Pub Date : 2024-10-02DOI: 10.1016/j.sleep.2024.09.045
C Jambon-Barbara, B Revol, A Hlavaty, M Joyeux-Faure, J C Borel, J L Cracowski, J L Pepin, C Khouri
We aim to discover new safety signals of drug-induced sleep apnoea (SA), a global health problem affecting approximately 1 billion people worldwide. We first conducted a series of sequence symmetry analyses (SSA) in a cohort composed from all patients who received a first SA diagnosis or treatment between 2006 and 2018 in the Echantillon Généraliste des Bénéficaires (EGB), a random sample of the French healthcare database. We used two primary outcomes to estimate the sequence ratio (SR) for all drug classes available in France: a sensitive one (diagnosis or treatment of SA) and a specific one (Positive Airway Pressure (PAP) therapy). We then performed disproportionality analyses using the "Bayesian neural network method" on all cases of sleep apnoea (MedDRA high level term) reported up to November 2023 in the World Health Organisation (WHO) pharmacovigilance database. Among the 728,167 individuals, 46,193 had an incident diagnosis or treatment for SA and 17,080 had started an incident treatment by PAP therapy. Fifty-eight drug classes had a significant SR, with 7 considered highly plausible: opium alkaloids and derivatives, benzodiazepine derivatives, other centrally acting agents, other anxiolytics, carbamic acid esters, quinine and derivatives and antivertigo preparations; with consistent signals found for the first 3 drug classes in the disproportionality analysis. In this signal detection study, we found that opioids, benzodiazepines (but not Z-drugs) and myorelaxing agents are associated with the onset or aggravation of SA. Moreover, a new safety signal for antivertigo preparations such as betahistine emerged and needs to be further explored.
我们的目标是发现药物诱发睡眠呼吸暂停(SA)的新安全信号,这是一个影响全球约 10 亿人的全球性健康问题。我们首先在法国医疗保健数据库随机抽样的Echantillon Généraliste des Bénéficaires (EGB)中,对2006年至2018年间首次接受睡眠呼吸暂停诊断或治疗的所有患者组成的队列进行了一系列序列对称性分析(SSA)。我们使用两个主要结果来估算法国现有所有药物类别的序列比(SR):一个是敏感结果(SA 的诊断或治疗),另一个是特定结果(气道正压(PAP)疗法)。然后,我们使用 "贝叶斯神经网络法 "对世界卫生组织(WHO)药物警戒数据库中截至 2023 年 11 月报告的所有睡眠呼吸暂停病例(MedDRA 高级术语)进行了比例失调分析。在 728,167 人中,46,193 人曾被诊断或治疗过睡眠呼吸暂停,17,080 人曾接受过 PAP 治疗。58类药物具有显著的SR,其中7类药物被认为具有高度可信性:鸦片生物碱及其衍生物、苯二氮卓衍生物、其他中枢作用药物、其他抗焦虑药、氨基甲酸酯、奎宁及其衍生物和抗眩晕制剂;在比例失调分析中发现前3类药物具有一致的信号。在这项信号检测研究中,我们发现阿片类药物、苯二氮卓类药物(但不包括 Z 类药物)和肌松弛剂与 SA 的发生或加重有关。此外,倍他司汀等抗眩晕制剂出现了新的安全信号,需要进一步探讨。
{"title":"Signal detection of drugs associated with obstructive and central sleep apnoea.","authors":"C Jambon-Barbara, B Revol, A Hlavaty, M Joyeux-Faure, J C Borel, J L Cracowski, J L Pepin, C Khouri","doi":"10.1016/j.sleep.2024.09.045","DOIUrl":"https://doi.org/10.1016/j.sleep.2024.09.045","url":null,"abstract":"<p><p>We aim to discover new safety signals of drug-induced sleep apnoea (SA), a global health problem affecting approximately 1 billion people worldwide. We first conducted a series of sequence symmetry analyses (SSA) in a cohort composed from all patients who received a first SA diagnosis or treatment between 2006 and 2018 in the Echantillon Généraliste des Bénéficaires (EGB), a random sample of the French healthcare database. We used two primary outcomes to estimate the sequence ratio (SR) for all drug classes available in France: a sensitive one (diagnosis or treatment of SA) and a specific one (Positive Airway Pressure (PAP) therapy). We then performed disproportionality analyses using the \"Bayesian neural network method\" on all cases of sleep apnoea (MedDRA high level term) reported up to November 2023 in the World Health Organisation (WHO) pharmacovigilance database. Among the 728,167 individuals, 46,193 had an incident diagnosis or treatment for SA and 17,080 had started an incident treatment by PAP therapy. Fifty-eight drug classes had a significant SR, with 7 considered highly plausible: opium alkaloids and derivatives, benzodiazepine derivatives, other centrally acting agents, other anxiolytics, carbamic acid esters, quinine and derivatives and antivertigo preparations; with consistent signals found for the first 3 drug classes in the disproportionality analysis. In this signal detection study, we found that opioids, benzodiazepines (but not Z-drugs) and myorelaxing agents are associated with the onset or aggravation of SA. Moreover, a new safety signal for antivertigo preparations such as betahistine emerged and needs to be further explored.</p>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142376042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
