Pub Date : 2024-07-16DOI: 10.1016/j.sleep.2024.07.020
Objective
To examine associations between sleep and flourishing among children ages 0–5 years in the United States and whether these differ by age, developmental needs, and family resilience.
Study design and methods
Cross-sectional data from the 2020–2021 National Survey of Children's Health (N = 31,095) were used with survey-weighted logistic regression to explore associations between insufficient sleep (defined as not meeting age-recommended daily sleep guidelines: 12–16 h for 4- to 12-month-olds, 11–14 h for 1- to 2-year-olds, and 10–13 h for 3- to 5-year-olds) and flourishing (using four markers combined and categorized into two groups). Tests of effect measure modification (EMM) were performed on the multiplicative and additive scales.
Results
Weak but notable evidence was found that children with insufficient sleep had decreased odds of flourishing (aOR = 0.76; 95 % CI: 0.60, 1.00). No evidence of EMM by child age or family resilience was found. However, the sleep-flourishing association differed significantly by children's developmental needs, suggesting that the combined effect of sleep and developmental needs impact flourishing more than either factor alone.
Conclusions
Approximately 38 % of children ages 0–5 years in the United States are estimated to have insufficient sleep. This study provides evidence that insufficient sleep is associated with decreased flourishing among children with special health care needs (CSHCN).
Future implications
Increasing sleep interventions among children under five is warranted among children with special health care needs. The association between sleep and flourishing within specific CSHCN categories, including emotional, behavioral, or developmental (EBD) criteria, should be explored to optimize sleep policies.
{"title":"Sleepless nights, troubled futures: The association between insufficient sleep and child flourishing","authors":"","doi":"10.1016/j.sleep.2024.07.020","DOIUrl":"10.1016/j.sleep.2024.07.020","url":null,"abstract":"<div><h3>Objective</h3><p>To examine associations between sleep and flourishing among children ages 0–5 years in the United States and whether these differ by age, developmental needs, and family resilience.</p></div><div><h3>Study design and methods</h3><p>Cross-sectional data from the 2020–2021 National Survey of Children's Health (N = 31,095) were used with survey-weighted logistic regression to explore associations between insufficient sleep (defined as not meeting age-recommended daily sleep guidelines: 12–16 h for 4- to 12-month-olds, 11–14 h for 1- to 2-year-olds, and 10–13 h for 3- to 5-year-olds) and flourishing (using four markers combined and categorized into two groups). Tests of effect measure modification (EMM) were performed on the multiplicative and additive scales.</p></div><div><h3>Results</h3><p>Weak but notable evidence was found that children with insufficient sleep had decreased odds of flourishing (aOR = 0.76; 95 % CI: 0.60, 1.00). No evidence of EMM by child age or family resilience was found. However, the sleep-flourishing association differed significantly by children's developmental needs, suggesting that the combined effect of sleep and developmental needs impact flourishing more than either factor alone.</p></div><div><h3>Conclusions</h3><p>Approximately 38 % of children ages 0–5 years in the United States are estimated to have insufficient sleep. This study provides evidence that insufficient sleep is associated with decreased flourishing among children with special health care needs (CSHCN).</p></div><div><h3>Future implications</h3><p>Increasing sleep interventions among children under five is warranted among children with special health care needs. The association between sleep and flourishing within specific CSHCN categories, including emotional, behavioral, or developmental (EBD) criteria, should be explored to optimize sleep policies.</p></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141841399","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 : 2024-07-15DOI: 10.1016/j.sleep.2024.07.015
Introduction
Restless legs syndrome (RLS) is a sensorimotor disorder of sleep/wake regulation characterized by an urge to move the legs accompanied by a wide range of sensory symptoms, mainly affecting the lower limbs. An increased incidence of RLS has been demonstrated in Parkinson's disease (PD) and has been associated with severe motor and non-motor manifestations. We aimed to provide a reliable estimate of RLS prevalence and the clinical features associated with its occurrence in PD (PD-RLS).
Methods
We performed a systematic literature search up to January 2024 using PubMed, Scopus, and PsycINFO databases. Articles were included if they provided data on PD patients with or without RLS, and these proportions were used to estimate the prevalence of PD-RLS. Clinical profile associated with PD-RLS was explored by comparing the clinical characteristics of PD patients with and without RLS.
Results
Forty-six studies were included in the meta-analysis. Pooled RLS prevalence was 20 % of a total sample of 6990 PD patients and was associated with female sex, mixed motor phenotype, worse motor disturbances and functional disability, and a wide range of non-motor symptoms such as sleep disorders, cognitive and autonomic dysfunctions, and more severe neuropsychiatric manifestations. Sensitivity analyses indicated significant associations of PD-RLS with variables related to dopaminergic therapy. No association was found with serum ferritin, serum iron and hemoglobin levels.
