Continuous positive airway pressure (CPAP) is increasingly used in infants. However, the limited number of commercially masks available for infants is challenging. The use of the Optiflow™ nasal cannula (Fisher & Paykel) with a regular CPAP device has been recently reported for chronic CPAP in children, with an objective improvement in polysomnographic events. However, this interface has not been used in young infants. We report here our experience of 4 infants aged between 3 and 8 weeks, who were treated with home CPAP with the Optiflow™ nasal cannula during a few months, before they could be successfully weaned. This pilot study reinforces the findings of the beneficial use of this nasal cannula in very young infants in whom nasal masks are scarce and not always suitably adapted. However, as this interface is not intended to be used with home CPAP, further studies are necessary to prove its clinical benefice and safety of use with home CPAP devices.
{"title":"The Optiflow™ interface for chronic CPAP in infants","authors":"Sonia Khirani , Plamen Bokov , Marine Dosso , Lucie Griffon , Clément Poirault , Benjamin Dudoignon , Brigitte Fauroux","doi":"10.1016/j.sleep.2024.11.014","DOIUrl":"10.1016/j.sleep.2024.11.014","url":null,"abstract":"<div><div>Continuous positive airway pressure (CPAP) is increasingly used in infants. However, the limited number of commercially masks available for infants is challenging. The use of the Optiflow™ nasal cannula (Fisher & Paykel) with a regular CPAP device has been recently reported for chronic CPAP in children, with an objective improvement in polysomnographic events. However, this interface has not been used in young infants. We report here our experience of 4 infants aged between 3 and 8 weeks, who were treated with home CPAP with the Optiflow™ nasal cannula during a few months, before they could be successfully weaned. This pilot study reinforces the findings of the beneficial use of this nasal cannula in very young infants in whom nasal masks are scarce and not always suitably adapted. However, as this interface is not intended to be used with home CPAP, further studies are necessary to prove its clinical benefice and safety of use with home CPAP devices.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"125 ","pages":"Pages 14-17"},"PeriodicalIF":3.8,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142658617","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 : 2024-11-12DOI: 10.1016/j.sleep.2024.11.012
Shuyu Jin , Haobo Chen , Ling Li , Yi Liu , Peng Liu , An Xie , Yanhui Liao
Background
The COVID-19 pandemic has led to long-term neurological and psychological effects, including sleep disturbances. While prior studies have identified altered brain function post-COVID-19, specific functional connectivity (FC) patterns predicting sleep quality after recovery remain unclear. This study aims to identify FC patterns associated with sleep quality two months after the first negative COVID-19 antigen test.
Methods
Using a connectome-based predictive modeling (CPM) approach, we identified the functional connectome regulating sleep quality based on a 164-region parcellation. Significant connections were analyzed using mediation models to examine their role in the relationship between anxiety, depression, and sleep.
Results
FC between the right cerebellar peduncle and the left VIII of the cerebellum, and between the left middle temporal pole (MTP) and left ventral tegmental area (VTA), significantly predicted Pittsburgh Sleep Quality Index (PSQI) scores for sleep disturbances two months post-recovery (q2 = 0.059, MSE = 0.154, p = 0.017, r = 0.350). Mediation analysis showed a significant indirect effect of FC between the left MTP and VTA on the relationship between generalized anxiety and sleep disturbances (indirect effect = 0.013, 95% CI = [0.002, 0.03], pfdr <0.05). FC between the right dorsal raphe nucleus and ipsilateral regions—including occipital, parietal, and temporal areas—predicted PSQI scores for daytime dysfunction (q2 = 0.092, MSE = 0.678, p = 0.025, r = 0.342).
Conclusion
Post-COVID-19 brain connectivity and anxiety predict sleep quality. These findings highlight the potential for targeted therapeutic strategies to improve sleep and identify patients at risk for prolonged disturbances through FC biomarkers.