REM Sleep Behavioral Disorder (RBD) is a parasomnia marked by the maintenance of muscle tone during REM sleep. Evidence has placed RBD as one of the possible prodromal stages of Parkinson's Disease (PD), but data on the proportion of people with PD who have had symptoms of RBD are limited. This study aimed to investigate the history of symptoms compatible with RBD in a population with PD. The sample was composed by 73 patients with clinically diagnosed PD being followed up at a reference outpatient setting, compared to 73 age- and sex-matched individuals with no PD. The evaluation of symptoms compatible with RBD was performed using the Brazilian version of the RBD Screening Questionnaire (RBDSQ). The prevalence of symptoms compatible with RBD was 65 % for PD and 10.09 % for controls. The RBDSQ score was significantly higher in the PD group (6.03 ± 0.35) in comparison to the control group (2.38 ± 0.23). The odds ratio for presenting previous RBD-compatible symptoms was 12.09 in favor of positive PD cases. PD diagnosis has the following diagnostic properties in relation to presenting RBD symptoms: sensitivity of 0.65, specificity of 0.86, positive predictive value of 0.82 and negative predictive value of 0.71. In conclusion, the proportion of PD patients showing RBD symptoms is high, corroborating the expected neuroprogression of the disease on a case-control design comprising outpatient PD cases. Clinical practitioners should include evaluations of RBD-compatible symptoms during the PD assessment and, if positive, forward to a sleep specialist.
{"title":"History of symptoms consistent with REM sleep behavior disorder in a population with Parkinson's Disease.","authors":"Viviane Akemi Kakazu, Dalva Poyares, Sergio Tufik, Henrique Ballalai Ferraz, Gabriel Natan Pires","doi":"10.1016/j.sleep.2024.09.042","DOIUrl":"https://doi.org/10.1016/j.sleep.2024.09.042","url":null,"abstract":"<p><p>REM Sleep Behavioral Disorder (RBD) is a parasomnia marked by the maintenance of muscle tone during REM sleep. Evidence has placed RBD as one of the possible prodromal stages of Parkinson's Disease (PD), but data on the proportion of people with PD who have had symptoms of RBD are limited. This study aimed to investigate the history of symptoms compatible with RBD in a population with PD. The sample was composed by 73 patients with clinically diagnosed PD being followed up at a reference outpatient setting, compared to 73 age- and sex-matched individuals with no PD. The evaluation of symptoms compatible with RBD was performed using the Brazilian version of the RBD Screening Questionnaire (RBDSQ). The prevalence of symptoms compatible with RBD was 65 % for PD and 10.09 % for controls. The RBDSQ score was significantly higher in the PD group (6.03 ± 0.35) in comparison to the control group (2.38 ± 0.23). The odds ratio for presenting previous RBD-compatible symptoms was 12.09 in favor of positive PD cases. PD diagnosis has the following diagnostic properties in relation to presenting RBD symptoms: sensitivity of 0.65, specificity of 0.86, positive predictive value of 0.82 and negative predictive value of 0.71. In conclusion, the proportion of PD patients showing RBD symptoms is high, corroborating the expected neuroprogression of the disease on a case-control design comprising outpatient PD cases. Clinical practitioners should include evaluations of RBD-compatible symptoms during the PD assessment and, if positive, forward to a sleep specialist.</p>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142376043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-29DOI: 10.1016/j.sleep.2024.09.036
Cele E Richardson, Natasha R Magson, Jasmine Fardouly, Ella L Oar, Carly J Johnco, Justin Freeman, Ronald M Rapee
Study objectives: Perfectionism is a possible risk factor for insomnia, yet longitudinal evidence of this relationship in adolescence is lacking. Cross-sectional evidence suggests the nature of the relationship may differ based on biological sex, and the form of perfectionism, since socially prescribed and self-oriented critical perfectionism are conceptualised as maladaptive for wellbeing, while self-oriented striving may be adaptive or neutral. This study aimed to investigate longitudinal bidirectional relationships between total perfectionism, and sub-forms of perfectionism (i.e., socially prescribed, self-oriented critical, self-oriented striving perfectionism), and symptoms of insomnia, over the course of mid-adolescence. Longitudinal models were examined for males and females separately.