Conclusions
The prevalence of PD-RLS exceeds that reported in the general population, suggesting the existence of a relationship between the two disorders. Dopaminergic treatment seems to play an ambivalent role relieving, worsening or “mimicking” RLS manifestations. However, the clinical profile of PD-RLS patients, characterized by a greater severity of non-motor symptoms, also suggests that neurotransmitter systems other than the dopaminergic one are involved in PD-RLS etiology.
{"title":"Prevalence and clinical profile of patients with restless legs syndrome in Parkinson's disease: A meta-analysis","authors":"","doi":"10.1016/j.sleep.2024.07.015","DOIUrl":"10.1016/j.sleep.2024.07.015","url":null,"abstract":"<div><h3>Introduction</h3><p>Restless legs syndrome (RLS) is a sensorimotor disorder of sleep/wake regulation characterized by an urge to move the legs accompanied by a wide range of sensory symptoms, mainly affecting the lower limbs. An increased incidence of RLS has been demonstrated in Parkinson's disease (PD) and has been associated with severe motor and non-motor manifestations. We aimed to provide a reliable estimate of RLS prevalence and the clinical features associated with its occurrence in PD (PD-RLS).</p></div><div><h3>Methods</h3><p>We performed a systematic literature search up to January 2024 using PubMed, Scopus, and PsycINFO databases. Articles were included if they provided data on PD patients with or without RLS, and these proportions were used to estimate the prevalence of PD-RLS. Clinical profile associated with PD-RLS was explored by comparing the clinical characteristics of PD patients with and without RLS.</p></div><div><h3>Results</h3><p>Forty-six studies were included in the meta-analysis. Pooled RLS prevalence was 20 % of a total sample of 6990 PD patients and was associated with female sex, mixed motor phenotype, worse motor disturbances and functional disability, and a wide range of non-motor symptoms such as sleep disorders, cognitive and autonomic dysfunctions, and more severe neuropsychiatric manifestations. Sensitivity analyses indicated significant associations of PD-RLS with variables related to dopaminergic therapy. No association was found with serum ferritin, serum iron and hemoglobin levels.</p></div><div><h3>Conclusions</h3><p>The prevalence of PD-RLS exceeds that reported in the general population, suggesting the existence of a relationship between the two disorders. Dopaminergic treatment seems to play an ambivalent role relieving, worsening or “mimicking” RLS manifestations. However, the clinical profile of PD-RLS patients, characterized by a greater severity of non-motor symptoms, also suggests that neurotransmitter systems other than the dopaminergic one are involved in PD-RLS etiology.</p></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1389945724003332/pdfft?md5=8ea3635c05c287c3069c03b7051526e8&pid=1-s2.0-S1389945724003332-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141694734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-15DOI: 10.1016/j.sleep.2024.07.016
Objective
Obstructive sleep apnea (OSA) is a complex, heterogeneous disease. Categorizing the disorder into phenotypes can help us better understand its pathology and guide us toward more personalized treatment approaches. Nevertheless, most of the previous cluster analysis (CA) studies in OSA predominantly included middle-aged to older men and may not adequately represent the heterogeneity of OSA phenotypes in women. Our aim is to identify these phenotypes in women using an extensive, exclusively female cohort.
Methods
Cross-sectional study of 1886 women diagnosed with OSA (apnea-hypopnea index >5 events/h) by PSG (polysomnography) and RP (respiratory polygraphy) at a tertiary hospital Sleep Unit. A CA was performed including general data, clinical variables, comorbidities and sleep study results.
Results
Four phenotypic subtypes were identified: Cluster 1 “Middle-aged paucisymptomatic women without cardiovascular risk factors” (507 patients, 27 %); Cluster 2 “Older paucisymptomatic women with established cardiovascular disease and severe OSA” (228 patients, 12 %); Cluster 3 “Middle-aged women with “classic” symptoms and cardiovascular risk factors” (892 patients, 47 %), and Cluster 4 ″Middle-aged women with mood disorders, nonrestorative sleep and cardiovascular risk factors” (259 patients, 14 %).
Conclusions
Conducting a CA exclusively within a female cohort reveals a heterogeneous presentation of OSA in women, similar to what has been previously reported in the literature for men. The “classical” presentation is notably the most prevalent, while the “atypical” presentation, which was previously more frequently associated with women, is less prevalent. Additionally, paucisymptomatic presentations, with or without associated comorbidities, are also present.