{"title":"Resting-state functional connectome predicts sleep quality two months after the first negative COVID-19 antigen test","authors":"Shuyu Jin , Haobo Chen , Ling Li , Yi Liu , Peng Liu , An Xie , Yanhui Liao","doi":"10.1016/j.sleep.2024.11.012","DOIUrl":"10.1016/j.sleep.2024.11.012","url":null,"abstract":"<div><h3>Background</h3><div>The COVID-19 pandemic has led to long-term neurological and psychological effects, including sleep disturbances. While prior studies have identified altered brain function post-COVID-19, specific functional connectivity (FC) patterns predicting sleep quality after recovery remain unclear. This study aims to identify FC patterns associated with sleep quality two months after the first negative COVID-19 antigen test.</div></div><div><h3>Methods</h3><div>Using a connectome-based predictive modeling (CPM) approach, we identified the functional connectome regulating sleep quality based on a 164-region parcellation. Significant connections were analyzed using mediation models to examine their role in the relationship between anxiety, depression, and sleep.</div></div><div><h3>Results</h3><div>FC between the right cerebellar peduncle and the left VIII of the cerebellum, and between the left middle temporal pole (MTP) and left ventral tegmental area (VTA), significantly predicted Pittsburgh Sleep Quality Index (PSQI) scores for sleep disturbances two months post-recovery (q<sup>2</sup> = 0.059, MSE = 0.154, p = 0.017, r = 0.350). Mediation analysis showed a significant indirect effect of FC between the left MTP and VTA on the relationship between generalized anxiety and sleep disturbances (indirect effect = 0.013, 95% CI = [0.002, 0.03], pfdr <0.05). FC between the right dorsal raphe nucleus and ipsilateral regions—including occipital, parietal, and temporal areas—predicted PSQI scores for daytime dysfunction (q<sup>2</sup> = 0.092, MSE = 0.678, p = 0.025, r = 0.342).</div></div><div><h3>Conclusion</h3><div>Post-COVID-19 brain connectivity and anxiety predict sleep quality. These findings highlight the potential for targeted therapeutic strategies to improve sleep and identify patients at risk for prolonged disturbances through FC biomarkers.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"124 ","pages":"Pages 727-736"},"PeriodicalIF":3.8,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644646","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 : 2024-11-12DOI: 10.1016/j.sleep.2024.11.015
Sonia Khirani , Lucie Griffon , Anais Le , Domenico Paolo La Regina , Marine Dosso , Clément Poirault , Brigitte Fauroux
Noninvasive ventilation (NIV) is widely used in children. The spontaneous/timed (S/T) mode is the most common used mode for home NIV. Different devices are available, and the manufacturers are free to name the modes and define the settings, with no regulation. In particular, the definitions of the trigger sensitivities still differ between manufacturers and/or devices. The inspiratory trigger (TgI) sensitivity may be set according to a numerical or word-rating scale, while the expiratory trigger (TgE) sensitivity may be set as a percentage of the peak inspiratory flow, or using a numerical or word rating scale which correspond to specific predefined percentages of inspiratory flow. Moreover, the TgE sensitivity may be set according to the peak inspiratory flow or to the diminution of peak inspiratory flow, which may be very confusing. Patient-ventilator asynchrony (PVA) may be due to an inadequate comprehension of the settings by the user, which is challenging. We report here the cases of four children and adolescents with an incorrect setting of the TgI and/or TgE, leading to PVA. This pleads for a harmonization of the definitions of the settings, and in particular of the trigger sensitivities. In the meanwhile, NIV professionals should be aware of the different definitions to avoid setting errors leading to PVA.
{"title":"Why NIV setting definitions may be tricky: Trigger sensitivity","authors":"Sonia Khirani , Lucie Griffon , Anais Le , Domenico Paolo La Regina , Marine Dosso , Clément Poirault , Brigitte Fauroux","doi":"10.1016/j.sleep.2024.11.015","DOIUrl":"10.1016/j.sleep.2024.11.015","url":null,"abstract":"<div><div>Noninvasive ventilation (NIV) is widely used in children. The spontaneous/timed (S/T) mode is the most common used mode for home NIV. Different devices are available, and the manufacturers are free to name the modes and define the settings, with no regulation. In particular, the definitions of the trigger sensitivities still differ between manufacturers and/or devices. The inspiratory trigger (TgI) sensitivity may be set according to a numerical or word-rating scale, while the expiratory trigger (TgE) sensitivity may be set as a percentage of the peak inspiratory flow, or using a numerical or word rating scale which correspond to specific predefined percentages of inspiratory flow. Moreover, the TgE sensitivity may be set according to the peak inspiratory flow or to the diminution of peak inspiratory flow, which may be very confusing. Patient-ventilator asynchrony (PVA) may be due to an inadequate comprehension of the settings by the user, which is challenging. We report here the cases of four children and adolescents with an incorrect setting of the TgI and/or TgE, leading to PVA. This pleads for a harmonization of the definitions of the settings, and in particular of the trigger sensitivities. In the meanwhile, NIV professionals should be aware of the different definitions to avoid setting errors leading to PVA.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"125 ","pages":"Pages 18-20"},"PeriodicalIF":3.8,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142658635","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 : 2024-11-12DOI: 10.1016/j.sleep.2024.11.013
Julie Flygare, Lauren Oglesby, Sairam Parthasarathy, Michael J Thorpy, Emmanuel Mignot, Eileen B Leary, Anne Marie Morse
Objective: To evaluate factors associated with feeling supported in adjusting to life when diagnosed with narcolepsy or idiopathic hypersomnia.
