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Comparison of physical activity and quality of life between obese individuals with obstructive sleep apnea syndrome and individuals with obesity hypoventilation syndrome. 患有阻塞性睡眠呼吸暂停综合征的肥胖者与患有肥胖低通气综合征的肥胖者在体育活动和生活质量方面的比较。
IF 4.6 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2024-12-01 Epub Date: 2024-08-20 DOI: 10.1007/s11325-024-03148-4
Aliki Karkala, Antonios Baxevanidis, Anastasia Chasiotou, Dimitra Siopi, Dimitra Mameletzi, Evangelia Kouidi, Diamantis Chloros, Georgia Pitsiou, Afroditi K Boutou

Purpose: Obstructive Sleep Apnea Syndrome (OSAS) and Obesity Hypoventilation Syndrome (OHS) share common causal factors and comorbidities but may have a variable effect on physical activity and associated quality of life, due to differences in pathophysiology. The aim of this study was to compare the levels of physical activity, mental health and quality of life between matched obese patients with either OSAS or OHS, aiming to identify which of the two syndromes may impose the most severe impact on these variables, for the first time in literature.

Methods: A total of 76 obese patients (OSAS: Ν1 = 48, OHS: N2 = 26) of similar age (58.2 ± 12.2 vs. 63.6 ± 9.8; p > 0.05), BMI (37.2 ± 6.2 vs. 40.3 ± 7.3; p > 0.05), and Apnea-Hypopnea Index (AHI) under non-invasive ventilation, completed International Physical Activity Questionnaire (IPAQ), Short-Form Health Questionnaire (SF-36), Personal Well-Being (PWB) Scale and Hospital Anxiety and Depression Scale (HADS-A and HADS-D), in this cross-sectional study.

Results: Both groups had similar scores in SF-36, HADS-A and HADS-D, while prevalence of clinical cases of anxiety (HADS-A > 8) and depression (HADS-D > 8) were also similar. OSAS patients scored significantly higher in physical activity [absolute IPAQ values 1100.75(7753.5) for OSAS vs. 518(3806) for OHS; p = 0.029]. Group comparisons yielded significant differences in physical functioning (p < 0.05) and general health perceptions (p < 0.05), in favor of the OSAS group.

Conclusion: Both syndromes significantly affect patients' quality of life and physical activity, with the burden being heavier for OHS patients. Daily physical activity seems to be more impaired among obese OHS patients perhaps due to daytime hypercapnia.

目的:阻塞性睡眠呼吸暂停综合征(OSAS)和肥胖低通气综合征(OHS)有共同的致病因素和并发症,但由于病理生理学的不同,它们对体育锻炼和相关生活质量的影响可能各不相同。本研究的目的是比较患有 OSAS 或 OHS 的配对肥胖患者的体力活动水平、心理健康和生活质量,旨在确定这两种综合征中哪一种对这些变量的影响最严重,这在文献中尚属首次:共有 76 名年龄(58.2 ± 12.2 vs. 63.6 ± 9.8; p > 0.05)、体重指数(37.2 ± 6.2 vs. 40.3 ± 7.3; p > 0.在这项横断面研究中,两组患者均完成了国际体力活动问卷(IPAQ)、短式健康问卷(SF-36)、个人幸福感量表(PWB)和医院焦虑抑郁量表(HADS-A 和 HADS-D):结果:两组患者的 SF-36、HADS-A 和 HADS-D 评分相似,焦虑(HADS-A > 8)和抑郁(HADS-D > 8)的临床病例发生率也相似。OSAS 患者的体力活动得分明显更高[IPAQ 绝对值 OSAS 为 1100.75(7753.5) vs. OHS 为 518(3806); p = 0.029]。组间比较显示,患者的身体功能存在显著差异(p 结论:OSAS 和 OHS 对患者的身体功能均有显著影响:两种综合征都会严重影响患者的生活质量和体力活动,而 OHS 患者的负担更重。肥胖 OHS 患者的日常体力活动似乎受到更大影响,这可能是由于日间高碳酸血症所致。
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引用次数: 0
Mandibular device treatment in obstructive sleep apnea -A structured therapy adjustment considering night-to-night variability night-to-night variability in mandibular devices. 阻塞性睡眠呼吸暂停的下颌装置治疗--考虑到下颌装置夜间变化的结构化治疗调整。
IF 4.6 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2024-12-01 Epub Date: 2024-09-06 DOI: 10.1007/s11325-024-03134-w
Greta Sophie Papenfuß, Inke R König, Christina Hagen, Alex Frydrychowicz, Fenja Zell, Alina Janna Ibbeken, Thorsten M Buzug, Ulrike Kirstein, Lina Kreft, Daniel Grünberg, Samer Hakim, Armin Steffen

Background: Mandibular advancement devices (MAD) are a well-established treatment option for obstructive sleep apnea (OSA). MAD are considered preferably for patients with mild to moderate OSA presenting with a elevated night-to-night variability (NNV). This study aimed to determine the treatment effect of MAD on NNV considering different protrusion distances and patient related outcome (PRO).

Methods: We conducted a prospective cohort analysis of patients before MAD with 60% and 80% of the maximum protrusion. OSA severity was assessed using a home-sleep test for two consecutive nights. PRO contained the Epworth Sleepiness Scale (ESS) and sleep related quality of life (FOSQ).