目的阻塞性睡眠呼吸暂停(OSA)是一种复杂的异质性疾病。将这种疾病分为不同的表型有助于我们更好地了解其病理,并指导我们采用更个性化的治疗方法。然而,之前大多数有关 OSA 的聚类分析(CA)研究主要包括中老年男性,可能无法充分代表女性 OSA 表型的异质性。我们的目的是利用一个广泛的、专门针对女性的队列来确定女性的这些表型。方法在一家三级医院的睡眠科对1886名通过PSG(多导睡眠图)和RP(呼吸多导图)确诊为OSA(呼吸暂停-低通气指数>5事件/小时)的女性进行横断面研究。结果确定了四种表型亚型:第一组 "无心血管风险因素的中年无症状女性"(507 名患者,占 27%);第二组 "有心血管疾病和严重 OSA 的老年无症状女性"(228 名患者,占 12%);第三组 "有'典型'症状和心血管风险因素的中年女性"(892 名患者,占 47%);第四组″有情绪障碍、非恢复性睡眠和心血管风险因素的中年女性"(259 名患者,占 14%)。结论专门在女性人群中进行CA分析,发现女性OSA的表现形式多种多样,与之前文献中报道的男性OSA表现形式相似。其中,"典型 "表现最为普遍,而以前更常见于女性的 "非典型 "表现则较少见。此外,还有一些无症状的表现,无论是否伴有相关的合并症。
{"title":"Phenotypes of obstructive sleep apnea in women: A real-life cohort study","authors":"","doi":"10.1016/j.sleep.2024.07.016","DOIUrl":"10.1016/j.sleep.2024.07.016","url":null,"abstract":"<div><h3>Objective</h3><p>Obstructive sleep apnea (OSA) is a complex, heterogeneous disease. Categorizing the disorder into phenotypes can help us better understand its pathology and guide us toward more personalized treatment approaches. Nevertheless, most of the previous cluster analysis (CA) studies in OSA predominantly included middle-aged to older men and may not adequately represent the heterogeneity of OSA phenotypes in women. Our aim is to identify these phenotypes in women using an extensive, exclusively female cohort.</p></div><div><h3>Methods</h3><p>Cross-sectional study of 1886 women diagnosed with OSA (apnea-hypopnea index >5 events/h) by PSG (polysomnography) and RP (respiratory polygraphy) at a tertiary hospital Sleep Unit. A CA was performed including general data, clinical variables, comorbidities and sleep study results.</p></div><div><h3>Results</h3><p>Four phenotypic subtypes were identified: <strong>Cluster 1</strong> “Middle-aged paucisymptomatic women without cardiovascular risk factors” (507 patients, 27 %); <strong>Cluster 2</strong> “Older paucisymptomatic women with established cardiovascular disease and severe OSA” (228 patients, 12 %); <strong>Cluster 3</strong> “Middle-aged women with “classic” symptoms and cardiovascular risk factors” (892 patients, 47 %), and <strong>Cluster 4</strong> ″Middle-aged women with mood disorders, nonrestorative sleep and cardiovascular risk factors” (259 patients, 14 %).</p></div><div><h3>Conclusions</h3><p>Conducting a CA exclusively within a female cohort reveals a heterogeneous presentation of OSA in women, similar to what has been previously reported in the literature for men. The “classical” presentation is notably the most prevalent, while the “atypical” presentation, which was previously more frequently associated with women, is less prevalent. Additionally, paucisymptomatic presentations, with or without associated comorbidities, are also present.</p></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141709850","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 : 2024-07-15DOI: 10.1016/j.sleep.2024.07.013
Objective
To explore the association between insomnia symptoms and cognitive flexibility among undergraduates, along with its potential neural mechanisms.
Method
A total of 102 participants were divided into insomnia (n = 55) and control (n = 47) groups based on sleep status. Cognitive flexibility was assessed using the Cognitive Flexibility Inventory (CFI) and the Number-Letter Task (N-L task). EEG data were recorded during the N-L task.
Results
The insomnia group exhibited lower CFI scores and higher switch costs in reaction time and accuracy compared to the control group. ERP analysis showed differences in P2, N2, and P3 component amplitudes between the two groups, with reduced N2 amplitude in the insomnia group under repeat trials. Time-frequency analysis revealed larger theta band event related synchronization in the frontal region and smaller theta band ERS in the parietal region under switch trials in the control group; the alpha band event-related desynchronization in the parietal region under repeat trials was significantly smaller in the control group compared to switch trials.
Conclusion
Compared to undergraduates with normal sleep, those with insomnia symptoms exhibited reduced cognitive flexibility, which may be associated with some alterations in brain electrophysiological activities.