Methods: An online survey was disseminated by nonprofit organization Project Sleep via email and social networks. Intended recipients were adults (≥18 years old) diagnosed with narcolepsy or idiopathic hypersomnia. Multivariable regression was used to assess predictors of feeling supported in adjusting to life with these conditions.
Results: The survey was completed by 1308 individuals (narcolepsy type 1, 48.4 %; narcolepsy type 2, 28.7 %; idiopathic hypersomnia, 22.9 %). Overall, 68.7 % of respondents were ≤40 years of age; 87.7 % were female; and 88.8 % were White. Respondents lived in 38 different countries (65.5 % in the United States). At time of diagnosis, most (91.1 %) did not know anyone with the same diagnosis. At time of the survey, 486 respondents (37.2 %) still did not know anyone with their diagnosis. Only 32.3 % of respondents felt supported in adjusting to life with narcolepsy or idiopathic hypersomnia. Knowing someone with the same diagnosis at the time of the survey was a significant predictor of perceived support. Younger age (18-30 years) and being married were also associated with greater perceived support, whereas a diagnosis of narcolepsy type 2 or idiopathic hypersomnia (versus narcolepsy type 1) and living outside the US were associated with less perceived support.
Conclusions: People with narcolepsy or idiopathic hypersomnia often do not know others living with the same condition, even though this is associated with feeling supported. Clinicians should assess for social support and assist with resource identification.
{"title":"Social support and isolation in narcolepsy and idiopathic hypersomnia: An international survey.","authors":"Julie Flygare, Lauren Oglesby, Sairam Parthasarathy, Michael J Thorpy, Emmanuel Mignot, Eileen B Leary, Anne Marie Morse","doi":"10.1016/j.sleep.2024.11.013","DOIUrl":"https://doi.org/10.1016/j.sleep.2024.11.013","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate factors associated with feeling supported in adjusting to life when diagnosed with narcolepsy or idiopathic hypersomnia.</p><p><strong>Methods: </strong>An online survey was disseminated by nonprofit organization Project Sleep via email and social networks. Intended recipients were adults (≥18 years old) diagnosed with narcolepsy or idiopathic hypersomnia. Multivariable regression was used to assess predictors of feeling supported in adjusting to life with these conditions.</p><p><strong>Results: </strong>The survey was completed by 1308 individuals (narcolepsy type 1, 48.4 %; narcolepsy type 2, 28.7 %; idiopathic hypersomnia, 22.9 %). Overall, 68.7 % of respondents were ≤40 years of age; 87.7 % were female; and 88.8 % were White. Respondents lived in 38 different countries (65.5 % in the United States). At time of diagnosis, most (91.1 %) did not know anyone with the same diagnosis. At time of the survey, 486 respondents (37.2 %) still did not know anyone with their diagnosis. Only 32.3 % of respondents felt supported in adjusting to life with narcolepsy or idiopathic hypersomnia. Knowing someone with the same diagnosis at the time of the survey was a significant predictor of perceived support. Younger age (18-30 years) and being married were also associated with greater perceived support, whereas a diagnosis of narcolepsy type 2 or idiopathic hypersomnia (versus narcolepsy type 1) and living outside the US were associated with less perceived support.</p><p><strong>Conclusions: </strong>People with narcolepsy or idiopathic hypersomnia often do not know others living with the same condition, even though this is associated with feeling supported. Clinicians should assess for social support and assist with resource identification.</p>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"125 ","pages":"65-73"},"PeriodicalIF":3.8,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142676767","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 : 2024-11-12DOI: 10.1016/j.sleep.2024.10.036
Xiaojie Zhou , Yan Kong , Beibei Yu , Shengnan Shi , Hui He
Purpose
Sleep is the foundation of human physiological health and psychological health, as well as one of the basic needs for human survival. Sleep quality problems are prevalent in the population, and poor sleep quality is often closely related to the occurrence of many diseases, which seriously affects the quality of life and may even result in a shortened lifespan, so that improving sleep health has become a real problem that needs to be solved urgently. Exercise, as an important non-pharmacological tool, has been widely used for sleep quality enhancement, while the efficacy of exercise on subjective and objective sleep with respect to individual sleep quality remains controversial. Therefore, the aim of this meta-analysis was to compare the effects of exercise on subjective sleep quality and objective sleep efficiency in a non-athlete population, and to further rank the effectiveness of exercise types to provide appropriate means of exercise to improve sleep.