Results: Twenty patients with a median overweight body-mass-index of 27.1 (interquartile range (IQR) 16.3 kg/m²), with a mainly mild to moderate OSA with an apnea -hypopnea index (AHI) of 18.3 / h (IQR 17.7) and elevated ESS of 12.5 (IQR 8.0) were included. As opposed to 80%, 60% protrusion significantly but not 80% relevantly reduced AHI (60%%: 11.2 (IQR 5.5)/h, p = 0.01; 80%: 12.9 (IQR18,0)/h, p = 0.32) and improved the ESS (60%: 8.0 (IQR 10,0); 80%: 10 (IQR 9.0)), with therapy settings. No correlation could be detected between NNV and ESS, and FOSQ changes. Higher baseline NNV was associated with severe OSA (p = 0.02) but not with gender, overweight, or status post-tonsillectomy.

Conclusions: OSA improvement is associated with lower NNV; both OSA and NNV are connected to the degree of protrusion. Therefore, higher NNV does not justify the exclusion of candidates for MAD treatment. PRO changes are not visibly affected by NNV but by general OSA changes. These findings may help to define and optimize future study designs for the primary outcome decision between objective OSA parameters and PRO.

背景:下颌前突装置(MAD)是治疗阻塞性睡眠呼吸暂停(OSA)的一种行之有效的方法。下颌前突矫正器被认为是轻度至中度 OSA 患者的最佳选择,这些患者表现为夜间变异性(NNV)升高。本研究旨在根据不同的突出距离和患者相关结果(PRO)确定 MAD 对 NNV 的治疗效果:我们对接受 MAD 治疗的患者进行了前瞻性队列分析,患者的最大突出度分别为 60% 和 80%。连续两晚的家庭睡眠测试评估了 OSA 的严重程度。PRO包括埃普沃思嗜睡量表(ESS)和睡眠相关生活质量(FOSQ):20名患者的体重指数中位数为27.1(四分位距(IQR)为16.3 kg/m²),主要患有轻度至中度OSA,呼吸暂停-低通气指数(AHI)为18.3/h(IQR为17.7),ESS值为12.5(IQR为8.0)。与 80% 的患者相比,60% 的患者能显著降低 AHI(60%:11.2 (IQR 5.5)/h, p = 0.01; 80%:12.9(IQR18,0)/小时,p = 0.32),并改善了ESS(60%:8.0(IQR 10,0);80%:10(IQR 9.0))。在 NNV 和 ESS 以及 FOSQ 变化之间未发现相关性。较高的基线 NNV 与严重 OSA 相关(p = 0.02),但与性别、超重或扁桃体切除术后的状况无关:结论:OSA 的改善与 NNV 的降低有关;OSA 和 NNV 都与突出程度有关。因此,NNV较高并不能成为排除 MAD 治疗候选者的理由。PRO的变化并不受NNV的明显影响,而是受OSA总体变化的影响。这些发现可能有助于确定和优化未来的研究设计,以决定 OSA 客观参数和 PRO 之间的主要结果。
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引用次数: 0
The impact of OSA on benign prostatic hyperplasia and metabolic syndrome Nocturia: a central mechanism analysis. OSA 对良性前列腺增生和代谢综合征夜尿的影响:中心机制分析。
IF 4.6 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2024-12-01 Epub Date: 2024-08-26 DOI: 10.1007/s11325-024-03086-1
Tsai-Yu Wang, Chun-Te Wu, Yu-Hsiang Lin
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引用次数: 0
Developing probabilistic ensemble machine learning models for home-based sleep apnea screening using overnight SpO2 data at varying data granularity. 利用不同数据粒度的隔夜 SpO2 数据,开发用于家庭睡眠呼吸暂停筛查的概率集合机器学习模型。
IF 4.6 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2024-12-01 Epub Date: 2024-08-27 DOI: 10.1007/s11325-024-03141-x
Zilu Liang

Purpose: This study aims to develop sleep apnea screening models with overnight SpO2 data, and to investigate the impact of the SpO2 data granularity on model performance.

Methods: A total of 7,718 SpO2 recordings from the SHHS and MESA datasets were used. Probabilistic ensemble machine learning was employed to predict sleep apnea status at three AHI cutoff points: ≥ 5, ≥ 15, and ≥ 30 events/hour. To investigate the impact of data granularity, SpO2 data were aggregated at 30, 60, and 300 s.

Results: Our models demonstrated good to excellent performance on internal test, with average area under the curve (AUC) values of 0.91, 0.93, and 0.96 for cutoffs ≥ 5, ≥ 15, and ≥ 30 at data granularity of 1 s, respectively. Both sensitivity (0.76, 0.84, 0.89) and specificity (0.87, 0.86, 0.90) ranged from good to excellent across three cutoffs. Positive predictive values (PPV) ranged from excellent to fair (0.97, 0.83, 0.66), and negative predictive values (NPV) ranged from low to excellent (0.43, 0.87, 0.98). Model performance on external test slightly dropped compared to internal test, but still achieved good to excellent AUC above 0.80 across all data granularity and all the three cutoffs. Data granularity of 300 s led to a reduction in performance metrics across all cutoffs.

Conclusion: Our models demonstrated superior performance across all three AHI cutoff thresholds compared to existing large sleep apnea screening models, even when considering varying SpO2 data granularity. However, lower data granularity was associated with decreased screening performance, indicating a need for further research in this area.