{"title":"The association between insomnia symptoms and cognitive flexibility among undergraduates: An event-related potential study","authors":"","doi":"10.1016/j.sleep.2024.07.013","DOIUrl":"10.1016/j.sleep.2024.07.013","url":null,"abstract":"<div><h3>Objective</h3><p>To explore the association between insomnia symptoms and cognitive flexibility among undergraduates, along with its potential neural mechanisms.</p></div><div><h3>Method</h3><p>A total of 102 participants were divided into insomnia (n = 55) and control (n = 47) groups based on sleep status. Cognitive flexibility was assessed using the Cognitive Flexibility Inventory (CFI) and the Number-Letter Task (N-L task). EEG data were recorded during the N-L task.</p></div><div><h3>Results</h3><p>The insomnia group exhibited lower CFI scores and higher switch costs in reaction time and accuracy compared to the control group. ERP analysis showed differences in P2, N2, and P3 component amplitudes between the two groups, with reduced N2 amplitude in the insomnia group under repeat trials. Time-frequency analysis revealed larger theta band event related synchronization in the frontal region and smaller theta band ERS in the parietal region under switch trials in the control group; the alpha band event-related desynchronization in the parietal region under repeat trials was significantly smaller in the control group compared to switch trials.</p></div><div><h3>Conclusion</h3><p>Compared to undergraduates with normal sleep, those with insomnia symptoms exhibited reduced cognitive flexibility, which may be associated with some alterations in brain electrophysiological activities.</p></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1389945724003319/pdfft?md5=95dc151219c933ea452992397d87e948&pid=1-s2.0-S1389945724003319-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141711019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-15DOI: 10.1016/j.sleep.2024.07.017
Background
Obstructive sleep apnea (OSA), due to its high prevalence, has been associated with a number of comorbidities, frequently impacting the overall course of these other diseases if left untreated. Recent studies highlight a potential association between OSA and cancer. This study investigates how OSA severity and hypoxia affect cancer prognosis, aiming to elucidate how they interplay.
Methods
Retrospective study including patients with a diagnosis of OSA after any cancer type followed up in a tertiary center during a 10-year period. OSA was mainly diagnosed after level III polysomnographic studies.
Results
Nocturnal hypoxia was significantly more prevalent in patients presenting lung cancer versus other malignancies and was associated with higher rates of oncologic disease progression. Overall survival was significantly lower in severe OSA patients and also in patients presenting nocturnal hypoxia. A composite hypoxia score considering both OSA severity and significant hypoxia was an independent predictor of mortality regardless of clinical cancer staging and treatment. Shorter time between cancer and OSA diagnosis was also associated with worse prognosis.
Conclusion
This study suggests an association between OSA severity and nocturnal hypoxia and increased cancer mortality independently from possible confounding factors such as age, cancer clinical staging at diagnosis, treatment modality and also progression. Neoplastic patients with severe OSA and/or complex hypoxia seem to have lower overall survival rates than those with less severe OSA and nocturnal hypoxia.
背景阻塞性睡眠呼吸暂停(OSA)由于发病率高,已与多种并发症相关联,如果不及时治疗,往往会影响这些其他疾病的整体病程。最近的研究强调了 OSA 与癌症之间的潜在联系。本研究调查了 OSA 严重程度和缺氧对癌症预后的影响,旨在阐明两者之间的相互作用。结果与其他恶性肿瘤相比,夜间缺氧在肺癌患者中的发病率明显更高,并且与肿瘤疾病进展的高发率有关。严重 OSA 患者和夜间缺氧患者的总生存率明显较低。考虑到 OSA 严重程度和明显缺氧的综合缺氧评分是预测死亡率的独立指标,与癌症临床分期和治疗无关。结论:本研究表明,OSA严重程度和夜间缺氧与癌症死亡率增加之间存在关联,不受年龄、诊断时的癌症临床分期、治疗方式和病情进展等可能的混杂因素影响。患有严重 OSA 和/或复杂性缺氧的肿瘤患者的总生存率似乎低于那些患有较轻 OSA 和夜间缺氧的患者。
{"title":"The role of obstructive sleep apnea and nocturnal hypoxia as predictors of mortality in cancer patients","authors":"","doi":"10.1016/j.sleep.2024.07.017","DOIUrl":"10.1016/j.sleep.2024.07.017","url":null,"abstract":"<div><h3>Background</h3><p>Obstructive sleep apnea (OSA), due to its high prevalence, has been associated with a number of comorbidities, frequently impacting the overall course of these other diseases if left untreated. Recent studies highlight a potential association between OSA and cancer. This study investigates how OSA severity and hypoxia affect cancer prognosis, aiming to elucidate how they interplay.</p></div><div><h3>Methods</h3><p>Retrospective study including patients with a diagnosis of OSA after any cancer type followed up in a tertiary center during a 10-year period. OSA was mainly diagnosed after level III polysomnographic studies.</p></div><div><h3>Results</h3><p>Nocturnal hypoxia was significantly more prevalent in patients presenting lung cancer versus other malignancies and was associated with higher rates of oncologic disease progression. Overall survival was significantly lower in severe OSA patients and also in patients presenting nocturnal hypoxia. A composite hypoxia score considering both OSA severity and significant hypoxia was an independent predictor of mortality regardless of clinical cancer staging and treatment. Shorter time between cancer and OSA diagnosis was also associated with worse prognosis.</p></div><div><h3>Conclusion</h3><p>This study suggests an association between OSA severity and nocturnal hypoxia and increased cancer mortality independently from possible confounding factors such as age, cancer clinical staging at diagnosis, treatment modality and also progression. Neoplastic patients with severe OSA and/or complex hypoxia seem to have lower overall survival rates than those with less severe OSA and nocturnal hypoxia.</p></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141692666","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 : 2024-07-14DOI: 10.1016/j.sleep.2024.07.014
Objective
Rapid eye movement sleep behavior disorder (RBD) is often underdiagnosed among people living with mental disorders. The present study aimed to investigate the prevalence of probable RBD (pRBD) and its associated factors among middle-aged and older adults in a psychiatric outpatient clinic.