Methods
This study was evaluated by literature search in five databases, PubMed, Embase, Web of Science, Cochrane, and EBSCO, and paired meta-analysis and network meta-analysis were performed using Review Manager 5.3 and stata16.0.
Results
A total of 7494 studies were retrieved, and 81 eligible randomized controlled trials involving 6193 subjects were finally included. The primary outcome metrics included subjective sleep quality (PSQI), and the secondary outcome was objective sleep efficiency (SE), of which 65 reported PSQI and 23 reported SE. The results of paired meta-analysis showed that exercise significantly decreased PSQI [MD = −1.77, (95 % CI = −2.28,-1.25),P < 0.05] and increased SE [MD = 4.81, (95 % CI = 2.89,6.73),P < 0.05]. The results of the network meta-analysis showed that body and mind exercise [MD = −2.28, (95 % CI = −3.19,-1.36),P < 0.05, SUCRA = 85.6] may be the best exercise to improve PSQI, and aerobic exercise [MD = 5.02, (95 % CI = 2.52,7.52),P < 0.05, SUCRA = 75.1] is most likely to be the best type of exercise to improve SE. In regression analyses, there was a moderating effect of exercise cycle (β = −0.25 [0.40, 0.46], SE = 0.10 [P = 0.015, R2 = 0.24]) and age (β = −0.20 [-0.04, −0.01, SE = −2.06 [P = 0.039,R2 = 0.16]) as moderators of objective sleep efficiency.
Conclusion
Exercise is effective in improving both subjective and objective sleep quality. Body and mind exercise, aerobic exercise, and aerobic combined with resistance exercise may be the preferred way to improve sleep, and the longer the exercise cycle, the more obvious the improvement in sleep effect, the improvement effect will gradually decrease with age.
目的睡眠是人类生理健康和心理健康的基础，也是人类生存的基本需求之一。睡眠质量问题在人群中普遍存在，睡眠质量差往往与多种疾病的发生密切相关，严重影响生活质量，甚至可能导致寿命缩短，因此改善睡眠健康已成为亟待解决的现实问题。运动作为一种重要的非药物手段，已被广泛用于提高睡眠质量，但运动对个体睡眠质量的主观和客观睡眠的疗效仍存在争议。因此，本荟萃分析旨在比较非运动员人群中运动对主观睡眠质量和客观睡眠效率的影响，并进一步对运动类型的有效性进行排序，为改善睡眠提供合适的运动手段。方法本研究通过PubMed、Embase、Web of Science、Cochrane和EBSCO五个数据库进行文献检索评估，并使用Review Manager 5.3和stata16.0进行配对荟萃分析和网络荟萃分析。结果共检索到7494项研究，最终纳入81项符合条件的随机对照试验，涉及6193名受试者。主要结果指标包括主观睡眠质量（PSQI），次要结果指标为客观睡眠效率（SE），其中 65 项报告了主观睡眠质量，23 项报告了客观睡眠效率。配对荟萃分析结果表明，运动可显著降低 PSQI [MD = -1.77, (95 % CI = -2.28,-1.25),P < 0.05]，提高 SE [MD = 4.81, (95 % CI = 2.89,6.73),P < 0.05]。网络荟萃分析结果显示，身心锻炼[MD = -2.28，（95 % CI = -3.19，-1.36），P < 0.05，SUCRA = 85.6]可能是改善 PSQI 的最佳锻炼方式，而有氧锻炼[MD = 5.02，（95 % CI = 2.52，7.52），P < 0.05，SUCRA = 75.1]最有可能是改善 SE 的最佳锻炼方式。在回归分析中，运动周期（β = -0.25 [0.40, 0.46], SE = 0.10 [P = 0.015, R2 = 0.24]）和年龄（β = -0.20 [-0.04, -0.01, SE = -2.06 [P = 0.039, R2 = 0.16]）对客观睡眠效率具有调节作用。身心锻炼、有氧运动、有氧运动与阻力运动相结合可能是改善睡眠的首选方式，且运动周期越长，改善睡眠的效果越明显，改善效果会随着年龄的增长而逐渐减弱。
{"title":"Effects of exercise on sleep quality in general population: Meta-analysis and systematic review","authors":"Xiaojie Zhou , Yan Kong , Beibei Yu , Shengnan Shi , Hui He","doi":"10.1016/j.sleep.2024.10.036","DOIUrl":"10.1016/j.sleep.2024.10.036","url":null,"abstract":"<div><h3>Purpose</h3><div>Sleep is the foundation of human physiological health and psychological health, as well as one of the basic needs for human survival. Sleep quality problems are prevalent in the population, and poor sleep quality is often closely related to the occurrence of many diseases, which seriously affects the quality of life and may even result in a shortened lifespan, so that improving sleep health has become a real problem that needs to be solved urgently. Exercise, as an important non-pharmacological tool, has been widely used for sleep quality enhancement, while the efficacy of exercise on subjective and objective sleep with respect to individual sleep quality remains controversial. Therefore, the aim of this meta-analysis was to compare the effects of exercise on subjective sleep quality and objective sleep efficiency in a non-athlete population, and to further rank the effectiveness of exercise types to provide appropriate means of exercise to improve sleep.