目的:本研究旨在利用夜间 SpO2 数据开发睡眠呼吸暂停筛查模型,并探讨 SpO2 数据粒度对模型性能的影响:方法:共使用了来自 SHHS 和 MESA 数据集的 7,718 条 SpO2 记录。采用概率集合机器学习预测三个AHI临界点的睡眠呼吸暂停状态:≥5、≥15和≥30次/小时。为了研究数据粒度的影响,SpO2 数据在 30 秒、60 秒和 300 秒时进行了汇总:我们的模型在内部测试中表现出良好到卓越的性能,在数据粒度为 1 秒时,截断值≥ 5、≥ 15 和≥ 30 的平均曲线下面积 (AUC) 值分别为 0.91、0.93 和 0.96。三个临界值的灵敏度(0.76、0.84、0.89)和特异度(0.87、0.86、0.90)从良好到优秀不等。阳性预测值(PPV)从优秀到一般(0.97、0.83、0.66)不等,阴性预测值(NPV)从低到优秀(0.43、0.87、0.98)不等。与内部测试相比,模型在外部测试中的表现略有下降,但在所有数据粒度和所有三个截止值中,AUC 仍达到了 0.80 以上的良好至优秀水平。数据粒度为 300 秒时,所有截止值的性能指标都有所下降:与现有的大型睡眠呼吸暂停筛查模型相比,即使考虑到不同的 SpO2 数据粒度,我们的模型在所有三个 AHI 临界值上都表现出卓越的性能。然而,较低的数据粒度与筛查性能下降有关,这表明需要在这一领域开展进一步研究。
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引用次数: 0
The association between sleep quantity, insomnia and lung cancer risk - A systematic review and meta-analysis. 睡眠质量、失眠与肺癌风险之间的关系--系统回顾与荟萃分析。
IF 4.6 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2024-12-01 Epub Date: 2024-08-15 DOI: 10.1007/s11325-024-03092-3
Brian Sheng Yep Yeo, Jin Hean Koh, Bryan Yichong Shi, Jun He Chan, Adele Chin Wei Ng, Shaun Loh, Leong Chai Leow, Thun How Ong, Joshua J Gooley, Song Tar Toh

Purpose: The effect of various sleep traits on the risk of lung cancer differs among pre-existing studies. This study aims to systematically review and synthesise the association between sleep duration and insomnia with the incidence of lung cancer.

Methods: PubMed, Embase and The Cochrane Library were searched from inception to 23 April 2023 for observational studies examining the effect of sleep quantity or insomnia on lung cancer incidence. We pooled maximally-adjusted hazard ratios and odds ratios separately using random effects inverse variance weighted models. The risk of bias of observational studies was assessed using the Newcastle-Ottawa Scale.

Results: We included 11 observational studies with a pooled cohort of 5,049,141 patients. The mean age of the patients was 49.5 ± 17.7 years, and 51.4% were males. The risk of bias ranged from low-moderate. Individuals who slept for a shorter or longer duration than the reference range of sleep per night showed an increased risk of lung cancer by 11% (HR:1.11; 95%CI:1.00-1.23) and 16% (HR:1.16; 95%CI:1.06-1.27) respectively. Furthermore, individuals with insomnia symptoms had a 9% greater risk of lung cancer than those without symptoms (HR:1.09; 95%CI:1.05-1.13).

Conclusion: This study suggests that insufficient sleep, excessive sleep and insomnia may be associated with an increased risk of lung cancer. Physicians should be mindful of this association and encourage healthy sleep practises among patients. Given the observed heterogeneity among some pre-existing studies, future research with longer periods of follow-up, greater control for covariates and objective testing of sleep parameters may add value to this topic.

目的:各种睡眠特征对肺癌风险的影响在已有研究中存在差异。本研究旨在系统回顾和总结睡眠时间和失眠与肺癌发病率之间的关系:方法:我们检索了 PubMed、Embase 和 Cochrane 图书馆中从开始到 2023 年 4 月 23 日有关睡眠时间或失眠对肺癌发病率影响的观察性研究。我们使用随机效应反方差加权模型分别汇总了最大调整危险比和几率比。我们使用纽卡斯尔-渥太华量表评估了观察性研究的偏倚风险:我们共纳入了 11 项观察性研究,汇集了 5,049,141 名患者。患者的平均年龄为 49.5 ± 17.7 岁,51.4% 为男性。偏倚风险从低到中等不等。每晚睡眠时间短于或长于参考睡眠时间范围的人患肺癌的风险分别增加了11%(HR:1.11;95%CI:1.00-1.23)和16%(HR:1.16;95%CI:1.06-1.27)。此外,与没有失眠症状的人相比,有失眠症状的人患肺癌的风险要高出9%(HR:1.09;95%CI:1.05-1.13):这项研究表明,睡眠不足、睡眠过度和失眠可能与肺癌风险增加有关。医生应注意这种关联,并鼓励患者保持健康的睡眠习惯。鉴于已观察到的一些已有研究之间的异质性,今后的研究应进行更长时间的随访,加强对协变量的控制,并对睡眠参数进行客观测试,从而为这一课题增添价值。
{"title":"The association between sleep quantity, insomnia and lung cancer risk - A systematic review and meta-analysis.","authors":"Brian Sheng Yep Yeo, Jin Hean Koh, Bryan Yichong Shi, Jun He Chan, Adele Chin Wei Ng, Shaun Loh, Leong Chai Leow, Thun How Ong, Joshua J Gooley, Song Tar Toh","doi":"10.1007/s11325-024-03092-3","DOIUrl":"10.1007/s11325-024-03092-3","url":null,"abstract":"<p><strong>Purpose: </strong>The effect of various sleep traits on the risk of lung cancer differs among pre-existing studies. This study aims to systematically review and synthesise the association between sleep duration and insomnia with the incidence of lung cancer.</p><p><strong>Methods: </strong>PubMed, Embase and The Cochrane Library were searched from inception to 23 April 2023 for observational studies examining the effect of sleep quantity or insomnia on lung cancer incidence. We pooled maximally-adjusted hazard ratios and odds ratios separately using random effects inverse variance weighted models. The risk of bias of observational studies was assessed using the Newcastle-Ottawa Scale.</p><p><strong>Results: </strong>We included 11 observational studies with a pooled cohort of 5,049,141 patients. The mean age of the patients was 49.5 ± 17.7 years, and 51.4% were males. The risk of bias ranged from low-moderate. Individuals who slept for a shorter or longer duration than the reference range of sleep per night showed an increased risk of lung cancer by 11% (HR:1.11; 95%CI:1.00-1.23) and 16% (HR:1.16; 95%CI:1.06-1.27) respectively. Furthermore, individuals with insomnia symptoms had a 9% greater risk of lung cancer than those without symptoms (HR:1.09; 95%CI:1.05-1.13).</p><p><strong>Conclusion: </strong>This study suggests that insufficient sleep, excessive sleep and insomnia may be associated with an increased risk of lung cancer. Physicians should be mindful of this association and encourage healthy sleep practises among patients. Given the observed heterogeneity among some pre-existing studies, future research with longer periods of follow-up, greater control for covariates and objective testing of sleep parameters may add value to this topic.</p>","PeriodicalId":21862,"journal":{"name":"Sleep and Breathing","volume":" ","pages":"2325-2334"},"PeriodicalIF":4.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141983249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Factors predictive of extensive use of CPAP treatment in obstructive sleep apnoea. 阻塞性睡眠呼吸暂停患者广泛使用 CPAP 治疗的预测因素。
IF 4.6 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2024-12-01 Epub Date: 2024-08-20 DOI: 10.1007/s11325-024-03146-6
Fatma Doghman, Haitham Ballo, Ulla Anttalainen, Tarja Saaresranta