Methods: 434 adolescents (Mage = 14.25, SD = 0.56, range = 13-16, 52 % male) completed questionnaire measures of perfectionism (Child-Adolescent Perfectionism Scale) and insomnia (Insomnia Severity Index) on three annual occasions (at approximately 14, 15 & 16 years of age). Data were from the larger Risks to Adolescent Wellbeing (RAW) Project.
Results: Biological sex did not moderate the association between insomnia symptoms and any form of perfectionism. Cross-lagged panel models showed no longitudinal relationship between self-oriented striving, nor self-oriented critical perfectionism and insomnia symptoms for males or females. Higher total perfectionism predicted moderate increases in insomnia symptoms for males and females, but insomnia symptoms did not predict changes in total perfectionism. Socially prescribed perfectionism and insomnia symptoms predicted large and moderate increases in one another over time, respectively, forming a perpetuating cycle.
Conclusions: Results suggest that perfectionism may be an important risk factor for insomnia symptoms in adolescents.
{"title":"Sleepless in the Pursuit of perfection: A longitudinal investigation of bidirectional relationships between insomnia and perfectionism in Adolescent males and females.","authors":"Cele E Richardson, Natasha R Magson, Jasmine Fardouly, Ella L Oar, Carly J Johnco, Justin Freeman, Ronald M Rapee","doi":"10.1016/j.sleep.2024.09.036","DOIUrl":"https://doi.org/10.1016/j.sleep.2024.09.036","url":null,"abstract":"<p><strong>Study objectives: </strong>Perfectionism is a possible risk factor for insomnia, yet longitudinal evidence of this relationship in adolescence is lacking. Cross-sectional evidence suggests the nature of the relationship may differ based on biological sex, and the form of perfectionism, since socially prescribed and self-oriented critical perfectionism are conceptualised as maladaptive for wellbeing, while self-oriented striving may be adaptive or neutral. This study aimed to investigate longitudinal bidirectional relationships between total perfectionism, and sub-forms of perfectionism (i.e., socially prescribed, self-oriented critical, self-oriented striving perfectionism), and symptoms of insomnia, over the course of mid-adolescence. Longitudinal models were examined for males and females separately.</p><p><strong>Methods: </strong>434 adolescents (M<sub>age</sub> = 14.25, SD = 0.56, range = 13-16, 52 % male) completed questionnaire measures of perfectionism (Child-Adolescent Perfectionism Scale) and insomnia (Insomnia Severity Index) on three annual occasions (at approximately 14, 15 & 16 years of age). Data were from the larger Risks to Adolescent Wellbeing (RAW) Project.</p><p><strong>Results: </strong>Biological sex did not moderate the association between insomnia symptoms and any form of perfectionism. Cross-lagged panel models showed no longitudinal relationship between self-oriented striving, nor self-oriented critical perfectionism and insomnia symptoms for males or females. Higher total perfectionism predicted moderate increases in insomnia symptoms for males and females, but insomnia symptoms did not predict changes in total perfectionism. Socially prescribed perfectionism and insomnia symptoms predicted large and moderate increases in one another over time, respectively, forming a perpetuating cycle.</p><p><strong>Conclusions: </strong>Results suggest that perfectionism may be an important risk factor for insomnia symptoms in adolescents.</p>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142366561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-29DOI: 10.1016/j.sleep.2024.09.034
Sebastian Sennock, Kristina V Lieres Und Wilkau, Astrid Günther, Isabel Brandhorst, Katharina Zinke, Annette Conzelmann, Tobias J Renner, Eva-Maria Kurz
Adolescents devote a significant portion of their time to smartphone usage, often engaging in social media activities. Social media use has previously been linked to diminished sleep quality and reduced sleep durations in correlational studies. In this experimental study, we aimed to investigate the influence of pre-sleep social media use on memory consolidation, subjective arousal and objectively assessed sleep quality in adolescents. We compared the social media condition to two reading conditions, one involving reading a book on a smartphone and the other reading from a physical book in a within-subjects design. Twenty participants between 12 and 14 years engaged in these activities for 45 min before bedtime. Contrary to our expectations, the results indicated that pre-sleep social media use did not have a discernible impact on sleep quality, pre-sleep arousal or memory consolidation. All assessed sleep measures remained consistent across the three conditions. Subjectively, the social media condition was rated less thrilling than the reading conditions. This suggests that, within the confines of this experiment, pre-sleep social media exposure did not significantly disrupt adolescents' sleep or their ability to consolidate memories during sleep. This deviation from previous correlational studies might be explained by a possible impact of mental health factors on media consumption and sleep or the fact that contrary to their daily routines participants had to sleep after our intervention and could not continue to engage in their activities. This highlights the need for further investigations into the complexities of this interaction.
