCMT改善睡眠障碍(0.31[-0.55,-0.07])。结论GSC和MCMT均能改善睡眠质量,但两者均无明显优势。MCMT组睡眠障碍得到改善,GSC组白天功能障碍得到改善。未来的研究将受益于包括一个真正的控制,客观的睡眠测量,并调查潜在的中介。
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引用次数: 0
P035 Investigating the Relationship Between Dietary Timing and Obstructive Sleep Apnoea. 研究饮食时间与阻塞性睡眠呼吸暂停之间的关系。
Pub Date : 2023-10-01 DOI: 10.1093/sleepadvances/zpad035.119
S Huddle, A Young, M Bonham, T Choi, D O'Driscoll
Abstract Introduction Late night eating is associated with obstructive sleep apnoea (OSA) and may increase obesity risk. Time Restricted Eating (TRE) involves shifting the eating window to 8-12 continuous hours per day, prompting energy intake to earlier in the day without any complex dietary prescription, and has metabolic benefits. We aimed to investigate timing of food intake in patients with OSA and assess their openness to trial TRE. Methods Adults undergoing in-laboratory diagnostic polysomnography (PSG, n=138, 67 male) completed a dietary questionnaire outlining typical eating habits, including timing of meals, frequency of getting up overnight, and frequency of eating/drinking overnight. Questionnaire responses were reviewed with demographics and PSG variables. Proportions of responses were compared across categories of OSA severity using z-tests. Results Patients with moderate/severe OSA (AHI&gt;15events/h, n=77) were more likely to report getting up at night “often” or “always” compared to patients with no/mild OSA (n=61) (63.6% v 47.5%, p=0.08), more likely to report getting up multiple times (66.2% v 47.5%, p=0.04), and more likely to report eating/drinking overnight (42.9% v 18.0%, p=0.003). 71.0% of all patients indicated they would consider trying a TRE diet, and 71.7% could incorporate a TRE diet into their lifestyle. Conclusion Moderate/severe OSA is associated with an increased likelihood of getting up multiple times overnight, and getting up to eat and drink. Patients in this clinical cohort reported a willingness to trial TRE. Future research should investigate the efficacy of implementing TRE in OSA and evaluating its effect on weight loss and sleep quality.
摘要:深夜进食与阻塞性睡眠呼吸暂停(OSA)有关,并可能增加肥胖风险。限时饮食法(TRE)包括将每天的进食时间改为连续8-12小时,在没有任何复杂的饮食处方的情况下,将能量摄入提前,并对代谢有益。我们的目的是调查OSA患者的食物摄入时间,并评估他们对试验TRE的开放程度。方法接受实验室诊断性多导睡眠图(PSG, n= 138,67名男性)的成年人完成了一份饮食问卷,概述了典型的饮食习惯,包括用餐时间、夜间起床频率和夜间进食/饮酒频率。问卷调查结果与人口统计学和PSG变量进行了回顾。采用z检验比较不同OSA严重程度类别的反应比例。结果与无/轻度OSA患者(n=61)相比,中度/重度OSA患者(AHI>15事件/小时,n=77)报告“经常”或“总是”夜间起床的比例(63.6% vs 47.5%, p=0.08),报告多次起床的比例(66.2% vs 47.5%, p=0.04),报告夜间进食/饮酒的比例(42.9% vs 18.0%, p=0.003)。71.0%的患者表示他们会考虑尝试TRE饮食,71.7%的患者可以将TRE饮食纳入他们的生活方式。结论中重度OSA与夜间多次起床、起床进食和饮水的可能性增加有关。该临床队列中的患者报告愿意试验TRE。未来的研究应探讨在OSA中实施TRE的疗效,并评估其对减肥和睡眠质量的影响。
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引用次数: 0
P036 A novel approach to nurture sleep education in a crowded curriculum 在拥挤的课程中培养睡眠教育的新方法
Pub Date : 2023-10-01 DOI: 10.1093/sleepadvances/zpad035.120
K Falloon, C Campos, M Nakatsuji, F Moir, A Wearn, H Bhoopatkar
Abstract Aims To explore Year 6 medical students’ perceptions of sleep education during medical school to inform the development of a sleep curriculum. Methods Year 6 medical students on their final general practice (GP) placement in 2020 (71/254 of the Year 6 cohort) were invited to complete an online survey regarding sleep education recalled during the medical programme. Results Sleep education survey responses were received from 51/71 of students in the final GP cohort (72%). Three areas were more frequently recalled - 83% recalled learning about sleep apnoea, 71% about sleep physiology, and 69% about snoring. Only 50% recalled learning about assessing sleep and 42% recalled receiving education about insomnia. More than 80% of students reported they received no education regarding preparing for, coping with, or recovering from night shifts. Students identified common sleep disorders, sleep assessment, and shift work as priority topics. Conclusions Whilst the majority of students recalled receiving education on select topics, most had no awareness of education relating to sleep assessment, insomnia, or shift work. Sleep education in the curriculum needs more emphasis and reinforcement given its relevance across many domains of health and morbidity. We propose that an identifiable sleep curriculum is necessary and useful to ensure medical students have the necessary core education regarding sleep and sleep disorders both for patients and themselves. Further, we believe this is possible to achieve within the constraints of the undergraduate curriculum and propose some creative solutions.
摘要目的了解医学院六年级学生对睡眠教育的看法,为睡眠课程的制定提供依据。方法邀请2020年全科医生(GP)毕业的六年级医学生(占六年级队列的71/254)完成一项关于医学课程期间回忆的睡眠教育的在线调查。结果在最终的GP队列中,有51/71的学生(72%)回复了睡眠教育调查。三个领域的记忆更频繁——83%的人回忆起睡眠呼吸暂停,71%的人回忆起睡眠生理学,69%的人回忆起打鼾。只有50%的人回忆起学习过评估睡眠,42%的人回忆起接受过有关失眠的教育。超过80%的学生报告说,他们没有接受过关于夜班的准备、应对或从夜班中恢复的教育。学生们确定了常见的睡眠障碍、睡眠评估和轮班工作作为优先主题。结论:虽然大多数学生回忆起接受过选定主题的教育,但大多数学生没有意识到有关睡眠评估、失眠或轮班工作的教育。鉴于睡眠教育与许多健康和发病率领域的相关性,课程中的睡眠教育需要更多的重视和加强。我们建议,一个明确的睡眠课程是必要和有用的,以确保医学生有必要的核心教育关于睡眠和睡眠障碍的病人和他们自己。此外,我们认为这是可以在本科课程的限制下实现的,并提出了一些创造性的解决方案。
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SLEEP Advances
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