Sleep and Breathing最新文献

Background: This study aimed to elucidate the relationship between physical activity, body weight, liver function, and insomnia in Korean adults, thereby providing a foundation for health promotion strategies.

Methods: We recruited 11,645 adults (8,051 males and 3,594 females). Participants underwent assessments using the Korean version of the Insomnia Severity Index, measures of physical activity (PA), anthropometric data (body weight, height, body mass index [BMI], and waist circumference [WC]), and liver function (alanine aminotransferase, aspartate aminotransferase [AST], and gamma-glutamyl transferase).

Results: One-way ANOVA revealed significant differences among male groups in height (p < .001), weight (p = .036), BMI (p = .002), diastolic blood pressure (p = .008), AST (p = .036), recreational PA (p = .026), moderate PA (p < .01), vigorous PA (p < .01), and moderate-to-vigorous PA (p < .001). Similarly, significant differences were found among female groups in height (p < .001), weight (p = .001), BMI (p = .006), WC (p = .013), moderate PA (p < .001), vigorous PA (p < .001), and moderate-to-vigorous PA (p < .001).

Conclusion: To prevent insomnia, it is essential to enhance physical activity and manage factors related to body weight and liver function, such as BMI, WC, and AST. Increasing moderate-to-vigorous physical activity is particularly crucial, as it has a substantial positive impact on reducing body weight and improving liver function.

Introduction: Hospitalised patients are at increased risk of poor sleep quality which can negatively impact on recovery and quality of life. This study aimed to assess sleep quality in hospitalised patients and explore the factors associated with poor sleep.

Methods: Prospective data were collected from 84 respiratory ward inpatients at time of discharge using a Likert scale questionnaire on contributing factors to sleep quality. Differences between groups reporting good and poor quality sleep were recorded.

Results: Most participants (77%) described inpatient sleep quality to be worse or much worse compared to their home environment. Noise (39%), checking of vital signs (33%) and light (24%) were most frequently identified as factors disrupting sleep. Binary logistic regression analysis demonstrated that men (OR 2.8, CI 1.1-7.4, p = 0.037) and those in shared rooms (OR 3.9, CI 1.4-10.9, p = 0.009) were more likely to be affected by noise. Younger patients (OR 0.92, CI 0.88-0.96, p < 0.001) and those in shared rooms (OR 8.5 CI 1.9-37.9, p < 0.001) were more likely to be affected by light.

Conclusion: In conclusion, a high proportion of hospitalised respiratory patients on a medical ward reported poorer sleep quality compared to home due to operational interruptions and noise. Age, gender and room type further modified the sleep disruption. Future research should focus on whether strategies to reduce interruptions and noise will improve sleep quality and clinical outcomes.

Purpose: Insomnia is a global health issue that imposes social and economic burdens. Aromatherapy is regarded as a promising alternative medicine for improving sleep quality. This meta-analysis was conducted to explore the potential of aromatherapy for addressing insomnia.

Methods: Seven databases were searched for relevant randomized controlled trials (RCTs) from their inception through August 12, 2023. Data were synthesized using random-effect pairwise meta-analysis, with standardized mean difference (SMD) and 95% confidence interval (CI) reported. The risk of bias of each RCT was appraised using the Cochrane risk of bias tool. Subgroup and sensitivity analysis, publication bias diagnosis were also performed.

Results: A total of 14 studies with 1043 participants were included. The meta-analysis revealed a significant difference between the intervention and control groups (SMD: -1.63, 95% CI: -2.20 to -1.04). Sensitivity analysis showed that, whichever study was omitted, the conclusions of the remaining studies did not reverse. Among the 14 RCTs included, 6 were deemed to have a low overall risk of bias, and 8 were found to have some concerns. Subgroup analysis revealed that Iran had a more significant therapeutic effect than other regions. The effects of rose and citrus aurantium are more obvious than those of lavender. The different treatments in the control groups, intervention durations and sleep quality questionnaires had impacts on therapeutic effects, while discrepancies were not significant for different health conditions.

Conclusion: Aromatic essential oil has a significant therapeutic effect on insomnia. Further research on the mechanisms and guidelines for implementing aromatherapy is needed. This meta-analysis has been registered in PROSPERO with the ID CRD42023454070.

Purpose: Studies have found that sleep disorders and autonomic dysfunction are associated with several metabolic diseases. Moreover, these factors also been reported to be related with the development of atherosclerosis and cardiovascular disease independent of other known factors, and details related to their pathogenesis have recently received increased attention. Additionally, the rates of incidence of heart and renal failure are showing an increasing trend.

Methods: A literature search was conducted to explore the interrelationship between sleep disorders, autonomic dysfunction, and cardio-renal function.