{"title":"Investigation of the influence of 45-minute pre-sleep social media use on sleep quality and memory consolidation in adolescents.","authors":"Sebastian Sennock, Kristina V Lieres Und Wilkau, Astrid Günther, Isabel Brandhorst, Katharina Zinke, Annette Conzelmann, Tobias J Renner, Eva-Maria Kurz","doi":"10.1016/j.sleep.2024.09.034","DOIUrl":"https://doi.org/10.1016/j.sleep.2024.09.034","url":null,"abstract":"<p><p>Adolescents devote a significant portion of their time to smartphone usage, often engaging in social media activities. Social media use has previously been linked to diminished sleep quality and reduced sleep durations in correlational studies. In this experimental study, we aimed to investigate the influence of pre-sleep social media use on memory consolidation, subjective arousal and objectively assessed sleep quality in adolescents. We compared the social media condition to two reading conditions, one involving reading a book on a smartphone and the other reading from a physical book in a within-subjects design. Twenty participants between 12 and 14 years engaged in these activities for 45 min before bedtime. Contrary to our expectations, the results indicated that pre-sleep social media use did not have a discernible impact on sleep quality, pre-sleep arousal or memory consolidation. All assessed sleep measures remained consistent across the three conditions. Subjectively, the social media condition was rated less thrilling than the reading conditions. This suggests that, within the confines of this experiment, pre-sleep social media exposure did not significantly disrupt adolescents' sleep or their ability to consolidate memories during sleep. This deviation from previous correlational studies might be explained by a possible impact of mental health factors on media consumption and sleep or the fact that contrary to their daily routines participants had to sleep after our intervention and could not continue to engage in their activities. This highlights the need for further investigations into the complexities of this interaction.</p>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142376044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-24DOI: 10.1016/j.sleep.2024.09.025
Cyclic alternating patterns (CAP) occur in electroencephalogram (EEG) signals during non-rapid eye movement sleep. The analysis of CAP can offer insights into various sleep disorders. The first step is the identification of phases A and B for the CAP cycles. In this work, we develop an easy-to-implement accurate system to differentiate between CAP A and CAP B. Small segments of the EEG signal are processed using Gaussian filters to obtain sub-band components. Features are extracted using some statistical characteristics of these signal components. Minimum redundancy maximum relevance test is employed to identify the more significant features. Three different machine learning classifiers are considered and their performance is compared. The results are analyzed for both the balanced and unbalanced datasets. The k-nearest neighbour (kNN) classifier achieves 79.14 % accuracy and F-1 score of 79.24 % for the balanced dataset. The proposed method outperforms the existing methods for CAP classification. It is easy-to-implement and can be considered as a candidate for real-time deployment.
在非快速眼动睡眠期间,脑电图(EEG)信号中会出现循环交替模式(CAP)。对 CAP 的分析可以帮助人们了解各种睡眠障碍。第一步是确定 CAP 周期的 A 相和 B 相。在这项工作中,我们开发了一种易于实施的精确系统来区分 CAP A 和 CAP B。利用这些信号分量的一些统计特征提取特征。采用最小冗余最大相关性测试来识别更重要的特征。考虑了三种不同的机器学习分类器,并对其性能进行了比较。对平衡和不平衡数据集的结果进行了分析。在平衡数据集上,k-近邻(kNN)分类器的准确率达到 79.14%,F-1 得分为 79.24%。在 CAP 分类方面,所提出的方法优于现有方法。该方法易于实施,可作为实时部署的候选方法。
{"title":"Classification of cyclic alternating patterns of sleep using EEG signals","authors":"","doi":"10.1016/j.sleep.2024.09.025","DOIUrl":"10.1016/j.sleep.2024.09.025","url":null,"abstract":"<div><div>Cyclic alternating patterns (CAP) occur in electroencephalogram (EEG) signals during non-rapid eye movement sleep. The analysis of CAP can offer insights into various sleep disorders. The first step is the identification of phases A and B for the CAP cycles. In this work, we develop an easy-to-implement accurate system to differentiate between CAP A and CAP B. Small segments of the EEG signal are processed using Gaussian filters to obtain sub-band components. Features are extracted using some statistical characteristics of these signal components. Minimum redundancy maximum relevance test is employed to identify the more significant features. Three different machine learning classifiers are considered and their performance is compared. The results are analyzed for both the balanced and unbalanced datasets. The k-nearest neighbour (kNN) classifier achieves 79.14 % accuracy and F-1 score of 79.24 % for the balanced dataset. The proposed method outperforms the existing methods for CAP classification. It is easy-to-implement and can be considered as a candidate for real-time deployment.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142359260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-21DOI: 10.1016/j.sleep.2024.09.031
Establishing well-defined relationships between sleep features and memory consolidation is essential in comprehending the pathophysiology of cognitive decline commonly seen in patients with insomnia, depression, and other sleep-disrupting conditions.