</div></div><div><h3>Methods</h3><div>This study was evaluated by literature search in five databases, PubMed, Embase, Web of Science, Cochrane, and EBSCO, and paired meta-analysis and network meta-analysis were performed using Review Manager 5.3 and stata16.0.</div></div><div><h3>Results</h3><div>A total of 7494 studies were retrieved, and 81 eligible randomized controlled trials involving 6193 subjects were finally included. The primary outcome metrics included subjective sleep quality (PSQI), and the secondary outcome was objective sleep efficiency (SE), of which 65 reported PSQI and 23 reported SE. The results of paired meta-analysis showed that exercise significantly decreased PSQI [MD = −1.77, (95 % CI = −2.28,-1.25),P < 0.05] and increased SE [MD = 4.81, (95 % CI = 2.89,6.73),P < 0.05]. The results of the network meta-analysis showed that body and mind exercise [MD = −2.28, (95 % CI = −3.19,-1.36),P < 0.05, SUCRA = 85.6] may be the best exercise to improve PSQI, and aerobic exercise [MD = 5.02, (95 % CI = 2.52,7.52),P < 0.05, SUCRA = 75.1] is most likely to be the best type of exercise to improve SE. In regression analyses, there was a moderating effect of exercise cycle (β = −0.25 [0.40, 0.46], SE = 0.10 [P = 0.015, R<sup>2</sup> = 0.24]) and age (β = −0.20 [-0.04, −0.01, SE = −2.06 [P = 0.039,R<sup>2</sup> = 0.16]) as moderators of objective sleep efficiency.</div></div><div><h3>Conclusion</h3><div>Exercise is effective in improving both subjective and objective sleep quality. Body and mind exercise, aerobic exercise, and aerobic combined with resistance exercise may be the preferred way to improve sleep, and the longer the exercise cycle, the more obvious the improvement in sleep effect, the improvement effect will gradually decrease with age.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"125 ","pages":"Pages 1-13"},"PeriodicalIF":3.8,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142658613","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 : 2024-11-10DOI: 10.1016/j.sleep.2024.11.001
Mengying Wang , Huangda Guo , Hexiang Peng , Siyue Wang , Xueheng Wang , Meng Fan , Jin Jiang , Tianjiao Hou , Chenghua Gao , Wenyan Xian , Jie Huang , Tao Wu
Objective
To investigate the prospective association between serum CRP levels and T2D incidence and explore whether such association was modified by sleep risk factors.
Methods
The study included 366 746 participants without diabetes and exhibited CRP measures at baseline from the UK Biobank. Sleep risk factors included sleep duration, insomnia, snoring, chronotype, and daytime sleepiness. Cox proportional hazards model was used to estimate the hazard ratio (HR), and 95 % confidence interval (CI) of T2D associated with CRP levels. Interactions between CRP and sleep risk factors were also tested.
Results
During a median follow-up of 10.4 years, 14 200 T2D cases were identified. The HRs (95 % CIs) of T2D were 1.31 (1.21–1.43), 1.62 (1.50–1.75), 1.98 (1.83–2.13), and 2.38 (2.21–2.57), respectively, in higher quintile groups of CRP levels compared with the lowest group (p-value for trend <0.001). There were interactions of CRP levels with self-reported sleep duration, snoring, and daytime sleepiness (p-value for interaction = 0.002, 0.0002, and 0.0001). The associated risks between T2D and the elevation in CRP were more evident among participants with high-risk sleep factors.
Conclusions
Our study indicates that the elevation in serum CRP levels is associated with a higher T2D incidence; and such relation is modified by sleep risk factors including sleep duration, snoring, and daytime sleepiness.