Aim: In patients with obstructive sleep apnoea (OSA), the benefits of continuous positive airway pressure (CPAP) therapy are increased for every additional hour of daily CPAP usage. However, the data of predictors of extensive usage is scarce, if any. Therefore, we evaluated potential predictors affecting extensive treatment usage.

Methods: In this retrospective study, we compiled an institutional cohort of consecutive patients diagnosed with who started CPAP therapy 1999-2022 and were included in a wireless telemonitoring system in May 2022 (N = 14,394). Patients using CPAP device ≥ 9 h/d were stratified into a younger (< 65 years; N = 124) and an older group (≥ 65 years; N = 131).

Results: We found 255 patients (male 61%) eligible for our study, with a median age of 65 (interquartile range, IQR 55-73) years, and mean body mass index (BMI) of 36 ± 6.9 kg/m2. Median CPAP use was 10 h/d (IQR 10-11). BMI and depressive symptoms (DEPS) in the younger group were higher than in the older group (37.9 ± 7 vs. 34.6 ± 6.4 kg/m2, p < 0.001 and 11 (IQR 5-20) vs. 7 (IQR 5-14), p = 0.01, respectively). During follow-up, the BMI of the younger group increased (39.9 ± 12.5 kg/m2 vs. 37.9 ± 7 kg/m2, p = 0.009). DEPS values decreased in the younger group and became comparable between the groups. In multivariate models, the baseline BMI independently predicted extensive CPAP use among the younger age group, and the mask leak among the older group.

Conclusion: BMI at baseline in the younger and mask leak in the older group could be independent predictive factors for extensive use of CPAP.