Results: Sleep disorders and autonomic dysfunction have been shown to be strongly and directly linked to cardio-renal function, as well as various metabolic disorders, while cardiac and renal diseases themselves have been found to have a bidirectional relationship, and can also cause sleep disorders and autonomic dysfunction.

Conclusion: Reported findings indicate that sleep disorders and autonomic dysfunction cause metabolic abnormalities, thus are directly or indirectly related to cardio-renal function. With increased attention given to this research field and more focused studies performed, sleep conditions and autonomic function are expected to receive greater recognition as promising clinical targets for the prevention of heart failure and chronic kidney disease in the future.

Crouzon syndrome (CS) is a hereditary disorder characterized by deformities of the face and skull brought on by syndromic craniosynostosis or the premature fusion of coronal sutures. Pediatric patients with Crouzon syndrome have a high likelihood of developing obstructive sleep apnea (OSAS), primarily due to skeletal hypoplasia and facial dysmorphism. Treatment of OSAS in patients with Crouzon syndrome requires multidisciplinary and sequential treatment planning because Crouzon syndrome often has different phenotypes with varying severity in OSA and facial dysmorphism. In this clinical case, we describe the first case of a child with Crouzon syndrome with sleep apnea who was treated with positive pressure ventilation in Vietnam.

Background: To evaluate the volume and the most constricted cross-sectional area (lumen) sizes of the upper pharyngeal airway among children with/without unilateral cleft lip and palate (UCLP) and with/without obstructive sleep apnea (OSA).

Methods: This prospective study was conducted on 66 Thai children aged 5 to 12 years, encompassing demographic information, polysomnographic data, and sex distribution: 34 with non-syndromic UCLP (16 with OSA; 18 without OSA) and 32 non-cleft children (16 with OSA; 16 without OSA). Subjects were divided into two age groups: preadolescent group (ages 10-12) and younger group (ages 5-9). Cone-beam computed tomography images were acquired with subjects in a supine position. Subsequent measurements were conducted using the Dolphin imaging program (version 11.7 premium) to investigate and compare the volumes and lumens of the nasopharyngeal, oropharyngeal, and hypopharyngeal airways.

Results: In the younger group, the UCLP with OSA group exhibited significantly smaller volumes and lumens in the oropharyngeal airway compared to the non-cleft group without OSA (volume: p = 0.044; lumen: p = 0.031, 95% CI). All upper pharyngeal airway parts had comparable volumes and lumens between age groups. However, preadolescence reported no significant differences.

Conclusions: Statistically significant differences were observed only in the oropharyngeal airway measurements in the younger sample compared to the adolescent sample. This underscores the importance of considering oropharyngeal airway structure in diagnosing and preventing OSA in children. However, it is essential to note that while airway size is a fundamental factor, it may not be the sole determinant of OSA occurrence. Other factors likely contribute to the condition as well.

Purpose: Conventional obstructive sleep apnea (OSA) diagnosis via polysomnography can be costly and inaccessible. Recent advances in artificial intelligence (AI) have enabled the use of craniofacial photographs to diagnose OSA. This meta-analysis aims to clarify the diagnostic accuracy of this innovative approach.

Methods: Two blinded reviewers searched PubMed, Embase, Scopus, Web of Science, and IEEE Xplore databases, then selected and graded the risk of bias of observational studies of adults (≥ 18 years) comparing the diagnostic performance of AI algorithms using craniofacial photographs, versus conventional OSA diagnostic criteria (i.e. apnea-hypopnea index [AHI]). Studies were excluded if they detected apneic events without diagnosing OSA. AI models evaluated with a random split test set or k-fold cross-validation were included in a Bayesian bivariate meta-analysis.

Results: From 5,147 records, 6 studies were included, containing 10 AI models trained/tested on 1,417/983 participants. The risk of bias was low. AI trained on craniofacial photographs achieved a pooled 84.9% sensitivity (95% credible interval [95% CrI]: 77.1-90.7%) and 71.2% specificity (95% CrI: 60.7-81.4%). Bayesian meta-regression identified deep learning (convolutional neural networks) as the most accurate AI algorithm (91.1% sensitivity, 79.2% specificity) comparable to home sleep apnea tests. AHI cutoffs, OSA prevalence, feature engineering, input data, camera type and informativeness of Bayesian prior did not alter diagnostic accuracy. There was no substantial publication bias.

Conclusion: AI trained on craniofacial photographs have high diagnostic accuracy and should be considered as a low-cost OSA screening tool. Future work focused on deep learning using smartphone images could improve the feasibility of this approach in primary care.