{"title":"Sleep risk factors modify the association between c-reactive protein and type 2 diabetes: A prospective cohort study","authors":"Mengying Wang , Huangda Guo , Hexiang Peng , Siyue Wang , Xueheng Wang , Meng Fan , Jin Jiang , Tianjiao Hou , Chenghua Gao , Wenyan Xian , Jie Huang , Tao Wu","doi":"10.1016/j.sleep.2024.11.001","DOIUrl":"10.1016/j.sleep.2024.11.001","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the prospective association between serum CRP levels and T2D incidence and explore whether such association was modified by sleep risk factors.</div></div><div><h3>Methods</h3><div>The study included 366 746 participants without diabetes and exhibited CRP measures at baseline from the UK Biobank. Sleep risk factors included sleep duration, insomnia, snoring, chronotype, and daytime sleepiness. Cox proportional hazards model was used to estimate the hazard ratio (HR), and 95 % confidence interval (CI) of T2D associated with CRP levels. Interactions between CRP and sleep risk factors were also tested.</div></div><div><h3>Results</h3><div>During a median follow-up of 10.4 years, 14 200 T2D cases were identified. The HRs (95 % CIs) of T2D were 1.31 (1.21–1.43), 1.62 (1.50–1.75), 1.98 (1.83–2.13), and 2.38 (2.21–2.57), respectively, in higher quintile groups of CRP levels compared with the lowest group (p-value for trend <0.001). There were interactions of CRP levels with self-reported sleep duration, snoring, and daytime sleepiness (p-value for interaction = 0.002, 0.0002, and 0.0001). The associated risks between T2D and the elevation in CRP were more evident among participants with high-risk sleep factors.</div></div><div><h3>Conclusions</h3><div>Our study indicates that the elevation in serum CRP levels is associated with a higher T2D incidence; and such relation is modified by sleep risk factors including sleep duration, snoring, and daytime sleepiness.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"124 ","pages":"Pages 674-680"},"PeriodicalIF":3.8,"publicationDate":"2024-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142628576","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 : 2024-11-09DOI: 10.1016/j.sleep.2024.11.009
Inês Dias , Christian R. Baumann , Daniela Noain
Sleep alterations are hallmarks of prodromal Alzheimer's (AD) and Parkinson's disease (PD), with fundamental neuropathological processes of both diseases showing susceptibility of change upon deep sleep modulation. However, promising pharmacological deep sleep enhancement results are hindered by specificity and scalability issues, thus advocating for noninvasive slow-wave activity (SWA) boosting methods to investigate the links between deep sleep and neurodegeneration. Accordingly, we have recently introduced mouse closed-loop auditory stimulation (mCLAS), which is able to successfully boost SWA during deep sleep in neurodegeneration models. Here, we aim at further exploring mCLAS’ acute effect onto disease-specific sleep and wake alterations in AD (Tg2576) and PD (M83) mice. We found that mCLAS adaptively rescues pathological sleep and wake traits depending on the disease-specific impairments observed at baseline in each model. Notably, in AD mice mCLAS significantly increases NREM long/short bout ratio, decreases vigilance state distances by decreasing transition velocities and increases the percentage of cumulative time spent in NREM sleep in the last 3h of the dark period. Contrastingly, in PD mice mCLAS significantly decreases NREM sleep consolidation, by potentiating faster and more frequent transitions between vigilance states, decreases average EMG muscle tone during REM sleep and increases alpha power in WAKE and NREM sleep. Overall, our results indicate that mCLAS selectively prompts an acute alleviation of neurodegeneration-associated sleep and wake phenotypes, by either potentiating sleep consolidation and vigilance state stability in AD or by rescuing bradysomnia and decreasing cortical hyperexcitability in PD. Further experiments assessing the electrophysiological, neuropathological and behavioural long-term effects of mCLAS in neurodegeneration may majorly impact the clinical establishment of sleep-based therapies.
