Sleep and Breathing最新文献

Purpose: We sought to determine whether risk for obstructive sleep apnea (OSA) and OSA severity are associated with sensorineural hearing loss (HL) among emergency responders.

Methods: We evaluated two independent variables: OSA risk, categorized using Berlin Questionnaire criteria, and OSA severity, determined by polysomnogram (PSG) apnea-hypopnea indices (AHI). Logistic regression, adjusted for confounders, was used to assess the association between each OSA exposure and the outcome of HL among a cohort of emergency responders.

Results: The study cohort included 13,909 participants with audiometric data, 12,834 with Berlin Questionnaire data, and 4,024 participants with PSG data. Those with high and very high OSA risk showed significantly elevated odds of HL at speech frequencies, with adjusted odds ratios (OR) of 1.34 (95% CI: 1.14-1.58; p < 0.01) and 1.56 (95% CI: 1.30-1.88; p < 0.01), respectively, compared to those with no OSA risk. Combining very high and high risk validated category groupings for the Berlin, those individuals had 41% higher odds for HL over speech frequencies compared to those with no risk (OR = 1.41; 95% CI = 1.21-1.65; p < 0.01). Those with PSG-determined severe OSA had higher adjusted odds of HL at speech frequencies than those with no OSA; OR of 1.33 (95% CI: 1.00-1.78; p = 0.04).

Conclusions: We report a significant association between OSA and HL among emergency responders. Our results underscore a need for an analysis of the longitudinal association between OSA and HL to identify potential causality and for integrated health interventions that target both conditions in this responder population.

Purpose: Epidemiological studies have revealed significant associations between obstructive sleep apnea (OSA) and thyroid disorders, but discrepancies and contradictory results remain in some studies. Given the limited research currently available on this topic, this article aims to review the relationship between OSA and thyroid diseases.

Methods: PubMed, Embase, Web of Science, and The Cochrane Library were searched for the most recent literature on the correlation, mechanism, and treatment of OSA with various thyroid disorders for the last 10 years up to December 5, 2024.

Results: There is a bidirectional association between OSA and thyroid disease. On the one hand, OSA not only increases the incidence of thyroid disorders, but also aggravates the severity of thyroid disorders, thereby negatively affecting treatment outcomes and prognosis; on the other hand, certain thyroid disorders may in turn promote the development of OSA.

Conclusion: OSA is closely associated with the development of thyroid disease, but the specific mechanism is not clear. Effective treatments for thyroid disease combined with OSA need to be further investigated.

Background: Obstructive sleep apnea (OSA) is a prevalent sleep disorder associated with intermittent hypoxia, sleep fragmentation, and systemic inflammation, all of which may influence cancer development. Continuous positive airway pressure (CPAP) therapy is the primary treatment for OSA, yet its impact on cancer risk remains uncertain. We conducted a systematic review and meta-analysis to evaluate the association between CPAP therapy and the incidence of newly diagnosed cancer in patients with OSA.

Methods: From inception to March 2025, a comprehensive literature search of MEDLINE, EMBASE, Cochrane databases, and reference lists was conducted. Observational studies assessing the risk of new cancer diagnoses in OSA patients treated with CPAP compared to non-CPAP users were included. Data extraction and quality assessment followed PRISMA guidelines, and meta-analysis was performed using a random-effects model.

Results: Three cohort studies from France, Spain, and Canada, including 72,498 participants, met the inclusion criteria. CPAP compliance varied, defined as > 4 h/night in two studies, while one study lacked specific usage criteria. Cancer diagnoses were ascertained via national registries, hospital databases, or electronic medical records. Meta-analysis revealed a pooled hazard ratio (HR) of 0.81 (95% CI: 0.60-1.09), suggesting a potential reduction in cancer risk among CPAP users. Sensitivity analysis reduced heterogeneity (I² = 0%) and revised the HR to 0.93 (95% CI: 0.81-1.08).

Conclusions: CPAP therapy does not appear to increase cancer risk in OSA patients, but the evidence is limited and inconclusive. Further research, including randomized controlled trials, is needed to confirm these observations and explore underlying mechanisms.

Purpose: The purpose of our study was to evaluate the effectiveness of CPAP in increasing the thickness of retinal layers. Other aims were to assess retinal and optic nerve damage predictors in OSA and establish predictors of poor response to CPAP treatment in optic nerve damage.

Methods: A prospective cohort study with consecutive inclusion of the first 3 patients who attended for treatment each day. All patients underwent a diagnostic polygraph, and patients with moderate-severe OSA treated with CPAP were recruited. Optical Coherence Tomography (OCT) was performed within 3 days of the patient's inclusion and 12 months after the start of CPAP treatment.