Purpose: This study aimed to compare cervical proprioception and related biomechanical factors among patients with Obstructive Sleep Apnea (OSA) and asymptomatic controls.

Methods: In this case-control study, polysomnography scores (apnea-hypopnea index-AHI) were examined to determine the disease severity of the OSA group. Also, we evaluated cervical proprioception by using a laser pointer to detect joint repositioning error sense in cervical rotational movements. Comparison statistics were also conducted for the cervical musculoskeletal variables such as range of motion (ROM) with bubble inclinometer, cranio-cervical (CVA), and thoracic posture (TKA) through photometric analysis, neck flexor muscle endurance test, and pain pressure thresholds of trapezius (PPT).

Results: This case-control study included 59 male participants: patients with OSA (n = 29; mean age = 49.10 years; mean BMI = 28.41 kg/m2) and asymptomatic controls (n = 30; mean age = 49.73 years; mean BMI = 26.89 ± 3.60 kg/m2). The mean AHI score was 26.06 events/hour, categorizing the severity of OSA as mild (31.03%), moderate (31.03%), and severe (37.94%). Patients with OSA demonstrated significantly poorer cervical proprioception compared to controls for both sides of cervical rotation with larger effect sizes (d:1.36-1.45; p < 0.05). Also, cervical ROM, CVA, TKA, neck flexor muscle endurance test, and PPT values were altered in the OSA group compared to the control group (p < 0.05).

Conclusion: Impaired cervical proprioception may be a previously unrecognized factor associated with OSA. This finding has implications for understanding the mechanisms underlying cervical musculoskeletal changes in OSA and for developing potential new interventions or exercise designs targeting postural control.

Background: To revise and critically summarize the available scientific evidence regarding the effect of exercise on sleep quality in people with diabetes.

Methods: Three electronic databases (MEDLINE/PubMed, PEDro Database and Scopus) were searched systematically from their inception until February 2024. The methodological quality of the included studies was assessed using the Physiotherapy Evidence Database and Quality Assessment Tool for Before-After Studies with No Control Group scales.

Results: A total of 7 randomized controlled trials and 3 single-arm studies were included. Most of the studies included patients with type 2 diabetes (n = 8). Self-reported sleep quality (n = 9) and objective sleep status (n = 1) were the main outcomes analysed. A variety of training programs were assessed over durations ranging from 4 to 16 weeks in the studies included. Data from eleven interventions demonstrated a significant improvement in self-reported sleep quality among patients with type 2 diabetes (Hedges' g -1.45; 95% CI -2.6; -0.29, p = 0.005). However, data synthesis indicated that participants who exercised did not obtain significant improvements on their self-reported sleep quality compared to those in the control groups (Hedges' g 1.40; 95% CI -1.36; 4.18, p = 0.111).

Conclusions: Preliminary evidence suggests that exercise can be prescribed to manage self-reported sleep quality in this population, although its effects may not surpass those of usual care.

Objective: To analyse the relationships between the expression levels of liver X receptor (LXR), cyclooxygenase-2(COX2) and cholesterol ester transfer protein (CETP) and the severity of obstructive sleep apnoea hypopnoea syndrome (OSAHS) in obese young rats, to obtain information for basic research on OSAHS in obese children.

Methods: Twenty-four 3-4-week-old young rats were randomly assigned to the normal control group, obesity group, OSAHS group, obesity and OSAHS group. We used polysomnography to measure the obstructive apnoea hypopnoea index (OAHI) to assess the severity of OSAHS and western blotting to test the expression levels of LXRα, COX2, and CETP in the liver, heart, kidney, and brain tissues.

Results: LXR, COX2, and CETP expression levels in the remaining groups were considerably higher than those in the control group (P < 0.05). Compared with those in the obesity group, LXRα, COX2, and CETP expression levels in the obesity and OSAHS group were considerably greater in the liver, kidney, and heart tissues (P < 0.05); the brain tissues of the obesity and OSAHS group showed considerably higher expression levels of COX2 and CETP (P < 0.05). Compared with those in the OSAHS group, LXRα, COX2, and CETP expression levels in the obesity and OSAHS group were significantly greater in all tissues (P < 0.05). The expression levels of LXRα, COX2, and CETP and obesity increased with increasing OSAHS severity (r = 0.777, P < 0.01; r = 0.728, P < 0.01; r = 0.793, P < 0.01; r = 0.786, P < 0.01; and r = 0.698, P < 0.01), and the oxygen concentration increased with decreasing OSAHS severity(r=-0.576, P < 0.01).

Conclusions: LXR, COX2, and CETP expression levels were significantly increased in the liver, kidney, heart, and brain tissues of young rats with obesity and OSAHS, and were positively correlated with the severity of OSAHS.