目的:对于阻塞性睡眠呼吸暂停(OSA)患者来说,每天多使用一小时 CPAP,持续气道正压(CPAP)疗法的疗效就会增加一小时。然而,有关大量使用的预测因素的数据却很少。因此,我们对影响广泛使用治疗的潜在预测因素进行了评估:在这项回顾性研究中,我们对 1999 年至 2022 年开始接受 CPAP 治疗并在 2022 年 5 月被纳入无线远程监控系统的连续确诊患者(N = 14,394 人)进行了机构队列整理。使用 CPAP 设备时间≥ 9 小时/天的患者被分层为年轻组(结果:我们发现有 255 名患者(男性占 61%)符合研究条件,中位年龄为 65 岁(四分位数间距,IQR 55-73),平均体重指数 (BMI) 为 36 ± 6.9 kg/m2。使用 CPAP 的中位数为 10 小时/天(IQR 10-11)。年轻组的体重指数和抑郁症状(DEPS)高于年长组(37.9 ± 7 vs. 34.6 ± 6.4 kg/m2,P 2 vs. 37.9 ± 7 kg/m2,P = 0.009)。年轻组的 DEPS 值有所下降,各组之间的 DEPS 值相当。在多变量模型中,基线体重指数可独立预测年轻组广泛使用 CPAP 的情况,以及老年组面罩泄漏的情况:结论:年轻组的基线体重指数和年长组的面罩泄漏可能是广泛使用 CPAP 的独立预测因素。
{"title":"Factors predictive of extensive use of CPAP treatment in obstructive sleep apnoea.","authors":"Fatma Doghman, Haitham Ballo, Ulla Anttalainen, Tarja Saaresranta","doi":"10.1007/s11325-024-03146-6","DOIUrl":"10.1007/s11325-024-03146-6","url":null,"abstract":"<p><strong>Aim: </strong>In patients with obstructive sleep apnoea (OSA), the benefits of continuous positive airway pressure (CPAP) therapy are increased for every additional hour of daily CPAP usage. However, the data of predictors of extensive usage is scarce, if any. Therefore, we evaluated potential predictors affecting extensive treatment usage.</p><p><strong>Methods: </strong>In this retrospective study, we compiled an institutional cohort of consecutive patients diagnosed with who started CPAP therapy 1999-2022 and were included in a wireless telemonitoring system in May 2022 (N = 14,394). Patients using CPAP device ≥ 9 h/d were stratified into a younger (< 65 years; N = 124) and an older group (≥ 65 years; N = 131).</p><p><strong>Results: </strong>We found 255 patients (male 61%) eligible for our study, with a median age of 65 (interquartile range, IQR 55-73) years, and mean body mass index (BMI) of 36 ± 6.9 kg/m<sup>2</sup>. Median CPAP use was 10 h/d (IQR 10-11). BMI and depressive symptoms (DEPS) in the younger group were higher than in the older group (37.9 ± 7 vs. 34.6 ± 6.4 kg/m<sup>2</sup>, p < 0.001 and 11 (IQR 5-20) vs. 7 (IQR 5-14), p = 0.01, respectively). During follow-up, the BMI of the younger group increased (39.9 ± 12.5 kg/m<sup>2</sup> vs. 37.9 ± 7 kg/m<sup>2</sup>, p = 0.009). DEPS values decreased in the younger group and became comparable between the groups. In multivariate models, the baseline BMI independently predicted extensive CPAP use among the younger age group, and the mask leak among the older group.</p><p><strong>Conclusion: </strong>BMI at baseline in the younger and mask leak in the older group could be independent predictive factors for extensive use of CPAP.</p>","PeriodicalId":21862,"journal":{"name":"Sleep and Breathing","volume":" ","pages":"2379-2386"},"PeriodicalIF":4.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11567983/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142005262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Sleep conditions and sleep hygiene behaviors in early pregnancy are associated with gestational diabetes mellitus: A propensity-score matched study. 孕早期的睡眠状况和睡眠卫生行为与妊娠糖尿病有关:倾向分数匹配研究
IF 4.6 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2024-12-01 Epub Date: 2024-08-27 DOI: 10.1007/s11325-024-03071-8
Guojun Ma, Yanqing Cai, Yong Zhang, Jianxia Fan

Purpose: To explore the influence of sleep conditions and sleep hygiene behaviors in early pregnancy on gestational diabetes mellitus (GDM) development.

Methods: This 1:1 propensity-score matched study included 1,216 pregnant women divided into GDM and control groups based on diagnosis via the oral glucose tolerance test at 24-28 gestational weeks. Sleep conditions and hygiene behaviors were evaluated using structural questionnaires, including the Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, and Sleep Hygiene Practice Scale. Univariate and multivariate logistic regression analyses and Spearman's correlation were conducted to identify the associations.

Results: After adjusting for baseline clinical characteristics, women with GDM were more likely to have poor sleep quality (adjusted odds ratio [AOR] = 1.585, 95% confidence interval [CI]: 1.261-1.992) and higher scores for subjective sleep quality, latency, duration, efficiency, and sleep disturbances (all P < 0.01). Mild sleepiness (AOR = 1.311, 95% CI: 1.012-1.699) and worrying about not being able to fall asleep (AOR = 1.123, 95% CI: 1.005-1.255) were more likely to occur in the GDM group. Sleep quality and hygiene behaviors such as sleep-irrelevant activities, staying in bed after waking up, weekend catch-up sleep, and overeating before bedtime were significantly correlated with gestational diabetes variables.

Conclusion: Poor sleep conditions and specific sleep hygiene behaviors in early pregnancy may be independent risk factors for GDM. This suggests that sleep assessment and behavior education can be used as new approaches for the early implementation of surveillance and prevention of GDM.

目的:探讨孕早期睡眠条件和睡眠卫生行为对妊娠糖尿病(GDM)发展的影响:这项1:1倾向得分匹配研究包括1,216名孕妇,根据24-28孕周口服葡萄糖耐量试验的诊断结果分为GDM组和对照组。采用结构性问卷对睡眠状况和卫生行为进行评估,包括匹兹堡睡眠质量指数、爱普沃斯嗜睡量表和睡眠卫生实践量表。通过单变量和多变量逻辑回归分析以及斯皮尔曼相关分析来确定两者之间的关联:结果:在对基线临床特征进行调整后,患有 GDM 的女性更有可能睡眠质量差(调整后的几率比 [AOR] = 1.585,95% 置信区间 [CI]:1.261-1.992):1.261-1.992),主观睡眠质量、潜伏期、持续时间、效率和睡眠障碍的得分更高(均为 P 结论:GDM 妇女更容易出现睡眠质量差的情况:孕早期不良的睡眠条件和特定的睡眠卫生行为可能是导致 GDM 的独立风险因素。这表明,睡眠评估和行为教育可作为早期监测和预防 GDM 的新方法。
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引用次数: 0
A genome-wide methylation analysis of Chinese Han patients with chronic insomnia disorder. 中国汉族慢性失眠症患者的全基因组甲基化分析。
IF 2.1 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2024-12-01 Epub Date: 2024-08-26 DOI: 10.1007/s11325-024-03145-7
Xiao Li, Xue Meng, Rong-Rong Zhao, Ya-Hui Xu

Background: As the most common sleep disorder, chronic insomnia disorder (CID) has become a global health burden to the public. However, it remains unclear about the pathogenesis of this disease. Epigenetic changes may provide important insights into the gene-environment interaction in CID. Therefore, this study was conducted to investigate the DNA methylation pattern in CID and reveal the epigenetic mechanism of this disease.