Results: Data from 37 patients with OSA were analysed. After 12 months of CPAP treatment, there was a significant improvement in the thickness of the superotemporal Bruch's membrane opening-minimum rim width (BMO-MRW) (316.54 to 318.23 μm, p-value = 0.08). There was a non-significant improvement in the thickness of nasal, inferonasal and superonasal retinal nerve fibre layers. In a multivariate analysis, HB and Type 2 diabetes mellitus have been associated with an increased odds ratio (OR) of retinal and optical nerve damage (OR = 3.58, p = 0.03 and OR = 4.344, p = 0.042, respectively).

Conclusion: BMO-MRW thickness may assess early damage induced by OSA and the response to CPAP. HB is a predictor of retinal and optic nerve damage in patients with OSA. CPAP treatment has a long-term protective effect on the retina and optic nerve.

Purpose: This study aimed to investigate changes in sleep-related respiratory parameters before and after orthognathic surgery in patients with skeletal class III malocclusion.

Methods: Adults with skeletal class III malocclusion and treated with isolated mandibular setback or bimaxillary surgery (maxillary advancement and mandibular setback) were recruited. Sleep-related respiratory parameters were obtained with type III sleep study. Epworth Sleepiness Scale (ESS) was also recorded. The pre- and post-operative (6 months) data were compared. Correlations between these changes and pre-operative characteristics were analyzed. Subjects were categorized into three groups based on changes in the respiratory event index (REI) and 3% oxygen desaturation index: Δ ≤ -2.5, -2.5 < Δ < 2.5, and Δ ≥ 2.5. Amounts of surgical movement and pre-surgical parameters were compared among the 3 groups.

Results: Thirty patients with an average age of 25.4 ± 5.0 years were recruited. Eleven patients underwent isolated mandibular setbacks while nineteen received bimaxillary surgery. Pre- and post-operative sleep-related respiratory parameters were not significantly different in the total samples, and when analyzed separately according to surgical procedures. Pre-operative ESS were correlated with the changes in REI (p = 0.01), average blood oxygen levels (p = 0.01), and snoring percentage (p = 0.04). Additionally, this study found that patients with a significant decrease in REI (ΔREI ≤ -2.5) after surgery had significantly higher pre-operative REI (6.2 events/hour) compared to those with minor REI changes (2.6 events/hour).

Conclusion: There was no significant change in sleep-related respiratory parameters following mandibular setbacks with or without maxillary advancement in this study.

Trail registered: This study was retrospectively registered and approved on February 11, 2025, under registration number TCTR20250211002.

Purpose: Night shift work is common today and disrupts circadian rhythms, leading to health concerns. This study examines the impact of night shifts on sleep quality among Tunisian workers, determines the prevalence of sleep disorders, and identifies factors associated with poor sleep quality.

Methodology: This cross-sectional study employed an online questionnaire to assess sleep disorders among night workers aged 18 and older. Key measures included sleep quality, daytime alertness, mood, and subjective well-being, assessed with validated Arabic versions of the Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), Epworth Sleepiness Scale (ESS), Patient Health Questionnaire-9 (PHQ-9), and WHO-Five Well-Being Index (WHO-5).

Results: A study of 503 Tunisian night shift workers aged 25 to 64 revealed significant sleep disturbances. Poor sleep quality (PSQI score > 5) was found in 59.4%, while 13.7% reported insomnia (ISI score > 15). Severe insomnia, excessive daytime sleepiness, severe depression, and poor well-being were present in 2%, 32.6%, 4%, and 58.3%, respectively. Factors linked to poor sleep quality included BMI, active smoking, fatty meals, hypnotic use, nasal obstruction, sinusitis, gastrointestinal disorders, and well-being scores.

Conclusion: The findings of this study highlight the significant impact of night shift work on sleep quality and overall well-being among Tunisian workers. To mitigate these effects, practical interventions are essential, including promoting shift work schedules, improving workplace wellness programs, encouraging healthier lifestyle choices, and providing access to mental health support. Future research should investigate the relationship between shift work, sleep, and mental health while finding ways to mitigate these effects.

Purpose: This study was conducted to determine the effect of breathing exercises on pain, sleep, and symptom management in patients undergoing hemodialysis.

Methods: The randomized controlled study was conducted with patients undergoing hemodialysis at a private dialysis center in the northern Black Sea region. Data were collected using the Descriptive Information Form, the Visual Analog Scale (VAS), the Richards-Campbell Sleep Questionnaire (RCSQ), the Dialysis Symptom Index (DSI), and the Vital Signs Form. According to the power analysis performed in the study, a total of 70 participants, 35 in each group, needed to be included in the study in order to conduct an independent t-test with a confidence level of 95%, a test power of 95%, and an effect size of d = 0.80. The study was conducted with a total of 69 patients divided into two groups: the experimental group (n = 35) and the control group (n = 34). Patients in the experimental group performed breathing exercises (Diaphragmatic breathing, Agni Sār, Nadi Shodhana, and the 4-7-8 breathing technique) on dialysis days for eight weeks. During this period, patients in the control group continued to receive routine nursing care in the hemodialysis unit.