Methods
We conducted a cross-sectional survey among 2907 people aged 45–80 years who visited the outpatient clinic between March 1 and August 31, 2022 in a psychiatric hospital. A cutoff score ≥5 on the RBD Screening Questionnaire (RBDSQ) was used to indicate the presence of probable RBD (pRBD). Potential factors associated with pRBD were also assessed with a structured checklist. The association between these factors and the presence of pRBD was examined with logistic regression.
Results
The response rate was 64.3 %. Among 1868 respondents [age 58.5 ± 9.6 years, male n = 738 (39.5 %), female n = 1130 (60.5 %)], 15.9 % (95 % CI 14.2–17.6 %) screened positive for pRBD. Occupational exposure to chemicals; positive family history of psychotic disorders; a late start of mental health care; a medical history of autonomic dysfunction; mood problems; and use of antidepressants, hypnotics, and acetylcholinesterase inhibitors were associated with an increased likelihood of having pRBD (P < 0.05 for all).
Conclusion
pRBD is common among outpatients with mental disorders, especially in mental disorders due to neurological diseases and physical conditions, mood disorders and anxiety or somatoform disorders. The findings highlight the importance of identifying sleep behavior disorders among people living with mental disorders in clinical practice.
{"title":"Prevalence and correlates of probable rapid eye movement sleep behavior disorder among middle-aged and older adults in a psychiatric outpatient clinic: A cross-sectional survey","authors":"","doi":"10.1016/j.sleep.2024.07.014","DOIUrl":"10.1016/j.sleep.2024.07.014","url":null,"abstract":"<div><h3>Objective</h3><p>Rapid eye movement sleep behavior disorder (RBD) is often underdiagnosed among people living with mental disorders. The present study aimed to investigate the prevalence of probable RBD (pRBD) and its associated factors among middle-aged and older adults in a psychiatric outpatient clinic.</p></div><div><h3>Methods</h3><p>We conducted a cross-sectional survey among 2907 people aged 45–80 years who visited the outpatient clinic between March 1 and August 31, 2022 in a psychiatric hospital. A cutoff score ≥5 on the RBD Screening Questionnaire (RBDSQ) was used to indicate the presence of probable RBD (pRBD). Potential factors associated with pRBD were also assessed with a structured checklist. The association between these factors and the presence of pRBD was examined with logistic regression.</p></div><div><h3>Results</h3><p>The response rate was 64.3 %. Among 1868 respondents [age 58.5 ± 9.6 years, male n = 738 (39.5 %), female n = 1130 (60.5 %)], 15.9 % (95 % CI 14.2–17.6 %) screened positive for pRBD. Occupational exposure to chemicals; positive family history of psychotic disorders; a late start of mental health care; a medical history of autonomic dysfunction; mood problems; and use of antidepressants, hypnotics, and acetylcholinesterase inhibitors were associated with an increased likelihood of having pRBD (P < 0.05 for all).</p></div><div><h3>Conclusion</h3><p>pRBD is common among outpatients with mental disorders, especially in mental disorders due to neurological diseases and physical conditions, mood disorders and anxiety or somatoform disorders. The findings highlight the importance of identifying sleep behavior disorders among people living with mental disorders in clinical practice.</p></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141692523","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 : 2024-07-10DOI: 10.1016/j.sleep.2024.07.007
Poor sleep quality is a widespread concern. While the influence of particle exposure on sleep disturbances has received considerable attention, research exploring other dimensions of sleep quality and the chemical components of the particles remains limited. We employed a marginal structural model to explore the association of long-term exposure to PM2.5 and its chemical components with poor sleep quality. The odds ratio (95 % CI) for poor sleep quality was 1.335 (1.292–1.378), 1.097 (1.080–1.113), 1.137 (1.100–1.174), 1.197 (1.156–1.240), and 1.124 (1.107–1.140) per IQR increase in the concentration of PM2.5, SO42−, NO3−, NH4+, and BC, respectively. The score (and 95 % CI) of sleep latency, use of sleep medication, habitual sleep efficiency, subjective sleep quality, and daytime dysfunction were affected by PM2.5, with an increase of 0.059 (0.050–0.069), 0.054 (0.049–0.059), 0.011 (0.008–0.014), 0.011 (0.005–0.018), and 0.026 (0.018–0.034) per IQR increase in PM2.5 concentrations, respectively. This study supports the association of long-term exposure to PM2.5 and its chemical components with poor sleep quality.