Twenty-eight volunteers participated in two experimental sessions: a session with selective SWS suppression during one night and a session with undisturbed night sleep (as a control condition). Fifteen of them also participated in a third session with REM suppression. Suppression was achieved by presenting an acoustic tone. In the evening and the morning, the participants completed procedural and declarative memory tasks and the Psychomotor vigilance task (PVT). Heart rate variability analysis and salivary cortisol were used to control possible stress reactions to sleep interference.
SWS and REM suppression led to more than 50 percent reduction in the amount of these stages. Neither vigilance nor memory consolidation was impaired after SWS or REM suppression. Unexpectedly, a beneficial effect of selective SWS suppression on PVT performance was found. Similarly, after a night with SWS suppression, the overnight improvement in procedural skills was higher than after a night with REM suppression and after a night with undisturbed sleep.
Our data brings into question the extent to which SWS and REM are truly necessary for effective memory consolidation to proceed. Moreover, SWS suppression may even improve the performance of some tasks, possibly by reducing sleep inertia associated with undisturbed sleep.
{"title":"Neither fifty percent slow-wave sleep suppression nor fifty percent rapid eye movement sleep suppression does impair memory consolidation","authors":"","doi":"10.1016/j.sleep.2024.09.031","DOIUrl":"10.1016/j.sleep.2024.09.031","url":null,"abstract":"<div><div>Establishing well-defined relationships between sleep features and memory consolidation is essential in comprehending the pathophysiology of cognitive decline commonly seen in patients with insomnia, depression, and other sleep-disrupting conditions.</div><div>Twenty-eight volunteers participated in two experimental sessions: a session with selective SWS suppression during one night and a session with undisturbed night sleep (as a control condition). Fifteen of them also participated in a third session with REM suppression. Suppression was achieved by presenting an acoustic tone. In the evening and the morning, the participants completed procedural and declarative memory tasks and the Psychomotor vigilance task (PVT). Heart rate variability analysis and salivary cortisol were used to control possible stress reactions to sleep interference.</div><div>SWS and REM suppression led to more than 50 percent reduction in the amount of these stages. Neither vigilance nor memory consolidation was impaired after SWS or REM suppression. Unexpectedly, a beneficial effect of selective SWS suppression on PVT performance was found. Similarly, after a night with SWS suppression, the overnight improvement in procedural skills was higher than after a night with REM suppression and after a night with undisturbed sleep.</div><div>Our data brings into question the extent to which SWS and REM are truly necessary for effective memory consolidation to proceed. Moreover, SWS suppression may even improve the performance of some tasks, possibly by reducing sleep inertia associated with undisturbed sleep.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142319877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-19DOI: 10.1016/j.sleep.2024.09.030
Background
Sleep conditions are important in children and adolescents with tic disorders. Psychiatric symptoms and tic symptoms themselves can detrimentally affect the quality of life (QOL) in individuals with tic disorders. However, there is currently a lack of explicit research evidence elucidating the relationship between sleep and the QOL in individuals with tic disorders.
Methods
We assessed 150 children/adolescents aged 4–14 years old diagnosed with tic disorders. Participants' tic symptoms were evaluated using the Yale Global Tic Severity Scale (YGTSS), while their sleep conditions were assessed using the Children's Sleep Habits Questionnaire (CSHQ), and quality of life was measured using the Gilles de la Tourette Syndrome-Quality of Life Scale (GTS-QOL), all utilizing standardized measurement instruments. Detailed statistical descriptions, correlation analyses, and mediation analyses of the data were performed.
Results
We observed significant correlations among tic symptoms, sleep, and quality of life. Then, we confirmed the mediating role of sleep in the relationship between tic symptoms and quality of life (β = .591, 95%CI: .252–1.007). We also found that among different sleep variables, particularly bedtime resistance (β = .088, 95 % CI: .003–.260), played a significant mediating role.