Results: Following the application, the average pain intensity in the control group (4.06 ± 3.1) was found to be statistically significantly higher than the average in the experimental group (0.4 ± 1.19) (p < 0.001). The average sleep score in the control group (48.56 ± 22.35) was found to be statistically significantly lower than the average in the experimental group (80.21 ± 16.46) (p < 0.001). The average DSI in the control group (92 ± 22.05) was found to be statistically significantly higher than the average in the experimental group (41.37 ± 7.15) (p < 0.001).

Conclusion: Breathing exercises in patients undergoing hemodialysis were found to reduce pain, improve sleep quality, and have a positive impact on symptom management. In light of this, it is recommended that nurses include breathing techniques as part of the care provided to hemodialysis patients. Using complementary methods such as breathing therapy supports the physical, psychological, psychosocial, and holistic care of patients, thus increasing patient satisfaction and quality of life. Training health professionals in breathing therapy will ensure a broader use of this complementary method in a larger patient population.

Background: Melatonin supplementation has gained considerable attention for its potential health impacts. This study aimed to review the recent literature on melatonin supplementation and its implications in areas such as obesity, diabetes, gut microbiome, neurodegenerative diseases, cancer, sports performance, sleep quality, psychiatric disorders, pediatrics, pregnancy, and respiratory health. Additionally, assess the supplementation protocols, potential adverse effects, associated risks, and symptoms observed during supplementation.

Methods: An extensive search was conducted across multiple databases, including PubMed, Scielo, Web of Science, CrossRef, and Google Scholar, focusing on publications from 2011 to 2024. A total of 71 articles were collected and analyzed.

Results: Recent studies highlight melatonin's promising antioxidant, anti-inflammatory, and immunomodulatory properties, particularly in improving sleep quality and addressing specific neurodegenerative diseases. Evidence supports its role in reducing anxiety in preoperative contexts and enhancing recovery under certain conditions in athletes. However, findings on melatonin's role in obesity, glycemic control, and gut microbiome regulation remain inconsistent and influenced by external factors such as diet and exercise. Similarly, evidence supporting its efficacy in cancer, psychiatric disorders, pregnancy, and pediatrics is limited and requires further research. For respiratory health, while melatonin's theoretical benefits include reducing oxidative stress and inflammation, current evidence is weak and largely preclinical. Concerns regarding adverse effects, including nightmares and grogginess, highlight the importance of thorough and careful monitoring. To ensure safety and effectiveness, supplementation protocols should be tailored to meet the unique needs of each individual.

Conclusion: Melatonin supplementation is not a universal solution but a potentially valuable tool in specific contexts. Its benefits are most evident in sleep regulation and certain neurodegenerative conditions. However, significant gaps in research, including inconsistent methodologies, small sample sizes, and limited data on long-term effects, necessitate further robust clinical trials. Individualized recommendations and cautious interpretation of findings are essential, particularly given the variability in outcomes based on study designs and populations.

Purpose: In-laboratory polysomnography (PSG) is the gold standard test for diagnosing certain paediatric sleep conditions. Children with neurodevelopmental disorders (NDD) often have difficulty tolerating PSG, but parent and patient experiences of PSG for children with NDD have not been thoroughly explored. The study aim was to evaluate the parent-reported experience of in-laboratory PSG undertaken in children with NDD and to identify factors predictive of poorer experience.

Methods: In this cross-sectional multicentre study, parents of 143 children with NDD who underwent in-laboratory PSG completed a customised survey to provide feedback on parent and child worry levels, subjective tolerance and overall experience of PSG, and hypothetical preference between in-laboratory PSG versus an in-home mat-based sleep test. ANOVA, Chi-squared and Kruskal-Wallis tests were used to determine participant factors associated with these outcomes.

Results: On average, parents rated their child's worry level with respect to undergoing PSG as 'moderate,' but their own worry levels lower. Autism spectrum / neuromuscular disorder diagnoses were risk factors for both higher worry score and reporting that sleep during PSG was non-representative of usual sleep at home. Parental preference was for in-home (mat-based) testing, with 57% indicating a preference for this if it wereavailable vs. 7% preferring in-laboratory testing.

Conclusion: Parent/carer reports regarding in-laboratory PSG experiences for their children with NDD suggest the test is associated with child worry and concerns that the sleep is not-representative of usual sleep at home. Consumer preference favours in-home sleep study testing over current in-laboratory diagnostic testing.

Clinical trial registration: This study is part of a larger trial ACTRN12622001544763.