{"title":"Association of long-term exposure to PM2.5 and its chemical components with the reduced quality of sleep","authors":"","doi":"10.1016/j.sleep.2024.07.007","DOIUrl":"10.1016/j.sleep.2024.07.007","url":null,"abstract":"<div><p>Poor sleep quality is a widespread concern. While the influence of particle exposure on sleep disturbances has received considerable attention, research exploring other dimensions of sleep quality and the chemical components of the particles remains limited. We employed a marginal structural model to explore the association of long-term exposure to PM<sub>2.5</sub> and its chemical components with poor sleep quality. The odds ratio (95 % <em>CI</em>) for poor sleep quality was 1.335 (1.292–1.378), 1.097 (1.080–1.113), 1.137 (1.100–1.174), 1.197 (1.156–1.240), and 1.124 (1.107–1.140) per <em>IQR</em> increase in the concentration of PM<sub>2.5</sub>, SO<sub>4</sub><sup>2−</sup>, NO<sub>3</sub><sup>−</sup>, NH<sub>4</sub><sup>+</sup>, and BC, respectively. The score (and 95 % <em>CI</em>) of sleep latency, use of sleep medication, habitual sleep efficiency, subjective sleep quality, and daytime dysfunction were affected by PM<sub>2.5</sub>, with an increase of 0.059 (0.050–0.069), 0.054 (0.049–0.059), 0.011 (0.008–0.014), 0.011 (0.005–0.018), and 0.026 (0.018–0.034) per <em>IQR</em> increase in PM<sub>2.5</sub> concentrations, respectively. This study supports the association of long-term exposure to PM<sub>2.5</sub> and its chemical components with poor sleep quality.</p></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141638862","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 : 2024-07-10DOI: 10.1016/j.sleep.2024.07.009
Background
Disordered and disturbed sleep is quite common among people with multiple sclerosis (PwMS). It is associated with fatigue one of most disabling symptoms in MS. This study aims at comparing polysomnographic (PSG) sleep parameters in a large single cohort of PwMS from a single center to that of the published norms. Hence establishing PSG parameters in PwMS.
Methods
This is a retrospective review of 299 consecutive adult PwMS who were seen and evaluated with an overnight PSG at a Comprehensive MS Care Center between 11/19/2001 to 9/17/2014. Data extracted from the PSG included Total Sleep Time (TST), sleep efficiency (SE), sleep onset latency (SOL), Relative REM latency, total apnea-hypopnea indices (AHI), spontaneous arousal indices (AI), total periodic leg movements indices (PLMI) and, sleep architecture metrics including percentage spent in stages N1/N2, N3, and REM.
Results
PwMS, compared to normative data, had, on average, 85.9 min shorter TST (p < 0.001), 27.3 min longer SOL (p < 0.0001), 62.1 min longer REM latency (p < 0.0001), 10.7 % lower SE (p < 0.0001), 16.4 % more N1/N2 (p < 0.0001) and 11.4 % less N3 (p < 0.0001). REM latency The prevalence of Obstructive Sleep Apnea (OSA) was high at 60.7 % and the mean AHI was higher by 11.1 events per hour (p < 0.0001).
Conclusions
This study establishes PSG parameters in the largest PwMS cohort reported to date. It is important to be vigilant of sleep complaints in PwMS. Future prospective large single cohort studies with standardized methods are needed to further understand sleep disturbances in PwMS as well as their causes and implications.