Methods: In this study, whole blood DNA was extracted from 8 CID patients (the CID group) and 8 healthy controls (the control group), respectively. Besides, genome-wide DNA methylation was detected by Illumina Human Methylation 850 K Beadchip. Moreover, the sleep quality and insomnia severity were evaluated by the Pittsburgh Sleep Quality Index (PSQI) and Insomnia Severity Index (ISI), respectively.

Results: A total of 369 differentially methylated positions (DMPs) and 23 differentially methylated regions (DMRs) were identified between the CID and control groups. LHX6 was identified as the most important differentially methylated gene (DMG). The Gene Ontology (GO) analysis results corroborated that DMPs were significantly enriched in 105 GO terms, including cell signaling, homogenous cell adhesion of plasma membrane adhesion molecules, nervous system development, cell adhesion, and calcium ion binding. In addition, it was demonstrated that DMPs were significantly enriched in the Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways, including the hippo signaling pathway, Ras signaling pathway, and vitamin B6 metabolism. The DMR-related GO analysis results revealed the positive regulation of protein kinase activities.

Conclusions: DNA methylation plays a critical role in the development of CID, and LHX6 is validated to be an important DMG.

背景:作为最常见的睡眠障碍,慢性失眠症(CID)已成为全球公众的健康负担。然而,该疾病的发病机制仍不清楚。表观遗传学变化可能为了解 CID 中基因与环境的相互作用提供了重要线索。因此,本研究旨在调查 CID 的 DNA 甲基化模式,揭示该疾病的表观遗传学机制:方法:本研究分别从 8 名 CID 患者(CID 组)和 8 名健康对照者(对照组)中提取全血 DNA。此外,利用Illumina Human Methylation 850 K Beadchip检测全基因组DNA甲基化。此外,还分别用匹兹堡睡眠质量指数(PSQI)和失眠严重程度指数(ISI)评估了睡眠质量和失眠严重程度:结果:在CID组和对照组之间共发现了369个差异甲基化位点(DMPs)和23个差异甲基化区域(DMRs)。LHX6被确定为最重要的差异甲基化基因(DMG)。基因本体(Gene Ontology,GO)分析结果证实,DMPs在105个GO术语中显著富集,包括细胞信号传导、质膜粘附分子的同源细胞粘附、神经系统发育、细胞粘附和钙离子结合。此外,研究还表明,DMPs在《京都基因和基因组百科全书》(KEGG)通路中也有明显的富集,包括河马信号通路、Ras信号通路和维生素B6代谢。DMR相关的GO分析结果显示了对蛋白激酶活性的正向调控:DNA甲基化在CID的发病过程中起着关键作用,而LHX6被证实是一种重要的DMG。
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引用次数: 0
Polysomnographic and clinical characteristics of sleep apnea headache patients. 睡眠呼吸暂停头痛患者的多导睡眠图和临床特征。
IF 4.6 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2024-12-01 Epub Date: 2024-10-10 DOI: 10.1007/s11325-024-03117-x
Esra Aydin Sunbul, Rahşan Karacı, Elif Gözde Türedi Karabulut, Hüseyin Güleç, Füsun Mayda Domaç

Purpose: Sleep apnea headache can be defined as a persistent, widespread, throbbing headache that occurs recurrently, is not accompanied by any additional symptoms after waking up, and usually resolves within four hours. Diagnosis of the condition requires confirmation through polysomnography with an apnea-hypopnea index of at least 5, indicating the presence of obstructive sleep apnea syndrome (OSAS). While sleep apnea headaches are common in 10-15% of individuals with OSAS, morning headaches are experienced by 5% of this population. The aim of this study is to examine both polysomnographic and clinical features associated with sleep apnea headache in individuals confirmed to have OSAS by polysomnography.

Method: The study was conducted in the sleep center of University of Health Science, Erenköy Mental and Nervous Disease Training and Research Hospital. We have examined the clinical and polysomnographic data of the patients with sleep apnea headache (SAH) diagnosed according to IHS-3 criteria retrospectively and grouped the patients as mild, moderate and severe OSAS. Patients with morning headache except sleep apnea headache and under PAP titration treatment were excluded. The differences between the sleep macro structures of patients with (WSAH) and without sleep apnea headache (WOSAH) were examined.

Results: The WSAH group consisted of 384 participants and the control group (WOSAH) consisted of 294 participants The mean age was 46.29 ± 12.18 and 45.08 ± 12.62 years, respectively. Patients in the WSAH group had significantly higher scores on the Epworth Sleepiness Scale (ESS) (p = 0.004) and higher periodic limb movement index (PLMI) (p = 0.014) compared to the WOSAH group. WSAH patients exhibited shorter wake times after sleep onset (WASO) and lower scores on the sleep quality index, in contrast to WOSAH patients. Additionally, within the WSAH group, there was a negative correlation between age and several sleep parameters, including total sleep parameters. A positive correlation was observed between sleep duration (p = 0.009), waking up after sleep (p = 0.043), sleep efficiency (p = 0.001) and apnea-hypopnea index (AHI) (p = 0.018). Additionally, ESS scores were positively correlated with AHI and total awake time (p = 0.000 and p = 0.008, respectively), while negatively correlated with stage N3 sleep percentage and mean minimum oxygen level (p = 0.001 and p = 0.020, respectively) in the WSAH group.