Conclusions
Sleep was found to be a significantly mediator between tic symptoms and quality of life across various domains, especially bedtime resistance played an important mediating role. This indicates that assessment and management of sleep conditions in children/adolescents with tic disorders are important. These findings provide potentially valuable insights into the clinical evaluation of children and adolescents with tic disorders and the potential improvement of their quality of life in the future.
{"title":"Clinical tics and quality of life in children and adolescents with tic disorders: The mediating role of sleep","authors":"","doi":"10.1016/j.sleep.2024.09.030","DOIUrl":"10.1016/j.sleep.2024.09.030","url":null,"abstract":"<div><h3>Background</h3><div>Sleep conditions are important in children and adolescents with tic disorders. Psychiatric symptoms and tic symptoms themselves can detrimentally affect the quality of life (QOL) in individuals with tic disorders. However, there is currently a lack of explicit research evidence elucidating the relationship between sleep and the QOL in individuals with tic disorders.</div></div><div><h3>Methods</h3><div>We assessed 150 children/adolescents aged 4–14 years old diagnosed with tic disorders. Participants' tic symptoms were evaluated using the Yale Global Tic Severity Scale (YGTSS), while their sleep conditions were assessed using the Children's Sleep Habits Questionnaire (CSHQ), and quality of life was measured using the Gilles de la Tourette Syndrome-Quality of Life Scale (GTS-QOL), all utilizing standardized measurement instruments. Detailed statistical descriptions, correlation analyses, and mediation analyses of the data were performed.</div></div><div><h3>Results</h3><div>We observed significant correlations among tic symptoms, sleep, and quality of life. Then, we confirmed the mediating role of sleep in the relationship between tic symptoms and quality of life (β = .591, 95%CI: .252–1.007). We also found that among different sleep variables, particularly bedtime resistance (β = .088, 95 % CI: .003–.260), played a significant mediating role.</div></div><div><h3>Conclusions</h3><div>Sleep was found to be a significantly mediator between tic symptoms and quality of life across various domains, especially bedtime resistance played an important mediating role. This indicates that assessment and management of sleep conditions in children/adolescents with tic disorders are important. These findings provide potentially valuable insights into the clinical evaluation of children and adolescents with tic disorders and the potential improvement of their quality of life in the future.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142319991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-19DOI: 10.1016/j.sleep.2024.09.032
Background
Elevated sleep apnea-specific hypoxic burden (HB) and pulse rate response (ΔHR) are associated with a higher cardiovascular risk in adults. The clinical significance of HB and ΔHR in children with obstructive sleep apnea (OSA) and their responses to therapy have not yet been investigated. This study aimed to compare the efficacy of high flow nasal cannula (HFNC) and continuous positive airway pressure (CPAP) in reducing HB and ΔHR in children.
Methods
This analysis included 17 children (11 males, mean age: 12.6 ± 3.9 years) with obesity and/or medical complexity and moderate-to-severe OSA. Each participant underwent two additional sleep studies: one for HFNC titration and another for CPAP titration. HB and ΔHR were derived from the oximetry and pulse rate signals from overnight sleep studies, respectively.
Results
Both HFNC and CPAP demonstrated significant reductions in HB from baseline, with similar magnitudes [HFNC: −129 (standard error, SE 55) %min/h, p = 0.003; CPAP: −138 (SE 53) %min/h, p = 0.005]. However, for ΔHR, a significant reduction from baseline was observed only in the CPAP group [–2.7 (SE 1.1) beats/min, p = 0.049], not the HFNC group [–1.0 (SE 1.4) beats/min, p = 0.67].
Conclusions
HFNC is as effective as CPAP in treating hypoxia in children with OSA, but HFNC might be less effective than CPAP in mitigating cardiovascular stress from autonomic disturbances during obstructive events.