{"title":"mCLAS adaptively rescues disease-specific sleep and wake phenotypes in neurodegeneration","authors":"Inês Dias , Christian R. Baumann , Daniela Noain","doi":"10.1016/j.sleep.2024.11.009","DOIUrl":"10.1016/j.sleep.2024.11.009","url":null,"abstract":"<div><div>Sleep alterations are hallmarks of prodromal Alzheimer's (AD) and Parkinson's disease (PD), with fundamental neuropathological processes of both diseases showing susceptibility of change upon deep sleep modulation. However, promising pharmacological deep sleep enhancement results are hindered by specificity and scalability issues, thus advocating for noninvasive slow-wave activity (SWA) boosting methods to investigate the links between deep sleep and neurodegeneration. Accordingly, we have recently introduced mouse closed-loop auditory stimulation (mCLAS), which is able to successfully boost SWA during deep sleep in neurodegeneration models. Here, we aim at further exploring mCLAS’ acute effect onto disease-specific sleep and wake alterations in AD (Tg2576) and PD (M83) mice. We found that mCLAS adaptively rescues pathological sleep and wake traits depending on the disease-specific impairments observed at baseline in each model. Notably, in AD mice mCLAS significantly increases NREM long/short bout ratio, decreases vigilance state distances by decreasing transition velocities and increases the percentage of cumulative time spent in NREM sleep in the last 3h of the dark period. Contrastingly, in PD mice mCLAS significantly decreases NREM sleep consolidation, by potentiating faster and more frequent transitions between vigilance states, decreases average EMG muscle tone during REM sleep and increases alpha power in WAKE and NREM sleep. Overall, our results indicate that mCLAS selectively prompts an acute alleviation of neurodegeneration-associated sleep and wake phenotypes, by either potentiating sleep consolidation and vigilance state stability in AD or by rescuing bradysomnia and decreasing cortical hyperexcitability in PD. Further experiments assessing the electrophysiological, neuropathological and behavioural long-term effects of mCLAS in neurodegeneration may majorly impact the clinical establishment of sleep-based therapies.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"124 ","pages":"Pages 704-716"},"PeriodicalIF":3.8,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142628571","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 : 2024-11-09DOI: 10.1016/j.sleep.2024.11.002
Yanyuan Dai , Jingwen Ma , Alexandros N. Vgontzas , Baixin Chen , Le Chen , Jun Wu , Dandan Zheng , Jiansheng Zhang , Maria Karataraki , Yun Li
Objective
Cortical hyperarousal has been proposed as a primary underlying mechanism for insomnia disorder. However, most evidence comes from nighttime sleep and whether patients with insomnia disorder have cortical hyperarousal through the 24-h sleep/wake cycle is not resolved.
Methods
We included 49 patients with insomnia disorder and 49 age-and sex-matched normal sleepers. All participants underwent an over-night polysomnography followed by a Multiple Sleep Latency Test during daytime. Nighttime and daytime delta, theta, alpha, sigma and beta relative power at central electroencephalogram derivations during wakefulness and non-rapid eye movement (NREM) sleep were calculated. Insomnia disorder was defined based on the International Classification of Sleep Disorders Third Edition criteria. Insomnia with objective short sleep duration was defined as patients with insomnia who slept <7 h based on nighttime polysomnography recording.
Results
Compared to normal sleepers, patients with insomnia disorder had significantly higher nighttime (P = 0.040) and daytime (P = 0.021) relative electroencephalogram power in beta during NREM sleep and marginally significantly lower relative electroencephalogram power in theta (P = 0.060) during nighttime wakefulness. Furthermore, linear trend association was observed across normal sleepers, and patients with insomnia who slept ≥7 h and insomnia who slept <7 h in relative electroencephalogram power in beta during nighttime and daytime NREM sleep, and relative electroencephalogram power in theta during nighttime wakefulness (all P for trend <0.05).
Conclusion
Increased high-frequency electroencephalogram power during nighttime and daytime sleep suggests that insomnia is a disorder of 24-h cortical hyperarousal. Decreasing both nighttime and daytime cortical arousal levels should be our therapeutic target for insomnia.
{"title":"Insomnia disorder is associated with 24-hour cortical hyperarousal","authors":"Yanyuan Dai , Jingwen Ma , Alexandros N. Vgontzas , Baixin Chen , Le Chen , Jun Wu , Dandan Zheng , Jiansheng Zhang , Maria Karataraki , Yun Li","doi":"10.1016/j.sleep.2024.11.002","DOIUrl":"10.1016/j.sleep.2024.11.002","url":null,"abstract":"<div><h3>Objective</h3><div>Cortical hyperarousal has been proposed as a primary underlying mechanism for insomnia disorder. However, most evidence comes from nighttime sleep and whether patients with insomnia disorder have cortical hyperarousal through the 24-h sleep/wake cycle is not resolved.</div></div><div><h3>Methods</h3><div>We included 49 patients with insomnia disorder and 49 age-and sex-matched normal sleepers. All participants underwent an over-night polysomnography followed by a Multiple Sleep Latency Test during daytime. Nighttime and daytime delta, theta, alpha, sigma and beta relative power at central electroencephalogram derivations during wakefulness and non-rapid eye movement (NREM) sleep were calculated. Insomnia disorder was defined based on the International Classification of Sleep Disorders Third Edition criteria. Insomnia with objective short sleep duration was defined as patients with insomnia who slept <7 h based on nighttime polysomnography recording.