{"title":"Polysomnography parameters in a large cohort of people with multiple sclerosis","authors":"","doi":"10.1016/j.sleep.2024.07.009","DOIUrl":"10.1016/j.sleep.2024.07.009","url":null,"abstract":"<div><h3>Background</h3><p>Disordered and disturbed sleep is quite common among people with multiple sclerosis (PwMS). It is associated with fatigue one of most disabling symptoms in MS. This study aims at comparing polysomnographic (PSG) sleep parameters in a large single cohort of PwMS from a single center to that of the published norms. Hence establishing PSG parameters in PwMS.</p></div><div><h3>Methods</h3><p>This is a retrospective review of 299 consecutive adult PwMS who were seen and evaluated with an overnight PSG at a Comprehensive MS Care Center between 11/19/2001 to 9/17/2014. Data extracted from the PSG included Total Sleep Time (TST), sleep efficiency (SE), sleep onset latency (SOL), Relative REM latency, total apnea-hypopnea indices (AHI), spontaneous arousal indices (AI), total periodic leg movements indices (PLMI) and, sleep architecture metrics including percentage spent in stages N1/N2, N3, and REM.</p></div><div><h3>Results</h3><p>PwMS, compared to normative data, had, on average, 85.9 min shorter TST (p < 0.001), 27.3 min longer SOL (p < 0.0001), 62.1 min longer REM latency (p < 0.0001), 10.7 % lower SE (p < 0.0001), 16.4 % more N1/N2 (p < 0.0001) and 11.4 % less N3 (p < 0.0001). REM latency The prevalence of Obstructive Sleep Apnea (OSA) was high at 60.7 % and the mean AHI was higher by 11.1 events per hour (p < 0.0001).</p></div><div><h3>Conclusions</h3><p>This study establishes PSG parameters in the largest PwMS cohort reported to date. It is important to be vigilant of sleep complaints in PwMS. Future prospective large single cohort studies with standardized methods are needed to further understand sleep disturbances in PwMS as well as their causes and implications.</p></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141630395","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 : 2024-07-10DOI: 10.1016/j.sleep.2024.07.005
Jinseung Kim , Ho-Joon Lee , Dong Ah Lee , Kang Min Park
Objectives
The function of choroid plexus is to produce cerebrospinal fluid, which is critical for the glymphatic system function. In this study, we aimed to analyze the differences in choroid plexus volume between patients with obstructive sleep apnea (OSA) and healthy controls, with the goal of discovering the glymphatic system dysfunction in patients with OSA.
Methods
We prospectively enrolled 40 patients with OSA confirmed by polysomnography and 38 age- and sex-matched healthy controls. All participants underwent three-dimensional T1-weighted brain imaging, which was suitable for volumetric analysis. We compared choroid plexus volumes between patients with OSA and healthy controls, and analyzed the association between choroid plexus volume and polysomnographic findings in patients with OSA.
Results
Choroid plexus volumes were significantly larger in patients with OSA than in healthy controls (2.311 % vs. 2.096 %, p = 0.005). However, no significant association was detected between choroid plexus volume and polysomnographic findings.
Conclusion
This study demonstrated enlargement of the choroid plexus in patients with OSA compared with healthy controls. This finding could be related with glymphatic system dysfunction in patients with OSA.
目的脉络丛的功能是产生脑脊液,而脑脊液对糖水系统功能至关重要。本研究旨在分析阻塞性睡眠呼吸暂停(OSA)患者与健康对照组之间脉络丛体积的差异,从而发现 OSA 患者的甘液系统功能障碍。所有参与者都接受了适合进行容积分析的三维 T1 加权脑成像。我们比较了 OSA 患者和健康对照组的脉络丛体积,并分析了 OSA 患者脉络丛体积与多导睡眠图结果之间的关联。结论本研究表明,与健康对照组相比,OSA 患者的脉络丛体积增大。这一发现可能与 OSA 患者的肾上腺系统功能障碍有关。
{"title":"Choroid plexus enlargement in patients with obstructive sleep apnea","authors":"Jinseung Kim , Ho-Joon Lee , Dong Ah Lee , Kang Min Park","doi":"10.1016/j.sleep.2024.07.005","DOIUrl":"https://doi.org/10.1016/j.sleep.2024.07.005","url":null,"abstract":"<div><h3>Objectives</h3><p>The function of choroid plexus is to produce cerebrospinal fluid, which is critical for the glymphatic system function. In this study, we aimed to analyze the differences in choroid plexus volume between patients with obstructive sleep apnea (OSA) and healthy controls, with the goal of discovering the glymphatic system dysfunction in patients with OSA.</p></div><div><h3>Methods</h3><p>We prospectively enrolled 40 patients with OSA confirmed by polysomnography and 38 age- and sex-matched healthy controls. All participants underwent three-dimensional T1-weighted brain imaging, which was suitable for volumetric analysis. We compared choroid plexus volumes between patients with OSA and healthy controls, and analyzed the association between choroid plexus volume and polysomnographic findings in patients with OSA.</p></div><div><h3>Results</h3><p>Choroid plexus volumes were significantly larger in patients with OSA than in healthy controls (2.311 % vs. 2.096 %, <em>p</em> = 0.005). However, no significant association was detected between choroid plexus volume and polysomnographic findings.</p></div><div><h3>Conclusion</h3><p>This study demonstrated enlargement of the choroid plexus in patients with OSA compared with healthy controls. This finding could be related with glymphatic system dysfunction in patients with OSA.</p></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141594458","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 : 2024-07-10DOI: 10.1016/j.sleep.2024.07.011
Juan Corral-Pérez , María Ángeles Vázquez-Sánchez , José Luis Casals-Sánchez , Francisco José Contreras-García , Manuel Costilla , Cristina Casals
Background
The prevalence of sleep-related issues among older adults is a significant concern, with half of the older population reporting these problems. Consequently, strategies to improve sleep are needed for this population. This study aims to assess the effects of a health educational program on sleep behaviour among pre-frail or frail older adults residing in the community and to explore possible associations with frailty.