{"title":"Sleep apnea-specific hypoxic burden and pulse rate response in children using high flow nasal cannula therapy compared with continuous positive airway pressure","authors":"","doi":"10.1016/j.sleep.2024.09.032","DOIUrl":"10.1016/j.sleep.2024.09.032","url":null,"abstract":"<div><h3>Background</h3><div>Elevated sleep apnea-specific hypoxic burden (HB) and pulse rate response (ΔHR) are associated with a higher cardiovascular risk in adults. The clinical significance of HB and ΔHR in children with obstructive sleep apnea (OSA) and their responses to therapy have not yet been investigated. This study aimed to compare the efficacy of high flow nasal cannula (HFNC) and continuous positive airway pressure (CPAP) in reducing HB and ΔHR in children.</div></div><div><h3>Methods</h3><div>This analysis included 17 children (11 males, mean age: 12.6 ± 3.9 years) with obesity and/or medical complexity and moderate-to-severe OSA. Each participant underwent two additional sleep studies: one for HFNC titration and another for CPAP titration. HB and ΔHR were derived from the oximetry and pulse rate signals from overnight sleep studies, respectively.</div></div><div><h3>Results</h3><div>Both HFNC and CPAP demonstrated significant reductions in HB from baseline, with similar magnitudes <strong>[</strong>HFNC: −129 (standard error, SE 55) %min/h, p = 0.003; CPAP: −138 (SE 53) %min/h, p = 0.005]. However, for ΔHR, a significant reduction from baseline was observed only in the CPAP group [–2.7 (SE 1.1) beats/min, p = 0.049], not the HFNC group [–1.0 (SE 1.4) beats/min, p = 0.67].</div></div><div><h3>Conclusions</h3><div>HFNC is as effective as CPAP in treating hypoxia in children with OSA, but HFNC might be less effective than CPAP in mitigating cardiovascular stress from autonomic disturbances during obstructive events.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142311948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-19DOI: 10.1016/j.sleep.2024.09.021
Background
To investigate the association between sleep disorder and depression in stroke population using data from the National Health and Nutrition Examination Surveys (NHANES) conducted between 2005 and 2014.
Methods
Participants included stroke population who reported on sleep disorder and completed the Patient Health Questionnaire-9 (PHQ-9) to assess depressive symptom. Sleep disorder was self-reported and categorized dichotomously. Multivariate logistic regression, subgroup analysis, receiver operating characteristic curve (ROC) and restricted cubic spline (RCS) were used to explore the association between sleep disorder and depression.
Results
The final sample included 566 stroke survivors (weighted n = 3,326,625). Multivariate logistic regression analysis confirmed that sleep disorder was independently associated with an increased risk of depression even after adjusting for potential confounders (OR = 2.616, 95 % CI: 2.561 to 2.599, P < 0.0001). Subgroup analysis indicated that this association was particularly strong among female stroke population (OR = 5.515). Sleep disorder as a significant predictor of depression, while the relationship between sleep time and depression is characterized by non-linearity.
Conclusions
Sleep disorder is significantly associated with an increased risk of depression in stroke. This relationship remains robust across various sociodemographic and lifestyle factors, highlighting the need for integrated interventions targeting both sleep and mood disturbances in stroke care.
{"title":"Association between sleep disorder and depression in stroke in the National Health and Nutrition Examination Surveys (NHANES) 2005 to 2014","authors":"","doi":"10.1016/j.sleep.2024.09.021","DOIUrl":"10.1016/j.sleep.2024.09.021","url":null,"abstract":"<div><h3>Background</h3><div>To investigate the association between sleep disorder and depression in stroke population using data from the National Health and Nutrition Examination Surveys (NHANES) conducted between 2005 and 2014.</div></div><div><h3>Methods</h3><div>Participants included stroke population who reported on sleep disorder and completed the Patient Health Questionnaire-9 (PHQ-9) to assess depressive symptom. Sleep disorder was self-reported and categorized dichotomously. Multivariate logistic regression, subgroup analysis, receiver operating characteristic curve (ROC) and restricted cubic spline (RCS) were used to explore the association between sleep disorder and depression.</div></div><div><h3>Results</h3><div>The final sample included 566 stroke survivors (weighted n = 3,326,625). Multivariate logistic regression analysis confirmed that sleep disorder was independently associated with an increased risk of depression even after adjusting for potential confounders (OR = 2.616, 95 % CI: 2.561 to 2.599, P < 0.0001). Subgroup analysis indicated that this association was particularly strong among female stroke population (OR = 5.515). Sleep disorder as a significant predictor of depression, while the relationship between sleep time and depression is characterized by non-linearity.</div></div><div><h3>Conclusions</h3><div>Sleep disorder is significantly associated with an increased risk of depression in stroke. This relationship remains robust across various sociodemographic and lifestyle factors, highlighting the need for integrated interventions targeting both sleep and mood disturbances in stroke care.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142315629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-18DOI: 10.1016/j.sleep.2024.09.029
Objective
Middle-aged to older adults often exhibit the co-existence of poor sleep health and multimorbidity. We examined cross-sectional and prospective associations of pooled index of sleep health with prevalent and incident multimorbidity in the framework of an ongoing cohort study in Canada.