Conclusion: The causes and possible mechanisms of sleep apnea headache are not fully clarified and the underlying processes are not fully understood. Sleep apnea headaches appear to be related to disturbances in nocturnal sleep. Dysregulation in regions that modulate sleep and nociception may be one possible mechanism.

目的:睡眠呼吸暂停头痛可定义为反复发作的持续性、广泛性、搏动性头痛,起床后不伴有任何其他症状,通常在四小时内缓解。要确诊这种病症,需要通过多导睡眠监测仪进行确认,呼吸暂停-低通气指数至少为 5,表明存在阻塞性睡眠呼吸暂停综合征(OSAS)。睡眠呼吸暂停头痛常见于 10-15% 的阻塞性睡眠呼吸暂停综合症患者,而晨起头痛则占这一人群的 5% 。本研究旨在对通过多导睡眠图检查确认为 OSAS 患者的睡眠呼吸暂停头痛的相关多导睡眠图和临床特征进行研究:研究在埃伦柯伊精神和神经疾病培训与研究医院健康科学大学睡眠中心进行。我们对根据 IHS-3 标准诊断出的睡眠呼吸暂停头痛(SAH)患者的临床和多导睡眠图数据进行了回顾性研究,并将患者分为轻度、中度和重度 OSAS。排除了除睡眠呼吸暂停头痛以外的晨起头痛患者和正在接受 PAP 滴定治疗的患者。研究了有睡眠呼吸暂停头痛(WSAH)和无睡眠呼吸暂停头痛(WOSAH)患者睡眠宏观结构的差异:平均年龄分别为(46.29±12.18)岁和(45.08±12.62)岁。与 WOSAH 组相比,WSAH 组患者的埃普沃思嗜睡量表(ESS)得分明显更高(p = 0.004),周期性肢体运动指数(PLMI)也更高(p = 0.014)。与 WOSAH 患者相比,WSAH 患者睡眠开始后的觉醒时间(WASO)更短,睡眠质量指数得分更低。此外,在 WSAH 组中,年龄与多项睡眠参数(包括总睡眠参数)呈负相关。睡眠持续时间(p = 0.009)、睡后觉醒(p = 0.043)、睡眠效率(p = 0.001)和呼吸暂停-低通气指数(AHI)(p = 0.018)之间呈正相关。此外,ESS评分与AHI和总清醒时间呈正相关(分别为p = 0.000和p = 0.008),而在WSAH组中,ESS评分与N3期睡眠百分比和平均最低氧气水平呈负相关(分别为p = 0.001和p = 0.020):结论:睡眠呼吸暂停头痛的原因和可能的机制尚未完全明确,其潜在的过程也不完全清楚。睡眠呼吸暂停头痛似乎与夜间睡眠紊乱有关。调节睡眠和痛觉的区域失调可能是一种可能的机制。
{"title":"Polysomnographic and clinical characteristics of sleep apnea headache patients.","authors":"Esra Aydin Sunbul, Rahşan Karacı, Elif Gözde Türedi Karabulut, Hüseyin Güleç, Füsun Mayda Domaç","doi":"10.1007/s11325-024-03117-x","DOIUrl":"10.1007/s11325-024-03117-x","url":null,"abstract":"<p><strong>Purpose: </strong>Sleep apnea headache can be defined as a persistent, widespread, throbbing headache that occurs recurrently, is not accompanied by any additional symptoms after waking up, and usually resolves within four hours. Diagnosis of the condition requires confirmation through polysomnography with an apnea-hypopnea index of at least 5, indicating the presence of obstructive sleep apnea syndrome (OSAS). While sleep apnea headaches are common in 10-15% of individuals with OSAS, morning headaches are experienced by 5% of this population. The aim of this study is to examine both polysomnographic and clinical features associated with sleep apnea headache in individuals confirmed to have OSAS by polysomnography.</p><p><strong>Method: </strong>The study was conducted in the sleep center of University of Health Science, Erenköy Mental and Nervous Disease Training and Research Hospital. We have examined the clinical and polysomnographic data of the patients with sleep apnea headache (SAH) diagnosed according to IHS-3 criteria retrospectively and grouped the patients as mild, moderate and severe OSAS. Patients with morning headache except sleep apnea headache and under PAP titration treatment were excluded. The differences between the sleep macro structures of patients with (WSAH) and without sleep apnea headache (WOSAH) were examined.</p><p><strong>Results: </strong>The WSAH group consisted of 384 participants and the control group (WOSAH) consisted of 294 participants The mean age was 46.29 ± 12.18 and 45.08 ± 12.62 years, respectively. Patients in the WSAH group had significantly higher scores on the Epworth Sleepiness Scale (ESS) (p = 0.004) and higher periodic limb movement index (PLMI) (p = 0.014) compared to the WOSAH group. WSAH patients exhibited shorter wake times after sleep onset (WASO) and lower scores on the sleep quality index, in contrast to WOSAH patients. Additionally, within the WSAH group, there was a negative correlation between age and several sleep parameters, including total sleep parameters. A positive correlation was observed between sleep duration (p = 0.009), waking up after sleep (p = 0.043), sleep efficiency (p = 0.001) and apnea-hypopnea index (AHI) (p = 0.018). Additionally, ESS scores were positively correlated with AHI and total awake time (p = 0.000 and p = 0.008, respectively), while negatively correlated with stage N3 sleep percentage and mean minimum oxygen level (p = 0.001 and p = 0.020, respectively) in the WSAH group.</p><p><strong>Conclusion: </strong>The causes and possible mechanisms of sleep apnea headache are not fully clarified and the underlying processes are not fully understood. Sleep apnea headaches appear to be related to disturbances in nocturnal sleep. Dysregulation in regions that modulate sleep and nociception may be one possible mechanism.</p>","PeriodicalId":21862,"journal":{"name":"Sleep and Breathing","volume":" ","pages":"2591-2596"},"PeriodicalIF":4.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142401370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Impact of obstructive sleep apnoea on postoperative outcomes of patients undergoing coronary artery bypass grafting: a systematic review and meta-analysis. 阻塞性睡眠呼吸暂停对冠状动脉旁路移植术患者术后效果的影响:系统回顾和荟萃分析。
IF 2.1 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2024-12-01 Epub Date: 2024-09-06 DOI: 10.1007/s11325-024-03154-6
Yajing Ni, Yan Zhou