Methods
This randomised controlled trial (NCT05610605) included a total of 197 community-dwelling older adults with frailty/pre-frailty, divided into control (n = 88) and educational (n = 109) groups, were assessed at baseline, after the 6-month educational program (6 months), and 6 months after the intervention (12 months). The intervention comprised four group sessions and six follow-up phone calls, focusing on frailty, physical activity, dietary habits, and cognitive training. Sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI) and wrist-worn accelerometry.
Results
At 6 months, a significant time-by-group interaction was found for self-reported [β = −0.449, 95%CI (−0.844, −0.053), p = 0.026] and accelerometer-measured [β = 0.505, 95%CI (0.085, 0.926), p = 0.019] sleep efficiency, showing improved sleep efficiency in the intervention group vs. controls. A significant time-by-group interaction at 6 months was noted for sleep awakenings [β = −0.402, 95%CI (−0.825, −0.020), p = 0.047]. The educational program led to a significant decrease in awakenings, while the control group experienced an increase. The change in the number of awakenings (Rs = 0.183, p = 0.020) at 6 months was significantly associated with changes in frailty. Moreover, a significant time-by-group interaction was reported at the 12-month assessment [β = −0.449, 95%CI (−0.844, −0.053), p = 0.026] for self-reported sleep quality, indicating better results in the intervention group compared to controls.
Conclusion
The educational program improved sleep quality and sleep efficiency while reducing the number of awakenings per night among community-dwelling frail older adults, offering a practical approach to addressing sleep-related challenges in this demographic.
{"title":"A 6-month educational program improves sleep behaviour in community-dwelling frail older adults: A randomised controlled trial","authors":"Juan Corral-Pérez , María Ángeles Vázquez-Sánchez , José Luis Casals-Sánchez , Francisco José Contreras-García , Manuel Costilla , Cristina Casals","doi":"10.1016/j.sleep.2024.07.011","DOIUrl":"10.1016/j.sleep.2024.07.011","url":null,"abstract":"<div><h3>Background</h3><p>The prevalence of sleep-related issues among older adults is a significant concern, with half of the older population reporting these problems. Consequently, strategies to improve sleep are needed for this population. This study aims to assess the effects of a health educational program on sleep behaviour among pre-frail or frail older adults residing in the community and to explore possible associations with frailty.</p></div><div><h3>Methods</h3><p>This randomised controlled trial (NCT05610605) included a total of 197 community-dwelling older adults with frailty/pre-frailty, divided into control (n = 88) and educational (n = 109) groups, were assessed at baseline, after the 6-month educational program (6 months), and 6 months after the intervention (12 months). The intervention comprised four group sessions and six follow-up phone calls, focusing on frailty, physical activity, dietary habits, and cognitive training. Sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI) and wrist-worn accelerometry.</p></div><div><h3>Results</h3><p>At 6 months, a significant time-by-group interaction was found for self-reported [β = −0.449, 95%CI (−0.844, −0.053), p = 0.026] and accelerometer-measured [β = 0.505, 95%CI (0.085, 0.926), p = 0.019] sleep efficiency, showing improved sleep efficiency in the intervention group <em>vs.</em> controls. A significant time-by-group interaction at 6 months was noted for sleep awakenings [β = −0.402, 95%CI (−0.825, −0.020), p = 0.047]. The educational program led to a significant decrease in awakenings, while the control group experienced an increase. The change in the number of awakenings (Rs = 0.183, p = 0.020) at 6 months was significantly associated with changes in frailty. Moreover, a significant time-by-group interaction was reported at the 12-month assessment [β = −0.449, 95%CI (−0.844, −0.053), p = 0.026] for self-reported sleep quality, indicating better results in the intervention group compared to controls.</p></div><div><h3>Conclusion</h3><p>The educational program improved sleep quality and sleep efficiency while reducing the number of awakenings per night among community-dwelling frail older adults, offering a practical approach to addressing sleep-related challenges in this demographic.</p></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1389945724003290/pdfft?md5=bd071a4a9f9225d203f236b590fe87a2&pid=1-s2.0-S1389945724003290-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141604117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}