Methods
Data were from approximately 24,000 individuals from the Canadian Longitudinal Study on Aging (CLSA), an ongoing national study of community-dwelling adults aged 45–85 years at baseline. Multimorbidity was defined as two or more chronic conditions out of five major condition categories. Sleep variables included sleep duration, quality, initiation, maintenance, and excessive daytime sleepiness, which were combined into an index using pooled approaches. Weighted logistic regression models were computed for each index with additional age- and sex-stratified analyses.
Results
Higher sleep index scores, indicating poorer sleep health, were observed in females and younger age groups (ages 45–54 and 55–64). In cross-sectional analysis, the fully adjusted model showed that a 1-unit increase in pooled scores was significantly associated with 1.48 higher odds (95 % CI = 1.38, 1.58; p < 0.001) of prevalent multimorbidity at baseline. Similarly, the prospective analysis indicated significant changes in incident multimorbidity with pooled index scores in the fully adjusted model (OR = 1.33; 95 % CI = 1.20, 1.48; p < 0.001).
Conclusion
The pooled sleep index introduced in this study may offer a novel, concise, and comprehensive approach to assessing sleep health among middle-aged and older adults. Those in these age groups experiencing poorer sleep health are at a greater risk of prevalent multimorbidity, as well as of developing multimorbidity over time.
目的 中老年人往往同时存在睡眠质量差和多病症的问题。我们在加拿大一项正在进行的队列研究框架内,研究了睡眠健康综合指数与流行性和偶发性多病症之间的横断面和前瞻性关联。方法数据来自加拿大老龄化纵向研究(CLSA)中的约 24,000 人,该研究是一项正在进行的全国性研究,研究对象为基线年龄在 45-85 岁之间、居住在社区的成年人。多病症的定义是在五种主要疾病类别中患有两种或两种以上慢性疾病。睡眠变量包括睡眠时间、睡眠质量、睡眠开始时间、睡眠维持时间和白天过度嗜睡,这些变量采用集合方法合并成一个指数。结果 女性和年轻年龄组(45-54 岁和 55-64 岁)的睡眠指数得分较高,表明睡眠健康状况较差。在横断面分析中,完全调整模型显示,集合得分每增加 1 个单位,基线多病流行几率就会增加 1.48(95 % CI = 1.38, 1.58; p <0.001)。同样,前瞻性分析表明,在完全调整模型中,随着集合指数得分的增加,多发病的发生率也会发生显著变化(OR = 1.33; 95 % CI = 1.20, 1.48; p <0.001)。在这些年龄组中,睡眠健康状况较差的人患多种疾病的风险更大,随着时间的推移,患多种疾病的风险也更大。
{"title":"Cross-sectional and prospective associations between sleep health and multimorbidity in middle to older-aged adults: Results from the Canadian Longitudinal Study on Aging (CLSA)","authors":"","doi":"10.1016/j.sleep.2024.09.029","DOIUrl":"10.1016/j.sleep.2024.09.029","url":null,"abstract":"<div><h3>Objective</h3><div>Middle-aged to older adults often exhibit the co-existence of poor sleep health and multimorbidity. We examined cross-sectional and prospective associations of pooled index of sleep health with prevalent and incident multimorbidity in the framework of an ongoing cohort study in Canada.</div></div><div><h3>Methods</h3><div>Data were from approximately 24,000 individuals from the Canadian Longitudinal Study on Aging (CLSA), an ongoing national study of community-dwelling adults aged 45–85 years at baseline. Multimorbidity was defined as two or more chronic conditions out of five major condition categories. Sleep variables included sleep duration, quality, initiation, maintenance, and excessive daytime sleepiness, which were combined into an index using pooled approaches. Weighted logistic regression models were computed for each index with additional age- and sex-stratified analyses.</div></div><div><h3>Results</h3><div>Higher sleep index scores, indicating poorer sleep health, were observed in females and younger age groups (ages 45–54 and 55–64). In cross-sectional analysis, the fully adjusted model showed that a 1-unit increase in pooled scores was significantly associated with 1.48 higher odds (95 % CI = 1.38, 1.58; p < 0.001) of prevalent multimorbidity at baseline. Similarly, the prospective analysis indicated significant changes in incident multimorbidity with pooled index scores in the fully adjusted model (OR = 1.33; 95 % CI = 1.20, 1.48; p < 0.001).</div></div><div><h3>Conclusion</h3><div>The pooled sleep index introduced in this study may offer a novel, concise, and comprehensive approach to assessing sleep health among middle-aged and older adults. Those in these age groups experiencing poorer sleep health are at a greater risk of prevalent multimorbidity, as well as of developing multimorbidity over time.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142319879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}