Objective: To assess the association between obstructive sleep apnoea (OSA) and postoperative complications in patients after coronary artery bypass graft (CABG).

Methods: PubMed, Embase, Web of Science and Scopus databases were explored to identify relevant observational studies that reported incidences of OSA in CABG patients, and assessed OSA using standard objective methods such as polysomnography (PSG). The primary outcomes of interest were risk of major adverse cardiac and cerebrovascular events (MACCE) and all-cause mortality. Pooled effect sizes were reported as odds ratio (OR) with 95% confidence intervals.

Results: Twelve studies were included. All studies, except one, had a prospective cohort design. CABG patients with OSA had increased risk of MACCE (OR 1.71, 95% CI: 1.16, 2.53), myocardial infarction (MI) (OR 2.21, 95% CI: 1.19, 4.13), pulmonary complications (OR 1.86, 95% CI: 1.03, 3.38), renal complications (OR 8.14, 95% CI: 2.07, 32.1), heart failure (OR 1.86, 95% CI: 1.19, 2.89) and need for revascularization (OR 2.80, 95% CI: 1.01, 7.75). However, risk of all-cause mortality (OR 1.63, 95% CI: 0.75, 3.52) was comparable in all patients.

Conclusion: This study showed that OSA significantly correlates with the increased risk of major adverse events. Our results indicate that recognizing and managing OSA in CABG patients is crucial for mitigating associated risks.

目的评估阻塞性睡眠呼吸暂停(OSA)与冠状动脉旁路移植术(CABG)患者术后并发症之间的关系:对 PubMed、Embase、Web of Science 和 Scopus 数据库进行了检索,以确定报告了 CABG 患者 OSA 发生率的相关观察性研究,并使用标准的客观方法(如多导睡眠图 (PSG))对 OSA 进行评估。主要研究结果为主要不良心脑血管事件(MACCE)风险和全因死亡率。汇总效应大小以几率比(OR)和 95% 置信区间的形式报告:结果:共纳入 12 项研究。除一项研究外,所有研究均采用前瞻性队列设计。患有 OSA 的 CABG 患者发生 MACCE(OR 1.71,95% CI:1.16, 2.53)、心肌梗死(MI)(OR 2.21,95% CI:1.19, 4.13)、肺部并发症(OR 1.86,95% CI:1.03,3.38)、肾脏并发症(OR 8.14,95% CI:2.07,32.1)、心力衰竭(OR 1.86,95% CI:1.19,2.89)和需要血管重建(OR 2.80,95% CI:1.01,7.75)。然而,所有患者的全因死亡风险(OR 1.63,95% CI:0.75,3.52)相当:本研究表明,OSA 与重大不良事件风险的增加密切相关。我们的研究结果表明,识别和管理 CABG 患者的 OSA 对降低相关风险至关重要。
{"title":"Impact of obstructive sleep apnoea on postoperative outcomes of patients undergoing coronary artery bypass grafting: a systematic review and meta-analysis.","authors":"Yajing Ni, Yan Zhou","doi":"10.1007/s11325-024-03154-6","DOIUrl":"10.1007/s11325-024-03154-6","url":null,"abstract":"<p><strong>Objective: </strong>To assess the association between obstructive sleep apnoea (OSA) and postoperative complications in patients after coronary artery bypass graft (CABG).</p><p><strong>Methods: </strong>PubMed, Embase, Web of Science and Scopus databases were explored to identify relevant observational studies that reported incidences of OSA in CABG patients, and assessed OSA using standard objective methods such as polysomnography (PSG). The primary outcomes of interest were risk of major adverse cardiac and cerebrovascular events (MACCE) and all-cause mortality. Pooled effect sizes were reported as odds ratio (OR) with 95% confidence intervals.</p><p><strong>Results: </strong>Twelve studies were included. All studies, except one, had a prospective cohort design. CABG patients with OSA had increased risk of MACCE (OR 1.71, 95% CI: 1.16, 2.53), myocardial infarction (MI) (OR 2.21, 95% CI: 1.19, 4.13), pulmonary complications (OR 1.86, 95% CI: 1.03, 3.38), renal complications (OR 8.14, 95% CI: 2.07, 32.1), heart failure (OR 1.86, 95% CI: 1.19, 2.89) and need for revascularization (OR 2.80, 95% CI: 1.01, 7.75). However, risk of all-cause mortality (OR 1.63, 95% CI: 0.75, 3.52) was comparable in all patients.</p><p><strong>Conclusion: </strong>This study showed that OSA significantly correlates with the increased risk of major adverse events. Our results indicate that recognizing and managing OSA in CABG patients is crucial for mitigating associated risks.</p>","PeriodicalId":21862,"journal":{"name":"Sleep and Breathing","volume":" ","pages":"2345-2353"},"PeriodicalIF":2.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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Sleep and Breathing
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