</div></div><div><h3>Results</h3><div>Compared to normal sleepers, patients with insomnia disorder had significantly higher nighttime (<em>P</em> = 0.040) and daytime (<em>P</em> = 0.021) relative electroencephalogram power in beta during NREM sleep and marginally significantly lower relative electroencephalogram power in theta (<em>P</em> = 0.060) during nighttime wakefulness. Furthermore, linear trend association was observed across normal sleepers, and patients with insomnia who slept ≥7 h and insomnia who slept <7 h in relative electroencephalogram power in beta during nighttime and daytime NREM sleep, and relative electroencephalogram power in theta during nighttime wakefulness (all <em>P</em> for trend <0.05).</div></div><div><h3>Conclusion</h3><div>Increased high-frequency electroencephalogram power during nighttime and daytime sleep suggests that insomnia is a disorder of 24-h cortical hyperarousal. Decreasing both nighttime and daytime cortical arousal levels should be our therapeutic target for insomnia.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"124 ","pages":"Pages 681-687"},"PeriodicalIF":3.8,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142628569","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 : 2024-11-09DOI: 10.1016/j.sleep.2024.10.027
Oreste De Rosa, Fiona C Baker, Giacinto Barresi, Francesca Conte, Gianluca Ficca, Massimiliano de Zambotti
{"title":"Response to \"Exploring the intersection of video gaming, sleep, and mental health in modern adults\" by Guilherme Nobre Nogueira.","authors":"Oreste De Rosa, Fiona C Baker, Giacinto Barresi, Francesca Conte, Gianluca Ficca, Massimiliano de Zambotti","doi":"10.1016/j.sleep.2024.10.027","DOIUrl":"https://doi.org/10.1016/j.sleep.2024.10.027","url":null,"abstract":"","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"124 ","pages":"763-764"},"PeriodicalIF":3.8,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142688968","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}
The relationship between daytime napping and depression remains debatable. Thus, we investigated whether daytime napping is associated with depressive symptoms in patients with bipolar disorder.
Methods
In a cross-sectional study, we enrolled 204 outpatients with bipolar disorder who were participants in the Association between Pathology of Bipolar Disorder and Light Exposure in Daily Life (APPLE) cohort study. Each participant's daytime napping was measured using an actigraph over 7 consecutive days. Depressive symptoms were evaluated using the Montgomery–Åsberg Depression Rating Scale, and scores of ≥8 points were considered indicative of a depressed state.
Results
One-hundred and ten (53.9 %) participants were depressed. In multivariable logistic regression analysis, as the number of nap days, number of naps per day, and nap duration increased, the odds ratio (OR) for depressed state significantly increased. Additionally, compared to the participants who did not nap, the participants who napped on five or more days a week or who had an average nap duration over 60 min had more than three times higher ORs in the depressed state (number of nap days: OR, 3.66; 95 % confidence interval [CI], 1.32–10.17; nap duration: OR, 3.14; 95 % CI, 1.12–8.81).
Conclusions
We found a significant and independent association between daytime napping and depressive symptoms in patients with bipolar disorder. Further studies are warranted to identify the effect of short napping on depressive symptoms in patients with bipolar disorder.
{"title":"Daytime napping and depressive symptoms in bipolar disorder: A cross-sectional analysis of the APPLE cohort","authors":"Yuichi Esaki , Kenji Obayashi , Keigo Saeki , Kiyoshi Fujita , Nakao Iwata , Tsuyoshi Kitajima","doi":"10.1016/j.sleep.2024.11.006","DOIUrl":"10.1016/j.sleep.2024.11.006","url":null,"abstract":"<div><h3>Background</h3><div>The relationship between daytime napping and depression remains debatable. Thus, we investigated whether daytime napping is associated with depressive symptoms in patients with bipolar disorder.</div></div><div><h3>Methods</h3><div>In a cross-sectional study, we enrolled 204 outpatients with bipolar disorder who were participants in the Association between Pathology of Bipolar Disorder and Light Exposure in Daily Life (APPLE) cohort study. Each participant's daytime napping was measured using an actigraph over 7 consecutive days. Depressive symptoms were evaluated using the Montgomery–Åsberg Depression Rating Scale, and scores of ≥8 points were considered indicative of a depressed state.</div></div><div><h3>Results</h3><div>One-hundred and ten (53.9 %) participants were depressed. In multivariable logistic regression analysis, as the number of nap days, number of naps per day, and nap duration increased, the odds ratio (OR) for depressed state significantly increased. Additionally, compared to the participants who did not nap, the participants who napped on five or more days a week or who had an average nap duration over 60 min had more than three times higher ORs in the depressed state (number of nap days: OR, 3.66; 95 % confidence interval [CI], 1.32–10.17; nap duration: OR, 3.14; 95 % CI, 1.12–8.81).</div></div><div><h3>Conclusions</h3><div>We found a significant and independent association between daytime napping and depressive symptoms in patients with bipolar disorder. Further studies are warranted to identify the effect of short napping on depressive symptoms in patients with bipolar disorder.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"124 ","pages":"Pages 688-694"},"PeriodicalIF":3.8,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142628565","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}
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